KITGUM, 20 June 2008 (IRIN) - Uganda's Ministry of Health has sent a team of experts to the northern district of Kitgum to investigate an outbreak of Hepatatis E (HEV) in camps for internally displaced persons (IDPs) which has killed 64 people over the past eight months.

The team will assess the extent of the epidemic, the level of intervention against the disease and identify response gaps, Kitgum District Chairman Komakech John Ogwok told IRIN.

"The biggest challenge we have is the attitude of the population," he said, explaining that many people preferred to visit traditional healers first and only go to health centres as a last resort.

No treatment is available for patients who have reached an acute stage of infection, "but HEV infections  are usually self-limited and hospitalisation is generally not required", according to the World Health Organization."

http://www.who.int/mediacentre/factsheets/fs280/en/

"Unless people change their attitude, it will be difficult to get rid of the disease and more people will continue dying," said Ogwok.

Community mobilisers in affected areas said sanitation and hygiene conditions were very poor in IDP camps and the villages to which people were returning in the wake of a rebel insurgency in the north.

HEV is a viral disease spread along the faecal-oral route. Outbreaks tend to be linked to contaminated water or food supplies. Mortality rates are generally low, ranging from 0.5 to 4.0 percent. But among pregnant women in their third trimester this rate can rise to 20 percent.

"The number of hepatitis E cases is continuing to increase in the district… Over 3,082 cases have been registered in the district since October 2007, with 64 deaths, Kitgum District Health Officer Alex Olwedo told IRIN.

"The majority of those getting the infection and dying are women who are pregnant and it's really disturbing," he said.

Worst affected areas

A report by the Kitgum health directorate said the worst affected areas of the district were Madi Opei sub-county, which is the epicentre of the disease with 1,114 cases, followed by Agoro with 685 cases, Paloga with 607 cases, Padibe 304 cases, Mucwini 277 cases and Lokung with 25 cases.

Others are Layamo with 16, Orom 12 cases, Kitgum town with 12 cases, Akwnag with three and Palabek Gem with two cases.

At Padibe health centre, Oyet Nestanery, 82, had recently been diagnosed with the viral disease.

"Oyet is the fourth person to suffer from hepatitis E in our family. Two of his sons and his elder brother died of hepatitis E last month," said Milly Lagum, the patient's son.

Gustave Opoka, the doctor in charge of Padibe emergency health unit, said 60 cases were reported there within a period of three weeks.

A near-term pregnant woman who had been brought to the health centre critically ill had recently succumbed to the disease, said Opoka.

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