Publications by authors named "Stephen Balinandi"

Background: In September 2022, Uganda experienced an outbreak of Sudan virus disease (SVD), mainly in central Uganda. As a result of enhanced surveillance activities for Ebola disease, samples from several patients with suspected viral hemorrhagic fever (VHF) were sent to the VHF Program at Uganda Virus Research Institute (UVRI), Entebbe, Uganda, and identified with infections caused by other viral etiologies. Herein, we report the epidemiologic and laboratory findings of Crimean-Congo hemorrhagic fever (CCHF) cases that were detected during the SVD outbreak response.

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  • Ebola disease (EBOD) is a serious illness caused by viruses in the Orthoebolavirus genus, primarily the Ebola virus, posing challenges for public health due to its human-to-human transmission and limited treatment options.
  • Despite decades of research, the origins and detailed epidemiology of these viruses remain unclear, with serosurveys indicating higher infection rates than the observed clinical cases.
  • Recent work has mapped a specific B-cell epitope in the Ebola virus spike protein, revealing that cross-reactive antibodies provide insight into unexpected seroprevalences and suggest potential improvements in serological specificity for diagnosing EBOD.
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Evaluating the adaptive immune responses to natural infection with Crimean-Congo hemorrhagic fever (CCHF) virus (CCHFV) in human survivors is critical to the development of medical countermeasures. However, the correlates of protection are unknown. As the most prevalent tick-borne human hemorrhagic fever virus with case fatality rates of 5%-30% and worldwide distribution, there is an urgent need to fill these knowledge gaps.

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Crimean-Congo hemorrhagic fever virus can cause lethal disease in humans yet there are no approved medical countermeasures. Viral glycoprotein GP38, exclusive to Nairoviridae, is a target of protective antibodies and is a key antigen in preclinical vaccine candidates. Here, we isolate 188 GP38-specific antibodies from human survivors of infection.

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  • The rVSVΔG-ZEBOV-GP vaccine has been used during Ebola outbreaks, and a study in Uganda assessed healthcare workers' knowledge, attitudes, and long-term immune responses following vaccination.
  • Out of 565 surveyed healthcare workers, only 37% reported being vaccinated, and a significant portion lacked knowledge that the vaccine only protects against Ebola.
  • Despite the general desire for booster doses, the findings highlight the need for continued education on Ebola and other viral hemorrhagic fevers, especially since the vaccine's long-term effectiveness remains uncertain.
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Background: On 20 September 2022, Uganda declared its fifth Sudan virus disease (SVD) outbreak, culminating in 142 confirmed and 22 probable cases. The reproductive rate (R) of this outbreak was 1.25.

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  • Rift Valley fever (RVF) is a viral disease affecting humans in Africa and the Arabian Peninsula, with recent reports highlighting severe illness and high mortality rates in Uganda, especially since 2016.
  • Between November 2017 and March 2020, 40 cases of RVF were confirmed in Uganda, predominantly affecting young adult males, with a significant number requiring hospitalization and a high death rate, particularly in older patients and those presenting with bleeding.
  • Survivors experienced prolonged and severe symptoms, including gastrointestinal issues and jaundice, with the duration of symptoms lasting from a couple of days up to four months, indicating the serious impact of RVF on affected individuals.
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Crimean-Congo hemorrhagic fever virus can cause lethal disease in humans yet there are no approved medical countermeasures. Viral glycoprotein GP38, unique to , is a target of protective antibodies, but extensive mapping of the human antibody response to GP38 has not been previously performed. Here, we isolated 188 GP38-specific antibodies from human survivors of infection.

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Background: Significant milestones have been made in the development of COVID19 diagnostics Technologies. Government of the republic of Uganda and the line Ministry of Health mandated Uganda Virus Research Institute to ensure quality of COVID19 diagnostics. Re-testing was one of the methods initiated by the UVRI to implement External Quality assessment of COVID19 molecular diagnostics.

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  • Rift Valley Fever (RVF) is a serious viral illness affecting both humans and livestock, characterized by high mortality and severe symptoms; the outbreak was highlighted by a confirmed human case in Uganda in December 2020.
  • The investigation involved defining suspect and confirmed cases through symptoms and testing methodologies (RT-PCR for humans and ELISA for livestock) to monitor the situation and gather data on exposure risks.
  • Results indicated that while the index case consumed raw cow milk and had a positive connection to the virus, most herdsmen and surrounding individuals remained asymptomatic; however, potential contact with infected animal fluids raised concerns about broader transmission.
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Crimean-Congo Hemorrhagic fever (CCHF) is an important zoonotic disease transmitted to humans both by tick vectors and contact with fluids from an infected animal or human. Although animals are not symptomatic when infected, they are the main source of human infection. Uganda has reported sporadic human outbreaks of CCHF in various parts of the country since 2013.

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Marburg virus disease, caused by Marburg and Ravn orthomarburgviruses, emerges sporadically in sub-Saharan Africa and is often fatal in humans. The natural reservoir is the Egyptian rousette bat (ERB), which sheds virus in saliva, urine, and feces. Frugivorous ERBs discard test-bitten and partially eaten fruit, potentially leaving infectious virus behind that could be consumed by other susceptible animals or humans.

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Ebola disease (EBOD) is a public health threat with a high case fatality rate. Most EBOD outbreaks have occurred in remote locations, but the 2013-2016 Western Africa outbreak demonstrated how devastating EBOD can be when it reaches an urban population. Here, the 2022 Sudan virus disease (SVD) outbreak in Mubende District, Uganda, is summarized, and the genetic relatedness of the new variant is evaluated.

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Article Synopsis
  • - In 2016, Rift Valley fever reemerged in Uganda's Kabale District, with confirmed human cases and a notable seropositivity rate of 13% in both humans and animals.
  • - A countrywide survey involving 3,181 livestock samples showed an overall RVFV seropositivity of 6.9%, with higher rates in cattle (10.7%) versus goats and sheep, and among females and adults compared to males and juveniles.
  • - The study highlights risk factors for RVFV seropositivity, including animal species, age, grazing methods, and regional differences, indicating the potential for targeted surveillance to prevent future outbreaks in humans and animals.
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Uganda has implemented several interventions that have contributed to prevention, early detection, and effective response to Public Health Emergencies (PHEs). However, there are gaps in collecting and documenting data on the overall response to these PHEs. We set out to establish a comprehensive electronic database of PHEs that occurred in Uganda since 2000.

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Rift Valley fever (RVF) is a zoonotic disease of public health and economic importance. Uganda has reported sporadic outbreaks of RVF in both humans and animals across the country, especially in the southwestern part of the "cattle corridor" through an established viral hemorrhagic fever surveillance system. We report 52 human cases of laboratory-confirmed RVF from 2017 to 2020.

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  • Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne virus that poses a health threat in Uganda, prompting an outbreak investigation after a human case linked to cattle.
  • Researchers tested blood and tick samples from 210 animals (117 cattle and 93 goats) to determine infection rates and identify risk factors.
  • The study found high levels of CCHF antibodies in the animals, particularly among females and those in pastoral systems, suggesting the need for enhanced surveillance and prevention measures in the region.
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Crimean-Congo hemorrhagic fever (CCHF) was detected in 2 refugees living in a refugee settlement in Kikuube district, Uganda. Investigations revealed a CCHF IgG seroprevalence of 71.3% (37/52) in goats within the refugee settlement.

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Background: Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral infection, present across Africa and Eurasia, which might pose a cryptic public health problem in Uganda. We aimed to understand the magnitude and distribution of CCHF risk in humans, livestock and ticks across Uganda by synthesising epidemiological (cross-sectional) and ecological (modelling) studies.

Methods: We conducted a cross-sectional study at three urban abattoirs receiving cattle from across Uganda.

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Rift Valley fever, endemic or emerging throughout most of Africa, causes considerable risk to human and animal health. We report 7 confirmed Rift Valley fever cases, 1 fatal, in Kiruhura District, Uganda, during 2021. Our findings highlight the importance of continued viral hemorrhagic fever surveillance, despite challenges associated with the COVID-19 pandemic.

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Background: Crimean-Congo Haemorrhagic Fever (CCHF) is an emerging human-health threat causing sporadic outbreaks in livestock farming communities. However, the full extent and the risks associated with exposure of such communities has not previously been well-described.

Methods: We collected blood samples from 800 humans, 666 cattle, 549 goats and 32 dogs in districts within and outside Ugandan cattle corridor in a cross-sectional survey, and tested for CCHFV-specific IgG antibodies using Enzyme-Linked Immunosorbent Assays.

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The risk for the emergence of novel viral zoonotic diseases in animals and humans in Uganda is high given its geographical location with high biodiversity. We aimed to identify and characterize viruses in 175 blood samples from cattle selected in Uganda using molecular approaches. We identified 8 viral species belonging to 4 families (Flaviviridae, Peribunyaviridae, Reoviridae and Rhabdoviridae) and 6 genera (Hepacivirus, Pestivirus, Orthobunyavirus, Coltivirus, Dinovernavirus and Ephemerovirus).

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Uganda established a domestic Viral Hemorrhagic Fever (VHF) testing capacity in 2010 in response to the increasing occurrence of filovirus outbreaks. In July 2018, the neighboring Democratic Republic of Congo (DRC) experienced its 10th Ebola Virus Disease (EVD) outbreak and for the duration of the outbreak, the Ugandan Ministry of Health (MOH) initiated a national EVD preparedness stance. Almost one year later, on 10th June 2019, three family members who had contracted EVD in the DRC crossed into Uganda to seek medical treatment.

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