Readiness of health public facilities to diagnose, manage, and prevent the Ebola epidemic along border districts in Southwestern Uganda

Abstract

Background: Ebola Virus Disease (EVD) outbreaks typically start from a single case of a probable zoonotic transmission and evolve into an epidemic because of the local and international movement of people, causing a global health security threat. This study aimed to assess the readiness of health facilities in the border districts of Southwestern Uganda towards prevention, diagnosis and management of EVD. Methods: This was a cross-sectional study conducted between July and September 2024. The study was conducted in the districts that share a border with the Democratic Republic of Congo, which were Kasese, Kanungu, and Kisoro districts. Data was collected using the World Health Organization Consolidated Ebola virus disease preparedness checklist, which was modified to suit the study objectives. Results: A total of 214 health facilities were surveyed, including 118 (55.1%) Health centre IIs, 76 (35.5%) health centre IIIs, 9 (4.2%) Health centre IVs and 11 (5.1%) Hospitals. The overall prevention capacity was moderate with a mean score of 62.0 (± 12.5), and only 88 (41.1%) had high prevention levels. Hospitals, 10/11 (90.9%) and Health centre IVs, 6/9 (65.2%) were more prepared to prevent EVD outbreaks as compared to lower-level facilities (p = 0.041). The mean score for facility readiness to diagnose EBV outbreak was 61.0% (± 13.2). Only half, 116 (54.2%), had trained laboratory personnel to handle an EVD outbreak. Management capacity was the weakest domain, with only one-third, 72/214 (33.6%) of all facilities rated high and a mean score of 55.0 (± 14.0). Major gaps were noted in the availability of burial/ decontamination teams, 85 (39.7%) and contingency funding, 74 (34.6%). Conclusion: The overall level of preparedness to manage EVD outbreak was moderate, with most facilities lacking essential preventive, diagnostic and treatment components, calling on the MoH and its partners to intensify cross border surveillance, coordination, and capacity-building efforts at the health facility level.