Abstract

Introduction: On March 7, 2024, the Public Health Emergency Operations Centre, Ministry of Health received reports of a suspected conjunctivitis outbreak in Uganda Prisons Service (UPS) and two schools in Kampala Metropolitan area (KMA). We assessed five laboratories for testing capacity, supply availability, laboratory surveillance, data management, sample management, human resource, facility suitability and equipment functionality. We also investigated the conjunctivitis causative agent and monitored turnaround time (TAT) from sample collection to return of test results to the requester.

Method: Laboratory capacity was assessed using the WHO Laboratory capacity assessment tool. We collected and referred 142 eye swab samples from 85 suspected cases to identify the causative agent. A total 116 samples were referred to the Uganda National Health Laboratory and Diagnostic Services (UNHLDS) Laboratory for culture and sensitivity testing and 26 samples to the Arbo-virus laboratory at Uganda Virus Research Institute (UVRI) for genomic sequencing. We tracked and calculated the average TAT from the date of sample collection to result return to requester.

Results: Overall laboratory capacity to respond to the conjunctivitis outbreak was at an average of 43%, below the WHO recommended 80%. All laboratories lacked testing and bio-risk management capacity. Assessed laboratories had 38% supply availability for sample collection and referral. Laboratories had access to the National Hub Sample Transportation Network. Culture and sensitivity testing for 116 (100%) samples showed no significant bacterial growth. We identified Enterovirus Type C as the causative agent for the conjunctivitis outbreak. The average TAT was 5 days (range:1-7) from the date of sample collection to result return to requester.

Conclusion: Timely laboratory testing informed public health interventions for clinical management without mass antibiotic usage.

Recommendation: Strengthening the UPS and KMA laboratory systems for preparedness, effective detection and sample management of future public health emergencies.