{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:20:20Z","timestamp":1777681220380,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:p>\n                    Global health security depends on effective surveillance for infectious diseases. In Uganda, resources are inadequate to support collection and reporting of data necessary for an effective and responsive surveillance system. We used a cross-cutting approach to improve surveillance and laboratory capacity in Uganda by leveraging an existing pediatric inpatient malaria sentinel surveillance system to collect data on expanded causes of illness, facilitate development of real-time surveillance, and provide data on antimicrobial resistance. Capacity for blood culture collection was established, along with options for serologic testing for select zoonotic conditions, including arboviral infection, brucellosis, and leptospirosis. Detailed demographic, clinical, and laboratory data for all admissions were captured through a web-based system accessible at participating hospitals, laboratories, and the Uganda Public Health Emergency Operations Center. Between July 2016 and December 2017, the expanded system was activated in pediatric wards of 6 regional government hospitals. During that time, patient data were collected from 30,500 pediatric admissions, half of whom were febrile but lacked evidence of malaria. More than 5,000 blood cultures were performed; 4% yielded bacterial pathogens, and another 4% yielded likely contaminants. Several WHO antimicrobial resistance priority pathogens were identified, some with multidrug-resistant phenotypes, including\n                    <jats:italic toggle=\"yes\">Acinetobacter<\/jats:italic>\n                    spp.,\n                    <jats:italic toggle=\"yes\">Citrobacter<\/jats:italic>\n                    spp.,\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    , and typhoidal and nontyphoidal\n                    <jats:italic toggle=\"yes\">Salmonella<\/jats:italic>\n                    spp. Leptospirosis and arboviral infections (alphaviruses and flaviviruses) were documented. The lessons learned and early results from the development of this multisectoral surveillance system provide the knowledge, infrastructure, and workforce capacity to serve as a foundation to enhance the capacity to detect, report, and rapidly respond to wide-ranging public health concerns in Uganda.\n                  <\/jats:p>","DOI":"10.1089\/hs.2018.0051","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T10:13:50Z","timestamp":1543313630000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["A Cross-Cutting Approach to Surveillance and Laboratory Capacity as a Platform to Improve Health Security in Uganda"],"prefix":"10.1177","volume":"16","author":[{"given":"Mohammed","family":"Lamorde","sequence":"first","affiliation":[{"name":"Mohammed Lamorde, PhD, FRCP, is Head of the Department of Prevention, Care and Treatment, Infectious Diseases Institute, Kampala, Uganda. Co-senior author."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Mpimbaza","sequence":"additional","affiliation":[{"name":"Arthur Mpimbaza, MBChB, MMed, MSc, is Project Coordinator, Infectious Diseases Research Collaboration, Kampala, and Lecturer, Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala. Co-senior author."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Walwema","sequence":"additional","affiliation":[{"name":"Richard Walwema, MBA, is with the Infectious Diseases Institute, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Kamya","sequence":"additional","affiliation":[{"name":"Moses Kamya, MBChB, MMed, MPH, PhD, is Professor and Chair, Makerere University School of Medicine, Kampala. Dr. Kamya is also with the Infectious Diseases Research Collaboration, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Kapisi","sequence":"additional","affiliation":[{"name":"James Kapisi, MBChB, MMed, MSc Epid, Infectious Diseases Research Collaboration, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Kajumbula","sequence":"additional","affiliation":[{"name":"Henry Kajumbula, MBChB, MMed, Department of Medical Microbiology, Makerere University School of Medicine, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asadu","family":"Sserwanga","sequence":"additional","affiliation":[{"name":"Asadu Sserwanga, MBChB, MPH, Infectious Diseases Research Collaboration, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane Frances","family":"Namuganga","sequence":"additional","affiliation":[{"name":"Jane Frances Namuganga, MPH, Infectious Diseases Research Collaboration, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel","family":"Kusemererwa","sequence":"additional","affiliation":[{"name":"Abel Kusemererwa, Infectious Diseases Research Collaboration, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannington","family":"Tasimwa","sequence":"additional","affiliation":[{"name":"Hannington Tasimwa, Department of Medical Microbiology, Makerere University School of Medicine, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Issa","family":"Makumbi","sequence":"additional","affiliation":[{"name":"Issa Makumbi, MBChB, is with the Uganda Ministry of Health Public Health Emergency Operations Centre, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kayiwa","sequence":"additional","affiliation":[{"name":"John Kayiwa, Uganda Virus Research Institute, Entebbe, Wakiso, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julius","family":"Lutwama","sequence":"additional","affiliation":[{"name":"Julius Lutwama, PhD, Uganda Virus Research Institute, Entebbe, Wakiso, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prosper","family":"Behumbiize","sequence":"additional","affiliation":[{"name":"Prosper Behumbiize is with the Health Information Systems Program, Kampala."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abner","family":"Tagoola","sequence":"additional","affiliation":[{"name":"Abner Tagoola, MBChB, MMed, MSc, is with the Jinja Regional Referral Hospital Republic of Uganda Ministry of Health, Jinja, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane Frances","family":"Nanteza","sequence":"additional","affiliation":[{"name":"Jane Frances Nanteza, MBChB, MMed, is with the Mubende Regional Referral Hospital, Republic of Uganda Ministry of Health, Mubende, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert","family":"Aniku","sequence":"additional","affiliation":[{"name":"Gilbert Aniku, MBChB, MMed, is with Arua Regional Referral Hospital, Republic of Uganda Ministry of Health, Arua, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meklit","family":"Workneh","sequence":"additional","affiliation":[{"name":"Meklit Workneh, MD, MPH, is a Medical Microbiology Fellow, Johns Hopkins School of Medicine, Baltimore, Maryland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari","family":"Manabe","sequence":"additional","affiliation":[{"name":"Yukari Manabe, MD, is Associate Director of Global Health Research and Innovation, Johns Hopkins School of Medicine, Baltimore, Maryland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff N.","family":"Borchert","sequence":"additional","affiliation":[{"name":"Jeff N. Borchert, MS, is a Public Health Analyst, Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vance","family":"Brown","sequence":"additional","affiliation":[{"name":"Vance Brown, MA, is Deputy Program Director, Centers for Disease Control and Prevention, Division of Global Health Protection, Kampala, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace D.","family":"Appiah","sequence":"additional","affiliation":[{"name":"Grace D. Appiah, MD, MS, is a Medical Epidemiologist, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Mintz","sequence":"additional","affiliation":[{"name":"Eric D. 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Mossel, PhD, is a Microbiologist, Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul S.","family":"Mead","sequence":"additional","affiliation":[{"name":"Paul S. 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