Case studies: a guide for conducting Ebola case investigation and contact tracing in resource-limited and or complex settings

¹Uganda Public Health Fellowship Program-Uganda National Institute of Public Health, Kampala, Uganda, ²Division of Global Health Protection, Global Health Center, US Centers for Disease Control and Prevention, Kampala, Uganda

^&Corresponding author
Lilian Bulage, Uganda Public Health Fellowship Program-Uganda National Institute of Public Health, Kampala, Uganda

Editorial    

Ebola virus disease (EVD) is a rare and often deadly viral hemorrhagic fever (VHF). Infection is transmitted through direct contact with infectious blood, body fluids, and animal tissues [1]. The first documented EVD outbreak occurred in 1976 in Ebola Zaire and it was designated Ebola Zaire. In the same year, another outbreak occurred in Sudan caused by a different virus strain that was designated Sudan Ebola Virus (SUDV). Since then, there have been several EVD outbreaks, all in sub-Saharan Africa with the most deadly occurring in 2014-2016, in West Africa, where 11,310 deaths and approximately 28,600 cases were recorded [2]. There is no specific treatment or vaccine for SUDV but it exists for the Zaire strain [1].

Uganda has experienced 6 EVD outbreaks since 2000 when the first one occurred [3]. On September 18, 2022, the Uganda Ministry of Health reported a confirmed case of SuDV in Mubende, a rural district located in Central Uganda [4]. Nine weeks later, the outbreak spread to nine other districts including Kampala, the capital city of Uganda [4]. Of the 6 EVD outbreaks Uganda has experienced, the 2000 outbreak was the worst, registering 425 cases and 224 deaths [3]. Since then, Uganda has registered an improvement in response to EVD outbreaks with the most recent i.e. September 2022 only registering 142 confirmed cases and 55 deaths. Despite the many EVD outbreaks being experienced in Africa, Uganda inclusive, no case studies had been written about our experiences to learn from and guide future responses. These outbreaks have been experienced in different settings including rural and complex settings such as Kampala, the capital city of Uganda. Case studies are a detailed examination of a person, a place, or a situation, usually to learn something from it by reviewing the details closely. They´re often meant to help others learn from a difficult situation that someone found themselves in and was able to resolve, with the interest of sharing that knowledge [5]

In this special supplement to the Pan African Medical Journal, we present three important case studies produced by the Uganda Public Health Fellowship Program (UPHFP), the capacity-building arm of the Uganda National Institute of Public Health (UNIPH). This edition brings out case studies that provide a guide for epidemiologists to carry out case investigations and contact tracing during Ebola Disease outbreaks or other viral hemorrhagic fever epidemics in resource-limited and or complex settings. This set of case studies lays out a step-by-step process of conducting epidemiological investigations in real-life scenarios in Uganda. These case studies and other future ones prepared by the UNIPH can be accessed by public health professionals and epidemiologists´ trainers including Field Epidemiology Training Programs in Africa and other resource-limited settings. We are confident that it will build the capacity of young epidemiologists to respond to public health threats in their countries and beyond.

Competing interests     

The authors declare no competing interests.

Authors' contributions     

All the authors have read and agreed to the final manuscript.

Acknowledgments     

We acknowledge Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) for the funding support offered to enable these case studies to be developed. We appreciate the US Centers for Disease Control and Prevention for the unwavering technical and financial support extended to the programs run by the UNIPH. Special gratitude goes to the Ministry of Health leadership for extending unlimited access to health data that enables the UPHFP to generate scientific communication products including these case studies.

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