Assessment of capacity and performance of points of entry in detection of public health events, reporting and responding to public health emergencies, Uganda, July–September 2022

Abstract

Abstract Introduction Expanded human mobility has increasingly led to the spread of disease outside of the areas in which it first occurs. Consequently, there is an enhanced focus on building capacity to detect disease at points of entry (PoEs). We assessed capacity and performance in the detection of public health events, reporting, and responding to public health emergencies (PHEs) at PoEs in Uganda. Methods We conducted a cross-sectional assessment from June 27 to September 12, 2022, at official PoEs in Uganda. We adopted a standardised assessment tool for the World Health Organisation’s (WHO) PoE capacity requirements. Capacity areas included coordination and communication, routine prevention and control measures expected at all times, and response to PHEs. We abstracted and analysed surveillance data on the performance of PoEs including completeness of PoE reporting, proportion of travellers screened, and proportion of suspected ill travellers isolated, investigated and referred for further care if necessary. Results We assessed all 53 gazetted PoEs (4 airports, 16 inland ports, and 33 ground crossings). Most (94%) reported communication capacities with national and sub-health authorities with 88% completeness of reporting. Forty-two per cent provided access to appropriate medical services for assessment and care of ill travellers, 42% had access to sanitary facilities, 21% had access to safe water, and 23% had appropriate waste management and vector control. Regarding the capacity to respond to PHEs, all designated PoEs had a public health emergency contingency plan,74% provided screening of all travellers but screened 56% of the travellers, 38% had the capacity to quarantine and isolate suspected human cases, and 15% had the capacity to transport suspected cases to referral health facilities. Twenty three percent of the suspected ill travellers were isolated, investigated and referred for further care if necessary. Only 8% assessed animals being transported through PoEs for priority animal transboundary diseases. Conclusion Existing capacity and performance gaps in detection and response to PHEs may limit the ability to respond effectively to potential PHEs if they occur. There is a need to establish infrastructure, equipment and personnel for and assessment, isolation and quarantine of humans and animals.