A Cross-Cutting Approach to Surveillance and Laboratory Capacity as a Platform to Improve Health Security in Uganda

Mohammed Lamorde, Arthur Mpimbaza, Richard Walwema, Moses Kamya, James Kapisi, Henry Kajumbula, Asadu Sserwanga, Jane Frances Namuganga, Abel Kusemererwa, Hannington Tasimwa, Issa Makumbi, John Kayiwa, Julius Lutwama, Prosper Behumbiize, Abner Tagoola, Jane Frances Nanteza, Gilbert Aniku, Meklit Workneh, Yukari Manabe, Jeff N. BorchertVance Brown, Grace D. Appiah, Eric D. Mintz, Jaco Homsy, George S. Odongo, Raymond L. Ransom, Molly M. Freeman, Robyn A. Stoddard, Renee Galloway, Matthew Mikoleit, Cecilia Kato, Ronald Rosenberg, Eric C. Mossel, Paul S. Mead, Kiersten J. Kugeler

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Global health security depends on effective surveillance for infectious diseases. In Uganda, resources are inadequate to support collection and reporting of data necessary for an effective and responsive surveillance system. We used a cross-cutting approach to improve surveillance and laboratory capacity in Uganda by leveraging an existing pediatric inpatient malaria sentinel surveillance system to collect data on expanded causes of illness, facilitate development of real-time surveillance, and provide data on antimicrobial resistance. Capacity for blood culture collection was established, along with options for serologic testing for select zoonotic conditions, including arboviral infection, brucellosis, and leptospirosis. Detailed demographic, clinical, and laboratory data for all admissions were captured through a web-based system accessible at participating hospitals, laboratories, and the Uganda Public Health Emergency Operations Center. Between July 2016 and December 2017, the expanded system was activated in pediatric wards of 6 regional government hospitals. During that time, patient data were collected from 30,500 pediatric admissions, half of whom were febrile but lacked evidence of malaria. More than 5,000 blood cultures were performed; 4% yielded bacterial pathogens, and another 4% yielded likely contaminants. Several WHO antimicrobial resistance priority pathogens were identified, some with multidrug-resistant phenotypes, including Acinetobacter spp., Citrobacter spp., Escherichia coli, Staphylococcus aureus, and typhoidal and nontyphoidal Salmonella spp. Leptospirosis and arboviral infections (alphaviruses and flaviviruses) were documented. The lessons learned and early results from the development of this multisectoral surveillance system provide the knowledge, infrastructure, and workforce capacity to serve as a foundation to enhance the capacity to detect, report, and rapidly respond to wide-ranging public health concerns in Uganda.

Original languageEnglish (US)
Pages (from-to)S76-S86
JournalHealth Security
StatePublished - Sep 1 2018
Externally publishedYes


  • Global health security
  • Surveillance
  • Uganda

ASJC Scopus subject areas

  • Health(social science)
  • Emergency Medicine
  • Safety Research
  • Public Health, Environmental and Occupational Health
  • Management, Monitoring, Policy and Law
  • Health, Toxicology and Mutagenesis


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