Using already existing polio structures to enhance COVID-19 surveillance
The Uganda Ministry of Health (MOH) in partnership with the African Field Epidemiology Network (AFENET) and with support from CDC Global Immunization Division’s Polio Eradication Branch has deployed surveillance teams to various districts to implement an integrated active case search for both COVID-19 and Acute Flaccid Paralysis (AFP) at health facilities and high risk communities in Uganda.
Dr Kevin Mugenyi, an Epidemiologist and the Regional supervisor for the COVID-19/AFP surveillance in Kyotera District, in the southern part of the Central Region of Uganda, explained that active search for COVID-19 includes review of all cases of Severe Acute Respiratory Illnesses like pneumonia occurring within two weeks of the facility visit by surveillance teams in May and June 2020, while AFP surveillance would include conducting active search in health facilities for diagnoses inferring paralysis in children 15 years and below. He mentioned that active surveillance for wild poliovirus through reporting and laboratory investigation of all cases of acute flaccid paralysis among children less than fifteen years of age was one of the four pillars of the Global Polio Eradication Initiative (GPEI).
According to Dr Mugenyi, the objective of the deployment is to strengthen surveillance for COVID-19 and AFP which includes: Mentorship of Health workers on COVID-19 and AFP surveillance, active search for COVID-19 and AFP in selected facilities, orientation of community health workers on COVID-19 and AFP and the follow up suspected cases for COVID-19.
What does this mean for MOH to respond to other essential services amidst COVID-19?
Mr. Omitta Patrick Owino, the Tororo District Surveillance officer, explained that key staff have been withdrawn from facilities to respond to COVID-19 at the points of entry hence denying the local communities of some of the essential services. He explains that in the current pandemic, available health supplies and drugs in districts have been re directed to the COVID-19 response.
“There is a need to enhance human resource at all district health facilities. We need to adopt better services and increase supplies to be able to accommodate others diseases alongside COVID-19 which is likely to stay in our communities for a long time”. Mr. Omitta Patrick Owino.
The National Stop Transmission of Polio (NSTOP) workers are using the WHO Open Data Kit (ODK) a free and open-source software for data collection to feed the correct surveillance data to the Ministry of Health.
A midwife at Iyolwa facility, Chelimo Sharon, explained that there has been no adequate training on how to deal with a case of COVID-19 and none of the nurses knew what to do if posed with the threat.
The NSTOP teams are sensitizing health workers in COVID-19 and AFP as well as documenting lessons learned in regard to leveraging existing programs to integrate surveillance for priority diseases.