Abstract

Background: In late April 2024, cholera cases emerged at Kasensero landing site, Kyotera District, Central Uganda, with the Ministry of Health confirming the outbreak on May 8, 2024. Regional laboratories played a pivotal role in the response, providing real-time, accurate diagnostics essential for outbreak management, transmission monitoring, and public health interventions. The team evaluated the capacity of regional laboratory systems to support sample management and ensure timely cholera sample collection and result dissemination during the outbreak.

Methods: We adapted a World Health Organization checklist to assess human resources, infrastructure, equipment functionality, and cholera logistics at Masaka Regional Referral Hospital (RRH) laboratory. A sample tracking register monitored collection, transportation, and result return times, evaluating the national transport network’s activation for timely delivery to testing facilities.

Results: Masaka RRH laboratory met human and infrastructural standards, supported by functional equipment and a qualified microbiologist. However, initial shortages of rapid diagnostic test (RDT) kits and culture media hindered early response. The national transport network enabled sample delivery from Kasensero to regional and national laboratories within 24 hours, with all isolates shipped to the Uganda National Health Laboratory and Diagnostic Services (UNHLDS). Of 47 verified alerts, samples from all (100%) were cultured, with 23 (49%) positive for Vibrio cholerae; 33 (70%) were RDT-tested, with 15 (45%) positive for cholera antigens. Two Lake Victoria water samples tested negative for V. cholerae. Results reached requesters within a median of six days (range: 5–7) from collection.

Conclusion: Timely sample collection, testing, and result return supported patient management and public health interventions, supported by robust regional laboratory capacity. Despite logistic challenges, decentralizing emergency diagnostics proved critical, highlighting the need for sustained investment in regional systems to enhance cholera outbreak preparedness and response.