OA-195 Spatial clustering, hotspot analysis and temporal distribution of the seventh Ebola Virus Disease outbreak in Uganda

BackgroundUganda is an ecological hot-spot with infectious disease transmission belts which exacerbates its vulnerability to epidemics. Its proximity to the Congo Basin, influx of refugees and the intrusion of humans into ecological areas formerly occupied by animals and other pathogen carriers, has resulted in an increased risk of Ebola virus disease (EVD) over the last two decades. This study aimed to determine the spatial clustering, hot spot analysis and temporal distribution of the recent EVD outbreak in Uganda.MethodsThe study used an ecological design based on the 2184 subcounties in Uganda as the spatial units. Initial exploratory analysis used measures of spatial autocorrelation in the R statistical package. Using the Anselin’s Local Moran test cluster detection method, spatial autocorrelation was applied to determine the presence of statistically significant clusters and hotspots.ResultsOverall, 142 confirmed cases of Sudan virus disease (SVD) were reported, of which 55 died (CFR: 39%), and 87 recovered. In addition, 22 deaths among probable cases were reported in individuals who died before samples could be taken (overall CFR: 47%). Overall, nine Ugandan districts were affected by this outbreak: Bunyangabu, Jinja, Kagadi, Kampala, Kassanda, Kyegegwa, Masaka, Mubende, and Wakiso. When the number of permutation test was set to 9999, Moran’s I = 0.37261, P = 0.0085, and was significant at significance level of 0.01. Spatial cluster analysis identified two most likely cluster; one large multi-centered cluster in districts of Mubende and Kassanda with 13 locations and one cluster in Rubaga division in Kampala district.ConclusionSubstantial spatial clustering of EVD was detected at sub-county level in the recent outbreak at two districts of Mubende and Kassanda in the central region of Uganda. This study identifies hotspot areas for efficient implementation of early-targeted interventions for the prevention and control of the outbreak.