Spatial and temporal distribution of lumpy skin disease outbreaks in Uganda (2002-2016)

Background: Lumpy skin disease (LSD) is a devastating transboundary viral disease of cattle which causes significant loss in production. Although this disease has been reported in Uganda and throughout East Africa, there is almost no information about its epidemiology, spatial or spatio-temporal distribution. We carried out a retrospective study on the epidemiology of LSD in Uganda between the years 2002 and 2016, using data on reported outbreaks collected monthly by the central government veterinary administration. Descriptive statistics were computed on frequency of outbreaks, number of cases, vaccinations and deaths. We evaluated differences in the number of reported outbreaks across different regions (agro-ecological zones), districts, months and years. Spatial, temporal and space-time scan statistics were used to identify possible epidemiological clusters of LSD outbreaks. Results: A total of 1161 outbreaks and 319,355 cases of LSD were reported from 55 out of 56 districts of Uganda. There was a significant difference in incidence between years (P = 0.007) and across different regions. However, there was no significant difference in the number of outbreaks per month (P = 0.443). The Central region reported the highest number of outbreaks (n = 418, 36%) followed by Eastern (n = 372, 32%), Southwestern (n = 140, 12%), Northern (n = 131, 11%), Northeastern (n = 37, 3%), Western (n = 41, 4%) and Northwestern (n = 22, 2%) regions. Several endemic hotspots for the circulation of LSD were identified in the Central and Eastern regions using spatial cluster analyses. Outbreaks in endemic hotspots were less seasonal and had strikingly lower mortality and case-fatality rates than the other regions, suggesting an underlying difference in the epidemiology and impact of LSD in these different zones. Conclusion: Lumpy Skin disease is endemic in Uganda, with outbreaks occurring annually in all regions of the country. We identified potential spatial hotspots for LSD outbreaks, underlining the need for risk-based surveillance to establish the actual disease prevalence and risk factors for disease maintenance. Space-time analysis revealed that sporadic LSD outbreaks tend to occur both within and outside of endemic areas. The findings from this study will be used as a baseline for further epidemiological studies for the development of sustainable programmes towards the control of LSD in Uganda.