Kampala declared its first EVD case on 9th October 2022, a spillover case from the country’s epicenter in Mubende District. Kampala registered 20 Sudan Virus Disease (SUDV) cases, and all the initial SUDV cases were detected at the facility level after healthcare workers unknowingly got exposed to virus victims. The healthcare workers had no reason to suspect the victim influx due to a low number of SUDV alerts (17 alerts as of 25th October 2022) coming from over 2,000 health facilities in the Kampala Metropolitan Area (KMA)
For this, KMA, with support from IDI with funding and technical support from US Centres for Disease Control and Prevention (CDC), looked at strengthening facility-based surveillance to improve the index of suspicion for SUVD. Kampala has a cluster model approach for health promotion where the five divisions are divided into 20 clusters for easy health service delivery. Each group comprises a clinician, a laboratory person, and surveillance officers. The team leveraged the cluster model approach to strengthen facility-level surveillance through cascading training to facilities to improve case detection and notification. Division and District surveillance focal persons and surveillance officers were trained and facilitated to cascade the training to facilities physically.
At the facility level, 2100 healthcare workers, including In-charges, facility leaders, and surveillance focal persons, were targeted and trained on surveillance and case identification covering Mukono, Wakiso, and the five divisions of Kampala.
496 facilities in Kampala, Wakiso( 76), Mukono( 132) were trained reaching 1552 health workers. Following the facility-based training and active case search, the proportion of alerts coming from facilities increased from 34% to 72% due to increased awareness and suspicion, thus leading to the success of response at that level. The interventions resulted in no new cases outside the Mubende-linked transmission chains.
