Collaboration with Traditional Healers to Expand Surveillance for Plague in Northern Uganda

Plague is a highly virulent zoonotic disease that can cause bubonic, septicemic, or pneumonic illness in humans. If recognized early, plague can be treated successfully with inexpensive antimicrobials. Without treatment, more than 50% of bubonic cases are fatal. Although plague occurs worldwide, the overwhelming burden is in rural, impoverished areas of sub-Saharan Africa. During 2004-2009, 97% of the over 20,000 plague cases reported to the World Health Organization (WHO) were reported from countries in Africa. In northwest Uganda, up to 400 cases are reported annually, with a case fatality rate of nearly 30%. Efforts at the National Center for Atmospheric Research (NCAR) in collaboration with the U.S. Centers for Disease Control and Prevention and the Uganda Ministry of Health have focused on using ensemble weather and climate data coupled with epidemiological data to develop predictive maps for plague in the West Nile region of northwestern Uganda. Building on this work, in an effort to reduce the burden of illness in an area with little access to western health care, a training module has been developed and successfully implemented. This module is designed to expand surveillance by bringing together traditional healers and clinical practitioners and is aimed at reducing incidence of plague in rural Uganda. Results from this ongoing, interdisciplinary study will be presented.