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Tuesday, February 9, 2016

What if Zika was in Uganda?

By Esther Nakkazi

The Zika virus is not in Uganda and it is not a threat, the Ministry of Health has said in an official statement. Travellers to Uganda have also been assured that Uganda is a safe destination.

But what would happen if Zika attacked Uganda?

The Uganda Virus Research Institute (UVRI) has testing facilities and has broad experiences of dealing with it. Surveillance reports across the country are also being done and none have indicated the risk of the virus, said Dr. Asuman Lukwago, the permanent secretary at the Ministry of Health.

The Zika virus, a mosquito-borne disease was first identified in Uganda and scientists and experts isolated it over 70 years ago. This was during a scientific research program on yellow fever.

Even when the virus was isolated it caused no death so it was ‘ignored,’ Julius Lutwama, a virologist, at UVRI has explained.

Zika is passed from one person to another by the bite of a mosquito called the ‘Aedes Mosquito’ which bites in the morning and the late afternoon. The Aedes differs from the Anopheles, which causes malaria and mostly bites in the evening.

So how can Ugandans be that careful all day with the Aedes mosquito? Where will we find the money to prevent it? In South America where the virus is now rampant, people stave it off with an insect repellent or by wearing light coloured clothes to cover the whole body. Currently, there is no medicine or vaccine to prevent or treat Zika.

Most of the insecticide-treated bed nets are distributed for free by non-government organisations funded by donors to Uganda. Will they also provide free insect repellent and how cheap is it?

Zika does not kill. If a pregnant woman catches it her baby can be born with microcephaly, a severe birth defect, where the baby has a small head and other problems to the body and brain.

Children born with Zika are hard to manage and Uganda’s disability policies and facilities to cater for such is limited. What will happen to all these babies? A generation with Zika?

Centers for Disease Control and Prevention (CDC) and other health authorities have advised pregnant women not to travel to affected areas and to delay pregnancy. If Zika appeared in Uganda, where the unmet need for family planning is 34 percent how would they delay pregnancy when access to contraception and reproductive health services are not readily available?

Uganda has high fertility rates at 6.7 percent. At Mulago hospital, the country’s largest referral, the number of babies delivered per day is 100 making it one of the busiest in the world. If babies at Muago were born with Zika this would be a sad and sorrowful nightmare.

Maybe some women would have wanted to abort if they knew that the baby had Zika but abortion is illegal in Uganda and restricted to certain medical circumstances. And a few attend antenatal or even deliver from health facilities.

People with the Zika virus disease usually have a mild fever, a rash and red itchy sore eyes, and this can last for 2-7 days. The WHO recommends that all suspected malaria cases undergo diagnostic confirmation prior to treatment but that is not usually the case.

There is an issue of self medication in case someone feels feverish. How will teh pregnant women even know?

In the USA, a case of sexually transmitted Zika infection was reported and CDC has advised men who've traveled to areas with circulating Zika to "consider wearing condoms". Uganda has constant condom shortages, the last one only recorded two months ago.

The best way is to empower the communities with knowledge and awareness and maybe to keep away the Aedes mosquito, which climate experts say has since mutated. If the mutated version came back to Uganda from South America, how would it behave?This is only a ‘What if Uganda had Zika’ article. There is no Zika in Uganda.

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