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. 2021 Feb 8;104(4):1225-1231.
doi: 10.4269/ajtmh.20-0741.

Refugee Settlements and Cholera Risks in Uganda, 2016-2019

Godfrey Bwire  1 , Christopher Garimoi Orach  2 , Freda Loy Aceng  1 , Sam Emmanuel Arianitwe  2 , David Matseketse  3 , Edson Tumusherure  4 , Issa Makumbi  5 , Allan Muruta  1 , Rebecca D Merrill  6 , Amanda Debes  7 , Mohammad Ali  7 , David A Sack  7
Affiliations

Refugee Settlements and Cholera Risks in Uganda, 2016-2019

Godfrey Bwire et al. Am J Trop Med Hyg. .

Abstract

During 2016 to 2019, cholera outbreaks were reported commonly to the Ministry of Health from refugee settlements. To further understand the risks cholera posed to refugees, a review of surveillance data on cholera in Uganda for the period 2016-2019 was carried out. During this 4-year period, there were seven such outbreaks with 1,495 cases and 30 deaths in five refugee settlements and one refugee reception center. Most deaths occurred early in the outbreak, often in the settlements or before arrival at a treatment center rather than after arrival at a treatment center. During the different years, these outbreaks occurred during different times of the year but simultaneously in settlements that were geographically separated and affected all ages and genders. Some outbreaks spread to the local populations within Uganda. Cholera control prevention measures are currently being implemented; however, additional measures are needed to reduce the risk of cholera among refugees including oral cholera vaccination and a water, sanitation and hygiene package during the refugee registration process. A standardized protocol is needed to quickly conduct case-control studies to generate information to guide future cholera outbreak prevention in refugees and the host population.

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Conflict of interest statement

Disclaimer: The funding agencies had no role in collecting, analyzing, or interpreting the results. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC or other participating agencies.

Figures

Figure 1.
Figure 1.
Map of Uganda showing distribution of refugee settlements in 2019. Bar: Refugee population in district as % of all refugees in Uganda. Color: Refugee population in district as % of the total population in districts. Circle: Districts with cholera cases among refugees. The identification of the districts are 1) Koboko, 2) Yumbe, 3) Obongi, 4) Adjumani, 5) Amaru, 6) Lamwo, 7) Arua, 8) Kiryandongo, 9) Kikuubi, 10) Kibaale, 11) Kamwenge, 12) Kyegegwa, 13) Kampala, 14) Isingiro, and 13) Kisoro (Nyakabande Reception Centre).
Figure 2.
Figure 2.
Weekly reported cholera cases among refugees in Uganda in 2016, 2018, and 2019.
Figure 3.
Figure 3.
Age (year) and gender distribution of cholera cases among refugees in Uganda, 2016–2019.
Figure 4.
Figure 4.
Cases of cholera among refugee and Ugandan residents in Hoima during outbreak in 2018.
See this image and copyright information in PMC

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