Patterns of Human Plague in Uganda, 2008-2016.

Area of Science:

• Zoonotic diseases
• Epidemiology
• Infectious disease surveillance

Background:

• Plague is a severe, flea-borne zoonotic disease with global distribution.
• Sub-Saharan Africa, particularly Uganda, reports a high burden of suspected human plague cases.
• Understanding plague epidemiology in endemic regions is crucial for public health interventions.

Purpose of the Study:

• To describe the epidemiology of human plague in Uganda's West Nile region.
• To assess the diagnostic value of reported environmental factors, such as dead rodents, in plague confirmation.
• To evaluate the mortality rates associated with suspected versus laboratory-confirmed plague.

Main Methods:

• Active surveillance and laboratory testing (bacterial culture, serology) for human plague cases.
• Retrospective analysis of suspected and confirmed plague cases from 2008-2016.
• Statistical association analysis between environmental factors and plague confirmation.

Main Results:

• 255 suspected human plague cases were identified between 2008 and 2016.
• One-third of suspected cases were laboratory-confirmed.
• Mortality rates were 7% for suspected and 26% for confirmed plague cases.
• Unusual numbers of dead rats in a village were significantly associated with laboratory-confirmed plague.

Conclusions:

• Human plague in Uganda is characterized by an episodic occurrence.
• Laboratory confirmation is critical for accurate diagnosis and understanding true disease burden.
• Environmental indicators like dead rodents can aid in early plague suspicion.
• Differential diagnosis is important, as other illnesses may be misidentified as plague in endemic areas.