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  • Undiagnosed illness - Uganda - Typhoid suspected

    http://www.monitor.co.ug/artman/publ...wo_88351.shtml

    Strange disease leaves 30 admitted in Bukwo
    David Mafabi

    Bukwo

    One person has died and 32 others are admitted at Bukwo Health Centre IV following an outbreak of a strange contagious disease. Zacharia Sokuton succumbed to the strange disease on July 13 after the medical team at Bukwo Health Centre failed to tame the disease.

    An eerie cloud of fear now hangs over the villages of Kapses, Sosho, Kapkorosoy and Kapkuripson in Bukwo Sub-county, Bukwo District along River Bukwo where the disease broke out from before spreading to the surrounding villages.

    A mini-survey by Daily Monitor reveals that most of the homesteads have been abandoned, villages deserted and it has become increasingly rare to come across people walking in groups for fear of contracting the disease.
    The World Health Organisation Public Health Specialist, Dr Mary Amongin, confirmed the disease outbreak in Bukwo.

    “We have lost one person and 32 are already admitted at Bukwo Health Centre IV but we have not yet established the disease,” Dr Amongin said, adding: “We are just suspecting that it could be typhoid due to the surrounding dirty water.”
    Dr Amongin told Daily Monitor that the patients are complaining of abdominal pain, headache, fever, diarrhoea and constant vomiting sending fears that it could be a contagious typhoid fever that has broken out.

    She revealed that a team of laboratory technicians have already camped in Bukwo to take blood and stool samples of the patients and water from River Bukwo for analysis to find out the disease and its cause. The District Health Officer, Dr Michael Mwanga, said it was a strange disease, the first of its kind in the district ever since they were elevated to a district status.

    Dr Mwanga also revealed that the villages of Kapses, Sosho, Kapkorosoy and Kapkuripson that surround the main local river Bukwo have contracted the disease raising more fears that the waters of the river could be dirty.

    “The people around River Bukwo have contracted the disease and the numbers keep going up but we suspect the water of the river that is being used for drinking could be dirty and thus causing the strange disease,” said Dr Mwanga.
    He said the number of people seeking treatment at Bukwo Hospital is overwhelming despite inadequate medical attention at the health facility.
    Last month, Moroto Municipality was hit by the leishmaniasis (kala-azar) disease which claimed some lives.

  • #2
    Re: Undiagnosed illness - Uganda - Typhoid suspected

    ProMed's East Africa regional site has posted this article along with the following comments:

    http://eafr.promedmail.org/

    --
    Communicated by:
    ProMED-EAFR
    < promed@promedmail.com >

    [Typhoid fever is a water related disease transmitted by the oral
    fecal route. Contaminated water has been implicated in previous
    outbreaks and as indicated in the newswire, there is need to conduct
    water quality tests on water drawn from the local river (river
    Bukwo). According to the WHO, typhoid is principally a problem of
    unsafe drinking water, inadequate sewage disposal and flooding ( see
    http://www.who.int/water_sanitation_...es/typhoid/en/).


    All open water sources are presumed contaminated until treated hence
    there is need to investigate water purification methods used in the
    affected communities. The recommended preventive interventions for
    typhoid fever include: health education about personal hygiene,
    especially regarding hand-washing after toilet use and before food
    preparation; provision of a safe water supply; proper sanitation
    systems; and excluding disease carriers from food handling (see
    http://www.who.int/water_sanitation_...es/typhoid/en/).

    Bukwo District in eastern Uganda can be located on the map at
    http://www.coetzee-uganda.com/index_..._of_Uganda.htm
    and the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/00BK.

    For additional background information on typhoid, available from the
    general ProMED-mail list, the postings below can be found at
    http://www.promedmail.org. - Mod.JFW]

    [see also:
    Typhoid fever update 2009 (01) 20090710.2472
    Typhoid fever - USA: (TN) cluster 20090608.2120
    2008
    ----
    Typhoid fever update 2008 (08) 20081229.4095
    Typhoid fever update 2008 (07) 20081118.3640
    Typhoid fever update 2008 (06): Canada (BC) ex India, alert 20081026.3386
    Undiagnosed illness, fatal - Uganda: (KS), typhoid susp. 20080814.2524
    Typhoid fever update 2008 (05): Philippines 20080312.0999
    Typhoid fever update 2008 (04): Philippines 20080305.0901
    Typhoid fever update 2008 (03): Philippines 20080303.0875
    Typhoid fever update 2008 (02): Philippines, Fiji 20080204.0450
    Typhoid fever update 2008 (01) 20080128.0358
    2007
    ----
    Typhoid fever update 2007 (14) 20071203.3893
    Typhoid fever update 2007 (13) 20070905.2928
    Typhoid fever update 2007 (12): Algeria 20070829.2842
    Typhoid fever update 2007 (11) 20070716.2286
    Typhoid fever update 2007 (10) 20070627.2072
    Typhoid fever update 2006 (09) 20070427.1373
    Typhoid fever update 2007 (08) 20070412.1226
    Typhoid fever update 2007 (07) 20070315.0912
    Typhoid fever update 2007 (06) 20070305.0776
    Typhoid fever update 2007 (05) 20070215.0570
    Typhoid fever update 2007 (04) 20070209.0507
    Typhoid fever update 2007 (03) 20070123.0301
    Typhoid fever update 2007 (02) 20070119.0254
    Typhoid fever update 2007 20070116.0205]
    ...................................jfw/mj/be

    _______________________________________________
    ProMED-EAFR mailing list
    ProMED-EAFR@promedmail.org
    http://eafr.promedmail.org/

    ©2001,2008 International Society for Infectious Diseases All Rights Reserved.
    Read our privacy guidelines

    Comment


    • #3
      Re: Undiagnosed illness - Uganda - Typhoid suspected

      Please rename and move this thread. This is confirmed as typhoid.

      http://eafr.promedmail.org/

      TYPHOID FEVER - UGANDA (02): (BUKWO)
      ************************************
      A ProMED-mail post
      http://www.promedmail.org
      ProMED-mail is a program of the
      International Society for Infectious Diseases
      http://www.isid.org


      Date: Mon 17 Aug 2009
      Source: Monitor Online [edited]
      http://www.monitor.co.ug/artman/publ...wo_89764.shtml

      Despite efforts by the government to combat typhoid in Bukwo
      District, fresh reports indicate that the disease is still spreading in the
      district and that at least 20 people have succumbed to it.

      The Ministry of Health Field Epidemiologist, Dr Luswa Lukwago, who
      has been on research and surveillance in the district, confirmed to
      Daily monitor the new development on the epidemic.He said: ?Over 20
      people have been reported dead and on average every
      family has about four cases.? ?Although we have treated the
      disease, recent research and surveillance indicates that the disease
      is still
      in Suam, Kapkorosoy, Kapkuripson and Kabei sub-counties,? he added.

      Dr Lukwago said this after making a presentation of the disease
      status report to the district team on Wednesday [12 August 2009]. He
      said many cases never receive adequate treatment and others who fled
      to Kenya came back. ?We have been treating patients
      using chloramphenicol and ceftraxone but the two drugs ran out of
      stock, forcing many to seek traditional means,? he said.

      Dr Lukwago said the poor latrine distribution in the district and
      the free movement across the border points between Uganda and Kenya is
      responsible for the disease spread in the wake of shortage of
      drugs.Bukwo has 57 per cent latrine coverage in the district and most of
      them are open structures that leave the human waste exposed. Also
      about 400 cases are believed to have fled to Kenya after the
      disease broke out in the villages surrounding River Bukwo and are
      now returning. He revealed that because many people died without getting
      medical attention, they have lost faith in the local health system
      and have now turned to Kenya where they believe they will receive better
      medical services.

      The World Health Organisation Public Health Specialist, Dr
      Mary Amongin, confirmed the disease is still spreading in Bukwo, claiming
      about 22 people and leaving about 32 bed-ridden in Bukwo Health Centre.

      [Byline: David Mafabi]

      --
      Communicated by:
      ProMED-EAFR
      < promed@promedmail.com >

      [The typhoid outbreak rages on in Bukwo district with over 20
      deaths now reported in the district since mid June 2009. The situation is
      bound to worsen given that the health facilities have run short
      of drugs. In addition the risk of the epidemic spreading to other areas
      will persist until measures are put in place to improve access to
      safe water and disposal of human waste.

      Bukwo District in eastern Uganda can be located on the map at
      http://www.coetzee-uganda.com/index_..._of_Uganda.htm
      and the HealthMap/ProMED-mail interactive map at
      http://healthmap.org/r/00BK - Mod.JFW]

      [See also:

      TYPHOID FEVER - UGANDA: (BUKWO) SUSPECTED 20090720.200669

      Comment


      • #4
        Re: Undiagnosed illness - Uganda - Typhoid suspected

        http://eafr.promedmail.org/

        ProMED-EAFR:East Africa

        View printable version
        Published Date
        2009-08-25 10:32:16
        Subject
        PRO/EAFR> Typhoid fever - Uganda (03): (Bukwo) conf
        Archive Number
        20090825.201422
        Full Text
        TYPHOID FEVER - UGANDA (03): (BUKWO) CONFIRMED
        **********************************************
        Date: Sun 23 Aug 2009
        Source: The New Vision (Uganda) [edited]
        http://www.newvision.co.ug/D/9/34/692217


        Update on the typhoid outbreak in Bukwo, Uganda
        -----------------------------------------------
        Business continues at Suam near River Bukwo on the Uganda-Kenya
        border, despite the outbreak of typhoid. Moses Kiptai, a resident,
        says despite the deaths, life goes on. "Our ancestors began drinking
        from this river hundreds of years ago. They produced our parents, who
        have lived here for several years. We too, shall drink this water and
        will survive," he says as he scoops water from the fast flowing river.

        A team of doctors from Makerere University School of Public Health
        funded by the African Field Epidemiology Network (AFENET) to
        investigate the epidemic outbreak confirmed it was typhoid.

        "According to our preliminary investigations the epidemic broke out
        around [13 Jul 2009] after the 1st case was reported at one of the
        markets near River Bukwo. The outbreak started from Kenya in early
        June [2009]," says Dr Luswa Lukwago, the health ministry field
        epidemiologist who headed the team.

        The team was in the district for a week and visited the affected
        families, villages, and hospitals where patients were admitted.

        Lukwago says the vessel for contamination is River Bukwo. "We
        discovered that every home had at least 4 patients. This means there
        is a lot of house-to-house infection."

        The epidemic would have been contained if the community maintained
        hygiene. "The area is littered with faeces that flow into the river
        where people fetch water for drinking," said Lukwago.

        The district health officer, Collins Satya, says: "We have registered
        over 600 cases of typhoid and 17 deaths. The majority are children
        and youths."

        The Bukwo district chairman, John Chelangant, says: "We are lucky the
        epidemic has not reached the camps, we would have registered more deaths."

        He urges the Government to help the district increase its safe water
        coverage, which is estimated at only 10 percent.

        "We have utilized UGX 15m [approx. USD 7300] out of the UGX 56m
        [approx. USD 27 300] allocated for the health budget this year [2009]
        and yet the financial year has just began," he says.

        The resident district commissioner, Christopher Chepkurui Songhor,
        says the population in Bukwo needs to be sensitized on the need to
        maintain personal hygiene.

        "When we tell them to boil water, they say it loses taste. We need to
        teach them not to plough near the river banks and the significance of
        latrines in every homestead," he said. The latrine coverage in Bukwo
        is less than 50 percent. Steven Mangusho, the district health
        inspector, says 80 percent of the people in the district do not wash
        their hands.

        Mangusho said the situation is aggravated by the fact that health
        inspectors at the sub-county are inadequately facilitated. "Movement
        in this area is too hard. When it rains, the roads are impassable and
        communities are flooded and yet the means to reach the affected areas
        are inadequate," he said.

        Carolyne Araptai, the secretary for social services, said efforts for
        the district to fill posts in health centre IIIs has hit a snug.
        Chelangat said the district council had passed a resolution to add
        UGX 300 000 [approx. USD 146] to the doctors' salaries as an
        incentive. He said over 10 health centres had been closed due to lack
        of manpower. But the team recommends that they be re-opened,
        promising to solicit support from the World Health Organisation for
        emergency kits for the typhoid outbreak.

        AFENET supports the health ministry and the School of Public Health.
        It was influential in responding to the [ebolavirus] outbreak in
        Bundibugyo and the swine flu outbreak in Uganda.

        [Byline: Patrick Jaramogi]

        --
        Communicated by:
        ProMED-EAFR


        [This recent update confirms that the cases are due to typhoid fever,
        though the nature of lab tests undertaken isn't clarified. The
        epidemic continues to escalate with 600 cases including 17 deaths due
        to typhoid fever reported in this border district of Bukwo. The
        report indicates that similar cases were first reported in adjacent
        communities across the border in Kenya, which all share the River
        Bukwo but to date there is no information on the extent of the
        problem in the nearby communities located in Kenya.

        There is need to address the challenges pointed out in the report and
        these include: poor access to safe water and sanitation facilities;
        poor attitude of communities towards adopting good personal hygiene
        and recommended water treatment methods; and poor access to health
        services in the district.

        Bukwo District in eastern Uganda can be located on the map
        athttp://healthmap.org/r/00BK. - Mod.JFW]

        [see also:
        Typhoid fever - Uganda (02): (Bukwo) 20090818.201314
        Typhoid fever - Uganda: (Bukwo) susp 20090720.200669

        For additional background information on typhoid, available from the
        general ProMED-mail list, the postings below can be found at
        http://www.promedmail.org. - Mod.JFW]

        Typhoid fever update 2009 (01) 20090710.2472
        Typhoid fever - USA: (TN) cluster 20090608.2120
        2008
        ----
        Typhoid fever update 2008 (08) 20081229.4095
        Typhoid fever update 2008 (07) 20081118.3640
        Typhoid fever update 2008 (06): Canada (BC) ex India 20081026.3386
        Undiagnosed illness, fatal - Uganda: (KS), typhoid susp. 20080814.2524
        Typhoid fever update 2008 (05): Philippines 20080312.0999
        Typhoid fever update 2008 (04): Philippines 20080305.0901
        Typhoid fever update 2008 (03): Philippines 20080303.0875
        Typhoid fever update 2008 (02): Philippines, Fiji 20080204.0450
        Typhoid fever update 2008 (01) 20080128.0358]
        ...................................jfw/mj/be

        _______________________________________________
        ProMED-EAFR mailing list
        ProMED-EAFR@promedmail.org
        http://eafr.promedmail.org/

        Comment

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