Timeliness of Measles Outbreak Detection, Notification, and Response in Uganda: A 7-1-7 Target Assessment, January–December 2025

Measles is among the most transmissible human infections, and delays in outbreak detection and response can rapidly amplify community transmission. The 7-1-7 target provides an operational benchmark for evaluating outbreak detection, notification, and early response. We assessed the timeliness of measles outbreak detection, notification, and response in Uganda during 2025 using the 7-1-7 framework to identify opportunities for improving response performance. We assessed 46 laboratory-confirmed measles outbreaks reported in Uganda during 2025 with complete 7-1-7 data. Outbreak timeline data were abstracted from rapid response investigation reports, district records, and laboratory data. Detection (T1) was measured from outbreak emergence to first recording by the surveillance system, notification (T2) from detection to notification of public health authorities, and response (T3) from notification to achievement of the final applicable early response milestone. Timeliness was summarised using medians, IQRs, and proportions meeting each target; new and recurrent outbreaks were compared using Fisher’s exact tests with exact 95% CIs. Qualitative data from 186 District Health Team members were analysed thematically to identify operational bottlenecks and enablers. Among 46 outbreaks, the median detection interval was 16 days (IQR: 8–31), notification interval 1 day (IQR: 0–5), and response interval 34 days (IQR: 22–49). Eight outbreaks (17.4%) met the 7-day detection target, 27 (58.7%) met the 1-day notification target, and two (4.3%) achieved all seven early response milestones within 7 days of notification; none met all three 7-1-7 targets. Detection was supported by effective facility triage, active surveillance, and prior outbreak awareness, while rapid notification was facilitated by mobile-phone communication and accessible surveillance focal persons. Delays were linked to low clinical suspicion, limited community-based surveillance, delayed availability of laboratory confirmation, coordination challenges, and shortages of vaccines, cold-chain equipment, transport, and operational funds. Measles outbreaks in Uganda were generally detected late and responded to slowly, despite comparatively timely notification. Improving performance will require stronger community- and facility-based surveillance, timely laboratory confirmation, functional district coordination structures, and reliable access to vaccines, transport, cold-chain capacity, and operational funding.