Kitgum still battling Hepatitis E
Sep 23, 2009
IN 2007, there was an outbreak of Hepatitis E in northern Uganda, killing 169 people and infecting over 10,000. Several awareness and sensitisation campaigns were effected, but the disease remains a public health concern.
By Frederick Womakuyu
NINE-year-old Reagan Otim was bedridden at Kitgum Hospital. He had lost weight and could hardly stand or sit without support. He was admitted with symptoms of excessive vomiting, severe jaundice (yellowing) of the eyes, loss of appetite, epiglottis pain and general body weakness.
Otim was diagonised with Hepatitis E, a viral infection that is transmitted through drinking contaminated water or eating contaminated food. The virus is found in the stool of infected persons or animals.
In 2007, there was an outbreak of Hepatitis E in northern Uganda, killing 169 people and infecting over 10,000.
Several awareness and sensitisation campaigns were launched. People were taught to wash their hands with soap after using the toilet and to boil drinking water. However, the disease remains a public health concern.
According to the medical superintendent of Kitgum Hospital, Dr. Alex Layoo, the number of infected people has reduced by 90%.
“According to the epidemiology report at the hospital, we have an average of three to four cases per week,†Layoo says.
Peter Opika Opoka, the Uganda Red Cross coordinator, says: “We are receiving an average of one to two new cases per week in health centres II, III and IV. However, people are aware of the need to seek immediate treatment.â€
Why the disease persists?
Behind the closed doors of a doctor’s office in Kitgum Hospital, a health worker was attending to a fellow health worker, George Odongo, who had been infected.
Odongo is a clinical officer at Pajimo Health Centre. He says he may have contracted the disease from his patients because of the poor hygiene at the centre.
Lack of clean water
“The problem is the inadequate supply of clean water. So when I attend to patients, I sometimes lack water to wash my hands,†Odongo says.
According to him, three–quarters of people in Pajimo have neither a safe drinking water source nor toilet. People collect water from open water sources and use the bush as toilets.
Dr. Layoo said 90% of the Hepatitis E cases registered at the hospital are from Kitgum district. “Many residents have no clean source of water and most do not own toilets,†he says.
Origin of the disease
The origin of the disease has not been contained. Opoka says: “We must understand that Hepatitis E was a new strain of disease in northern Uganda. The source of the disease is Sudan, where there are no interventions to contain its spread.â€
He says the outbreak in Kitgum can be traced to a family in Madi Opei that hosted a Sudanese national.
According to Opoka, a 40-year-old Sudanese woman came to Madi Opei Health Centre III at the time of Hepatitis E outbreak in Sudan. The health centre is close to the Sudan border.
Although the current relative peace in the region has encouraged people to return home, three-quarters do not have toilets. The district health secretary, Tony Tolit, says 60% of the residents do not have toilets.
He says there is poor sanitation in both villages and camps and safe water coverage stands at only 30%. This has accelerated the spread of the disease.
At least 17 out of the 19 sub-counties of Kitgum district were affected by the disease, which later spread to Pader, Gulu and the northern parts of Lango.
Dr. Layoo says most people store drinking water in pots. “When fetching the water, people use dirty cups, they do not wash hands after visiting the toilet or garden. Dirty cups or hands end up contaminating water,†he says.
He maintains that samples of water taken from the pots and open water bodies indicated the water was contaminated.
Layoo says the virus spread from one person to another as people moved from the camps to their homes.
“It was hard to detect it because Hepatitis E has an incubation period of three to eight weeks. The disease also has no cure. However, 85% of the patients with strong immunity recover with treatment.â€
Doctors say recovery of the patients depends on how soon the case is reported.
Opoka says: “The earlier a person reports to the hospital, the greater the chances of recovery. The symptoms associated with the disease can be identified early and treated.â€
He says treatment includes taking fluids like juices or clean boiled water to replace the lost fluids.
Government intervention
In the year 2008, the Government launched a sh10b emergency intervention in the districts of Gulu, Pader and Kitgum.
Tolit says toilet coverage has increased from 20% to about 40% in Kitgum district. “But 60% of the people still do not have toilets. Many people returning home are faced with the choice of constructing a house or a toilet, yet they do not have money to do both.â€
He says although the safe water coverage has improved from 30% during the outbreak to 56%, in rural areas, safe water coverage may be as low as 10%.
According to Opoka, the Red Cross is providing health education to the people. It is advising them to boil their drinking water, wash hands after visiting the toilet and construct toilets.
“We are supplying the public health department with chlorine to treat the water sources,†he says.
Despite the interventions, Hepatitis E continues to ravage the region. Overall statistics from Kitgum indicate Hepatitis E hospital admissions have reduced from 90% to 6% annually.
NINE-year-old Reagan Otim was bedridden at Kitgum Hospital. He had lost weight and could hardly stand or sit without support. He was admitted with symptoms of excessive vomiting, severe jaundice (yellowing) of the eyes, loss of appetite, epiglottis pain and general body weakness.
Otim was diagonised with Hepatitis E, a viral infection that is transmitted through drinking contaminated water or eating contaminated food. The virus is found in the stool of infected persons or animals.
In 2007, there was an outbreak of Hepatitis E in northern Uganda, killing 169 people and infecting over 10,000.
Several awareness and sensitisation campaigns were launched. People were taught to wash their hands with soap after using the toilet and to boil drinking water. However, the disease remains a public health concern.
According to the medical superintendent of Kitgum Hospital, Dr. Alex Layoo, the number of infected people has reduced by 90%.
“According to the epidemiology report at the hospital, we have an average of three to four cases per week,†Layoo says.
Peter Opika Opoka, the Uganda Red Cross coordinator, says: “We are receiving an average of one to two new cases per week in health centres II, III and IV. However, people are aware of the need to seek immediate treatment.â€
Why the disease persists?
Behind the closed doors of a doctor’s office in Kitgum Hospital, a health worker was attending to a fellow health worker, George Odongo, who had been infected.
Odongo is a clinical officer at Pajimo Health Centre. He says he may have contracted the disease from his patients because of the poor hygiene at the centre.
Lack of clean water
“The problem is the inadequate supply of clean water. So when I attend to patients, I sometimes lack water to wash my hands,†Odongo says.
According to him, three–quarters of people in Pajimo have neither a safe drinking water source nor toilet. People collect water from open water sources and use the bush as toilets.
Dr. Layoo said 90% of the Hepatitis E cases registered at the hospital are from Kitgum district. “Many residents have no clean source of water and most do not own toilets,†he says.
Origin of the disease
The origin of the disease has not been contained. Opoka says: “We must understand that Hepatitis E was a new strain of disease in northern Uganda. The source of the disease is Sudan, where there are no interventions to contain its spread.â€
He says the outbreak in Kitgum can be traced to a family in Madi Opei that hosted a Sudanese national.
According to Opoka, a 40-year-old Sudanese woman came to Madi Opei Health Centre III at the time of Hepatitis E outbreak in Sudan. The health centre is close to the Sudan border.
Although the current relative peace in the region has encouraged people to return home, three-quarters do not have toilets. The district health secretary, Tony Tolit, says 60% of the residents do not have toilets.
He says there is poor sanitation in both villages and camps and safe water coverage stands at only 30%. This has accelerated the spread of the disease.
At least 17 out of the 19 sub-counties of Kitgum district were affected by the disease, which later spread to Pader, Gulu and the northern parts of Lango.
Dr. Layoo says most people store drinking water in pots. “When fetching the water, people use dirty cups, they do not wash hands after visiting the toilet or garden. Dirty cups or hands end up contaminating water,†he says.
He maintains that samples of water taken from the pots and open water bodies indicated the water was contaminated.
Layoo says the virus spread from one person to another as people moved from the camps to their homes.
“It was hard to detect it because Hepatitis E has an incubation period of three to eight weeks. The disease also has no cure. However, 85% of the patients with strong immunity recover with treatment.â€
Doctors say recovery of the patients depends on how soon the case is reported.
Opoka says: “The earlier a person reports to the hospital, the greater the chances of recovery. The symptoms associated with the disease can be identified early and treated.â€
He says treatment includes taking fluids like juices or clean boiled water to replace the lost fluids.
Government intervention
In the year 2008, the Government launched a sh10b emergency intervention in the districts of Gulu, Pader and Kitgum.
Tolit says toilet coverage has increased from 20% to about 40% in Kitgum district. “But 60% of the people still do not have toilets. Many people returning home are faced with the choice of constructing a house or a toilet, yet they do not have money to do both.â€
He says although the safe water coverage has improved from 30% during the outbreak to 56%, in rural areas, safe water coverage may be as low as 10%.
According to Opoka, the Red Cross is providing health education to the people. It is advising them to boil their drinking water, wash hands after visiting the toilet and construct toilets.
“We are supplying the public health department with chlorine to treat the water sources,†he says.
Despite the interventions, Hepatitis E continues to ravage the region. Overall statistics from Kitgum indicate Hepatitis E hospital admissions have reduced from 90% to 6% annually.