What did we learn about in the last three minutes of lecture on Monday?? That's right...Hepatitis E. Well, it looks like there has been a Hep E epidemic in Uganda recently. A total of 314 cases, with 11 deaths, have been reported since the epidemic began in 11/2007. It is interesting that about 75% of the cases have been in the age group 15-44 and also that approximately 60% of the cases have been females.
As we learned on Monday, "vowels in the bowels," meaning that Hep A and Hep E are both transmitted via the fecal-oral route. This route of transmission has important implications for sanitation practices...meaning that increased sanitation results in decreased incidence of disease. The Ugandan Ministry of Health has attributed the epidemic to extremely low latrine coverage, contamination of water at household levels, and poor hygiene practices. In an analysis of sanitary conditions carried out in Northern Uganda, it was found that an average of 112 people share one latrine...which is about 6 times above the limit of 20 people per facility. Also, since most communities lack latrines altogether, the people have taken to the practice of open air defecation. Also, there was no indication of communities using soap to wash their hands, even though it was being supplied to them (the water for handwashing was also found to have tons of e. coli).
Looks like international health advocates might focus on spreading awareness about Hep E in these areas experiencing Hep E epidemics.