Feature Stories

A recent paper highlights the importance of integrating gender perspectives into the One Health approach to better manage the risks at the human-animal-environment interface. Researchers Claudia Cataldo, Maria Bellenghi, Roberta Masella, and Luca Busani emphasize that gender-specific roles influence individuals' exposure to zoonoses and other infectious diseases.

The paper presents case studies on avian influenza and leptospirosis, showing how women, especially in rural communities, face higher risks due to their domestic and caregiving roles. By incorporating gender analysis, the One Health approach can improve public health interventions and reduce infection risks.

Read the full paper here: https://doi.org/10.1016/j.onehlt.2023.100530

On January 11, 2023, Uganda officially declared the end of the Ebola outbreak caused by the Sudan ebolavirus, following 42 consecutive days without any new cases since the last patient was discharged from care.

In total, there were 142 confirmed cases of Sudan virus disease (SVD), resulting in 55 deaths (a case fatality rate of 39%), while 87 individuals recovered. Additionally, 22 deaths were reported among probable cases, individuals who passed away before samples could be collected, bringing the overall case fatality rate to 47%. Among the affected were 19 healthcare workers, seven of whom tragically died.

The World Health Organization (WHO) reported that over 4,000 contacts were monitored for 21 days during the outbreak.

The virus spread across nine districts in Uganda, including Bunyangabu, Jinja, Kagadi, Kampala, Kassanda, Kyegegwa, Masaka, Mubende, and Wakiso.

Background

On 20 September 2022, the Ministry of Health in Uganda, together with WHO AFRO, confirmed an outbreak of SVD in Mubende District, Uganda, after one fatal case was confirmed. 

The index case was a 24-year-old man, a resident of Ngabano village of the Madudu sub-county in Mubende District. The patient experienced high fever, diarrhoea, abdominal pain, and began vomiting blood on 11 September 2022. Samples were collected on 17 September 2022 and SVD was laboratory-confirmed on 19 September. The patient died on the same day, five days after hospitalisation. 

This was the fifth SVD outbreak that occurred in Uganda.

What is Ebola?

Ebola virus disease (EVD) is a rare, severe, and often fatal illness in humans. The disease was first identified in 1976 during two simultaneous outbreaks in South Sudan and the Democratic Republic of the Congo, near the Ebola River, from which it takes its name. Ebola is caused by a virus from the Filoviridae family, which includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are six species of Ebolavirus: Zaire, Bundibugyo, Sudan, Taï Forest, Reston, and Bombali.

Transmission

Ebola is thought to be spread to humans from infected animals, particularly fruit bats, which are considered the natural hosts. The virus can also be transmitted through contact with blood, organs, or other bodily fluids from animals like chimpanzees, gorillas, monkeys, or forest antelopes. Human-to-human transmission occurs through direct contact with body fluids of infected individuals or contaminated objects, like clothing or bedding.

Health-care workers and individuals involved in burial ceremonies are at increased risk of infection. Ebola can also be sexually transmitted after recovery, and pregnant women may still carry the virus in breast milk or pregnancy-related fluids after recovery.

Symptoms

Ebola symptoms typically appear 2 to 21 days after exposure and begin with fever, fatigue, headache, and muscle pain. This progresses to vomiting, diarrhea, rashes, and both internal and external bleeding. People can only transmit the virus once symptoms develop, and those who recover may experience long-term symptoms such as joint pain, memory loss, and vision problems.

Diagnosis

Distinguishing Ebola from other diseases like malaria or typhoid fever can be difficult. Diagnosis is confirmed through methods such as:

Antibody-capture ELISA

Antigen-capture detection tests

RT-PCR assay

Electron microscopy

Virus isolation by cell culture

Treatment

Immediate medical care is essential for improving survival rates. Treatment includes fluids, pain management, and medications for secondary infections. An effective vaccine exists for the Zaire species of Ebola, and antibodies administered intravenously increase the chance of survival. Research continues on vaccines and treatments for other species of Ebola.

Prevention and Control

Preventive measures include regular handwashing, avoiding contact with body fluids of infected individuals, safe burial practices, and vaccination for those at risk of the Zaire Ebola species. Outbreak containment relies on a combination of case management, contact tracing, safe burials, and community engagement. Health-care workers must follow strict infection control measures to prevent transmission.

WHO Recommendations

WHO emphasizes the importance of raising awareness and following guidelines to reduce the risk of transmission. Laboratory samples should only be handled by trained professionals in properly equipped facilities. Health-care workers should use personal protective equipment and follow standard precautions at all times.

More details on this link .

Burundi’s Ministry of Health declared a cholera outbreak on Wednesday, 6th September 2023, with 15 cases reported in the western part of the country, an area prone to water shortages.

Polycarpe Ndayizeye, spokesperson for the Ministry of Public Health and AIDS Control, confirmed that cholera patients had been admitted to hospitals and treatment centers in the municipality of Bujumbura. He called on authorities, residents of affected areas such as Bujumbura, Gatumba, and Rugombo, and all stakeholders to collaborate in combating the outbreak. Residents, especially those in impacted districts, were urged to strictly adhere to hygiene practices to help contain the disease.

Earlier this year, cholera claimed two lives in Bujumbura’s health district, notably at Kajaga beach on Lake Tanganyika. Water shortages, particularly during the dry season from May to September, exacerbate the risk of cholera outbreaks in Burundi’s western region.

Causative agent

Cholera is caused by the bacterium Vibrio cholerae. It produces a toxin that targets the intestines, leading to severe watery diarrhea and dehydration. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), not all strains of V. cholerae cause illness; only specific toxin-producing strains are responsible for cholera outbreaks.

How cholera spreads

Cholera spreads through the consumption of contaminated food or water, particularly in areas with inadequate sanitation or limited access to clean water. The bacterium thrives in environments where drinking water, food, or sanitation is compromised, often after natural disasters or in densely populated areas.

Symptoms

Symptoms of cholera typically manifest within 2-5 days after exposure and include:

Profuse watery diarrhea (often described as “rice-water stools”)

Vomiting

Rapid dehydration

Muscle cramps

Severe thirst

If untreated, cholera can lead to shock and even death within hours due to the rapid loss of fluids.

Preventive measures

Preventing cholera requires addressing the core issues of water and sanitation. The WHO, Africa CDC, and US CDC recommend the following preventive actions:

Ensuring access to safe drinking water by boiling, treating with chlorine, or using bottled water

Proper disposal of human waste

Regular handwashing with soap, especially before eating and after using the bathroom

Safe food handling, including thoroughly cooking food and washing fruits and vegetables

Vaccination in high-risk areas, although vaccines alone are not a substitute for proper hygiene and sanitation practices

What to do if you get cholera

Immediate rehydration is crucial in treating cholera. The WHO recommends:

Drinking Oral Rehydration Salts (ORS) solution to replace lost fluids and electrolytes

Seeking medical care immediately if severe symptoms like frequent vomiting or extreme diarrhea occur

In severe cases, intravenous (IV) fluids may be necessary if oral hydration is insufficient

Treatment

Cholera treatment primarily focuses on rehydration. Antibiotics can also be prescribed in more severe cases to shorten the duration of the illness and reduce the volume of diarrhea. Zinc supplements are also recommended for children to aid recovery. Access to adequate treatment dramatically reduces cholera’s mortality rate to less than 1%, according to the WHO.

Regional impact

Burundi is not alone in facing cholera outbreaks. A recent update from the WHO African Region, as of August, 2023 reported cholera cases across 15 countries. Among the latest outbreaks, six countries—Burundi, Cameroon, Kenya, Mozambique, Uganda, and Zimbabwe—account for over 200 new cases. While the overall trend in the region is declining, WHO and other public health authorities urge countries to bolster surveillance, readiness, and community-based prevention measures, especially around border crossings to limit cross-border infections.

Read more here: Cholera in the WHO African Region

https://iris.who.int/bitstream/handle/10665/373305/AFRO-Cholerabulletin30.pdf

A new report by Oxfam, released on World Food Day 16th October 2024, reveals an unpleasant reality: up to 21,000 people are dying from hunger daily, largely driven by conflicts worldwide. Titled Food Wars, the report highlights how conflicts are not only fueling food insecurity but actively weaponizing food, water, and aid to gain control in war-torn regions.

Manufactured Hunger and Public Health Risks
The report underscores that many of today’s food crises are “largely manufactured” by warring parties. Countries embroiled in conflict account for nearly all 281.6 million people facing acute hunger globally. The destruction of infrastructure, blocking of humanitarian aid, and displacement of people are contributing to severe food shortages and increasing public health risks. The lack of access to food, clean water, and essential health services due to conflict escalates the spread of diseases and malnutrition, especially among vulnerable populations like children and the elderly.

The Economic Impact of Hunger and Conflict
Beyond the immediate health risks, hunger crises significantly damage economies. Many conflict-affected countries rely on exports of primary products like gold, oil, and livestock. In Sudan, for example, 95% of the country’s export earnings come from these sectors. However, mining operations and resource extraction have often fueled violence, forcing people from their homes and devastating the environment. This displacement disrupts economic activity, destroys livelihoods, and increases poverty rates.

Oxfam criticizes the current peace-building efforts focused on attracting foreign investment, which often exacerbates inequalities rather than alleviating them. The model of economic liberalization, aimed at promoting export-driven economies, has failed to address the root causes of conflict and hunger, worsening economic instability.

The Global Impact: Climate, Conflict, and Rising Food Prices
The hunger crisis is not limited to conflict zones alone. Climate-related disasters such as droughts, floods, and rising global food prices, worsened by the COVID-19 pandemic and disruptions from the Russia-Ukraine war, have intensified food insecurity worldwide. East and Southern Africa are particularly affected, with soaring food prices making essential goods unaffordable for millions. This creates a global ripple effect, as nations interconnected through trade and supply chains face economic and food shortages as well.

Breaking the Cycle: What the World Must Do
The Oxfam report calls on global leaders to take decisive action. To meet the 2030 goal of “zero hunger,” world leaders must address the root causes of these crises. Oxfam advocates for holding those responsible for “starvation crimes” accountable under international law. The United Nations Security Council and other international bodies must prioritize peace-building strategies that address systemic inequalities, human rights abuses, and the lingering effects of colonialism.

In addition, the global community must work to strengthen public health systems, create resilient economies, and build infrastructure that can withstand the pressures of conflict, climate change, and economic shocks. The solutions must be comprehensive, addressing the full range of risks that contribute to hunger. Only then can the cycle of hunger, displacement, and conflict be broken, ensuring a healthier, more equitable future for all.

Read full report Food Wars
 

Read also read Global ceremony highlights the right to nutritious safe and affordable foods  on this link World Food Day 2024 
 

Since the start of 2023, Tanzania has experienced a troubling rise in road traffic accidents, with over 1,550 people killed in crashes by mid-December. These accidents have not only taken a heavy human toll but also exerted a significant economic and social burden on the country. Addressing the issue of road safety requires a comprehensive understanding of the causes of accidents, their impacts on public health and the economy, as well as potential solutions.

Causes of road traffic accidents in Tanzania

The causes of road traffic accidents in Tanzania are multi-faceted, stemming from a combination of human error, vehicle conditions, and poor infrastructure.

• Human Factors: Driver behavior plays a crucial role in road safety. Speeding, reckless driving, failure to follow traffic laws, and distracted driving are some of the most common causes of accidents. Alcohol consumption and fatigue also contribute to a significant number of crashes, particularly during long-distance travel.
• Poor Road Conditions: A significant portion of Tanzania's road network, especially in rural areas, is in poor condition. Potholes, lack of road markings, and insufficient lighting make driving hazardous. Many roads are narrow and unable to accommodate the growing number of vehicles, leading to frequent accidents.
• Vehicle Conditions: Many vehicles on Tanzanian roads are poorly maintained, which increases the likelihood of mechanical failures. Faulty brakes, worn tires, and outdated safety features have all been linked to serious accidents.
• Overloading: Overloading is another critical factor that contributes to road accidents. Buses and trucks often carry more passengers and goods than their capacity allows, leading to instability, reduced maneuverability, and an increased risk of collisions.

Health and economic impacts

Road accidents in Tanzania have far-reaching consequences on both the health sector and the economy.

• Health Impact: Road traffic injuries are a leading cause of hospital admissions and a major contributor to the burden on Tanzania's healthcare system. Victims of road accidents often require long-term medical care and rehabilitation, which strains already limited healthcare resources. Moreover, the psychological trauma faced by survivors and their families cannot be overstated.
• Economic Impact: The economic cost of road traffic accidents is substantial. According to studies, road accidents in Tanzania result in a loss of approximately 3% of the country's Gross Domestic Product (GDP). These losses arise from healthcare expenses, lost productivity due to injuries and deaths, and damage to vehicles and infrastructure. Additionally, many accident victims are of working age, which further exacerbates the economic consequences by removing key contributors from the workforce.

Efforts to improve Road Safety

Several initiatives have been launched to curb the growing number of road accidents in Tanzania, but much more needs to be done.

• Government policies: The Tanzanian government has made efforts to improve road safety through policies and regulations. These include stricter enforcement of traffic laws, the introduction of speed limits, and mandatory vehicle inspections. The use of seat belts, helmet laws for motorcyclists, and campaigns to reduce drunk driving have also been promoted.
• Road infrastructure development: Ongoing road infrastructure projects are expected to improve safety conditions. The expansion and modernization of major highways, improved road signage, and better traffic management systems can reduce the frequency and severity of accidents.
• Driver education and awareness campaigns: Efforts to educate drivers on safe driving practices are crucial. Road safety campaigns targeting both professional drivers (e.g., bus and truck operators) and private vehicle owners can help change driving behaviors. Public awareness programs focusing on the dangers of speeding, drunk driving, and the importance of regular vehicle maintenance are key to preventing accidents.
• Global support and partnerships: Organizations like the Global Road Safety Facility (GRSF) have been working with the Tanzanian government to improve road safety. Their involvement includes providing funding for infrastructure improvements, capacity-building efforts, and data collection systems that can help policymakers make informed decisions.

The way forward

To successfully reduce road traffic accidents in Tanzania, a multi-pronged approach is needed. While government initiatives are essential, they must be supported by public cooperation and international partnerships. Prioritizing road safety not only saves lives but also helps to alleviate the economic burden that road accidents place on the country.

Future interventions should focus on improving road conditions, strengthening enforcement of traffic laws, enhancing vehicle safety standards, and promoting a culture of responsible driving. By addressing the root causes of road accidents and implementing sustainable solutions, Tanzania can pave the way for safer roads and a more secure future for all its citizens.

References

• Xinhua. (2023). 1,550 people killed in road accidents in Tanzania since start of 2023: minister. Link
• Global Road Safety Facility. (n.d.). Tanzania Road Safety Profile. Link
• ResearchGate. (2009). Road Traffic Accidents in Tanzania: A Ten-Year Epidemiological Appraisal. Link
• Global Scientific Journal. (2021). Road Accidents in Tanzania: Causes, Impact, and Solution. Link
• ScienceDirect. (2022). Road Traffic Accidents in Tanzania: Exploring the Economic and Health Impacts. Link

The number of recoveries from the Marburg virus in Rwanda has reached 30, while the total number of vaccinated individuals stands at 876 as of Thursday, October 17, according to the Ministry of Health.

An update from the ministry also confirmed 62 cases of the virus, including 15 deaths and 4 patients currently in isolation receiving treatment (down from 17 earlier in the week).

A total of 4,486 tests have been conducted so far.

Since the outbreak was first declared on September 27, all new confirmed cases have been linked to the hospital cluster in Kigali, and affected individuals remain in isolation and treatment.

Read Ministry of Health's update here .

Kenya has ramped up its efforts to combat the spread of Mpox and neglected tropical diseases (NTDs) with the receipt of vital testing kits and medicines from global health partners, including the World Health Organization (WHO) and USAID. This support arrives as the country records its first Mpox death, with confirmed cases rising to 13. Health officials emphasized the significance of these resources in strengthening the nation’s capacity for disease surveillance and response, particularly in regions with high disease burdens. The Ministry of Health also announced upcoming mass drug administration campaigns aimed at controlling NTDs like lymphatic filariasis and schistosomiasis. Read more here and and here . 

 

Countries that have faced Marburg virus outbreaks, such as Tanzania, Ghana, Equatorial Guinea, and Guinea, have employed several key strategies to contain the virus. These include the deployment of specialized surge teams trained to manage health emergencies and the activation of Emergency Operations Centres to coordinate efforts efficiently. Rapid response teams were mobilized to enhance surveillance, case management, and real-time assessments. Robust contact tracing and surveillance systems were implemented to break the chain of transmission, while specialized treatment centres provided intensive care and isolated infected patients, helping to prevent further spread. Collaboration with the WHO ensured timely access to necessary resources, including medical supplies and expert support. Read more in the New Times.

Across Rwanda, stringent health protocols are being implemented to curb the spread of the Marburg virus. Public spaces like churches, hospitals, and busy locations such as Nyabugogo taxi park now require individuals to sanitize their hands and undergo temperature checks before entry. If a person’s temperature exceeds 36°C, further evaluations are conducted. The Ministry of Health, supported by the Rwanda Governance Board, has mandated religious institutions to enforce strict hygiene measures, discouraging risky behaviors such as certain Holy Communion practices and funeral rituals for those who died from the virus. Public compliance with these guidelines, including voluntary handwashing and mask-wearing, is on the rise. Additionally, a trial vaccination drive was launched on October 6, prioritizing high-risk individuals like healthcare workers. Read more in the New Times.

With the ongoing outbreak of the Marburg virus in some regions, travelers need to be cautious and well-informed about the risks and the necessary precautions to ensure their safety. The World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the UK Foreign Office have all issued relevant advice to guide travelers in making safe decisions. Below is a summary of their recommendations and travel advice.

What is Marburg Virus?

Marburg virus is a highly contagious and deadly virus that causes Marburg Virus Disease (MVD), a hemorrhagic fever similar to Ebola. It is transmitted through direct contact with the bodily fluids of infected individuals, contaminated surfaces, or infected animals such as bats. The virus has a high fatality rate, and there is currently no specific treatment or vaccine.

Travel Recommendations

World Health Organization (WHO)

The WHO has not recommended any travel or trade restrictions with Rwanda or any other countries affected by the Marburg virus. However, the organization advises travelers to stay informed about the outbreak and take basic precautions to minimize the risk of exposure. WHO encourages all travelers to monitor official channels for updates on the outbreak and to follow local health authority guidance when in affected areas.

U.S. Centers for Disease Control and Prevention (CDC)

The CDC has issued a Level 2 travel notice for Rwanda, which means that travelers should practice enhanced precautions. Key recommendations include:

Avoiding contact with sick individuals who show symptoms consistent with Marburg Virus Disease (MVD), such as fever, vomiting, diarrhea, or unexplained bleeding.

Avoiding healthcare facilities in outbreak zones unless seeking urgent care.

Obtaining travel insurance that covers medical evacuation and treatment for infectious diseases before traveling.

Monitoring for symptoms of MVD for 21 days after leaving an outbreak area, such as fever, headache, muscle pain, rash, vomiting, or unexplained bleeding. In case of symptoms, travelers should immediately isolate and seek medical care.

CDC also advises travelers to stay updated on the outbreak and prepare for potential changes in travel conditions or advisories.

European Centre for Disease Prevention and Control (ECDC)

The ECDC emphasizes the importance of travelers being aware of the ongoing Marburg outbreak and following the guidance of local health authorities. Their key recommendations include:

Avoiding contact with individuals showing MVD symptoms and steering clear of healthcare facilities in affected areas for non-urgent medical reasons.

Avoiding wildlife habitats such as caves or mines that may be inhabited by bats, and refraining from handling or consuming bushmeat.

Reporting symptoms upon return from affected areas. Travelers returning to the EU/EEA should promptly seek medical attention if they develop symptoms consistent with MVD and disclose their travel history to healthcare providers.

UK Foreign Office

The UK Foreign Office has not yet advised against travel to Rwanda, but it acknowledges the outbreak on its website and urges travelers to consult local authorities before traveling. Organizations that send workers to affected areas are encouraged to register with the UK Health Security Agency (UKHSA) Returning Workers Scheme. This allows returning workers to be monitored for potential symptoms of MVD.

General Precautions for Travelers

Travelers heading to regions affected by the Marburg virus should consider the following precautions:

Avoid close contact with sick individuals, especially those showing symptoms such as fever, vomiting, diarrhea, or unexplained bleeding.

Steer clear of healthcare facilities in affected areas unless necessary.

Avoid high-risk activities such as visiting bat-inhabited caves or handling wildlife, particularly primates, bats, and bushmeat.

Monitor for symptoms for 21 days after leaving the outbreak area and seek immediate medical attention if symptoms develop.

Stay informed through reliable sources like the WHO, US CDC, Africa CDC, ECDC, and local health authorities about any changes in the outbreak and travel advisories.

Conclusion

While the Marburg virus outbreak poses serious health risks, taking proper precautions can significantly reduce the chances of exposure and infection. Travelers to affected areas should stay informed, avoid risky behaviors, and be prepared for potential changes in travel restrictions. By following the guidance of health organizations like WHO, CDC, ECDC, and the UK Foreign Office, travelers can protect themselves and prevent further spread of the virus.

References:

World Health Organization (WHO). Marburg Virus (https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease )

U.S. Centers for Disease Control and Prevention (CDC). Marburg Virus Travel Notice (https://wwwnc.cdc.gov/travel/notices/level2/marburg-rwanda )

European Centre for Disease Prevention and Control (ECDC). Marburg Virus Disease (https://www.ecdc.europa.eu/en/marburg-virus-disease )

UK Foreign Office. Foreign Travel Advice (https://www.gov.uk/foreign-travel-advice/rwanda/health )