Science.gov

Sample records for rakai district uganda

  1. Widows' and orphans' property disputes: the impact of AIDS in Rakai District, Uganda.

    PubMed

    Roys, C

    1995-11-01

    The 1991 census identified 44,000 orphans in the Rakai District of Uganda. The Child Social Care Project (CSCP) in the district helps ensure that orphaned children under 18 years who have lost one or both parents to AIDS receive the property rights to which they are entitled. The property rights of widows are also championed by the CSCP. The project has enjoyed considerable success in settling individual disputes. The CSCP has also had some success in enabling communities to deal appropriately with the conflicts without recourse to experts. The author notes that while it is important to promote the empowerment of women, the phrase is so overused that it is in danger of becoming meaningless. That said, a vital aspect of empowerment is economic independence. The CSCP helps women claim the right to own property, land, and housing, as well as to care for their children in the attempt to give them some degree of economic control over their destiny and that of their children. The paper discusses widows' and orphans' property disputes in sections on wills, customary law, and statutory law. The CSCP is described followed by a case study and consideration of gender and legal reform.

  2. AIDS and agricultural production. Report of a land utilization survey, Masaka and Rakai districts of Uganda.

    PubMed

    Hunter, S S; Bulirwa, E; Kisseka, E

    1993-07-01

    Increased AIDS mortality and other preexisting conditions have contributed to agricultural productivity declines in the districts of Masaka and Rakai in Uganda. These two districts were the most fertile in Uganda and also had the highest HIV seroprevalence rates in Africa. 66% of study households experienced land use decline to some extent over the past 5 years. The 11% decline in poultry production and 32% decline in cattle production was reportedly due to poor management and loss of grazing land from overpopulation and larger scale farms. The most frequently reported reasons for crop reductions were death and sickness; these was estimated as affecting 8% of families with children under 5 years in the study area. Morbidity and mortality as a reason for the decline was reported two times as much as poverty and decline in international coffee prices. Other reasons for loss of productivity were food shortages and insecurity, loss of income, and reduced ability to respond to educational and medical needs. Cassava is replacing the culturally preferred matooke banana as a crop that is more disease-, pest-, and drought resistant. The banana weevil has been a recent problem. Marginal farming systems have been the most affected by declines in land use and livestock production, but fertile areas have not been spared the impact from AIDS and adult mortality. Poverty has decreased the use of pesticides, herbicides, and fertilizers in the districts. Policy has had an impact on agricultural practices: population growth and inheritance have added to loss of individual land holdings and contributed to fallow periods and infertility. Appropriate land management practices have not been adequately promoted in the agricultural extension service. Civil wars and the drop in coffee prices have reduced the number of farm laborers. Common grazing land has been turned over to large commercial ranches. Government should maintain research and monitoring of declines in food and cash crop

  3. AIDS and agricultural production. Report of a land utilization survey, Masaka and Rakai districts of Uganda.

    PubMed

    Hunter, S S; Bulirwa, E; Kisseka, E

    1993-07-01

    Increased AIDS mortality and other preexisting conditions have contributed to agricultural productivity declines in the districts of Masaka and Rakai in Uganda. These two districts were the most fertile in Uganda and also had the highest HIV seroprevalence rates in Africa. 66% of study households experienced land use decline to some extent over the past 5 years. The 11% decline in poultry production and 32% decline in cattle production was reportedly due to poor management and loss of grazing land from overpopulation and larger scale farms. The most frequently reported reasons for crop reductions were death and sickness; these was estimated as affecting 8% of families with children under 5 years in the study area. Morbidity and mortality as a reason for the decline was reported two times as much as poverty and decline in international coffee prices. Other reasons for loss of productivity were food shortages and insecurity, loss of income, and reduced ability to respond to educational and medical needs. Cassava is replacing the culturally preferred matooke banana as a crop that is more disease-, pest-, and drought resistant. The banana weevil has been a recent problem. Marginal farming systems have been the most affected by declines in land use and livestock production, but fertile areas have not been spared the impact from AIDS and adult mortality. Poverty has decreased the use of pesticides, herbicides, and fertilizers in the districts. Policy has had an impact on agricultural practices: population growth and inheritance have added to loss of individual land holdings and contributed to fallow periods and infertility. Appropriate land management practices have not been adequately promoted in the agricultural extension service. Civil wars and the drop in coffee prices have reduced the number of farm laborers. Common grazing land has been turned over to large commercial ranches. Government should maintain research and monitoring of declines in food and cash crop

  4. "They don't care what happens to us." The situation of double orphans heading households in Rakai District, Uganda

    PubMed Central

    Dalen, Nina; Nakitende, Ann Jacqueline; Musisi, Seggane

    2009-01-01

    Background This article is based on information collected about the situation of double orphans who are heading households in Rakai District, Uganda. The information will be used as justification and guidance for planning actions to improve the situation of these and similar children. This research is thus the first step in an Action Research approach leading to specific interventions. The aim of this article is to describe the situation of these orphaned children, with an emphasis on the psychosocial challenges they face. Methods The study involved interviews, focus group discussions, observations and narratives. Forty-three heads of sibling-headed households participated. Information derived from informal discussions with local leaders is also included. The responses were analyzed using a modified version of Giorgi's psychological phenomenological method as described by Malterud [1]. Results Factors such as lack of material resources, including food and clothes, limited possibilities to attend school on a regular basis, vast responsibilities and reduced possibilities for social interaction all contribute to causing worries and challenges for the child heads of households. Most of the children claimed that they were stigmatized and, to a great extent, ignored and excluded from their community. The Local Council Secretary ("Chairman") seemed to be the person in the community most responsible and helpful, but some chairmen seemed not to care at all. The children requested counseling for themselves as well as for community members because they experienced lack of understanding from other children and from adult community members. Conclusion The children experienced their situation as a huge and complex problem for themselves as well as for people in their villages. However, the situation might improve if actions focused on practical and psychological issues as well as on sensitization about the children's situation could be initiated. In addition to the fact that

  5. Rising School Enrollment and Declining HIV and Pregnancy Risk Among Adolescents in Rakai District, Uganda, 1994-2013

    PubMed Central

    Santelli, John; Mathur, Sanyukta; Song, Xiaoyu; Huang, Tzu Jung; Wei, Ying; Lutalo, Tom; Nalugoda, Fred; Gray, Ron H.; Serwadda, David M.

    2015-01-01

    Background Poverty, family stability, and social policies influence the ability of adolescents to attend school. Likewise, being enrolled in school may shape an adolescent's risk for HIV and pregnancy. We identified trends in school enrollment, factors predicting school enrollment (antecedents), and health risks associated with staying in or leaving school (consequences). Methods Data from the Rakai Community Cohort Study (RCCS) were examined for adolescents 15-19 years (n=21,735 person-rounds) from 1994 to 2013. Trends, antecedents, and consequences were assessed using logistic and linear regression with robust variance estimation. Qualitative data were used to explore school leaving among HIV+ and HIV- youth (15-24 years). Results School enrollment and socioeconomic status (SES) rose steadily from 1994 to 2013 among adolescents; orphanhood declined after availability of antiretroviral therapy. Antecedent factors associated with school enrollment included age, SES, orphanhood, marriage, family size, and the percent of family members <20 years. In qualitative interviews, youth reported lack of money, death of parents, and pregnancy as primary reasons for school dropout. Among adolescents, consequences associated with school enrollment included lower HIV prevalence, prevalence of sexual experience, and rates of alcohol use and increases in consistent condom use. Young women in school were more likely to report use of modern contraception and never being pregnant. Young men in school reported fewer recent sexual partners and lower rates of sexual concurrency. Conclusions Rising SES and declining orphanhood were associated with rising school enrollment in Rakai. Increasing school enrollment was associated with declining risk for HIV and pregnancy. PMID:26075159

  6. Hypertension, Cardiovascular Risk Factors and Anti-Hypertensive Medication Utilization among HIV-infected Individuals in Rakai, Uganda

    PubMed Central

    Sander, Laura D.; Newell, Kevin; Ssebbowa, Paschal; Serwadda, David; Quinn, Thomas C.; Gray, Ronald H.; Wawer, Maria J.; Mondo, George; Reynolds, Steven

    2014-01-01

    Objectives To assess the prevalence of hypertension, elevated blood pressure and cardiovascular risk factors among HIV-positive individuals in rural Rakai District, Uganda. Methods We assessed 426 HIV-positive individuals in Rakai, Uganda from 2007 to 2010. Prevalence of hypertension and elevated blood pressure assessed by clinical measurement was compared to clinician-recorded hypertension in case report forms. Multiple logistic regression and z-tests were used to examine the association of hypertension and elevated blood pressure with age, sex, body mass index, CD4 cell count, and anti-retroviral treatment (ART) use. For individuals on anti-hypertensives, medication utilization was reviewed. Results The prevalence of hypertension (two elevated blood pressure readings at different time points) was 8.0% (95% CI: 5.4–10.6%), and that of elevated blood pressure (one elevated blood pressure reading) was 26.3% (95% CI: 22.1–30.5%). Age ≥50 years and higher body mass index were positively associated with elevated blood pressure. ART use, time on ART, and CD4 cell count were not associated with hypertension. 83% of subjects diagnosed with hypertension were on anti-hypertensive medications, most commonly beta-blockers and calcium channel blockers. Conclusions Hypertension is common among HIV-positive individuals in rural Uganda. PMID:25430847

  7. Penile Microbiota and Female Partner Bacterial Vaginosis in Rakai, Uganda

    PubMed Central

    Hungate, Bruce A.; Tobian, Aaron A. R.; Ravel, Jacques; Prodger, Jessica L.; Serwadda, David; Kigozi, Godfrey; Galiwango, Ronald M.; Nalugoda, Fred; Keim, Paul; Wawer, Maria J.; Price, Lance B.; Gray, Ronald H.

    2015-01-01

    ABSTRACT Bacterial vaginosis (BV) is a common vaginal bacterial imbalance associated with risk for HIV and poor gynecologic and obstetric outcomes. Male circumcision reduces BV-associated bacteria on the penis and decreases BV in female partners, but the link between penile microbiota and female partner BV is not well understood. We tested the hypothesis that having a female partner with BV increases BV-associated bacteria in uncircumcised men. We characterized penile microbiota composition and density (i.e., the quantity of bacteria per swab) by broad-coverage 16S rRNA gene-based sequencing and quantitative PCR (qPCR) in 165 uncircumcised men from Rakai, Uganda. Associations between penile community state types (CSTs) and female partner’s Nugent score were assessed. We found seven distinct penile CSTs of increasing density (CST1 to 7). CST1 to 3 and CST4 to 7 were the two major CST groups. CST4 to 7 had higher prevalence and abundance of BV-associated bacteria, such as Mobiluncus and Dialister, than CST1 to 3. Men with CST4 to 7 were significantly more likely to have a female partner with a high Nugent score (P = 0.03). Men with two or more extramarital partners were significantly more likely to have CST4 to 7 than men with only marital partners (CST4 to 7 prevalence ratio, 1.84; 95% confidence interval [CI], 1.16 to 2.92). Female partner Nugent BV is significantly associated with penile microbiota. Our data support the exchange of BV-associated bacteria through intercourse, which may explain BV recurrence and persistence. PMID:26081632

  8. Sexualised space, sexual networking & the emergence of AIDS in Rakai, Uganda.

    PubMed

    Kuhanen, Jan

    2010-03-01

    This paper argues that the outbreak of the epidemic of AIDS in Rakai, Uganda, in the early 1980s was a consequence of economic change, leading to the erosion of conventional cultural checks on juvenile, female and male sexuality and the emergence and growth of sexualised spaces and sexual networking in a few remote rural hubs of economic activity which exhibited a different sexual culture from the surrounding countryside. The trading hubs developed dense local and regional sexual networks which enabled HIV to spread quickly among the "risk groups" and local people of the busiest trading towns and villages. The high degree of sexual mixing in these hubs opened up new routes for HIV to infect the general population. This paper, which shows the importance of understanding the role of the aggravated economic disparities and changing sexual culture in the onset and spread of the HIV and AIDS epidemic in Rakai, Uganda, is primarily based on in-depth interviews and focus group discussions and on the analysis of newspapers, unofficial and official documents and academic studies. PMID:19884035

  9. Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda

    PubMed Central

    Matovu, Joseph K. B.; Todd, Jim; Wanyenze, Rhoda K.; Wabwire-Mangen, Fred; Serwadda, David

    2015-01-01

    Background Studies show that uptake of couples’ HIV counseling and testing (couples’ HCT) can be affected by individual, relationship, and socioeconomic factors. However, while couples’ HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples’ HCT services, this is yet to be documented. We explored the correlates of previous couples’ HCT uptake among married individuals in a rural Ugandan district with differing HIV prevalence levels. Design This was a cross-sectional study conducted among 2,135 married individuals resident in the three HIV prevalence strata (low HIV prevalence: 9.7–11.2%; middle HIV prevalence: 11.4–16.4%; and high HIV prevalence: 20.5–43%) in Rakai district, southwestern Uganda, between November 2013 and February 2014. Data were collected on sociodemographic and behavioral characteristics, including previous receipt of couples’ HCT. HIV testing data were obtained from the Rakai Community Cohort Study. We conducted multivariable logistic regression analysis to identify correlates that are independently associated with previous receipt of couples’ HCT. Data analysis was conducted using STATA (statistical software, version 11.2). Results Of the 2,135 married individuals enrolled, the majority (n=1,783, 83.5%) had been married for five or more years while (n=1,460, 66%) were in the first-order of marriage. Ever receipt of HCT was almost universal (n=2,020, 95%); of those ever tested, (n=846, 41.9%) reported that they had ever received couples’ HCT. There was no significant difference in previous receipt of couples’ HCT between low (n=309, 43.9%), middle (n=295, 41.7%), and high (n=242, 39.7%) HIV prevalence settings (p=0.61). Marital order was not significantly associated with previous receipt of couples’ HCT. However, marital duration [five or more years vis-à-vis 1–2 years: adjusted odds ratio (aOR): 1.06; 95% confidence interval (95% CI): 1.04–1.08] and awareness about

  10. High Frequency of False-Positive Hepatitis C Virus Enzyme-Linked Immunosorbent Assay in Rakai, Uganda

    PubMed Central

    Mullis, Caroline E.; Laeyendecker, Oliver; Reynolds, Steven J.; Ocama, Ponsiano; Quinn, Jeffrey; Boaz, Iga; Gray, Ronald H.; Kirk, Gregory D.; Thomas, David L.; Quinn, Thomas C.; Stabinski, Lara

    2013-01-01

    The prevalence of hepatitis C virus (HCV) infection in sub-Saharan Africa remains unclear. We tested 1000 individuals from Rakai, Uganda, with the Ortho version 3.0 HCV enzyme-linked immunosorbent assay. All serologically positive samples were tested for HCV RNA. Seventy-six of the 1000 (7.6%) participants were HCV antibody positive; none were confirmed by detection of HCV RNA. PMID:24051866

  11. The psychological effect of orphanhood: a study of orphans in Rakai district.

    PubMed

    Sengendo, J; Nambi, J

    1997-01-01

    This paper examines the psychological effect of orphanhood in a case study of 193 children in Rakai district of Uganda. Studies on orphaned children have not examined the psychological impact. Adopting parents and schools have not provided the emotional support these children often need. Most adopting parents lack information on the problem and are therefore unable to offer emotional support; and school teachers do not know how to identify psychological and social problems and consequently fail to offer individual and group attention. The concept of the locus of control is used to show the relationship between the environment and individuals' assessment of their ability to deal with it and to adjust behaviour. Most orphans risk powerful cumulative and often negative effects as a result of parents' death, thus becoming vulnerable and predisposed to physical and psychological risks. The children were capable of distinguishing between their quality of life when their parents were alive and well, when they became sick, and when they eventually died. Most children lost hope when it became clear that their parents were sick, they also felt sad and helpless. When they were adopted, many of them felt angry and depressed. Children living with widowed fathers and those living on their own were significantly more depressed. These children were also more externally oriented than those who lived with their widowed mothers. Teachers need to be retrained in diagnosing psycho-social problems and given skills to deal with them. Short courses should be organized for guardians and community development workers in problem identification and counselling.

  12. Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach.

    PubMed

    Kairania, Robert; Gray, Ronald H; Kiwanuka, Noah; Makumbi, Fredrick; Sewankambo, Nelson K; Serwadda, David; Nalugoda, Fred; Kigozi, Godfrey; Semanda, John; Wawer, Maria J

    2010-09-01

    Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision in Rakai, Uganda. HIV-discordant couples and a random sample of HIV-infected concordant and HIV-negative concordant couples (to mask HIV status) were invited to sensitisation meetings to discuss the benefits of disclosure and couple counselling. HIV-infected partners were subsequently contacted to encourage HIV disclosure to their HIV-uninfected partners. If the index positive partner agreed, the counsellor facilitated the disclosure of HIV results, and provided ongoing support. The proportion of disclosure was determined. Eighty-one per cent of HIV-positive partners in discordant relationships disclosed their status to their HIV-uninfected partners in the presence of the counsellor. The rates of disclosure were 81.3% in male HIV-positive and 80.2% in female HIV-positive discordant couples. Disclosure did not vary by age, education or occupation. In summary, disclosure of HIV-positive results in discordant couples using facilitated couple counselling approach is high, but requires a stepwise process of sensitisation and agreement by the infected partner.

  13. Trichomonas vaginalis Incidence Associated with Hormonal Contraceptive Use and HIV Infection among Women in Rakai, Uganda

    PubMed Central

    Brahmbhatt, Heena; Musoke, Richard; Makumbi, Frederick; Kigozi, Godfrey; Serwadda, David; Wawer, Maria; Gray, Ronald

    2014-01-01

    Background. Data on the incidence of Trichomonas vaginalis and use of hormonal contraception (HC) are limited. Methods. 2,374 sexually active women aged 15–49 years from cohort surveys in Rakai, Uganda, were included. Incidence of T. vaginalis was estimated per 100 person years (py) and association between HC (DMPA, Norplant, and oral contraceptives) and T. vaginalis infection was assessed by incidence rate ratios (IRR), using Poisson regression models. Results. At baseline, 34.9% had used HC in the last 12 months, 12.8% HIV+, 39.7% with high BV-scores (7–10), and 3.1% syphilis positive. The 12-month incidence of T. vaginalis was 2.4/100 py; CI (1.90, 3.25). When stratified by type of HC used, compared to women who did not use HC or condoms, incidence of T. vaginalis was significantly higher among users of Norplant (adj.IRR = 3.01, CI: 1.07–8.49) and significantly lower among DMPA users (adj.IRR = 0.55, CI: 0.30, 0.98) and women who discontinued HC use at follow-up (adj.IRR = 0.30, CI: 0.09, 0.99). HIV infection was associated with an increase in incidence of T. vaginalis (adj.IRR = 2.34, CI: 1.44, 3.78). Conclusions. Use of Norplant and being HIV+ significantly increased the risk of T. vaginalis, while use of DMPA and discontinuation of overall HC use were associated with a decreased incidence of T. vaginalis. PMID:26316977

  14. Traditional Herbal Medicine Use Associated with Liver Fibrosis in Rural Rakai, Uganda

    PubMed Central

    Auerbach, Brandon J.; Reynolds, Steven J.; Lamorde, Mohammed; Merry, Concepta; Kukunda-Byobona, Collins; Ocama, Ponsiano; Semeere, Aggrey S.; Ndyanabo, Anthony; Boaz, Iga; Kiggundu, Valerian; Nalugoda, Fred; Gray, Ron H.; Wawer, Maria J.; Thomas, David L.; Kirk, Gregory D.; Quinn, Thomas C.; Stabinski, Lara

    2012-01-01

    Background Traditional herbal medicines are commonly used in sub-Saharan Africa and some herbs are known to be hepatotoxic. However little is known about the effect of herbal medicines on liver disease in sub-Saharan Africa. Methods 500 HIV-infected participants in a rural HIV care program in Rakai, Uganda, were frequency matched to 500 HIV-uninfected participants. Participants were asked about traditional herbal medicine use and assessed for other potential risk factors for liver disease. All participants underwent transient elastography (FibroScan®) to quantify liver fibrosis. The association between herb use and significant liver fibrosis was measured with adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CI) using modified Poisson multivariable logistic regression. Results 19 unique herbs from 13 plant families were used by 42/1000 of all participants, including 9/500 HIV-infected participants. The three most-used plant families were Asteraceae, Fabaceae, and Lamiaceae. Among all participants, use of any herb (adjPRR = 2.2, 95% CI 1.3–3.5, p = 0.002), herbs from the Asteraceae family (adjPRR = 5.0, 95% CI 2.9–8.7, p<0.001), and herbs from the Lamiaceae family (adjPRR = 3.4, 95% CI 1.2–9.2, p = 0.017) were associated with significant liver fibrosis. Among HIV infected participants, use of any herb (adjPRR = 2.3, 95% CI 1.0–5.0, p = 0.044) and use of herbs from the Asteraceae family (adjPRR = 5.0, 95% CI 1.7–14.7, p = 0.004) were associated with increased liver fibrosis. Conclusions Traditional herbal medicine use was independently associated with a substantial increase in significant liver fibrosis in both HIV-infected and HIV-uninfected study participants. Pharmacokinetic and prospective clinical studies are needed to inform herb safety recommendations in sub-Saharan Africa. Counseling about herb use should be part of routine health counseling and counseling of HIV-infected persons in Uganda

  15. Trends in HIV-1 prevalence may not reflect trends in incidence in mature epidemics: data from the Rakai population-based cohort, Uganda.

    PubMed

    Wawer, M J; Serwadda, D; Gray, R H; Sewankambo, N K; Li, C; Nalugoda, F; Lutalo, T; Konde-Lule, J K

    1997-07-01

    Findings are reported from a 2-year follow-up study of an open cohort of people aged 15-59 years living in a sample of 31 representative community clusters in rural Rakai district, Uganda, to measure whether trends in serial HIV-1 prevalence reflect trends in HIV incidence, and to gain insight into the effects of HIV-1 incidence, mortality, mobility, and compliance upon HIV-1 prevalence. In each year of study, all consenting adults provided a serological sample and were interviewed; 2591 adults were enrolled at baseline. HIV prevalence among adults declined significantly between 1990 and 1992; from 23.4% in 1990, to 21.8% in 1991, and 20.9% in 1992. Declining prevalence was also observed in subgroups, including young adults aged 15-24 years from 20.6% to 16.2%, reproductive-age women from 27.1% to 23.5%, and pregnant women from 25.4% to 20.0%. The decline in HIV prevalence among pregnant women, however, is not significant. HIV incidence did not change significantly among all adults aged 15-59 years, nor in population subgroups. HIV-related mortality was 13.5/person-year of observation among those who were HIV-positive. Substantial numbers of HIV-infected individuals were also loss to emigration. PMID:9223737

  16. No difference in keratin thickness between inner and outer foreskins from elective male circumcisions in Rakai, Uganda.

    PubMed

    Dinh, Minh H; Hirbod, Taha; Kigozi, Godfrey; Okocha, Eneniziaogochukwu A; Cianci, Gianguido C; Kong, Xiangrong; Prodger, Jessica L; Broliden, Kristina; Kaul, Rupert; Serwadda, David; Wawer, Maria J; Gray, Ronald H; Hope, Thomas J

    2012-01-01

    It has been hypothesized that increased HIV acquisition in uncircumcised men may relate to a more thinly keratinized inner foreskin. However, published data are contradictory and potentially confounded by medical indications for circumcision. We tested the hypothesis that the inner foreskin was more thinly keratinized than the outer foreskin using tissues from 19 healthy, HIV-uninfected men undergoing routine prophylactic circumcision in Rakai, Uganda. Sections from 3 foreskin anatomic sites (inner, outer, and frenar band) were snap-frozen separately. Two independent laboratories each separately stained, imaged, and measured keratin thicknesses in a blinded fashion. There was no significant difference in keratin thickness between the inner (mean = 14.67±7.48 µm) and outer (mean = 13.30±8.49 µm) foreskin, or between the inner foreskin and the frenar band (mean = 16.91±12.42 µm). While the frenar band showed the greatest intra-individual heterogeneity in keratin thickness, there was substantial inter-individual variation seen in all regions. Measurements made by the two laboratories showed high correlation (r = 0.741, 95% CI, 0.533-0.864). We conclude that, despite inter- and intra-individual variability, keratin thickness was similar in the inner and outer foreskin of healthy Ugandan men, and that reduced keratin thickness is not likely to make the inner foreskin more susceptible to HIV acquisition. PMID:22815984

  17. High Prevalence of Liver Fibrosis Associated with HIV Infection: A Cross-Sectional Study in Rural Rakai, Uganda

    PubMed Central

    Stabinski, Lara; Reynolds, Steven J.; Ocama, Ponsiano; Laeyendecker, Oliver; Boaz, Iga; Ndyanabo, Anthony; Kiggundu, Valerian; Gray, Ron H.; Wawer, Maria; Thio, Chloe; Thomas, David L.; Quinn, Thomas C.; Kirk, Gregory D.

    2011-01-01

    Background Liver disease is a leading cause of mortality among HIV-infected persons in the US and Europe; however, data regarding effects of HIV and anti-retroviral therapy (ART) on liver disease in Africa remains sparse. Methods 500 HIV-infected participants in an HIV care program in Rakai, Uganda were frequency-matched by age, gender and site to 500 HIV-uninfected participants in a population cohort. All participants underwent transient elastography (FibroScan®) to quantify liver stiffness measurements (LSM) and identify participants with significant liver fibrosis, defined as LSM ≥9.3 kPa (≈ Metavir F ≥2). 962 (96 %) of participants had valid LSM data. Risk factors for liver fibrosis were identified by estimating adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CI) using modified Poisson multivariate regression. Findings The prevalence of significant fibrosis was 17% among HIV-infected and 11% in HIV-uninfected participants (p =0.008). In multivariate analysis, HIV infection was associated with a 50% increase in liver fibrosis (adjPRR 1.5, 95%CI 1.1–2.1; p=0.010). Fibrosis was also associated with male gender (adjPRR 1.4, 95% CI 1.0–1.9; p=0.045), herbal medicine use (adjPRR 2.0, 95%CI 1.2–3.3; p=0.005), heavy alcohol consumption (adjPRR 2.3, 95% CI 1.3–3.9; 0.005), occupational fishing (adjPRR 2.5, 1.2–5.3; p=0.019), and chronic HBV infection (adjPRR 1.7, 95% CI 1.0–3.1; p=0.058). Among HIV-infected participants, ART appeared to reduce fibrosis risk (adjPRR 0.6, 95% CI 0.4–1.0; p=0.030). Interpretation The burden of liver fibrosis among rural Ugandans is high, particularly among persons with HIV infection. These data suggest that liver disease may represent a significant cause of HIV-related morbidity and mortality in Africa; clarifying the etiology of liver disease in this population is a research priority. PMID:21555823

  18. Multilingual Cultural Resources in Child-Headed Families in Uganda

    ERIC Educational Resources Information Center

    Namazzi, Elizabeth; Kendrick, Maureen E.

    2014-01-01

    This article reports on a study focusing on the use of multilingual cultural resources in child-headed households (CHHs) in Uganda's Rakai District. Using funds of knowledge and sociocultural perspectives on children's learning, we documented through ethnographic observations and interviews how children in four CHHs used multilingual…

  19. Importance of relationship context in HIV transmission: results from a qualitative case-control study in Rakai, Uganda.

    PubMed

    Higgins, Jenny A; Mathur, Sanyukta; Eckel, Elizabeth; Kelley, Laura; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S

    2014-04-01

    We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health.

  20. Experiences of Sexual Coercion among Adolescent Women: Qualitative Findings from Rakai District, Uganda

    ERIC Educational Resources Information Center

    Wagman, Jennifer; Baumgartner, Joy Noel; Waszak Geary, Cindy; Nakyanjo, Neema; Ddaaki, William George; Serwadda, David; Gray, Ron; Nalugoda, Fred Kakaire; Wawer, Maria J.

    2009-01-01

    Limited data from low-income countries are available on the continuum of coercive experiences, the contexts in which they occur, and how adolescent women perceive and respond to coercion. This article presents results from focus group discussions and in-depth interviews with pregnant and never pregnant sexually active female adolescents, aged 15…

  1. Impact of patient-selected care buddies on adherence to HIV care, disease progression and conduct of daily life among pre-antiretroviral HIV-infected patients in Rakai, Uganda: a randomized controlled trial

    PubMed Central

    Nakigozi, Gertrude; Makumbi, Fredrick E.; Bwanika, John Baptist; Atuyambe, Lynn; Reynolds, Steven J.; Kigozi, Godfrey; Nalugoda, Fred; Chang, Larry W.; Kiggundu, Valerian; Serwadda, David; Wawer, Maria J.; Gray, Ronald H.; Kamya, Moses R.

    2015-01-01

    Background Data are limited on effects of household or community support persons (“care buddies”) on enrolment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression and conduct of daily life among pre-ART HIV-infected individuals in Rakai, Uganda. Methods 1209 HIV infected pre-ART patients aged ≥15 years were randomized to standard of care (SOC) (n = 604) or patient-selected care buddy (PSCB) (n= 605) and followed at 6 and 12 months. Outcomes were adherence to clinic visits; HIV disease progression and self-reported conduct of daily life. Incidence and prevalence rate ratios and 95% confidence intervals (95%CI) were used to assess outcomes in the intent-to-treat and as-treated analyses. Results Baseline characteristics were comparable. In the ITT analysis both arms were comparable with respect to adherence to CD4 monitoring visits (adjPRR 0.98, 95%CI 0.93-1.04, p=0.529) and HIV progression (adjPRR=1.00, 95%CI 0.77-1.31, p=0.946). Good conduct of daily life was significantly higher in the PSCB than the SOC arm (adjPRR 1.08, 95%CI 1.03-1.13, p=0.001). More men (61%) compared to women (30%) selected spouses/partners as buddies (p<0.0001.) 22% of PSCB arm participants discontinued use of buddies. Conclusion In pre-ART persons, having care buddies improved the conduct of daily life of the HIV infected patients but had no effect on HIV disease progression and only limited effect on clinic appointment adherence. PMID:26039929

  2. African swine fever among slaughter pigs in Mubende district, Uganda.

    PubMed

    Muwonge, Adrian; Munang'andu, Hetron M; Kankya, Clovice; Biffa, Demelash; Oura, Chris; Skjerve, Eystein; Oloya, James

    2012-10-01

    Owing to frequent reports of suspected outbreaks and the presence of reservoir hosts and vectors (warthogs, bushpigs and O. moubata ticks), African swine fever (ASF) is believed to be an endemic disease in Uganda. There have, however, been very few studies carried out to confirm its existence in Uganda. This study was carried out to describe the prevalence of ASF based on pathologic lesions and analysis of serum samples from slaughtered pigs during a suspected outbreak in the Mubende district of Uganda. The study was based on visits to 22 slaughterhouses where individual pigs were randomly selected for a detailed ante-mortem and post-mortem inspections. Sera were also collected for laboratory analysis. A total of 997 pigs (53.7% male and 46.3% female) were examined for lesions suggestive of ASF and sero-positivity of sera for ASF antibodies. The sera were tested using enzyme-linked immunosorbent assay (ELISA) and positive samples were further confirmed with an immunoblot assay. The results showed that 3.8% (38/997) of the pigs examined had clinical signs and post-mortem lesions suggestive of ASF. Two of 997 (0.2%) sera analysed were positive for ASF antibodies. Of the sub-counties investigated, Bagezza (12%) and Kiyuni (11%) had the highest prevalence of lesions suggestive of ASF based on ante- and post-mortem examination results, while Mubende town council (1.7%) had the lowest. This study found a low number of pigs (3.8%) with lesions suggestive of ASF at slaughter and an even lower number of pigs (0.2%) that were seropositive at slaughter, however a significantly higher number of pigs were slaughtered during the outbreak as a strategy for farmers to avoid losses associated with mortality.

  3. “Men are always scared to test with their partners … it is like taking them to the Police”: Motivations for and barriers to couples’ HIV counselling and testing in Rakai, Uganda: a qualitative study

    PubMed Central

    Matovu, Joseph KB; Wanyenze, Rhoda K; Wabwire-Mangen, Fred; Nakubulwa, Rosette; Sekamwa, Richard; Masika, Annet; Todd, Jim; Serwadda, David

    2014-01-01

    Introduction Uptake of couples’ HIV counselling and testing (couples’ HCT) can positively influence sexual risk behaviours and improve linkage to HIV care among HIV-positive couples. However, less than 30% of married couples have ever tested for HIV together with their partners. We explored the motivations for and barriers to couples’ HCT among married couples in Rakai, Uganda. Methods This was a qualitative study conducted among married individuals and selected key informants between August and October 2013. Married individuals were categorized by prior HCT status as: 1) both partners never tested; 2) only one or both partners ever tested separately; and 3) both partners ever tested together. Data were collected on the motivations for and barriers to couples’ HCT, decision-making processes from tested couples and suggestions for improving couples’ HCT uptake. Eighteen focus group discussions with married individuals, nine key informant interviews with selected key informants and six in-depth interviews with married individuals that had ever tested together were conducted. All interviews were audio-recorded, translated and transcribed verbatim and analyzed using Nvivo (version 9), following a thematic framework approach. Results Motivations for couples’ HCT included the need to know each other's HIV status, to get a treatment companion or seek HIV treatment together – if one or both partners were HIV-positive – and to reduce mistrust between partners. Barriers to couples’ HCT included fears of the negative consequences associated with couples’ HCT (e.g. fear of marital dissolution), mistrust between partners and conflicting work schedules. Couples’ HCT was negotiated through a process that started off with one of the partners testing alone initially and then convincing the other partner to test together. Suggestions for improving couples’ HCT uptake included the need for couple- and male-partner-specific sensitization, and the use of

  4. Ivermectin distribution using community volunteers in Kabarole district, Uganda.

    PubMed

    Kipp, W; Burnham, G; Bamuhiiga, J; Weis, P; Büttner, D W

    1998-06-01

    Ivermectin mass distribution for the control of onchocerciasis in Uganda began in 1991. This report describes a community based ivermectin distribution programme covering two foci in the Kabarole district which have an estimated 32,000 persons infected and another 110,000 at risk. Through nodule palpation in adult males, 143 villages were identified where nodule prevalence exceeded 20%. Skin snips were also taken from a sample of the population to measure changes in community microfilarial load (CMFL) with treatment. The delivery programme was integrated into the district health management structure, and used community volunteers supervised by medical assistants from adjacent health facilities for annual ivermectin distribution campaigns. After initial efforts by the community to support distributors in-kind proved inadequate, ivermectin distributors earned money retailing condoms as part of the social marketing component of district STD/AIDS programme. Reduction in the CMFL ranged from 40-62% twelve months after the second ivermectin treatment in three villages, and from 69-84% six months after the fourth round of treatment in two villages. After four years of treatment, 85% of eligible persons were receiving ivermectin from community volunteers in each treatment cycle. Drop out rates among volunteers did not exceed 20% over the four years reported here. The direct cost of treatment was US $0.29 per person. Among the reasons for low per-person treatment costs were the strong supervisory structure, the presence of health centres in the foci and a well developed and capable district Primary Health Care management team. PMID:10180405

  5. Risk Denial and Socio-Economic Factors Related to High HIV Transmission in a Fishing Community in Rakai, Uganda: A Qualitative Study

    PubMed Central

    Lubega, Muhamadi; Nakyaanjo, Neema; Nansubuga, Sumaya; Hiire, Edgar; Kigozi, Godfrey; Nakigozi, Gertrude; Lutalo, Tom; Nalugoda, Fred; Serwadda, David; Gray, Ronald; Wawer, Maria; Kennedy, Caitylin; Reynolds, Steven James

    2015-01-01

    Background In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44%, reaching up to 74% among female sex workers. We explored drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions. Methods 20 in-depth interviews including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community were conducted during April-September 2014. Content analysis was performed to identify recurrent themes. Results The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior. Conclusions There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV

  6. The Safety and Acceptance of the PrePex Device for Non-Surgical Adult Male Circumcision in Rakai, Uganda. A Non-Randomized Observational Study

    PubMed Central

    Kigozi, Godfrey; Musoke, Richard; Watya, Stephen; Kighoma, Nehemia; Nkale, James; Nakafeero, Mary; Namuguzi, Dan; Serwada, David; Nalugoda, Fred; Sewankambo, Nelson; Wawer, Maria Joan; Gray, Ronald Henry

    2014-01-01

    Objectives To assess the safety and acceptance of the PrePex device for medical male circumcision (MMC) in rural Uganda. Methods In an observational study, HIV-uninfected, uncircumcised men aged 18 and older who requested elective MMC were informed about the PrePex and dorsal slit methods and offered a free choice of their preferred procedure. 100 men received PrePex to assess preliminary safety (aim 1). An additional 329 men, 250 chose PrePex and 79 chose Dorsal slit, were enrolled following approval by the Safety Monitoring Committee (aim 2). Men were followed up at 7 days to assess adverse events (AEs) and to remove the PrePex device. Wound healing was assessed at 4 weeks, with subsequent weekly follow up until completed healing. Results The PrePex device was contraindicated in 5.7% of men due to a tight prepuce or phimosis/adhesions. Among 429 enrolled men 350 (82.0%) got the PrePex device and 79 (18.0%) the dorsal slit procedure. 250 of 329 men (76.0%) who were invited to choose between the 2 procedures chose Prepex. There were 9 AEs (2.6%) with the PrePex, of which 5 (1.4%) were severe complications, 4 due to patient self-removal of the device leading to edema and urinary obstruction requiring emergency surgical circumcision, and one due to wound dehiscence following device removal. 71.8% of men reported an unpleasant odor prior to PrePex removal. Cumulative rates of completed wound healing with the PrePex were 56.7% at week 4, 84.8% week 5, 97.6% week 6 and 98.6% week 7, compared to 98.7% at week 4 with dorsal slit (p<0.0001). Conclusion The PrePex device was well accepted, but healing was slower than with dorsal slit surgery. Severe complications, primarily following PrePex self-removal, required rapid access to emergency surgical facilities. The need to return for removal and delayed healing may increase Program cost and client burden. PMID:25144194

  7. Serological and molecular investigation for brucellosis in swine in selected districts of Uganda.

    PubMed

    Erume, Joseph; Roesel, Kristina; Dione, Michel M; Ejobi, Francis; Mboowa, Gerald; Kungu, Joseph M; Akol, Joyce; Pezo, Danilo; El-Adawy, Hosny; Melzer, Falk; Elschner, Mandy; Neubauer, Heinrich; Grace, Delia

    2016-08-01

    Brucellosis is a notifiable zoonotic disease affecting livestock, humans, and wildlife in Uganda. Pigs can be infected with human pathogenic Brucella suis biovars 1 and 3 and can be a significant source of brucellosis for humans. Uganda has a rapidly growing pig population, and the pork consumption per capita is the highest in East Africa. The objective of this work was to determine the seroprevalence of brucellosis in Ugandan pigs. A cross-sectional serosurvey of pigs was conducted in three of the major pig-keeping districts in Uganda (Masaka (n = 381 samples), Mukono (n = 398), and Kamuli (n = 414)). In addition, pigs originating from these districts were sampled in the major pig abattoir in Kampala (n = 472). In total, 1665 serum samples were investigated by serological and molecular tests. Only three putative brucellosis-positive samples were detected serologically using indirect ELISA. These sera were found negative for Brucella antibodies by CFT; however, two had antibodies against Yersinia enterocolitica as determined by SAT. Presence of antibodies against Yersiniae was confirmed by Y. enterocolitica antibody-specific ELISA. The two Yersiniae ELISA-positive samples were brucellosis negative using real-time PCR. We tested additional 142 sera from the 1665 samples with real-time PCR. All tested negative. Under this type of production system, we expect a maximum B. suis prevalence of less than 1 % at 95 % confidence level, and therefore, the risk of acquiring brucellosis from the pigs or their products is negligible. However, pigs may harbor the zoonotic Y. enterocolitica. This is the first study to investigate the occurrence of brucellosis in pigs in Uganda and the first study to report Y. enterocolitica antibodies in swine in Uganda. PMID:27142028

  8. Uganda.

    PubMed

    1988-03-01

    Uganda occupies 94,354 square miles in central Africa, bounded by Kenya, Tanzania, Rwanda, Zaire, and Sudan. It includes part of Lake Victoria, and the Ruwenzori mountains are on its border with Zaire. The country is largely on a plateau and thus has a pleasant climate. 12% of the land is devoted to national parks and game preserves. The northeast is semiarid; the southwest and west are rainy. The population of 15,900,896, growing at 3.7% a year, is mostly rural and is composed of 3 ethnic groups: The Bantu, including the Buganda, the Banyankole and the Basoga; the Nilo-Hamitic Iteso; and the Nilots. There are also some Asians and Arabs. The official language is English, but Luganda and Swahili are widely used. The majority of the people are Christian. Literacy is about 52%, and 57% of school-age children attend primary school. Infant mortality rate is 108/1000, and life expectancy is 49 years. The 1st Englishman to see Uganda was Captain John Speke in 1862. The Kingdom of Buganda became a British protectorate in 1894, and the protectorate was extended to the rest of the country in 1896. In the 1950s the British began an africanization of the government prior to formal independence, but the 1st general elections in 1961 were boycotted by the Bugandans, who wanted autonomy. In the 2nd election, in March, 1962, the Democratic Party, led by Benedicto Kiwanuka, defeated the Uganda People's Congress (UPC), led by Apollo Milton Obote; however, a month later, the UPC allied with the Buganda traditionalists, the Kabaka Yekka, and formed a collision government under Obote. Uganda became independent in 1962 with the King of Buganda, Sir Edward Frederick Mutesa II as president. Political rivalries continued, and in 1966 Prime Minister Obote suspended the constitution, and the Buganda government lost its semiautonomy. Obote's government was overthrown in 1971 by Idi Amin Dada, under whose 8-year reign of terror 100,000 Ugandans were murdered. Amin was ousted by an invading

  9. Uganda.

    PubMed

    1988-03-01

    Uganda occupies 94,354 square miles in central Africa, bounded by Kenya, Tanzania, Rwanda, Zaire, and Sudan. It includes part of Lake Victoria, and the Ruwenzori mountains are on its border with Zaire. The country is largely on a plateau and thus has a pleasant climate. 12% of the land is devoted to national parks and game preserves. The northeast is semiarid; the southwest and west are rainy. The population of 15,900,896, growing at 3.7% a year, is mostly rural and is composed of 3 ethnic groups: The Bantu, including the Buganda, the Banyankole and the Basoga; the Nilo-Hamitic Iteso; and the Nilots. There are also some Asians and Arabs. The official language is English, but Luganda and Swahili are widely used. The majority of the people are Christian. Literacy is about 52%, and 57% of school-age children attend primary school. Infant mortality rate is 108/1000, and life expectancy is 49 years. The 1st Englishman to see Uganda was Captain John Speke in 1862. The Kingdom of Buganda became a British protectorate in 1894, and the protectorate was extended to the rest of the country in 1896. In the 1950s the British began an africanization of the government prior to formal independence, but the 1st general elections in 1961 were boycotted by the Bugandans, who wanted autonomy. In the 2nd election, in March, 1962, the Democratic Party, led by Benedicto Kiwanuka, defeated the Uganda People's Congress (UPC), led by Apollo Milton Obote; however, a month later, the UPC allied with the Buganda traditionalists, the Kabaka Yekka, and formed a collision government under Obote. Uganda became independent in 1962 with the King of Buganda, Sir Edward Frederick Mutesa II as president. Political rivalries continued, and in 1966 Prime Minister Obote suspended the constitution, and the Buganda government lost its semiautonomy. Obote's government was overthrown in 1971 by Idi Amin Dada, under whose 8-year reign of terror 100,000 Ugandans were murdered. Amin was ousted by an invading

  10. STUDIES ON THE SPECIES COMPOSITION AND RELATIVE ABUNDANCE OF MOSQUITOES OF MPIGI DISTRICT, CENTRAL UGANDA

    PubMed Central

    Mayanja, Martin; Mutebi, John-Paul; Crabtree, Mary B.; Ssenfuka, Fred; Muwawu, Teddy; Lutwama, Julius J.

    2015-01-01

    Prediction of arboviral disease outbreaks and planning for appropriate control interventions require knowledge of the mosquito vectors involved. Although mosquito surveys have been conducted in different regions of Uganda since the mid 30’s such studies have not been carried out in Mpigi District. In October 2011, we conducted mosquito collections in Mpigi district to determine species composition and relative abundance of the different species. The survey was conducted in four villages, Njeru, Ddela, Kiwumu and Nsumbain Kammengo sub-county, Mpigi district, Uganda. CDC light traps baited with dry ice (carbon dioxide) were used to capture adult mosquitoes. A total of 54,878 mosquitoes comprising 46 species from eight genera were collected. The dominant species at all sites was Coquilletidia (Coquilletidia) fuscopennata Theobald (n=38,059, 69%), followed by Coquillettidia (Coquillettidia) metallica Theobald (n=4,265, 7.8%). The number of species collected varied from 17 in the genus Culex to 1 in the genus Lutzia. Of the 46 species identified, arboviruses had previously been isolated from 28 (60.9%) suggesting a high potential for arboviral transmission and/or maintenance in Mpigi District. PMID:26346305

  11. The topic is the Relevance of wetland economic valuation in Uganda Acase study of Kiyanja-Kaku wetland in Lwengo District-Central Uganda.

    NASA Astrophysics Data System (ADS)

    Namulema, Mary Jude

    2016-04-01

    This study examined the relevance of economic valuation of wetlands in Uganda. A case study was done on Kiyanja-Kaku wetland in Lwengo District in Central Uganda using a semi-structured survey. Three objectives were examined i.e.: (i) To identify wetland ecosystem services in Uganda (ii) To identify the economic valuation methods appropriate for wetlands in Uganda (iii) To value clean water obtained from Kiyanja-Kaku wetland. The wetland ecosystem services were identified as provisioning, regulating, habitat, cultural and amenities services. The community had knowledge about 17 out of the 22 services as given by TEEB (2010). The economic valuation methods identified were, market price, efficiency price, travel cost, contingent valuation, hedonic pricing, and production function and benefit transfer methods. These were appropriate for valuation of wetlands in Uganda but only three methods i.e. market price, contingent valuation and productivity methods have been applied by researchers in Uganda so far. The economic value of clean water from Kiyanja-Kaku wetland to the nearby community was established by using the market price of clean water the National water and Sewerage Corporation charges for the water in Uganda to obtain the low value and the market price of water from the survey was used to obtain the high value. The estimated economic value of clean water service for a household ranges from UGX. 612174 to 4054733 (US 168.0-1095.0). The estimated economic value of clean water service from Kiyanja-Kaku wetland to the entire community ranges from UGX. 2,732,133,000.0 to 18,096,274,000.0 (US 775,228.0-4,885,994.0).

  12. Herbal medicine use in the districts of Nakapiripirit, Pallisa, Kanungu, and Mukono in Uganda

    PubMed Central

    2012-01-01

    Background Traditional medicine (TM) occupies a special place in the management of diseases in Uganda. Not with standing the many people relying on TM, indigenous knowledge (IK) related to TM is getting steadily eroded. To slow down this loss it is necessary to document and conserve as much of the knowledge as possible. This study was conducted to document the IK relevant to traditional medicine in the districts of Mukono, Nakapiripirit, Kanungu and Pallisa, in Uganda. Methods An ethnobotanical survey was conducted between October 2008 and February 2009 using techniques of key informant interviews and household interviews. Results The common diseases and conditions in the four districts include malaria, cough, headache, diarrhea, abdominal pain, flu, backache and eye diseases. Respondents stated that when they fall sick they self medicate using plant medicines or consult western-trained medicine practitioners. Self medication using herbal medicines was reported mostly by respondents of Nakapiripirit and Mukono. Respondents have knowledge to treat 78 ailments using herbal medicines. 44 species, mentioned by three or more respondents have been prioritized. The most frequently used part in herbal medicines is the leaf, followed by the stem and root. People sometime use animal parts, soil, salt and water from a grass roof, in traditional medicines. Herbal medicines are stored for short periods of time in bottles. The knowledge to treat ailments is acquired from parents and grandparents. Respondents’ age and tribe appears to have a significant influence on knowledge of herbal medicine, while gender does not. Conclusion This survey has indicated that IK associated with TM stills exists and that TM is still important in Uganda because many people use it as a first line of health care when they fall sick. Age and tribe influence the level of IK associated with herbal medicine, but gender does not. PMID:22943789

  13. Ethnopharmacological practices by livestock farmers in Uganda: Survey experiences from Mpigi and Gulu districts

    PubMed Central

    2014-01-01

    Background There is continued reliance on conventional veterinary drugs including anthelmintics, to some of which resistance has developed. Loss of indigenous technical knowledge (ITK) from societies affects the opportunities for utilization of ethnopharmacological practices unless properly documented. This study was conducted to identify common traditional practices using medicinal plants against helminthosis and other livestock diseases in Mpigi and Gulu districts of Uganda. Methods Seven focus group discussions with ten farmers per group plus 18 key informant interviews were held in each district from August to November 2011. Ranking was used to quantify disease burdens and to identify priority livestock and breeds. Samples of each plant were submitted to Makerere University herbarium for identification and documentation. The local name, relative availability and International Union for Conservation of Nature (IUCN) status were recorded. Results Seventy six farmers in Mpigi and 74 in Gulu were interviewed. Theileriosis and helminthosis were the most common disease conditions in cattle and goats, respectively. Forty plant species within 34 genera from 22 botanical families were identified, with 20 of these used against helminthosis. Other plants treated wounds and ecto-parasites, theileriosis, retained placenta and bovine ephemeral fever. Non-plant practices (7) and plants cited were used in combination depending on availability. Males older than 40 years had most ethnopharmacological knowledge. Most plants (75%, n = 40) were common, but 10 were rare. IUCN status was not evaluated for 95% of these plants. Conventional and traditional drug use in Gulu and Mpigi districts was different (χ2 = 24; p < 0.001). The scientific, English, Luganda and Acholi names of all plants and their availability within the communities are documented herein. Conclusion This is the first detailed livestock-related ethnopharmacological study in Gulu district. Farmers in

  14. False Teeth Still a Public Health Problem among Children in Kanungu District--South Western Uganda 2006

    ERIC Educational Resources Information Center

    Stephen, Sebudde

    2006-01-01

    False teeth among children are a Public Health problem which has not received adequate attention in Uganda. This study was therefore developed as a community-based descriptive cross-sectional carried out in Kanungu District using qualitative methods of data collection among caregivers of children, Community Owned Resource Persons and Service…

  15. Prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda

    PubMed Central

    Wafula, Solomon Tsebeni; Ssemugabo, Charles; Namuhani, Noel; Musoke, David; Ssempebwa, John; Halage, Abdullah Ali

    2016-01-01

    Introduction Tungiasis is an endemic but neglected health problem in Uganda especially in resource poor communities. It is largely affecting rural communities in the Eastern, West Nile and Central regions. This study assessed prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda. Methods This was a cross sectional study that used a semi-structured questionnaire and observational checklist to collect quantitative data from 422 households in 12 villages. Prevalence of tungiasis was defined as presence of Tunga penetrans in the skin of any household member at the time of data collection. Results The prevalence of tungiasis was 22.5%. However, a big percentage 41.5% of households were reported to have had T. penetrans in the previous month while 49.5% had T. penetrans for more than one month. Majority (90.5%)of the participants used a pin, needle, or thorn to remove sand flea from infected body parts. Having dirty feet (AOR 3.86, CI (1.76-8.34)), dirty clothes (AOR 3.46, CI (2.00-5.97)), cracked house floor (AOR =6.28, CI (3.28-12.03)), dirty floor (AOR 3.21, CI (1.38-7.46)), littered compounds (AOR= 2.95, CI (1.66-5.26)) and rearing cattle (AOR 2.38, CI (1.28-4.45)) were associated with tungiasis. However, practicing preventive measures (AOR 0.51, CI (0.29-0.90)) was found protective for disease. Conclusion Tungiasis is still a prevalent health problem in rural communities in Eastern Uganda due to a number of individual (host) and environmental factors. There is need to increase awareness regarding improvement in sanitation and hygiene to enable communities’ implements interventions for prevention of T. penetrans.

  16. Prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda

    PubMed Central

    Wafula, Solomon Tsebeni; Ssemugabo, Charles; Namuhani, Noel; Musoke, David; Ssempebwa, John; Halage, Abdullah Ali

    2016-01-01

    Introduction Tungiasis is an endemic but neglected health problem in Uganda especially in resource poor communities. It is largely affecting rural communities in the Eastern, West Nile and Central regions. This study assessed prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda. Methods This was a cross sectional study that used a semi-structured questionnaire and observational checklist to collect quantitative data from 422 households in 12 villages. Prevalence of tungiasis was defined as presence of Tunga penetrans in the skin of any household member at the time of data collection. Results The prevalence of tungiasis was 22.5%. However, a big percentage 41.5% of households were reported to have had T. penetrans in the previous month while 49.5% had T. penetrans for more than one month. Majority (90.5%)of the participants used a pin, needle, or thorn to remove sand flea from infected body parts. Having dirty feet (AOR 3.86, CI (1.76-8.34)), dirty clothes (AOR 3.46, CI (2.00-5.97)), cracked house floor (AOR =6.28, CI (3.28-12.03)), dirty floor (AOR 3.21, CI (1.38-7.46)), littered compounds (AOR= 2.95, CI (1.66-5.26)) and rearing cattle (AOR 2.38, CI (1.28-4.45)) were associated with tungiasis. However, practicing preventive measures (AOR 0.51, CI (0.29-0.90)) was found protective for disease. Conclusion Tungiasis is still a prevalent health problem in rural communities in Eastern Uganda due to a number of individual (host) and environmental factors. There is need to increase awareness regarding improvement in sanitation and hygiene to enable communities’ implements interventions for prevention of T. penetrans. PMID:27642416

  17. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda.

    PubMed

    Musoke, David; Ekirapa-Kiracho, Elizabeth; Ndejjo, Rawlance; George, Asha

    2015-05-01

    Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. From the study, known health systems problems including inadequate transport, long distance to health facilities, long waiting times at facilities and poor quality of care were confirmed, but other aspects that needed to be addressed were also established. These included key gender-related determinants of maternal health, such as domestic violence, low contraceptive use and early teenage pregnancy, as well as problems of unclean water, poor sanitation and women's lack of income. Community members appreciated learning about the research findings precisely hence designing and implementing appropriate solutions to the problems identified because they could see photographs from their own local area. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders.

  18. Implementation of a comprehensive AIDS education programme for schools in Masaka District, Uganda.

    PubMed

    Kinsman, J; Harrison, S; Kengeya-Kayondo, J; Kanyesigye, E; Musoke, S; Whitworth, J

    1999-10-01

    As part of a large IEC (Information, Education and Communication)/STD intervention trial, a 19-lesson, comprehensive school-based AIDS education programme was implemented and evaluated in 50 primary and 16 secondary schools in 12 parishes of Masaka District, Uganda. A series of three teacher-training and evaluation workshops spread over a year was held in each parish, between which teachers implemented the programme in the classroom. One hundred and forty-eight teachers were trained and about 3,500 students were subsequently exposed to the programme. Both teachers and students responded positively, which suggests that this type of programme has much to offer young people who attend school. However, some problems were encountered: language, programme content, community resistance to teaching about condoms, and several practical issues. Proposed solutions include flexibility with the English language policy, alternative approaches to role play activities, targeting influential individuals with information about the need for young people to learn about safer sex, and a parallel community-based IEC programme to facilitate community acceptance of the need for the programme. In addition, implementation may be incomplete unless comprehensive AIDS education is fully incorporated into the curriculum, and properly examined. These findings are placed in the context of other life skills/AIDS education programmes being introduced both in Uganda and elsewhere in Africa.

  19. Challenges Faced by Village Health Teams (VHTs) in Amuru, Gulu and Pader Districts in Northern Uganda

    PubMed Central

    Kimbugwe, Geofrey; Mshilla, Maghanga; Oluka, Denis; Nalikka, Olivia; Kyangwa, Joseph; Zalwango, Stella; Kilizza, Uthuman; Turyasiima, Munanura; Ntambazi, Louis; Walugembe, Fred; Galiwango, Julius

    2015-01-01

    Primary health care provision through innovative community level interventions such as the Village Health Team (VHT) concept in Uganda can be a rational way of achieving universal access to healthcare. This cross-sectional study interviewed 150 VHT members and 16 key informants in three districts in Northern Uganda to establish the roles of VHTs, the service gaps encountered and the measures in place to address these gaps. Quantitative data were analyzed using SPSS 16.0. Direct content analysis of themes of transcribed qualitative data was conducted manually for common codes. The majority of the respondents 64.29% (n = 72) reported to have been VHT volunteers for more than 5 years. Among the roles were community mobilization reported by 99.1% (n = 111) and home visiting of individuals reported by 97.3% (n = 109). Lack of transport, motivation, adequate skills and community appreciation with nearly no measures in place to counteract the challenges was reported by almost all respondents. Although the VHT concept can be a significant means of achieving universal access to primary health care, extensive community involvement and motivation of the volunteers are highly needed for a maximum benefit. PMID:26301128

  20. Community perceptions and experiences of domestic violence and induced abortion in Wakiso district, Uganda.

    PubMed

    Kaye, Dan K

    2006-10-01

    In this qualitative research, the author explored (in general) whether domestic violence and induced abortion feature in men's and women's sexual and reproductive health experiences. In particular, he explored whether and how gender roles influence reproductive decision-making behavior regarding contraception, unwanted pregnancy, and induced abortion. The study area was Wakiso district in central Uganda, which surrounds the capital city, Kampala. The author collected data using in-depth interviews and focus group discussions and analyzed them using grounded theory. Effects of unplanned pregnancy were perceived to be gender specific. Unintended pregnancy and induced abortion as a health issue did not concern men. Rather, what concerned them was spouses' contraception, which they often strongly opposed. Consequently, covert contraceptive use was common. The author describes a relation between domestic violence, nonuse of contraception, unintended pregnancy, and induced abortion.

  1. Arbovirus infections and viral haemorrhagic fevers in Uganda: a serological survey in Karamoja district, 1984.

    PubMed

    Rodhain, F; Gonzalez, J P; Mercier, E; Helynck, B; Larouze, B; Hannoun, C

    1989-01-01

    Sera collected in May 1984 from 132 adult residents of Karamoja district, Uganda, were examined by haemagglutination inhibition tests for antibodies against selected arboviruses, namely Chikungunya and Semliki Forest alphaviruses (Togaviridae); dengue type 2, Wesselsbron, West Nile, yellow fever and Zika flaviviruses (Flaviviridae); Bunyamwera, Ilesha and Tahyna bunyaviruses (Bunyaviridae); and Sicilian sandfly fever phlebovirus (Bunyaviridae); and by immunofluorescence tests against certain haemorrhagic fever viruses, Lassa fever arenavirus (Arenaviridae), Ebola-Sudan, Ebola-Zaïre and Marburg filoviruses (Filoviridae), Crimean-Congo haemorrhagic fever nairovirus and Rift Valley fever phlebovirus (Bunyaviridae). Antibodies against Chikungunya virus were the most prevalent (47%), followed by flavivirus antibodies (16%), which were probably due mainly to West Nile virus. No evidence of yellow fever or dengue virus circulation was observed. A few individuals had antibodies against Crimean-Congo haemorrhagic fever, Lassa, Ebola and Marburg viruses, suggesting that these viruses all circulate in the area.

  2. Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda

    PubMed Central

    2013-01-01

    Background Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. Methods We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Results Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. Conclusion TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks -governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately. PMID:23915376

  3. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  4. Occurrence of anti-D alloantibodies among pregnant women in Kasese District, Western Uganda

    PubMed Central

    Mbalibulha, Yona; Muwanguzi, Enoch; Mugyenyi, Godfrey R; Natukunda, Bernard

    2015-01-01

    Objectives This study was undertaken to determine the distribution of ABO/RhD (rhesus D antigen) blood phenotypes, prevalence of anti-D alloantibodies, and the risk factors for alloimmunization among pregnant women in Kasese District, Western Uganda. Materials and methods Ethylenediamine tetraacetic acid-containing plasma samples and serum samples were taken from pregnant women attending the antenatal clinic. The blood groups were identified using the microplate grouping method, while the presence of anti-D alloantibodies was detected by the indirect antiglobulin test (IAT). Data were also collected from the pregnant women on the risk factors associated with anti-D alloantibody formation. Results Among the 726 participants, the blood group distribution was as follows: O: 356 (49.%); A: 190 (26.%); B: 152 (21%); and AB: 28 (4%). A total of 28 (3.86%) pregnant women were RhD negative. Anti-D alloantibodies were detected in 88 (12.1%) of the participants; and of these, 13 (14.8%) were RhD negative. Statistically significant risk factors for anti-D alloimmunization included miscarriage, stillbirth, and postpartum hemorrhage. Conclusion Blood group O was the most common among the pregnant women in this study and the prevalence of Rh negativity was 3.8%. The frequency of anti-D alloimmunization among pregnant women in Kasese District was 12.12%, with 85.5% of these being RhD positive. Risk factors such as a history of stillbirths, miscarriages, and incidence of postpartum hemorrhage were significantly associated with anti-D alloimmunization. There is a need to routinely carry out antenatal blood grouping and IAT screening on pregnant women in Uganda to detect anti-D alloimmunization. Given the high prevalence of anti-D alloantibody formation among RhD-positive women, we recommend additional research studies on the role of autoimmunity among antigen-positive women, as well as the occurrence of RhD variants plus their implications on hemolytic disease of the fetus and

  5. Domestic violence in rural Uganda: evidence from a community-based study.

    PubMed Central

    Koenig, Michael A.; Lutalo, Tom; Zhao, Feng; Nalugoda, Fred; Wabwire-Mangen, Fred; Kiwanuka, Noah; Wagman, Jennifer; Serwadda, David; Wawer, Maria; Gray, Ron

    2003-01-01

    Although domestic violence is an increasing public health concern in developing countries, evidence from representative, community-based studies is limited. In a survey of 5109 women of reproductive age in the Rakai District of Uganda, 30% of women had experienced physical threats or physical abuse from their current partner--20% during the year before the survey. Three of five women who reported recent physical threats or abuse reported three or more specific acts of violence during the preceding year, and just under a half reported injuries as a result. Analysis of risk factors highlights the pivotal roles of the male partner's alcohol consumption and his perceived human immunodeficiency virus (HIV) risk in increasing the risk of male against female domestic violence. Most respondents--70% of men and 90% of women--viewed beating of the wife or female partner as justifiable in some circumstances, posing a central challenge to preventing violence in such settings. PMID:12640477

  6. Prevalence and spatial distribution of Theileria parva in cattle under crop-livestock farming systems in Tororo District, Eastern Uganda

    PubMed Central

    2014-01-01

    Background Tick-borne diseases (TBDs) present a major economic burden to communities across East Africa. Farmers in East Africa must use acaracides to target ticks and prevent transmission of tick-borne diseases such as anaplasmosis, babesiosis, cowdriosis and theileriosis; the major causes of cattle mortality and morbidity. The costs of controlling East Coast Fever (ECF), caused by Theileria parva, in Uganda are significant and measures taken to control ticks, to be cost-effective, should take into account the burden of disease. The aim of the present work was to estimate the burden presented by T. parva and its spatial distribution in a crop-livestock production system in Eastern Uganda. Methods A cross sectional study was carried out to determine the prevalence and spatial distribution of T. parva in Tororo District, Uganda. Blood samples were taken from all cattle (n: 2,658) in 22 randomly selected villages across Tororo District from September to December 2011. Samples were analysed by PCR and T. parva prevalence and spatial distribution determined. Results The overall prevalence of T. parva was found to be 5.3%. Herd level prevalence ranged from 0% to 21% with majority of the infections located in the North, North-Eastern and South-Eastern parts of Tororo District. No statistically significant differences in risk of infection were found between age classes, sex and cattle breed. Conclusions T. parva infection is widely distributed in Tororo District, Uganda. The prevalence and distribution of T. parva is most likely determined by spatial distribution of R. appendiculatus, restricted grazing of calves and preferential tick control targeting draft animals. PMID:24589227

  7. Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda

    PubMed Central

    Bannink, Femke; Larok, Rita; Kirabira, Peter; Bauwens, Lieven; van Hove, Geert

    2015-01-01

    Introduction The intake of folic acid before conception and during the first trimester of pregnancy can prevent spina bifida. This paper describes folic acid intake in women in Gulu district in northern Uganda. Methods Structured interviews were held with 394 women attending antenatal care (ANC), 15 mothers of children with spina bifida, and 35 health workers in 2012 and 2013. SPSS16 was used for data analysis. Results 1/4 mothers of children with spina bifida took folic acid during late pregnancy, none preconception. None had knowledge about folic acid and spina bifida prevention. 33.5% of women attending ANC had ever heard about spina bifida, 1% knew folic acid intake can prevent spina bifida. 42.4% took folic acid supplements in late pregnancy, 8.1% during the first trimester, none preconception. All women said to have eaten food rich in folic acid. None were aware about fortified foods. 7% of health workers understood the importance of early folic acid intake. All health workers recommended folic acid intake to women attending ANC. 20% of the health workers and 25% of the women said folic acid supplements are not always available. Conclusion Folic acid intake is limited in northern Uganda. This is attributed to limited education and understanding of women and health workers about the importance of early folic acid intake, late presentation of women at ANC, poor supply chain and dilapidated health services caused by war and poverty. A combination of food fortification, sensitization of health workers, women, and improving folic acid supply is recommended. PMID:26090048

  8. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    PubMed Central

    Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

    2016-01-01

    Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

  9. Medicinal plants of Otwal and Ngai Sub Counties in Oyam District, Northern Uganda

    PubMed Central

    2011-01-01

    Background An ethnobotanical study was carried out in four parishes in the Ngai and Otwal Sub Counties in Oyam district, Northern Uganda, where insurgency has been prevalent for the past 20 years. Documenting medicinal plant species used in treating various health conditions among the local people. Methods Information was obtained from mainly the local population, the traditional healers and other experienced persons through interviews, formal and informal discussions and field excursions. Results Seventy one plant species were reported for use in the treatment of various diseases in the study area. These plant species belongs to 41 families, with Asteraceae being the most represented. Roots were ranked the commonest plant part used. Oral administration was the most frequently used route of administration. A total of 41 different health conditions were reported to be treated by use of medicinal plant species. Thirty nine percent of the recorded plant species were reported for treating stomach related ailments. Conclusion The use of medicinal plants in primary healthcare is still a common practice in Ngai and Otwal Sub Counties. The trust they have is built on the curative outcome properties claimed, poverty and armed conflict that lead to inadequate healthcare facilities. The generation gap caused by the over 20 years of insurgency in the area has brought about knowledge gap on the usage of medicinal plant species between the young and the older generation. PMID:21241484

  10. Ambient particulate matter air pollution in Mpererwe District, Kampala, Uganda: a pilot study.

    PubMed

    Schwander, Stephan; Okello, Clement D; Freers, Juergen; Chow, Judith C; Watson, John G; Corry, Melody; Meng, Qingyu

    2014-01-01

    Air quality in Kampala, the capital of Uganda, has deteriorated significantly in the past two decades. We made spot measurements in Mpererwe district for airborne particulate matter PM2.5 (fine particles) and coarse particles. PM was collected on Teflon-membrane filters and analyzed for mass, 51 elements, 3 anions, and 5 cations. Both fine and coarse particle concentrations were above 100 µg/m(3) in all the samples collected. Markers for crustal/soil (e.g., Si and Al) were the most abundant in the PM2.5 fraction, followed by primary combustion products from biomass burning and incinerator emissions (e.g., K and Cl). Over 90% of the measured PM2.5 mass can be explained by crustal species (41% and 59%) and carbonaceous aerosol (33%-55%). Crustal elements dominated the coarse particles collected from Kampala. The results of this pilot study are indicative of unhealthy air and suggest that exposure to ambient air in Kampala may increase the burden of environmentally induced cardiovascular, metabolic, and respiratory diseases including infections. Greater awareness and more extensive research are required to confirm our findings, to identify personal exposure and pollution sources, and to develop air quality management plans and policies to protect public health. PMID:24693293

  11. User fees, health staff incentives, and service utilization in Kabarole District, Uganda.

    PubMed Central

    Kipp, W.; Kamugisha, J.; Jacobs, P.; Burnham, G.; Rubaale, T.

    2001-01-01

    OBJECTIVE: To determine the impact of user fees on the utilization of health services in a community-based cost-sharing scheme in Kabarole District, western Uganda. METHODS: Of the 38 government health units that had introduced user-fee financing schemes, 11 were included in the study. Outpatient utilization was assessed as the median number of visits per month before and after cost sharing began. FINDINGS: After the introduction of cost sharing, overall utilization of general outpatient services, assessed by combining the data from all the participating units, dropped by 21.3%. Utilization increased, however, in facilities located in remote areas, while it decreased in those located in urban or semi-urban areas. The increased utilization in remote facilities was considered to be largely attributable to health workers' incentive payments derived from cost-sharing revenues. CONCLUSIONS: Incentive payments led the health workers to offer improved services. Other factors may also have been influential, such as an improved drug supply to health facilities and increased public identification with community projects in remote areas. PMID:11731810

  12. Responding to abuse: Children's experiences of child protection in a central district, Uganda.

    PubMed

    Child, Jennifer Christine; Naker, Dipak; Horton, Jennifer; Walakira, Eddy Joshua; Devries, Karen M

    2014-10-01

    Part of a comprehensive response to violence against children involves child protection systems, but there are few data available on such systems in low-income countries. This study describes the characteristics and help seeking behavior of children referred to local child protection services and the quality of the first-line response in one district in Uganda. Participants included 3,706 children from 42 primary schools who participated in a baseline survey on violence as part of the Good Schools Study (NCT01678846, clinicaltrial.gov). Children who disclosed violence were referred according to predefined criteria based on the type, severity, and timeframe of their experiences. Children were followed up to 4 months after the study ended. First-line responses by receiving agencies were classified into 3 categories: plan for action only, some action taken, and no plan and no action taken. Appropriateness of responses was based on which agency responded, timeliness of the response, quality of the documentation, and final status of the case. From the baseline survey, 529 children (14%) were referred. Girls were more likely to be referred and to meet the criteria for a serious case (9% girls, 4% boys). In total, 104 referrals (20%) had some kind of concrete action taken, but only 20 (3.8%) cases met all criteria for having received an adequate response. Nearly half (43%) of referred children had ever sought help by disclosing their experiences of violence prior to the baseline survey. In our study areas, the first-line response to children's reports of abuse was poor even though some referral structures are in place.

  13. Behavioral change communication strategy vital in malaria prevention interventions in rural communities: Nakasongola district, Uganda

    PubMed Central

    Mugisa, Margaret; Muzoora, Abel

    2012-01-01

    Introduction Malaria is a leading killer disease in Uganda and it accounts for significant morbidity in pregnant women and children. Pregnant women are more susceptible to malaria, which causes adverse effects including abortion, low birth weight and maternal anaemia. Children with severe malaria frequently develop one of these symptoms including: severe anaemia, respiratory distress, Prostration, convulsions and cerebral malaria. Due to the severity of the disease there is need for multiple interventions to reduce the disease burden. African Medical and Research Foundation (AMREF) adopted community based approaches to improve malaria prevention. Behavioral change communication (BCC) was fundamental at every process of Project implementation. This paper shares AMREF's experience in using BCC strategies amidst other interventions in malaria prevention approaches involving use of insecticide treated nets and environment management. Methods AMREF through a Malaria project (2007-2010) in Nakasongola district supported BCC activities through training, community mobilization, mass media, health promotion and advocacy. Program performance was measured through baseline and evaluation surveys in 2007 and 2010. Results The final project evaluation indicated improvement from baseline values as follows: knowledge on prevention of malaria among school children from 76.6% to 90%, under five children sleeping under bed net the previous night from 51% to 74.7%, and from 24% to 78% among pregnant women. Conclusion Mobilization of malaria prevention interventions can be successful once BCC approaches are adequately planned and coordinated. Malaria prevention through BCC strategies are likely to be more effective with integration of other malaria interventions, and involvement of community based structures. PMID:23467840

  14. Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

    PubMed Central

    Kovacic, Vanja; Tirados, Inaki; Esterhuizen, Johan; Mangwiro, Clement T. N.; Torr, Stephen J.; Lehane, Michael J.; Smith, Helen

    2013-01-01

    Background There is renewed vigour in efforts to eliminate neglected tropical diseases including sleeping sickness (human African trypanosomiasis or HAT), including attempts to develop more cost-effective methods of tsetse control. In the West Nile region of Uganda, newly designed insecticide-treated targets are being deployed over an area of ∼500 km2. The operational area covers villages where tsetse control has not been conducted previously. The effectiveness of the targets will depend, in part, on their acceptance by the local community. Methodology/Principal Findings We assessed knowledge, perceptions and acceptance of tsetse baits (traps, targets) in villages where they had or had not been used previously. We conducted sixteen focus group discussions with male and female participants in eight villages across Arua District. Discussions were audio recorded, translated and transcribed. We used thematic analysis to compare the views of both groups and identify salient themes. Conclusions/Significance Despite the villages being less than 10 km apart, community members perceived deployed baits very differently. Villagers who had never seen traps before expressed fear, anxiety and panic when they first encountered them. This was related to associations with witchcraft and “ghosts from the river” which are traditionally linked with physical or mental illness, death and misfortune. By contrast, villagers living in areas where traps had been used previously had positive attitudes towards them and were fully aware of their purpose and benefits. The latter group reported that they had similar negative perceptions when tsetse control interventions first started a decade ago. Our results suggest that despite their proximity, acceptance of traps varies markedly between villages and this is related to the duration of experience with tsetse control programs. The success of community-based interventions against tsetse will therefore depend on early engagements with

  15. Intestinal helminth infections and nutritional status of children attending primary schools in Wakiso District, Central Uganda.

    PubMed

    Lwanga, Francis; Francis, Lwanga; Kirunda, Barbara Eva; Orach, Christopher Garimoi

    2012-08-01

    A cross-sectional study to assess the prevalence of intestinal helminth infections and nutritional status of primary school children was conducted in the Wakiso district in Central Uganda. A total of 432 primary school children aged 6-14 years were randomly selected from 23 schools. Anthropometric measurements of weight, height, MUAC were undertaken and analyzed using AnthroPlus software. Stool samples were examined using a Kato-Katz method. The prevalence of stunting, underweight and moderate acute malnutrition (MAM) was 22.5%, 5.3% and 18.5% respectively. Males had a threefold risk of being underweight (OR 3.2, 95% CI 1.17-9.4, p = 0.011) and 2 fold risk of suffering from MAM (OR 2.1, 95% CI 1.21-3.48, p = 0.004). Children aged 10-14 years had a 2.9 fold risk of stunting (OR 2.9, 95% CI 1.37-6.16, p = 0.002) and 1.9 risk of MAM (OR 1.9, 95% CI 1.07-3.44, p = 0.019). Attending urban slum schools had 1.7 fold risk of stunting (OR 1.7, 95% CI 1.03-2.75, p = 0.027). Rural schools presented a twofold risk of helminth infection (OR 1.95, 95% CI 1.12-3.32, p = 0.012). The prevalence of helminth infections was (10.9%), (3.1%), (1.9%), (0.2%) for hookworm, Trichuriatrichiura, Schistosomamansoni and Ascarislumbricoides, respectively. The study revealed that 26.6%, 46% and 10.3% of incidences of stunting, underweight and MAM respectively were attributable to helminth infections.

  16. Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda

    PubMed Central

    Mubiru, Denis; Byabasheija, Robert; Bwanika, John Baptist; Meier, Joslyn Edelstein; Magumba, Godfrey; Kaggwa, Flavia Mpanga; Abusu, Jackson Ojera; Opio, Alex Chono; Lodda, Charles Clarke; Patel, Jaanki; Diaz, Theresa

    2015-01-01

    Objective Evidence is limited on whether Integrated Community Case Management (iCCM) improves treatment coverage of the top causes of childhood mortality (acute respiratory illnesses (ARI), diarrhoea and malaria). The coverage impact of iCCM in Central Uganda was evaluated. Methods Between July 2010 and December 2012 a pre-post quasi-experimental study in eight districts with iCCM was conducted; 3 districts without iCCM served as controls. A two-stage household cluster survey at baseline (n = 1036 and 1042) and end line (n = 3890 and 3844) was done in the intervention and comparison groups respectively. Changes in treatment coverage and timeliness were assessed using difference in differences analysis (DID). Mortality impact was modelled using the Lives Saved Tool. Findings 5,586 Village Health Team members delivered 1,907,746 treatments to children under age five. Use of oral rehydration solution (ORS) and zinc treatment of diarrhoea increased in the intervention area, while there was a decrease in the comparison area (DID = 22.9, p = 0.001). Due to national stock-outs of amoxicillin, there was a decrease in antibiotic treatment for ARI in both areas; however, the decrease was significantly greater in the comparison area (DID = 5.18; p<0.001). There was a greater increase in Artemisinin Combination Therapy treatment for fever in the intervention areas than in the comparison area but this was not significant (DID = 1.57, p = 0.105). In the intervention area, timeliness of treatments for fever and ARI increased significantly higher in the intervention area than in the comparison area (DID = 2.12, p = 0.029 and 7.95, p<0.001, respectively). An estimated 106 lives were saved in the intervention area while 611 lives were lost in the comparison area. Conclusion iCCM significantly increased treatment coverage for diarrhoea and fever, mitigated the effect of national stock outs of amoxicillin on ARI treatment, improved timeliness of treatments for fever and ARI and saved

  17. A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda.

    PubMed

    Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

    2016-03-01

    In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences.

  18. Gendered Distances: A Methodological Inquiry into Spatial Analysis as an Instrument for Assessing Gender Equality in Access to Secondary Schools in Mukono District, Uganda

    ERIC Educational Resources Information Center

    Wawro, Patrick R.

    2010-01-01

    This study focused on how accessibility to secondary schools in the Mukono District of Uganda is related to the sex and gender of the student and the distance that separates the student's home from the school they attend. This research is a methodological inquiry exploring the use of spatial analysis, specifically how cognitive and metric…

  19. A process evaluation of performance-based incentives for village health workers in Kisoro district, Uganda

    PubMed Central

    2014-01-01

    Background Designing effective incentive systems for village health workers (VHWs) represents a longstanding policy issue with substantial impact on the success and sustainability of VHW programs. Using performance-based incentives (PBI) for VHWs is an approach that has been proposed and implemented in some programs, but has not received adequate review and evaluation in the peer-reviewed literature. We conducted a process evaluation examining the use of PBI for VHWs in Kisoro, Uganda. In this system, VHWs are paid based on 20 indicators, divided among routine follow-up visits, health education activities, new patient identifications, sanitation coverage, and uptake of priority health services. Methods Surveys of VHWs (n = 30) and program supervisors (n = 7) were conducted to assess acceptability and feasibility. Interviews were conducted with all 8 program supervisors and with 6 purposively selected VHWs to gain a deeper understanding of their views on the PBI system. Program budget records were used to assess the costs of the program. Detailed payment records were used to assess the fairness of the PBI system with respect to VHWs’ gender, education level, and village location. Results In surveys and interviews, supervisors expressed high satisfaction with the PBI system, though some supervisors expressed concerns about possible negative effects from the variation in payments between VHWs and the uncertainty of reward for effort. VHWs perceived the system as generally fair, and preferred it to the previous payment system, but expressed a desire to be paid more. The annual program cost was $516 per VHW, with each VHW covering an average of 115 households. VHWs covering more households tended to earn more. There was some evidence that female gender was associated with higher earnings. Education level and proximity to the district hospital did not appear to be associated with earnings under the PBI system. Conclusions In a one-year pilot of PBI within a

  20. Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

    PubMed Central

    2010-01-01

    Background Northern Uganda unlike other rural regions has registered high HIV prevalence rates comparable to those of urbanized Kampala and the central region. This could be due to the linkages of culture, insecurity and HIV. We explored community perceptions of HIV and AIDS as a problem and its inter-linkage with culture and insecurity in Pader District. Methods A cross sectional qualitative study was conducted in four sub-counties of Pader District, Uganda between May and June 2008. Data for the study were collected through 12 focus group discussions (FGDs) held separately; 2 FGDs with men, 6 FGDs with women, and 4 FGDs with the youth (2 for each sex). In addition we conducted 15 key informant interviews with; 3 health workers, 4 community leaders at village and parish levels, 3 persons living with HIV and 5 district officials. Data were analysed using the content thematic approach. This process involved identification of the study themes and sub-themes following multiple reading of interview and discussion transcripts. Relevant quotations per thematic area were identified and have been used in the presentation of study findings. Results The struggles to meet the basic and survival needs by individuals and households overshadowed HIV as a major community problem. Conflict and risky sexual related cultural practices were perceived by communities as major drivers of HIV and AIDS in the district. Insecurity had led to congestion in the camps leading to moral decadence, rape and defilement, prostitution and poverty which increased vulnerability to HIV infection. The cultural drivers of HIV and AIDS were; widow inheritance, polygamy, early marriages, family expectations, silence about sex and alcoholism. Conclusions Development partners including civil society organisations, central government, district administration, religious and cultural leaders as well as other stakeholders should mainstream HIV in all community development and livelihood interventions in the

  1. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

    PubMed Central

    Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

    2016-01-01

    Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

  2. Influence of pregnancy perceptions on patterns of seeking antenatal care among women in reproductive age of Masaka District, Uganda.

    PubMed

    Atekyereza, Peter R; Mubiru, Kenneth

    2014-10-01

    Maternal mortality remains a challenge in Sub-Saharan Africa including Uganda. Antenatal Care (ANC) is one of the recommended measures to improve maternal and child health. However, the influence of pregnancy definition and perception on patterns of seeking regular and timely antenatal care among women in the reproductive age group (15-49 years) is not known. The objectives of this study were to: (i) understand the women's social definitions and perceptions on their pregnancy; (ii) understand the socio-cultural beliefs related to pregnancy among women of the reproductive age group; and, (iii) examine the influence of social definitions, perceptions and beliefs about pregnancy on women's antenatal care seeking behaviour patterns to inform the decentralised health care delivery system in Uganda. A total of 45 women, mothers and expectant women who were purposively selected from Kimanya sub county of Masaka district in Uganda participated in the study. Ten key informant interviews and four Focus Group Discussions (FGDs) were also conducted. Key findings indicate that the women's socio-definitions and perceptions of pregnancy influence their seeking behaviour on antenatal health care. To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and suffering. It is an uncomfortable and regrettable experience. Women also hold socio-cultural beliefs on pregnancy, which are culturally constructed and rooted in taboos, rituals and practices of their communities. It is therefore important to sensitise women and those who attend to them when they are pregnant to understand these perceptions and definitions to motivate them to seek antenatal and postnatal care for better maternal and child health. PMID:26891521

  3. Spatial Predictions of Rhodesian Human African Trypanosomiasis (Sleeping Sickness) Prevalence in Kaberamaido and Dokolo, Two Newly Affected Districts of Uganda

    PubMed Central

    Batchelor, Nicola A.; Atkinson, Peter M.; Gething, Peter W.; Picozzi, Kim; Fèvre, Eric M.; Kakembo, Abbas S. L.; Welburn, Susan C.

    2009-01-01

    The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT) within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda. PMID:20016846

  4. Participatory assessment of animal health and husbandry practices in smallholder pig production systems in three high poverty districts in Uganda.

    PubMed

    Dione, Michel M; Ouma, Emily A; Roesel, Kristina; Kungu, Joseph; Lule, Peter; Pezo, Danilo

    2014-12-01

    While animal health constraints have been identified as a major limiting factor in smallholder pig production in Uganda, researchers and policy makers lack information on the relative incidence of diseases and their impacts on pig production. This study aimed to assess animal health and management practices, constraints and opportunities for intervention in smallholder pig value chains in three high poverty districts of Uganda. Semi-qualitative interview checklists through Focus Group Discussions (FGDs) were administered to 340 pig farmers in 35 villages in Masaka, Kamuli and Mukono districts. Quantitative data was obtained during the exercise through group consensus. Results of FGDs were further triangulated with secondary data and information obtained from key informant interviews. Findings show that pig keeping systems are dominated by tethering and scavenging in rural areas. In peri-urban and urban areas, intensive production systems are more practiced, with pigs confined in pens. The main constraints identified by farmers include high disease burden such as African swine fever (ASF) and parasites, poor housing and feeding practices, poor veterinary services, ineffective drugs and a general lack of knowledge on piggery management. According to farmers, ASF is the primary cause of pig mortality with epidemics occurring mainly during the dry season. Worms and ectoparasites namely; mange, lice and flies are endemic leading to stunted growth which reduces the market value of pigs. Diarrhoea and malnutrition are common in piglets. Ninety-three percent of farmers say they practice deworming, 37% practice ectoparasite spraying and 77% castrate their boars. Indigenous curative treatments include the application of human urine and concoctions of local herbs for ASF control and use of old engine oil or tobacco extracts to control ectoparasites. There is a need for better technical services to assist farmers with these problems. PMID:25458705

  5. Participatory assessment of animal health and husbandry practices in smallholder pig production systems in three high poverty districts in Uganda.

    PubMed

    Dione, Michel M; Ouma, Emily A; Roesel, Kristina; Kungu, Joseph; Lule, Peter; Pezo, Danilo

    2014-12-01

    While animal health constraints have been identified as a major limiting factor in smallholder pig production in Uganda, researchers and policy makers lack information on the relative incidence of diseases and their impacts on pig production. This study aimed to assess animal health and management practices, constraints and opportunities for intervention in smallholder pig value chains in three high poverty districts of Uganda. Semi-qualitative interview checklists through Focus Group Discussions (FGDs) were administered to 340 pig farmers in 35 villages in Masaka, Kamuli and Mukono districts. Quantitative data was obtained during the exercise through group consensus. Results of FGDs were further triangulated with secondary data and information obtained from key informant interviews. Findings show that pig keeping systems are dominated by tethering and scavenging in rural areas. In peri-urban and urban areas, intensive production systems are more practiced, with pigs confined in pens. The main constraints identified by farmers include high disease burden such as African swine fever (ASF) and parasites, poor housing and feeding practices, poor veterinary services, ineffective drugs and a general lack of knowledge on piggery management. According to farmers, ASF is the primary cause of pig mortality with epidemics occurring mainly during the dry season. Worms and ectoparasites namely; mange, lice and flies are endemic leading to stunted growth which reduces the market value of pigs. Diarrhoea and malnutrition are common in piglets. Ninety-three percent of farmers say they practice deworming, 37% practice ectoparasite spraying and 77% castrate their boars. Indigenous curative treatments include the application of human urine and concoctions of local herbs for ASF control and use of old engine oil or tobacco extracts to control ectoparasites. There is a need for better technical services to assist farmers with these problems.

  6. Prevalence and risk factors of Echinococcus granulosus infection in dogs in Moroto and Bukedea districts in Uganda.

    PubMed

    Oba, Peter; Ejobi, Francis; Omadang, Leonard; Chamai, Martin; Okwi, Andrew Livex; Othieno, Emmanuel; Inangolet, Francis Olaki; Ocaido, Michael

    2016-02-01

    A cross sectional study was conducted in Moroto and Bukedea districts of Uganda from May to September 2013 to determine the prevalence and risk factors of Echinococcus granulosus infection in dogs. Fresh dog faecal samples were collected, preserved in 70 % ethanol, and later screened for presence of taeniid eggs using zinc chloride floatation method. Positive samples were confirmed by a copro-PCR (polymerase chain reaction) for E. granulosus using NADH dehydrogenase sub-unit 1 gene (NADH1) as a target molecular marker. Structured questionnaires and focus group discussions were used to collect quantitative and qualitative data for risk factor identification. Study sub-counties were selected by simple random sampling. Overall apparent prevalence of taeniid infection in dogs of 14.9 % (39/261, confidence interval 10.6-19.2) in both districts was recorded using the faecal floatation test. The sensitivity of the faecal floatation test was found to be 78 % (25/32), while the specificity was 93 % (215/229). Copro-PCR results revealed a true prevalence of 14.4 % (9.91-19.0, 95 % CI) in dogs in Moroto district and 7.4 % (2.14-12.60, 95 % CI) in Bukedea district. The overall true prevalence of cystic echinococcosis (CE) was 12.2 % (8.70-15.76, 95 % CI) in both districts. The major risk factors identified using logistic regression were uncontrolled access of dogs to animal slaughter facilities, higher cattle herd sizes and lack of knowledge about the disease. It was recommended that restricting dog access to infected tissues and public health education about epidemiology of CE should be done. PMID:26526956

  7. Prevalence and risk factors of Echinococcus granulosus infection in dogs in Moroto and Bukedea districts in Uganda.

    PubMed

    Oba, Peter; Ejobi, Francis; Omadang, Leonard; Chamai, Martin; Okwi, Andrew Livex; Othieno, Emmanuel; Inangolet, Francis Olaki; Ocaido, Michael

    2016-02-01

    A cross sectional study was conducted in Moroto and Bukedea districts of Uganda from May to September 2013 to determine the prevalence and risk factors of Echinococcus granulosus infection in dogs. Fresh dog faecal samples were collected, preserved in 70 % ethanol, and later screened for presence of taeniid eggs using zinc chloride floatation method. Positive samples were confirmed by a copro-PCR (polymerase chain reaction) for E. granulosus using NADH dehydrogenase sub-unit 1 gene (NADH1) as a target molecular marker. Structured questionnaires and focus group discussions were used to collect quantitative and qualitative data for risk factor identification. Study sub-counties were selected by simple random sampling. Overall apparent prevalence of taeniid infection in dogs of 14.9 % (39/261, confidence interval 10.6-19.2) in both districts was recorded using the faecal floatation test. The sensitivity of the faecal floatation test was found to be 78 % (25/32), while the specificity was 93 % (215/229). Copro-PCR results revealed a true prevalence of 14.4 % (9.91-19.0, 95 % CI) in dogs in Moroto district and 7.4 % (2.14-12.60, 95 % CI) in Bukedea district. The overall true prevalence of cystic echinococcosis (CE) was 12.2 % (8.70-15.76, 95 % CI) in both districts. The major risk factors identified using logistic regression were uncontrolled access of dogs to animal slaughter facilities, higher cattle herd sizes and lack of knowledge about the disease. It was recommended that restricting dog access to infected tissues and public health education about epidemiology of CE should be done.

  8. Community knowledge and perceptions about indoor residual spraying for malaria prevention in Soroti district, Uganda: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Malaria is the leading cause of morbidity and mortality in Uganda. The Ministry of Health (MoH) plans to scale up indoor residual spraying (IRS) for malaria vector control. However, there is limited information on community knowledge and perceptions towards IRS. This study assessed community knowledge and perceptions about IRS in Soroti district, eastern Uganda. Methods The study was cross-sectional and it covered 770 randomly selected households in urban and rural settings in Soroti district, Eastern Uganda. The respondents were heads of household and or their proxies. The data were collected on the sociodemographic characteristics, knowledge of the insecticides that could be used for IRS, parts of the houses that would be sprayed, importance of IRS, role of household heads in IRS programme, frequency and the time of spraying. Responses to the questions on these areas were used to create a composite dependent variable categorized as knowledgeable if they had responded correctly to at least three questions or not knowledgeable about IRS if they responded correctly to less than three questions. In addition, respondents were asked if they thought the IRS programme would be beneficial or not. Bivariate and multivariate logistic regression analyses were carried out using SPSS version 17. Results Less than half, (48.6%, 374/770) of the respondents were knowledgeable about IRS. Urban residents (AOR 1.92, 95% CI 1.04-3.56) and those with secondary education or higher (AOR 4.81, 95% CI 2.72-8.52) were knowledgeable about IRS. Three-quarters, (74.4%, 354/473) of respondents who had ever heard of IRS, perceived it as beneficial. Two-thirds, (66.4%, 314/473) reported that IRS would have negative effects. Respondents who reported that, IRS programme is beneficial were: 23 years or older (AOR 2.17, 95% CI 1.07-4.38), had attained secondary education or higher (AOR 2.16, 95% CI 1.22-3.83) and were knowledgeable about IRS (AOR 2.21, 95% CI 1.17-4.17). Conclusions

  9. E-governance in the developing world in action: the case of DistrictNet in Uganda.

    PubMed

    Van Reijswoud, Victor; De Jager, Arjan

    2007-01-01

    E-Governance is a powerful tool to bring about change to the government processes in the developing world. E-governance operates at the cross roads between Information and Communication Technology and government processes and is divided in three overlapping domains: e-administration, e-services and e-society. In order to be successful, e-governance needs to be firmly embedded in the existing government processes, needs to be politically and technically supported by the governments and provide users reasons to go and stay on-line. In order to maximize the impact, process change needs to be considered part and parcel of e-governance. In this report we present and evaluate an e-governance programme in Uganda - East Africa. The programme, DistrictNet, tries to provide transparency at a local government level and improve the provision of public information through the implementation of ICT. DistrictNet started in 2002 and is on-going. The achievements of the programme are presented and evaluated against three domains of e-governance and the impact on the government processes. On the basis of the evaluation we elicit lessons learned to guide similar programmes at the local government levels in the developing world. PMID:17621772

  10. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda

    PubMed Central

    Pearson, Raewynne; Kankya, Clovice; Kajura, Charles; Alinaitwe, Lordrick; Kakooza, Steven; Pelican, Katharine M.; Travis, Dominic A.; Mahero, Michael; Boulware, David R.; Mugisha, Lawrence

    2016-01-01

    Background The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda. Methodology and Principal Findings 359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2–40.3%) defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95%CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer ≥1:800) was 1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys nearby. Conclusions/Significance The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis should be a diagnostic consideration in febrile illness and “smear-negative malaria” in rural East Africa. PMID:27487398

  11. Missed opportunities in the diagnosis and management of protein energy malnutrition among children under 5 years in Wakiso district, Uganda.

    PubMed

    Akugizibwe, Roselyne; Kasolo, Josephine; Makubuya, Duncan B; Damani, Ali M

    2013-11-30

    Protein energy malnutrition (PEM) is one of the leading causes of death among children below 5 years in Uganda. It develops after acute childhood illnesses despite children having received treatment from health facilities. This study assessed knowledge and practices of health workers in the diagnosis and management of PEM, which was used to establish missed opportunities to prevent severe acute malnutrition (SAM) in its management. This was a cross sectional descriptive study that used questionnaires and observation of health workers at Health Center IV (HCIV) in Wakiso district, Uganda. The clinical nutrition diagnosis of the children was then obtained. There were 44 health workers that assessed 225 children. Most of the health workers 32 (72.7%) had education in PEM management and over 60% of them knew the forms of PEM, clinical signs of kwashiorkor and marasmus and the factors that predispose to PEM. Health workers did not weigh 56 (24.9%) of the children, 193 (86%) children had no height taken and only 32 (14.2%) had mid upper arm circumference measured. The weight for height of 223 (99.2%) and weight for age of 109 (93%) children was not calculated. Only 38 (16.89%) were examined for edema and 40 (17.78%) for muscle wasting. Health workers diagnosed only 21 (9%) children with malnutrition, while researchers found 94 (31.9%) with malnutrition. Children who missed opportunity to have malnutrition diagnosed at the health facility were 73 (32.9%). The knowledge of health workers on PEM is adequate, but their practice is inadequate. There is missed opportunity to diagnose and manage PEM among children who present with acute illnesses at the health centers, hence missed opportunity to prevent SAM.

  12. Using burden of disease/cost-effectiveness as an instrument for district health planning: experiences from Uganda.

    PubMed

    Jeppsson, Anders; Okuonzi, Sam Agatre; Ostergren, Per-Olof; Hagström, Bo

    2004-12-01

    The burden of disease/cost-effectiveness analysis (BoD/CE) was introduced as a method for detailed planning and budgeting in 13 districts of Uganda. This endeavor can be seen as a "natural experiment", attempting to pursue policy implementation by means of a heavy focus on rationalistic/technical arguments as a main supportive factor. However, modern theory of policy implementation, e.g. the new institutionalism postulate that the implementation process is far from a passive diffusion process which only would need support by technical rationality, and that the result of the implementation process often is very different from prior expectations and depend on a number of factors in the so called translation process. The aim of this paper was to study the outcome of the mentioned "natural experiment" and, if the outcome diverted from the intended ones (which we hypothesized), to analyze some of the reasons for this by using the theoretical framework of new institutionalism. District budgets as well as actual expenditures before and after the introduction of the BoD and CE methods were analyzed. District health officials were interviewed to obtain their views and experiences of the method. Our study of budget allocations and actual expenditures revealed an increasing discrepancy from the pattern shown in the BoD/CE analysis. The district officials were positive about the methods but stated that it had to be used together with other methods. However, we found that the seemingly pure focus of BoD/CE, i.e. technical efficiency of budget allocations at the district level, collided with issues of accountability. The final budgets, and even more, the actual expenditures can be seen as the outcome of negotiation processes where other rationalities have considered, that is the translation process. This implies that the "technical" issue of efficiency has to become better understood and integrated in the notion of an accountable health care system at the district level. It is

  13. Occurrence of porcine cysticercosis in free-ranging pigs delivered to slaughter points in Arapai, Soroti district, Uganda.

    PubMed

    Zirintunda, Gerald; Ekou, Justine

    2015-01-01

    Poverty, hunger and the need for production of pigs with meagre or zero inputs have made most farmers release their pigs to range freely, thus creating a pig-human cycle that maintains Taenia solium, the pig tapeworm and cause of porcine cysticercosis, in the ecosystem. A preliminary study was designed to establish the prevalence of porcine cysticercosis by postmortem examination of the tongue and carcass of free-range pigs from February to April 2014 in Arapai subcounty, Soroti district, eastern Uganda. The tongue of each pig was extended and examined before deep incisions were made and the cut surfaces were examined. The rest of the carcasses were examined for cysts. Out of 178 pigs examined, 32 were qualitatively positive for porcine cysticercosis, representing a prevalence of 18.0%. This high prevalence represents a marked risk to the communities in the study area of neurocysticercosis, a debilitating parasitic zoonosis. Proper human waste disposal by use of pit latrines, confinement of free-range pigs and treatment with albendazole and oxfendazole are recommended. PMID:26244682

  14. Occurrence of porcine cysticercosis in free-ranging pigs delivered to slaughter points in Arapai, Soroti district, Uganda.

    PubMed

    Zirintunda, Gerald; Ekou, Justine

    2015-06-11

    Poverty, hunger and the need for production of pigs with meagre or zero inputs have made most farmers release their pigs to range freely, thus creating a pig-human cycle that maintains Taenia solium, the pig tapeworm and cause of porcine cysticercosis, in the ecosystem. A preliminary study was designed to establish the prevalence of porcine cysticercosis by postmortem examination of the tongue and carcass of free-range pigs from February to April 2014 in Arapai subcounty, Soroti district, eastern Uganda. The tongue of each pig was extended and examined before deep incisions were made and the cut surfaces were examined. The rest of the carcasses were examined for cysts. Out of 178 pigs examined, 32 were qualitatively positive for porcine cysticercosis, representing a prevalence of 18.0%. This high prevalence represents a marked risk to the communities in the study area of neurocysticercosis, a debilitating parasitic zoonosis. Proper human waste disposal by use of pit latrines, confinement of free-range pigs and treatment with albendazole and oxfendazole are recommended.

  15. THE GENERATION, USE AND DISPOSAL OF WASTE CRANKCASE OIL IN DEVELOPING COUNTRIES: A CASE FOR KAMPALA DISTRICT, UGANDA

    PubMed Central

    Ssempebwa, John C.; Carpenter, David O.

    2008-01-01

    Waste Crankcase Oil (WCO), the oil that is removed from motor engines during an oil change, is frequently discarded into the environment, resulting in pollution of both aquatic and terrestrial ecosystems. In some developing countries, this common hazardous material is not properly managed. In Uganda little is known about its generation, utilization, and disposal. These factors were investigated using in-depth interviews of a sample of mechanics from 379 motor repair garages and 109 fuel stations in the Kampala district. Most garages (94%) and fuel stations (96%) in the study area offered oil-changing services. On average, each garage produced 62 litres, and each fuel station produced 134 litres of WCO per week. In garages 35% was sold, 16% poured on the ground, 18% taken by vehicle owners and 31% given away for free. At fuel stations, 49% was picked by private collectors, 27% sold, 4% poured on the ground, 2% burnt, 13% taken by vehicle owners, and 6% given away for free. Uses of WCO included coating roofing timber and fencing posts, use in timber cutting, marking play grounds, and pest control in animals. Its disposal involved burning, and pouring in the environment. Lack of policy and information for proper handling of WCO contributed to the poor management of WCO exhibited. PMID:18513868

  16. Maternal mortality estimated using the Sisterhood method in Gulu district, Uganda.

    PubMed

    Orach, C G

    2000-04-01

    A community-based retrospective maternal mortality study using the Sisterhood method was conducted in Gulu district between February and March 1996. The objectives were to estimate the magnitude of and identify factors associated with maternal mortality in the district. A total of 5522 adult respondents, randomly selected from 27 parishes, of the five counties in the district were interviewed. Between 1960-1996 324 maternal deaths occurred in the sisterhood sample. The maternal mortality rate (MMR) was estimated to be 662 per 100,000 deliveries [95% confidence interval (CI) 421-839 per 100 deliveries]. The leading causes of maternal death were: haemorrhage 45.1%; obstructed labour 26.2%; puerperal sepsis 9.6%; anaemia 2.2%; AIDS 2.2%; and gunshot wounds (GSW) 1.0%. Factors associated with maternal mortality included: age--31.8% of the mothers who died were below 20 years; education--57.1% had no formal education; 65% of the mothers had delivered at home, 50.6% had been attended to by untrained traditional birth attendants (TBAs), while 37.8% were attended to by relatives. The MMR was found to be 1.3 times higher than the estimated national MMR of 500 per 100,000 deliveries. Most maternal deaths (80.9%) were due to preventable causes, being related to low socioeconomic status and low-level education of women in the district. The intractable civil war in the district was a major underlying and contributory factor to the high maternal mortality in the area. A multifaceted approach to reduce maternal mortality in the district should target improving the socioeconomic conditions in the district with special emphasis on encouraging and supporting female education. Intensive education on maternal healthcare in antenatal clinics be conducted targeting husbands/spouses and relatives who care for the prenatal/pregnant and postnatal mothers. There is need for more trained TBAs per village who should be given effective support supervision. Ambulance transport services, motor

  17. Understanding low uptake of mass treatment for intestinal schistosomiasis among school children: a qualitative study in Jinja district, Uganda.

    PubMed

    Muhumuza, Simon; Olsen, Annette; Nuwaha, Fred; Katahoire, Anne

    2015-07-01

    Despite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.

  18. Promising Perceptions, Divergent Practices and Barriers to Integrated Malaria Prevention in Wakiso District, Uganda: A Mixed Methods Study

    PubMed Central

    Musoke, David; Miiro, George; Karani, George; Morris, Keith; Kasasa, Simon; Ndejjo, Rawlance; Nakiyingi-Miiro, Jessica; Guwatudde, David; Musoke, Miph Boses

    2015-01-01

    Background The World Health Organization recommends use of multiple approaches to control malaria. The integrated approach to malaria prevention advocates the use of several malaria prevention methods in a holistic manner. This study assessed perceptions and practices on integrated malaria prevention in Wakiso district, Uganda. Methods A clustered cross-sectional survey was conducted among 727 households from 29 villages using both quantitative and qualitative methods. Assessment was done on awareness of various malaria prevention methods, potential for use of the methods in a holistic manner, and reasons for dislike of certain methods. Households were classified as using integrated malaria prevention if they used at least two methods. Logistic regression was used to test for factors associated with the use of integrated malaria prevention while adjusting for clustering within villages. Results Participants knew of the various malaria prevention methods in the integrated approach including use of insecticide treated nets (97.5%), removing mosquito breeding sites (89.1%), clearing overgrown vegetation near houses (97.9%), and closing windows and doors early in the evenings (96.4%). If trained, most participants (68.6%) would use all the suggested malaria prevention methods of the integrated approach. Among those who would not use all methods, the main reasons given were there being too many (70.2%) and cost (32.0%). Only 33.0% households were using the integrated approach to prevent malaria. Use of integrated malaria prevention by households was associated with reading newspapers (AOR 0.34; 95% CI 0.22 –0.53) and ownership of a motorcycle/car (AOR 1.75; 95% CI 1.03 – 2.98). Conclusion Although knowledge of malaria prevention methods was high and perceptions on the integrated approach promising, practices on integrated malaria prevention was relatively low. The use of the integrated approach can be improved by promoting use of multiple malaria prevention methods

  19. Identification of Echinococcus granulosus strains using polymerase chain reaction-restriction fragment length polymorphism amongst livestock in Moroto district, Uganda.

    PubMed

    Chamai, Martin; Omadang, Leonard; Erume, Joseph; Ocaido, Michael; Oba, Peter; Othieno, Emmanuel; Bonaventure, Straton; Kitibwa, Annah

    2016-01-01

    A descriptive study was conducted to identify the different strains of Echinococcus granulosus occurring in livestock in Moroto district, Uganda. Echinococcus cysts from 104 domestic animals, including cattle, sheep, goats and camels, were taken and examined by microscopy, polymerase chain reaction with restriction fragment length polymorphism and Sanger DNA sequencing. Echinococcus granulosus genotypes or strains were identified through use of Bioinformatics tools: BioEdit, BLAST and MEGA6. The major finding of this study was the existence of a limited number of E. granulosus genotypes from cattle, goats, sheep and camels. The most predominant genotype was G1 (96.05%), corresponding to the common sheep strain. To a limited extent (3.95%), the study revealed the existence of Echinococcus canadensis G6/7 in three (n = 3) of the E. granulosus-positive samples. No other strains of E. granulosus were identified. It was concluded that the common sheep strain of Echinococcus sensu stricto and G6/7 of E. canadensis were responsible for echinococcal disease in Moroto district, Uganda. PMID:27543147

  20. Identification of Echinococcus granulosus strains using polymerase chain reaction-restriction fragment length polymorphism amongst livestock in Moroto district, Uganda.

    PubMed

    Chamai, Martin; Omadang, Leonard; Erume, Joseph; Ocaido, Michael; Oba, Peter; Othieno, Emmanuel; Bonaventure, Straton; Kitibwa, Annah

    2016-07-29

    A descriptive study was conducted to identify the different strains of Echinococcus granulosus occurring in livestock in Moroto district, Uganda. Echinococcus cysts from 104 domestic animals, including cattle, sheep, goats and camels, were taken and examined by microscopy, polymerase chain reaction with restriction fragment length polymorphism and Sanger DNA sequencing. Echinococcus granulosus genotypes or strains were identified through use of Bioinformatics tools: BioEdit, BLAST and MEGA6. The major finding of this study was the existence of a limited number of E. granulosus genotypes from cattle, goats, sheep and camels. The most predominant genotype was G1 (96.05%), corresponding to the common sheep strain. To a limited extent (3.95%), the study revealed the existence of Echinococcus canadensis G6/7 in three (n = 3) of the E. granulosus-positive samples. No other strains of E. granulosus were identified. It was concluded that the common sheep strain of Echinococcus sensu stricto and G6/7 of E. canadensis were responsible for echinococcal disease in Moroto district, Uganda.

  1. Economic effects of foot and mouth disease outbreaks along the cattle marketing chain in Uganda

    PubMed Central

    Baluka, Sylvia Angubua

    2016-01-01

    Aim: Disease outbreaks increase the cost of animal production; reduce milk and beef yield, cattle sales, farmers’ incomes, and enterprise profitability. The study assessed the economic effects of foot and mouth disease (FMD) outbreaks along the cattle marketing chain in selected study districts in Uganda. Materials and Methods: The study combined qualitative and quantitative study designs. Respondents were selected proportionally using simple random sampling from the sampling frame comprising of 224, 173, 291, and 185 farmers for Nakasongola, Nakaseke, Isingiro, and Rakai, respectively. Key informants were selected purposively. Data analysis combined descriptive, modeling, and regression analysis. Data on the socio-economic characteristics and how they influenced FMD outbreaks, cattle markets revenue losses, and the economic cost of the outbreaks were analyzed using descriptive measures including percentages, means, and frequencies. Results: Farmers with small and medium herds incurred higher control costs, whereas large herds experienced the highest milk losses. Total income earned by the actors per month at the processing level reduced by 23%. In Isingiro, bulls and cows were salvage sold at 83% and 88% less market value, i.e., a loss of $196.1 and $1,552.9 in small and medium herds, respectively. Conclusion: All actors along the cattle marketing chain incur losses during FMD outbreaks, but smallholder farmers are most affected. Control and prevention of FMD should remain the responsibility of the government if Uganda is to achieve a disease-free status that is a prerequisite for free movement and operation of cattle markets throughout the year which will boost cattle marketing. PMID:27397974

  2. An Evaluation of the Relationship between Supervisory Techniques and Organizational Outcomes among the Supervisors in the Agricultural Extension Service in the Eastern Region Districts of Uganda. Summary of Research 81.

    ERIC Educational Resources Information Center

    Padde, Paul; And Others

    A descriptive study examined the relationship between supervisory techniques and organizational outcomes among supervisors in the agricultural extension service in eight districts in eastern Uganda. Self-rating and rater forms of the Multifactor Leadership Questionnaire were sent to 220 extension agents, 8 field supervisors, and 8 deputy field…

  3. Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda

    PubMed Central

    2014-01-01

    Background Uptake of HIV testing by men remains low in high prevalence settings in many parts of Africa. By focusing on masculinity, this study explores the social context and relations that shape men’s access to HIV testing in Mam-Kiror, Busia district, rural eastern Uganda. Methods From 2009–2010 in-depth interviews were undertaken with 26 men: nine being treated for HIV, eight who had tested but dropped out of treatment, six not tested but who suspected HIV infection and three with other health problems unrelated to HIV. These data were complemented by participant observation. Thematic analysis was undertaken. Results There were two main categories of masculinity in Mam-Kiror, one based on ‘reputation’ and the other on ‘respectability’, although some of their ideals overlapped. The different forms of masculine esteem led to different motives for HIV testing. Men positioned HIV testing as a social process understood within the social context and relationships men engaged in rather than an entirely self-determined enterprise. Wives’ inferior power meant that they had less influence on men’s testing compared to friends and work colleagues who discussed frankly HIV risk and testing. Couple testing exposed men’s extra-marital relationships, threatening masculine esteem. The fear to undermine opportunities for sex in the context of competition for partners was a barrier to testing by men. The construction of men as resilient meant that they delayed to admit to problems and seek testing. However, the respectable masculine ideal to fulfil responsibilities and obligations to family was a strong motivator to seeking an HIV test and treatment by men. Conclusion The two main forms of masculine ideals prevailing in Mam-Kiror in Busia led men to have different motives for HIV testing. Reputational masculinity was largely inconsistent with the requirements of couple testing, community outreach testing and the organisation of testing services, discouraging men

  4. Health Seeking Behaviours among Caretakers of Children with Nodding Syndrome in Pader District - Northern Uganda: A Mixed Methods Study

    PubMed Central

    Atim, Pamela; Ochola, Emmanuel; Ssendagire, Stephen; Rutebemberwa, Elizeus

    2016-01-01

    Background Nodding syndrome is a neurological disorder which had affected about 3000 children with over 170 deaths in northern Uganda by 2012. With limited data on health seeking, the study aimed to assess the health seeking behavior and associated factors among caretakers of children with nodding syndrome in Pader district. Methods A mixed methods cross sectional study was conducted in July 2013 among 249 caretakers of children with nodding syndrome in three sub-counties of Pader. Respondents were consecutively interviewed using semi-structured questionnaires. Eleven key informants were additionally interviewed. We determined the associations of various factors with health care seeking and obtained adjusted odds ratios and 95% confidence intervals using logistic regression model. Quantitative data was analysed using Stata version 12 while qualitative data was analysed manually and quotes reported. Results Most caretakers, 78.3% (195/249) sought care first from a health facility, 12.9% (32/249) visited traditional healers and 8.8% (22/249) self-medicated. Of those who sought care from a health facility, 50% sought care after a month. Factors associated with improved care seeking included: Time taken to reach care 1–3 hours; adjusted odds ratio = 6.4 (95% CI = 2.96–14.03), time spent in care above five years; adjusted odds ratio = 12.0 (95% CI: 1.24–117.73) and changed care seeking place; adjusted odds ratio = 17.2 (95% CI: 3.64–81.67). Conclusion/ Recommendation Caretakers sought care from multiple places. One in five caretakers still sought care outside a formal health facility. Many respondents who sought care first from health facilities went late, at least one month after symptoms onset. Factors associated with health seeking included distance, duration in treatment and not having changing care provider. There is need for massive sensitization of community to enhance prompt care seeking. More research is needed to elucidate the cause, thus finding the

  5. Profiles and outcome of traditional healing practices for severe mental illnesses in two districts of Eastern Uganda

    PubMed Central

    Abbo, Catherine

    2011-01-01

    Background The WHO estimates that more than 80% of African populations attend traditional healers for health reasons and that 40%–60% of these have some kind of mental illness. However, little is known about the profiles and outcome of this traditional approach to treatment. Objective The purpose of this study was to describe the profiles and outcome of traditional healing practices for severe mental illnesses in Jinja and Iganga districts in the Busoga region of Eastern Uganda. Methods Four studies were conducted. Study I used focus group discussions (FGDs) with case vignettes with local community members and traditional healers to explore the lay concepts of psychosis. Studies II and III concerned a cross-sectional survey of patients above 18 years at the traditional healer's shrines and study IV was made on a prospective cohort of patients diagnosed with psychosis in study III. Manual content analysis was used in study I; quantitative data in studies II, III, and IV were analyzed at univariate, bivariate, and multivariate levels to determine the association between psychological distress and socio-demographic factors; for study IV, factors associated with outcome were analyzed. One-way ANOVA for independent samples was the analysis used in Study IV. Results The community gave indigenous names to psychoses (mania, schizophrenia, and psychotic depression) and had multiple explanatory models for them. Thus multiple solutions for these problems were sought. Of the 387 respondents, the prevalence of psychological distress was 65.1%, where 60.2% had diagnosable current mental illness, and 16.3% had had one disorder in their lifetime. Over 80% of patients with psychosis used both biomedical and traditional healing systems. Those who combined these two systems seemed to have a better outcome. All the symptom scales showed a percentage reduction of more than 20% at the 3- and 6-month follow-ups. Conclusion Traditional healers shoulder a large burden of care of patients

  6. Extent of Use of Aloe vera Locally Extracted Products for Management of Ailments in Communities of Kitagata Sub-county in Sheema District, Western Uganda

    PubMed Central

    Adams, Kamukama; Eliot, Twineomujuni; Gerald, Agaba

    2015-01-01

    Aloe vera is widely used locally in communities in Uganda as a medicinal plant. It is said to contain various nutrient substances and vitamins that have curative properties. It is said to heal a variety of diseases in various communities. However the extent of use of this potential medicinal plant in Uganda and the various ailments for which it is used and the treatment outcomes are not clearly established and documented. In this cross-sectional study, carried out in August 2012 in Kitagata sub-county in Sheema district in western Uganda, data was collected from 131 randomly selected adult respondents using an interviewer administered semi-structured questionnaire. Key informants interviews and focused group discussions were also carried out with purposively selected participants. Data were collected on social demographic characteristics, practices and beliefs about Aloe vera. The data were analyzed using Excel version 2007 and Epi_Info software. To get the proportion of the community that use Aloe vera, the number of respondents that use aloe vera was expressed as a percentage of the total number of respondents. It was found out that all the respondents (100%) know aloe vera plant, 96.1% think that it can cure and 84.7% have ever used it. 90.9% of the respondents believe that Aloe vera is effective in curing ailments. 82.9% of these strongly believe in Aloe vera’s effectiveness. The diseases reported included malaria (31%), wounds (23%), abdominal pains (16%) and skin diseases (9%) among others. It was significantly noted that all the participants who had ever used Aloe vera still believe in it. 92.0% respondents reported that they can recommend aloe vera to a friend or relative. Only one participant strongly disagrees that Aloe vera has any curative properties and has never used it. PMID:26855960

  7. Iron and zinc content of selected foods in the diet of schoolchildren in Kumi district, east of Uganda: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Iron and zinc are essential micronutrients for humans and deficiency of the two elements is widespread in the world with the highest prevalence in less developed countries. There are few data on dietary intake of iron and zinc in Uganda, and no food composition table is available. There is hardly any widely published literature that clearly documents the quality of Ugandan children's diet. Thus information of both food intake and the concentration of these trace elements in local food ingredients are needed in order to assess daily intake. Methods The present study focused on the iron and zinc content in selected foods and intake of the micronutrients iron and zinc among schoolchildren in Kumi District, Uganda. Over a period of 4 weeks single 24-hour dietary recall interviews were carried out on a convenience sample of 178 schoolchildren (9-15 years old). Data from the dietary recalls was used when selecting foods for chemical analysis. Results Results from this study showed that the iron concentrations varied, and were high in some cereals and vegetables. The zinc concentrations in foods generally corresponded with results from other African countries (Mali and Kenya). Data from the 24-hour dietary recall showed that the daily Recommended Nutrient Intake (RNI) was met for iron but not for zinc. Conclusions The schoolchildren of Kumi district had a predominantly vegetable based diet. Foods of animal origin were consumed occasionally. The iron content in the selected foods was high and variable, and higher than in similar ingredients from Kenya and Mali, while the zinc concentrations were generally in accordance with reported values. The total daily zinc (mg) intake does not meet the daily RNI. The iron intake is adequate according to RNI, but due to iron contamination and reduced bioavailability, RNI may not be met in a vegetable based diet. More studies are needed to investigate possible sources of contamination. PMID:21827701

  8. Use of postpartum health services in rural Uganda: knowledge, attitudes, and barriers.

    PubMed

    Nabukera, Sarah K; Witte, Kim; Muchunguzi, Charles; Bajunirwe, Francis; Batwala, Vincent K; Mulogo, Edgar M; Farr, Celeste; Barry, Souleymane; Salihu, Hamisu M

    2006-04-01

    The purpose of this study was to explore the knowledge, attitudes and barriers to use of postpartum care service among rural communities in Uganda. Study was a part of a larger reproductive health evaluation project, and was cross-sectional in nature utilizing qualitative research methods using the narrative inquiry. Two matched rural communities were used in this study; Semuto in Luwero district, and Lwamaggwa in Rakai district. Fifty key informants who were purposefully selected from each study site were interviewed. They included community leaders, political leaders, health care providers, women leaders and community members. One-on-one interviews were conducted with key community informants using an interview guide. The purpose of the interview was explained to each participant, and written informed consent was obtained before the start of the interview. Respondents were allowed to express their views, opinions and observations on several health issues including postpartum health care services. There was a low level of knowledge about postpartum care services among the respondents of the two communities. There was lack of awareness about postpartum care and it's benefits. The main barriers to use of services were; misconceptions regarding the importance of postpartum care, distance to health facilities, poverty, and health system factors notably; poor facilities, lack of essential drugs, and poor attitudes of health workers. In the effort to improve reproductive health care services, there is an urgent need to improve postpartum services, and make them more accessible and user friendly. The training of providers at all levels is essential, in addition to educating families on the importance of postpartum care services.

  9. Education attainment as a predictor of HIV risk in rural Uganda: results from a population-based study.

    PubMed

    Smith, J; Nalagoda, F; Wawer, M J; Serwadda, D; Sewankambo, N; Konde-Lule, J; Lutalo, T; Li, C; Gray, R H

    1999-07-01

    We examined the association between education and prevalent HIV-1 infection in the Rakai district, rural Uganda based on a cross-sectional analysis of a population-based cohort. In 1990, 1397 men and 1705 women aged 13 years and older, were enrolled in 31 randomly selected communities. Strata were comprised of main road trading centres, secondary road trading villages and rural villages. Sociodemographic and behavioural data were obtained by interview and serum for HIV serostatus were obtained in the home. The analysis examines the association between sex-specific prevalent HIV infection and educational attainment, categorized as secondary, primary or none. The odds ratios (ORs) and 95% confidence intervals (95% CIs) of HIV infection were estimated, using no education as the referent group. Higher levels of education were associated with a higher HIV seroprevalence in bivariate analyses (OR 2.7 for primary and 4.1 for secondary education, relative to no education). The strength of the association was diminished but remained statistically significant after multivariate adjustment for sociodemographic and behavioural variables (adjusted OR of HIV infection 1.6 (95% CI: 1.2-2.1)) for primary education and 1.5 (95% CI: 1.0-2.2) for secondary education. Stratified multivariate analyses by place of residence indicated that the association between education and HIV prevalence was statistically significant in the rural villages, but not in the main road trading centres and intermediate trading villages. Educational attainment is a significant predictor of HIV risk in rural Uganda, in part because of risk behaviours and other characteristics among better educated individuals. Preventive interventions need to focus on better educated adults and on school-aged populations.

  10. Effect of School-based Human Papillomavirus (HPV) Vaccination on Adolescent Girls’ Knowledge and Acceptability of the HPV Vaccine in Ibanda District in Uganda

    PubMed Central

    Turiho, Andrew Kampikaho; Okello, Elialilia S.; Muhwezi, Wilson W.; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R.

    2015-01-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls’ knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19–8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56–2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16–5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  11. Effect of school-based human papillomavirus (hpv) vaccination on adolescent girls' knowledge and acceptability of the HPV vaccine in Ibanda District in Uganda.

    PubMed

    Turiho, Andrew Kampikaho; Okello, Elialilia S; Muhwezi, Wilson W; Harvey, Steve; Byakika-Kibwika, Pauline; Meya, David; Katahoire, Anne R

    2014-12-01

    From 2008 to 2011, schoolgirls were vaccinated against HPV in two districts in Uganda following sensitization. This study assessed girls' knowledge of cervical cancer and HPV vaccine, and their acceptance of future vaccination of friends and hypothetical daughters. The cross-sectional, mixed methods comparative study was conducted in two districts. Univariate, bivariate, logistic regression and thematic analyses were done. HPV vaccination was positively associated with knowledge (Crude OR: 5.31, CI: 3.19-8.86; p = 0.000); but knowledge (Adjusted OR: 1.13, CI: 0.56-2.28; p = 0.73) and HPV vaccination (Adjusted OR: 0.92, CI: 0.16-5.36; p = 0.93) did not predict vaccine acceptability. Seemingly important motivations for vaccine acceptance were: its role in cancer prevention and advancement of reproductive health, minimal side effects, and positive peer role models. Major deterrents to vaccine acceptance were: rumours and misconceptions about possible side effects, perceived inadequate information about vaccine, and fear of side effects. PMID:25854092

  12. Lost in Transition: HIV Prevalence and Correlates of Infection among Young People Living in Post-Emergency Phase Transit Camps in Gulu District, Northern Uganda

    PubMed Central

    Patel, Sheetal; Schechter, Martin T.; Sewankambo, Nelson K.; Atim, Stella; Kiwanuka, Noah; Spittal, Patricia M.

    2014-01-01

    Objective Little is known about HIV infection and the related vulnerabilities of young people living in resource-scarce, post-emergency transit camps that are now home to thousands of Internally Displaced Persons (IDPs) following two decades of war in northern Uganda. The objective of this analysis was to assess the prevalence and correlates of HIV infection among young people living in post-conflict transition in Gulu District, northern Uganda. Methods In 2010, a cross-sectional demographic and behavioural survey was conducted in two of Gulu District’s sub-counties with 384 purposively selected transit camp residents aged 15 to 29 years. Biological specimens were collected for rapid HIV testing in the field and confirmatory laboratory testing. Multivariable logistic regression identified independent determinants of HIV infection. Results HIV prevalence was alarmingly high at 12.8% (95% CI: 9.6%, 16.5%). The strongest determinant of HIV infection among young people was a non-consensual sexual debut (adjusted odds ratio [AOR], 9.88; 95% CI: 1.70–18.06). Residing in Awach sub-county (AOR, 2.93; 95% CI: 1.28–6.68), experiencing STI symptoms in the previous 12 months (AOR, 2.36; 95% CI: 1.43–6.17), and practicing dry sex (AOR, 2.31; 95% CI: 1.04–5.13) were other key determinants of HIV infection. Conclusions Study findings contribute to filling an important gap in epidemiological evidence and are useful for planning public health interventions in northern Uganda that effectively target young people in post-conflict transition and support them in the resettlement process. Findings serve to recommend reaching beyond traditional prevention programming in a way more effectively beneficial to young people in post-conflict settings by developing population-specific responses sensitive to local contexts and sufficient to address the underlying causes of the complex risk factors influencing the spread of HIV. PMID:24587034

  13. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

    PubMed Central

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-01-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  14. Menstrual hygiene management amongst schoolgirls in the Rukungiri district of Uganda and the impact on their education: a cross-sectional study

    PubMed Central

    Boosey, Robyn; Prestwich, Georgina; Deave, Toity

    2014-01-01

    Introduction An increasing number of studies have found that girls in low-income settings miss or struggle at school during menstruation if they are unable to manage their menstrual hygiene effectively. This study explores the menstrual hygiene practices and knowledge of girls at rural government primary schools in the Rukungiri district in Uganda and assesses the extent to which poor menstrual hygiene management (MHM) affects their education. Methods A self-administered questionnaire was completed by schoolgirls in six government-run primary schools in the Rukungiri district. Focus groups were held with girls from each school and semi-structured interviews were conducted with headteachers and female teachers from the participating schools. A toilet assessment was also conducted in each school. Results One hundred and forty schoolgirls completed the questionnaire. The girls reported a lack of access to adequate resources, facilities and accurate information to manage their menstrual hygiene effectively at school. They reported that, as a result, during menstruation they often struggle at school or miss school. Eighty-six girls (61.7%) reported missing school each month for menstrual-related reasons (mean 1.64, range 0-10, SD. 1.84). Conclusion It is common for girls who attend government-run primary schools in the Rukungiri district to miss school or struggle in lessons during menstruation because they do not have access to the resources, facilities, or information they need to manage for effective MHM. This is likely to have detrimental effects on their education and future prospects. A large-scale study is needed to explore the extent of this issue. PMID:25852796

  15. Lessons learned from engaging men in sexual and reproductive health as clients, partners and advocates of change in the Hoima district of Uganda

    PubMed Central

    Stern, Erin; Pascoe, Laura; Shand, Tim; Richmond, Samantha

    2015-01-01

    This study examined the impact of a three-year intervention project conducted in the Hoima district of Uganda, which sought to engage men in sexual and reproductive health as clients, equal partners and advocates of change. Structured surveys with 164 self-reported heterosexual men aged 18–54 years were used to assess knowledge and attitudes towards sexual and reproductive health. Data from these were analysed using Stata and SPSS. Additionally, five focus groups were conducted with the female partners and male beneficiaries of the project and with project peer educators. Four interviews were conducted with project staff and male beneficiaries. Data from these and the focus groups were analysed using a thematic approach. Following the intervention, a significantly greater number of men accessed, and supported their partners in accessing sexual health services services, had gained sexual and reproductive health awareness, reported sharing domestic duties and contraceptive decision-making, and displayed a decreased tolerance for domestic violence. It was more difficult to assess men's involvement and behaviours as advocates of change, which sheds light on the complexities of a gender transformative project and the importance of evaluating such projects from both men's and their partners' perspectives and at different levels of the male involvement model in sexual and reproductive health. PMID:25953243

  16. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study

    PubMed Central

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N.; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26–48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  17. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study.

    PubMed

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease.

  18. Knowledge and Misconceptions about Malaria among Pregnant Women in a Post-Conflict Internally Displaced Persons' Camps in Gulu District, Northern Uganda.

    PubMed

    Obol, James; David Lagoro, Kitara; Christopher Garimoi, Orach

    2011-01-01

    Background. In Uganda Malaria continues to be a major public health problem accounting for about 30-50% of all outpatient consultations and 35% of hospital admissions and a leading cause of mortality and morbidity. Pregnant women and their unborn children are vulnerable to malaria. Methods. A cross-sectional survey was conducted in 20 postconflict IDP camps of Gulu district selected randomly as clusters. 769 pregnant women were interviewed. Results. The majority of the respondents 85% have ever heard about malaria. Most (80%) 571 respondent attributed malaria to be transmitted by mosquito bites, 15 said cold weather, 53 said dirt, and 35 said not sleeping under net. Most (91%) 683 respondents mentioned that malaria was caused by mosquito, 28 mentioned cold food, 3 mentioned playing in the rain, 19 mentioned cold weather, and 6 mentioned eating mangos. Conclusion. Most pregnant women in the post conflict IDP camps have relatively high knowledge about malaria transmission, signs, symptoms, and consequences during pregnancy. However, majority of respondents had misconception about the cause of malaria while a few had misconception about the mode of malaria transmission.

  19. Knowledge and Misconceptions about Malaria among Pregnant Women in a Post-Conflict Internally Displaced Persons' Camps in Gulu District, Northern Uganda

    PubMed Central

    Obol, James; David Lagoro, Kitara; Christopher Garimoi, Orach

    2011-01-01

    Background. In Uganda Malaria continues to be a major public health problem accounting for about 30–50% of all outpatient consultations and 35% of hospital admissions and a leading cause of mortality and morbidity. Pregnant women and their unborn children are vulnerable to malaria. Methods. A cross-sectional survey was conducted in 20 postconflict IDP camps of Gulu district selected randomly as clusters. 769 pregnant women were interviewed. Results. The majority of the respondents 85% have ever heard about malaria. Most (80%) 571 respondent attributed malaria to be transmitted by mosquito bites, 15 said cold weather, 53 said dirt, and 35 said not sleeping under net. Most (91%) 683 respondents mentioned that malaria was caused by mosquito, 28 mentioned cold food, 3 mentioned playing in the rain, 19 mentioned cold weather, and 6 mentioned eating mangos. Conclusion. Most pregnant women in the post conflict IDP camps have relatively high knowledge about malaria transmission, signs, symptoms, and consequences during pregnancy. However, majority of respondents had misconception about the cause of malaria while a few had misconception about the mode of malaria transmission. PMID:22312565

  20. Lessons learned from engaging men in sexual and reproductive health as clients, partners and advocates of change in the Hoima district of Uganda.

    PubMed

    Stern, Erin; Pascoe, Laura; Shand, Tim; Richmond, Samantha

    2015-01-01

    This study examined the impact of a three-year intervention project conducted in the Hoima district of Uganda, which sought to engage men in sexual and reproductive health as clients, equal partners and advocates of change. Structured surveys with 164 self-reported heterosexual men aged 18-54 years were used to assess knowledge and attitudes towards sexual and reproductive health. Data from these were analysed using Stata and SPSS. Additionally, five focus groups were conducted with the female partners and male beneficiaries of the project and with project peer educators. Four interviews were conducted with project staff and male beneficiaries. Data from these and the focus groups were analysed using a thematic approach. Following the intervention, a significantly greater number of men accessed, and supported their partners in accessing sexual health services services, had gained sexual and reproductive health awareness, reported sharing domestic duties and contraceptive decision-making, and displayed a decreased tolerance for domestic violence. It was more difficult to assess men's involvement and behaviours as advocates of change, which sheds light on the complexities of a gender transformative project and the importance of evaluating such projects from both men's and their partners' perspectives and at different levels of the male involvement model in sexual and reproductive health.

  1. Knowledge and Attitudes of Parkinson's Disease in Rural and Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study.

    PubMed

    Kaddumukasa, Mark; Kakooza, Angelina; Kaddumukasa, Martin N; Ddumba, Edward; Mugenyi, Levi; Sajatovic, Martha; Katabira, Elly

    2015-01-01

    Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the study respondents did not know the body part involved in or apparent cause of PD. Nearly 1/3 of individuals believed that PD is a form of insanity and 17% believed that PD is contagious. Rural dwellers were more likely to have incorrect knowledge regarding selected aspects of PD. Conclusions. Understanding the cause of PD is very limited in our setting. Some beliefs about PD aetiology may potentially worsen stigma and social isolation. This study highlights the need for increasing PD awareness in our settings. Public health approaches that improve knowledge are urgently needed to promote care access and community response to Parkinson's disease. PMID:26688774

  2. The prevalence of serum antibodies to tick-borne infections in Mbale District, Uganda: The effect of agro-ecological zone, grazing management and age of cattle

    PubMed Central

    Rubaire-Akiiki, C.; Okello-Onen, J.; Nasinyama, G.W.; Vaarst, M.; Kabagambe, E. K.; Mwayi, W.; Musunga, D.; Wandukwa, W.

    2004-01-01

    Between August and October 2000, a cross-sectional study was conducted in smallholder dairy farms in Mbale District, Uganda to assess the prevalence of ticks and tick-borne diseases under different grazing systems and agro-ecological zones and understand the circumstances under which farmers operated. A questionnaire was administered to obtain information on dairy farm circumstances and practices. A total of 102 farms were visited and sera and ticks were collected from 478 animals. Sero-prevalence of tick-borne diseases was determined using an enzyme-linked immunoassay. Acaricides were used indiscriminately but the intensity of their use varied with the grazing system and zone. Cattle from different farms mixed for various reasons. During the dry seasons farmers have to get additional fodder from outside their farms that can result in importation of ticks. The prevalence of ticks and serum antibodies to tick-borne infections differed across the grazing systems and zones. The highest serum antibody prevalence (>60%) was recorded in the lowland zone under the free range and tethering grazing systems. The lowest tick challenge and serum antibody levels (<50%) were recorded in the midland and upland zones under a zero-grazing system. These findings suggest that endemic stability to East Coast Fever, babesiosis and anaplasmosis is most likely to have existed in the lowland zone, particularly, under the tethering and free-range grazing systems. Also, endemic stability for babesiosis existed in the upland zones. Endemic instability for East Coast Fever existed in the midland and upland zones. These structured observational studies are instrumental in planning of control strategies for ticks and tick borne diseases since production systems and the cattle population at high risk of the diseases in the district have been identified. Abbreviation: zone agro-ecological zone PMID:15861224

  3. Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

    PubMed

    Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

    2015-12-01

    Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level. PMID:26556225

  4. Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

    PubMed

    Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

    2015-12-01

    Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level.

  5. Herpes Simplex [corrected] Virus Type 2 Shedding From Male Circumcision Wounds in Rakai, Uganda.

    PubMed

    Grabowski, Mary K; Kigozi, Godfrey; Gray, Ronald H; Armour, Benjamin; Manucci, Jordyn; Serwadda, David; Redd, Andrew D; Nalugoda, Fred; Patel, Eshan U; Wawer, Maria J; Quinn, Thomas C; Tobian, Aaron A R

    2015-11-15

    A prospective observational study of 176 men coinfected with human immunodeficiency virus and herpes simplex virus type 2 (HSV-2) was conducted to assess whether their sexual partners may be at an increased risk of HSV-2 from male circumcision (MC) wounds. Preoperative and weekly penile lavage samples were tested for penile HSV-2 shedding. Prevalence risk ratios (PRRs) were estimated using Poisson regression. Detectable penile HSV-2 shedding was present in 9.7% of men (17 of 176) before MC, compared with 12.9% (22 of 170) at 1 week (PRR, 1.33; 95% confidence interval [CI], .74-2.38) and 14.8% (23 of 155) at 2 weeks (PRR, 1.50; 95% CI, .86-2.62) after MC. HSV-2 shedding was lower among men with healed MC wounds (adjusted PRR, 0.62; 95% CI, .35-1.08). Men undergoing MC should be counseled on sexual abstinence and condom use.

  6. Immune correlates of HIV exposure without infection in foreskins of men from Rakai, Uganda.

    PubMed

    Prodger, J L; Hirbod, T; Kigozi, G; Nalugoda, F; Reynolds, S J; Galiwango, R; Shahabi, K; Serwadda, D; Wawer, M J; Gray, R H; Kaul, R

    2014-05-01

    Human immunodeficiency virus (HIV) susceptibility is heterogenous, with some HIV-exposed but seronegative (HESN) individuals remaining uninfected despite repeated exposure. Previous studies in the cervix have shown that reduced HIV susceptibility may be mediated by immune alterations in the genital mucosa. However, immune correlates of HIV exposure without infection have not been investigated in the foreskin. We collected sub-preputial swabs and foreskin tissue from HESN (n=20) and unexposed control (n=57) men undergoing elective circumcision. Blinded investigators assayed swabs for HIV-neutralizing IgA, innate antimicrobial peptides, and cytokine levels. Functional T-cell subsets from foreskin tissue were assessed by flow cytometry. HESN foreskins had elevated α-defensins (3,027 vs. 1,795 pg ml(-1), P=0.011) and HIV-neutralizing IgA (50.0 vs. 13.5% of men, P=0.019). Foreskin tissue from HESN men contained a higher density of CD3 T cells (151.9 vs. 69.9 cells mm(-2), P=0.018), but a lower proportion of these was Th17 cells (6.12 vs. 8.04% of CD4 T cells, P=0.007), and fewer produced tumor necrosis factor α (TNFα) (34.3 vs. 41.8% of CD4 T cells, P=0.037; 36.9 vs. 45.7% of CD8 T cells, P=0.004). A decrease in the relative abundance of susceptible CD4 T cells and local TNFα production, in combination with HIV-neutralizing IgA and α-defensins, may represent a protective immune milieu at a site of HIV exposure. PMID:24150258

  7. The Quality of Tuberculosis Services in Health Care Centres in a Rural District in Uganda: The Providers' and Clients' Perspective

    PubMed Central

    Kigenyi, Omar; Mupere, Ezekiel

    2014-01-01

    Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence, and treatment completion. In this study, we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. A cross-sectional study was conducted in 8 health care facilities, among 20 health care workers and 392 patients. Data was obtained using face-to-face interviews, an observation guide, a check list, and record review of the TB unit and laboratory registers. Data entry and analysis were done using EPI INFO 2008 and STATA 10 versions, respectively. A high number 150 (87.21%) of TB patients were not aware of all the signs to stop TB medication, and 100 (25.51%) patients received laboratory results after a period of 3–5 working days. The major challenges faced by health workers were poor attitude of fellow health workers, patients defaulting treatment, and fear of being infected with TB. One of the worst performance indicators was low percentage of cure. Comprehensive strengthening of the health system focusing on quality of support supervisions, patient follow up, promoting infection control measures, and increasing health staffing levels at health facilities is crucial. PMID:25276424

  8. “I Spent a Full Month Bleeding, I Thought I Was Going to Die…” A Qualitative Study of Experiences of Women Using Modern Contraception in Wakiso District, Uganda

    PubMed Central

    Kibira, Simon P. S.; Muhumuza, Christine; Bukenya, Justine N.; Atuyambe, Lynn M.

    2015-01-01

    Introduction There is high unmet need for family planning (FP) in Uganda as well as high contraceptive discontinuation rates. These contribute to the high fertility rates that in part are due to unplanned pregnancies. There are gaps in knowledge about experiences that couples go through while using contraceptives in their lives. This study explored women’s experiences during the course of their contraceptive use. Methods We conducted a qualitative study involving 30 women who had used modern contraception for at least one year in Wakiso district, central Uganda. We used in-depth interviews to obtain their personal accounts. Index women were approached through health officers at four health centres in the district. All ethical approvals and informed consent were obtained. We used conventional content analysis; identifying codes through open coding, on which basis categories were developed and grouped into overarching themes. Results Women’s accounts were summarised in the following themes: negative experiences with modern contraceptive use, motivation to continue using FP in spite of these negative experiences, the role of influential people, and discontinuation of use. Negative accounts dominated the experiences of most women but they expressed strong desire to continue using modern contraception even amidst all challenges. Health workers emerged as the most influential people that played a vital role in women’s decisions. Conclusion Varied negative experiences with modern contraception and misperceptions exist amidst a determination to continue use. Partner engagement, health service strengthening to improve side effects management and health worker skills, and engaging older women that have successfully used contraception as community champions, are potential strategies to support women’s contraceptive decisions. PMID:26524603

  9. Initiation of antiretroviral therapy and viral suppression after home HIV testing and counselling in KwaZulu-Natal, South Africa, and Mbarara district, Uganda: a prospective, observational intervention study

    PubMed Central

    Barnabas, Ruanne V.; van Rooyen, Heidi; Tumwesigye, Elioda; Murnane, Pamela M.; Baeten, Jared M.; Humphries, Hilton; Turyamureeba, Bosco; Joseph, Philip; Krows, Meighan; Hughes, James P; Celum, Connie

    2014-01-01

    Objective Antiretroviral therapy (ART) significantly decreases HIV-associated morbidity, mortality, and HIV transmission through HIV viral load suppression. In high HIV prevalence settings, outreach strategies are needed to find asymptomatic HIV positive persons, link them to HIV care and ART, and achieve viral suppression. Methods We conducted a prospective intervention study in two rural communities in KwaZulu-Natal, South Africa, and Mbabara district, Uganda. The intervention included home HIV testing and counseling (HTC), point-of-care CD4 count testing for HIV positive persons, referral to care, and one month then quarterly lay counselor follow-up visits. The outcomes at 12 months were linkage to care, and ART initiation and viral suppression among HIV positive persons eligible for ART (CD4≤350 cells/μL). Findings 3,393 adults were tested for HIV (96% coverage), of whom 635 (19%) were HIV positive. At baseline, 36% of HIV positive persons were newly identified (64% were previously known to be HIV positive) and 40% were taking ART. By month 12, 619 (97%) of HIV positive persons visited an HIV clinic, and of 123 ART eligible participants, 94 (76%) initiated ART by 12 months. Of the 77 participants on ART by month 9, 59 (77%) achieved viral suppression by month 12. Among all HIV positive persons, the proportion with viral suppression (<1,000 copies/mL) increased from 50% to 65% (p=<0.001) at 12 months. Interpretation Community-based HTC in rural South Africa and Uganda achieved high testing coverage and linkage to care. Among those eligible for ART, a high proportion initiated ART and achieved viral suppression, indicating high adherence. Implementation of this HTC approach by existing community health workers in Africa should be evaluated to determine effectiveness and costs. PMID:25601912

  10. Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda

    PubMed Central

    Obol, James Henry; Arony, Denis Anywar; Wanyama, Ronald; Moi, Kenneth Luryama; Bodo, Bongomin; Odong, Patrick Olwedo; Odida, Michael

    2016-01-01

    Introduction Nodding syndrome was first reported in Uganda in 2003 among internally displaced populations. Risk factors for the syndrome remain unknown. We therefore explored vitamin B6 deficiency and resulting high 3-hydroxykynurenine (3-HK) levels as risk factor for nodding syndrome in Northern Uganda. Methods Case-control study conducted in Gulu and Amuru districts. Cases were children/young adults with nodding syndrome. Healthy children/young adults were recruited as controls from same community as cases. Data on socio-demographic and other risk factors was collected using questionnaires. Whole blood was collected in EDTA tubes for assay of 3-HK and vitamin B6 using sandwich ELISA. Conditional logistic regression model was used to assess associations. Results 66 cases and 73 controls were studied. Factors associated with nodding syndrome were being positive for 3-HK (AOR=4.50, p=0.013), vitamin B6 concentration below mean (AOR=7.22, P=0.001), child being taken care of by mother only (AOR=5.43, p=0.011), child being taken care of by guardian (AOR=5.90, p=0.019) and child consuming relief food at weaning (AOR=4.05, p=0.021). Conclusion Having low vitamin B6 concentration which leads to a build up of 3-hydroxykynurenine concentration in cases as a main risk factor. Therefore, cases should be treated with vitamin B6 and community members should be sensitise to ensure adequate dietary intake of vitamin B6 so that the risk of nodding syndrome among children is averted. We encourage future prospective intervention study to be conducted to assess the effect of low vitamin B6 on the development of nodding syndrome via raised 3-HK concentration. PMID:27642461

  11. Multiple Sexual Partnerships among Female Adolescents in Rural Uganda: The effects of family structure and school attendance

    PubMed Central

    Pilgrim, Nanlesta A.; Ahmed, Saifuddin; Gray, Ronald H.; Sekasanvu, Joseph; Lutalo, Tom; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.

    2015-01-01

    Background A better understanding is needed of the contextual factors that influence HIV risk behaviors among female adolescents in sub-Saharan Africa. The objectives of this study were to assess the influence of family structure on lifetime sexual partners and on the number of sexual partners in the last year among female adolescents in rural Rakai, Uganda; and to determine if the influence of family structure on these outcomes differed by adolescents’ school attendance status. Methods The sample consisted of 2,337 unmarried adolescent girls, aged 15-19, enrolled in the Rakai Community Cohort Study. The last survey interview within the time period 2001-2008 available for each girl was used. Analyses were stratified by age (15-17 year olds and 18-19 year olds) and school status. Multinomial logistic regression was used. Results Living in a household with a biological father was protective against both outcomes. Family structure was not associated with the outcomes among in-school adolescents but was significantly associated with outcomes among out-of-school adolescents. Conclusions Findings suggest that understanding the familial context in which female adolescents develop, as well as its interaction with school attendance, is important for HIV prevention efforts. Both research and programmatic initiatives must consider the interplay between the family and school domains when considering ways to reduce HIV acquisition among adolescent women. PMID:25415632

  12. District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

    PubMed

    Curtale, Filippo; Musila, Timothy; Opigo, Jimmy; Nantamu, Dyogo; Ezati, Isaac Alidria

    2016-05-01

    A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results. PMID:27178674

  13. District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

    PubMed

    Curtale, Filippo; Musila, Timothy; Opigo, Jimmy; Nantamu, Dyogo; Ezati, Isaac Alidria

    2016-05-01

    A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results.

  14. Assessing Community Understanding of Local Environmental Issues in Two Areas of Uganda

    ERIC Educational Resources Information Center

    Ferrie, Gina M.; Bettinger, Tammie L.; Kuhar, Christopher W.; Lehnhardt, Kathy; Apell, Peter; Kasoma, Panta

    2011-01-01

    Although there are many conservation education projects working in Uganda, there is currently little evaluation of educational initiatives in the communities. A survey was developed to better understand the environmental knowledge, attitudes, and behaviors of people in 2 districts of Uganda. The main environmental problem listed by the respondents…

  15. Information and Communication for Rural Innovation and Development: Context, Quality and Priorities in Southeast Uganda

    ERIC Educational Resources Information Center

    Sseguya, Haroon; Mazur, Robert; Abbott, Eric; Matsiko, Frank

    2012-01-01

    Purpose: To examine the status and priorities for agricultural information generation, dissemination and utilization in the context of agricultural innovation systems in southeast Uganda. Design/Methodology/Approach: Group discussions were conducted with six communities in Kamuli district, southeast Uganda. The focus was on information sources and…

  16. Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

    PubMed Central

    Shaw, Alexandra P. M.; Tirados, Inaki; Mangwiro, Clement T. N.; Esterhuizen, Johan; Lehane, Michael J.; Torr, Stephen J.; Kovacic, Vanja

    2015-01-01

    Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were calculated for this operation as if managed by the Ugandan vector control services: removing purely research components of the work and applying local salaries. This calculation assumed that all resources are fully used, with no spare capacity. The full cost of the operation was assessed at USD 85.4 per km2, of which USD 55.7 or 65.2% were field costs, made up of three component activities (target deployment: 34.5%, trap monitoring: 10.6% and target maintenance: 20.1%). The remaining USD 29.7 or 34.8% of the costs were for preliminary studies and administration (tsetse surveys: 6.0%, sensitisation of local populations: 18.6% and office support: 10.2%). Targets accounted for only 12.9% of the total cost, other important cost components were labour (24.1%) and transport (34.6%). Discussion Comparison with the updated cost of historical HAT vector control projects and recent estimates indicates that this work represents a major reduction in cost levels. This is attributed not just to the low unit cost of tiny targets but also to the organisation of delivery, using local labour with bicycles or motorcycles. Sensitivity analyses were undertaken, investigating key prices and assumptions. It is believed that these costs are generalizable to other HAT foci, although in more remote areas, with denser vegetation and fewer people, costs would increase, as would be the case for other tsetse control techniques. PMID:25811956

  17. Bubonic and pneumonic plague - Uganda, 2006.

    PubMed

    2009-07-24

    Plague is a life-threatening fleaborne disease caused by the bacterium Yersinia pestis. The most common clinical form is bubonic plague, which is characterized by high fever and regional lymphadenitis. Without treatment, infection can spread from lymph nodes to the lungs, resulting in pneumonic plague and the potential for person-to-person transmission through respiratory droplets. In November 2006, the Uganda Ministry of Health received reports of an increase in bubonic plague cases and a possible outbreak of pneumonic plague among residents in the Arua and Nebbi districts. In response, the Uganda Ministry of Health and CDC conducted a joint investigation in the two districts during November 28-December 30, 2006. Overall, 127 clinical plague cases were identified, along with evidence of a focal pneumonic outbreak in Nebbi District. Median age of the patients was 14 years (range: 2 weeks-65 years); 65 (51%) were female. Twenty-eight (22%) of the 127 patients died. Among the 102 patients with documented symptoms, 90 (88%) had bubonic plague, and 12 (12%) had pneumonic plague. The results of this investigation underscore the need to 1) continue efforts to educate residents of rural Uganda regarding the source, signs, and symptoms of plague and the life-saving importance of seeking treatment; 2) strengthen plague surveillance and diagnostic capabilities; and 3) improve emergency response and vector-control capacity, especially in remote regions of the country.

  18. Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process

    PubMed Central

    2014-01-01

    competence to initiate a community trial was established through performance monitoring. Conclusion Local information/communication consultants, working in concert with a university based department of pediatrics, can design and implement a robust mobile phone based system that may be anticipated to contribute to efficient delivery of iCCM by trained volunteer CHWs in rural settings in Uganda. PMID:25079241

  19. Prevalence of nodding syndrome--Uganda, 2012-2013.

    PubMed

    Iyengar, Preetha J; Wamala, Joseph; Ratto, Jeffrey; Blanton, Curtis; Malimbo, Mugagga; Lukwago, Luswa; Becknell, Steven; Downing, Robert; Bunga, Sudhir; Sejvar, James; Makumbi, Issa

    2014-07-18

    Nodding syndrome (NS) is a seizure disorder of unknown etiology, predominately affecting children aged 3-18 years in three sub-Saharan countries (Uganda, South Sudan, and Tanzania), with the primary feature of episodic head nodding. These episodes are thought to be one manifestation of a syndrome that includes neurologic deterioration, cognitive impairment, and additional seizure types. NS investigations have focused on clinical features, progression, and etiology; however, none have provided a population-based prevalence assessment using a standardized case definition. In March 2013, CDC and the Ugandan Ministry of Health (MOH) conducted a single-stage cluster survey to perform the first systematic assessment of prevalence of NS in Uganda using a new consensus case definition, which was modified during the course of the investigation. Based on the modified definition, the estimated number of probable NS cases in children aged 5-18 years in three northern Uganda districts was 1,687 (95% confidence interval [CI] = 1,463-1,912), for a prevalence of 6.8 (CI = 5.9-7.7) probable NS cases per 1,000 children aged 5-18 years in the three districts. These findings can guide the MOH to understand and provide the health-care resources necessary to address NS in northern Uganda, and provide a basis for future studies of NS in Uganda and in other areas affected by NS. PMID:25029112

  20. Funds of Knowledge in Child-Headed Households: A Ugandan Case Study

    ERIC Educational Resources Information Center

    Kendrick, Maureen; Kakuru, Doris

    2012-01-01

    Much of the research on orphan and vulnerable children in sub-Saharan Africa has focused on their risks and vulnerabilities. This article describes the "funds of knowledge" (Moll and Greenberg, 1990) and means of acquiring new knowledge of children living in child-headed households in Uganda's Rakai District. Using ethnographic methods, the…

  1. Laramie in Uganda

    ERIC Educational Resources Information Center

    Kagan, Eve

    2011-01-01

    No matter how disturbing, it is common to hear "that's so gay" or "you're such a fag" echoing through the halls of a high school, but when the high school is an international school in Uganda, those words have a newfound potency. As an American teacher working abroad, the author often struggled over her responsibility for the ethical conduct of…

  2. Runyakitara: Uganda's "New" Language.

    ERIC Educational Resources Information Center

    Bernsten, Jan

    1998-01-01

    Examined the emergence of Runyakitara as a new language in Uganda in the 1980s. The formation of Runyakitara through the realignment of four Western Bantu varieties illustrates the potential for the use of language as a resource in ethnic competition. Discusses the construction of Runyakitara in the context of the current political situation in…

  3. Uganda's eco-rebirth.

    PubMed

    Lazarus, D

    1991-01-01

    In 1986, the Government of Uganda established the Ministry of Environmental Protection to meet the country's socioeconomic development needs without destroying the environment. A Ministry-supported village pilot project in the Gombe region promotes self-sufficiency in potable water, food, and energy and tests means to achieve ecologically sound management of sustainable food/energy/fodder production. The Ministry also serves to sensitize the public to environmental issues by encouraging Ugandan newspapers to report more environment-related stories. A newspaper story informed the government about fishermen along a 20 km stretch of the Nile River and in Lake Victoria who used dynamite to kill fish, including juvenile and noncommercial fish. Thus, the government quickly put a halt to dynamiting. The ministry also produces films on Uganda's environmental problems. Some of these problems include the indiscriminate destruction of forests (e.g., Mabira, Mt. Elgon, Kibale, Budongo, Bwindi, and Maramagambo) and farmlands along Lake Victoria. Further, Uganda is witnessing either killing or smuggling of its elephants, rhinos, insects, birds, reptiles, and primates. In 1988, the World Bank committed about US$33.5 million to activities to protect Uganda's forests. They include planting of exotic softwoods, timber harvesting from remaining forests, and reestablishment of self-sufficiency in fuelwoods. The government hopes that forest rehabilitation will bring back tourism which before the civil war was the country's second highest foreign exchange earner. In fact, the remaining forests house the world's greatest population densities of primates (e.g., mountain gorillas in the southwest) and many rate birds. The UN Environmental Program will write Uganda's environmental protection law and helps the Ministry to promote environmental and public awareness. PMID:12285370

  4. Uganda's eco-rebirth.

    PubMed

    Lazarus, D

    1991-01-01

    In 1986, the Government of Uganda established the Ministry of Environmental Protection to meet the country's socioeconomic development needs without destroying the environment. A Ministry-supported village pilot project in the Gombe region promotes self-sufficiency in potable water, food, and energy and tests means to achieve ecologically sound management of sustainable food/energy/fodder production. The Ministry also serves to sensitize the public to environmental issues by encouraging Ugandan newspapers to report more environment-related stories. A newspaper story informed the government about fishermen along a 20 km stretch of the Nile River and in Lake Victoria who used dynamite to kill fish, including juvenile and noncommercial fish. Thus, the government quickly put a halt to dynamiting. The ministry also produces films on Uganda's environmental problems. Some of these problems include the indiscriminate destruction of forests (e.g., Mabira, Mt. Elgon, Kibale, Budongo, Bwindi, and Maramagambo) and farmlands along Lake Victoria. Further, Uganda is witnessing either killing or smuggling of its elephants, rhinos, insects, birds, reptiles, and primates. In 1988, the World Bank committed about US$33.5 million to activities to protect Uganda's forests. They include planting of exotic softwoods, timber harvesting from remaining forests, and reestablishment of self-sufficiency in fuelwoods. The government hopes that forest rehabilitation will bring back tourism which before the civil war was the country's second highest foreign exchange earner. In fact, the remaining forests house the world's greatest population densities of primates (e.g., mountain gorillas in the southwest) and many rate birds. The UN Environmental Program will write Uganda's environmental protection law and helps the Ministry to promote environmental and public awareness.

  5. Barriers and facilitators in the provision of post-abortion care at district level in central Uganda – a qualitative study focusing on task sharing between physicians and midwives

    PubMed Central

    2014-01-01

    Background Abortion is restricted in Uganda, and poor access to contraceptive methods result in unwanted pregnancies. This leaves women no other choice than unsafe abortion, thus placing a great burden on the Ugandan health system and making unsafe abortion one of the major contributors to maternal mortality and morbidity in Uganda. The existing sexual and reproductive health policy in Uganda supports the sharing of tasks in post-abortion care. This task sharing is taking place as a pragmatic response to the increased workload. This study aims to explore physicians’ and midwives’ perception of post-abortion care with regard to professional competences, methods, contraceptive counselling and task shifting/sharing in post-abortion care. Methods In-depth interviews (n = 27) with health care providers of post-abortion care were conducted in seven health facilities in the Central Region of Uganda. The data were organized using thematic analysis with an inductive approach. Results Post-abortion care was perceived as necessary, albeit controversial and sometimes difficult to provide. Together with poor conditions post-abortion care provoked frustration especially among midwives. Task sharing was generally taking place and midwives were identified as the main providers, although they would rarely have the proper training in post-abortion care. Additionally, midwives were sometimes forced to provide services outside their defined task area, due to the absence of doctors. Different uterine evacuation skills were recognized although few providers knew of misoprostol as a method for post-abortion care. An overall need for further training in post-abortion care was identified. Conclusions Task sharing is taking place, but providers lack the relevant skills for the provision of quality care. For post-abortion care to improve, task sharing needs to be scaled up and in-service training for both doctors and midwives needs to be provided. Post-abortion care should further be

  6. Phylogenetic analysis of rubella viruses identified in Uganda, 2003-2012.

    PubMed

    Namuwulya, Prossy; Abernathy, Emily; Bukenya, Henry; Bwogi, Josephine; Tushabe, Phionah; Birungi, Molly; Seguya, Ronald; Kabaliisa, Theopista; Alibu, Vincent P; Kayondo, Jonathan K; Rivailler, Pierre; Icenogle, Joseph; Bakamutumaho, Barnabas

    2014-12-01

    Molecular data on rubella viruses are limited in Uganda despite the importance of congenital rubella syndrome (CRS). Routine rubella vaccination, while not administered currently in Uganda, is expected to begin by 2015. The World Health Organization recommends that countries without rubella vaccination programs assess the burden of rubella and CRS before starting a routine vaccination program. Uganda is already involved in integrated case-based surveillance, including laboratory testing to confirm measles and rubella, but molecular epidemiologic aspects of rubella circulation have so far not been documented in Uganda. Twenty throat swab or oral fluid samples collected from 12 districts during routine rash and fever surveillance between 2003 and 2012 were identified as rubella virus RNA positive and PCR products encompassing the region used for genotyping were sequenced. Phylogenetic analysis of the 20 sequences identified 19 genotype 1G viruses and 1 genotype 1E virus. Genotype-specific trees showed that the Uganda viruses belonged to specific clusters for both genotypes 1G and 1E and grouped with similar sequences from neighboring countries. Genotype 1G was predominant in Uganda. More epidemiological and molecular epidemiological data are required to determine if genotype 1E is also endemic in Uganda. The information obtained in this study will assist the immunization program in monitoring changes in circulating genotypes.

  7. Phylogenetic analysis of rubella viruses identified in Uganda, 2003-2012.

    PubMed

    Namuwulya, Prossy; Abernathy, Emily; Bukenya, Henry; Bwogi, Josephine; Tushabe, Phionah; Birungi, Molly; Seguya, Ronald; Kabaliisa, Theopista; Alibu, Vincent P; Kayondo, Jonathan K; Rivailler, Pierre; Icenogle, Joseph; Bakamutumaho, Barnabas

    2014-12-01

    Molecular data on rubella viruses are limited in Uganda despite the importance of congenital rubella syndrome (CRS). Routine rubella vaccination, while not administered currently in Uganda, is expected to begin by 2015. The World Health Organization recommends that countries without rubella vaccination programs assess the burden of rubella and CRS before starting a routine vaccination program. Uganda is already involved in integrated case-based surveillance, including laboratory testing to confirm measles and rubella, but molecular epidemiologic aspects of rubella circulation have so far not been documented in Uganda. Twenty throat swab or oral fluid samples collected from 12 districts during routine rash and fever surveillance between 2003 and 2012 were identified as rubella virus RNA positive and PCR products encompassing the region used for genotyping were sequenced. Phylogenetic analysis of the 20 sequences identified 19 genotype 1G viruses and 1 genotype 1E virus. Genotype-specific trees showed that the Uganda viruses belonged to specific clusters for both genotypes 1G and 1E and grouped with similar sequences from neighboring countries. Genotype 1G was predominant in Uganda. More epidemiological and molecular epidemiological data are required to determine if genotype 1E is also endemic in Uganda. The information obtained in this study will assist the immunization program in monitoring changes in circulating genotypes. PMID:24700073

  8. Petrophysical database of Uganda

    NASA Astrophysics Data System (ADS)

    Ruotoistenmäki, Tapio; Birungi, Nelson R.

    2015-06-01

    The petrophysical database of Uganda contains data on ca. 5800 rock samples collected and analyzed during 2009-2012 in international geological and geophysical projects covering the main part of the land area of Uganda. The parameters included are the susceptibilities and densities of all available field samples. Susceptibilities were measured from the samples from three directions. Using these parameters, we also calculated the ratios of susceptibility maxima/minima reflecting direction homogeneity of magnetic minerals, and estimated the iron content of paramagnetic samples and the magnetite content of ferrimagnetic samples. Statistical and visual analysis of the petrophysical data of Uganda demonstrated their wide variation, thus emphasizing their importance in analyzing the bedrock variations in three dimensions. Using the density-susceptibility diagram, the data can be classified into six main groups: 1. A low density and susceptibility group, consisting of sedimentary and altered rocks. 2. Low-susceptibility, felsic rocks (e.g. quartzites and metasandstones). 3. Paramagnetic, felsic rocks (e.g. granites). 4. Ferrimagnetic, magnetite-containing felsic rocks (e.g. granites). 5. Paramagnetic mafic rocks (e.g. amphibolites and dolerites). 6. Ferrimagnetic, mafic rocks containing magnetite and high-density mafic minerals (mainly dolerites). Moreover, analysis revealed that the parameter distributions of even a single rock type (e.g. granites) can be very variable, forming separate clusters. This demonstrates that the simple calculation of density or susceptibility averages of rock types can be highly erratic. For example, the average can lie between two groups, where only few, if any, samples exist. Therefore, estimation of the representative density and susceptibility must be visually verified from these diagrams. The areal distribution of parameters and their calculated derivatives generally correlate well with the regional distribution of lithological and

  9. The Varying Vulnerability of African Orphans: The Case of the Langi, Northern Uganda

    ERIC Educational Resources Information Center

    Oleke, Christopher; Blystad, Astrid; Moland, Karen Marie; Rekdal, Ole Bjorn; Heggenhougen, Kristian

    2006-01-01

    This article is based on a qualitative study carried out in Lira District, northern Uganda, to assess the situation of orphans cared for in extended families. The objective of the article is to bring attention to the varying vulnerability of different categories of orphans. The methods employed in data collection included ethnographic fieldwork,…

  10. Mission of the month: Uganda.

    PubMed

    Snead, B

    1988-04-01

    US Agency for International Development (USAID) assistance to Uganda has been interrupted several times due to Uganda's turbulent history since independence. Mission Director Richard Podol explains that because USAID is not a major donor to Uganda, an effort is made to maximize effectiveness by being cautious about how agency money is spent. USAID looks for critical gaps that are not being filled by other donor programs yet are essential to the development of Uganda at present and in the future. 1 such area is export promotion. Another area is macroeconomic reform. Agricultural rehabilitation is a major factor in the mission's strategy to restore Uganda prosperity. USAID has a package of interrelated projects that work to increase agricultural production and improve processing and marketing, all supported by appropriate economic policies. In 1983, USAID began to fund the Manpower for Agriculture Development (MFAD) Project to assist the MInistry of Agriculture and Makerere University in strengthening their agricultural research and training capabilities. Also designed to increase food production is USAID's 6-year and $20 million Cooperative Agriculture and Agribusiness Support project. IN the health sector, USAID's Family Health Initiatives project works cooperatively with US and international organizations in supporting the MInistry of Health and Ugandan private organizations in their efforts to implement family planning policies and programs. The missions' oral rehydration project is being implemented throughout Uganda to reduce child mortality and severe cases of childhood illness caused by diarrheal diseases. The US in 1986 made pledges toward the budget for UGanda's Acquired Immune Deficiency Syndrome (AIDS) program. Podol maintains that while there has been significant economic and political progress, the primary issue continues to be political, i.e,, can full peace be restored to Uganda.

  11. Effectiveness of Peer Support on Care Engagement and Preventive Care Intervention Utilization among Pre-Antiretroviral Therapy, HIV-Infected Adults in Rakai, Uganda: a Randomized Trial

    PubMed Central

    Chang, Larry W.; Nakigozi, Gertrude; Billioux, Veena G; Gray, Ronald H.; Serwadda, David; Quinn, Thomas C.; Wawer, Maria J; Bollinger, Robert C.; Reynolds, Steven J.

    2015-01-01

    442 pre-ART, HIV-infected adults were randomized to peer support consisting of structured home visits to promote clinic attendance and preventive care intervention use or standard of care. At baseline, 62% reported previously visiting an HIV clinic, 45% reported taking cotrimoxazole prophylaxis, and 31% were “care-naïve” (no previous clinic visit and not on cotrimoxazole). After one year, intervention participants were more likely to report being in care (92% vs 84%; PRR 1.09, p=0.039), on cotrimoxazole (89% vs 81%; PRR 1.10, p=0.047), and safe water vessel adherence (23% vs 14%; PRR 1.64, p=0.024). The effect was observed only among care-naïve participants (n=139) with 83% intervention vs 53% controls reporting being in HIV care (PRR 1.47, p=0.006), 78% vs 58% on cotrimoxazole (PRR 1.35, p=0.04), and 20% vs 4% safe water vessel adherence (PRR 5.78, p=0.017). Peer support may be an effective intervention to facilitate pre-ART care compliance in this important population. PMID:26271815

  12. Hepatitis E as a cause of acute jaundice syndrome in northern Uganda, 2010-2012.

    PubMed

    Gerbi, Gemechu B; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D; Teshale, Eyasu H

    2015-02-01

    Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7-24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda.

  13. Hepatitis E as a cause of acute jaundice syndrome in northern Uganda, 2010-2012.

    PubMed

    Gerbi, Gemechu B; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D; Teshale, Eyasu H

    2015-02-01

    Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7-24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda. PMID:25448237

  14. Ray of hope in Uganda in war against HIV.

    PubMed

    1997-03-24

    According to an October 1996 report from the Ugandan Health Ministry's STD/AIDS Control Program (STD/ACP) on HIV prevalence among pregnant women at six hospitals between 1991 and 1995, HIV infection has been declining in parts of the country and Ugandans have significantly changed their sexual behavior to avoid infection. The health ministry still estimates that there are 1.5 million infected Ugandans and more than 48,000 cumulative cases of AIDS have been reported in Uganda since the mid-1980s. The actual number of AIDS cases could, however, be 5-10 times greater. Other African countries with HIV infection rates of more than 10% among pregnant women are Kenya, Malawi, Rwanda, Tanzania, Zambia, and Cote d'Ivoire. The prevalence of infection among pregnant women will soon exceed 10% in Botswana and South Africa. Uganda has achieved some reduction in the incidence and prevalence of HIV infection by applying a multisectoral approach of coordinated efforts by the Uganda AIDS Commission's National Secretariat, ministries, districts, and village councils. Technical committees, task forces, steering committees, nongovernmental organizations, religious groups, academics and researchers, the media, the private sector, unions, workers, employers, herbalists, people living with HIV/AIDS, artists, and other groups are involved.

  15. An outbreak of Ebola in Uganda.

    PubMed

    Okware, S I; Omaswa, F G; Zaramba, S; Opio, A; Lutwama, J J; Kamugisha, J; Rwaguma, E B; Kagwa, P; Lamunu, M

    2002-12-01

    An outbreak of Ebola disease was reported from Gulu district, Uganda, on 8 October 2000. The outbreak was characterized by fever and haemorrhagic manifestations, and affected health workers and the general population of Rwot-Obillo, a village 14 km north of Gulu town. Later, the outbreak spread to other parts of the country including Mbarara and Masindi districts. Response measures included surveillance, community mobilization, case and logistics management. Three coordination committees were formed: National Task Force (NTF), a District Task Force (DTF) and an Interministerial Task Force (IMTF). The NTF and DTF were responsible for coordination and follow-up of implementation of activities at the national and district levels, respectively, while the IMTF provided political direction and handled sensitive issues related to stigma, trade, tourism and international relations. The international response was coordinated by the World Health Organization (WHO) under the umbrella organization of the Global Outbreak and Alert Response Network. A WHO/CDC case definition for Ebola was adapted and used to capture four categories of cases, namely, the 'alert', 'suspected', 'probable' and 'confirmed cases'. Guidelines for identification and management of cases were developed and disseminated to all persons responsible for surveillance, case management, contact tracing and Information Education Communication (IEC). For the duration of the epidemic that lasted up to 16 January 2001, a total of 425 cases with 224 deaths were reported countrywide. The case fatality rate was 53%. The attack rate (AR) was highest in women. The average AR for Gulu district was 12.6 cases/10 000 inhabitants when the contacts of all cases were considered and was 4.5 cases/10 000 if limited only to contacts of laboratory confirmed cases. The secondary AR was 2.5% when nearly 5000 contacts were followed up for 21 days. Uganda was finally declared Ebola free on 27 February 2001, 42 days after the last case

  16. Longitudinal evaluation of aflatoxin exposure in two cohorts in south-western Uganda.

    PubMed

    Kang, Min-Su; Nkurunziza, Peter; Muwanika, Richard; Qian, Guoqing; Tang, Lili; Song, Xiao; Xue, Kathy; Nkwata, Allan; Ssempebwa, John; Lutalo, Tom; Asiki, Gershim; Serwadda, David; Seeley, Janet; Kaleebu, Pontiano; Nalugoda, Fred; Newton, Robert; William, Jonathan H; Wang, Jia-Sheng

    2015-01-01

    Aflatoxins (AF) are a group of mycotoxins. AF exposure causes acute and chronic adverse health effects such as aflatoxicosis and hepatocellular carcinoma in human populations, especially in the developing world. In this study, AF exposure was evaluated using archived serum samples from human immunodeficiency virus (HIV)-seronegative participants from two cohort studies in south-western Uganda. AFB1-lysine (AFB-Lys) adduct levels were determined via HPLC fluorescence in a total of 713 serum samples from the General Population Cohort (GPC), covering eight time periods between 1989 and 2010. Overall, 90% (642/713) of the samples were positive for AFB-Lys and the median level was 1.58 pg mg(-1) albumin (range = 0.40-168 pg mg(-1) albumin). AFB-Lys adduct levels were also measured in a total of 374 serum samples from the Rakai Community Cohort Study (RCCS), across four time periods between 1999 and 2003. The averaged detection rate was 92.5% (346/374) and the median level was 1.18 pg mg(-1) albumin (range = 0.40-122.5 pg mg(-1) albumin). In the GPC study there were no statistically significant differences between demographic parameters, such as age, sex and level of education, and levels of serum AFB-Lys adduct. In the RCCS study, longitudinal analysis using generalised estimating equations revealed significant differences between the adduct levels and residential areas (p = 0.05) and occupations (p = 0.02). This study indicates that AF exposure in people in two populations in south-western Uganda is persistent and has not significantly changed over time. Data from one study, but not the other, indicated that agriculture workers and rural area residents had more AF exposure than those non-agricultural workers and non-rural area residents. These results suggest the need for further study of AF-induced human adverse health effects, especially the predominant diseases in the region. PMID:26208708

  17. The Impact of the School-Based Psychosocial Structured Activities (PSSA) Program on Conflict-Affected Children in Northern Uganda

    ERIC Educational Resources Information Center

    Ager, Alastair; Akesson, Bree; Stark, Lindsay; Flouri, Eirini; Okot, Braxton; McCollister, Faith; Boothby, Neil

    2011-01-01

    Background: Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention…

  18. Sexual and Reproductive Health Information Sources Preferred by Out-of-School Adolescents in Rural Southwest Uganda

    ERIC Educational Resources Information Center

    Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

    2010-01-01

    This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex…

  19. Inclusion of Pupils with Intellectual Disabilities: Primary School Teachers' Attitudes and Willingness in a Rural Area in Uganda

    ERIC Educational Resources Information Center

    Ojok, Patrick; Wormnaes, Siri

    2013-01-01

    Teachers in regular schools have a responsibility to accommodate the needs and interests of all learners. The attitudes and willingness of teachers to include learners with intellectual disabilities in their classes in regular schools in a district with a semi-nomadic pastoral population in north-eastern Uganda was investigated. A survey of 125…

  20. The Effect of Land Tenure System on Women's Knowledge-Base and Resource Management in Manjiya County, Uganda

    ERIC Educational Resources Information Center

    Kagoda, Alice Merab

    2008-01-01

    This study examines the status of women in relationship to land ownership, the resources they are exposed to and management practices, consequently its effect on the environment of Manjiya County, Mbale District in (now Manafwa since 2008) Uganda. It was found out that low levels of education limit women's abilities of creativity and…

  1. IUDs in Uganda.

    PubMed

    Saxton, G A; Pike, M C

    1967-01-01

    Dr G.A. Saxton of the department of preventive and social medicine, Makerere University College Medical School, Kampala, Uganda, and Dr M.C. Pike, of the Medical Research Council statistical research unit, carried out an investigation into the use of IUDs in a multiracial group in Kampala. A full report of their findings will shortly be published, but in the meantime they have supplied the Bulletin with a survey of their work: Between November 1963 and September 1966, approximately 1500 women attended the Uganda Family Planning Association clinic in Kampala, seeking birth control advice. After various contraceptive methods had been described to them, 1000 of these women chose the IUD. Of these, 921 had an IUD fitted. The experience of these women was reviewed at the end of 1966, and using the actuarial life-table method of analysis on the data obtained, we found that : 1. The total retention of the IUDs was depressingly poor and very much the same in all racial groups--approximately 63% of women still having a device (not necessarily the first one) in situ 12 months after the first insertion. 2. There was a steady and marked increase in the total retention of the IUDs with higher parity (and older) women. 3. Lippes loop D was clearly superior to Lippes loop C in terms of total retention (56% as compared to 20% of first loops in situ at 12 months). This superiority was accounted for almost solely by a higher expulsion rate with Lippes loop C. 4. The most significant medical observation in this small study was that for any given IUD the rate of expulsion of the first device did not fall with the length of time since insertion. In this type of study the number of women at risk rapidly diminishes with time after insertion, so that at first sight one gets the false impression that the expulsion rate is hishest in the first month or two. Similarly, the rate of removal of first devices is only somewhat less constant, tending to increase after about a year--this increase

  2. Delayed School Entry in Uganda

    ERIC Educational Resources Information Center

    Moyi, Peter

    2011-01-01

    Since 1997 Uganda has seen a large increase in school enrolment. Despite this increased enrolment, universal education has remained elusive. Many children enrol in school, but not at the recommended age, and they drop out before completing school. This article focuses on one of these problems--delayed school entry. What household factors are…

  3. Over-the-counter suboptimal dispensing of antibiotics in Uganda

    PubMed Central

    Mukonzo, Jackson K; Namuwenge, Proscovia M; Okure, Gildo; Mwesige, Benjamin; Namusisi, Olivia K; Mukanga, David

    2013-01-01

    Background Overuse and misuse of antibiotics is a serious global problem. While resistance to older antibiotics is increasing, development of newer molecules has stalled. Resistance to the existing antibiotics that is largely driven by their high-volume use is a global public health problem. Uganda is one of the countries where prescription-only drugs, including antibiotics, can be obtained over the counter. We determined the rate of antibiotic dispensing and use in Uganda. Methods The study utilized a descriptive cross-sectional study design to determine the number of antibiotic “prescribed” daily doses per 1,000 clients. Data were collected from one health center II, eight general/district hospitals, one national referral hospital, and 62 registered community pharmacies. From each study site, data were collected for five consecutive days over the months of November 2011 to January 2012. Results The overall antibiotic issue rate was 43.2%. Amoxicillin, metronidazole, ciprofloxacin, sulfamethoxazole–trimethoprim, cloxacillin, and ampicillin, belonging to the WHO anatomical therapeutic chemical classifications of penicillin with extended spectra, imidazole derivatives, fluoroquinolones, and sulfonamide–trimethoprim combinations, constituted 70% of the issued antibiotics. About 41% of antibiotics were issued over the counter. At community pharmacies, where 30% of antibiotic dispensing occurred, the number of prescribed daily doses/1,000 antibiotic clients was 4,169 compared to 6,220, 7,350 and 7,500 at general/district hospitals, the national referral hospital, and the health center, respectively. Conclusion In Uganda, at least four in every ten individuals that visit a health-care facility are treated with an antibiotic. Antibiotics are largely given as over-the-counter drugs at community pharmacies. The number of antibiotic prescribed daily doses/1,000 antibiotic clients does not significantly differ between categories of health-care facilities except at

  4. POVERTY, LIFE EVENTS AND THE RISK FOR DEPRESSION IN UGANDA

    PubMed Central

    2012-01-01

    Background Understanding the determinants of major depression in sub-Saharan Africa is important for planning effective intervention strategies. Objective To investigate the social and life-event determinants of major depressive disorder in the African socio-cultural context of rural Uganda. Methods A cross-section survey was carried out in 14 districts in Uganda from 1st June 2003-30th October 2004. 4660 randomly selected respondents (15 years and above) were interviewed. The primary outcome was the presence of major depressive disorder as assessed by the Hopkins Symptom Checklist (HSCL-25). Results The prevalence of major depressive disorder was 29.3% (95% confidence interval, 28.0%-30.6%). Factors independently associated with depression in both genders included: the ecological factor, district; age (increase with each age category after 35 years); indices of poverty and deprivation (no formal education, having no employment, broken family, and socio-economic classes III-V). Only a few adverse life events, notably those suggestive of a disrupted family background (death of a father in females and death of a mother in males) were associated with increased risk. Conclusion: Socioeconomic factors operating at both ecological and the individual level are the strongest independent determinants of depression. Adverse life events were less strongly associated with depression in this sample. PMID:19916062

  5. Frequent Detection of HPV before and after Initiation of Antiretroviral Therapy among HIV/HSV-2 Co-Infected Women in Uganda

    PubMed Central

    Rositch, Anne F.; Gravitt, Patti E.; Tobian, Aaron A. R.; Newell, Kevin; Quinn, Thomas C.; Serwadda, David; Ssebbowa, Paschal; Kiggundu, Valerian; Gray, Ronald H.; Reynolds, Steven J.

    2013-01-01

    Objectives Most data on HPV and antiretroviral therapy (ART) come from high-resource countries with infrequent sampling for HPV pre- and post-ART initiation. Therefore, we examined the frequency of cervical HPV DNA detection among HIV/HSV-2 co-infected women followed monthly for 6 months both before and after initiation of ART in Rakai, Uganda. Methods Linear Array was used to detect 37 HPV genotypes in self-collected cervicovaginal swabs from 96 women who initiated ART. Random-effects log-binomial regression was used to compare the prevalence of HPV detection in the pre- and post-ART periods and determine other potential risk factors, including CD4 counts and HIV viral load. Results Nearly all women had detectable HPV in the 6 months preceding ART initiation (92%) and the cumulative prevalence remained high following initiation of therapy (90%). We found no effect of ART on monthly HPV DNA detection (prevalence ratio: 1.0; 95% confidence interval: 0.96, 1.08), regardless of immune reconstitution or HIV viral suppression. Older age and higher pre-ART CD4 counts were associated with a significantly lower risk of HPV DNA detection. Conclusions ART did not impact HPV detection within 6 months of therapy initiation, highlighting the importance of continued and consistent screening, even after ART-initiation and immune reconstitution. PMID:23383171

  6. Discontinuation of cost sharing in Uganda.

    PubMed Central

    Burnham, Gilbert M.; Pariyo, George; Galiwango, Edward; Wabwire-Mangen, Fred

    2004-01-01

    OBJECTIVE: To assess the effects of ending cost sharing on use of outpatient services and how this was perceived by health workers and members of a health unit management committee. METHODS: From 10 districts across Uganda, 78 health facilities were selected. Attendance at these facilities was assessed for eight months before and 12 months after cost sharing ended. The data represented 1 966 522 outpatient visits. Perceptions about the impact of ending cost sharing were obtained from the 73 health workers and 78 members of the health unit management committee who were available. FINDINGS: With the end of cost sharing, the mean monthly number of new visits increased by 17 928 (53.3%), but among children aged <5 years the increase was 3611 (27.3%). Mean monthly reattendances increased by 2838 (81.3%) among children aged <5 years and 1889 (24.3%) among all people. Attendances for immunizations, antenatal clinics, and family planning all increased, despite these services having always been free. Health workers reported a decline in morale, and many health unit management committees no longer met regularly. CONCLUSION: Use of all services increased - even those that had never before been subject to fees. The loss of some autonomy by the health facility and diminished community governance of health facilities may have long term negative effects. PMID:15112007

  7. Nodding syndrome, western Uganda, 1994.

    PubMed

    Kaiser, Christoph; Rubaale, Tom; Tukesiga, Ephraim; Kipp, Walter; Asaba, George

    2015-07-01

    Nodding syndrome (NS) is a poorly understood condition, which was delineated in 2008 as a new epilepsy syndrome. So far, confirmed cases of NS have been observed in three circumscribed African areas: southern Tanzania, southern Sudan, and northern Uganda. Case-control studies have provided evidence of an association between NS and infection with Onchocerca volvulus, but the causation of NS is still not fully clarified. We report a case of a 15-year old boy with head nodding seizures and other characteristic features of NS from an onchocerciasis endemic area in western Uganda, with no contiguity to the hitherto known areas. We suggest that the existence of NS should be systematically investigated in other areas. PMID:25918208

  8. Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda

    PubMed Central

    Mueller, Dirk H; Abeku, Tarekegn A; Okia, Michael; Rapuoda, Beth; Cox, Jonathan

    2009-01-01

    Background Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. Methods An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. Results The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. Conclusion Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates. PMID:19149878

  9. Women for women's health: Uganda.

    PubMed

    Andrews, C M

    1996-01-01

    The primary health care model targets social, political, and economic environments as key determinants of health for populations, as well as for individuals. If nursing in Uganda is to make a difference in health care outcomes and in the health of all Ugandans, nurses must look broadly at situations and be educated to practice primary health care nursing. After 14 years of civil war, Uganda is finally experiencing a period of reconstruction and rehabilitation: the whole infrastructure is undergoing a face-lift. Ugandan nurses recognize that their educational preparation has stagnated for many years and that it was not only the political unrest in their country that put them behind professionally. They realize that, given the new directions set by the government, they must become prepared to implement primary health care. They are demanding a university education so they may take their place alongside other health care providers prepared at the university level. Some of the most convincing arguments for a university program for nurses came from doctors at the university who spoke about the need to raise the standards of nursing practice, the quality of teachers, and the morale of practitioners. One nurse said: "If we lose hope for a BScN program, I think all the nurses will quit and we won't have any new students going into the profession." This program is designed to improve the health and well-being of all Ugandans, especially the most vulnerable groups of women and children in rural areas, through strengthening and expanding health services by targeting the educational preparation of nurses. Health planners in Uganda envision the professional nurse as key to the implementation of the national health policy of primary health care. University-educated nurses should be able to assess problems, make clinically sound decisions, and act appropriately within the scope of nursing practice. They should be able to interact and consult collegially with other health care

  10. Alcohol disorder amongst forcibly displaced persons in northern Uganda

    PubMed Central

    Roberts, Bayard; Felix Ocaka, Kaducu; Browne, John; Oyok, Thomas; Sondorp, Egbert

    2011-01-01

    Background Alcohol use may be a coping mechanism for the stressors related to forced displacement. The aim of this study was to investigate levels and determinants of alcohol disorder amongst internally displaced persons (IDPs) in northern Uganda. Methods A cross-sectional survey with 1206 adult IDPs was conducted in Gulu and Amuru districts. Alcohol disorder was measured using the AUDIT instrument. Multivariate logistic regression was used to explore demographic, socio-economic, displacement and trauma exposure determinants of alcohol disorder. Findings The prevalence of probable alcohol disorder was 17% of all respondents, and 66% amongst those who drank alcohol once a month or more frequently. Factors associated with alcohol disorder included men compared to women, older age, and experiencing a higher number of traumatic events. These findings can help identify potentially vulnerable groups and target responses more effectively. PMID:21481540

  11. Experiences of Parents with the Reading to Learn Approach: A Randomised Control Trial Initiative to Improve Literacy and Numeracy in Kenya and Uganda

    ERIC Educational Resources Information Center

    Abuya, Benta A.; Oketch, Moses; Ngware, Moses W.; Mutisya, Maurice; Musyoka, Peter K.

    2015-01-01

    Parental involvement in their children's schooling is in recognition that establishing the context in which a child attends school is important. Reading to Learn (RtL)was implemented in two districts of Kwale and Kinango in Kenya and of Amolatar and Dokolo in Uganda. This paper looks at parental involvement and their experiences with RtL. Data are…

  12. Bartonella species in invasive rats and indigenous rodents from Uganda.

    PubMed

    Billeter, Sarah A; Borchert, Jeff N; Atiku, Linda A; Mpanga, Joseph T; Gage, Kenneth L; Kosoy, Michael Y

    2014-03-01

    The presence of bartonellae in invasive rats (Rattus rattus) and indigenous rodents (Arvicanthis niloticus and Cricetomys gambianus) from two districts in Uganda, Arua and Zombo, was examined by PCR detection and culture. Blood from a total of 228 R. rattus, 31 A. niloticus, and 5 C. gambianus was screened using genus-specific primers targeting the 16S-23S intergenic spacer region. Furthermore, rodent blood was plated on brain heart infusion blood agar, and isolates were verified as Bartonella species using citrate synthase gene- (gltA) specific primers. One hundred and four fleas recovered from R. rattus were also tested for the presence of Bartonella species using the same gltA primer set. An overall prevalence of 1.3% (three of 228) was obtained in R. rattus, whereas 61.3% of 31 A. niloticus and 60% of five C. gambianus were positive for the presence of Bartonella species. Genotypes related to Bartonella elizabethae, a known zoonotic pathogen, were detected in three R. rattus and one C. gambianus. Bartonella strains, similar to bacteria detected in indigenous rodents from other African countries, were isolated from the blood of A. niloticus. Bartonellae, similar to bacteria initially cultured from Ornithodorus sonrai (soft tick) from Senegal, were found in two C. gambianus. Interestingly, bartonellae detected in fleas from invasive rats were similar to bacteria identified in indigenous rodents and not their rat hosts, with an overall prevalence of 6.7%. These results suggest that if fleas are competent vectors of these bartonellae, humans residing in these two districts of Uganda are potentially at greater risk for exposure to Bartonella species from native rodents than from invasive rats. The low prevalence of bartonellae in R. rattus was quite surprising, in contrast, to the detection of these organisms in a large percentage of Rattus species from other geographical areas. A possible reason for this disparity is discussed.

  13. Men in despair: a qualitative psychological autopsy study of suicide in northern Uganda.

    PubMed

    Kizza, Dorothy; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

    2012-11-01

    The psychosocial circumstances surrounding men's suicide in postconflict Central Northern Uganda were investigated using qualitative psychological autopsy interviews. Records of 17 men who died by suicide were identified through police and local leaders in Internally Displaced Peoples' camps of Amuru and Gulu Districts. Two to five significant others were interviewed around each case. Data were analyzed by interpretative phenomenological analysis (IPA). Lost dignity and social value, lack of hope for the family's future, overwhelming family responsibility, and mental illness were circumstances found to have preceded the suicides. The protracted war in the Northern region of Uganda left men in rural communities feeling disempowered and disenfranchised. This may have contributed to suicidal behavior in some of them. Suicide prevention in this area needs to be multidisciplinary with an emphasis on helping both men and women understand and deal with the many social changes that have evolved over time and affected their traditional roles and responsibilities. PMID:23075801

  14. The Babel effect: community linguistic diversity and extramarital sex in Uganda.

    PubMed

    Bishai, David; Patil, Priya; Pariyo, George; Hill, Ken

    2006-07-01

    We examine the association of community linguistic diversity with non-spousal sexual activity in Uganda. We conducted a survey on rates of sexual contact in last 12 months among 1709 respondents age 18-60 living in Uganda in early 2001. Households were selected at random from Demographic and Health Survey (DHS) 2000 household sampling frame listings in 12 districts and 120 clusters. Household listings described the principal language spoken by every household in the cluster. Sexual contact was reported by 26 vs. 13% of unmarried women in multilingual vs. monolingual clusters respectively. Extramarital sexual contact occurred for 29 vs. 16% for married men in multilingual vs. monolingual clusters respectively. These results were robust to multivariate models which included confounders such as urbanity, and cluster distance to market places, cinemas, and transportation. Our results suggest a robust association between residence in a multilinguistic community and higher rates of non-spousal sex.

  15. Towards Introducing Space Science in Uganda

    NASA Astrophysics Data System (ADS)

    Anguma, S.; Ayikoru, J.

    This paper discusses the strategies and importance of introducing space science in Uganda. It proposes that Mbarara University, as a new university focusing on science and technology, would be ideally situated to spearhead the introduction of space science in Uganda. It is our expectation that this will have a spin-off effect to other higher institutions of learning and that consequently space science will become fully incorporated into the national teaching curriculum for all schools in Uganda. Based on the fact that the Government has a deliberate policy of popularizing science and technology to accelerate national economic development, the introduction of space science in the school system is to be enhanced by these efforts. We have charted the way forward for space science in Uganda and outlined the conceptual framework illustrating the spin-off effect into the education system.

  16. How Uganda Reversed Its HIV Epidemic

    PubMed Central

    Okware, Sam; Naamara, Warren; Sutherland, Don; Flanagan, Donna; Carael, Michel; Blas, Erik; Delay, Paul; Tarantola, Daniel

    2006-01-01

    Uganda is one of only two countries in the world that has successfully reversed the course of its HIV epidemic. There remains much controversy about how Uganda's HIV prevalence declined in the 1990s. This article describes the prevention programs and activities that were implemented in Uganda during critical years in its HIV epidemic, 1987 to 1994. Multiple resources were aggregated to fuel HV prevention campaigns at multiple levels to a far greater degree than in neighboring countries. We conclude that the reversed direction of the HIV epidemic in Uganda was the direct result of these interventions and that other countries in the developing world could similarly prevent or reverse the escalation of HIV epidemics with greater availability of HIV prevention resources, and well designed programs that take efforts to a critical breadth and depth of effort. PMID:16858635

  17. World Bank credits Uganda with $50m. -- emphasis on communities, NGOs and health.

    PubMed

    1994-01-01

    Between 1983 and 1984, the World Bank financed 11 AIDS/STD projects in Africa, most of which tended to cost comparatively small amounts. It increased the amount of its AIDS/STD loans considerably in 1993 and 1994 ($75 million in Zimbabwe and $50 million in Uganda). The Ugandan government, Germany, Sweden, and the UK are also funding the AIDS/STD project. Since the money is from the Bank's International Development Association, Uganda does not need to pay any interest on the loan. About 1.5 million people in Uganda are HIV positive. The number of AIDS patients continues to rise. The AIDS project in Uganda focuses on prevention of sexual transmission of HIV, mitigation of the personal impact of the epidemic, and institutional development. Prevention of sexual transmission activities are: promotion of safer sex behavior, condoms, and STD care-seeking behavior and effective STD care. Support for community-based and home-based health care and social support for people with AIDS, training staff about and providing drugs for opportunistic infections, protective supplies for public and private district health facilities, and diagnosis and case management of tuberculosis comprise mitigation of the personal impact of AIDS activities. Institutional development efforts include strengthening the district level's capacity to plan, coordinate, implement, monitor, and evaluate integrated AIDS-related activities, and the national level's capacity to provide adequate technical support on health issues linked to AIDS. Three key policies of the project are decentralization, community mobilization, and encouragement of nongovernmental organizations to work with communities and to complement government efforts. A large scale AIDS/STD mass media program is planned. Project goals are: 50% of the population knowing at least 2 actual ways to protect themselves from HIV. 50% of the population using condoms, and 70% of people seeking STD care receiving appropriate STD case management.

  18. World Bank credits Uganda with $50m. -- emphasis on communities, NGOs and health.

    PubMed

    1994-01-01

    Between 1983 and 1984, the World Bank financed 11 AIDS/STD projects in Africa, most of which tended to cost comparatively small amounts. It increased the amount of its AIDS/STD loans considerably in 1993 and 1994 ($75 million in Zimbabwe and $50 million in Uganda). The Ugandan government, Germany, Sweden, and the UK are also funding the AIDS/STD project. Since the money is from the Bank's International Development Association, Uganda does not need to pay any interest on the loan. About 1.5 million people in Uganda are HIV positive. The number of AIDS patients continues to rise. The AIDS project in Uganda focuses on prevention of sexual transmission of HIV, mitigation of the personal impact of the epidemic, and institutional development. Prevention of sexual transmission activities are: promotion of safer sex behavior, condoms, and STD care-seeking behavior and effective STD care. Support for community-based and home-based health care and social support for people with AIDS, training staff about and providing drugs for opportunistic infections, protective supplies for public and private district health facilities, and diagnosis and case management of tuberculosis comprise mitigation of the personal impact of AIDS activities. Institutional development efforts include strengthening the district level's capacity to plan, coordinate, implement, monitor, and evaluate integrated AIDS-related activities, and the national level's capacity to provide adequate technical support on health issues linked to AIDS. Three key policies of the project are decentralization, community mobilization, and encouragement of nongovernmental organizations to work with communities and to complement government efforts. A large scale AIDS/STD mass media program is planned. Project goals are: 50% of the population knowing at least 2 actual ways to protect themselves from HIV. 50% of the population using condoms, and 70% of people seeking STD care receiving appropriate STD case management. PMID

  19. Earth Science Education in Uganda

    NASA Astrophysics Data System (ADS)

    Barifaijo, E.

    1999-05-01

    Uganda has two Government funded universities, five operating private universities and four other universities are due to start soon. Geology was first taught in Uganda at Makerere University in 1968 within the Department of Geography. Through the leadership of Prof. Robert Macdonald it became established as a full department in August 1969 as part of the Faculty of Science. Both pure and applied geology are taught and the courses are designed to suit the current job market. At present, the three-term academic year is being replaced by a semester-based course unit system. At the same time, the 3:2:2 subject combination, requiring a student to do three subjects in first year and two subjects in both second and third years, is to be replaced by a major-minor subject combination. Currently, there are about 50 undergraduate students and four Ph.D. students in the Department. A student Geological Association acts as a forum for the exchange of information on matters of geological concern. An affirmative action policy has improved the intake of women students into the Department. On average, the number of women has increased from about 10% to 33.3% in the years 1984/85 to 1997/98. Their performance parallels that of the male students and they are readily employed. Of the eight members of academic staff, two are women. The Department of Geology has good links with regional and overseas universities through which a number of research programmes are currently supported. In addition, most of the training of manpower for the University and research programmes is supported by regional and international research agencies. Academic staff combine teaching with research and consultancy.

  20. Evaluation Of A Maternal Health Program In Uganda And Zambia Finds Mixed Results On Quality Of Care And Satisfaction.

    PubMed

    Kruk, Margaret E; Vail, Daniel; Austin-Evelyn, Katherine; Atuyambe, Lynn; Greeson, Dana; Grépin, Karen Ann; Kibira, Simon P S; Macwan'gi, Mubiana; Masvawure, Tsitsi B; Rabkin, Miriam; Sacks, Emma; Simbaya, Joseph; Galea, Sandro

    2016-03-01

    Saving Mothers, Giving Life is a multidonor program designed to reduce maternal mortality in Uganda and Zambia. We used a quasi-random research design to evaluate its effects on provider obstetric knowledge, clinical confidence, and job satisfaction, and on patients' receipt of services, perceived quality, and satisfaction. Study participants were 1,267 health workers and 2,488 female patients. Providers' knowledge was significantly higher in Ugandan and Zambian intervention districts than in comparison districts, and in Uganda there were similar positive differences for providers' clinical confidence and job satisfaction. Patients in Ugandan intervention facilities were more likely to give high ratings for equipment availability, providers' knowledge and communication skills, and care quality, among other factors, than patients in comparison facilities. There were fewer differences between Zambian intervention and comparison facilities. Country differences likely reflect differing intensity of program implementation and the more favorable geography of intervention districts in Uganda than in Zambia. National investments in the health system and provider training and the identification of intervention components most associated with improved performance will be required for scaling up and sustaining the program.

  1. Evaluation Of A Maternal Health Program In Uganda And Zambia Finds Mixed Results On Quality Of Care And Satisfaction.

    PubMed

    Kruk, Margaret E; Vail, Daniel; Austin-Evelyn, Katherine; Atuyambe, Lynn; Greeson, Dana; Grépin, Karen Ann; Kibira, Simon P S; Macwan'gi, Mubiana; Masvawure, Tsitsi B; Rabkin, Miriam; Sacks, Emma; Simbaya, Joseph; Galea, Sandro

    2016-03-01

    Saving Mothers, Giving Life is a multidonor program designed to reduce maternal mortality in Uganda and Zambia. We used a quasi-random research design to evaluate its effects on provider obstetric knowledge, clinical confidence, and job satisfaction, and on patients' receipt of services, perceived quality, and satisfaction. Study participants were 1,267 health workers and 2,488 female patients. Providers' knowledge was significantly higher in Ugandan and Zambian intervention districts than in comparison districts, and in Uganda there were similar positive differences for providers' clinical confidence and job satisfaction. Patients in Ugandan intervention facilities were more likely to give high ratings for equipment availability, providers' knowledge and communication skills, and care quality, among other factors, than patients in comparison facilities. There were fewer differences between Zambian intervention and comparison facilities. Country differences likely reflect differing intensity of program implementation and the more favorable geography of intervention districts in Uganda than in Zambia. National investments in the health system and provider training and the identification of intervention components most associated with improved performance will be required for scaling up and sustaining the program. PMID:26953307

  2. Effectiveness of vaccines and vaccination programs for the control of foot-and-mouth disease in Uganda, 2001-2010.

    PubMed

    Muleme, Michael; Barigye, Robert; Khaitsa, Margaret L; Berry, Eugene; Wamono, Anthony W; Ayebazibwe, Chrisostom

    2013-01-01

    Foot-and-mouth disease (FMD) is a highly contagious disease of cloven-hoofed animals. In Uganda, FMD outbreaks are mainly controlled by ring vaccination and restriction of animal movements. Vaccination stimulates immunity and prevents animals from developing clinical signs which include lameness, inappetence, and decreased production. Ring vaccination and restriction of animal movements have, however, not successfully controlled FMD in Uganda and outbreaks reoccur annually. The objective of this study was to review the use of FMD virus (FMDV) vaccines and assess the effectiveness of vaccination programs for controlling FMD in Uganda (2001-2010), using retrospective data. FMD vaccine distribution patterns in Uganda (2001-2010) matched occurrence of outbreaks with districts reporting the highest number of outbreaks also receiving the largest quantity of vaccines. This was possibly due to "fire brigade" response of vaccinating animals after outbreaks have been reported. On average, only 10.3 % of cattle within districts that reported outbreaks during the study period were vaccinated. The average minimum time between onset of outbreaks and vaccination was 7.5 weeks, while the annual cost of FMDV vaccines used ranged from US $58,000 to 1,088,820. Between 2001 and 2010, serotyping of FMD virus was done in only 9/121 FMD outbreaks, and there is no evidence that vaccine matching or vaccine potency tests have been done in Uganda. The probability of FMDV vaccine and outbreak mismatch, the delayed response to outbreaks through vaccination, and the high costs associated with importation of FMDV vaccines could be reduced if virus serotyping and subtyping as well as vaccine matching were regularly done, and the results were considered for vaccine manufacture.

  3. Epidemiological Overview of African Swine Fever in Uganda (2001-2012).

    PubMed

    Kalenzi Atuhaire, David; Ochwo, Sylvester; Afayoa, Mathias; Norbert Mwiine, Frank; Kokas, Ikwap; Arinaitwe, Eugene; Ademun-Okurut, Rose Anna; Boniface Okuni, Julius; Nanteza, Ann; Ayebazibwe, Christosom; Okedi, Loyce; Olaho-Mukani, William; Ojok, Lonzy

    2013-01-01

    African swine fever (ASF) is a contagious viral disease, which can cause up to 100% mortality among domestic pigs. In Uganda there is paucity of information on the epidemiology of the disease, hence a study was carried out to elucidate the patterns of ASF outbreaks. Spatial and temporal analyses were performed with data collected monthly by the district veterinary officers (DVOs) and sent to the central administration at MAAIF from 2001 to 2012. Additionally, risk factors and the associated characteristics related to the disease were assessed based on semistructured questionnaires sent to the DVOs. A total of 388 ASF outbreaks were reported in 59 districts. Of these outbreaks, 201 (51.8%) were reported in districts adjacent to the national parks while 80 (20.6%) were adjacent to international borders. The number of reported ASF outbreaks changed over time and by geographical regions; however, no outbreak was reported in the North-Eastern region. ASF was ranked as second most important disease of pigs, and it occurred mostly during the dry season (P = 0.01). Pig movements due to trade (OR 15.5, CI 4.9-49.1) and restocking (OR 6.6, CI 2.5-17.3) were the major risk factors. ASF control strategies should focus on limiting pig movements in Uganda.

  4. Postemergency health services for refugee and host populations in Uganda, 1999-2002.

    PubMed

    Orach, Christopher Garimoi; De Brouwere, Vincent

    Since 1990, Uganda has hosted an estimated 200?000 refugees in postemergency settlements interspersed within host communities. We investigated the extent to which obstetric needs were met in the refugee and host populations during 1999-2002. Between September and December, 2000, we retrospectively collected data from 1999 and 2000 on major obstetric interventions for absolute maternal indications from all five hospitals in Arua, Adjumani, and Moyo districts, Uganda. The same data were collected prospectively for 2001. We did community-based maternal mortality surveys on refugee and host populations in Adjumani district in 2002. Rates of major obstetric interventions were significantly higher for refugees than for the host population who live in the same rural areas as refugees (1.01% [95% CI 0.77-1.25] vs 0.45% [0.38-0.52]; p<0.0001). Rates of major obstetric interventions were also significantly higher for refugees than for the host population who live in rural areas without refugees (1.01% [0.77-1.25] vs 0.40% [0.36-0.44]; p<0.0001). Maternal mortality was 2.5 times higher in the host population than in refugees in the Adjumani district (322 per 100000 births [247-396] vs 130 [81-179]. Refugees had better access to health services than did the rural host population in the northern Ugandan communities that we surveyed. PMID:15313362

  5. Acceptability of male circumcision for prevention of HIV infection among men and women in Uganda.

    PubMed

    Albert, Lisa M; Akol, Angela; L'Engle, Kelly; Tolley, Elizabeth E; Ramirez, Catalina B; Opio, Alex; Tumwesigye, Nazarius M; Thomsen, Sarah; Neema, Stella; Baine, Sebastian O

    2011-12-01

    In the last decade, three randomized controlled trials in Kenya, South Africa, and Uganda have shown that medical male circumcision (MMC) reduces the sexual transmission of HIV from women to men. Objectives of this assessment were to measure acceptability of adult MMC and circumcision of children to inform policies regarding whether and how to promote MMC as an HIV prevention strategy. This mixed-method study, conducted across four Ugandan districts, included a two-stage household survey of 833 adult males and 842 adult females, focus group discussions, and a health provider survey. Respondents' acceptability of MMC was positive and substantial after being informed about the results of recent randomized trials. In uncircumcised men, between 40% and 62% across the districts would consider getting circumcised. Across the four districts between 60% and 86% of fathers and 49% and 95% of mothers were supportive of MMC for sons. Widespread support exists among men and women in this study for promoting MMC as part of Uganda's current 'ABC + ' HIV prevention strategy. PMID:21732902

  6. Capacity building for child health: Canadian paediatricians in Uganda

    PubMed Central

    Brenner, Jennifer L; Godel, John C

    2005-01-01

    BACKGROUND For six years, Canadian paediatricians have worked in partnership with their Ugandan colleagues to promote improved child health in southwestern Uganda. OBJECTIVES To describe a collaboration between the Mbarara University of Science and Technology and Canadian partners that aims to build local capacity in child health through support of training at university, community and health centre levels. METHODS Three low-cost initiatives are now implemented. At the university level, volunteer Canadian paediatricians support Ugandan faculty colleagues through teaching health care trainees at a busy tertiary referral and teaching hospital. In the community, the Healthy Child Project helps Ugandans train local health volunteers who educate mothers and caregivers about child health. At health centres in the Mbarara and Bushenyi Districts, Canadians support a locally initiated outreach program that provides paediatric consultation and continuing medical education for staff at rural health posts. RESULTS Ugandans and Canadians have benefited from this collaboration. Hundreds of Ugandan undergraduate and graduate health care trainees, more than 100 community volunteers and numerous local health practitioners have received child health training through one of these three Canadian-supported paediatric initiatives. More than 25 Canadian paediatricians have benefited greatly from their overseas teaching and clinical experience. CONCLUSIONS The strength of this collaboration is a shared interest in improving child health in southwestern Uganda. A strong Ugandan-Canadian partnership has built significant child health capacity with great benefit to both partners. These initiatives may serve as a model for other child health providers wishing to support capacity-building initiatives in less developed countries to improve global health. PMID:19668631

  7. Condom use within marriage: an assessment of changes in South Africa and Uganda.

    PubMed

    Maharaj, Pranitha; Neema, Stella; Cleland, John; Busza, Joanna; Shah, Iqbal

    2012-01-01

    The aim of the study is to measure trends in condom use in marital and cohabiting relationships in South Africa and Uganda. The data for the study come from two cross sectional surveys conducted in 1998 and 2008 among adult men and women and their partners in KwaZulu-Natal, South Africa and the Jinja district, Uganda. The findings suggest that consistent condom use has risen substantially in both countries. The percentage reporting consistent condom use in the South African sample of husbands increased from 2.5% in 1998 to 12% in 2008 and from 5.5 to 12.5% among wives. In Uganda, the corresponding trends are 1.1-8.3% for husbands and 4-8.6% for wives. In both countries, condom use was considerably higher among the minority of couples where one or both partners were thought to be HIV positive. Increasingly, in both countries condoms are also used for contraceptive purposes. Condoms play a role in preventing HIV infection but the challenge is for prevention programs to broaden their focus toward meeting the needs of married and cohabiting couples.

  8. Uganda does what it can for women.

    PubMed

    1993-01-01

    Uganda is a fertile, but poor, predominately rural country that was a British protectorate from 1894 until 1962. Uganda made significant achievements in the delivery of health care and education until the rule of Idi Amin (1971-79), when the country was plunged into chaos. The current Ugandan president enjoys broad-based support and has responded to the health care crisis by creating a national system of Resistance Councils using traditional networks to monitor local health developments. The health priorities for women in Uganda include improving maternal-child health; combating AIDS, rape, and sexual abuse; increasing use of family planning; understanding and working to change the cultural context that shapes reproductive health and sex behavior (such as "sugar daddies," older men who entice sex from young girls with presents and money); and expanding women's rights so that they can improve their health.

  9. Unintended pregnancy and abortion in Uganda.

    PubMed

    Hussain, Rubina

    2013-01-01

    Unintended pregnancy is common in Uganda, leading to high levels of unplanned births, unsafe abortions, and maternal injury and death. Because most pregnancies that end in abortion are unwanted, nearly all ill health and mortality resulting from unsafe abortion is preventable. This report summarizes evidence on the context and consequences of unintended pregnancy and unsafe abortion in Uganda, points out gaps in knowledge, and highlights steps that can be taken to reduce levels of unintended pregnancy and unsafe abortion, and, in turn, the high level of maternal mortality.

  10. A climate trend analysis of Uganda

    USGS Publications Warehouse

    Funk, Christopher C.; Rowland, Jim; Eilerts, Gary; White, Libby

    2012-01-01

    This brief report, drawing from a multi-year effort by the U.S. Agency for International Development (USAID) Famine Early Warning Systems Network (FEWS NET), identifies observed changes in rainfall and temperature in Uganda, based on an analysis of a quality-controlled, long time series of station observations throughout Uganda. Extending recent trends forward, it also provides a current and near-future context for understanding the actual nature of climate change impacts in the country, and a basis for identifying climate adaptations that may protect and improve the country's food security.

  11. Partnerships for Policy Development: A Case Study From Uganda's Costed Implementation Plan for Family Planning.

    PubMed

    Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

    2016-06-20

    In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda's CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda's CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda's CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

  12. Partnerships for Policy Development: A Case Study From Uganda's Costed Implementation Plan for Family Planning.

    PubMed

    Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

    2016-06-20

    In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda's CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda's CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda's CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution.

  13. Expert knowledge sourcing for public health surveillance: national tsetse mapping in Uganda.

    PubMed

    Berrang-Ford, Lea; Garton, Kelly

    2013-08-01

    In much of sub-Saharan Africa, availability of standardized and reliable public health data is poor or negligible. Despite continued calls for the prioritization of improved health datasets in poor regions, public health surveillance remains a significant global health challenge. Alternate approaches to surveillance and collection of public health data have thus garnered increasing interest, though there remains relatively limited research evaluating these approaches for public health. Herein, we present a case study applying and evaluating the use of expert knowledge sources for public health dataset development, using the case of vector distributions of Human African Trypanosomiasis (HAT) in Uganda. Specific objectives include: 1) Review the use of expert knowledge sourcing methods for public health surveillance, 2) Review current knowledge on tsetse vector distributions of public health importance in Uganda and the methods used for tsetse mapping in Africa; 3) Quantify confidence of the presence or absence of tsetse flies in Uganda based on expert informant reports, and 4) Assess the reliability and potential utility of expert knowledge sourcing as an alternative or complimentary method for public health surveillance in general and tsetse mapping in particular. Information on tsetse presence or absence, and associated confidence, was collected through interviews with District Entomologist and Veterinary Officers to develop a database of tsetse distributions for 952 sub-counties in Uganda. Results show high consistency with existing maps, indicating potential reliability of modeling approaches, though failing to provide evidence for successful tsetse control in past decades. Expert-sourcing methods provide a novel, low-cost and rapid complimentary approach for triangulating data from prediction modeling where field-based validation is not feasible. Data quality is dependent, however, on the level of expertise and documentation to support confidence levels for

  14. Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda

    PubMed Central

    Tsongo, Lawrence; Nakavuma, Jessica; Mugasa, Claire; Kamalha, Edwin

    2015-01-01

    Introduction To meet key millennium development goals, the rural population needs to be reached for health assessment and service delivery. Gastroduodenal ulcer disease is a common ailment affecting the health of people in Uganda. A cross-sectional study was conducted at Bwera Hospital in Kasese district of western Uganda, to establish the prevalence and predisposing factors of Helicobacter pylori among gastroduodenal ulcer disease patients. Methods A sample of 174 patients with symptoms of gastroduodenal ulcer disease was purposively obtained. Using two laboratory test methods, the prevalence of H. pylori among these patients was determined. A structured questionnaire was administered to participants to establish their demographic background and selected aspects of their lifestyle. Finally, the results obtained by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic rapid test (IRT) were compared. Results We established the prevalence of H. pylori as 29.9% (52/174) by ELISA and 37.4% (65/174) by IRT. Cigarette smoking, poor sanitation, and lack of formal education were the significant predisposing factors with p-values <0.05. The two tests gave identical results in 87.9% of the patients. Discussion The prevalence of H. pylori by IRT and ELISA test methods was similar to what has been reported elsewhere in developed countries; but was lower than previously reported in developing countries including Uganda. The previous studies in Uganda were carried out in the urban population and on young children; and some used antibody-detection methods only, therefore leading to different prevalence as a result of difference in study population and methods. PMID:26560860

  15. Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

    PubMed

    OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

    2015-10-01

    Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda. PMID:26356209

  16. Predictive mapping of prospectivity for orogenic gold in Uganda

    NASA Astrophysics Data System (ADS)

    Herbert, Sarah; Woldai, Tsehaie; Carranza, Emmanuel John M.; van Ruitenbeek, Frank J. A.

    2014-11-01

    Integration of enhanced regional geo-datasets has facilitated new geological interpretation and modelling of prospectivity for orogenic gold in southwestern Uganda. The geo-datasets include historical geological maps, geological field data, digital terrain models, Landsat TM data and airborne geophysical data. The study area, bordered by the western branch of the East African Rift, covers a range of different aged terranes including the Archaean basement gneisses, Palaeoproterozoic volcano-sedimentary Buganda Toro Belt, Mesoproterozoic clastic sedimentary Karagwe Ankolean Belt and several outliers of undeformed Neoproterozoic sediments. The mineral systems approach to practical exploration targeting requires a framework to link conceptual models of mineralisation with available data. A conceptual model requires good understanding of key processes and their timing within the geodynamic history of an area. The challenge is that processes cannot be mapped, only their results or effects. In this study, a district-scale (1:100,000) investigation is considered appropriate given the scarcity of geological information and the absence of world-renowned gold deposits in southwestern Uganda. At this scale of orogenic gold mineral systems understanding, evidence for the source of gold, active pathways and the physical traps are considered critical. Following the mineral system approach, these processes critical to orogenic gold systems are translated into district-scale mappable proxies using available regional-scale datasets. Tectono-stratigraphic domains, mantle indicators and gold occurrences represent the “source of gold” as a critical process. Zones of hydrothermal alteration were extracted from radiometric data, structures involved in the orogenies and terrane contacts were extracted to represent the active pathway as a critical process and finally the physical throttle is represented by rheological contrasts and geological complexity. Then, the knowledge

  17. Early Childhood Development Policy Advances in Uganda

    ERIC Educational Resources Information Center

    Ejuu, Godfrey

    2012-01-01

    Knowledge of the history and development of early childhood development in Uganda is paramount if we are to know how far we have come and where we are going. This article explores the introduction of early childhood development in Ugandan policy and government interventions from 1960 to 2011. Data was obtained from a review of available early…

  18. Institutional Efficiency in Selected Universities in Uganda

    ERIC Educational Resources Information Center

    Amina, Nakimuli; Turyahebwa, Abanis

    2015-01-01

    Universities are accountable This study looked into Institutional Efficiency in selected Universities in Central Uganda. The study was guided by the following objectives; Determine the level of institutional efficiency of the universities in terms of educational efficiency; research efficiency and community service efficiency. The study employed…

  19. Seroprevalence of histoplasmosis in Kampala, Uganda

    PubMed Central

    Bahr, Nathan C; Sarosi, George A.; Meya, David B; Bohjanen, Paul R; Richer, Sarah M; Swartzentruber, Samantha; Halupnick, Ryan; Jarrett, Deidre; Wheat, L. Joseph; Boulware, David R

    2016-01-01

    Histoplasmosis is endemic to the Midwestern United States, but cases have been reported nearly worldwide. A 1970 study found 3.8% skin test sensitivity to Histoplasma capsulatum in Uganda but no systemic study of histoplasmosis exposure has occurred since the onset of the human immunodeficiency virus (HIV) pandemic. This study investigated the seroprevalence of H. capsulatum and sought previously undetected cases of histoplasmosis in Kampala, Uganda. Serum, cerebrospinal fluid (CSF) and/or urine specimens were obtained from HIV-infected persons with suspected meningitis. Specimens were tested for H. capsulatum IgG and IgM by enzyme immune assay and Histoplasma antigen. 147 of the 257 subjects who were enrolled had cryptococcal meningitis. Overall, 1.3% (2/151) of subjects were serum Histoplasma IgG positive, and zero of 151 were IgM positive. Antigen was not detected in any serum (n = 57), urine (n = 37, or CSF (n = 63) samples. Both subjects with serum Histoplasma IgG positivity had cryptococcal meningitis. Histoplasma capsulatum IgG was detected at low levels in persons with HIV/AIDS in Kampala, Uganda. Histoplasmosis is not widespread in Uganda but micro-foci do exist. There appears to be no cross-reactivity between Cryptococcus neoformans and Histoplasma antigen testing, and cryptococcosis appears to be at most, a rare cause of positive Histoplasma IgG. PMID:26527637

  20. Science, Technology and Innovation in Uganda

    ERIC Educational Resources Information Center

    Brar, Sukhdeep; Farley, Sara E.; Hawkins, Robert; Wagner, Caroline S.

    2010-01-01

    Science, Technology and Innovation in Uganda is part of the World Bank Studies series. These papers are published to communicate the results of the Bank's ongoing research and to stimulate public discussion. This study presents a unique methodology to view science, technology and innovation (STI) in developing countries. The study provides a set…

  1. One World-One Health and neglected zoonotic disease: elimination, emergence and emergency in Uganda.

    PubMed

    Smith, James; Taylor, Emma Michelle; Kingsley, Pete

    2015-03-01

    This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to interactions between: a) international, external actors not engaging with the Ugandan state; b) actors setting up structures and activities parallel to those of the state; c) actors deciding when emergencies begin and end without consultation; d) weak Ugandan state capacity to coordinate its own integrated response to disease; e) limited collaboration between core Ugandan planning activities and a weak, increasingly devolved district health system. These interrelated dynamics result in the global, international interventionalist mode of OWOH undermining the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU), the body within the Ugandan state mandated expressly with managing a sustainable One Health response to trypanosomiasis outbreaks in Uganda. This does two things, firstly it suggests we need a more grounded, national perspective of OWOH, where states and health systems are acknowledged and engaged with by international actors and initiatives. Secondly, it suggests that more support needs to be given to core coordinating capacity in resource-poor contexts. Supporting national coordinating bodies, focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains.

  2. One World-One Health and neglected zoonotic disease: elimination, emergence and emergency in Uganda.

    PubMed

    Smith, James; Taylor, Emma Michelle; Kingsley, Pete

    2015-03-01

    This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to interactions between: a) international, external actors not engaging with the Ugandan state; b) actors setting up structures and activities parallel to those of the state; c) actors deciding when emergencies begin and end without consultation; d) weak Ugandan state capacity to coordinate its own integrated response to disease; e) limited collaboration between core Ugandan planning activities and a weak, increasingly devolved district health system. These interrelated dynamics result in the global, international interventionalist mode of OWOH undermining the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU), the body within the Ugandan state mandated expressly with managing a sustainable One Health response to trypanosomiasis outbreaks in Uganda. This does two things, firstly it suggests we need a more grounded, national perspective of OWOH, where states and health systems are acknowledged and engaged with by international actors and initiatives. Secondly, it suggests that more support needs to be given to core coordinating capacity in resource-poor contexts. Supporting national coordinating bodies, focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains. PMID:24984807

  3. Incidence and Severity of Maize Ear Rots and Factors Responsible for Their Occurrence in Uganda

    NASA Astrophysics Data System (ADS)

    Bigirwa, G.; Kaaya, A. N.; Sseruwu, G.; Adipala, E.; Okanya, S.

    Eleven major maize growing districts of Uganda were surveyed for three consecutive seasons between 2002 and 2003 to establish maize ear rot incidence and severity. Sternocarpella maydis and Fusarium species particularly F. graminearum and F. verticillioides were the identified maize ear rot causing fungi. Incidence of S. maydis ranged from 2.5 to 32.5% while that of Fusarium sp. was in the range of 1.9 and 15.3%. In districts of higher altitude (above 1,800 m above sea level) F. graminearum dominated in all seasons while in districts with an altitude between 900 and 1,500 m above sea level, S. maydis was the major cause of ear rots. This observation was attributed to differences in temperature, altitude and rainfall. There was a strong positive correlation (p = 0.001) between incidence and severity for S. maydis and a weak one for Fusarium sp. because the latter would rarely infect the entire cob unlike the former. All farmers expressed concern about the quality of maize due to ear rots and sort out infected grain after harvest. However, varied uses of infected grain were noted. For example, in Kapchorwa district 82% of the respondents indicated that the infected grain is used for making local brew because the moulds give it a good taste and aroma, while in Kamuli and Masaka districts, 36% use it as animal feed ingredient. This indicates that people and animals could be ingesting mycotoxins unknowingly thus the need for sensitization programmes.

  4. Traditional methods in management of diarrhoeal diseases in Uganda.

    PubMed Central

    Anokbonggo, W. W.; Odoi-Adome, R.; Oluju, P. M.

    1990-01-01

    A total of 292 traditional healers were interviewed in five districts of Uganda to discover how diarrhoeal diseases were treated by them. At least two healers were present in every village visited, and over 42% of their case-load was concerned with diarrhoeal treatment. The investigation showed that a great variety of herbs/plants are used by traditional healers in the treatment of diarrhoeal diseases. All those interviewed used water as the main vehicle for their herbal preparations, the amount prescribed daily ranging from 20 ml to over 100 ml for children (in the case of 54.5% of healers) and 100 ml to over 500 ml for adults (56.6%); 26.4% of healers considered fluid supplements as mandatory and 70.5% advised patients to take as much fluid as possible. Only 3.1% of healers either limited or did not advise fluid intake. These findings indicate that traditional healers could play an important role in interventions to control diarrhoeal diseases using modern oral rehydration therapy if they are assisted to improve their techniques. PMID:2393983

  5. Between a rock and a hard place: stigma and the desire to have children among people living with HIV in northern Uganda

    PubMed Central

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C; Orach, Christopher G; Earnest, Jaya

    2012-01-01

    Background HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion The social-cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children

  6. Factors which predict violence victimization in Uganda

    PubMed Central

    Fry, Lincoln

    2014-01-01

    Introduction Violence is a major public health issue, globally and on the African continent. This paper looks at Uganda and begins the process of identifying the factors that predict violence in that country. The purpose is to interpret the implications of the study results for violence prevention programs. Methods The study includes the responses of 2 399 Ugandans collected in 2011 by the Fifth Round of the Afrobarometer surveys. The study concentrates on 259 respondents who reported either they or someone else in their family had been the victim of violence, defined as being physically attacked, in the last year. Results Logistical regression analysis identified six factors that predict physical violence in Uganda. In order, these included being the victim of a property crime, age, gender, fear of crime in the home, poverty, and residential crowding. The surprising findings relate to what may be called target hardening, especially for those likely to be re-victimized. Respondents did tend to be re-victimized, with about 61 percent of violence victims also property crime victims. Fear of crime in home was another predictor of violence victimization, and many of these respondents had been crime victims. Conclusion These findings imply that target hardening should be the basis to begin to implement violence prevention programs in Uganda. The suggestion is crime prevention personnel/ law enforcement need to respond to reported incidents of property and/or violence victimization and attempt to prepare victims to protect both their premises and their persons in the future. PMID:25918575

  7. Making a start with district health libraries.

    PubMed

    Materia, E; Omar, M A; Guerra, R; Ahmed, A M

    1994-01-01

    The dissemination of information at the district level in developing countries is hampered by an acute shortage of teaching materials and health information and the lack of libraries accessible to potential users. The lack of libraries is particularly serious, because of their usefulness in continuing education, job training, and supportive supervision. Health workers are helped by libraries in rural areas where professional support is lacking. Health workers in rural areas could serve to spread information on primary care and as literature resources for planners and evaluators of health services, and to facilitate the transmission of information from the system in which they operate. It is important that basic training be reinforced with updated health information; sophisticated systems of communication may not be affordable in remote or rural areas. A pilot project to address these concerns was developed by the Instituto Superiore di Sanita in Rome; the project would establish 30 district health libraries in Uganda and the Tanzania. The libraries would provide materials relevant to the users' local work activities, working environments, learning styles, language and semantics, and complementary to other available materials. Selection of materials would take place in consultation with local personnel. Questionnaires were administered to 30 district medical officers in Ethiopia, Tanzania, and Uganda; included in the survey were questions about their recommendations for 25 essential books and 20 books selected from the World Health Organization and Teaching Aids at Low Cost lists. A standard package of materials was prepared on clinical medicine, preventive health measures, primary care management, and other germane topics, and delivered to the target countries in July and August, 1992. Simultaneously coordinated workshops were held to introduce the packages to district medical officers, discuss the role of libraries in the continuing education of health workers

  8. Cattle movements and trypanosomes: restocking efforts and the spread of Trypanosoma brucei rhodesiense sleeping sickness in post-conflict Uganda

    PubMed Central

    2013-01-01

    Background The northwards spread of acute T. b. rhodesiense sleeping sickness in Uganda has been linked to cattle movements associated with restocking following the end to military conflict in 2006. This study examined the number of cattle traded from T. b. rhodesiense endemic districts, the prevalence of the parasite in cattle being traded and the level of trypanocidal treatment at livestock markets. Methods Between 2008 and 2009 interviews were carried out with government veterinarians from 20 districts in Uganda, 18 restocking organisations and numerous livestock traders and veterinarians. Direct observations, a review of movement permit records (2006 to 2008) and blood sampling of cattle (n = 1758) for detection of parasites were also conducted at 10 livestock markets in T. b. rhodesiense endemic districts. Results Records available from 8 out of 47 identified markets showed that 39.5% (5,238/13,267) of the inter-district cattle trade between mid-2006 and mid-2008 involved movement from endemic areas to pathogen-free districts. PCR analysis showed a prevalence of 17.5% T. brucei s.l. (n = 307/1758 [95% CI: 15.7-19.2]) and 1.5% T. b. rhodesiense (n = 26/1758 [95% CI: 0.9-2.0]) from these same markets. In a two-year period, between late-2006 to late-2008, an estimated 72,321 to 86,785 cattle (57, 857 by 18 restocking organisations and 10,214 to 24,679 by private traders) were imported into seven pathogen-free northern districts, including districts that were endemic for T. b. gambiense. Between 281 and 1,302 of these cattle were likely to have carried T. b. rhodesiense. While governmental organisations predominantly adhered to trypanocidal treatment, most Non-Governmental Organisations (NGOs) and private traders did not. Inadequate market infrastructure, poor awareness, the need for payment for drug treatments, and the difficulty in enforcing a policy of treatment at point of sale contributed to non-compliance. Conclusion With increasing private trade, preventing

  9. Mind the Gap: House Structure and the Risk of Malaria in Uganda

    PubMed Central

    Wanzirah, Humphrey; Tusting, Lucy S.; Arinaitwe, Emmanuel; Katureebe, Agaba; Maxwell, Kilama; Rek, John; Bottomley, Christian; Staedke, Sarah G.; Kamya, Moses; Dorsey, Grant; Lindsay, Steve W.

    2015-01-01

    Background Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. We assessed how house design may affect mosquito house entry and malaria risk in Uganda. Methods 100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878) were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves) or traditional (all other homes). Results A total of 113,618 female Anopheles were collected over 6,765 nights. 6,816 routine blood smears were taken of which 1,061 (15.6%) were malaria parasite positive. 2,582 episodes of uncomplicated malaria were diagnosed after 1,569 person years of follow-up, giving an overall incidence of 1.6 episodes per person year at risk. The human biting rate was lower in modern homes than in traditional homes (adjusted incidence rate ratio (IRR) 0.48, 95% confidence interval (CI) 0.37–0.64, p<0.001). The odds of malaria infection were lower in modern homes across all the sub-counties (adjusted odds ratio 0.44, 95%CI 0.30–0.65, p<0.001), while malaria incidence was lower in modern homes in Kihihi (adjusted IRR 0.61, 95%CI 0.40–0.91, p = 0.02) but not in Walukuba or Nagongera. Conclusions House design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas. PMID:25635688

  10. Gender and Age-Appropriate Enrolment in Uganda

    ERIC Educational Resources Information Center

    Wells, Ryan

    2009-01-01

    Secondary school enrolment in Uganda has historically favoured males over females. Recently, however, researchers have reported that the secondary enrolment gender gap has significantly diminished, and perhaps even disappeared in Uganda. Even if gender parity is being achieved for enrolment broadly, there may be a gender gap concerning…

  11. Dilemmas in Implementing Language Rights in Multilingual Uganda

    ERIC Educational Resources Information Center

    Namyalo, Saudah; Nakayiza, Judith

    2015-01-01

    Even after decades of uttering platitudes about the languages of Uganda, language policy pronouncements have invariably turned out to be public relations statements rather than blueprints for action. A serious setback for the right to linguistic equality and the right to use Uganda's indigenous languages has largely hinged on the language…

  12. Community health insurance amidst abolition of user fees in Uganda: the view from policy makers and health service managers

    PubMed Central

    2010-01-01

    Background This paper investigates knowledge of Community Health Insurance (CHI) and the perception of its relevance by key policy makers and health service managers in Uganda. Community Health Insurance schemes currently operate in the private-not-for-profit sector, in settings where church-based facilities function. They operate in a wider policy environment where user fees in the public sector have been abolished. Methods Semi-structured interviews were conducted during the second half of 2007 with District Health Officers (DHOs) and senior staff of the Ministry of Health (MOH). The qualitative data collected were analyzed using the framework method, facilitated by EZ-Text software. Results There is poor knowledge and understanding of CHI activities by staff of the MOH headquarters and DHOs. However, a comparison of responses reveals a relatively high level of awareness of CHI principles among DHOs compared to that of MOH staff. All the DHOs in the districts with schemes had a good understanding of CHI principles compared to DHOs in districts without schemes. Out-of-pocket expenditure remains an important feature of health care financing in Uganda despite blanket abolition of user fees in government facilities. Conclusion CHI is perceived as a relevant policy option and potential source of funds for health care. It is also considered a means of raising the quality of health care in both public and private health units. To assess whether it is also feasible to introduce CHI in the public sector, there is an urgent need to investigate the willingness and readiness of stakeholders, in particular high level political authorities, to follow this new path. The current ambiguity and contradictions in the health financing policy of the Uganda MOH need to be addressed and clarified. PMID:20132539

  13. Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey

    PubMed Central

    Abbo, Catherine; Okello, Elialilia S.; Muhwezi, Wilson; Akello, Grace; Ovuga, Emilio

    2016-01-01

    Aims 1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda. Study Design This was a cross-sectional study. Place and Duration of study Departments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012. Methodology Four (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence. Results A total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower

  14. Factors associated with the health status of internally displaced persons in northern Uganda

    PubMed Central

    Roberts, B; Ocaka, K Felix; Browne, J; Oyok, T; Sondorp, E

    2009-01-01

    Background: Globally, there are over 24 million internally displaced persons (IDPs) who have fled their homes due to violence and insecurity but who remain within their own country. There have been up to 2 million IDPs in northern Uganda alone. The objective of this study was to investigate factors associated with mental and physical health status of IDPs in northern Uganda. Methods: A cross-sectional survey was conducted in November 2006 in IDP camps in the Gulu and Amuru districts of northern Uganda. The study outcome of physical and mental health was measured using the SF-8 instrument, which produces physical (PCS) and mental (MCS) component summary measures. Independent demographic, socio-economic, and trauma exposure (using the Harvard Trauma Questionnaire) variables were also measured. Multivariate regression linear regression analysis was conducted to investigate associations of the independent variables on the PCS and MCS outcomes. Results: 1206 interviews were completed. The respective mean PCS and MCS scores were 42.2 (95% CI 41.32 to 43.10) and 39.3 (95% CI 38.42 to 40.13), well below the instrument norm of 50, indicating poor health. Variables with negative associations with physical or mental health included gender, age, marital status, income, distance of camp from home areas, food security, soap availability, and sense of safety in the camp. A number of individual trauma variables and the frequency of trauma exposure also had negative associations with physical and mental health. Conclusions: This study provides evidence on the impact on health of deprivation of basic goods and services, traumatic events, and fear and uncertainty amongst displaced and crisis affected populations. PMID:19028730

  15. Knowledge and Perception of Stroke: A Population-Based Survey in Uganda

    PubMed Central

    Nakibuuka, Jane; Sajatovic, Martha; Katabira, Elly; Ddumba, Edward; Byakika-Tusiime, Jayne; Furlan, Anthony J.

    2014-01-01

    Purpose This study, designed to complement a large population survey on prevalence of stroke risk factors, assessed knowledge and perception of stroke and associated factors. Methods A population survey was conducted in urban Nansana and rural Busukuma, Wakiso district, central Uganda. Adult participants selected by multistage stratified sampling were interviewed about selected aspects of stroke knowledge and perception in a pretested structured questionnaire. Results There were 1616 participants (71.8% urban; 68.4% female; mean age: 39.6 years ± 15.3). Nearly 3/4 did not know any stroke risk factors and warning signs or recognize the brain as the organ affected. Going to hospital (85.2%) was their most preferred response to a stroke event. Visiting herbalists/traditional healers was preferred by less than 1%. At multivariable logistic regression, good knowledge of stroke warning signs and risk factors was associated with tertiary level of education (OR 4.29, 95% CI 2.13–8.62 and OR 5.96, 95% CI 2.94–12.06), resp.) and self-reported diabetes (OR 1.97, 95% CI 1.18–3.32 and OR 1.84, 95% CI 1.04–3.25), resp.). Conclusion Knowledge about stroke in Uganda is poor although the planned response to a stroke event was adequate. Educational strategies to increase stroke knowledge are urgently needed as a prelude to developing preventive programmes. PMID:25202472

  16. The UNDP spends $2m. on grass-roots income-generation in Uganda.

    PubMed

    1994-01-01

    A $2 million UNDP project designed to provide assistance to those suffering from human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), is having problems finding its target population in Uganda. Staff cannot rely on many nongovernmental organizations (NGOs), so money is being directly channeled to villages via local leaders, who weed out the undeserving. Internationally, most funds are directed at prevention, education, and prediction of the social and economic impacts of the epidemic. However, the impact at the national, local, and family levels has gone unaddressed. The approach has been charitable, rather than sustainable. The aims of the project are as follows: 1) establishment of income generation programs for orphans, widows, low income survivors, and communities with large numbers of patients with AIDS; and 2) establishment of skills and resources in local groups to implement and manage the projects. 90 microprojects are currently funded in 20 of 39 Ugandan districts. Funds are channelled through the HIV/AIDS Grassroots Initiative Support Fund. The steering committee includes representatives of the Uganda AIDS Commission and the Ministry of Planning and Economic Development. In an effort to rehabilitate prostitutes in Kampala, $6000 was loaned to 21 women and 15 orphans to buy cooking and sewing equipment. Other income generation programs include carpentry and agricultural projects and piggeries. The project time has been extended by 18 months and funds have increased from $700,000 to $2,000,000. PMID:12288156

  17. Health services for survivors of gender-based violence in northern Uganda: a qualitative study.

    PubMed

    Henttonen, Mirkka; Watts, Charlotte; Roberts, Bayard; Kaducu, Felix; Borchert, Matthias

    2008-05-01

    The 20-year war in northern Uganda has resulted in up to 1.7 million people being internally displaced, and impoverishment and vulnerability to violence amongst the civilian population. This qualitative study examined the status of health services available for the survivors of gender-based violence in the Gulu district, northern Uganda. Semi-structured interviews were carried out in 2006 with 26 experts on gender-based violence and general health providers, and availability of medical supplies was reviewed. The Inter-Agency Standing Committee (IASC) guidelines on gender-based violence interventions in humanitarian settings were used to prepare the interview guides and analyse the findings. Some legislation and programmes do exist on gender-based violence. However, health facilities lacked sufficiently qualified staff and medical supplies to adequately detect and manage survivors, and confidential treatment and counselling could not be ensured. There was inter-sectoral collaboration, but greater resources are required to increase coverage and effectiveness of services. Intimate partner violence, sexual abuse of girls aged under 18, sexual harassment and early and forced marriage may be more common than rape by strangers. As the IASC guidelines focus on sexual violence by strangers and do not address other forms of gender-based violence, we suggest the need to explore this issue further to determine whether a broader concept of gender-based violence should be incorporated into the guidelines.

  18. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives

    PubMed Central

    2010-01-01

    Background High fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people. Methods In 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis. Results Young men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size. Conclusions Our findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed. PMID:20813069

  19. Aspirations for quality health care in Uganda: How do we get there?

    PubMed Central

    2013-01-01

    Background Despite significant investments and reforms, health care remains poor for many in Africa. To design an intervention to improve access and quality of health care at health facilities in eastern Uganda, we aimed to understand local priorities for qualities in health care, and factors that enable or prevent these qualities from being enacted. Methods In 2009 to 2010, we carried out 69 in-depth interviews and 6 focus group discussions with 65 health workers at 17 health facilities, and 10 focus group discussions with 113 community members in Tororo District, Uganda. Results Health-care workers and seekers valued technical, interpersonal and resource qualities in their aspirations for health care. However, such qualities were frequently not enacted, and our analysis suggests that meeting aspirations required social and financial resources to negotiate various power structures. Conclusions We argue that achieving aspirations for qualities valued in health care will require a genuine reorientation of focus by health workers and their managers toward patients, through renewed respect and support for these providers as professionals. PMID:23521859

  20. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda

    PubMed Central

    Roberts, Bayard; Ocaka, Kaducu Felix; Browne, John; Oyok, Thomas; Sondorp, Egbert

    2008-01-01

    Background The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors. Methods A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Results Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. Conclusion This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives. PMID:18489768

  1. Further experience with Kaposi's sarcoma in Uganda.

    PubMed Central

    Serwadda, D.; Carswell, W.; Ayuko, W. O.; Wamukota, W.; Madda, P.; Downing, R. G.

    1986-01-01

    Four Ugandan patients (1 women, 3 men) with generalized Kaposi's sarcoma (KS) were seen in the Uganda Cancer Institute between October 1983 and December 1984. They presented with generalized lymphadenopathy, plaques/nodules on the body, general swelling of the head, oral and visceral involvement and respiratory distress. Initial responses to adriamycin as a single or a combination chemotherapy of actinomycin D, vincristine, adriamycin and imidazole carboxamide appeared to be favourable but no sustained response was obtained. Serological tests for human T-lymphotropic virus (HTLV-II) antibodies were positive in all 4 cases. Images Figure 1 Figure 2 PMID:3011052

  2. Medical education and health care in Uganda.

    PubMed

    Kiely, J M

    1980-10-01

    Health care and medical education in Uganda, once the best in Black Africa, have been adversely affected by the economic, political, and social upheavals in this developing country during the past decade. Crop failures, inadequate public health measures, shortage of medical equipment and essential drugs, and lack of sufficient medical school faculty have resulted in a major crisis. Substantial aid from the medical profession in developed countries will be necessary to help restore medical practice and education to the level present before the regime of Idi Amin.

  3. Off-Grid Electricity Access and its Impact on Micro-Enterprises: Evidence from Rural Uganda

    NASA Astrophysics Data System (ADS)

    Muhoro, Peter N.

    The history of development shows convincingly that no country has substantially reduced poverty without massively increasing the use of electricity. The development of micro-enterprises in rural areas of Uganda is linked with increased access and use of electricity services. In this study, I combine quantitative and qualitative methods, including informal surveys, intra-business energy allocation studies and historical analysis, to analyze off-grid electricity access among micro-enterprises in rural western Uganda. I explore the linkages between of grid electricity access and the influence it has on micro- enterprises. Data is obtained from 56 micro-enterprises located in 11 village-towns within 3 districts in Uganda. In studying the micro-enterprises. the focus is on the services that are provided by electricity from modern energy carriers. The type of equipment used, forms of transportation, technical support, level of understanding and education of the entrepreneur, financing for energy equipment, and the role of donors are discussed in this thesis. Qualitative methods are used to allow for new insights and prioritization of concepts to emerge from the field rattier than from theory. Micro-enterprises in rural Uganda create income for the poor; they are resources for poverty reduction. With price adjustments, it becomes possible for those who live below the poverty line, nominally less than $1 a day, to afford the products and services and therefore mitigating the vicious cycle of poverty. Energy consumption among the micro-enterprises is at an average of 0.13kWh/day. The cost of accessing this amount of electricity attributes to about 50% of total revenue. I find that the "practices" used in off-grid electricity access lead to situations where the entrepreneurs have to evaluate pricing and output of products and services to generate higher profits. Such numbers indicate the need for appropriate technologies and profitable policies to be implemented. The data

  4. Coping Strategies for Landslide and Flood Disasters: A Qualitative Study of Mt. Elgon Region, Uganda

    PubMed Central

    Osuret, Jimmy; Atuyambe, Lynn M; Mayega, Roy William; Ssentongo, Julius; Tumuhamye, Nathan; Mongo Bua, Grace; Tuhebwe, Doreen; Bazeyo, William

    2016-01-01

    Introduction: The occurrence of landslides and floods in East Africa has increased over the past decades with enormous Public Health implications and massive alterations in the lives of those affected. In Uganda, the Elgon region is reported to have the highest occurrence of landslides and floods making this area vulnerable. This study aimed at understanding both coping strategies and the underlying causes of vulnerability to landslides and floods in the Mt. Elgon region. Methods: We conducted a qualitative study in three districts of Bududa, Manafwa and Butalejja in the Mt. Elgon region in eastern Uganda. Six Focus Group Discussions (FGDs) and eight Key Informant Interviews (KIIs) were conducted. We used trained research assistants (moderator and note taker) to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. We explored both coping strategies and underlying causes of vulnerability. Data were analysed using latent content analysis; through identifying codes from which basis categories were generated and grouped into themes. Results: The positive coping strategies used to deal with landslides and floods included adoption of good farming methods, support from government and other partners, livelihood diversification and using indigenous knowledge in weather forecasting and preparedness. Relocation was identified as unsustainable because people often returned back to high risk areas. The key underlying causes of vulnerability were; poverty, population pressure making people move to high risk areas, unsatisfactory knowledge on disaster preparedness and, cultural beliefs affecting people’s ability to cope. Conclusion: This study revealed that deep rooted links to poverty, culture and unsatisfactory knowledge on disaster preparedness were responsible for failure to overcome the effects to landslides and floods in disaster prone communities of Uganda. However, good farming practices and support from the government and

  5. Improving retention and performance in civil society in Uganda.

    PubMed

    O'Neil, Mary L; Paydos, Michael

    2008-01-01

    This article is the second article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH) under the theme of leadership and management in public health and will be published article-by-article over the next few weeks. The journal invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog. This article--number two in the series--describes the experience of the Family Life Education Programme (FLEP), a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Management Sciences for Health (MSH) Human Resource Management Rapid Assessment Tool. A few years ago, the FLEP of Busoga Diocese began to see an increase in staff turnover and a decrease in overall organizational performance. The workplace climate was poor and people stopped coming for services even though there were few other choices in the area. An external assessment found the quality of the health care services provided was deficient. An action plan to improve their human resource management (HRM) system was developed and implemented. To assess the strengths and weaknesses of their system and to develop an action plan, they used the Rapid Assessment Tool. The tool guides users through a process of prioritizing and action planning after the assessment is done. By implementing the various recommended changes, FLEP established an improved, responsive HRM system. Increased employee satisfaction led to less staff turnover, better performance, and increased utilization of health services. These benefits were achieved by cost-effective measures focused on professionalizing the organization's approach to HRM. PMID:18570658

  6. A dental experience with the Abayudaya community in Uganda.

    PubMed

    Zwetchkenbaum, Samuel

    2008-03-01

    If anyone told me four months ago that I would be taking out teeth and caring about the future of dental health in Uganda, the land of Idi Amin and Raid on Entebbe, I'd have told them they were crazy. I was going to Kenya for Operation Smile; a string of events led me to Samson Wamani, Medical Director for the Abayudaya community in Uganda, and helped me realize there's a huge difference between dental care here in the U.S., and what it is for fellow Jews of Uganda.

  7. Ebola hemorrhagic fever associated with novel virus strain, Uganda, 2007-2008.

    PubMed

    Wamala, Joseph F; Lukwago, Luswa; Malimbo, Mugagga; Nguku, Patrick; Yoti, Zabulon; Musenero, Monica; Amone, Jackson; Mbabazi, William; Nanyunja, Miriam; Zaramba, Sam; Opio, Alex; Lutwama, Julius J; Talisuna, Ambrose O; Okware, Sam I

    2010-07-01

    During August 2007-February 2008, the novel Bundibugyo ebolavirus species was identified during an outbreak of Ebola viral hemorrhagic fever in Bundibugyo district, western Uganda. To characterize the outbreak as a requisite for determining response, we instituted a case-series investigation. We identified 192 suspected cases, of which 42 (22%) were laboratory positive for the novel species; 74 (38%) were probable, and 77 (40%) were negative. Laboratory confirmation lagged behind outbreak verification by 3 months. Bundibugyo ebolavirus was less fatal (case-fatality rate 34%) than Ebola viruses that had caused previous outbreaks in the region, and most transmission was associated with handling of dead persons without appropriate protection (adjusted odds ratio 3.83, 95% confidence interval 1.78-8.23). Our study highlights the need for maintaining a high index of suspicion for viral hemorrhagic fevers among healthcare workers, building local capacity for laboratory confirmation of viral hemorrhagic fevers, and institutionalizing standard precautions.

  8. [Campaign against sleeping sickness in South-West Uganda by trapping tsetse flies].

    PubMed

    Lancien, J

    1991-01-01

    An outbreak of human trypanosomiasis due to Trypanosoma brucei rhodesiense has been affecting the Busoga district of Uganda since 1976. More than 40,000 cases have been recorded up to 1990. Since two years the epidemic area has been extending to the Tororo district. The vector is Glossina fuscipes. In order to stop the disease transmission a vector control project was launched in 1988 in Busoga area. It is based on tsetse fly trapping, using pyramidal optic traps impregnated with deltamethrin (10 traps per square kilometer). The results were excellent. Everywhere fly populations were reduced by more than 95%. In some parishes flies elimination was achieved. The number of new human cases of trypanosomiasis has been reduced in the same proportions. A complete break down of the transmission in the Busoga area can be reasonably expected in the near future. Since 1990 the trapping has been extended to the epidemic areas of the Tororo District. The results after only a few months were also excellent. Because cattle in the main blood source for tsetse flies in this area, the monthly treatment of cattle with pour-on of deltamethrin has been experimented in a small area to strengthen trapping. First results are promising. The cost of the protection is 0.9 US $ per person and per year.

  9. Financial management systems under decentralization and their effect on malaria control in Uganda.

    PubMed

    Kivumbi, George W; Nangendo, Florence; Ndyabahika, Boniface Rutagira

    2004-01-01

    A descriptive case study with multiple sites and a single level of analysis was carried out in four purposefully selected administrative districts of Uganda to investigate the effect of financial management systems under decentralization on malaria control. Data were primarily collected from 36 interviews with district managers, staff at health units and local leaders. A review of records and documents related to decentralization at the central and district level was also used to generate data for the study. We found that a long, tedious, and bureaucratic process combined with lack of knowledge in working with new financial systems by several actors characterized financial flow under decentralization. This affected the timely use of financial resources for malaria control in that there were funds in the system that could not be accessed for use. We were also told that sometimes these funds were returned to the central government because of non-use due to difficulties in accessing them and/or stringent conditions not to divert them to other uses. Our data showed that a cocktail of bureaucratic control systems, corruption and incompetence make the financial management system under decentralization counter-productive for malaria control. The main conclusion is that good governance through appropriate and efficient financial management systems is very important for effective malaria control under decentralization.

  10. Cost of individual peer counselling for the promotion of exclusive breastfeeding in Uganda

    PubMed Central

    2011-01-01

    Background Exclusive breastfeeding (EBF) for 6 months is the recommended form of infant feeding. Support of mothers through individual peer counselling has been proved to be effective in increasing exclusive breastfeeding prevalence. We present a costing study of an individual peer support intervention in Uganda, whose objective was to raise exclusive breastfeeding rates at 3 months of age. Methods We costed the peer support intervention, which was offered to 406 breastfeeding mothers in Uganda. The average number of counselling visits was about 6 per woman. Annual financial and economic costs were collected in 2005-2008. Estimates were made of total project costs, average costs per mother counselled and average costs per peer counselling visit. Alternative intervention packages were explored in the sensitivity analysis. We also estimated the resources required to fund the scale up to district level, of a breastfeeding intervention programme within a public health sector model. Results Annual project costs were estimated to be US$56,308. The largest cost component was peer supporter supervision, which accounted for over 50% of total project costs. The cost per mother counselled was US$139 and the cost per visit was US$26. The cost per week of EBF was estimated to be US$15 at 12 weeks post partum. We estimated that implementing an alternative package modelled on routine public health sector programmes can potentially reduce costs by over 60%. Based on the calculated average costs and annual births, scaling up modelled costs to district level would cost the public sector an additional US$1,813,000. Conclusion Exclusive breastfeeding promotion in sub-Saharan Africa is feasible and can be implemented at a sustainable cost. The results of this study can be incorporated in cost effectiveness analyses of exclusive breastfeeding promotion programmes in sub-Saharan Africa. PMID:21714877

  11. Associations with HIV testing in Uganda: an analysis of the Lot Quality Assurance Sampling database 2003-2012.

    PubMed

    Jeffery, Caroline; Beckworth, Colin; Hadden, Wilbur C; Ouma, Joseph; Lwanga, Stephen K; Valadez, Joseph J

    2016-01-01

    Beginning in 2003, Uganda used Lot Quality Assurance Sampling (LQAS) to assist district managers collect and use data to improve their human immunodeficiency virus (HIV)/AIDS program. Uganda's LQAS-database (2003-2012) covers up to 73 of 112 districts. Our multidistrict analysis of the LQAS data-set at 2003-2004 and 2012 examined gender variation among adults who ever tested for HIV over time, and attributes associated with testing. Conditional logistic regression matched men and women by community with seven model effect variables. HIV testing prevalence rose from 14% (men) and 12% (women) in 2003-2004 to 62% (men) and 80% (women) in 2012. In 2003-2004, knowing the benefits of testing (Odds Ratio [OR] = 6.09, 95% CI = 3.01-12.35), knowing where to get tested (OR = 2.83, 95% CI = 1.44-5.56), and secondary education (OR = 3.04, 95% CI = 1.19-7.77) were significantly associated with HIV testing. By 2012, knowing the benefits of testing (OR = 3.63, 95% CI = 2.25-5.83), where to get tested (OR = 5.15, 95% CI = 3.26-8.14), primary education (OR = 2.01, 95% CI = 1.39-2.91), being female (OR = 3.03, 95% CI = 2.53-3.62), and being married (OR = 1.81, 95% CI = 1.17-2.8) were significantly associated with HIV testing. HIV testing prevalence in Uganda has increased dramatically, more for women than men. Our results concurred with other authors that education, knowledge of HIV, and marriage (women only) are associated with testing for HIV and suggest that couples testing is more prevalent than other authors.

  12. The milk delivery chain and presence of Brucella spp. antibodies in bulk milk in Uganda.

    PubMed

    Rock, Kim Toeroek; Mugizi, Denis Rwabiita; Ståhl, Karl; Magnusson, Ulf; Boqvist, Sofia

    2016-06-01

    This study examined the influence of informal milk delivery chains on the risk of human exposure to Brucella spp. through milk consumption in two regions of Uganda (Gulu and Soroti Districts). The work involved describing milk delivery chains, investigating brucellosis awareness amongst milk deliverers and determining the presence of Brucella spp. antibodies in cattle milk on delivery to primary collection points (boiling points and dairies). Milk samples (n = 331) were collected from deliverers at primary collection points and from street vendors at point of sale and analysed using indirect enzyme-linked immunosorbent assay (I-ELISA). A written questionnaire was used to collect data from deliverers (n = 279) on their milk delivery chains and their brucellosis awareness. The most common delivery points in Gulu District were small dairies and in Soroti District boiling points. The presence of Brucella spp. antibodies in milk samples was higher in Soroti (40 %) than in Gulu (11 %) (P < 0.0001). There are possible public health risk consequences of this finding as 42 % of deliverers in Soroti District reported drinking raw milk, compared with 15 % in Gulu District (P < 0.0001). Awareness of brucellosis was low, with 70 % of all milk deliverers reporting not having heard of the disease or the bacterium. Application of quality controls for milk (colour and odour) along the delivery chain varied depending upon supply and demand. This study provides evidence of the diversity of informal milk markets in low-income countries and of the potential public health risks of consuming unpasteurised milk. These results can be useful to those planning interventions to reduce brucellosis. PMID:27026231

  13. The milk delivery chain and presence of Brucella spp. antibodies in bulk milk in Uganda.

    PubMed

    Rock, Kim Toeroek; Mugizi, Denis Rwabiita; Ståhl, Karl; Magnusson, Ulf; Boqvist, Sofia

    2016-06-01

    This study examined the influence of informal milk delivery chains on the risk of human exposure to Brucella spp. through milk consumption in two regions of Uganda (Gulu and Soroti Districts). The work involved describing milk delivery chains, investigating brucellosis awareness amongst milk deliverers and determining the presence of Brucella spp. antibodies in cattle milk on delivery to primary collection points (boiling points and dairies). Milk samples (n = 331) were collected from deliverers at primary collection points and from street vendors at point of sale and analysed using indirect enzyme-linked immunosorbent assay (I-ELISA). A written questionnaire was used to collect data from deliverers (n = 279) on their milk delivery chains and their brucellosis awareness. The most common delivery points in Gulu District were small dairies and in Soroti District boiling points. The presence of Brucella spp. antibodies in milk samples was higher in Soroti (40 %) than in Gulu (11 %) (P < 0.0001). There are possible public health risk consequences of this finding as 42 % of deliverers in Soroti District reported drinking raw milk, compared with 15 % in Gulu District (P < 0.0001). Awareness of brucellosis was low, with 70 % of all milk deliverers reporting not having heard of the disease or the bacterium. Application of quality controls for milk (colour and odour) along the delivery chain varied depending upon supply and demand. This study provides evidence of the diversity of informal milk markets in low-income countries and of the potential public health risks of consuming unpasteurised milk. These results can be useful to those planning interventions to reduce brucellosis.

  14. Patterns, risk factors and characteristics of reported and perceived foot-and-mouth disease (FMD) in Uganda.

    PubMed

    Ayebazibwe, Chrisostom; Tjørnehøj, Kirsten; Mwiine, Frank N; Muwanika, Vincent B; Okurut, Anna Rose Ademun; Siegismund, Hans R; Alexandersen, Soren

    2010-10-01

    Patterns of outbreaks of foot-and-mouth disease (FMD) in Uganda were elucidated from spatial and temporal retrospective data retrieved from monthly reports from District Veterinary Officers (DVOs) to the central administration for the years spanning 2001-2008. An assessment of perceived FMD occurrence, risk factors and the associated characteristics was made based on semi-structured questionnaires administered to the DVOs. During this period, a total of 311 FMD outbreaks were reported in 56 (70%) out of Uganda's 80 districts. The number of reported FMD outbreaks changed over time and by geographical regions. Occurrence of FMD was significantly associated with the dry season months (p = 0.0346), the time when animals movements are more frequent. The average number of FMD outbreaks was higher for some sub-counties adjacent to national parks than for other sub-counties, whilst proximity to international border only seemed to play a role at the southern border. DVOs believed that the major risk factor for FMD outbreaks was animal movements (odds ratio OR 50.8, confidence interval CI 17.8-144.6) and that most outbreaks were caused by introduction of sick animals.

  15. Safe motherhood voucher programme coverage of health facility deliveries among poor women in South-western Uganda.

    PubMed

    Kanya, Lucy; Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben

    2014-07-01

    There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which the programmes have succeeded in reaching the target populations. This article estimates the coverage of facility deliveries by a maternal health voucher programme in South-western Uganda and examines whether such coverage is correlated with district-level characteristics such as poverty density and the number of contracted facilities. Analysis entails estimating the voucher coverage of health facility deliveries among the general population and poor population (PP) using programme data for 2010, which was the most complete calendar year of implementation of the Uganda safe motherhood (SM) voucher programme. The results show that: (1) the programme paid for 38% of estimated deliveries among the PP in the targeted districts, (2) there was a significant negative correlation between the poverty density in a district and proportions of births to poor women that were covered by the programme and (3) improving coverage of health facility deliveries for poor women is dependent upon increasing the sales and redemption rates. The findings suggest that to the extent that the programme stimulated demand for SM services by new users, it has the potential of increasing facility-based births among poor women in the region. In addition, the significant negative correlation between the poverty density and the proportions of facility-based births to poor women that are covered by the voucher programme suggests that there is need to increase both voucher sales and the rate of redemption to improve coverage in districts with high levels of poverty.

  16. Charter School Districts.

    ERIC Educational Resources Information Center

    Hill, Paul T.

    2002-01-01

    Discusses the difference between charter schools and charter districts (all schools in the district are chartered), why charter school districts are spreading, and how local school districts can become charter districts. Current laws in Arizona, California, Florida, Georgia, New Mexico, Oregon, and Texas allow charter districts. (PKP)

  17. Geothermal district heating systems

    SciTech Connect

    Budney, G.S.; Childs, F.

    1982-01-01

    Ten district heating demonstration projects and their present status are described. The projects are Klamath County YMCA, Susanville District Heating, Klamath Falls District Heating, Reno Salem Plaza Condominium, El Centro Community Center Heating/Cooling, Haakon School and Business District Heating, St. Mary's Hospital, Diamond Ring Ranch, Pagosa Springs District Heating, and Boise District Heating.

  18. Stakeholder analysis for a maternal and newborn health project in Eastern Uganda

    PubMed Central

    2013-01-01

    Background Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to assess and map stakeholders’ interests, influence/power and position in relation to the interventions; their views regarding the success and sustainability; and how this research can influence policy formulation in the country. Methods A stakeholder analysis was carried out in March 2011 at national level and in four districts of Eastern Uganda where the proposed interventions would be conducted. At the national level, four key informant interviews were conducted with the ministry of health representative, Member of Parliament, and development partners. District health team members were interviewed and also engaged in a workshop; and at community level, twelve focus group discussions were conducted among women, men and motorcycle transporters. Results This analysis revealed that district and community level stakeholders were high level supporters of the proposed interventions but not drivers. At community level the mothers, their spouses and transporters were of low influence due to the limited funds they possessed. National level and district stakeholders believed that the intervention is costly and cannot be affordably scaled up. They advised the study team to mobilize and sensitize the communities to contribute financially from the start in order to enhance sustainability beyond the study period. Stakeholders believed that the proposed interventions will influence policy through modeling on how to improve the quality of maternal/newborn health services, male involvement

  19. Bribery in health care in Uganda.

    PubMed

    Hunt, Jennifer

    2010-09-01

    I examine the role of household permanent income in determining who bribes and how much they bribe in health care in Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household expenditure increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount is about 0.37. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector is able to price discriminate less effectively than public institutions with less competition from the private sector. PMID:20638738

  20. Cultural Contexts of Ebola in Northern Uganda

    PubMed Central

    Amola, Richard P.

    2003-01-01

    Technical guidelines for the control of Ebola hemorrhagic fever (EHF) indicate that understanding local views and responses to an outbreak is essential. However, few studies with such information exist. Thus, we used qualitative and quantitative methods to determine how local residents of Gulu, Uganda, viewed and responded to the 2000–2001 outbreak of EHF. Results indicated that Acholi people used at least three explanatory models to explain and respond to the outbreak; indigenous epidemic control measures were often implemented and consistent with those being promoted by healthcare workers; and some cultural practices amplified the outbreak (e.g., burial practices). However, most persons were willing to modify and work with national and international healthcare workers. PMID:14609458

  1. The Development of Professional Counseling in Uganda: Current Status and Future Trends

    ERIC Educational Resources Information Center

    Senyonyi, Ruth M.; Ochieng, Lois A.; Sells, James

    2012-01-01

    Professional counseling in Uganda has foundations in traditional cultures of its peoples, guidance offered in schools, and counseling to curb the HIV/AIDS epidemic. Currently, a definitive professional counselor profile in Uganda is being established. The Uganda Counselling Association continues the process of seeking legal authority to regulate…

  2. Uganda: The Challenge of Growth and Poverty Reduction. A World Bank Country Study.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    This report examines the outcomes of economic reform in Uganda and defines issues that Uganda must address in medium- and long-term strategies for poverty reduction. With a per capita income of approximately $220, Uganda is one of the poorest countries in the world. Its economy and social indicators bear the marks of nearly 15 years of political…

  3. Assessment of core capacities for the International Health Regulations (IHR[2005]) – Uganda, 2009

    PubMed Central

    2010-01-01

    Background Uganda is currently implementing the International Health Regulations (IHR[2005]) within the context of Integrated Disease Surveillance and Response (IDSR). The IHR(2005) require countries to assess the ability of their national structures, capacities, and resources to meet the minimum requirements for surveillance and response. This report describes the results of the assessment undertaken in Uganda. Methods We conducted a descriptive cross-sectional assessment using the protocol developed by the World Health Organisation (WHO). The data collection tools were adapted locally and administered to a convenience sample of HR(2005) stakeholders, and frequency analyses were performed. Results Ugandan national laws relevant to the IHR(2005) existed, but they did not adequately support the full implementation of the IHR(2005). Correspondingly, there was a designated IHR National Focal Point (NFP), but surveillance activities and operational communications were limited to the health sector. All the districts (13/13) had designated disease surveillance offices, most had IDSR technical guidelines (92%, or 12/13), and all (13/13) had case definitions for infectious and zoonotic diseases surveillance. Surveillance guidelines were available at 57% (35/61) of the health facilities, while case definitions were available at 66% (40/61) of the health facilities. The priority diseases list, surveillance guidelines, case definitions and reporting tools were based on the IDSR strategy and hence lacked information on the IHR(2005). The rapid response teams at national and district levels lacked food safety, chemical and radio-nuclear experts. Similarly, there were no guidelines on the outbreak response to food, chemical and radio-nuclear hazards. Comprehensive preparedness plans incorporating IHR(2005) were lacking at national and district levels. A national laboratory policy existed and the strategic plan was being drafted. However, there were critical gaps hampering the

  4. Getting closer to people: family planning provision by drug shops in Uganda

    PubMed Central

    Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

    2014-01-01

    ABSTRACT Background: Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Methods: Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Results: Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36

  5. Determining Food Insecurity: An Application of the Rasch Model with Household Survey Data in Uganda

    PubMed Central

    Nabugoomu, Fabian

    2014-01-01

    The inexplicable nature of food insecurity in parts of Uganda and worldwide necessitated an investigation into the nature, extent, and differentials of household food security. The main objective of this study was to examine the food security dynamics and model household food insecurity. The Rasch modelling approach was employed on a dataset from a sample of 1175 (Tororo = 577; Busia = 598) randomly selected households in the year 2010. All households provided responses to the food security questions and none was omitted from the analysis. At 5 percent level of significance the analysis indicated that Tororo district average food security assessment (0.137 ± 0.181) was lower than that for Busia district (0.768 ± 0.177). All the mean square fit statistics were in the range of 0.5 to 1.5, and none of them showed any signs of distortion, degradation, or less productivity for measurement. This confirmed that items used in this study were very productive for measurement of food security in the study area. The study recommends further analysis where item responses are ordered polytomous rather than the dichotomous item response functions used. Furthermore, consideration should be given to fit models that allow for different latent distributions for households with children and those without children and possibly other subgroups of respondents. PMID:26904617

  6. Impact of malaria morbidity on gross domestic product in Uganda

    PubMed Central

    2012-01-01

    Background The burden of malaria is a key challenge to both human and economic development in malaria endemic countries. The impact of malaria can be categorized from three dimensions, namely: health, social and economic. The objective of this study was to estimate the impact of malaria morbidity on gross domestic product (GDP) of Uganda. Methods The impact of malaria morbidity on GDP of Uganda was estimated using double-log econometric model. The 1997-2003 time series macro-data used in the analysis were for 28 quarters, i.e. 7 years times 4 quarters per year. It was obtained from national and international secondary sources. Results The slope coefficient for Malaria Index (M) was -0.00767; which indicates that when malaria morbidity increases by one unit, while holding all other explanatory variables constant, per capita GDP decreases by US$0.00767 per year. In 2003 Uganda lost US$ 49,825,003 of GDP due to malaria morbidity. Dividing the total loss of US$49.8 million by a population of 25,827,000 yields a loss in GDP of US$1.93 per person in Uganda in 2003. Conclusion Malaria morbidity results in a substantive loss in GDP of Uganda. The high burden of malaria leads to decreased long-term economic growth, and works against poverty eradication efforts and socioeconomic development of the country. PMID:22439685

  7. A scoping study on task shifting; the case of Uganda

    PubMed Central

    2014-01-01

    Background Task shifting has been implemented in Uganda for decades with little documentation. This study’s objectives were to; gather evidence on task-shifting experiences in Uganda, establish its acceptability and perceptions among health managers and policymakers, and make recommendations. Methods This was a qualitative study. Data collection involved; review of published and gray literature, and key informant interviews of stakeholders in health policy and decision making in Uganda. Data was analyzed by thematic content analysis. Results Task shifting was the mainstay of health service delivery in Uganda. Lower cadre of health workers performed duties of specialized health workers. However, Uganda has no task shifting policy and guidelines, and task shifting was practiced informally. Lower cadre of health workers were deemed to be incompetent to handle shifted roles and already overworked, and support supervision was poor. Advocates of task shifting argued that lower cadre of health workers already performed the roles of highly trained health workers. They needed a supporting policy and support supervision. Opponents argued that lower cadre of health workers were; incompetent, overworked, and task shifting was more expensive than recruiting appropriately trained health workers. Conclusions Task shifting was unacceptable to most health managers and policy makers because lower cadres of health workers were; incompetent, overworked and support supervision was poor. Recruitment of existing unemployed well trained health workers, implementation of human resource motivation and retention strategies, and government sponsored graduates to work for a defined mandatory period of time were recommended. PMID:24754917

  8. Assessment of impact of climate change and adaptation strategies on maize production in Uganda

    NASA Astrophysics Data System (ADS)

    Kikoyo, Duncan A.; Nobert, Joel

    2016-06-01

    Globally, various climatic studies have estimated a reduction of crop yields due to changes in surface temperature and precipitation especially for the developing countries which is heavily dependent on agriculture and lacks resources to counter the negative effects of climate change. Uganda's economy and the wellbeing of its populace depend on rain-fed agriculture which is susceptible to climate change. This study quantified the impacts of climate change and variability in Uganda and how coping strategies can enhance crop production against climate change and/or variability. The study used statistical methods to establish various climate change and variability indicators across the country, and uses the FAO AquaCrop model to simulate yields under possible future climate scenarios with and without adaptation strategies. Maize, the most widely grown crop was used for the study. Meteorological, soil and crop data were collected for various districts representing the maize growing ecological zones in the country. Based on this study, it was found that temperatures have increased by up to 1 °C across much of Uganda since the 1970s, with rates of warming around 0.3 °C per decade across the country. High altitude, low rainfall regions experience the highest level of warming, with over 0.5 °C/decade recorded in Kasese. Rainfall is variable and does not follow a specific significant increasing or decreasing trend. For both future climate scenarios, Maize yields will reduce in excess of 4.7% for the fast warming-low rainfall climates but increase on average by 3.5% for slow warming-high rainfall regions, by 2050. Improved soil fertility can improve yields by over 50% while mulching and use of surface water management practices improve yields by single digit percentages. The use of fertilizer application needs to go hand in hand with other water management strategies since more yields as a result of the improved soil fertility leads to increased water stress, especially

  9. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    PubMed

    Vonasek, Bryan J; Bajunirwe, Francis; Jacobson, Laura E; Twesigye, Leonidas; Dahm, James; Grant, Monica J; Sethi, Ajay K; Conway, James H

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents' understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers' knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018-1.802). When asked why vaccination rates may be low in their community, the two most common responses were "fearful of side effects" and "ignorance/disinterest/laziness" (44% each). The factors influencing caregivers' demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates. PMID:26918890

  10. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    PubMed

    Vonasek, Bryan J; Bajunirwe, Francis; Jacobson, Laura E; Twesigye, Leonidas; Dahm, James; Grant, Monica J; Sethi, Ajay K; Conway, James H

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents' understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers' knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018-1.802). When asked why vaccination rates may be low in their community, the two most common responses were "fearful of side effects" and "ignorance/disinterest/laziness" (44% each). The factors influencing caregivers' demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates.

  11. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    PubMed Central

    Vonasek, Bryan J.; Bajunirwe, Francis; Jacobson, Laura E.; Twesigye, Leonidas; Dahm, James; Grant, Monica J.; Sethi, Ajay K.; Conway, James H.

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents’ understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers’ knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018–1.802). When asked why vaccination rates may be low in their community, the two most common responses were “fearful of side effects” and “ignorance/disinterest/laziness” (44% each). The factors influencing caregivers’ demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates. PMID:26918890

  12. Civil conflict and sleeping sickness in Africa in general and Uganda in particular

    PubMed Central

    Berrang Ford, Lea

    2007-01-01

    Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa. Conflict contributes to disease risk by affecting the transmission potential of sleeping sickness via economic impacts, degradation of health systems and services, internal displacement of populations, regional insecurity, and reduced access for humanitarian support. Particular focus is given to the case of sleeping sickness in south-eastern Uganda, where incidence increase is expected to continue. Disease intervention is constrained in regions with high insecurity; in these areas, political stabilization, localized deployment of health resources, increased administrative integration and national capacity are required to mitigate incidence. Conflict-related variables should be explicitly integrated into risk mapping and prioritization of targeted sleeping sickness research and mitigation initiatives. PMID:17411421

  13. Factors influencing modes of transport and travel time for obstetric care: a mixed methods study in Zambia and Uganda.

    PubMed

    Sacks, Emma; Vail, Daniel; Austin-Evelyn, Katherine; Greeson, Dana; Atuyambe, Lynn M; Macwan'gi, Mubiana; Kruk, Margaret E; Grépin, Karen A

    2016-04-01

    Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight districts in Uganda and Zambia. Quantitative data were analysed using univariate statistics, and qualitative data were analysed using thematic content analysis techniques. On average, women spent 62-68 min travelling to a clinic for delivery. Very different patterns in modes of transport were observed in the two countries: 91% of Ugandan women employed motorized forms of transportation, while only 57% of women in Zambia did. Motorcycle taxis were the most commonly used in Uganda, while cars, trucks and taxis were the most commonly used mode of transportation in Zambia. Lower-income women were less likely to use motorized modes of transportation: in Zambia, women in the poorest quintile took 94 min to travel to a health facility, compared with 34 for the wealthiest quintile; this difference between quintiles was ∼50 min in Uganda. Focus group discussions confirmed that transport is a major challenge due to a number of factors we categorized as the 'three A's:' affordability, accessibility and adequacy of transport options. Women reported that all of these factors had influenced their decision not to deliver in a health facility. The two countries had markedly different patterns of transportation for obstetric care, and modes of transport and travel times varied dramatically by wealth quintile, which policymakers need to take into account when designing obstetric transport interventions. PMID:26135364

  14. Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda

    PubMed Central

    2013-01-01

    Background Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the ‘Stamp Out Sleeping Sickness’ programme. Methods A mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews. Results Although 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km2. Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non

  15. Banana streak virus is very diverse in Uganda.

    PubMed

    Harper, Glyn; Hart, Darren; Moult, Sarah; Hull, Roger

    2004-03-01

    Banana streak virus (BSV) is a badnavirus that causes a viral leaf streak disease of banana and plantain (Musa spp.). Identified in essentially all Musa growing areas of the world, it has a deleterious effect on the productivity of infected plants as well as being a major constraint to Musa breeding programmes and germplasm dissemination. Banana is a staple food in Uganda which is, per capita, one of the worlds largest banana producers and consumers. BSV was isolated from infected plants sampled across the Ugandan Musa growing area and the isolates were analysed using molecular and serological techniques. These analyses showed that BSV is very highly variable in Uganda. They suggest that the variability is, in part, due to a series of introductions of banana into Uganda, each with a different complement of infecting viruses.

  16. School District Mergers: What One District Learned

    ERIC Educational Resources Information Center

    Kingston, Kathleen

    2009-01-01

    Throughout the planning process for a school district merger in a northwestern Pennsylvania school district, effective communication proved to be a challenge. Formed in 1932, this school district of approximately 1400 students was part of a utopian community; one established by a transportation system's corporation that was a major industrial…

  17. Burden of tuberculosis in Kampala, Uganda.

    PubMed Central

    Guwatudde, David; Zalwango, Sarah; Kamya, Moses R.; Debanne, Sara M.; Diaz, Mireya I.; Okwera, Alphonse; Mugerwa, Roy D.; King, Charles; Whalen, Christopher C.

    2003-01-01

    OBJECTIVE: To determine the prevalence and incidence of tuberculosis in one of Uganda's poor peri-urban areas. METHODS: Multi-stage sampling was used to select a sample of households whose members were evaluated for presence of signs and/or symptoms of active tuberculosis; history of tuberculosis treatment; and relevant demographic, socioeconomic, and household environment characteristics. Patients with suspected tuberculosis underwent standardized evaluation for active disease. FINDINGS: A sample of 263 households with 1142 individuals was evaluated. Nineteen people were classified as having had tuberculosis during the one-year reference period (May 2001-April 2002): nine (47%) cases already had been diagnosed through the health care system, while 10 cases (53%) were diagnosed through the survey. The prevalences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 14.0 (95% confidence interval (CI) 7.8-20.3) and 4.4 (CI = 0.83-7.89) per thousand, respectively. The incidences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 9.2 (CI = 3.97-14.4) and 3.7 (CI = 0.39-6.95) per thousand per year, respectively. CONCLUSION: The rate of tuberculosis in this peri-urban community was exceptionally high and may be underestimated by current surveillance systems. The need for interventions aimed at reducing tuberculosis transmission in this, and other similar communities with high case rates, is urgent. PMID:14758406

  18. Disclosure of HIV status between parents and children in Uganda in the context of greater access to treatment.

    PubMed

    Kyaddondo, David; Wanyenze, Rhoda K; Kinsman, John; Hardon, Anita

    2013-07-01

    While disclosure of HIV sero-status is encouraged in the management of the HIV and AIDS epidemic, it remains a challenge, especially among family members. This article examines the moral dilemmas and pragmatic incentives surrounding disclosure of HIV status in contemporary Uganda. Our findings are based on 12 in-depth interviews, 2 focus-group discussions, 6 key informant interviews with AIDS activists, and open-ended responses derived from 148 HIV-positive persons in a quantitative survey. The study was conducted in 2008-2009 in Kampala, Mpigi, and Soroti districts in Uganda. We found both parents and adult children facing dilemmas in disclosure, whether it was parents revealing their own HIV status to their children or the status of their perinatally infected children, or young people infected through sexual intercourse telling their parents. For both groups, there is fear of blame, stigma, discrimination, and shame and guilt related to unsafe sex, while young people also fear loss of privileges. On the other hand, there are practical imperatives for disclosure in terms of gaining access to care, treatment, and material resources. Faced with these dilemmas, HIV-positive people and their families require professional counselling to help them work through the emotional challenges encountered and identify mechanisms of support and coping. PMID:23844801

  19. Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda.

    PubMed

    Colón-González, Felipe J; Tompkins, Adrian M; Biondi, Riccardo; Bizimana, Jean Pierre; Namanya, Didacus Bambaiha

    2016-01-01

    We investigate the short-term effects of air temperature, rainfall, and socioeconomic indicators on malaria incidence across Rwanda and Uganda from 2002 to 2011. Delayed and nonlinear effects of temperature and rainfall data are estimated using generalised additive mixed models with a distributed lag nonlinear specification. A time series cross-validation algorithm is implemented to select the best subset of socioeconomic predictors and to define the degree of smoothing of the weather variables. Our findings show that trends in malaria incidence agree well with variations in both temperature and rainfall in both countries, although factors other than climate seem to play an important role too. The estimated short-term effects of air temperature and precipitation are nonlinear, in agreement with previous research and the ecology of the disease. These effects are robust to the effects of temporal correlation. The effects of socioeconomic data are difficult to ascertain and require further evaluation with longer time series. Climate-informed models had lower error estimates compared to models with no climatic information in 77 and 60% of the districts in Rwanda and Uganda, respectively. Our results highlight the importance of using climatic information in the analysis of malaria surveillance data, and show potential for the development of climate informed malaria early warning systems. PMID:27063731

  20. Determinants of First Antenatal Care Visit by Pregnant Women at Community Based Education, Research and Service Sites in Northern Uganda

    PubMed Central

    TURYASIIMA, M.; TUGUME, R.; OPENY, A.; AHAIRWOMUGISHA, E.; OPIO, R.; NTUNGUKA, M.; MAHULO, N.; AKERA, P.; ODONGO-AGINYA, E.

    2015-01-01

    Background Antenatal care (ANC) aims mainly at prevention, early detection and management of general medical and pregnancy associated disorders. Early booking is recommended for maximum utilisation. Objective To investigate the determinants of first ANC visit and trimesters at which pregnant mothers enrol for ANC at the COBERS sites of Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Five community based education, research and service sites (COBERS) of Atiak, Madi Opei, Mungula, Namukora and Pajule health centre fours (HC IV) in the five respective districts of Amuru, Lamwo, Adjumani, Kitgum and Pader, Northern Uganda, from April to July 2013. Subjects Four hundred and seventeen (417) pregnant women attending antenatal care (ANC) in five health centers and 10 purposively selected midwives were interviewed using questionnaires. Results Of the 417 respondents, only 11.5% (n = 48) had their first ANC at the recommended period of 0–16 weeks. Prevalence of late entry to ANC was 88.5% (n = 369). Mean gestational age at booking was 22.6±5.7 weeks. Paternal level of education, outcome of previous pregnancy, previous ANC attendance, weeks of amenorrhea, convenience of opening hours at ANC facility, commuting distance from home to health facility, knowing the right time for ANC enrollment, and pregnancy planning remained significant predictors governing early booking. Conclusion Late ANC booking is still a major public health concern that demands public enlightenment, and paternal education coupled with women empowerment will reduce the magnitude of the problem. PMID:26640281

  1. Barriers to Condom Use among High Risk Men Who Have Sex with Men in Uganda: A Qualitative Study

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Matovu, Joseph K. B.; Nuwaha, Fred; Mujisha, Geoffrey; Kiguli, Juliet; Arinaitwe, Jim; Van Geertruyden, Jean-Pierre; Wanyenze, Rhoda K.

    2015-01-01

    Background Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda. Methods The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach. Results Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption. Conclusion The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM. PMID:26172374

  2. Perceptions on use of sulfadoxine-pyrimethamine in pregnancy and the policy implications for malaria control in Uganda.

    PubMed

    Mbonye, Anthony Kabanza; Neema, Stella; Magnussen, Pascal

    2006-08-01

    In malaria endemic areas intermittent treatment with sulfadoxine-pyrimethamine (SP) is recommended for malaria prevention in pregnancy. Yet, data on perceptions regarding use of this drug are scarce. An exploratory study was conducted to assess perceptions on SP in Mukono district, Uganda. This is an initial step towards a review of the policy aimed at improving access and use of SP in pregnancy, which is currently low. Results show that SP is perceived to be an effective drug that cures malaria quickly. However there are negative perceptions related to its use in pregnancy. SP is believed to be strong and weakens pregnant women, causes abortions and foetal abnormalities. There is also a perception that resorting first to SP for malaria treatment may lead to the development of drug resistance. This perception may limit access to effective treatment of malaria in this community since the policy in Uganda recommends SP in combination with chloroquine as the first-line treatment. The policy implications of these findings include developing a health promotion package to demystify the misconceptions on the strength of SP, to explain its benefits and side-effects. This package will involve giving health workers refresher training on communication and counselling on use of SP in pregnancy targeting special groups like pregnant adolescents. These results provide important lessons to policy makers and programme managers who aim at scaling up access of SP for malaria prevention in pregnancy.

  3. Environmental Education in the Formal Sector of Education in Uganda.

    ERIC Educational Resources Information Center

    Mucunguzi, P.

    1995-01-01

    Provides a critical review of the present state of environmental education in the formal sector of education in Uganda. Recommends an improved approach to formal environmental education based on a multidisciplinary foundation that embraces the biophysical environment, people, culture, politics, and socioeconomic systems. (LZ)

  4. A Review of Non-formal Environmental Education in Uganda.

    ERIC Educational Resources Information Center

    Mucunguzi, Patrick

    1995-01-01

    Reviews contemporary environmental education in Uganda. Presents a new approach that emphasizes the adoption of multidisciplinary, interdisciplinary, people-centered, and participatory programs in environmental concerns. Embraces the diversity of the biophysical, social, and economic environments and is closely associated with permanent…

  5. Christianity and Rural Community Literacy Practices in Uganda

    ERIC Educational Resources Information Center

    Openjuru, George Ladaah; Lyster, Elda

    2007-01-01

    In this article, we examine how Christianity provides the impetus for local literacy practices in a rural community in Uganda. These Christian literacy practices form a central part of the literacy activities of the community and are manifested in a variety of contexts from public to private, using a wide variety of readily available religious…

  6. Successful Community Nutrition Programming: Lessons from Kenya, Tanzania, and Uganda.

    ERIC Educational Resources Information Center

    Iannotti, Lora; Gillespie, Stuart

    This report on the key findings from a series of assessments of successful community nutrition programming conducted in Kenya, Tanzania, and Uganda between 1999 and 2000. The aim of the assessments was to identify key lessons learned from the successful processes and outcomes in these programs. The report is divided into eight chapters: (1)…

  7. Schistosomiasis among Recreational Users of Upper Nile River, Uganda, 2007

    PubMed Central

    Brunette, Gary; Kapella, Bryan K.; McAuliffe, Isabel; Katongole-Mbidde, Edward; Li, Wenkai; Marano, Nina; Okware, Sam; Olsen, Sonja J.; Secor, W. Evan; Tappero, Jordan W.; Wilkins, Patricia P.; Montgomery, Susan P.

    2010-01-01

    After recreational exposure to river water in Uganda, 12 (17%) of 69 persons had evidence of schistosome infection. Eighteen percent self-medicated with praziquantel prophylaxis immediately after exposure, which was not appropriate. Travelers to schistosomiasis-endemic areas should consult a travel medicine physician. PMID:20409387

  8. Indigenous Adaptation: Uganda's Village Schools, ca. 1880-1937

    ERIC Educational Resources Information Center

    Hanson, Holly Elisabeth

    2010-01-01

    In Uganda, the implementation of universal primary education (UPE) in 1997 and universal secondary education (USE) in 2005 have led educational policy makers, teachers, parents, and students to seek creative solutions to the problem of ensuring educational quality as schools incorporate 4 million more students. Some Ugandans worry about…

  9. Universal Secondary Education in Uganda: The Head Teachers' Dilemma

    ERIC Educational Resources Information Center

    Chapman, David W.; Burton, Lisa; Werner, Jessica

    2010-01-01

    Uganda has received considerable international attention for being the first and, to date, only African country to adopt a policy of free universal secondary education (USE). However, the policy was adopted with little attention to system capacity or involvement of secondary head teachers, even though there is considerable research documenting the…

  10. Forensic medicine services in Uganda--present and future.

    PubMed

    Bimenya, G S; Bhootra, B L; Mukasa, Nsereko

    2005-04-01

    Forensic medicine services (medico-legal services) as it is provided today in Uganda is discussed with special reference to forensic pathology and also to future plans for improvement to ensure quality service. Forensic medicine services are divided into clinical forensic medicine and forensic pathology. In Uganda, these services are rendered partly by pathologists attached to University, by pathologists and medical officers employed by police and by medical officers attached to hospitals. In Uganda, all types of unnatural deaths are reported to nearest police station and appointed investigating police officer(s) will take necessary action to have a medico-legal postmortem done as soon as possible. Currently there is no qualified forensic pathologist in Uganda. Suggestions are made with regard to the enactment of a Forensic Medicine Services Act by the Department of Health, the creation of a forensic medicine unit with, under the administrative umbrella of pathology department, in medical schools and imparting of forensic medicine training to anatomical pathologists to act as a qualified, specialist forensic pathologists.

  11. Conservation and Education in Murchison Falls Conservation Area, Uganda

    ERIC Educational Resources Information Center

    Jordahl, Mark D.

    2005-01-01

    This thesis forms the foundation for a conservation education training manual to help guides in Murchison Falls National Park, Uganda, communicate to foreign visitors about conservation issues. For background information I used a combination of text-based research and interviews to examine the application of community conservation and…

  12. Higher Education Research in Uganda: Problems and Prospects

    ERIC Educational Resources Information Center

    Owoeye, J. S.; Oyebade, S. A.

    2010-01-01

    Research is regarded as essential for development and the application of new knowledge for the benefit of society. Higher education in Uganda has expanded rapidly in the last 20 years. Universities have become the most important institutions in the achievement of national and international goals in enhancing the quality of life, wealth creation,…

  13. Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: limitations of diagnostic testing in the reality of diagnosis.

    PubMed

    Chandler, Clare I R; Hall-Clifford, Rachel; Asaph, Turinde; Pascal, Magnussen; Clarke, Siân; Mbonye, Anthony K

    2011-03-01

    In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis.

  14. Designing for action: adapting and implementing a community-based newborn care package to affect national change in Uganda

    PubMed Central

    Waiswa, Peter; Namazzi, Gertrude; Kerber, Kate; Peterson, Stefan

    2015-01-01

    Background There is a lack of literature on how to adapt new evidence-based interventions for maternal and newborn care into local health systems and policy for rapid scale-up, particularly for community-based interventions in low-income settings. The Uganda Newborn Study (UNEST) was a cluster randomised control trial to test a community-based care package which was rapidly taken up at national level. Understanding this process may help inform other studies looking to design and evaluate with scale-up in mind. Objective This study aimed to describe the process of using evidence to design a community-based maternal and newborn care package in rural eastern Uganda, and to determine the dissemination and advocacy approaches used to facilitate rapid policy change and national uptake. Design We reviewed UNEST project literature including meeting reports and minutes, supervision reports, and annual and midterm reports. National stakeholders, project and district staff were interviewed regarding their role in the study and perceptions of what contributed to uptake of the package under evaluation. Data related to UNEST formative research, study design, implementation and policy influence were extracted and analysed. Results An advisory committee of key players in development of maternal and newborn policies and programmes in Uganda was constituted from many agencies and disciplines. Baseline qualitative and quantitative data collection was done at district, community and facility level to examine applicability of aspects of a proposed newborn care package to the local setting. Data were summarised and presented to stakeholders to adapt the intervention that was ultimately tested. Quarterly monitoring of key activities and events around the interventions were used to further inform implementation. The UNEST training package, home visit schedule and behaviour change counselling materials were incorporated into the national Village Health Team and Integrated Community Case

  15. Comparison of HIV-related vulnerabilities between former child soldiers and children never abducted by the LRA in northern Uganda

    PubMed Central

    2013-01-01

    Background Thousands of former child soldiers who were abducted during the prolonged conflict in northern Uganda have returned to their home communities. Programmes that facilitate their successful reintegration continue to face a number of challenges. Although there is increasing knowledge of the dynamics of HIV infection during conflict, far less is known about its prevalence and implications for population health in the post-conflict period. This study investigated the effects of abduction on the prevalence of HIV and HIV-risk behaviours among young people in Gulu District, northern Uganda. An understanding of abduction experiences and HIV-risk behaviours is vital to both the development of effective reintegration programming for former child soldiers and the design of appropriate HIV prevention interventions for all young people. Methods In 2010, we conducted a cross-sectional study of 2 sub-counties in Gulu District. A demographic and behavioural survey was interview-administered to a purposively selected sample of 384 transit camp residents aged 15–29. Biological specimens were collected for HIV rapid testing in the field and confirmatory laboratory testing. Descriptive statistics were used to describe characteristics of abduction. Additionally, a gender-stratified bivariate analysis compared abductees’ and non-abductees’ HIV risk profiles. Results Of the 384 participants, 107 (28%) were former child soldiers (61% were young men and 39% were young women). The median age of participants was 20 and median age at abduction was 13. HIV prevalence was similar among former abductees and non-abductees (12% vs. 13%; p = 0.824), with no differences observed by gender. With respect to differences in HIV vulnerability, our bivariate analysis identified greater risky sexual behaviours in the past year for former abductees than non-abductees, but there were no differences between the two groups’ survival/livelihood activities and food insufficiency experiences

  16. An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

    PubMed Central

    2013-01-01

    Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and

  17. Bovine trypanosome species prevalence and farmers' trypanosomiasis control methods in south-western Uganda.

    PubMed

    Alingu, Richard A; Muhanguzi, Dennis; MacLeod, Ewan; Waiswa, Charles; Fyfe, Jenna

    2014-10-28

    A cross-sectional study was conducted in Mbarara district, south-western Uganda in May 2012 to determine the burden of African animal trypanosomosis (AAT) in the semi-intensive dairy production systems where pyrethroid acaricides are frequently used in the control of tick-borne diseases (TBDs). A total of 295 cattle blood samples were taken and analysed using a single pair of primers previously designed to amplify internal transcribed spacer (ITS1) of trypanosome ribosomal deoxyribonucleic acid (rDNA). A structured questionnaire was administered to 55 participating livestock farmers to generate data on acaricide and trypanocidal drug usage. The overall prevalence of trypanosome species was 2.4% (95% CI; 1.0% - 4.8%); Trypanosoma vivax was the most predominant species (2.0%; 95% CI; 0.7% - 4.4%). A single mixed infection of T. vivax and Trypanosoma brucei s.l. was detected. All the participating farmers used acaricides for tsetse and TBD control; 89.1% of the acaricides used were pyrethroids. About half of the farmers used trypanocidal drugs, mainly diminazene formulations (Berenil®). Low prevalence of trypanosomes in examined samples is most likely related to the frequent use of pyrethroid insecticides, trypanocides and restricted grazing (paddocking and tethering). These rigorous management practices are geared towards optimising production of exotic dairy breeds kept in this region that are highly susceptible to TBDs and AAT.

  18. Evidence for exposure to HTLV-III in Uganda before 1973.

    PubMed

    Saxinger, W C; Levine, P H; Dean, A G; de Thé, G; Lange-Wantzin, G; Moghissi, J; Laurent, F; Hoh, M; Sarngadharan, M G; Gallo, R C

    1985-03-01

    Fifty of 75 serum samples collected in the West Nile district of Uganda between August 1972 and July 1973 contained antibodies reactive with human T-cell leukemia (lymphotropic) virus type 3 (HTLV-III; mean titer, 601), while 12 of 75 samples were positive in a similar test for HTLV type 1 (HTLV-1) antibodies (mean titer, 236). The samples were screened by enzyme-linked immunosorbent assay and positive results were confirmed by a newly developed unlabeled antibody-peroxidase procedure with enhanced sensitivity for detection of antibody binding to immunoblots of HTLV-III antigen, demonstrating antibodies to proteins with molecular weights of 24,000, 41,000, and 76,000 in nearly all positive samples. Analysis of titration data indicated enhanced titers of antibody against HTLV-III and HTLV-I when coinfection occurred. The high prevalence and relatively low titers [compared to serum from patients with acquired immune deficiency syndrome (AIDS)] of antibodies recognizing HTLV-III proteins in sera from this population at a time that may predate or coincide with the appearance or spread of the AIDS agent (HTLV-III) suggest that the virus detected may have been a predecessor of HTLV-III or is HTLV-III itself but existing in a population acclimated to its presence. It further suggests an African origin of HTLV-III.

  19. Antiretroviral therapy and changing patterns of HIV stigmatisation in Entebbe, Uganda.

    PubMed

    Russell, Steve; Zalwango, Flavia; Namukwaya, Stella; Katongole, Joseph; Muhumuza, Richard; Nalugya, Ruth; Seeley, Janet

    2016-01-01

    Antiretroviral therapy (ART) has the potential to change processes of HIV stigmatisation. In this article, changing processes of stigmatisation among a group of people living with HIV (PLWH) on ART in Wakiso District, Uganda, are analysed using qualitative data from a study of PLWH's self-management of HIV on ART. There were 38 respondents (20 women, 18 men) who had been taking ART for at least 1 year. They were purposefully selected from government and non-government ART providers. Two in-depth interviews were held with each participant. Processes of reduced self-stigmatisation were clearly evident, caused by the recovery of their physical appearance and support from health workers. However most participants continued to conceal their status because they anticipated stigma; for example, they feared gossip, rejection and their status being used against them. Anticipated stigma was gendered: women expressed greater fear of enacted forms of stigma such as rejection by their partner; in contrast men's fears focused on gossip, loss of dignity and self-stigmatisation. The evidence indicates that ART has not reduced underlying structural drivers of stigmatisation, notably gender identities and inequalities, and that interventions are still required to mitigate and tackle stigmatisation, such as counselling, peer-led education and support groups that can help PLWH reconstruct alternative and more positive identities. A video abstract of this article can be found at: https://youtu.be/WtIaZJQ3Y_8.

  20. Newly Discovered Ebola Virus Associated with Hemorrhagic Fever Outbreak in Uganda

    PubMed Central

    Towner, Jonathan S.; Sealy, Tara K.; Khristova, Marina L.; Albariño, César G.; Conlan, Sean; Reeder, Serena A.; Quan, Phenix-Lan; Lipkin, W. Ian; Downing, Robert; Tappero, Jordan W.; Okware, Samuel; Lutwama, Julius; Bakamutumaho, Barnabas; Kayiwa, John; Comer, James A.; Rollin, Pierre E.; Ksiazek, Thomas G.; Nichol, Stuart T.

    2008-01-01

    Over the past 30 years, Zaire and Sudan ebolaviruses have been responsible for large hemorrhagic fever (HF) outbreaks with case fatalities ranging from 53% to 90%, while a third species, Côte d'Ivoire ebolavirus, caused a single non-fatal HF case. In November 2007, HF cases were reported in Bundibugyo District, Western Uganda. Laboratory investigation of the initial 29 suspect-case blood specimens by classic methods (antigen capture, IgM and IgG ELISA) and a recently developed random-primed pyrosequencing approach quickly identified this to be an Ebola HF outbreak associated with a newly discovered ebolavirus species (Bundibugyo ebolavirus) distantly related to the Côte d'Ivoire ebolavirus found in western Africa. Due to the sequence divergence of this new virus relative to all previously recognized ebolaviruses, these findings have important implications for design of future diagnostic assays to monitor Ebola HF disease in humans and animals, and ongoing efforts to develop effective antivirals and vaccines. PMID:19023410

  1. Mansonella perstans filariasis in Uganda: patterns of microfilaraemia and clinical manifestations in two endemic communities.

    PubMed

    Asio, Santa Maria; Simonsen, Paul E; Onapa, Ambrose W

    2009-03-01

    Surveys for Mansonella perstans infection and potentially related clinical manifestations were undertaken in two endemic communities in Mukono and Luwero districts of Uganda where no other human filarial infections are transmitted. A sensitive and accurate counting chamber method was used for quantifying microfilaraemia in 100microl of finger-prick blood. Among 575 and 991 examined individuals aged >or=1 year in the two communities, the overall microfilariae (mf) prevalence was significantly higher in Mukono (76.5%) than in Luwero (57.7%). As early as age 1-4 years, 40.6% and 20.5% of the children were mf-positive. Prevalences increased rapidly with increasing age to reach 89.2% and 81.4% in the 15-19 years age group and then remained high in subsequent age groups. The geometric mean mf intensity among mf-positive individuals was slightly higher in the Mukono community (32.4mf/100microl) than in the Luwero community (29.9mf/100microl), and this parameter increased with age in both communities. No obvious associations were observed between various clinical parameters and M. perstans microfilaraemia in any of the study communities. The observed patterns of microfilaraemia and the lack of obvious visible clinical manifestations suggest that the host's regulatory responses are downregulated in M. perstans infections. [ClinicalTrials.gov identifier: NCT00215280]. PMID:18809192

  2. Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda.

    PubMed

    Kiguli, Julie; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Mutebi, Aloysius; Macgregor, Hayley; Pariyo, George William

    2009-01-01

    This paper examines the community's perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility. PMID:19936148

  3. Data-Driven Districts.

    ERIC Educational Resources Information Center

    LaFee, Scott

    2002-01-01

    Describes the use of data-driven decision-making in four school districts: Plainfield Public Schools, Plainfield, New Jersey; Palo Alto Unified School District, Palo Alto, California; Francis Howell School District in eastern Missouri, northwest of St. Louis; and Rio Rancho Public Schools, near Albuquerque, New Mexico. Includes interviews with the…

  4. The Role of Astronomy in Development: The Case of Uganda

    NASA Astrophysics Data System (ADS)

    Jurua, Edward

    2015-08-01

    Science and technology play a key role in economic development; and Universities have a direct stake in this process. A knowlwdge based ecomony requires scientific and technological expertise which are both strongly influenced by the strength of training in science and technology. However, in Uganda not many students opt for science subject at higher levels, and subsquently in the University. Therefore, there is need to encourage and motivate students to study science subjects in order for this to be successful. This can be achieved through introduction of stimulating subjects such as astronomy in the university curriculum. Astronomy is considered as the most appealing subject and an excellent tool for conveying scientific knowledge to young students. In this paper, the role astromony has played to motivate and interest students to study physics in Mbarara University of Science and Technology, in Uganda, is discussed.

  5. Active seeps, investment climate draw interest to Uganda

    SciTech Connect

    Patton, D.K.; Kashambuzi, R.; Rubondo, E.N.T.

    1995-05-01

    Production has not been established in Uganda, but the hydrocarbon generating capacity of its rift basin is clearly evident. Reports of oil seeps date to 1925 to observations by Wayland; who relates 52 hydrocarbon occurrences in and around Lake Albert. Although not all remain active, nine oil seeps in the rift basin are confirmed active at present. The Albertine graben, a part of the East African rift system, dominates the geology of Uganda. Other, larger basins of similar evolution in Africa include the Sirte basin and the Gulf of Suez basin. These prolific basins account for one third of Africa`s total reserves. The paper describes the geologic setting, reservoirs, source rocks, geologic seals, structures, exploration history, licenses available, and fiscal terms.

  6. Soil Quality and Human Migration in Kenya and Uganda

    PubMed Central

    Gray, Clark L.

    2011-01-01

    Soil degradation is widely considered to be a key factor undermining agricultural livelihoods in the developing world and contributing to rural out-migration. To date, however, few quantitative studies have examined the effects of soil characteristics on human migration or other social outcomes for potentially vulnerable households. This study takes advantage of a unique longitudinal survey dataset from Kenya and Uganda containing information on household-level soil properties to investigate the effects of soil quality on population mobility. Random effects multinomial logit models are used to test for effects of soil quality on both temporary and permanent migration while accounting for a variety of potential confounders. The analysis reveals that soil quality significantly reduces migration in Kenya, particularly for temporary labor migration, but marginally increases migration in Uganda. These findings are consistent with several previous studies in showing that adverse environmental conditions tend to increase migration but not universally, contrary to common assumptions about environmentally-induced migration. PMID:22016577

  7. Two Severe Cases of Tungiasis in Goat Kids in Uganda.

    PubMed

    Mutebi, Francis; Krücken, Jürgen; Mencke, Norbert; Feldmeier, Hermann; von Samson-Himmelstjerna, Georg; Waiswa, Charles

    2016-01-01

    Tungiasis ensues from the penetration and burrowing of female sand fleas (Tunga spp.; Siphonaptera: Tungidae) in the skin of mammals. There are few case reports of severe tungiasis in goats and in these cases the Tunga species were not in most cases clearly identified. Two cases of severe tungiasis caused by Tunga penetrans in goat kids from tungiasis-endemic rural Uganda are reported. These are the first severe cases of tungiasis in goats reported from outside South America. PMID:27012871

  8. Examining dimensions of vulnerability among children in Uganda.

    PubMed

    Kalibala, Samuel; Schenk, Katie D; Weiss, Deborah C; Elson, Lynne

    2012-01-01

    Insufficient data on the nature and extent of children's vulnerability in Uganda has challenged government and donors in priority setting, resource allocation and developing effective approaches to improve well-being. We conducted a population-based survey among a nationally representative sample of 2551 households, covering a total of 7946 children. We engaged national stakeholders in a priority-setting exercise to develop a scoring system to assess dimensions of children's vulnerability. The exercise identified individual and household characteristics to assess vulnerability--many of which had not been measured previously--to which numerical weights representing vulnerability level were assigned. Highly weighted characteristics included maternal death, disability, child labour and pregnancy before age 17. Psychosocial elements included living apart from siblings, having nobody to talk to and never visiting a living parent. According to this approach, an estimated 51.1% of children in Uganda (weighted for national population distribution) are considered critically or moderately vulnerable. It is to these children, equivalent to a national total of 8.7 million, that support services should be prioritised. However, survey data suggest that the most critically vulnerable children are under-represented in several types of support services. This pioneering, participatory methodology provides a rudimentary, but valuable, first step towards quantifying the vulnerability of children in Uganda and assessing their resource needs. It has been used by the Government of Uganda to determine subcategories of vulnerability for resource allocation. A major advantage is that it uses local contextual knowledge of child vulnerability rather than generic criteria applied in international surveys. Further analytical work is required to validate the methodology, link it to child well-being outcomes and devise a practical tool for service providers to refine programme targeting. The

  9. Two Severe Cases of Tungiasis in Goat Kids in Uganda.

    PubMed

    Mutebi, Francis; Krücken, Jürgen; Mencke, Norbert; Feldmeier, Hermann; von Samson-Himmelstjerna, Georg; Waiswa, Charles

    2016-01-01

    Tungiasis ensues from the penetration and burrowing of female sand fleas (Tunga spp.; Siphonaptera: Tungidae) in the skin of mammals. There are few case reports of severe tungiasis in goats and in these cases the Tunga species were not in most cases clearly identified. Two cases of severe tungiasis caused by Tunga penetrans in goat kids from tungiasis-endemic rural Uganda are reported. These are the first severe cases of tungiasis in goats reported from outside South America.

  10. Two Severe Cases of Tungiasis in Goat Kids in Uganda

    PubMed Central

    Mutebi, Francis; Krücken, Jürgen; Mencke, Norbert; Feldmeier, Hermann; von Samson-Himmelstjerna, Georg; Waiswa, Charles

    2016-01-01

    Tungiasis ensues from the penetration and burrowing of female sand fleas (Tunga spp.; Siphonaptera: Tungidae) in the skin of mammals. There are few case reports of severe tungiasis in goats and in these cases the Tunga species were not in most cases clearly identified. Two cases of severe tungiasis caused by Tunga penetrans in goat kids from tungiasis-endemic rural Uganda are reported. These are the first severe cases of tungiasis in goats reported from outside South America. PMID:27012871

  11. Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda

    PubMed Central

    2010-01-01

    Background Male partner attendance of skilled Antenatal Care (ANC) is beneficial to improving maternal outcomes. This study investigated the level, perceived benefits and factors associated with male partner attendance of skilled ANC in a peri-urban community recovering from two decades of civil conflict. Methods This cross-sectional survey used multi-stage sampling in 12 villages of Omoro county to select 331 married male respondents aged 18 years or more, whose female spouses had childbirth within 24 months prior to the survey. A structured questionnaire elicited responses about male partner attendance of ANC during pregnancy at a public health facility as the main outcome variable. Analysis used Generalized Linear Model (GLM) in Stata version 10.0 to obtain Prevalence Risk Ratios (PRR) for association between the binary outcome and independent factors. All factors significant at p < 0.15 and potential confounders were included in the multivariable model. Results Overall, 65.4% (95%CI; 60.3, 70.5) male partners attended at least one skilled ANC visit. Mean age was 31.9 years [SD 8.2]. Perceived benefits of attending ANC were: HIV screening (74.5%), monitoring foetal growth (34%) and identifying complications during pregnancy (18.9%). Factors independently associated with higher ANC attendance were: knowledge of 3 or more ANC services (adj.PRR 2.77; 95%CI 2.24, 3.42), obtaining health information from facility health workers (adj.PRR 1.14; 95%CI 1.01, 1.29) and if spouse had skilled attendance at last childbirth (adj.PRR 1.31; 95%CI 1.04-1.64). However, factors for low attendance were: male partners intending their spouse to carry another pregnancy (adj.PRR 0.83; 95%CI 0.71, 0.97) and living more than 5 Km from a health facility (adj.PRR 0.83, 95%CI 0.70, 0.98). Conclusions Men who were knowledgeable of ANC services, obtained health information from a health worker and whose spouses utilised skilled delivery at last pregnancy were more likely to accompany their spouses at ANC, unlike those who wanted to have more children and lived more than 5 km from the health facility. These findings suggest that empowering male partners with knowledge about ANC services may increase their ANC participation and in turn increase skilled delivery. This strategy may improve maternal health care in post conflict and resource-limited settings. PMID:20846369

  12. Motivational Practices and Teachers' Performance in Jinja Municipality Secondary Schools, Jinja District, Uganda

    ERIC Educational Resources Information Center

    Justine, Nairuba

    2011-01-01

    The purpose of the study was to establish the effect of provision of fringe benefits and the nature of working conditions under motivational practices on teachers' performance in secondary schools. The study was qualitative and quantitative; and descriptive-correlation research design was used in the study. The researcher used purposive and simple…

  13. Further observations on the blood parasites of birds in Uganda.

    PubMed

    Valkiūnas, Gediminas; Sehgal, Ravinder N M; Iezhova, Tatjana A; Smith, Thomas B

    2005-07-01

    Birds from three National Parks (Bwindi Impenetrable, Kibale, and Queen Elizabeth) in western Uganda were surveyed during the dry season in July 2003 and investigated for hematozoa by microscopic examination of stained blood films. Of 307 birds examined, representing 68 species of 15 families and four orders, 61.9% were found to be infected with blood parasites. Species of Haemoproteus (15.3% prevalence), Plasmodium (20.5%), Leucocytozoon (40.1%), Trypanosoma (11.4%), Hepatozoon (2.6%), Atoxoplasma (0.3%), and microfilariae (3.9%) were recorded. Except for Haemoproteus spp. infections, the overall prevalence of hematozoa belonging to all genera was significantly higher in this study than was previously reported in Uganda. Thirty-six species of birds were examined for blood parasites for the first time and 112 new host-parasite associations were identified. Eighty-one were at the generic and 31 at the specific level of the hematozoa. Hepatozoon and Atoxoplasma spp. were detected for the first time in Uganda.

  14. Implementing a Palliative Care Nurse Leadership Fellowship Program in Uganda.

    PubMed

    Downing, Julia; Leng, Mhoira; Grant, Liz

    2016-05-01

    Global oncology and palliative care needs are increasing faster than the available capacity to meet these needs. This is particularly marked in sub-Saharan Africa, where healthcare capacity and systems are limited and resources are stretched. Uganda, a country of 35.6 million people in eastern Africa, faces the challenges of a high burden of communicable disease and a rising number of cases of non-communicable disease, including cancer. The vast majority of patients in Uganda are diagnosed with cancer too late for curative treatment to be an option because of factors like poor access to healthcare facilities, a lack of health education, poverty, and delays resulting from seeking local herbal or other traditional remedies. This article describes an innovative model of nurse leadership training in Uganda to improve the delivery of palliative care. The authors believe this model can be applicable to other low- and middle-income countries, where health resources are constrained and care needs are great.
. PMID:27105201

  15. Dismantling reified African culture through localised homosexualities in Uganda.

    PubMed

    Nyanzi, Stella

    2013-01-01

    Uganda's Anti-Homosexuality Bill of 2009 aimed at protecting the cherished culture of the people against emergent threats to the traditional heterosexual family. The Bill's justification, however, lay in myopic imaginings of a homogenous African-ness and pedestrian oblivion to pluralities within African sexualities. This paper revisits the debate that homosexuality is 'un-African'. Rhetoric analysis of the Anti-Homosexuality Bill exposes how dominant discourses of law, medicine, religion, geography and culture reinforce the view that homosexuality is foreign to Africa. Based on ethnography in contemporary Uganda, I explore how self-identified same-sex-loving individuals simultaneously claim their African-ness and their homosexuality. Their strategies include ethnic belonging, membership to kinship structures, making connections with pre-colonial histories of homosexuality, civic participation in democratic processes, national identity, organising of lesbian, gay, bisexual, transgender, intersex and questioning support groups, language and nomenclature, visibility and voice in local communal activities, solidarity and adherence to cultural rituals. In present-day Uganda, same-sex-loving men, women and transgender people variously assert their African-ness.

  16. Out of Africa: Uganda and UNAIDS advance a bold experiment.

    PubMed

    Zuniga, J

    1999-10-01

    The UNAIDS HIV Drug Access Initiative was launched in 1997 to aid four resource-limited countries: Chile, Cote d'Ivoire, Uganda, and Viet Nam. This multipronged initiative between pharmaceutical companies and government officials aims to expand access to HIV-related drugs on a small, sustainable scale in developing countries. Uganda's experience in the implementation of the UNAIDS HIV Drug Access Initiative is presented. Ugandan President Yoweri Museveni was struck by the reality of AIDS in 1986 when he learned that up to 25 percent of Ugandan troops might be HIV-infected. The overall Ugandan incidence of AIDS has been reduced since that time from 30 percent to about 14.5 percent due, in part, to cooperation between government and international institutions. Various charts are included, indicating cost estimates for the delivery of HIV care, and a flow chart diagrams drug procurement from six pharmaceutical companies for distribution to Ugandans living with HIV/AIDS. Minister of Health Crispus Kiyonga appointed a 15-member National Advisory Board in 1998 that established subcommittees on Drug Policy and Financing, Care and Practice, and Vertical Transmission to implement and oversee responsibilities. The establishment of Uganda's antiretroviral (ARV) treatment guidelines, standards, and educational and treatment efforts are discussed.

  17. Community systems strengthening for HIV care: experiences from Uganda.

    PubMed

    Mburu, Gitau; Oxenham, Danielle; Hodgson, Ian; Nakiyemba, Alice; Seeley, Janet; Bermejo, Alvaro

    2013-01-01

    The growing HIV burden on families and health systems is exerting a shift toward community caregivers, and is increasing the demand for functional community systems. In Uganda, where the number of people with HIV is increasing against a background of weak health systems, the role of community systems is poorly understood. We investigated the role of community systems in palliative care and the system elements required for an effective community response in Uganda. Qualitative interviews and focus group discussions were conducted among providers and recipients of palliative care, their family members, and governmental and community stakeholders in Mbale and Jinja, Uganda. Results showed that community systems play an important role in many aspects of palliative care--including personal, livelihood, nutritional and bereavement support--and often strengthen care linkages and referrals. For community systems to fulfill these roles effectively, multiple system elements--including leadership, training, partnerships, and enabling policies--are essential. Strengthening community systems could be an effective strategy to alleviate HIV burden on families and health systems. A systems approach could be a potent mechanism for determining which community structures to strengthen in order to maximize the impact of palliative care programs, and for guiding investments in HIV and health. PMID:24295101

  18. Open access, open education resources and open data in Uganda

    PubMed Central

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students’ Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country. PMID:26327966

  19. Open access, open education resources and open data in Uganda.

    PubMed

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country. PMID:26327966

  20. Dismantling reified African culture through localised homosexualities in Uganda.

    PubMed

    Nyanzi, Stella

    2013-01-01

    Uganda's Anti-Homosexuality Bill of 2009 aimed at protecting the cherished culture of the people against emergent threats to the traditional heterosexual family. The Bill's justification, however, lay in myopic imaginings of a homogenous African-ness and pedestrian oblivion to pluralities within African sexualities. This paper revisits the debate that homosexuality is 'un-African'. Rhetoric analysis of the Anti-Homosexuality Bill exposes how dominant discourses of law, medicine, religion, geography and culture reinforce the view that homosexuality is foreign to Africa. Based on ethnography in contemporary Uganda, I explore how self-identified same-sex-loving individuals simultaneously claim their African-ness and their homosexuality. Their strategies include ethnic belonging, membership to kinship structures, making connections with pre-colonial histories of homosexuality, civic participation in democratic processes, national identity, organising of lesbian, gay, bisexual, transgender, intersex and questioning support groups, language and nomenclature, visibility and voice in local communal activities, solidarity and adherence to cultural rituals. In present-day Uganda, same-sex-loving men, women and transgender people variously assert their African-ness. PMID:23767462

  1. Patterns and predictors of violence against children in Uganda: a latent class analysis

    PubMed Central

    Clarke, Kelly; Patalay, Praveetha; Allen, Elizabeth; Knight, Louise; Naker, Dipak; Devries, Karen

    2016-01-01

    Objective To explore patterns of physical, emotional and sexual violence against Ugandan children. Design Latent class and multinomial logistic regression analysis of cross-sectional data. Setting Luwero District, Uganda. Participants In all, 3706 primary 5, 6 and 7 students attending 42 primary schools. Main outcome and measure To measure violence, we used the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool—Child Institutional. We used the Strengths and Difficulties Questionnaire to assess mental health and administered reading, spelling and maths tests. Results We identified three violence classes. Class 1 (N=696 18.8%) was characterised by emotional and physical violence by parents and relatives, and sexual and emotional abuse by boyfriends, girlfriends and unrelated adults outside school. Class 2 (N=975 26.3%) was characterised by physical, emotional and sexual violence by peers (male and female students). Children in Classes 1 and 2 also had a high probability of exposure to emotional and physical violence by school staff. Class 3 (N=2035 54.9%) was characterised by physical violence by school staff and a lower probability of all other forms of violence compared to Classes 1 and 2. Children in Classes 1 and 2 were more likely to have worked for money (Class 1 Relative Risk Ratio 1.97, 95% CI 1.54 to 2.51; Class 2 1.55, 1.29 to 1.86), been absent from school in the previous week (Class 1 1.31, 1.02 to 1.67; Class 2 1.34, 1.10 to 1.63) and to have more mental health difficulties (Class 1 1.09, 1.07 to 1.11; Class 2 1.11, 1.09 to 1.13) compared to children in Class 3. Female sex (3.44, 2.48 to 4.78) and number of children sharing a sleeping area predicted being in Class 1. Conclusions Childhood violence in Uganda forms distinct patterns, clustered by perpetrator and setting. Research is needed to understand experiences of victimised children, and to develop mental health interventions for those with severe violence

  2. Uptake of Mass Drug Administration Programme for Schistosomiasis Control in Koome Islands, Central Uganda

    PubMed Central

    Tuhebwe, Doreen; Bagonza, James; Kiracho, Elizabeth Ekirapa; Yeka, Adoke; Elliott, Alison M.; Nuwaha, Fred

    2015-01-01

    Introduction Schistosomiasis is one of the neglected tropical diseases targeted for elimination in Uganda through the Mass Drug Administration (MDA) programme. Praziquantel has been distributed using community resource persons in fixed sites and house-to-house visits; however the uptake is still below target coverage. In 2011/2012 MDA exercise, uptake stood at 50% yet WHO target coverage is 75% at community level. We assessed the uptake of MDA and the associated factors in Koome Islands, Central Uganda. Methods In March 2013, we conducted a mixed methods cross sectional study in 15 randomly selected villages. We interviewed a total of 615 respondents aged 18 years and above using semi structured questionnaires and five key informants were also purposively selected. Univariate and multivariate analysis was done. MDA uptake was defined as self reported swallowing of praziquantel during the last (2012) MDA campaign. We conducted key informant interviews with Ministry of Health, district health personnel and community health workers. Results Self reported uptake of praziquantel was 44.7% (275/615), 95% confidence interval (CI) 40.8–48.7%. Of the 275 community members who said they had swallowed praziquantel, 142 (51.6%) reported that they had developed side effects. Uptake of MDA was more likely if the respondent was knowledgeable about schistosomiasis transmission and prevention (adjusted odds ratio [AOR] 1.85, 95% CI 1.22–2.81) and reported to have received health education from the health personnel (AOR 5.95, 95% CI 3.67–9.65). Service delivery challenges such as drug shortages and community health worker attrition also influenced MDA in Koome Islands. Conclusions Uptake of MDA for schistosomiasis control in Koome was sub optimal. Lack of knowledge about schistosomiasis transmission and prevention, inadequate health education and drug shortages are some of the major factors associated with low uptake. These could be addressed through routine health education

  3. Animal Reservoirs of Zoonotic Tungiasis in Endemic Rural Villages of Uganda

    PubMed Central

    Mutebi, Francis; Krücken, Jürgen; Feldmeier, Hermann; Waiswa, Charles; Mencke, Norbert; Sentongo, Elizabeth; von Samson-Himmelstjerna, Georg

    2015-01-01

    Background Animal tungiasis is believed to increase the prevalence and parasite burden in humans. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda. Methods and Findings To identify the major animal reservoirs of Tunga penetrans and their relative importance in the transmission of tungiasis in Uganda, a cross sectional study was conducted in animal rearing households in 10 endemic villages in Bugiri District. T. penetrans infections were detected in pigs, dogs, goats and a cat. The prevalences of households with tungiasis ranged from 0% to 71.4% (median 22.2) for animals and from 5 to 71.4% (median 27.8%) for humans. The prevalence of human tungiasis also varied among the population of the villages (median 7%, range 1.3–37.3%). Pig infections had the widest distribution (nine out of 10 villages) and highest prevalence (median 16.2%, range 0–64.1%). Pigs also had a higher number of embedded sand fleas than all other species combined (p<0.0001). Dog tungiasis occurred in five out of 10 villages with low prevalences (median of 2%, range 0–26.9%). Only two goats and a single cat had tungiasis. Prevalences of animal and human tungiasis correlated at both village (rho = 0.89, p = 0.0005) and household (rho = 0.4, p<0.0001) levels. The median number of lesions in household animals correlated with the median intensity of infection in children three to eight years of age (rho = 0.47, p<0.0001). Animal tungiasis increased the odds of occurrence of human cases in households six fold (OR = 6.1, 95% CI 3.3–11.4, p<0.0001). Conclusion Animal and human tungiasis were closely associated and pigs were identified as the most important animal hosts of T. penetrans. Effective tungiasis control should follow One Health principles and integrate ectoparasites control in animals. PMID:26473360

  4. Determinants of personal demand for an AIDS vaccine in Uganda: contingent valuation survey.

    PubMed Central

    Bishai, David; Pariyo, George; Ainsworth, Martha; Hill, Kenneth

    2004-01-01

    OBJECTIVE: To assess the factors affecting demand for an HIV/AIDS vaccine among adults in their prime earning and childbearing years and the impact of vaccination on risk behaviour in a high-prevalence, low-income country. METHODS: A contingent valuation survey of 1677 adults aged 18-60 years was conducted in 12 districts in Uganda. Respondents were asked about a hypothetical vaccine to prevent HIV infection. Households were randomly assigned survey questionnaires with one of two levels of vaccine efficacy (50% or 95%) and one of five prices. The influence of demographic characteristics, vaccine efficacy, self-assessed risk of infection, price, and household assets on vaccine demand was assessed using multivariate regression analysis. FINDINGS: Altogether, 94% (1576/1677) of respondents would be willing to be vaccinated with a free HIV/AIDS vaccine; 31% (78/251) would not be willing to be vaccinated at a price of 5000 Ugandan shillings (2.86 U.S. dollars). Household wealth, vaccine price, and risk behaviour were significant determinants of individual demand. Demand was equally high for both low-efficacy and high-efficacy vaccines. Respondents believed that condom use would be slightly less necessary with a high-efficacy vaccine (655/825; 79.4%) than a low-efficacy vaccine (690/843; 81.8%). However, reported condom use with partners other than spouses in the absence of a vaccine was much lower (137/271; 50.6%), with 26% (175/670) of men and 9.5% (96/1007) of women reporting having had partners other than their spouses during the past year. CONCLUSION: The high demand for an AIDS vaccine of any level of efficacy can be explained by the heavy toll of AIDS in Uganda: 72% (990/1371) of respondents had lost a family member to the disease. An AIDS vaccine would be self-targeting: those with a greater chance of becoming infected and spreading HIV would be more likely to seek a vaccine, improving the efficiency of vaccination programmes. However,,high levels of risk

  5. District cooling in Scandinavia

    SciTech Connect

    Andersson, B.

    1996-11-01

    This paper will present the status of the development of district cooling systems in Scandinavia over the last 5 years. It will describe the technologies used in the systems that have been constructed as well as the options considered in different locations. It will identify the drivers for the development of the cooling business to-date, and what future drivers for a continuing development of district cooling in Sweden. To-date, approximately 25 different cities of varying sizes have completed feasibility studies to determine if district cooling is an attractive option. In a survey, that was conducted by the Swedish District Heating Association, some 25 cities expected to have district cooling systems in place by the year 2000. In Sweden, district heating systems with hot water is very common. In many cases, it is simply an addition to the current service for the district heating company to also supply district cooling to the building owners. A parallel from this can be drawn to North America where district cooling systems now are developing rapidly. I am convinced that in these cities a district heating service will be added as a natural expansion of the district cooling company`s service.

  6. Intimate Partner Violence Attitudes and Experience among Women and Men in Uganda

    ERIC Educational Resources Information Center

    Speizer, Ilene S.

    2010-01-01

    This study examines intimate partner violence (IPV) attitudes and experience among women and men in Uganda to inform IPV-prevention programs in the region. Nationally representative population-based data from women aged 15 to 49 and men aged 15 to 54 were collected between May and October 2006 as part of the Uganda Demographic and Health Survey.…

  7. Privatisation of Higher Education in Uganda and the Global Gender Justice Ideal: Uneasy Bedfellows?

    ERIC Educational Resources Information Center

    Baine, Euzobia M. Mugisha

    2010-01-01

    This paper examines ways in which privatisation of education is affecting the search for gender justice through education focusing on Uganda's higher education institutions (HEIs). Since 1988 when the first private university was opened, the winds of change have swept Uganda's higher education sector to change how it is financed and managed. The…

  8. Into the Forest: The Evolution of a Conservation Education Program at Kalinzu Forest Reserve, Uganda

    ERIC Educational Resources Information Center

    Kuhar, Christopher W.; Bettinger, Tammie L.; Lehnhardt, Kathy; Townsend, Stephanie; Cox, Debbie

    2007-01-01

    While there are many conservation programs in east Africa, relatively little is invested in environmental education or capacity building within the community. With this in mind, the National Forest Authority of Uganda, the Ugandan Ministry of Education and Sports, Disney's Animal Kingdom[R], and the Jane Goodall Institute--Uganda entered into a…

  9. Hollywood in Uganda: Local Appropriation of Trans-National English-Language Movies

    ERIC Educational Resources Information Center

    Achen, Stella; Openjuru, George Ladaah

    2012-01-01

    Hollywood movies are popular in Uganda. This paper reports a study that investigated access to English-language Hollywood movies in Uganda, by way of an ethnographic audience study carried out in slum areas of the city of Kampala. The researchers visited and participated in the watching and reviewing of English-language movies in makeshift video…

  10. Developing a Framework for Monitoring Child Poverty: Results from a Study in Uganda

    ERIC Educational Resources Information Center

    Witter, Sophie

    2004-01-01

    In 2002 Save the Children UK carried out a study of child poverty in Uganda, as part of the on-going Uganda Participatory Poverty Assessment Programme. Using participants from all regions of the country, the researchers asked children about their perceptions of poverty and anti-poverty strategies, as well as questioning adult key informants about…

  11. Teacher Competence and the Academic Achievement of Sixth Grade Students in Uganda

    ERIC Educational Resources Information Center

    Wamala, Robert; Seruwagi, Gerald

    2013-01-01

    The study investigates the influence of teacher competence on the academic achievement of sixth grade students in Uganda. The investigation is based on data sourced from the 2009 Southern African Consortium for Monitoring Education Quality (SACMEQ) survey comprising 5,148 records of sixth grade students enrolled in primary schools in Uganda. The…

  12. Additions to the fauna of plume moths (Lepidoptera, Pterophoridae) of Uganda.

    PubMed

    Ustjuzhanin, Petr; Kovtunovich, Vasily; Anikin, Vasily; Aarvik, Leif

    2016-01-01

    An overview of 20 Pterophoridae species from Uganda is given. Three of them are described as new to science: Crassuncus agassizi Ustjuzhanin & Kovtunovich sp. nov., Hellinsia anikini Ustjuzhanin & Kovtunovich sp. nov. and Hellinsia nawrothi Ustjuzhanin & Kovtunovich sp. nov. Twelve species are recorded as new to the fauna of Uganda. PMID:27395680

  13. Foot-and-mouth disease virus serotype SAT 3 in long-horned Ankole calf, Uganda.

    PubMed

    Dhikusooka, Moses Tefula; Tjørnehøj, Kirsten; Ayebazibwe, Chrisostom; Namatovu, Alice; Ruhweza, Simon; Siegismund, Hans Redlef; Wekesa, Sabenzia Nabalayo; Normann, Preben; Belsham, Graham J

    2015-01-01

    After a 16-year interval, foot-and-mouth disease virus serotype SAT 3 was isolated in 2013 from an apparently healthy long-horned Ankole calf that grazed close to buffalo in Uganda. The emergent virus strain is ≈20% different in nucleotide sequence (encoding VP1 [viral protein 1]) from its closest relatives isolated previously from buffalo in Uganda. PMID:25531186

  14. Foot-and-Mouth Disease Virus Serotype SAT 3 in Long-Horned Ankole Calf, Uganda

    PubMed Central

    Dhikusooka, Moses Tefula; Tjørnehøj, Kirsten; Ayebazibwe, Chrisostom; Namatovu, Alice; Ruhweza, Simon; Siegismund, Hans Redlef; Wekesa, Sabenzia Nabalayo; Normann, Preben

    2015-01-01

    After a 16-year interval, foot-and-mouth disease virus serotype SAT 3 was isolated in 2013 from an apparently healthy long-horned Ankole calf that grazed close to buffalo in Uganda. The emergent virus strain is ≈20% different in nucleotide sequence (encoding VP1 [viral protein 1]) from its closest relatives isolated previously from buffalo in Uganda. PMID:25531186

  15. The Influence of Price on School Enrollment under Uganda's Policy of Free Primary Education

    ERIC Educational Resources Information Center

    Lincove, Jane Arnold

    2012-01-01

    This study uses household survey data to estimate determinants of schooling in Uganda, with a model that includes the price of school. Uganda's universal education policy offered free tuition, fees, and supplies to up to four children per family, including two daughters. The empirical method includes an estimation of a child-specific price of…

  16. Counteracting Fabricated Anti-Gay Public Pedagogy in Uganda with Strategic Lifelong Learning as Critical Action

    ERIC Educational Resources Information Center

    Grace, André P.

    2016-01-01

    Political, cultural and social fallout following the introduction of the anti-homosexuality bill in Uganda in 2009 intensified fabrication of an anti-gay public pedagogy of negation and nemesis that fuelled the passage of the Anti-Homosexuality Act, 2014. The Government of Uganda, conventional Anglicanism and US evangelical Christianity were all…

  17. Building Rain Water Tanks and Building Skills: A Case Study of a Women's Organization in Uganda

    ERIC Educational Resources Information Center

    Payne, Deborah; Nakato, Margaret; Nabalango, Caroline

    2008-01-01

    Water collection in rural areas of Uganda is left primarily to women and children. Katosi Women Development Trust, an NGO based in rural Uganda has focused on addressing the gender-linked issue of increased water sources near the home through the construction of rain water collection tanks. In an effort to improve the income of members as well as…

  18. Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord's Resistance Army in northern Uganda

    PubMed Central

    Pham, Phuong N; Vinck, Patrick; Stover, Eric

    2009-01-01

    Background Since the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being. Methods This is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures. Results One-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over two-thirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction. Conclusion Abduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma

  19. Uptake of Cervical Cancer Screening and Associated Factors among Women in Rural Uganda: A Cross Sectional Study

    PubMed Central

    Ndejjo, Rawlance; Mukama, Trasias; Musabyimana, Angele; Musoke, David

    2016-01-01

    Background In developing countries, inadequate access to effective screening for cervical cancer often contributes to the high morbidity and mortality caused by the disease. The largest burden of this falls mostly on underserved populations in rural areas, where health care access is characterized by transport challenges, ill equipped health facilities, and lack of information access. This study assessed uptake of cervical cancer screening and associated factors among women in rural Uganda. Methods This descriptive cross sectional study was carried out in Bugiri and Mayuge districts in eastern Uganda and utilised quantitative data collection methods. Data were collected using a semi-structured questionnaire on cervical cancer screening among females aged between 25 and 49 years who had spent six or more months in the area. Data were entered in Epidata 3.02 and analysed in STATA 12.0 statistical software. Univariate, bivariate and multivariate analyses were performed. Results Of the 900 women, only 43 (4.8%) had ever been screened for cervical cancer. Among respondents who were screened, 21 (48.8%) did so because they had been requested by a health worker, 17 (39.5%) had certain signs and symptoms they associated with cervical cancer while 16 (37.2%) did it voluntarily to know their status. Barriers to cervical cancer screening were negative individual perceptions 553 (64.5%) and health facility related challenges 142 (16.6%). Other respondents said they were not aware of the screening service 416 (48.5%). The independent predictors of cervical cancer screening were: being recommended by a health worker [AOR = 87.85, p<0.001], knowing where screening services were offered [AOR = 6.24, p = 0.004], and knowing someone who had ever been screened [AOR = 9.48, p = 0.001]. Conclusion The prevalence of cervical cancer screening is very low in rural Uganda. Interventions to increase uptake of cervical cancer screening should be implemented so as to improve access to the

  20. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study

    PubMed Central

    Muhoozi, Grace K. M.; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C.

    2016-01-01

    Background Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. Objective In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. Design Five hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. Results The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for

  1. Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda

    PubMed Central

    Nabyonga-Orem, Juliet; Mijumbi, Rhona

    2015-01-01

    Background: Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods: Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results: Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion: What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. PMID:25905479

  2. Breakfast, midday meals and academic achievement in rural primary schools in Uganda: implications for education and school health policy

    PubMed Central

    Acham, Hedwig; Kikafunda, Joyce K.; Malde, Marian K.; Oldewage-Theron, Wilna H.; Egal, AbdulKadir A.

    2012-01-01

    Background Underachievement in schools is a global problem and is especially prevalent in developing countries. Indicators of educational performance show that Uganda has done remarkably well on education access-related targets since the introduction of universal primary education in 1997. However, educational outcomes remain disappointing. The absence of school feeding schemes, one of the leading causes of scholastic underachievement, has not been given attention by the Ugandan authorities. Instead, as a national policy, parents are expected to provide meals even though many, especially in the rural areas, cannot afford to provide even the minimal daily bowl of maize porridge. Objective To assess and demonstrate the effect of breakfast and midday meal consumption on academic achievement of schoolchildren. Design, Materials and Methods We assessed household characteristics, feeding patterns and academic achievement of 645 schoolchildren (aged 9–15 years) in Kumi district, eastern Uganda, in 2006–2007, using a modified cluster sampling design which involved only grade 1 schools (34 in total) and pupils of grade four. Household questionnaires and school records were used to collect information on socio-demographic factors, feeding patterns and school attendance. Academic achievement was assessed using unstandardized techniques, specifically designed for this study. Results Underachievement (the proportion below a score of 120.0 points) was high (68.4%); in addition, significantly higher achievement and better feeding patterns were observed among children from the less poor households (p<0.05). Achievement was significantly associated with consumption of breakfast and a midday meal, particularly for boys (p<0.05), and a greater likelihood of scoring well was observed for better nourished children (all OR values>1.0). Conclusion We observed that underachievement was relatively high; inadequate patterns of meal consumption, particularly for the most poor

  3. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis: implications for malaria control in Uganda

    PubMed Central

    2011-01-01

    Background Current Uganda National Malaria treatment guidelines recommend parasitological confirmation either by microscopy or rapid diagnostic test (RDT) before treatment with artemether-lumefantrine (AL). However, the cost-effectiveness of these strategies has not been assessed at rural operational primary care centres. Methods Three health centres (HCs) were randomized to three diagnostic arms (microscopy, RDT and presumptive diagnosis) in a district of low and another of high malaria transmission intensities in Uganda. Some 22,052 patients presenting with fever at outpatients departments were enrolled from March 2010 to February 2011. Of these, a random sample of 1,627 was selected to measure additional socio-economic characteristics. Costing was performed following the standard step-down cost allocation and the ingredients approach. Effectiveness was measured as the number and proportion of patients correctly diagnosed and treated. Incremental Cost-Effectiveness Ratios (ICERs) were estimated from the societal perspective (http://Clinicaltrials.gov, NCT00565071). Results Overall RDT was most cost-effective with lowest ICER US$5.0 compared to microscopy US$9.61 per case correctly diagnosed and treated. In the high transmission setting, ICER was US$4.38 for RDT and US$12.98 for microscopy. The corresponding ICERs in the low transmission setting were US$5.85 and US$7.63 respectively. The difference in ICERs between RDT and microscopy was greater in the high transmission area (US$8.9) than in low transmission setting (US$1.78). At a willingness to pay of US$2.8, RDT remained cost effective up to a threshold value of the cost of treatment of US$4.7. Conclusion RDT was cost effective in both low and high transmission settings. With a global campaign to reduce the costs of AL and RDT, the Malaria Control Programme and stakeholders need a strategy for malaria diagnosis because as the cost of AL decreases, presumptive treatment is likely to become more attractive. PMID

  4. Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria, Uganda

    PubMed Central

    Nevin, Paul E.; Pfeiffer, James; Kibira, Simon P. S.; Lubinga, Solomon J.; Mukose, Aggrey; Babigumira, Joseph B.

    2015-01-01

    Background In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC) strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3–5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria. Methods We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda. Results There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients’ physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient’s first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing. Conclusions Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers

  5. Tuberculosis in the era of infection with the human immunodeficiency virus: assessment and comparison of community knowledge of both infections in rural Uganda

    PubMed Central

    2012-01-01

    Background In Uganda, despite a significant public health burden of tuberculosis (TB) in the context of high human immunodeficiency virus (HIV) prevalence, little is known about community knowledge of TB. The purpose of this study was to assess and compare knowledge about TB and HIV in the general population of western Uganda and to examine common knowledge gaps and misconceptions. Methods We implemented a multi-stage survey design to randomly survey 360 participants from one district in western Uganda. Weighted summary knowledge scores for TB and HIV were calculated and multiple linear regression (with knowledge score as the dependant variable) was used to determine significant predictors. Six focus group discussions were conducted to supplement survey findings. Results Mean (SD) HIV knowledge score was 58 (12) and TB knowledge score was 33 (15), both scores out of 100. The TB knowledge score was statistically significantly (p < 0.001) lower. Multivariate regression models included age, sex, marital status, education, residence, and having a friend with HIV/TB as independent variables. TB knowledge was predicted by rural residence (coefficient = −6.27, 95% CI: -11.7 to −0.8), and age ≥45 years (coefficient = 7.45, 95% CI: 0.3-14.6). HIV knowledge was only predicted by higher education (coefficient = 0.94, 95%CI: 0.3-1.6). Focus group participants mentioned various beliefs in the aetiology of TB including sharing cups, alcohol consumption, smoking, air pollution, and HIV. Some respondents believed that TB was not curable. Conclusion TB knowledge is low and many misconceptions about TB exist: these should be targeted through health education programs. Both TB and HIV-infection knowledge gaps could be better addressed through an integrated health education program on both infections, whereby TB program managers include HIV information and vice versa. PMID:23254144

  6. Yellow fever vaccination coverage following massive emergency immunization campaigns in rural Uganda, May 2011: a community cluster survey

    PubMed Central

    2013-01-01

    Background Following an outbreak of yellow fever in northern Uganda in December 2010, Ministry of Health conducted a massive emergency vaccination campaign in January 2011. The reported vaccination coverage in Pader District was 75.9%. Administrative coverage though timely, is affected by incorrect population estimates and over or under reporting of vaccination doses administered. This paper presents the validated yellow fever vaccination coverage following massive emergency immunization campaigns in Pader district. Methods A cross sectional cluster survey was carried out in May 2011 among communities in Pader district and 680 respondents were indentified using the modified World Health Organization (WHO) 40 × 17 cluster survey sampling methodology. Respondents were aged nine months and above. Interviewer administered questionnaires were used to collect data on demographic characteristics, vaccination status and reasons for none vaccination. Vaccination status was assessed using self reports and vaccination card evidence. Our main outcomes were measures of yellow fever vaccination coverage in each age-specific stratum, overall, and disaggregated by age and sex, adjusting for the clustered design and the size of the population in each stratum. Results Of the 680 survey respondents, 654 (96.1%, 95% CI 94.9 – 97.8) reported being vaccinated during the last campaign but only 353 (51.6%, 95% CI 47.2 – 56.1) had valid yellow fever vaccination cards. Of the 280 children below 5 years, 269 (96.1%, 95% CI 93.7 – 98.7) were vaccinated and nearly all males 299 (96.9%, 95% CI 94.3 – 99.5) were vaccinated. The main reasons for none vaccination were; having travelled out of Pader district during the campaign period (40.0%), lack of transport to immunization posts (28.0%) and, sickness at the time of vaccination (16.0%). Conclusions Our results show that actual yellow fever vaccination coverage was high and satisfactory in Pader district since it was above the

  7. Using formative research to design a behavior change strategy to increase the use of improved cookstoves in peri-urban Kampala, Uganda.

    PubMed

    Martin, Stephanie L; Arney, Jennifer K; Mueller, Lisa M; Kumakech, Edward; Walugembe, Fiona; Mugisha, Emmanuel

    2013-12-10

    Household air pollution from cooking with biomass fuels negatively impacts maternal and child health and the environment, and contributes to the global burden of disease. In Uganda, nearly 20,000 young children die of household air pollution-related pneumonia every year. Qualitative research was used to identify behavioral determinants related to the acquisition and use of improved cookstoves in peri-urban Uganda. Results were used to design a behavior change strategy for the introduction of a locally-fabricated top-lit updraft gasifier (TLUD) stove in Wakiso district. A theoretical framework--opportunity, ability, and motivation--was used to guide the research and behavior change strategy development. Participants consistently cited financial considerations as the most influential factor related to improved cookstove acquisition and use. In contrast, participants did not prioritize the potential health benefits of improved cookstoves. The theoretical framework, research methodology, and behavior change strategy design process can be useful for program planners and researchers interested in identifying behavioral determinants and designing and evaluating improved cookstove interventions.

  8. Using Formative Research to Design a Behavior Change Strategy to Increase the Use of Improved Cookstoves in Peri-Urban Kampala, Uganda

    PubMed Central

    Martin, Stephanie L.; Arney, Jennifer K.; Mueller, Lisa M.; Kumakech, Edward; Walugembe, Fiona; Mugisha, Emmanuel

    2013-01-01

    Household air pollution from cooking with biomass fuels negatively impacts maternal and child health and the environment, and contributes to the global burden of disease. In Uganda, nearly 20,000 young children die of household air pollution-related pneumonia every year. Qualitative research was used to identify behavioral determinants related to the acquisition and use of improved cookstoves in peri-urban Uganda. Results were used to design a behavior change strategy for the introduction of a locally-fabricated top-lit updraft gasifier (TLUD) stove in Wakiso district. A theoretical framework—opportunity, ability, and motivation—was used to guide the research and behavior change strategy development. Participants consistently cited financial considerations as the most influential factor related to improved cookstove acquisition and use. In contrast, participants did not prioritize the potential health benefits of improved cookstoves. The theoretical framework, research methodology, and behavior change strategy design process can be useful for program planners and researchers interested in identifying behavioral determinants and designing and evaluating improved cookstove interventions. PMID:24336020

  9. Groundwater resources monitoring and population displacement in northern Uganda

    NASA Astrophysics Data System (ADS)

    Chalikakis, K.; Hammache, Y.; Nawa, A.; Slinski, K.; Petropoulos, G.; Muteesasira, A.

    2009-04-01

    Northern Uganda has been devastated by more than 20 years of open conflict by the LRA (Lord's Resistance Army) and the Government of Uganda. This war has been marked by extreme violence against civilians, who had been gathered in protected IDP (Internally Displaced Persons) camps. At the height of the displacement in 2007, the UN office for coordination of humanitarian affairs, estimated that nearly 2.5 million people were interned into approximately 220 camps throughout Northern Uganda. With the improved security since mid-2006, the people displaced by the conflict in Northern Uganda started to move out of the overcrowded camps and return either to their villages/parishes of origin or to resettlement/transit sites. However, basic water, sanitation and hygiene infrastructure in the return areas or any new settlements sites are minimal. People returning to their villages of origin encounter a situation where in many cases there is no access to safe water. Since 1998 ACF (Action Against Hunger, part of the Action Contre la Faim International Network) activities have been concentrated in the Acholi and Lango regions of Northern Uganda. ACF's WASH (Water, sanitation and hygiene) department interventions concern sanitation infrastructure, hygiene education and promotion as well as water points implementation. To ensure safe water access, actions are focused in borehole construction and traditional spring rehabilitation, also called "protected" springs. These activities follow the guidelines as set forth by the international WASH cluster, led by UNICEF. A three year project (2008-2010) is being implemented by ACF, to monitor the available groundwater resources in Northern Uganda. The main objectives are: 1. to monitor the groundwater quality from existing water points during different hydrological seasons, 2. to identify, if any, potential risks of contamination from population concentrations and displacement, lack of basic infrastructure and land use, and finally 3. to

  10. Sexually transmitted diseases in the history of Uganda.

    PubMed Central

    Lyons, M

    1994-01-01

    First noticed in Uganda in 1863 by a European explorer, sexually transmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century. In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine. By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measures. PMID:8206475

  11. African Indigenous science in higher education in Uganda

    NASA Astrophysics Data System (ADS)

    Akena Adyanga, Francis

    This study examines African Indigenous Science (AIS) in higher education in Uganda. To achieve this, I use anticolonial theory and Indigenous knowledge discursive frameworks to situate the subjugation of Indigenous science from the education system within a colonial historical context. These theories allow for a critical examination of the intersection of power relations rooted in the politics of knowledge production, validation, and dissemination, and how this process has become a systemic and complex method of subjugating one knowledge system over the other. I also employ qualitative and autoethnographic research methodologies. Using a qualitative research method, I interviewed 10 students and 10 professors from two universities in Uganda. My research was guided by the following key questions: What is African Indigenous Science? What methodology would help us to indigenize science education in Uganda? How can we work with Indigenous knowledge and anticolonial theoretical discursive frameworks to understand and challenge the dominance of Eurocentric knowledge in mainstream education? My research findings revealed that AIS can be defined in multiple ways, in other words, there is no universal definition of AIS. However, there were some common elements that my participants talked about such as: (a) knowledge by Indigenous communities developed over a long period of time through a trial and error approach to respond to the social, economic and political challenges of their society. The science practices are generational and synergistic with other disciplines such as history, spirituality, sociology, anthropology, geography, and trade among others, (b) a cumulative practice of the use, interactions with and of biotic and abiotic organism in everyday life for the continued existence of a community in its' totality. The research findings also indicate that Indigenous science is largely lacking from Uganda's education curriculum because of the influence of colonial and

  12. Kaposi's Sarcoma in Uganda: Geographic and Ethnic Distribution

    PubMed Central

    Taylor, J. F.; Smith, P. G.; Bull, Diana; Pike, M. C.

    1972-01-01

    Over the quinquennium 1964-68 the crude annual incidence of Kaposi's sarcoma in Uganda per million of the population was 7·9 overall, 14·6 for males and 1·1 for females. Statistical analysis indicates that the disease is most prevalent in highland areas to the west and among the indigenous Bantu tribes. There was no correlation with the distribution of squamous cell carcinoma of the lower leg, and Kaposi's sarcoma was not seen in an Indian or European during the period under review. PMID:4647399

  13. Resistance and religion: health care in Uganda, 1971-1979.

    PubMed

    Reckart, Madeline; Wall, Barbra Mann

    2014-01-01

    This article situates women's roles in community health care during violence in Uganda in the 1970s. It examines the lived reality of Catholic missionary sister nurses, midwives, and physicians on the ground where sisters administered health care to local communities. The goal is to examine how religious women worked with local individuals and families in community health during periods of violence and war. Catholic sisters claimed to be apolitical, yet their mission work widened to include political issues. As they saw local Ugandans threatened, sisters engaged in political activities by their identification with and protection of "their people."

  14. District, Know Thyself

    ERIC Educational Resources Information Center

    Tupa, Megan; McFadden, Ledyard

    2009-01-01

    Finalists for the Broad Prize for Urban Education demonstrate that identifying strategies that fit the local context is essential in creating success for students. Long Beach Unified School District in California and Broward County Public Schools in Florida demonstrate how districts can use different strategies to achieve the same goals.

  15. School District Energy Manual.

    ERIC Educational Resources Information Center

    Association of School Business Officials International, Reston, VA.

    This manual serves as an energy conservation reference and management guide for school districts. The School District Energy Program (SDEP) is designed to provide information and/or assistance to school administrators planning to implement a comprehensive energy management program. The manual consists of 15 parts. Part 1 describes the SDEP; Parts…

  16. Do School Districts Matter?

    ERIC Educational Resources Information Center

    Whitehurst, Grover J.; Chingos, Matthew M.; Gallaher, Michael R.

    2013-01-01

    School districts occupy center stage in education reform in the U.S. They manage nearly all public funding and are frequently the locus of federal and state reform initiatives, e.g., instituting meaningful teacher evaluation systems. Financial compensation for district leaders is high, with many being paid more than the chief state school officers…

  17. A One Health, participatory epidemiology assessment of anthrax (Bacillus anthracis) management in Western Uganda.

    PubMed

    Coffin, Jeanne L; Monje, Fred; Asiimwe-Karimu, Grace; Amuguni, Hellen Janetrix; Odoch, Terence

    2015-03-01

    Sporadic anthrax outbreaks have occurred in and around Uganda's Queen Elizabeth National Park (QENP) for years, affecting wildlife, domestic animals, and humans. Reported outbreaks (2004-2005 and 2010) in QENP collectively killed over 500 wild animals and over 400 domestic animals. A 2011 outbreak in Sheema district temporarily froze local markets while killing two humans and seven bovines. One Health is multidisciplinary at its core, yet studies sometimes focus on the effects of animals on human health to the detriment of investigating the surrounding ecological and cultural contexts. Participatory methods connect problems - such as disease - to their context. A multidisciplinary team used participatory epidemiology and conventional structured questionnaires to investigate the impacts of anthrax on human livelihoods and the related perceptions of conservation, public health, and veterinary health efforts in the QENP area. Proximities to previous anthrax outbreaks and to QENP were treated as risk factors in the collection and evaluation of data. Participants' feedback indicates that anthrax prevalence may be greater than officially reported. Community member perceptions about anthrax and other diseases appear to be more closely related to their proximity to QENP than their proximity to anthrax outbreaks. Neither risk factor had a strong effect on knowledge of disease, nor any effect on behaviors associated with disease response or control. Instead, participants reported that social pressures, the economics of poverty, and the lack of health and veterinary infrastructure highly influenced responses to disease. The complex connections between the social needs and the economic context of these communities seem to be undermining current anthrax control and education measures. This livelihood-based decision-making may be unlikely to respond to educational intervention alone. This study provides a strong base for further research and for improvements in effective disease

  18. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.

    PubMed

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet

    2016-01-01

    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH's motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH's self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH's self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH's self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new 'self': they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management which ART

  19. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.

    PubMed

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet

    2016-01-01

    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH's motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH's self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH's self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH's self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new 'self': they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management which ART

  20. A One Health, participatory epidemiology assessment of anthrax (Bacillus anthracis) management in Western Uganda.

    PubMed

    Coffin, Jeanne L; Monje, Fred; Asiimwe-Karimu, Grace; Amuguni, Hellen Janetrix; Odoch, Terence

    2015-03-01

    Sporadic anthrax outbreaks have occurred in and around Uganda's Queen Elizabeth National Park (QENP) for years, affecting wildlife, domestic animals, and humans. Reported outbreaks (2004-2005 and 2010) in QENP collectively killed over 500 wild animals and over 400 domestic animals. A 2011 outbreak in Sheema district temporarily froze local markets while killing two humans and seven bovines. One Health is multidisciplinary at its core, yet studies sometimes focus on the effects of animals on human health to the detriment of investigating the surrounding ecological and cultural contexts. Participatory methods connect problems - such as disease - to their context. A multidisciplinary team used participatory epidemiology and conventional structured questionnaires to investigate the impacts of anthrax on human livelihoods and the related perceptions of conservation, public health, and veterinary health efforts in the QENP area. Proximities to previous anthrax outbreaks and to QENP were treated as risk factors in the collection and evaluation of data. Participants' feedback indicates that anthrax prevalence may be greater than officially reported. Community member perceptions about anthrax and other diseases appear to be more closely related to their proximity to QENP than their proximity to anthrax outbreaks. Neither risk factor had a strong effect on knowledge of disease, nor any effect on behaviors associated with disease response or control. Instead, participants reported that social pressures, the economics of poverty, and the lack of health and veterinary infrastructure highly influenced responses to disease. The complex connections between the social needs and the economic context of these communities seem to be undermining current anthrax control and education measures. This livelihood-based decision-making may be unlikely to respond to educational intervention alone. This study provides a strong base for further research and for improvements in effective disease

  1. Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV

    PubMed Central

    Mburu, Gitau; Ram, Mala; Skovdal, Morten; Bitira, David; Hodgson, Ian; Mwai, Grace W; Stegling, Christine; Seeley, Janet

    2013-01-01

    Introduction Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood. Methods This paper utilizes data from a qualitative study exploring the impact of networked groups of people living with HIV in Jinja and Mbale districts of Uganda. Participants were people living with HIV (n=40), members of their households (n=10) and their health service providers (n=15). Data were collected via interviews and focus group discussions in 2010, and analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ anti-stigma activities. Results Study participants reported that HIV stigma in their communities had declined as a result of the collective activities of groups of people living with HIV. However, they believed that stigma remained an ongoing challenge. Gender, family relationships, social and economic factors emerged as important drivers of stigma. Challenging stigma collectively transcended individual experiences and united people living with HIV in a process of social renegotiation to achieve change. Groups of people living with HIV provided peer support and improved the confidence of their members, which ultimately reduced self-stigma and improved their ability to deal with external stigma when it was encountered. Conclusions Antiretroviral therapy and group-based approaches in the delivery of HIV services are opening up new avenues for the collective participation of people living with HIV to challenge HIV stigma and act as agents of social change. Interventions for reducing HIV stigma should be expanded beyond those that aim to increase the resilience and coping mechanisms of individuals, to those that build the capacity of groups to collectively cope with and challenge HIV stigma. Such

  2. District nursing in Dominica.

    PubMed

    Kolkman, P M; Luteijn, A J; Nasiiro, R S; Bruney, V; Smith, R J; Meyboom-de Jong, B

    1998-10-01

    District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the use of a questionnaire. Check-ups for hypertension, diabetes, pregnancy and immunisations constituted 40% of all reasons for encounter. The district nurses dealt with 80% of all contacts; only 20% of all patients were referred to the district medical officer. There are several discouragements to the motivation of the nurses. In addition to being a nurse, all have their family and other obligations. Postgraduate training with diversified certification and upgrading of wages could contribute to a continued high motivation and increased job satisfaction.

  3. INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Despite 10 to% of persons living with HIV in sub-Saharan Africa having clinical depression, and the consequences of depression for key public health outcomes (HIV treatment adherence and condom use), depression treatment is rarely integrated into HIV care programs. Task-shifting, protocolized approaches to depression care have been used to overcome severe shortages of mental health specialists in developing countries, but not in sub-Saharan Africa and not with HIV clients. The aims of this trial are to evaluate the implementation outcomes and cost-effectiveness of a task-shifting, protocolized model of antidepressant care for HIV clinics in Uganda. Methods/Design INDEPTH-Uganda is a cluster randomized controlled trial that compares two task-shifting models of depression care - a protocolized model versus a model that relies on the clinical acumen of trained providers to provide depression care in ten public health HIV clinics in Uganda. In addition to data abstracted from routine data collection mechanisms and supervision logs, survey data will be collected from patient and provider longitudinal cohorts; at each site, a random sample of 150 medically stable patients who are depressed according to the PHQ-2 screening will be followed for 12 months, and providers involved in depression care implementation will be followed over 24 months. These data will be used to assess whether the two models differ on implementation outcomes (proportion screened, diagnosed, treated; provider fidelity to model of care), provider adoption of treatment care knowledge and practices, and depression alleviation. A cost-effectiveness analysis will be conducted to compare the relative use of resources by each model. Discussion If effective and resource-efficient, the task-shifting, protocolized model will provide an approach to building the capacity for sustainable integration of depression treatment in HIV care settings across sub-Saharan Africa and improving key public

  4. Mosquitoes of Zika Forest, Uganda: species composition and relative abundance.

    PubMed

    Kaddumukasa, M A; Mutebi, J-P; Lutwama, J J; Masembe, C; Akol, A M

    2014-01-01

    Mosquito collections were conducted in Zika Forest near Entebbe, Uganda, from July 2009 through June 2010 using CO2-baited light traps, ovitraps, and human-baited catches. In total, 163,790 adult mosquitoes belonging to 12 genera and 58 species were captured. Of these, 22 species (38%) were captured in Zika Forest for the first time. All the new records found in the forest in this study had previously been captured in other regions of Uganda, implying that they are native to the country and do not represent new introductions. More than 20 species previously collected in Zika Forest were not detected in our collections, and this may suggest a change in the mosquito fauna during the past 40 yr or variation in species composition from year to year. Arboviruses of public health importance have previously been isolated from >50% of the 58 mosquito species captured in Zika Forest, which suggests ahigh potential for transmission and maintenance of a wide range of arboviruses in Zika Forest.

  5. Total Economic Value of Wetlands Products and Services in Uganda

    PubMed Central

    Kakuru, Willy; Turyahabwe, Nelson; Mugisha, Johnny

    2013-01-01

    Wetlands provide food and non-food products that contribute to income and food security in Uganda. This study determined the economic value of wetland resources and their contribution to food security in the three agroecological zones of Uganda. The values of wetland resources were estimated using primary and secondary data. Market price, Productivity, and Contingent valuation methods were used to estimate the value of wetland resources. The per capita value of fish was approximately US$ 0.49 person−1. Fish spawning was valued at approximately US$ 363,815 year−1, livestock pastures at US$ 4.24 million, domestic water use at US$ 34 million year−1, and the gross annual value added by wetlands to milk production at US$ 1.22 million. Flood control was valued at approximately US$ 1,702,934,880 hectare−1 year−1 and water regulation and recharge at US$ 7,056,360 hectare−1 year−1. Through provision of grass for mulching, wetlands were estimated to contribute to US$ 8.65 million annually. The annual contribution of non-use values was estimated in the range of US$ 7.1 million for water recharge and regulation and to US$ 1.7 billion for flood control. Thus, resource investment for wetlands conservation is economically justified to create incentives for continued benefits. PMID:24163614

  6. Yellow fever and Zika virus epizootics and enzootics in Uganda.

    PubMed

    McCrae, A W; Kirya, B G

    1982-01-01

    Data of monkey serology are presented which, together with past evidence, support the view that yellow fever (YF) virus circulates in its primary sylvan host populations, i.e., forest monkeys, in an enzootic state in Bwamba County in western Uganda but as series of epizootics in the forest-savanna mosaic zone of central Uganda. Evidence of an epizootic of Zika virus at the Zika Forest near Entebbe is described which occurred in two episodes, the first (in 1969) apparently following the build-up of non-immune monkey populations since a previous epizootic of 1962-63 and the second (in 1970) when Aedes africanus biting densities rose. This was followed only 18 months later by an intensive epizootic of YF virus, contradictory to the hypothesis that Zika virus alone would suppress subsequent epizootics of YF virus in nature, at least when redtail monkeys are involved. Conclusions are finally reviewed in the light of more recent evidence of transovarial flavivirus transmission in mosquitoes, pointing out that phlebotomine sandflies also require fresh attention.

  7. Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda

    PubMed Central

    2011-01-01

    Background Improving knowledge of obstetric danger signs and promoting birth preparedness practices are strategies aimed at enhancing utilization of skilled care in low-income countries. The aim of the study was to explore the association between knowledge of obstetric danger signs and birth preparedness among recently delivered women in south-western Uganda. Methods The study included 764 recently delivered women from 112 villages in Mbarara district. Community survey methods were used and 764 recently delivered women from 112 villages in Mbarara district were included in study. Interviewer administered questionnaire were used to collect data. Logistic regression analyses were conducted to explore the relationship between knowledge of key danger signs and birth preparedness. Results Fifty two percent of women knew at least one key danger sign during pregnancy, 72% during delivery and 72% during postpartum. Only 19% had knowledge of 3 or more key danger signs during the three periods. Of the four birth preparedness practices; 91% had saved money, 71% had bought birth materials, 61% identified a health professional and 61% identified means of transport. Overall 35% of the respondents were birth prepared. The relationship between knowledge of at least one key danger sign during pregnancy or during postpartum and birth preparedness showed statistical significance which persisted after adjusting for probable confounders (OR 1.8, 95% CI: 1.2-2.6) and (OR 1.9, 95% CI: 1.2-3.0) respectively. Young age and high levels of education had synergistic effect on the relationship between knowledge and birth preparedness. The associations between knowledge of at least one key danger sign during childbirth or knowledge that prolonged labour was a key danger sign and birth preparedness were not statistically significant. Conclusions The prevalence of recently delivered women who had knowledge of key danger signs or those who were birth prepared was very low. Since the majority of

  8. Glossina fuscipes populations provide insights for human African trypanosomiasis transmission in Uganda.

    PubMed

    Aksoy, Serap; Caccone, Adalgisa; Galvani, Alison P; Okedi, Loyce M

    2013-08-01

    Uganda has both forms of human African trypanosomiasis (HAT): the chronic gambiense disease in the northwest and the acute rhodesiense disease in the south. The recent spread of rhodesiense into central Uganda has raised concerns given the different control strategies the two diseases require. We present knowledge on the population genetics of the major vector species Glossina fuscipes fuscipes in Uganda with a focus on population structure, measures of gene flow between populations, and the occurrence of polyandry. The microbiome composition and diversity is discussed, focusing on their potential role on trypanosome infection outcomes. We discuss the implications of these findings for large-scale tsetse control programs, including suppression or eradication, being undertaken in Uganda, and potential future genetic applications.

  9. Glossina fuscipes populations provide insights for Human African Trypanosomiasis transmission in Uganda

    PubMed Central

    Aksoy, Serap; Caccone, Adalgisa; Galvani, Alison P.; Okedi, Loyce M.

    2013-01-01

    Uganda has both forms of human African trypanosomiasis (HAT): the chronic gambiense disease in the northwest and the acute rhodesiense disease in the south. The recent spread of rhodesiense into central Uganda has raised concerns given the different control strategies the two diseases require. We present knowledge on the population genetics of the major vector species Glossina fuscipes fuscipes in Uganda with a focus on population structure, measures of gene flow between populations, and the occurrence of polyandry. The microbiome composition and diversity is discussed, focusing on their potential role on trypanosome infection outcomes. We discuss the implications of these findings for large-scale tsetse control programs, including suppression or eradication, being undertaken in Uganda and potential future genetic applications. PMID:23845311

  10. Evaluation of district mental healthcare plans: the PRIME consortium methodology

    PubMed Central

    De Silva, Mary J.; Rathod, Sujit D.; Hanlon, Charlotte; Breuer, Erica; Chisholm, Dan; Fekadu, Abebaw; Jordans, Mark; Kigozi, Fred; Petersen, Inge; Shidhaye, Rahul; Medhin, Girmay; Ssebunnya, Joshua; Prince, Martin; Thornicroft, Graham; Tomlinson, Mark; Lund, Crick; Patel, Vikram

    2016-01-01

    Background Few studies have evaluated the implementation and impact of real-world mental health programmes delivered at scale in low-resource settings. Aims To describe the cross-country research methods used to evaluate district-level mental healthcare plans (MHCPs) in Ethiopia, India, Nepal, South Africa and Uganda. Method Multidisciplinary methods conducted at community, health facility and district levels, embedded within a theory of change. Results The following designs are employed to evaluate the MHCPs: (a) repeat community-based cross-sectional surveys to measure change in population-level contact coverage; (b) repeat facility-based surveys to assess change in detection of disorders; (c) disorder-specific cohorts to assess the effect on patient outcomes; and (d) multilevel case studies to evaluate the process of implementation. Conclusions To evaluate whether and how a health-system-level intervention is effective, multidisciplinary research methods are required at different population levels. Although challenging, such methods may be replicated across diverse settings. PMID:26447175

  11. Geothermal District Heating Economics

    1995-07-12

    GEOCITY is a large-scale simulation model which combines both engineering and economic submodels to systematically calculate the cost of geothermal district heating systems for space heating, hot-water heating, and process heating based upon hydrothermal geothermal resources. The GEOCITY program simulates the entire production, distribution, and waste disposal process for geothermal district heating systems, but does not include the cost of radiators, convectors, or other in-house heating systems. GEOCITY calculates the cost of district heating basedmore » on the climate, population, and heat demand of the district; characteristics of the geothermal resource and distance from the distribution center; well-drilling costs; design of the distribution system; tax rates; and financial conditions.« less

  12. The Medical Research Council (UK)/Uganda Virus Research Institute Uganda Research Unit on AIDS--'25 years of research through partnerships'.

    PubMed

    Kaleebu, P; Kamali, A; Seeley, J; Elliott, A M; Katongole-Mbidde, E

    2015-02-01

    For the past 25 years, the Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS has conducted research on HIV-1, coinfections and, more recently, on non-communicable diseases. Working with various partners, the research findings of the Unit have contributed to the understanding and control of the HIV epidemic both in Uganda and globally, and informed the future development of biomedical HIV interventions, health policy and practice. In this report, as we celebrate our silver jubilee, we describe some of these achievements and the Unit's multidisciplinary approach to research. We also discuss the future direction of the Unit; an exemplar of a partnership that has been largely funded from the north but led in the south.

  13. The Medical Research Council (UK)/Uganda Virus Research Institute Uganda Research Unit on AIDS – ‘25 years of research through partnerships’

    PubMed Central

    Kaleebu, P; Kamali, A; Seeley, J; Elliott, A M; Katongole-Mbidde, E

    2015-01-01

    For the past 25 years, the Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS has conducted research on HIV-1, coinfections and, more recently, on non-communicable diseases. Working with various partners, the research findings of the Unit have contributed to the understanding and control of the HIV epidemic both in Uganda and globally, and informed the future development of biomedical HIV interventions, health policy and practice. In this report, as we celebrate our silver jubilee, we describe some of these achievements and the Unit's multidisciplinary approach to research. We also discuss the future direction of the Unit; an exemplar of a partnership that has been largely funded from the north but led in the south. PMID:25354929

  14. Geothermal district G1

    SciTech Connect

    Not Available

    1988-12-01

    Geothermal District G1 includes 37 northeastern California counties and six geothermal fields: Lake City, Susanville, Litchfield, Wendel, Amedee, and Casa Diablo. Electrical generation from geothermal resources occurs in three of the fields: Wendel, Amedee, and Casa Diablo. Low-temperature geothermal projects are underway throughout the district and are described in a road log format. The ten projects described are located at Big Bend, Glass Mountain, Bieber, Alturas, Cedarville, Lake City, Honey Lake Valley, Greenville, and in Sierra and Mono Counties.

  15. Sunguru virus: a novel virus in the family Rhabdoviridae isolated from a chicken in north-western Uganda.

    PubMed

    Ledermann, Jeremy P; Zeidner, Nord; Borland, Erin M; Mutebi, John-Paul; Lanciotti, Robert S; Miller, Barry R; Lutwama, Julius J; Tendo, Joseph M; Andama, Vincent; Powers, Ann M

    2014-07-01

    Sunguru virus (SUNV), a novel virus belonging to the highly diverse Rhabdoviridae family, was isolated from a domestic chicken in the district of Arua, Uganda, in 2011. This is the first documented isolation of a rhabdovirus from a chicken. SUNV is related to, but distinct from, Boteke virus and other members of the unclassified Sandjimba group. The genome is 11056 nt in length and contains the five core rhabdovirus genes plus an additional C gene (within the ORF of a phosphoprotein gene) and a small hydrophobic protein (between the matrix and glycoprotein genes). Inoculation of vertebrate cells with SUNV resulted in significant viral growth, with a peak titre of 7.8 log10 p.f.u. ml(-1) observed in baby hamster kidney (BHK) cells. Little to no growth was observed in invertebrate cells and in live mosquitoes, with Anopheles gambiae mosquitoes having a 47.4% infection rate in the body but no dissemination of the virus to the salivary glands; this suggests that this novel virus is not arthropod borne as some other members of the family Rhabdoviridae.

  16. 'Big push' to reduce maternal mortality in Uganda and Zambia enhanced health systems but lacked a sustainability plan.

    PubMed

    Kruk, Margaret E; Rabkin, Miriam; Grépin, Karen Ann; Austin-Evelyn, Katherine; Greeson, Dana; Masvawure, Tsitsi Beatrice; Sacks, Emma Rose; Vail, Daniel; Galea, Sandro

    2014-06-01

    In the past decade, "big push" global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts in Uganda and Zambia. We evaluated the first six to twelve months of the program's implementation, its ownership by national ministries of health, and its effects on health systems. The project's impact on maternal mortality is not reported here. We found that the Saving Mothers, Giving Life initiative delivered a large "dose" of intervention quickly by capitalizing on existing US international health assistance platforms, such as the President's Emergency Plan for AIDS Relief. Early benefits to the broader health system included greater policy attention to maternal and child health, new health care infrastructure, and new models for collaborating with the private sector and communities. However, the rapid pace, external design, and lack of a long-term financing plan hindered integration into the health system and local ownership. Sustaining and scaling up early gains of similar big push initiatives requires longer-term commitments and a clear plan for transition to national control.

  17. A large-scale field trial of malathion as an insecticide for antimalarial work in southern Uganda

    PubMed Central

    Najera, J. A.; Shidrawi, G. R.; Gibson, F. D.; Stafford, J. S.

    1967-01-01

    Malathion shows promise as a substitute for chlorinated-hydrocarbon insecticides in the control of malaria whenever the latter are unsuitable because of Anopheles resistance or other reasons. A field trial of malathion was carried out in 1963-64, covering an area of about 500 km2 with a population of about 26 000, in Masaka District, southern Uganda. All houses and animal shelters were sprayed with malathion at 2 g/m2 at roughly 4-month intervals. The average combined densities of the females of the two main malaria vectors, Anopheles funestus and An. gambiae, fell from an average of 66 per shelter per day in a pre-trial survey in 1960-61 to 0.0011 at the end of 1964 in the sprayed area; no significant changes were noted in unsprayed comparison areas. The transmission of the infection in humans was apparently interrupted when allowance was made for imported cases. The presence of unsprayed surfaces in houses which had recently been built or altered interfered somewhat with complete coverage. Case detection was reliable and achieved excellent coverage. No toxic effects of malathion in humans were noted, while the effect on mosquitos was considerable even in the absence of direct contact. This effect of malathion lasted for a considerably shorter period of time in houses roofed with corrugated iron than with thatch; this should be borne in mind in the design of spraying programmes. PMID:5299860

  18. 'Big push' to reduce maternal mortality in Uganda and Zambia enhanced health systems but lacked a sustainability plan.

    PubMed

    Kruk, Margaret E; Rabkin, Miriam; Grépin, Karen Ann; Austin-Evelyn, Katherine; Greeson, Dana; Masvawure, Tsitsi Beatrice; Sacks, Emma Rose; Vail, Daniel; Galea, Sandro

    2014-06-01

    In the past decade, "big push" global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts in Uganda and Zambia. We evaluated the first six to twelve months of the program's implementation, its ownership by national ministries of health, and its effects on health systems. The project's impact on maternal mortality is not reported here. We found that the Saving Mothers, Giving Life initiative delivered a large "dose" of intervention quickly by capitalizing on existing US international health assistance platforms, such as the President's Emergency Plan for AIDS Relief. Early benefits to the broader health system included greater policy attention to maternal and child health, new health care infrastructure, and new models for collaborating with the private sector and communities. However, the rapid pace, external design, and lack of a long-term financing plan hindered integration into the health system and local ownership. Sustaining and scaling up early gains of similar big push initiatives requires longer-term commitments and a clear plan for transition to national control. PMID:24889956

  19. Predictors of sustainability for community-managed handpumps in sub-Saharan Africa: evidence from Liberia, Sierra Leone, and Uganda.

    PubMed

    Foster, Tim

    2013-01-01

    Rural water supply sustainability has remained an enduring policy challenge in sub-Saharan Africa for decades. Drawing on the largest data set assembled on rural water points in sub-Saharan Africa to date, this paper employs logistic regression analyses to identify operational, technical, institutional, financial, and environmental predictors of functionality for over 25 000 community-managed handpumps in Liberia, Sierra Leone, and Uganda. Risk factors significantly associated with nonfunctionality across all three countries were (a) system age, (b) distance from district/county capital, and (c) absence of user fee collection. In at least one of the three countries, other variables found to have significant multivariable adjusted associations with functionality status included well type, handpump type, funding organization, implementing organization, spare parts proximity, availability of a handpump mechanic, regular servicing, regular water committee meetings, women in key water committee positions, rainfall season, and perceived water quality. While the findings reinforce views that a multifaceted range of conditions is critical for the sustainability of community-managed handpumps, they also demonstrate that these factors remain absent from a high proportion of cases. Governments and development partners must significantly strengthen postconstruction support for operation and maintenance systems, and greater efforts are needed to test and evaluate alternative models for managing handpump water supplies.

  20. Social marketing in a rural African district.

    PubMed

    Kipp, W; Kabwa, P; Mwesigye, B

    1992-01-01

    21 focus group discussions were held in 5 locations of Kabarole district, Uganda, with 200 male and female participants to assess the demand for and acceptability of condoms in the region. The discussions were also held to obtain information related to the design of products and motivational materials, and included people believed to engage in high-risk sex, lower-risk members of the general population, and shop owners. Condoms and condom use are strongly desired within this population, with participants expressing interest in high-quality products of uniform size which are continuously available at convenient outlets. Moreover, shop and pharmacy owners were more than willing to display subtle messages about condoms and advertise their availability. The main barriers to use were low female acceptance, unavailability, societal attitudes, high cost, and the inability to buy condoms at night when shops are closed. Feedback led to the development of the logo of a man holding a spear and a shield and the adoption of the brand name Engabu, Rutooro terminology for a wooden shield. Comparatively stronger, yet sensitive, brown condoms were eventually packaged in dark brown wrappings in groups of 5. Vendors are offered the packets of 5 condoms for US$0.06, which they are expected t sell at US$0.08; owners expressed the preference for slot-box distribution containers. In addition, people in the sales network were all trained so they could explain proper condom use to clients. A post-study assessment found people content with the product and its presentation, so the social marketing program was officially launched in September, 1992. Condoms were sold heavily in the 1st few weeks of the program despite the lack of media and newspaper coverage per national government condom policy. Knowledge of the availability of condoms will instead be spread through counseling and health education sessions, seminars, and informal talks.

  1. Parents' knowledge, risk perception and willingness to allow young males to receive human papillomavirus (HPV) vaccines in Uganda.

    PubMed

    Muhwezi, Wilson Winstons; Banura, Cecily; Turiho, Andrew Kampikaho; Mirembe, Florence

    2014-01-01

    The Ministry of Health in Uganda in collaboration with the Program for Appropriate Technology for Health (PATH) supported by Bill and Melinda Gates Foundation in 2008-2009 vaccinated approximately 10,000 girls with the bivalent humanpapilloma virus (HPV) vaccine. We assessed parent's knowledge, risk perception and willingness to allow son(s) to receive HPV vaccines in future through a cross-sectional survey of secondary school boys aged 10-23 years in 4 districts. 377 questionnaires were distributed per district and 870 were used in analysis. Parents that had ever heard about cervical cancer and HPV vaccines; those who would allow daughter(s) to be given the vaccine and those who thought that HPV infection was associated with genital warts were more willing to allow son(s) to receive the HPV vaccine. Unwilling parents considered HPV vaccination of boys unimportant (p = 0.003), believed that only females should receive the vaccine (p = 0.006), thought their son(s) couldn't contract HPV (p = 0.010), didn't know about HPV sexual transmissibility (p = 0.002), knew that males could not acquire HPV (p = 0.000) and never believed that the HPV vaccines could protect against HPV (p = 0.000). Acceptance of HPV vaccination of daughters and likelihood of recommending HPV vaccines to son(s) of friends and relatives predicted parental willingness to allow sons to receive HPV vaccines. Probable HPV vaccination of boys is a viable complement to that of girls. Successfulness of HPV vaccination relies on parental acceptability and sustained sensitization about usefulness of HPV vaccines even for boys is vital. PMID:25203053

  2. Characterization of the goat feeding system among rural small holder farmers in the semi-arid regions of Uganda.

    PubMed

    Nampanzira, Dorothy Kalule; Kabasa, John David; Nalule, Sara Agnes; Nakalembe, Immaculate; Tabuti, John Robert Stephen

    2015-01-01

    Goats (Capra hircus) are widely distributed in Africa and Asia, and are important to the subsistence and economic livelihoods of many people in these areas. The goat feeding system among rural small holder farmers in Buyende district (Uganda) was characterised by determining the goat rearing practices, feed resources fed on by goats and availability of browse species mentioned by small holder farmers. Data was gathered using ethnobotanical and ecological approaches. Results from the ethnobotanical survey revealed that farmers were rearing indigenous goat breeds that are managed by tethering in natural pastures during the rainy season but free ranging during the dry season (i.e. when no crops are susceptible of damage). Major challenges facing goat production in the study area were diseases, shortage of land and inadequate pastures. The reduction of grazing land due to crop farming, has led to tethering of animals which in turn leads to restricted feeding. Goats were known to feed on 48 plant species distributed in 18 families and 39 genera dominated by trees and shrubs. Browse species were known to stay longer in the dry season when the grass and herbaceous species were no longer available. The most frequently mentioned browse species were Ficus natalensis, Harrisonia abyssinica, Acalypha psilostachya, Artocarpus heterophyllus and Lantana camara while Panicum maximum and Impeata cylindrica were the most mentioned herbaceous species. 31 browse species were encountered in the ecological survey. These were dominated by Combretum molle, L. camara, A. zygia, M. indica, and Albizia coriaria. In conclusion, the rearing practices of goats in Buyende district are comprised of indigenous goats tethered in natural pastures especially browses which stay longer through the dry season. However, most of the preferred browses are rare according to the computed IVI (i.e. less than 30%). PMID:25932373

  3. Caregivers' Attitudes towards HIV Testing and Disclosure of HIV Status to At-Risk Children in Rural Uganda.

    PubMed

    Lorenz, Rick; Grant, Eisha; Muyindike, Winnie; Maling, Samuel; Card, Claire; Henry, Carol; Nazarali, Adil J

    2016-01-01

    Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96%) of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers' communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver's perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child's level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to facilitate the

  4. Characterization of the goat feeding system among rural small holder farmers in the semi-arid regions of Uganda.

    PubMed

    Nampanzira, Dorothy Kalule; Kabasa, John David; Nalule, Sara Agnes; Nakalembe, Immaculate; Tabuti, John Robert Stephen

    2015-01-01

    Goats (Capra hircus) are widely distributed in Africa and Asia, and are important to the subsistence and economic livelihoods of many people in these areas. The goat feeding system among rural small holder farmers in Buyende district (Uganda) was characterised by determining the goat rearing practices, feed resources fed on by goats and availability of browse species mentioned by small holder farmers. Data was gathered using ethnobotanical and ecological approaches. Results from the ethnobotanical survey revealed that farmers were rearing indigenous goat breeds that are managed by tethering in natural pastures during the rainy season but free ranging during the dry season (i.e. when no crops are susceptible of damage). Major challenges facing goat production in the study area were diseases, shortage of land and inadequate pastures. The reduction of grazing land due to crop farming, has led to tethering of animals which in turn leads to restricted feeding. Goats were known to feed on 48 plant species distributed in 18 families and 39 genera dominated by trees and shrubs. Browse species were known to stay longer in the dry season when the grass and herbaceous species were no longer available. The most frequently mentioned browse species were Ficus natalensis, Harrisonia abyssinica, Acalypha psilostachya, Artocarpus heterophyllus and Lantana camara while Panicum maximum and Impeata cylindrica were the most mentioned herbaceous species. 31 browse species were encountered in the ecological survey. These were dominated by Combretum molle, L. camara, A. zygia, M. indica, and Albizia coriaria. In conclusion, the rearing practices of goats in Buyende district are comprised of indigenous goats tethered in natural pastures especially browses which stay longer through the dry season. However, most of the preferred browses are rare according to the computed IVI (i.e. less than 30%).

  5. Health implications of war in Uganda and Sudan.

    PubMed

    Dodge, C P

    1990-01-01

    Civil war disrupted agriculture and trade in Uganda and Sudan. This reduced tax revenues and drained scarce resources away from health budgets to finance increased military expenditures. Hundreds and thousands of people were driven from their homes either as internally displaced people or as refugees. Normal health service delivery systems were broken down forcing doctors, nurses and other health professionals into towns, cities or neighbouring countries in search of peace and employment. Scores of hospitals, health centres and dispensaries were abandoned, destroyed or looted, rendering even the limited physical facilities useless. Preventive public health services such as immunization and provision of potable drinking water were discontinued leaving huge populations susceptible to controllable infectious diseases and epidemics. PMID:2122523

  6. Fault kinematics and stress fields in the Rwenzori Mountains, Uganda

    NASA Astrophysics Data System (ADS)

    Sachau, Till; Koehn, Daniel; Stamps, D. Sarah; Lindenfeld, Michael

    2016-09-01

    The Rwenzori Mountains in western Uganda form an active rift-transfer zone in the western branch of the East African Rift System. Here we quantify local stress fields in high resolution from field observations of fault structures to shed light on the complex, polyphase tectonics expected in transfer zones. We apply the multiple inverse method, which is optimized for heterogeneous fault-slip data, to the northern and central Rwenzori Mountains. Observations from the northern Rwenzori Mountains show larger heterogeneity than data from the central Rwenzori, including unexpected compressional features; thus the local stress field indicates polyphase transpressional tectonics. We suggest that transpression here is linked to rotational and translational movements of the neighboring Victoria block relative to the Rwenzori block that includes strong overprinting relationships. Stress inversions of data from the central Rwenzori Mountains indicate two distinct local stress fields. These results suggest that the Rwenzori block consists of smaller blocks.

  7. Fault kinematics and stress fields in the Rwenzori Mountains, Uganda

    NASA Astrophysics Data System (ADS)

    Sachau, Till; Koehn, Daniel; Stamps, D. Sarah; Lindenfeld, Michael

    2015-03-01

    The Rwenzori Mountains in western Uganda form an active rift-transfer zone in the western branch of the East African Rift System. Here we quantify local stress fields in high resolution from field observations of fault structures to shed light on the complex, polyphase tectonics expected in transfer zones. We apply the multiple inverse method, which is optimized for heterogeneous fault-slip data, to the northern and central Rwenzori Mountains. Observations from the northern Rwenzori Mountains show larger heterogeneity than data from the central Rwenzori, including unexpected compressional features; thus the local stress field indicates polyphase transpressional tectonics. We suggest that transpression here is linked to rotational and translational movements of the neighboring Victoria block relative to the Rwenzori block that includes strong overprinting relationships. Stress inversions of data from the central Rwenzori Mountains indicate two distinct local stress fields. These results suggest that the Rwenzori block consists of smaller blocks.

  8. Girls' education and HIV risk: evidence from Uganda.

    PubMed

    Alsan, Marcella M; Cutler, David M

    2013-09-01

    Uganda is widely viewed as a public health success for curtailing its HIV/AIDS epidemic in the early 1990s. The period of rapid HIV decline coincided with a dramatic rise in girls' secondary school enrollment. We instrument for this enrollment with distance to school, conditional on a rich set of demographic and locational controls, including distance to market center. We find that girls' enrollment in secondary education significantly increased the likelihood of abstaining from sex. Using a triple-difference estimator, we find that some of the schooling increase among young women was in response to a 1990 affirmative action policy giving women an advantage over men on University applications. PMID:23911724

  9. Girls’ Education and HIV Risk: Evidence from Uganda

    PubMed Central

    Alsan, Marcella M.; Cutler, David M.

    2013-01-01

    Uganda is widely viewed as a public health success for curtailing its HIV/AIDS epidemic in the early 1990s. The period of rapid HIV decline coincided with a dramatic rise in girls’ secondary school enrollment. We instrument for this enrollment with distance to school, conditional on a rich set of demographic and locational controls, including distance to market center. We find that girls’ enrollment in secondary education significantly increased the likelihood of abstaining from sex. Using a triple-difference estimator, we find that some of the schooling increase among young women was in response to a 1990 affirmative action policy giving women an advantage over men on University applications. PMID:23911724

  10. Variation of water quality in Kakira catchment area, Jinja - Uganda

    NASA Astrophysics Data System (ADS)

    Munabi, C.; Kansiime, F.; Amel, A.

    Kakira Sugar Works Limited (KSWL) owns one of the largest commercial sugarcane plantations and factory in Uganda. KSWL uses fertilizers, pesticides and herbicides to enhance crop yields. This study was carried out to assess the effect of the KSWL sugarcane plantation on the water resources of Lake Victoria. Water quality assessment within and without the sugarcane plantation was carried out for six months over two seasons (wet and dry) and these were tested for physico-chemical parameters. Temperature values at all the sampling sites were <35 °C. pH values at all the sampling sites were within the range of 6.0-8.5 except S4 which was located in the outgrowers’ field (pH = 5.9). Electrical conductivity values on the stream draining through the workers settlement was high (1412.3 μS/cm) compared to the other sampling sites which had values <300 μS/cm. NH 4-N and TN values at all the sampling sites were <10 mg/l. Although TP and O-PO 4-P values for all the streams were within standards recommended by the National Environment Standard (Standards for Discharge of Effluents onto Water or on Land Regulations) of 1999 for Uganda, the sampling sites including the one located at the lake did not qualify to be categorized as being pristine. Nutrient loads were higher during the wet season than in the dry season. Nutrient loads from the estate were higher than those from the outgrowers’ field. In spite of the fact that nutrient concentrations were within permissible limits, it was concluded that annual nutrient loads of nitrogen and phosphorus could in a long run increase the trophic levels of Lake Victoria.

  11. Improving knowledge translation in Uganda: more needs to be done

    PubMed Central

    Orem, Juliet Nabyonga; Mafigiri, David Kaawa; Nabudere, Harriet; Criel, Bart

    2014-01-01

    Introduction Meeting the health-related Millennium Development Goals in Africa calls for better access to and higher utilisation of quality evidence. The mechanisms through which research evidence can effectively guide public health policy and implementation of health programmes are not fully understood. Challenges to the use of evidence to inform policy and practice include the lack of a common understanding of what constitutes evidence and limited insight on the effectiveness of different research uptake activities. Available Knowledge Translation (KT) models have mainly been developed in high income countries and may not be directly applicable in resource-limited settings. In this study we examine the uptake of evidence in public health policy making in Uganda. Methods We conducted a cross-sectional qualitative study consisting of in-depth interviews with 17 purposively-selected health policy makers and researchers. The study explored respondents’ perceptions of the role of evidence in public health policy development, their understanding of KT and their views on the appropriateness of different KT activities that are currently implemented in Uganda. Results Although all respondents stated that evidence should inform health policies and programmes, they noted that this occurred infrequently. We noted a lack of conceptual clarity about KT and what precisely constitutes evidence. Respondents reported having been involved in different KT activities, including partnerships and platforms created for knowledge sharing between researchers and end users, but with very mixed results. Conclusion There is need for conceptual clarity on the notion of KT and an understanding of the most appropriate KT strategies in low-income settings. PMID:24624247

  12. Science Education Policy for Emergency, Conflict, and Post-Conflict: An Analysis of Trends and Implications for the Science Education Program in Uganda

    ERIC Educational Resources Information Center

    Udongo, Betty Pacutho

    2009-01-01

    This study analyzes the impact of armed conflicts on the development of education policy and particularly science education program in Uganda. Since independence from the British colonial rule, Uganda has experienced a series of armed conflicts, with the most devastating being the 21 years of conflict in Northern Uganda. The research study was…

  13. A Cluster Randomised Trial Introducing Rapid Diagnostic Tests into Registered Drug Shops in Uganda: Impact on Appropriate Treatment of Malaria

    PubMed Central

    Mbonye, Anthony K.; Magnussen, Pascal; Lal, Sham; Hansen, Kristian S.; Cundill, Bonnie; Chandler, Clare; Clarke, Siân E.

    2015-01-01

    Background Inappropriate treatment of malaria is widely reported particularly in areas where there is poor access to health facilities and self-treatment of fevers with anti-malarial drugs bought in shops is the most common form of care-seeking. The main objective of the study was to examine the impact of introducing rapid diagnostic tests for malaria (mRDTs) in registered drug shops in Uganda, with the aim to increase appropriate treatment of malaria with artemisinin-based combination therapy (ACT) in patients seeking treatment for fever in drug shops. Methods A cluster-randomized trial of introducing mRDTs in registered drug shops was implemented in 20 geographical clusters of drug shops in Mukono district, central Uganda. Ten clusters were randomly allocated to the intervention (diagnostic confirmation of malaria by mRDT followed by ACT) and ten clusters to the control arm (presumptive treatment of fevers with ACT). Treatment decisions by providers were validated by microscopy on a reference blood slide collected at the time of consultation. The primary outcome was the proportion of febrile patients receiving appropriate treatment with ACT defined as: malaria patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving ACT or rectal artesunate, and patients with no malaria parasites not given ACT. Findings A total of 15,517 eligible patients (8672 intervention and 6845 control) received treatment for fever between January-December 2011. The proportion of febrile patients who received appropriate ACT treatment was 72·9% versus 33·7% in the control arm; a difference of 36·1% (95% CI: 21·3 – 50·9), p<0·001. The majority of patients with fever in the intervention arm accepted to purchase an mRDT (97·8%), of whom 58·5% tested mRDT-positive. Drug shop vendors adhered to the mRDT results, reducing over-treatment of malaria by 72·6% (95% CI: 46·7– 98·4), p<0·001) compared to drug shop vendors using presumptive

  14. Integrated approach to malaria prevention at household level in rural communities in Uganda: experiences from a pilot project

    PubMed Central

    2013-01-01

    Background Malaria is a major public health challenge in sub-Saharan Africa. In Uganda, malaria is the leading cause of morbidity and mortality especially among children under five years of age. This pilot project promoted prevention of malaria at household level using an integrated approach in two rural communities in Wakiso District, Uganda. This involved advocating and implementing several strategies in a holistic manner geared towards reduction in the occurrence of malaria. The specific strategies involved can be classified as: 1) personal protection – use of insecticide-treated bed nets and insecticide sprays; 2) reducing mosquito breeding sites – draining pools of water, larviciding and clearing unnecessary vegetation around homes; and 3) reducing entry of mosquitoes into houses – installing mosquito proofing in windows, ventilators and open eaves, and closing windows and doors early in the evenings. Case description The objectives of the project were to: carry out a baseline survey on malaria prevention; train community health workers and increase awareness among the community on the integrated approach to malaria prevention; and, establish demonstration sites using the integrated approach. A baseline survey among 376 households was conducted which generated information on the knowledge, attitudes and practices of the community in relation to malaria prevention. The project trained 25 community health workers and over 200 community members were sensitized on the integrated approach to malaria prevention. In addition, 40 demonstration households using the integrated approach were established. Discussion and evaluation The use of multiple methods in the prevention of malaria was appreciated by the community particularly the demonstration households using the integrated approach. Initial project evaluation showed that the community had become more knowledgeable about the various malaria prevention methods that were advocated in the integrated approach. In

  15. The Urgent Need to Train Teachers for Multigrade Pedagogy in African Schooling Contexts: Lessons from Uganda and Zambia

    ERIC Educational Resources Information Center

    Kivunja, Charles

    2014-01-01

    Our research project funded by the British Council on multigrade teaching capacity building in Uganda and Zambia found that Uganda does not have a single higher education institution training teachers in multigrade pedagogy and Zambia has only one located at Serenje village in rural Zambia. Yet the research found that in both countries many…

  16. Exploring Differences in National and International Poverty Estimates: Is Uganda on Track to Halve Poverty by 2015?

    ERIC Educational Resources Information Center

    Levine, Sebastian

    2012-01-01

    This paper explores causes of differences in estimates of poverty incidence in Uganda since the early 1990s as measured by the Uganda Bureau of Statistics and the World Bank. While both sets of estimates from the two organisations show a declining trend in poverty incidence there are important differences in the levels of poverty, the speed of the…

  17. Non-Formal Education and Livelihood Skills for Marginalised Street and Slum Youth in Uganda. Project Report

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization (UNESCO), 2006

    2006-01-01

    The Building Capacities for Non formal Education and Life Skills Programmes project in Uganda was implemented by Uganda Youth Development Link (UYDEL) with financial and technical support from UNESCO--Section for Literacy and non Formal Education in 2004-05; aiming at assisting vulnerable and marginalised youth affected by HIV/AIDS and other risk…

  18. Factors Associated with Perceived Stigma among People Living with HIV/AIDS in Post-Conflict Northern Uganda

    ERIC Educational Resources Information Center

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C.; Orach, Christopher G.; Earnest, Jaya

    2011-01-01

    HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…

  19. Public Discourse on HIV and AIDS: An Archival Analysis of National Newspaper Reporting in Uganda, 1996-2011

    ERIC Educational Resources Information Center

    Lagone, Elizabeth; Mathur, Sanyukta; Nakyanjo, Neema; Nalugoda, Fred; Santelli, John

    2014-01-01

    Uganda is recognised as an early success story in the HIV epidemic at least in part due to an open and vigorous national dialogue about HIV prevention. This study examined the national discourse about HIV, AIDS, and young people in New Vision, Uganda's leading national newspaper between 1996 and 2011, building from a previous archival…

  20. Benefit Incidence Analysis of Government Spending on Public-Private Partnership Schooling under Universal Secondary Education Policy in Uganda

    ERIC Educational Resources Information Center

    Wokadala, J.; Barungi, M.

    2015-01-01

    The study establishes whether government spending on private universal secondary education (USE) schools is equitable across quintiles disaggregated by gender and by region in Uganda. The study employs benefit incidence analysis tool on the Uganda National Panel Survey (UNPS 2009/10) data to establish the welfare impact of public subsidy on…

  1. A Study of End-Users' Attitudes towards Digital Media Approach: The Experience of a Public University in Uganda

    ERIC Educational Resources Information Center

    Ndawula, Stephen; Ngobi, David Henry; Namugenyi, Deborah; Nakawuki, Rose Coaster

    2012-01-01

    University students in Uganda had been confined to use of traditional educational technologies such as chalkboards, papers and text books. Digital Media Approach recently found its way in the academia at public universities in Uganda. Information and communication technology (ICT) have become popular means of surfing, downloading and obtaining…

  2. Budget Planning and the Quality of Educational Services in Uganda Public Universities: A Case Study of Kyambogo University

    ERIC Educational Resources Information Center

    Basheka, Benon C.; Nabwire, Addah

    2013-01-01

    This paper examines the relationship between budget planning and the quality of educational services at Kyambogo University in Uganda. We argue that the manner in which the university's budget planning activities are conducted determines in a significant way (by 76.8%) the quality of the services offered by public universities in Uganda. The…

  3. Use of an Innovative, Affordable, and Open-Source Short Message Service–Based Tool to Monitor Malaria in Remote Areas of Uganda

    PubMed Central

    Asiimwe, Caroline; Gelvin, David; Lee, Evan; Amor, Yanis Ben; Quinto, Ebony; Katureebe, Charles; Sundaram, Lakshmi; Bell, David; Berg, Matt

    2011-01-01

    Quality health management requires timely and accurate data, and paper-based reporting does not fill this role adequately. The introduction of malaria rapid diagnostic tests and the availability of wireless communications present an opportunity to open direct data transmission and feedback between peripheral health workers and central managers. In November 2009, the Uganda Ministry of Health deployed a short message service–based reporting system in two districts. At a set-up cost of $100/health facility, local technician support of $ 400 per month, and a cost of $0.53/week/clinic, the SMS reporting system was started at more than 140 clinics. Positivity rates for rapid diagnostic tests and artemisinin combination therapy stock outs were 48% and 54% in Kabale and 71% and 54% in Gulu, among other reports, at more than 85% health facilities reporting weekly and without monetary incentives or additional supervision. The SMS-based reporting systems have potential to improve timeliness in reporting of specific, time-sensitive metrics at modest cost, while by-passing current bottlenecks in the flow of data. With the development of specific capacity to manage stock data at district level, the availability of timely data offers potential to address commodity distribution problems and reduce stock-outs. PMID:21734120

  4. Has Uganda experienced any stalled fertility transitions? Reflecting on the last four decades (1973–2011)

    PubMed Central

    Kabagenyi, Allen; Reid, Alice; Rutaremwa, Gideon; Atuyambe, Lynn M.; Ntozi, James P. M.

    2015-01-01

    Background Persistent high fertility is associated with mother and child mortality. While most regions in the world have experienced declines in fertility rates, there are conflicting views as to whether Uganda has entered a period of fertility transition. There are limited data available that explicitly detail the fertility trends and patterns in Uganda over the last four decades, from 1973 to 2011. Total fertility rate (TFR) is number of live births that a woman would have throughout her reproductive years if she were subject to the prevailing age specific fertility patterns. The current TFR for Uganda stands at 6.2 children born per woman, which is one of the highest in the region. This study therefore sought to examine whether there has been a fertility stall in Uganda using all existing Demographic Health Survey data, to provide estimates for the current fertility levels and trends in Uganda, and finally to examine the demographic and socioeconomic factors responsible for fertility levels in Uganda. This is a secondary analysis of data from five consecutive Ugandan Demographic Health Surveys (UDHS); 1988/1989, 1995, 2000/2001, 2006 and 2011. Using pooled data to estimate for fertility levels, patterns and trends, we applied a recently developed fertility estimation approach. A Poisson regression model was also used to analyze fertility differentials over the study period. Results Over the studied period, fertility trends and levels fluctuated from highs of 8.8 to lows of 5.7, with no specific lag over the study period. These findings suggest Uganda is at the pre-transitional stage, with indications of imminent fertility rate reductions in forthcoming years. Marital status remained a strong predictor for number of children born, even after controlling for other variables. Conclusions This study suggests there is no evidence of a fertility stall in Uganda, but demonstrates an onset of fertility transition in the country. If this trend continues, Uganda will

  5. Competency: District Views from Southern California.

    ERIC Educational Resources Information Center

    Tyo, John

    1979-01-01

    Educators from Fullerton Union High School District, Newport-Mesa Unified School District, Capistrano Unified School District, and Huntington Beach Union High School District describe their efforts toward developing competency-based curriculum to meet state mandates. (SJL)

  6. Key Aspects of Health Policy Development to Improve Surgical Services in Uganda

    PubMed Central

    Luboga, Sam; Galukande, Moses; Mabweijano, Jacqueline; Jayaraman, Sudha

    2010-01-01

    Recently, surgical services have been gaining greater attention as an integral part of public health in low-income countries due to the significant volume and burden of surgical conditions, growing evidence of the cost-effectiveness of surgical intervention, and global disparities in surgical care. Nonetheless, there has been limited discussion of the key aspects of health policy related to surgical services in low-income countries. Uganda, like other low-income sub-Saharan African countries, bears a heavy burden of surgical conditions with low surgical output in health facilities and significant unmet need for surgical care. To address this lack of adequate surgical services in Uganda, a diverse group of local stakeholders met in Kampala, Uganda, in May 2008 to develop a roadmap of key policy actions that would improve surgical services at the national level. The group identified a list of health policy priorities to improve surgical services in Uganda. The priorities were classified into three areas: (1) human resources, (2) health systems, and (3) research and advocacy. This article is a critical discussion of these health policy priorities with references to recent literature. This was the first such multidisciplinary meeting in Uganda with a focus on surgical services and its output may have relevance to health policy development in other low-income countries planning to improve delivery of surgical services. PMID:20730430

  7. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda

    PubMed Central

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet

    2016-01-01

    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH’s motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH’s self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH’s self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH’s self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new ‘self’: they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self

  8. Admission Risk Score to Predict Inpatient Pediatric Mortality at Four Public Hospitals in Uganda.

    PubMed

    Mpimbaza, Arthur; Sears, David; Sserwanga, Asadu; Kigozi, Ruth; Rubahika, Denis; Nadler, Adam; Yeka, Adoke; Dorsey, Grant

    2015-01-01

    Mortality rates among hospitalized children in many government hospitals in sub-Saharan Africa are high. Pediatric emergency services in these hospitals are often sub-optimal. Timely recognition of critically ill children on arrival is key to improving service delivery. We present a simple risk score to predict inpatient mortality among hospitalized children. Between April 2010 and June 2011, the Uganda Malaria Surveillance Project (UMSP), in collaboration with the National Malaria Control Program (NMCP), set up an enhanced sentinel site malaria surveillance program for children hospitalized at four public hospitals in different districts: Tororo, Apac, Jinja and Mubende. Clinical data collected through March 2013, representing 50249 admissions were used to develop a mortality risk score (derivation data set). One year of data collected subsequently from the same hospitals, representing 20406 admissions, were used to prospectively validate the performance of the risk score (validation data set). Using a backward selection approach, 13 out of 25 clinical parameters recognizable on initial presentation, were selected for inclusion in a final logistic regression prediction model. The presence of individual parameters was awarded a score of either 1 or 2 based on regression coefficients. For each individual patient, a composite risk score was generated. The risk score was further categorized into three categories; low, medium, and high. Patient characteristics were comparable in both data sets. Measures of performance for the risk score included the receiver operating characteristics curves and the area under the curve (AUC), both demonstrating good and comparable ability to predict deathusing both the derivation (AUC =0.76) and validation dataset (AUC =0.74). Using the derivation and validation datasets, the mortality rates in each risk category were as follows: low risk (0.8% vs. 0.7%), moderate risk (3.5% vs. 3.2%), and high risk (16.5% vs. 12.6%), respectively. Our

  9. Admission Risk Score to Predict Inpatient Pediatric Mortality at Four Public Hospitals in Uganda

    PubMed Central

    Mpimbaza, Arthur; Sears, David; Sserwanga, Asadu; Kigozi, Ruth; Rubahika, Denis; Nadler, Adam; Yeka, Adoke; Dorsey, Grant

    2015-01-01

    Mortality rates among hospitalized children in many government hospitals in sub-Saharan Africa are high. Pediatric emergency services in these hospitals are often sub-optimal. Timely recognition of critically ill children on arrival is key to improving service delivery. We present a simple risk score to predict inpatient mortality among hospitalized children. Between April 2010 and June 2011, the Uganda Malaria Surveillance Project (UMSP), in collaboration with the National Malaria Control Program (NMCP), set up an enhanced sentinel site malaria surveillance program for children hospitalized at four public hospitals in different districts: Tororo, Apac, Jinja and Mubende. Clinical data collected through March 2013, representing 50249 admissions were used to develop a mortality risk score (derivation data set). One year of data collected subsequently from the same hospitals, representing 20406 admissions, were used to prospectively validate the performance of the risk score (validation data set). Using a backward selection approach, 13 out of 25 clinical parameters recognizable on initial presentation, were selected for inclusion in a final logistic regression prediction model. The presence of individual parameters was awarded a score of either 1 or 2 based on regression coefficients. For each individual patient, a composite risk score was generated. The risk score was further categorized into three categories; low, medium, and high. Patient characteristics were comparable in both data sets. Measures of performance for the risk score included the receiver operating characteristics curves and the area under the curve (AUC), both demonstrating good and comparable ability to predict deathusing both the derivation (AUC =0.76) and validation dataset (AUC =0.74). Using the derivation and validation datasets, the mortality rates in each risk category were as follows: low risk (0.8% vs. 0.7%), moderate risk (3.5% vs. 3.2%), and high risk (16.5% vs. 12.6%), respectively. Our

  10. Admission Risk Score to Predict Inpatient Pediatric Mortality at Four Public Hospitals in Uganda.

    PubMed

    Mpimbaza, Arthur; Sears, David; Sserwanga, Asadu; Kigozi, Ruth; Rubahika, Denis; Nadler, Adam; Yeka, Adoke; Dorsey, Grant

    2015-01-01

    Mortality rates among hospitalized children in many government hospitals in sub-Saharan Africa are high. Pediatric emergency services in these hospitals are often sub-optimal. Timely recognition of critically ill children on arrival is key to improving service delivery. We present a simple risk score to predict inpatient mortality among hospitalized children. Between April 2010 and June 2011, the Uganda Malaria Surveillance Project (UMSP), in collaboration with the National Malaria Control Program (NMCP), set up an enhanced sentinel site malaria surveillance program for children hospitalized at four public hospitals in different districts: Tororo, Apac, Jinja and Mubende. Clinical data collected through March 2013, representing 50249 admissions were used to develop a mortality risk score (derivation data set). One year of data collected subsequently from the same hospitals, representing 20406 admissions, were used to prospectively validate the performance of the risk score (validation data set). Using a backward selection approach, 13 out of 25 clinical parameters recognizable on initial presentation, were selected for inclusion in a final logistic regression prediction model. The presence of individual parameters was awarded a score of either 1 or 2 based on regression coefficients. For each individual patient, a composite risk score was generated. The risk score was further categorized into three categories; low, medium, and high. Patient characteristics were comparable in both data sets. Measures of performance for the risk score included the receiver operating characteristics curves and the area under the curve (AUC), both demonstrating good and comparable ability to predict deathusing both the derivation (AUC =0.76) and validation dataset (AUC =0.74). Using the derivation and validation datasets, the mortality rates in each risk category were as follows: low risk (0.8% vs. 0.7%), moderate risk (3.5% vs. 3.2%), and high risk (16.5% vs. 12.6%), respectively. Our

  11. Rare, Serious, and Comprehensively Described Suspected Adverse Drug Reactions Reported by Surveyed Healthcare Professionals in Uganda

    PubMed Central

    Kiguba, Ronald; Karamagi, Charles; Waako, Paul; Ndagije, Helen B.; Bird, Sheila M.

    2015-01-01

    Background Lack of adequate detail compromises analysis of reported suspected adverse drug reactions (ADRs). We investigated how comprehensively Ugandan healthcare professionals (HCPs) described their most recent previous-month suspected ADR, and determined the characteristics of HCPs who provided comprehensive ADR descriptions. We also identified rare, serious, and unanticipated suspected ADR descriptions with medication safety-alerting potential. Methods During 2012/13, this survey was conducted in purposively selected Ugandan health facilities (public/private) including the national referral and six regional referral hospitals representative of all regions. District hospitals, health centres II to IV, and private health facilities in the catchment areas of the regional referral hospitals were conveniently selected. Healthcare professionals involved in prescribing, transcribing, dispensing, and administration of medications were approached and invited to self-complete a questionnaire on ADR reporting. Two-thirds of issued questionnaires (1,345/2,000) were returned. Results Ninety per cent (241/268) of HCPs who suspected ADRs in the previous month provided information on five higher-level descriptors as follows: body site (206), drug class (203), route of administration (127), patient age (133), and ADR severity (128). Comprehensiveness (explicit provision of at least four higher-level descriptors) was achieved by at least two-fifths (46%, 124/268) of HCPs. Received descriptions were more likely to be comprehensive from HCPs in private health facilities, regions other than central, and those not involved in teaching medical students. Overall, 106 serious and 51 rare previous-month suspected ADRs were described. The commonest serious and rare ADR was Stevens-Johnson syndrome (SJS); mostly associated with oral nevirapine or cotrimoxazole, but haemoptysis after diclofenac analgesia and paralysis after quinine injection were also described. Conclusion Surveyed Ugandan

  12. Evaluation of the Performance of Routine Information System Management (PRISM) framework: evidence from Uganda

    PubMed Central

    2010-01-01

    Background Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS). In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM) framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a) to assess the reliability and validity of the PRISM instruments and b) to assess the validity of the PRISM conceptual framework. Methods Facility- and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework. Results Cronbach's alpha analysis suggests high reliability (0.7 or greater) for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance. Conclusions The study

  13. Districts for 104th Congress

    USGS Publications Warehouse

    ,

    1990-01-01

    This is a polygon coverage of 104th Congressional District boundaries obtained from the U.S. Bureau of the Census. The 103rd Congress was the first Congress that reflected the reapportionment and delineation of congressional districts based on the 1990 census. The next (104th) Congress reflects redelineation of districts that occurred for six states: Georgia, Louisiana, Maine, Minnesota, South Carolina, and Virginia. Congressional Districts U.S. House of Representatives Census TIGER/Line Files

  14. Factors Associated with Malaria Parasitemia, Anemia and Serological Responses in a Spectrum of Epidemiological Settings in Uganda

    PubMed Central

    Yeka, Adoke; Nankabirwa, Joaniter; Mpimbaza, Arthur; Kigozi, Ruth; Arinaitwe, Emmanuel; Drakeley, Chris; Greenhouse, Bryan; Kamya, Moses R.; Dorsey, Grant; Staedke, Sarah G.

    2015-01-01

    Background Understanding the current epidemiology of malaria and the relationship between intervention coverage, transmission intensity, and burden of disease is important to guide control activities. We aimed to determine the prevalence of anemia, parasitemia, and serological responses to P. falciparum antigens, and factors associated with these indicators, in three different epidemiological settings in Uganda. Methods and Findings In 2012, cross-sectional surveys were conducted in 200 randomly selected households from each of three sites: Walukuba, Jinja district (peri-urban); Kihihi, Kanungu district (rural); and Nagongera, Tororo district (rural) with corresponding estimates of annual entomologic inoculation rates (aEIR) of 3.8, 26.6, and 125.0, respectively. Of 2737 participants, laboratory testing was done in 2227 (81.4%), including measurement of hemoglobin, parasitemia using microscopy, and serological responses to P. falciparum apical membrane antigen 1 (AMA-1) and merozoite surface protein 1, 19 kilodalton fragment (MSP-119). Analysis of laboratory results was restricted to 1949 (87.5%) participants aged ≤ 40 years. Prevalence of anemia (hemoglobin < 11.0 g/dL) was significantly higher in Walukuba (18.9%) and Nagongera (17.4%) than in Kihihi (13.1%), and was strongly associated with decreasing age for those ≤ 5 years at all sites. Parasite prevalence was significantly higher in Nagongera (48.3%) than in Walukuba (12.2%) and Kihihi (12.8%), and significantly increased with age to 11 years, and then significantly decreased at all sites. Seropositivity to AMA-1 was 53.3% in Walukuba, 63.0% in Kihihi, and 83.7% in Nagongera and was associated with increasing age at all sites. AMA-1 seroconversion rates strongly correlated with transmission intensity, while serological responses to MSP-119 did not. Conclusion Anemia was predominant in young children and parasitemia peaked by 11 years across 3 sites with varied transmission intensity. Serological responses

  15. In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected Northern Uganda

    PubMed Central

    2012-01-01

    Background Adolescent girls are an overlooked group within conflict-affected populations and their sexual health needs are often neglected. Girls are disproportionately at risk of HIV and other STIs in times of conflict, however the lack of recognition of their unique sexual health needs has resulted in a dearth of distinctive HIV protection and prevention responses. Departing from the recognition of a paucity of literature on the distinct vulnerabilities of girls in time of conflict, this study sought to deepen the knowledge base on this issue by qualitatively exploring the sexual vulnerabilities of adolescent girls surviving abduction and displacement in Northern Uganda. Methods Over a ten-month period between 2004–2005, at the height of the Lord’s Resistance Army insurgency in Northern Uganda, 116 in-depth interviews and 16 focus group discussions were held with adolescent girls and adult women living in three displacement camps in Gulu district, Northern Uganda. The data was transcribed and key themes and common issues were identified. Once all data was coded the ethnographic software programme ATLAS was used to compare and contrast themes and categories generated in the in-depth interviews and focus group discussions. Results Our results demonstrated the erosion of traditional Acholi mentoring and belief systems that had previously served to protect adolescent girls’ sexuality. This disintegration combined with: the collapse of livelihoods; being left in camps unsupervised and idle during the day; commuting within camp perimeters at night away from the family hut to sleep in more central locations due to privacy and insecurity issues, and; inadequate access to appropriate sexual health information and services, all contribute to adolescent girls’ heightened sexual vulnerability and subsequent enhanced risk for HIV/AIDS in times of conflict. Conclusions Conflict prevention planners, resettlement programme developers, and policy-makers need to recognize

  16. District Consolidation: Rivals Coming Together

    ERIC Educational Resources Information Center

    Mart, Dan

    2011-01-01

    District consolidation is a highly emotional process. One key to success is sticking to the facts. In Iowa, school districts facing financial difficulties or enrollment concerns do not have to move directly to consolidation. In many cases, districts begin by developing sharing agreements. These sharing agreements may start with simple sharing of…

  17. Problems of Affluent School Districts.

    ERIC Educational Resources Information Center

    McLoone, Eugene P.

    All school districts are affected by the stagnant economy, the growing needs of the public sector, the increased burden of transfer payments, and the limited growth of public revenues. Retrenchment is common to all school districts, but it may be more severe in affluent districts. By 1969-70, suburban school systems were the clear-cut expenditure…

  18. How High Poverty Districts Improve.

    ERIC Educational Resources Information Center

    Togneri, Wendy; Anderson, Stephen E.

    2003-01-01

    Describes results of study of five high-poverty districts' successful efforts to improve academic achievement: Adline Independent School District (Texas), Chula Vista Elementary School District (California), Kent County Public Schools (Maryland), Minneapolis Public Schools (Minnesota), and Providence Public Schools (Rhode Island). Focuses on…

  19. FACTORS IN FUTURE DISTRICT ORGANIZATION.

    ERIC Educational Resources Information Center

    Citrus Junior Coll., Azusa, CA.

    CALIFORNIA HAS ACCEPTED THE CONCEPT THAT ALL SCHOOL DISTRICTS ARE TO BE INCLUDED IN JUNIOR COLLEGE DISTRICTS. THIS STUDY DETERMINED WHAT EFFECT ANY CHANGE IN THE TERRITORY NOW INCLUDED IN THE CITRUS JUNIOR COLLEGE DISTRICT WOULD HAVE UPON THE SCHOOL'S ENROLLMENTS, BUILDING PROGRAM, AND FINANCIAL STRUCTURE. TOTAL ENROLLMENT IN THE COLLEGE, 1963-64,…

  20. Pribram uranium district

    SciTech Connect

    1990-11-01

    Pribram is one of the largest and richest vein uranium districts in the world. The Pribram district has accounted for about 60 percent of Czechoslovakia`s total uranium production. The Pribram uranium district is located about 60 kilometers southwest of Prague, in Cezechslovakia`s central Bohemia region. This district contains perigranitic, monometallic, vein-type uranium deposits. The deposits are within a northeast-southwest elongated area, about 20 kilometers long and 1-2 kilometers wide, located between Oboriste in the northeast and Tresko in the southwest. Several thousand veins have been discovered; about 1,600 have been mined. Most of the veins are grouped in clusters, which are intense accumulations of veins paralleling or intersecting each other within a narrow segment. Until this year, all uranium production was exported to the USSR, with only the amount required for Czechoslovakia`s nuclear power stations being returned (as fabricated fuel). Most of Czechoslovakia`s present and future uranium production will come from sandstone deposits in the North Bohemian Cretaceous Basin, such as Hamr and Straz.

  1. District Leadership Conference Planner.

    ERIC Educational Resources Information Center

    Washington State Coordinating Council for Occupational Education, Olympia.

    This manual provides usable guidelines and planning forms and materials for planning district leadership conferences, which were designed and initiated in Washington State to meet the problems in student enrollment and, consequently, Distributive Education Clubs of America membership. The conferences have become a useful means to increase…

  2. School District Purchasing.

    ERIC Educational Resources Information Center

    Natale, Joseph L.

    This chapter of "Principles of School Business Management" discusses the effective management of purchasing processes in a school district. These processes include obtaining materials, supplies, and equipment of maximum value for the least expense, and receiving, storing, and distributing the items obtained. The chapter opens with an overview of…

  3. District-Level Downsizing

    ERIC Educational Resources Information Center

    Schachter, Ron

    2011-01-01

    Draconian cuts have become the order of business for many school districts since the economic recession hit in 2008. But for the coming school year, "draconian" has taken on an even harsher meaning, as states from California and Texas to Illinois and New York wrestle with deficits in the tens of billions of dollars and make multi-billion-dollar…

  4. Districts Delivering Online

    ERIC Educational Resources Information Center

    Sternberg, Ruth

    2006-01-01

    The idea is not new: Offer courses remotely, build in variety and the students will come. This article discusses how public schools are investing in offering online courses, catering to students' specific learning needs and to remote locations. Several surveys conducted in recent years show that school districts nationwide are embracing this…

  5. School District Budgeting.

    ERIC Educational Resources Information Center

    Hartman, William T.

    This book is devoted exclusively to the budgeting process in school districts, unlike the more common generic budgeting texts. As such, it allows an in-depth treatment of both conceptual and practical aspects of budgeting in a single volume. By default, school business officials have had to rely on the state education accounting manual as their…

  6. Districts Tackling Meal Debt

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2012-01-01

    School districts have resorted to hiring debt collectors, employing constables, and swapping out standard meals for scaled-back versions to try to coerce parents to pay off school lunch debt that, in recent years, appears to have surged as the result of a faltering economy and better record-keeping. While the average school lunch costs just about…

  7. Districts Shun Stimulus Bids

    ERIC Educational Resources Information Center

    Maxwell, Lesli A.

    2010-01-01

    In the final sprint to polish Race to the Top applications, hundreds of school districts shunned a shot at a share of $4 billion in grants by refusing to sign on to their states' plans for the federal competition. California officials had secured the signatures of 790 local education agencies (leas) late last week, including most of the state's…

  8. Modelling district nurse expertise.

    PubMed

    Burke, Michelle

    2014-12-01

    As changes in society and health provision mean that one in four people over the age of 75 will require nursing care at home, pre-registration adult nurse education increasingly prepares student nurses for a future career within the community. District nurses undertake complex, multidimensional health and social assessments and care in a non-clinical setting and work in partnership with patients and their significant others to promote practical and psychological coping mechanisms and self-care. The district nurse's first assessment visit is key to developing a therapeutic partnership and it is often during this visit that expertise in district nursing practice emerges. The holistic, contextual and dynamic aspects of nursing in the home setting can make district nursing expertise difficult to illustrate and demonstrate within the classroom setting. This article explores the ways in which an understanding of expertise development theory can enable the tacit expertise that occurs within the first assessment visit to be made visible to student nurses, using simulation and expert narrative as a pedagogical strategy. PMID:25475676

  9. Rightsizing a School District

    ERIC Educational Resources Information Center

    Esselman, Mary; Lee-Gwin, Rebecca; Rounds, Michael

    2012-01-01

    The transformation of the Kansas City, Missouri Public Schools (KCMSD) has been long overdue. Multiple superintendents and administrations, using billions of dollars of desegregation funds ventured to transform the district by creating magnet schools, themed schools, and career-focused high schools. Missing from these initiatives, but included in…

  10. Districts Weigh Obesity Screening

    ERIC Educational Resources Information Center

    Butler, Kevin

    2008-01-01

    Parents of children in most elementary grades in Minnesota's Independent School District 191 receive an annual notice with potentially life-altering data for their children--and they are not state test scores, attendance rates, or grades. The notice contains the child's body mass index (BMI) score, which estimates whether the student has excess…

  11. School District Spending.

    ERIC Educational Resources Information Center

    Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.

    Minnesota spends more for education than most states and has increased its financial commitment steadily over the past 15 years. Because of the state's dominant role in education funding, legislators have enacted measures requiring all local school districts to follow uniform financial accounting and reporting standards (UFARS). Since 1980, the…

  12. Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

    PubMed Central

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

    2016-01-01

    Objectives The main objective of this study was to assess practices of antibiotic prescription at registered drug shops with a focus on upper respiratory tract infections among children in order to provide data for policy discussions aimed at improving quality of care and patient safety in the private health sector in Uganda. Methods A survey was conducted within 57 parishes from August to October 2014 in Mukono District, Uganda. Data was captured on the following variables: drug shop characteristics, training of staff in management of pneumonia, availability of guidelines and basic equipment, available antibiotics, knowledge on treatment of pneumonia in children aged <5 years. The main study outcome was the proportion of private health facilities prescribing an antibiotic. Results A total of 170 registered drug shops were surveyed between August and October 2014. The majority of drug shops, 93.5% were prescribing antibiotics, especially amoxicillin and trimethoprim-sulfamethoxazole (septrin). The professional qualification of a provider was significantly associated with this practice, p=0.04; where lower cadre staff (nursing assistants and enrolled nurses) overprescribed antibiotics. A third, 29.4% of drug shop providers reported that antibiotics were the first-line treatment for children with diarrhoea; yet the standard guideline is to give oral rehydration salts and zinc tablets. Only few providers, 8.2%, had training on antibiotics, with 10.6% on pneumonia case management. Further to this, 7.1% drug shops had WHO-Integrated Management of Childhood Illness guidelines, and a negligible proportion (<1%) had respiratory timers and baby weighing scales. Although the majority of providers, 82.4%, knew severe signs and symptoms of pneumonia, few, 17.6%, knew that amoxicillin was the first-line drug for treatment of pneumonia in children according to the guidelines. Conclusions There is urgent need to regulate drug shop practices of prescribing and selling

  13. Knowledge, sources and use of family planning methods among women aged 15-49 years in Uganda: a cross-sectional study

    PubMed Central

    Alege, Stephen Galla; Matovu, Joseph KB; Ssensalire, Simon; Nabiwemba, Elizabeth

    2016-01-01

    Introduction Lack of knowledge of where to obtain correct family planning (FP) information and methods can be a critical barrier to eventual uptake of FP services. We assessed knowledge, sources and use of FP methods among women of reproductive age in rural Uganda. Methods This secondary analysis uses data from a larger cross-sectional study conducted to measure changes in perceptions towards long-term and reversible contraceptive use among 2,033 women of reproductive age (15-49years) resident in 34 districts of Uganda. Both users and non-users of FP methods were interviewed. Data were analyzed using STATA statistical software, version 12. Results Majority of the women were less than 30 years of age (64.3%). Nearly three-quarters were married (73.1%), 51.1% had primary education and more than half (57%) were engaged in employment. Knowledge of FP methods was universal (98.1%). Clinic providers (60.4%), friends (56.9%) and the media (51.3%) were the most trusted sources of contraceptive information. Government (27.6%) and private (21.1%) health facilities were the main sources of modern FP methods. Sixty two per cent of women reported current use of any FP method. Among non-users of FP, injectables (50.4%), implants (22.8%) and pills (20.2%) were the most preferred FP methods. Conclusion Our findings show that knowledge of FP methods is almost universal and that six in ten women use any FP method. Clinic providers, friends and the media are the most trusted sources of FP information. Government and private health facilities are the main sources of FP services. PMID:27583102

  14. Community Perceptions on Integrating Animal Vaccination and Health Education by Veterinary and Public Health Workers in the Prevention of Brucellosis among Pastoral Communities of South Western Uganda

    PubMed Central

    Kansiime, Catherine; Atuyambe, Lynn M.; Asiimwe, Benon B.; Mugisha, Anthony; Mugisha, Samuel; Guma, Victor; Rwego, Innocent B.; Rutebemberwa, Elizeus

    2015-01-01

    Background Brucellosis is a zoonotic disease of veterinary, public health, and economic significance in most developing countries, yet there are few studies that show integrated human and veterinary health care intervention focusing on integration at both activity and actors levels. The aim of our study, therefore, was to explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis in Uganda. Methods This study used a qualitative design where six Focus Group Discussions (FGDs) that were homogenous in nature were conducted, two from each sub-county, one with the local leaders, and another with pastoralists and farmers. Five Key Informant Interviews (KIIs) with two public health workers and three veterinary extension workers from three sub-counties in Kiruhura district, Uganda were conducted. All FGDs were conducted in the local language and tape recorded with consent from the participants. KIIs were in English and later transcribed and analyzed using latent content data analysis method. Results All the groups mentioned that they lacked awareness on brucellosis commonly known as Brucella and its vaccination in animals. Respondents perceived improvement in human resources in terms of training and recruiting more health personnel, facilitation of the necessary activities such as sensitization of the communities about brucellosis, and provision of vaccines and diagnostic tests as very important in the integration process in the communities. The FGD participants also believed that community participation was crucial for sustainability and ownership of the integration process. Conclusions The respondents reported limited knowledge of brucellosis and its vaccination in animals. The community members believed that mass animal vaccination in combination with health education about the disease is important and possible if it involves government and all other stakeholders such

  15. Efficacy of single and double doses of albendazole and mebendazole alone and in combination in the treatment of Trichuris trichiura in school-age children in Uganda.

    PubMed

    Namwanje, Harriet; Kabatereine, Narcis B; Olsen, Annette

    2011-10-01

    A randomised clinical trial was conducted in Kabale District, southwestern Uganda, to compare the efficacies of single and double doses of a combination of 400mg albendazole (ALB) and 500mg mebendazole (MBZ) with those of single and double doses of each drug given alone in the treatment of Trichuris trichiura. Infected pupils (n=611) were randomised to six treatment groups. Three groups received either a single dose of ALB, MBZ or the combination (ALB+MBZ). The other three groups received either a double dose of ALB (ALB/ALB), MBZ (MBZ/MBZ) or the combination (ALB+MBZ/ALB+MBZ). All double doses were given 8h apart. Children were followed-up weekly for 1 month. Cure rates were significantly higher using double doses compared with single doses (irrespective of drug; z=-4.02, P<0.0005) as well as using the drug combination compared with single drugs (irrespective of doses; z=-7.64, P<0.0005). Cure rates measured at Day 7 were significantly higher than on Days 14 and 21 after treatment (Day 14, z=9.90, P<0.0005; Day 21, z=7.36, P<0.0005). Geometric mean (GM) intensities of positives were significantly lower on Day 7 compared with all other subsequent days (P<0.00005), and on Day 28 GM intensities reached pre-treatment levels (P=0.096). Whilst there was no difference in egg excretion between single and double doses of the same drug or drug combination (F((df)(1))=0.28, P=0.60), the combination treatment resulted in lower egg excretion than use of single drugs (F((df)(2))=50.90, P<0.00005). All the tested regimens of ALB and MBZ had low cure rates against T. trichiura in Uganda, but both combination treatments showed satisfactory egg reduction rates 3 weeks after treatment.

  16. Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation

    PubMed Central

    Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine

    2015-01-01

    Objectives This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Method Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. Results We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. Conclusions A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. PMID:26525721

  17. A protocol for engaging unlicensed private drug shops in Rural Eastern Uganda for Integrated Community Case Management (ICCM) of malaria, pneumonia and diarrhoea in children under 5 years of age

    PubMed Central

    Buchner, Denise L; Awor, Phyllis

    2015-01-01

    Introduction Malaria, pneumonia and diarrhoea are leading causes of death in young children in Uganda. In 2010, Integrated Community Case Management (ICCM) was adopted in Uganda for community level diagnosis and treatment of these diseases through community health workers. However, 50–60% of sick children will receive treatment from the private sector, especially drug shops. Only about half of drug shops are licensed and the quality of care is poor. There is an urgent need to improve quality of care and regulation of drug shops in Uganda. Methods This is a pre–post cross-sectional study with before and after measurement in an intervention area in Kamujli district. A snowball mapping exercise, exit interviews, focus group discussions and interviews will be used. 25 randomly selected drug shops will be selected for an intervention that will assist drug shops to become licensed, and provide five days of ICCM training, subsidised prepackaged medicines (artemisinin-based combination therapies for malaria, amoxicillin for pneumonia, Oral Rehydration Salts/zinc for diarrhoea) and free diagnostic tools (rapid diagnostic tests, respiratory timers, thermometers, algorithms). We anticipate a sample size of 1200 (600 at baseline and 600 at the end of the study). Analysis Quantitative data will be analysed using SPSS for proportions and CIs. Bivariate and multiple logistic regression analysis with adjustment for clustering of data will be performed to adjust for confounding and determine intervention effect. Qualitative data will be entered into NVivo 10 and analysed using content analysis. Ethics and Dissemination Research ethics approval is received from the University of Calgary (REB 14–0269), and Makerere University (IRB00011353). Findings from this study will be disseminated through journal articles and conference presentations, and will illustrate the feasibility of introducing ICCM for drug shops. PMID:26446166

  18. “If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated”: Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda

    PubMed Central

    Wanyenze, Rhoda K.; Musinguzi, Geofrey; Matovu, Joseph K. B.; Kiguli, Juliet; Nuwaha, Fred; Mujisha, Geoffrey; Musinguzi, Joshua; Arinaitwe, Jim; Wagner, Glenn J.

    2016-01-01

    Background Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. Methods In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Results Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Two-thirds (n = 56, 66%) participated in MSM social networks and 86% of these (48) received support from the networks to overcome barriers to accessing services. Conclusions Negative perceptions among providers and the community present barriers to service access among MSM. Guidelines, provider skills building and use of social networks for mobilization and service delivery could expand access to HIV services among MSM in Uganda. PMID:26808653

  19. Translating health research evidence into policy and practice in Uganda

    PubMed Central

    2013-01-01

    Background Uganda experiences a high disease burden of malaria, infectious and non-communicable diseases. Recent data shows that malaria is the leading cause of morbidity and mortality among all age groups, while HIV prevalence is on the increase and there is re-emergence of viral haemorrhagic fevers and cholera epidemics. In order to respond to the above situation, a team of researchers, policy makers, civil society and the media was formed in order to build a collaboration that would help in discussing appropriate strategies to mitigate the high disease burden in Uganda. Methods A preparatory secretariat composed of individuals from Ministry of Health, Malaria Research Centre and School of Public Health was formed. The secretariat identified researchers, key resource persons to guide the workshops and the format for presentation. The criteria for selection of the research topics were: National public health importance and had been published in peer-reviewed journals. The presentations were structured as follows: research questions, hypotheses, methodology, major findings and policy implications. The secretariat compiled all the proceedings of the workshops including attendance, address of participants including telephone and email contacts. During the last workshop, an evaluation was conducted to assess the impact of the workshops. Results Four workshops were held between 2006 and 2009. A total of 322 participants attended of whom mid-level policy makers, researchers and the media were consistently high. The workshops generated a lot of interest that lead to presentation and discussion of nationally relevant health research results. The workshops had an impact on the participants’ skills in writing policy briefs, participating in the policy review process and entering into dialogue with policy makers. Conclusion The following lessons have been learned: getting health research into policy is feasible but requires few self-motivated individuals to act as

  20. Giving "Sadness" a Name: The Need for Integrating Depression Treatment into HIV Care in Uganda.

    PubMed

    Odokonyero, Raymond; Wagner, Glenn; Ngo, Victoria; Nakasujja, Noeline; Musisi, Seggane; Akena, Dickens

    2015-01-01

    Depression is common among people living with HIV/AIDS (PLWHA) in sub-Saharan Africa (SSA), and can have significant consequences for HIV disease progression, treatment response and prevention. Yet mental health services are limited in most HIV care programs in this region, in part due to severe shortages of mental health professionals. To address the need for establishing an effective, sustainable model for integrating depression treatment into HIV care in SSA, we have embarked upon a 3-year research project, INDEPTH Uganda (INtegrating DEPression Treatment and in HIV care in Uganda), to evaluate a task-sharing, protocolized approach to providing antidepressant care in ten HIV clinics in Uganda. In this paper we share our experiences with two treated cases identified during the initial days of implementation, which we believe highlight the potential value and policy implications for task shifting depression care models in under-resourced settings. PMID:25376926

  1. Governing chronic poverty under inclusive liberalism: the case of the Northern Uganda Social Action Fund.

    PubMed

    Golooba-Mutebi, Frederick; Hickey, Sam

    2010-01-01

    The paradigm of 'inclusive neoliberalism' that currently characterises international development places a particular emphasis on community-based responses to the often structural problems of poverty and exclusion. Such approaches have become increasingly controversial: celebrated by optimists as the most empowering way forward for marginal citizens on the one hand, and derided as an abrogation of responsibility by development trustees by sceptics on the other. Uganda provides a particularly interesting context to explore these debates, not least because it has become a standard bearer for inclusive neoliberalism at the same time that regional inequalities within it have become increasingly apparent. Our investigation of the flagship response to deep impoverishment in its northern region, the World Bank-funded Northern Uganda Social Action Fund, offers greater support to the sceptics, not least because of the ways in which the more pernicious tendencies within inclusive neoliberalism have converged with the contemporary politics of development in Uganda.

  2. Community Factors Influencing Birth Spacing among Married Women in Uganda and Zimbabwe.

    PubMed

    McGuire, Courtney; Stephenson, Rob

    2015-03-01

    Short birth spacing continues to be a problem in Uganda and Zimbabwe, resulting in negative infant, child, and maternal health outcomes. This study investigates community-level influences on birth spacing outcomes among women aged 15-49 in Uganda and Zimbabwe, using Demographic and Health Surveys conducted in 2011 (Uganda) and 2010-2011 (Zimbabwe). Women living in communities with higher mean maternal age, mean age at marriage, and mean parity were significantly more likely to have longer birth spacing. Women living in communities with higher levels of contraceptive use and low levels of unmet contraceptive need were more likely to have short birth spacing. The significance of community-level demographic and fertility norms, gender norms, economic prosperity, and family planning behaviors demonstrate the broad influence of community variables on birth spacing outcomes. This analysis highlights the importance of moving beyond individual and household-level interventions in order to harness the power of contextual influences on birth spacing.

  3. Characterization of coagulase negative staphylococci from cases of subclinical mastitis in dairy cattle in Kampala, Uganda

    PubMed Central

    2014-01-01

    Background Coagulase negative staphylococci (CNS) are the most common pathogens leading to subclinical mastitis (SCM) in dairy cattle in Uganda. Coagulase negative staphylococci can vary between bacterial species in how they cause disease. The aim of the study was to characterize CNS, from cows with SCM in Uganda, at the species level. Findings Quarter milk samples (n = 166) were collected from 78 animals with SCM. Bacteriological analyses were carried out at Makerere University, Kampala, Uganda and at the National Veterinary Institute (SVA), Uppsala, Sweden. The most common pathogens found in milk samples from cows with SCM were CNS (31.7%). Two species of CNS were found, S. epidermidis (85%) and S. haemolyticus (15%). Of the CNS isolates, 16/20 (80%) were positive for β-lactamase production (β+). Conclusions In milk samples from cows with SCM caused by CNS, S. epidermidis was most prevalent, followed by S. haemolyticus. PMID:24917926

  4. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Boundaries: The Community Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING...

  5. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Boundaries: The Community Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING...

  6. 36 CFR 28.3 - Boundaries: The Community Development District; The Dune District; The Seashore District.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Boundaries: The Community Development District; The Dune District; The Seashore District. 28.3 Section 28.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR FIRE ISLAND NATIONAL SEASHORE: ZONING...

  7. Sexual Behavior of Older Adults Living with HIV in Uganda.

    PubMed

    Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet

    2016-02-01

    Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.

  8. PTSD, depression and anxiety among former abductees in Northern Uganda

    PubMed Central

    2011-01-01

    Background The population in Northern Uganda has been exposed to extreme levels of traumatic stress and thousands abducted forcibly became rebel combatants. Methods Using structured interviews, the prevalence and severity of posttraumatic stress disorder (PTSD), depression and anxiety was assessed in 72 former abducted adults, 62 of them being former child soldiers. Results As retrospective reports of exposure to traumatic stress increased, anxiety and PTSD occurrence increased (r = .45). 49% of respondents were diagnosed with PTSD, 70% presented with symptoms of depression, and 59% with those of anxiety. In a multiple linear regression analysis four factors could best explain the development of PTSD symptoms: male respondents (sex) living in an IDP-Camp (location) with a kinship murdered in the war (family members killed in the war) and having experienced a high number of traumatic events (number of traumatic events) were more likely to develop symptoms of PTSD than others. In disagreement to a simple dose-response-effect though, we also observed a negative correlation between the time spent with the rebels and the PTSD symptom level. Conclusions Former abductees continue to suffer from severe mental ill-health. Adaptation to the living condition of rebels, however, may lower trauma-related mental suffering. PMID:21871069

  9. Land Use Change, Fuel Use and Respiratory Health in Uganda

    PubMed Central

    Jagger, Pamela; Shively, Gerald

    2014-01-01

    This paper examines how biomass supply and consumption are affected by land use change in Uganda. We find that between 2007 and 2012 there was a 22% reduction in fuelwood sourced from proximate forests, and an 18% increase in fuelwood sourced from fallows and other areas with lower biomass availability and quality. We estimate a series of panel regression models and find that deforestation has a negative effect on total fuel consumed. We also find that access to forests, whether through ownership or proximity, plays a large role in determining fuel use. We then explore whether patterns of biomass fuel consumption are related to the incidence of acute respiratory infection using a cross-sectional data set of 1209 women and 598 children. We find a positive and significant relationship between ARI and the quantity of fuelwood from non-forest areas; a 100 kilogram increase in fuelwood sourced from a non-forest area results in a 2.4% increase in the incidence of ARI for children. We find the inverse effect of increased reliance on crop residues. As deforestation reduces the availability of high quality fuelwood, rural households may experience higher incidence of health problems associated with exposure to biomass burning. PMID:24535892

  10. Land Use Change, Fuel Use and Respiratory Health in Uganda.

    PubMed

    Jagger, Pamela; Shively, Gerald

    2014-04-01

    This paper examines how biomass supply and consumption are affected by land use change in Uganda. We find that between 2007 and 2012 there was a 22% reduction in fuelwood sourced from proximate forests, and an 18% increase in fuelwood sourced from fallows and other areas with lower biomass availability and quality. We estimate a series of panel regression models and find that deforestation has a negative effect on total fuel consumed. We also find that access to forests, whether through ownership or proximity, plays a large role in determining fuel use. We then explore whether patterns of biomass fuel consumption are related to the incidence of acute respiratory infection using a cross-sectional data set of 1209 women and 598 children. We find a positive and significant relationship between ARI and the quantity of fuelwood from non-forest areas; a 100 kilogram increase in fuelwood sourced from a non-forest area results in a 2.4% increase in the incidence of ARI for children. We find the inverse effect of increased reliance on crop residues. As deforestation reduces the availability of high quality fuelwood, rural households may experience higher incidence of health problems associated with exposure to biomass burning.

  11. Understanding shallow groundwater contamination in Bwaise slum, Kampala, Uganda

    NASA Astrophysics Data System (ADS)

    Nyenje, P. M.; Havik, J.; Foppen, J. W.; Uhlenbrook, S.

    2012-04-01

    Groundwater in unsewered urban areas is heavily contaminated by onsite sanitation activities and is believed to be an important source of nutrients ex-filtrating into streams and thus contributing to eutrophication of Lakes in urban areas. Currently the fate of nutrients and especially phosphorus leached into groundwater in such areas is not well known. In this study, we undertook an extensive investigation of groundwater in Bwaise slum, Kampala Uganda to understand the distribution and fate of sanitation-related nutrients N and P that are leached into groundwater. Transects of monitoring wells were installed in Bwaise slum and downstream of the slum. From these wells, water levels were measured and water quality analyses done to understand the distribution and composition of the nutrients, how they evolve downstream and the possible subsurface processes affecting their fate during transport. These findings are necessary to evaluate the risk of eutrophication posed by unsewered areas in urban cities and to design/implement sanitation systems that will effectively reduce the enrichment of these nutrients in groundwater. Key words: fate, groundwater, nutrients, processes, slums

  12. The status of wild food plants in Bulamogi County, Uganda.

    PubMed

    Tabuti, J R S; Dhillion, S S; Lye, K A

    2004-09-01

    We present here an inventory of the edible plants of Bulamogi, Uganda, and related aspects of exploitation of wild food plants (WFPs) by the local community. The edible plants consist of 105 species distributed in 77 genera and 39 families. Most of the edible plants are herbaceous (70.7%) and are cultivated (49.1%). Some introduced food plants have become naturalised and grow wild. Most of the edible plants yield fruits that are consumed as snacks (41.4%). The major food crops of the Balamogi are consumed locally, while few are traded. The proportion of WFPs is only 32.8% of the edible plants. WFPs are infrequently eaten and their consumption is limited to casual encounters, periods of food shortages and as supplements to major food crops. The main reasons for their neglect are the wide variety of introduced cultivated foods and the increasing difficulty of finding WFPs in the wild. Erosion of traditional knowledge about WFPs has also contributed to their declining use.

  13. Food shortages and gender relations in Ikafe settlement, Uganda.

    PubMed

    Payne, L

    1998-03-01

    In 1996, an 18-month-old settlement created for 55,000 Sudanese refugees in northern Uganda came under attack by Ugandan rebels. By March 1997, the entire population of the settlement had migrated in search of safety. Because the refugees lost their livelihoods and cultivated fields, they had to adopt short-term coping strategies to acquire food. Two Oxfam researchers gathering information during this period for use in program planning and monitoring found that coping strategies included 1) hazarding dangerous journeys (women risked rape or abduction; men risked beating, looting, killing, or abduction) to harvest crops; 2) seeking piece-work employment; 3) exchanging sex for food; and 4) depleting assets. The crisis was particularly severe for single people (especially those with children). In families where the women but not the men could find employment, some men took on household responsibilities. As malnutrition increased, health declined. Observed changes to household gender relations included new sexual divisions of labor, assumption by females of decision-making power, increased domestic quarreling, and marital break-down (especially in cases where women had been raped). On the community level, women assumed more responsibility as men withdrew socially or left the settlement. These findings point to the importance of providing refugees with seeds, with small loans to stimulate business, and with the means to rebuild their sense of community.

  14. An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda.

    PubMed

    Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K

    2014-12-01

    There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries.

  15. Science-based health innovation in Uganda: creative strategies for applying research to development

    PubMed Central

    2010-01-01

    Background Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Results Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Conclusions Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development

  16. Framing HIV prevention discourse to encompass the complexities of war in northern Uganda.

    PubMed

    Westerhaus, Michael J; Finnegan, Amy C; Zabulon, Yoti; Mukherjee, Joia S

    2007-07-01

    In northern Uganda, physical and structural violence (political repression, economic inequality, and gender-based discrimination) increase vulnerability to HIV infection. In settings of war, traditional HIV prevention that solely promotes risk avoidance and risk reduction and assumes the existence of personal choice inadequately addresses the realities of HIV transmission. The design of HIV prevention strategies in northern Uganda must recognize how HIV transmission occurs and the factors that put people at risk for infection. A human rights approach provides a viable model for achieving this aim.

  17. Rapid assessment of the demand and supply of tobacco dependence pharmacotherapy in Uganda.

    PubMed

    Kirenga, B J; Jones, R; Muhofa, A; Nyakoojo, G; Williams, S

    2016-03-21

    Tobacco dependence pharmacotherapy (TDP) plays a major role in smoking cessation. We conducted a rapid assessment of current smoking, availability of TDP and the willingness to quit and to pay for TDP among 56 patients with tobacco-attributable diseases and 38 pharmacies in Uganda. Of the 56 patients, 63% were current smokers, 77.4% wanted to quit and 37% were willing to pay. Drugs were largely unavailable: nicotine replacement products were available in only seven pharmacies (18%) and bupropion in three (8%); these cost respectively US$15.7 and US$17.1 for a 1-month supply. Improving supplies and lowering prices could facilitate access to TDP in Uganda.

  18. A review of potable water accessibility and sustainability issues in developing countries - case study of Uganda.

    PubMed

    Nayebare, Shedrack R; Wilson, Lloyd R; Carpenter, David O; Dziewulski, David M; Kannan, Kurunthachalam

    2014-01-01

    Providing sources of sustainable and quality potable water in Uganda is a significant public health issue. This project aimed at identifying and prioritizing possible actions on how sustainable high quality potable water in Uganda's water supply systems could be achieved. In that respect, a review of both the current water supply systems and government programs on drinking water in Uganda was completed. Aspects of quantity, quality, treatment methods, infrastructure, storage and distribution of water for different water systems were evaluated and compared with the existing water supply systems in the U.S., Latin America and the Caribbean, for purposes of generating feasible recommendations and opportunities for improvement. Uganda utilizes surface water, groundwater, and rainwater sources for consumption. Surface water covers 15.4% of the land area and serves both urban and rural populations. Lake Victoria contributes about 85% of the total fresh surface water. Potable water quality is negatively affected by the following factors: disposal of sewage and industrial effluents, agricultural pesticides and fertilizers, and surface run-offs during heavy rains. The total renewable groundwater resources in Uganda are estimated to be 29 million m3/year with about 20,000 boreholes, 3000 shallow-wells and 200,000 springs, serving more than 80% of the rural and slum communities. Mean annual rainfall in Uganda ranges from 500 mm to 2500 mm. Groundwater and rainwater quality is mainly affected by poor sanitation and unhygienic practices. There are significant regional variations in the accessibility of potable water, with the Northeastern region having the least amount of potable water from all sources. Uganda still lags behind in potable water resource development. Priorities should be placed mainly on measures available for improvement of groundwater and rainwater resource utilization, protection of watersheds, health education, improved water treatment methods and

  19. An Empirical Test of the Theory of Planned Behaviour Applied to Contraceptive Use in Rural Uganda

    PubMed Central

    Kiene, Susan M.; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K.

    2013-01-01

    There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health behaviour change theories to contraceptive use amongst this population. The present study tested the Theory of Planned Behaviour’s ability to predict contraceptive use-related behaviours among postpartum women in rural Uganda. Results gave modest support to the theory’s application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. PMID:23928989

  20. An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda.

    PubMed

    Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K

    2014-12-01

    There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. PMID:23928989

  1. Strategies for helping families prepare for birth: experiences from eastern central Uganda

    PubMed Central

    Timša, Līga; Marrone, Gaetano; Ekirapa, Elizabeth; Waiswa, Peter

    2015-01-01

    Background Promotion of birth preparedness and raising awareness of potential complications is one of the main strategies to enhance the timely utilisation of skilled care at birth and overcome barriers to accessing care during emergencies. Objective This study aimed to investigate factors associated with birth preparedness in three districts of eastern central Uganda. Design This was a cross-sectional baseline study involving 2,010 women from Iganga [community health worker (CHW) strategy], Buyende (vouchers for transport and services), and Luuka (standard care) districts who had delivered within the past 12 months. ‘Birth prepared’ was defined as women who had taken all of the following three key actions at least 1 week prior to the delivery: 1) chosen where to deliver from; 2) saved money for transport and hospital costs; and 3) bought key birth materials (a clean instrument to cut the cord, a clean thread to tie the cord, cover sheet, and gloves). Logistical regression was performed to assess the association of various independent variables with birth preparedness. Results Only about 25% of respondents took all three actions relating to preparing for childbirth, but discrete actions (e.g. financial savings and identification of place to deliver) were taken by 75% of respondents. Variables associated with being prepared for birth were: having four antenatal care (ANC) visits [adjusted odds ratio (ORA)=1.42; 95% confidence interval (CI) 1.10–1.83], attendance of ANC during the first (ORA=1.94; 95% CI 1.09–3.44) or second trimester (ORA=1.87; 95% CI 1.09–3.22), and counselling on danger signs during pregnancy or on place of referral (ORA=2.07; 95% CI 1.57–2.74). Other associated variables included being accompanied by one's husband to the place of delivery (ORA=1.47; 95% CI 1.15–1.89), higher socio-economic status (ORA=2.04; 95% CI 1.38–3.01), and having a regular income (ORA=1.83; 95% CI 1.20–2.79). Women from Luuka and Buyende were less likely

  2. Alabama district flood plan

    USGS Publications Warehouse

    Hedgecock, T. Scott; Pearman, J. Leroy; Stricklin, Victor E.

    2002-01-01

    The purpose of this flood plan is to outline and record advance planning for flood emergencies, so that all personnel will know the general plan and have a ready-reference for necessary information. This will ensure that during any flood event, regardless of the extent or magnitude, the resources of the District can be mobilized into a maximum data collection operation with a mimimum of effort.

  3. Attitudes to routine HIV counselling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: a cross-sectional survey among antenatal attendees

    PubMed Central

    2010-01-01

    Background HIV testing rates have exceeded 90% among the pregnant women at Mbale Regional Referral Hospital in Mbale District, eastern Uganda, since the introduction of routine antenatal counselling and testing for HIV in June 2006. However, no documented information was available about opinions of pregnant women in eastern Uganda about this HIV testing approach. We therefore conducted a study to assess attitudes of antenatal attendees towards routine HIV counselling and testing at Mbale Hospital. We also assessed their knowledge about mother to child transmission of HIV and infant feeding options for HIV-infected mothers. Methods The study was a cross-sectional survey of 388 women, who were attending the antenatal clinic for the first time with their current pregnancy at Mbale Regional Referral Hospital from August to October 2009. Data were collected using a pre-tested questionnaire and analysed using descriptive statistics and logistic regression. Permission to conduct the study was obtained from the Makerere University College of Health Sciences, the Uganda National Council of Science and Technology, and Mbale Hospital. Results The majority of the antenatal attendees (98.5%, 382/388) had positive attitudes towards routine HIV counselling and testing, and many of them (more than 60%) had correct knowledge of how mother to child transmission of HIV could occur during pregnancy, labour and through breastfeeding, and ways of preventing it. After adjusting for independent variables, having completed secondary school (odds ratio: 2.5, 95% confidence interval: 1.3-4.9), having three or more pregnancies (OR: 2.5, 95% CI: 1.4-4.5) and belonging to a non-Bagisu ethnic group (OR: 1.7, 95% CI: 1.0-2.7) were associated with more knowledge of exclusive breastfeeding as one of the measures for prevention of mother to child transmission of HIV. Out of 388 antenatal attendees, 386 (99.5%) tested for HIV and 382 (98.5%) received same-day HIV test results. Conclusions Routine

  4. ‘You sit in fear’: understanding perceptions of nodding syndrome in post-conflict northern Uganda

    PubMed Central

    Buchmann, Kristine

    2014-01-01

    Background Nodding syndrome, a disabling epidemic epileptic encephalopathy, has affected an estimated 1,834 children in northern Uganda, with reports of as many as 3,000. Etiology is unknown and children are being treated symptomatically but inconsistently with anti-epileptic drugs. Design This qualitative study comprised 10 semi-structured interviews with caregivers of affected children and five focus group discussions with 23 participants; relatives, teachers, and religious leaders. Data collection and participant observation were carried out from July to September 2012 in Kitgum and Pader districts. The material was coded through inductive thematic analysis. Results Nodding syndrome has brought signs of discrimination in school admission procedures, founded in a fear of transmission. The suffering and loss caused by nodding syndrome is collective, and participants felt that nodding syndrome was viewed as a threat to the Acholi only, and that interventions had therefore been delayed. Multiple theories of causation exist, most commonly that the disease is caused by chemicals from bombs or that food aid distributed in IDP camps had expired or been poisoned. A feeling of uncertainty was present in all focus group discussions, fueled by the fact that results of investigations were not being shared with the communities. It was especially agonizing that CDC results had been given to the Ugandan government in 2010 but not to the public. The definitive fear is that the disease will be the end of the Acholi. Conclusions This study provided insight into the perceptions of communities affected by an unknown emerging disease. Families of affected children are grieving not only their child's illness; it is a loss of social value and of lineage. The loss and suffering involved with nodding syndrome should be seen in the context of the wider suffering of a society disrupted by violent conflict. The memory of war is omnipresent and is also how nodding syndrome is understood

  5. Higher quality of life and lower depression for people on ART in Uganda as compared to a community control group.

    PubMed

    Martin, Faith; Russell, Steve; Seeley, Janet

    2014-01-01

    Provision of antiretroviral treatment (ART) to people living with HIV (PLWH) has increased globally. Research measuring whether ART restores subjective well-being to "normal" levels is lacking, particularly in resource limited settings. The study objectives are to compare quality of life and depression symptoms for PLWH on ART to a general community population and to explore factors to explain these differences, including socio-economic status and the impact of urban or rural residence. PLWH on ART (n = 263) were recruited from ART delivery sites and participants not on ART (n = 160) were recruited from communities in Wakiso District, Uganda. Participants were interviewed using the translated World Health Organisation Quality of Life brief measure, the Hopkins Symptom Checklist depression section, and questions about socio-economic status, residence as urban or rural and, for PLWH on ART, self-reported adherence and use of HIV counselling. Compared to the community sample and controlling for location of residence, PLWH on ART had significantly higher quality of life (QOL) for physical, psychological and environment domains, but not the social domain. These differences were not due to socio-economic status alone. Depression scores were significantly lower for PLWH on ART. Both comparisons controlled for the effect of location of residence. People on ART self-reported high adherence and the majority had used HIV counselling services. Our findings show better QOL amongst PLWH on ART compared to a general community sample, which cannot be explained solely by differences in socio-economic status nor location of residence. The general community sample results point towards the challenges of life in this setting. Access to health services may underpin this difference and further research should explore this finding, in addition to identification of psychological mechanisms that relate to better QOL. ART provision infrastructure has clear benefits. Further work

  6. Challenging logics of complex intervention trials: community perspectives of a health care improvement intervention in rural Uganda.

    PubMed

    Okwaro, Ferdinand M; Chandler, Clare I R; Hutchinson, Eleanor; Nabirye, Christine; Taaka, Lilian; Kayendeke, Miriam; Nayiga, Susan; Staedke, Sarah G

    2015-04-01

    Health systems in many African countries are failing to provide populations with access to good quality health care. Morbidity and mortality from curable diseases such as malaria remain high. The PRIME trial in Tororo, rural Uganda, designed and tested an intervention to improve care at health centres, with the aim of reducing ill-health due to malaria in surrounding communities. This paper presents the impact and context of this trial from the perspective of community members in the study area. Fieldwork was carried out for a year from the start of the intervention in June 2011, and involved informal observation and discussions as well as 13 focus group discussions with community members, 10 in-depth interviews with local stakeholders, and 162 context descriptions recorded through quarterly interviews with community members, health workers and district officials. Community members observed a small improvement in quality of care at most, but not all, intervention health centres. However, this was diluted by other shortfalls in health services beyond the scope of the intervention. Patients continued to seek care at health centres they considered inadequate as well as positioning themselves and their children to access care through other sources such as research and nongovernmental organization (NGO) projects. These findings point to challenges of designing and delivering interventions within a paradigm that requires factorial (reduced to predictable factors) problem definition with easily actionable and evaluable solutions by small-scale projects. Such requirements mean that interventions often work on the periphery of a health system rather than tackling the murky political and economic realities that shape access to care but are harder to change or evaluate with randomized controlled trials. Highly projectified settings further reduce the ability to genuinely 'control' for different health care access scenarios. We argue for a raised consciousness of how

  7. Perceptions about medical male circumcision and sexual behaviours of adults in rural Uganda: a cross sectional study

    PubMed Central

    Mukama, Trasias; Ndejjo, Rawlance; Musinguzi, Geofrey; Musoke, David

    2015-01-01

    Introduction Medical male circumcision is currently recognized as an additional important HIV preventive intervention to reduce the risk of heterosexually acquired HIV infection in men. However, sexual behaviours after medical circumcision can potentially reduce the expected benefits of the practice. This study explored the perceptions about medical male circumcision and sexual behaviours of adults in Kayunga district, Uganda. Methods A cross-sectional study was carried out among 393 respondents using a semi structured questionnaire. In addition, four focus group discussions were conducted. Quantitative data was analysed using STATA 12. Univariate, bivariate and multivariate analyses were carried out. Qualitative data was analysed thematically. Results The study established various perceptions about medical male circumcision and sexual behaviours. Majority 247 (64.5%) did not perceive circumcision as a practice that can lead men to have multiple sexual partners. Males were 3 times more likely to think that circumcision would lead to having multiple sexual partners than females (AOR=2.99, CI: 1.93-4.61). Only 89 (23.2%) believed that circumcision would lead to complacency and compromise the use of condoms to prevent against infection with HIV. Respondents who had education above primary were less likely to think that circumcision would compromise the use of condoms (AOR=0.49, CI: 0.31- 0.79). The perception that circumcised youths were less likely to abstain from sexual intercourse was less held among those with education above primary (AOR=0.58, CI: 0.37-0.91) and those older than 30 years (AOR=0.59, CI: 0.38-0.92). Conclusion There were gaps in knowledge and negative perceptions about MMC in the study community. Measures are needed to avert the negative perceptions by equipping communities with sufficient, accurate and consistent information about medical male circumcision and sexual behaviour. PMID:26985272

  8. Does mass drug administration for the integrated treatment of neglected tropical diseases really work? Assessing evidence for the control of schistosomiasis and soil-transmitted helminths in Uganda

    PubMed Central

    2011-01-01

    Background Less is known about mass drug administration [MDA] for neglected tropical diseases [NTDs] than is suggested by those so vigorously promoting expansion of the approach. This paper fills an important gap: it draws upon local level research to examine the roll out of treatment for two NTDs, schistosomiasis and soil-transmitted helminths, in Uganda. Methods Ethnographic research was undertaken over a period of four years between 2005-2009 in north-west and south-east Uganda. In addition to participant observation, survey data recording self-reported take-up of drugs for schistosomiasis, soil-transmitted helminths and, where relevant, lymphatic filariasis and onchocerciasis was collected from a random sample of at least 10% of households at study locations. Data recording the take-up of drugs in Ministry of Health registers for NTDs were analysed in the light of these ethnographic and social survey data. Results The comparative analysis of the take-up of drugs among adults revealed that although most long term residents have been offered treatment at least once since 2004, the actual take up of drugs for schistosomiasis and soil-transmitted helminths varies considerably from one district to another and often also within districts. The specific reasons why MDA succeeds in some locations and falters in others relates to local dynamics. Issues such as population movement across borders, changing food supply, relations between drug distributors and targeted groups, rumours and conspiracy theories about the 'real' purpose of treatment, subjective experiences of side effects from treatment, alternative understandings of affliction, responses to social control measures and historical experiences of public health control measures, can all make a huge difference. The paper highlights the need to adapt MDA to local circumstances. It also points to specific generalisable issues, notably with respect to health education, drug distribution and more effective use of

  9. Spatial epidemiology of hospital-diagnosed brucellosis in Kampala, Uganda

    PubMed Central

    2011-01-01

    Background A retrospective case-control study was undertaken to examine the spatial risk factors for human brucellosis in Kampala, Uganda. Methods Information on age, sex and month of diagnosis was derived from records from plate agglutination tests undertaken at Mulago Hospital, Kampala. Information on Parishes (LC2s) where patients reside was sourced from the outpatient registration book. In-patient fracture cases were selected for use as controls using 1:1 matching based on the age, sex and month of diagnosis. The locations of cases and controls were obtained by calculating Cartesian coordinates of the centroids of Parish level (LC2) polygons and a spatial scan statistic was applied to test for disease clustering. Parishes were classified according to the level of urbanization as urban, peri-urban or rural. Results Significantly more females than males were found to show sero-positivity for brucellosis when compared with the sex ratio of total outpatients, in addition female brucellosis patients were found to be significantly older than the male patients. Spatial clustering of brucellosis cases was observed including around Mulago Hospital (radius = 6.8 km, p = 0.001). The influence of proximity to the hospital that was observed for brucellosis cases was not significantly different from that observed in the controls. The disease cluster was confounded by the different catchment areas between cases and controls. The level of urbanization was not associated with the incidence of brucellosis but living in a slum area was a significant risk factor among urban dwellers (odds ratio 1.97, 95% CI: 1.10-3.61). Conclusions Being female was observed to be a risk factor for brucellosis sero-positvity and among urban dwellers, living in slum areas was also a risk factor although the overall risk was not different among urban, peri-urban and rural areas of the Kampala economic zone. PMID:21962176

  10. The stable isotope ecology of Pan in Uganda and beyond.

    PubMed

    Loudon, James E; Sandberg, Paul A; Wrangham, Richard W; Fahey, Babette; Sponheimer, Matt

    2016-10-01

    Stable isotope analysis has long been used to study the dietary ecology of living and fossil primates, and there has been increasing interest in using stable isotopes to study primate habitat use and anthropogenic impacts on non-human primates. Here, we examine the stable carbon and nitrogen isotope compositions of chimpanzees (Pan troglodytes) from seven communities in Uganda across a continuum of habitat structure (closed to more open) and access to anthropogenic resources (no reliance to heavy reliance). In general, the hair δ(13) C, but not δ(15) N, values of these communities vary depending on forest structure and degree of anthropogenic influence. When integrated with previously published hair δ(13) C and δ(15) N values for Pan, it is apparent that modern "savanna" and "forest" Pan form discrete clusters in carbon and nitrogen isotope space, although there are exceptions probably relating to microhabitat specialization. The combined dataset also reveals that Pan δ(13) C values (but not δ(15) N values) are inversely related to rainfall (r(2)  = 0.62). We converted Pan hair δ(13) C values to enamel equivalents and made comparisons to the fossil hominoids Sivapithecus sp., Gigantopithecus blacki, Ardipithecus ramidus, and Australopithecus anamensis. The δ(13) C values of the fossil hominins Ar. ramidus and Au. anamensis do not cluster with the δ(13) C values of modern Pan in "forest" habitats, or with fossil hominoids that are believed to have inhabited forests. Am. J. Primatol. 78:1070-1085, 2016. © 2016 Wiley Periodicals, Inc.

  11. The stable isotope ecology of Pan in Uganda and beyond.

    PubMed

    Loudon, James E; Sandberg, Paul A; Wrangham, Richard W; Fahey, Babette; Sponheimer, Matt

    2016-10-01

    Stable isotope analysis has long been used to study the dietary ecology of living and fossil primates, and there has been increasing interest in using stable isotopes to study primate habitat use and anthropogenic impacts on non-human primates. Here, we examine the stable carbon and nitrogen isotope compositions of chimpanzees (Pan troglodytes) from seven communities in Uganda across a continuum of habitat structure (closed to more open) and access to anthropogenic resources (no reliance to heavy reliance). In general, the hair δ(13) C, but not δ(15) N, values of these communities vary depending on forest structure and degree of anthropogenic influence. When integrated with previously published hair δ(13) C and δ(15) N values for Pan, it is apparent that modern "savanna" and "forest" Pan form discrete clusters in carbon and nitrogen isotope space, although there are exceptions probably relating to microhabitat specialization. The combined dataset also reveals that Pan δ(13) C values (but not δ(15) N values) are inversely related to rainfall (r(2)  = 0.62). We converted Pan hair δ(13) C values to enamel equivalents and made comparisons to the fossil hominoids Sivapithecus sp., Gigantopithecus blacki, Ardipithecus ramidus, and Australopithecus anamensis. The δ(13) C values of the fossil hominins Ar. ramidus and Au. anamensis do not cluster with the δ(13) C values of modern Pan in "forest" habitats, or with fossil hominoids that are believed to have inhabited forests. Am. J. Primatol. 78:1070-1085, 2016. © 2016 Wiley Periodicals, Inc. PMID:27188271

  12. Treating AIDS: dilemmas of unequal access in Uganda.

    PubMed

    Whyte, S R; Whyte, M A; Meinert, L; Kyaddondo, B

    2004-05-01

    The price of antiretroviral (ARV) medicines in Uganda has fallen dramatically in recent years and more people are under treatment. By mid-2003 it was estimated that 10 000 people were taking ARVs. Drawing on participant observation, qualitative interviews, work with key informants and document reviews, we seek to map out the channels through which ARVs are being made available to people and to describe and assess the social implications of the present system of distribution. Four channels of access to ARV medicines were common in mid-2003: (i) Medicines were provided free in structured research and treatment programmes funded by donors, but only to those who lived in a defined catchment area and met inclusion criteria. (ii) Gazetted treatment centres provided drugs on a fee-for-service basis; these urban-based institutions account for the largest number of drugs dispensed. (iii) Private practitioners, mainly based in Kampala, provided discrete treatment for those who could afford it. (iv) Finally, medicines were 'facilitated' along informal networks, supplying friends and relatives on a less regular basis, sometimes for free, sometimes for cash. However, access to ARVs remains highly uneven. We argue that cheaper drugs make possible different kinds of access, different qualities of care, and a growing awareness of inequity. Because the price of drugs has fallen drastically, middle-class families now have the possibility of buying them. But this requires tough prioritising and many cannot follow the regimen regularly. Health workers must consider whether patients will be able to purchase the drugs or not. In a kind of popular social pharmacy, people assess who can and should and does get access to ARVs. Further research should examine the whole range of ARV access channels in different countries and the associated patterns of social differentiation and exclusions. PMID:17600996

  13. A Description of Congenital Anomalies Among Infants in Entebbe, Uganda

    PubMed Central

    Ndibazza, Juliet; Lule, Swaib; Nampijja, Margaret; Mpairwe, Harriet; Oduru, Gloria; Kiggundu, Molly; Akello, Miriam; Muhangi, Lawrence; Elliott, Alison M

    2011-01-01

    BACKGROUND: Data on congenital anomalies from developing countries of the sub-Saharan region are scarce. However, it is important to have comprehensive and reliable data on the description and prevalence of congenital anomalies to allow surveillance and the implementation of appropriate public health strategies for prevention and management. In this study, we describe the profile of congenital anomalies seen in a birth cohort in Entebbe, Uganda. METHODS: Congenital anomalies were defined as any structural defect present at birth. Pregnant women were recruited to the cohort between 2003 and 2005. Defects present at birth were recorded by the midwife at delivery and by physicians at the routine six-week postnatal visit and at illness-related visits until 1 year of life. The anomalies were classified by organ system according to the 10th version of the World Health Organization International Classification of Diseases (ICD-10). RESULTS: There were 180 infants with a congenital anomaly among 2365 births. The most commonly affected systems were the musculoskeletal (42.7 per 1000 births) and skin (16.1 per 1000 births). The prevalence of major anomalies was 20.3 per 1000 births; 1.7 per 1000 births for cardiac anomalies and 1.3 per 1000 births for neural system anomalies. Forty (22%) of the congenital anomalies were identified at birth, 131 (73%) at the 6-week postnatal visit, and nine (5%) at illness-related visits. CONCLUSION: Congenital anomalies are common in developing countries. Establishment of comprehensive databases for surveillance would be helpful for surveillance of effects of new exposures, for prevention, management, and health care planning. Birth Defects Research (Part A) 2011. © 2011 Wiley-Liss, Inc. PMID:21770020

  14. Influence of Parental Education and Family Income on Children's Education in Rural Uganda

    ERIC Educational Resources Information Center

    Drajea, Alice J.; O'Sullivan, Carmel

    2014-01-01

    This article investigates the effect of parents' literacy levels and family income in Uganda on the quality and nature of parents' involvement in their children's primary education. A mixed-methods study with an ethnographic element was employed to explore the views and opinions of 21 participants through a qualitative approach. Methods for data…

  15. Improving Early-Grade Literacy in East Africa: Experimental Evidence from Kenya and Uganda

    ERIC Educational Resources Information Center

    Lucas, Adrienne M.; McEwan, Patrick J.; Ngware, Moses; Oketch, Moses

    2014-01-01

    Primary school enrollments have increased rapidly in sub-Saharan Africa, spurring concerns about low levels of learning. We analyze field experiments in Kenya and Uganda that assessed whether the Reading to Learn intervention, implemented by the Aga Khan Foundation in both countries, improved early-grade literacy as measured by common assessments.…

  16. Religious Views on Suicide among the Baganda, Uganda: A Qualitative Study

    ERIC Educational Resources Information Center

    Mugisha, James; Hjelmeland, Heidi; Kinyanda, Eugene; Knizek, Birthe Loa

    2013-01-01

    Relatively little research has been conducted on religion and suicide in Africa, yet religion has a lot of influence on people's way of life in Africa. To study religious views on suicide among the Baganda, Uganda, we used grounded theory and discourse analysis on a total of 28 focus groups and 30 key informant interviews. Suicide is largely seen…

  17. The Challenges of Implementing Distance Education in Uganda: A Case Study

    ERIC Educational Resources Information Center

    Basaza, Gudula Naiga; Milman, Natalie B.; Wright, Clayton R.

    2010-01-01

    This brief case study provides a pithy introduction to Uganda and outlines key factors that affect the implementation of distance education in the nation: poor infrastructure, the high cost of an education, an outdated curriculum, inadequate expertise in distance education, and poor attitudes towards distance learning. These factors are also…

  18. Girls' Secondary Education in Uganda: Assessing Policy within the Women's Empowerment Framework

    ERIC Educational Resources Information Center

    Jones, Shelley Kathleen

    2011-01-01

    This paper makes the case that policies, such as the National Strategy for Girls' Education in Uganda (NSGE), intended to achieve gender equity in education for girls in developing countries, have limited relevance to, and impact on girls' actual educational experiences. Recent considerations of girls' education acknowledge that gender equity…

  19. Teachers' Protest Movements and Prospects for Teachers Improved Welfare in Uganda

    ERIC Educational Resources Information Center

    Namara, Rose B.; Kasaija, Josephine

    2016-01-01

    Since the early 40s to today, teachers in Uganda organized themselves into unions and demanded for better conditions of service. Despite the long history of different forms of teachers' protests, the contribution of these protests towards influencing the teacher's welfare in the country is not sufficiently analyzed in the academic and policy…

  20. Increasing Access to Health Education in Eastern Uganda: Rethinking the Role and Preparation of Volunteers

    ERIC Educational Resources Information Center

    Siu, Godfrey E.; Whyte, Susan R.

    2009-01-01

    Objective: In many parts of Uganda, the demand for health education is greater than the conventional health sector can provide and community health education volunteers fill the gap. Using two case study non government organizations (NGOs) that heavily rely on volunteers as health educators, this article shows the problems of unsystematic…

  1. Empowerment, partner’s behaviours and intimate partner physical violence among married women in Uganda

    PubMed Central

    2013-01-01

    Background There is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda. Methods The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV. Results The prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV. Conclusion In the Ugandan context, women’s empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners’ negative behaviours and history of witnessing parental violence. PMID:24289495

  2. Meeting Emergent Needs in Uganda: A Path to Accelerated Development of Community and Work Colleges

    ERIC Educational Resources Information Center

    Cutright, Marc

    2014-01-01

    National development conditions and goals in Uganda, as in many nations, are such that the robust establishment of community colleges could provide many solutions. Yet the creation of such has been inhibited by a number of factors including the historic roots of higher education in former colonial contexts and a lack of Ugandan familiarity with…

  3. Knowledge of Millennium Development Goals among University Faculty in Uganda and Kenya

    ERIC Educational Resources Information Center

    Wamala, Robert; Nabachwa, Mary Sonko; Chamberlain, Jean; Nakalembe, Eva

    2012-01-01

    This article examines the level of knowledge of the Millennium Development Goals (MDGs) among university faculty. The assessment is based on data from 197 academic unit or faculty heads randomly selected from universities in Uganda and Kenya. Frequency distributions and logistic regression were used for analysis. Slightly more than one in three…

  4. Does Cost of Schooling Affect Enrollment by the Poor? Universal Primary Education in Uganda.

    ERIC Educational Resources Information Center

    Deininger, Klaus

    2003-01-01

    Evaluates the impact of Uganda's program of "Universal Primary Education," which, starting from 1997, dispensed with fees for primary enrollment. Finds, for example, that while the program was associated with a dramatic increase in primary school attendance and that inequalities in attendance related to gender, income, and region were…

  5. Situation Reports--Brasil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in six foreign countries are presented in these situation reports. Countries included are Brazil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda. Information is provided, where appropriate and available, under two topics, general background and family planning situation. General background…

  6. A Review of Community Extension Approaches to Innovation for Improved Livelihoods in Ghana, Uganda and Malawi

    ERIC Educational Resources Information Center

    Wellard, Kate; Rafanomezana, Jenny; Nyirenda, Mahara; Okotel, Misaki; Subbey, Vincent

    2013-01-01

    Purpose: Farmer-to-farmer extension offers a potentially low-cost and wide-reach alternative in supporting agricultural innovation. Various approaches are being promoted but information on their impact and sustainability is sparse. This study examines experiences of Self Help Africa and partners in Ghana, Uganda and Malawi. It asks: What is good…

  7. Tone and Syntax in Rutooro, a Toneless Bantu Language of Western Uganda

    ERIC Educational Resources Information Center

    Kaji, Shigeki

    2009-01-01

    This paper explores the interaction of tone and syntax in Rutooro, a Bantu language of Western Uganda. Rutooro has lost its lexical tone but retains a phrasally defined high pitch that appears on the penultimate syllable--the default position in Bantu. This high pitch can work grammatically and in fact distinguishes between the noun phrase vs.…

  8. Impacts of the Universal Primary Education Policy on Educational Attainment and Private Costs in Rural Uganda

    ERIC Educational Resources Information Center

    Nishimura, Mikiko; Yamano, Takashi; Sasaoka, Yuichi

    2008-01-01

    While some governments in Sub-Saharan Africa have abolished tuition to achieve universal primary education (UPE), few studies have examined the impacts of the UPE policy beyond school enrolment. This study estimates the impact of the UPE policy in Uganda on overall primary education attainments by using data including 940 rural households. We find…

  9. Characterization and distribution of a Potyvirus associated with passion fruit woodiness disease in Uganda

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper describes the incidence and etiology of viral infection on passion fruit in Uganda. Viral disease symptoms, including those characteristic of Passion fruit woodiness disease (PWD), were observed in producing areas with an overall mean infection level of 27%. Electron microscopic observati...

  10. Strengthening Universal Primary Education in Uganda: The Potential Role of an Asset-Based Development Policy

    ERIC Educational Resources Information Center

    Ssewamala, Fred M.; Wang, Julia Shu-Huah; Karimli, Leyla; Nabunya, Proscovia

    2011-01-01

    This paper is divided into three complementary parts. First, we examine the challenges to the Universal Primary Education (UPE) policy in Uganda, including insufficient instructional materials and family-level poverty. Second, guided by asset theory, and based on a systematic review of studies on asset-based development programs and interventions,…

  11. Teacher Supervision Practices and Characteristics of In-School Supervisors in Uganda

    ERIC Educational Resources Information Center

    Kalule, Lawrence; Bouchamma, Yamina

    2014-01-01

    We examined teacher supervision practices (supervision models, phases, and professional development guidelines) of in-school supervisors (principals, vice principals, and study program directors) in Uganda, the supervisors' efficacy perceptions regarding teacher supervision, and supervisor characteristics associated with the choice of…

  12. Post-Primary Education and Capabilities: Insights from Young Women in Rural Uganda

    ERIC Educational Resources Information Center

    Jones, Shelley K.

    2015-01-01

    This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that…

  13. Teaching Reading and Writing in Local Language Using the Child-Centred Pedagogy in Uganda

    ERIC Educational Resources Information Center

    Akello, Dora Lucy; Timmerman, Greetje; Namusisi, Speranza

    2016-01-01

    Uganda introduced the use of mother tongue as medium of instruction in primary schools in 2007. This was meant to promote interaction and participation in the learning process and improve children's proficiency in reading and writing. Drawing elements of interaction and participation from the socio-cultural theory, the child-centred pedagogy was…

  14. Implementing the Early Childhood Development Teacher Training Framework in Uganda: Gains and Challenges

    ERIC Educational Resources Information Center

    Ejuu, Godfrey

    2012-01-01

    Training of quality early childhood development (ECD) teachers is paramount in ensuring quality ECD service provision. This exploratory study focuses on the gains and challenges met in the implementation of the Uganda ECD teacher training framework. Data were obtained using questionnaires and interviews from principals and tutors of ECD teacher…

  15. Locally Generated Printed Materials in Agriculture: Experience from Uganda and Ghana. Education Research Paper. Report.

    ERIC Educational Resources Information Center

    Carter, Isabel

    The needs of grassroots farmers in Uganda and Ghana for locally developed print materials were examined through a postal survey of nearly 200 organizations and examinations of 75 autonomous farmer groups and 95 organizations sharing agricultural information in both countries. Both printed agricultural information relevant to grassroots farmers and…

  16. Remuneration discrepancies in the landlocked economies of Malaŵi and Uganda.

    PubMed

    Munthali, Alister; Matagi, Leon; Tumwebaze, Callist

    2010-10-01

    Although the original study of remuneration differences between local and expatriate development workers took place in the landlocked economy of Malaŵi, the study has never been replicated outside of one sector and organization (the National University), and took place prior to the 2000 Millennium Development Goals. Participating in the present studies were 458 aid and development professionals, working across a range of sectors in Malaŵi (n = 241, response rate = 50%) and Uganda (n = 217, response rate = 51%). The size of the gap between local and international workers, measured using the World Bank's purchasing power parity, was higher in Malaŵi (4.04:1) than in Uganda (1.97:1). The ratio was more clearly within tolerance levels in Uganda than in Malaŵi. Consistent with these differences, and controlling for organization, cultural, and demographic factors, locally remunerated workers reported more and expatriate workers less injustice and demotivation in Malaŵi than in Uganda. Although sample sizes for the internationally remunerated are small, the findings suggest that wider disparities may (1) hinder perspective-taking and (2) decrease motivation. In-country workshops with stakeholders and subject-matter experts considered the findings, and potential solutions offered through the survey form. They recommended the implementation of performance-based remuneration, including competency-based job analysis and evaluation. Competencies in such functions can be provided by humanitarian work psychology.

  17. Male Youth and Voluntary Counseling and HIV-Testing: The Case of Malawi and Uganda

    ERIC Educational Resources Information Center

    Izugbara, Chimaraoke O.; Undie, Chi-Chi; Mudege, Netsayi N.; Ezeh, Alex C.

    2009-01-01

    There is limited research addressing the beliefs of adolescents related to Voluntary Counseling and HIV-Testing (VCT). This paper analyzes qualitative data on such beliefs elicited from male youth in Uganda and Malawi. Although study participants understood the mainstream public health rhetoric on VCT, much of their narratives framed going for HIV…

  18. Curriculum Change in Uganda: Teacher Perspectives on the New Thematic Curriculum

    ERIC Educational Resources Information Center

    Altinyelken, Hulya Kosar

    2010-01-01

    Based on a fieldwork study, this article seeks to investigate the implementation of "thematic curriculum" in Uganda from the perspectives of teachers. The article shows that although the majority of teachers are enthusiastic about the new curriculum, their implementation efforts are constrained by a multitude of challenges. The findings raise…

  19. Remuneration discrepancies in the landlocked economies of Malaŵi and Uganda.

    PubMed

    Munthali, Alister; Matagi, Leon; Tumwebaze, Callist

    2010-10-01

    Although the original study of remuneration differences between local and expatriate development workers took place in the landlocked economy of Malaŵi, the study has never been replicated outside of one sector and organization (the National University), and took place prior to the 2000 Millennium Development Goals. Participating in the present studies were 458 aid and development professionals, working across a range of sectors in Malaŵi (n = 241, response rate = 50%) and Uganda (n = 217, response rate = 51%). The size of the gap between local and international workers, measured using the World Bank's purchasing power parity, was higher in Malaŵi (4.04:1) than in Uganda (1.97:1). The ratio was more clearly within tolerance levels in Uganda than in Malaŵi. Consistent with these differences, and controlling for organization, cultural, and demographic factors, locally remunerated workers reported more and expatriate workers less injustice and demotivation in Malaŵi than in Uganda. Although sample sizes for the internationally remunerated are small, the findings suggest that wider disparities may (1) hinder perspective-taking and (2) decrease motivation. In-country workshops with stakeholders and subject-matter experts considered the findings, and potential solutions offered through the survey form. They recommended the implementation of performance-based remuneration, including competency-based job analysis and evaluation. Competencies in such functions can be provided by humanitarian work psychology. PMID:22044055

  20. Expanding Access and Quality in Uganda: The Challenges of Building a Plane while Flying It

    ERIC Educational Resources Information Center

    Cutright, Marc

    2010-01-01

    Uganda is among many nations in sub-Saharan Africa that are trying simultaneously to expand higher education opportunities and to enhance the quality of higher-education offerings. These are particularly challenging goals in resource-rich environments and are even more difficulty in environments of more limited resources to include funding,…

  1. Does the Oganizational Structure Affect the Management of Universities in Uganda? An Empirical Analysis

    ERIC Educational Resources Information Center

    Zziwa, Gertrude

    2014-01-01

    The organisational structure of universities follows particular models that distinguish them from other learning institutions. This research investigated the effect of the organisational structure on the management of universities in Uganda using a sample of 361, 44% of whom were members of academic staff, and the rest contained university top…

  2. Laptops and Diesel Generators: Introducing PhET Simulations to Teachers in Uganda

    ERIC Educational Resources Information Center

    McKagan, Sam

    2010-01-01

    This article describes workshops for high school physics teachers in Uganda on inquiry-based teaching and PhET simulations. I hope it increases awareness of the conditions teachers face in developing countries and inspires others to give similar workshops. This work demonstrates what is possible with some concerted, but not extraordinary, effort.

  3. Validity and Reliability of the 3-E Tool for Evaluating the Curriculum Support Intervention in Uganda

    ERIC Educational Resources Information Center

    Mutto, Milton; Mukasa, Immaculate; Avasi, Victor; Kilibo, Charles; Kamwesigye, Charles; Duku, Tom

    2015-01-01

    This study determined psychometric properties of 3-ET, an instrument specifically designed to track the effects of a curriculum support intervention created to enhance the delivery of the national curriculum in a war zone in Uganda. The instrument was developed through brain storm and expert review before being committed to structural and…

  4. Comparative genomics of archived pyrazinamide resistant Mycobacterium tuberculosis complex isolates from Uganda

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bovine tuberculosis is a ‘neglected zoonosis’ and its contribution to the proportion of Mycobacterium tuberculosis complex infections in humans is unknown. A retrospective study on archived Mycobacterium tuberculosis complex (MTC) isolates from a reference laboratory in Uganda was undertaken to iden...

  5. A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda

    ERIC Educational Resources Information Center

    Falk, Diane S.; Pettet, Kristen; Mpagi, Charles

    2016-01-01

    In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…

  6. Understanding Vulnerability: From Categories to Experiences of Young Congolese People in Uganda

    ERIC Educational Resources Information Center

    Clark, Christina R.

    2007-01-01

    This article problematises the "vulnerables" category that the United Nations High Commissioner for Refugees applies to groups of refugees. Drawing on 9 months' qualitative research with young Congolese refugees in Uganda, it presents research subjects' self-identification and lived realities that do not correspond to the homogenous, fixed…

  7. Affirmative Action, Gender Equity and University Admissions--Kenya, Uganda and Tanzania

    ERIC Educational Resources Information Center

    Onsongo, Jane

    2009-01-01

    The article examines the outcomes of affirmative action policies aimed at improving access for women students to university education in Kenya, Uganda and Tanzania. Different interpretations of affirmative action are found in the three countries. These include lower entry scores, remedial pre-university programmes and financial assistance. There…

  8. Non-Formal Vocational Education in Uganda: Practical Empowerment through a Workable Alternative

    ERIC Educational Resources Information Center

    Blaak, Marit; Openjuru, George L.; Zeelen, Jacques

    2013-01-01

    This article reflects on the potential of non-formal vocational education in Uganda to improve the quality of life of those excluded from formal education. Based on an exploration of humanizing development theorists Sen, Freire and Nyerere, together with two case studies, practical empowerment is described as a desirable outcome of education for…

  9. Acceptability and Trust of Community Health Workers Offering Maternal and Newborn Health Education in Rural Uganda

    ERIC Educational Resources Information Center

    Singh, Debra; Cumming, Robert; Negin, Joel

    2015-01-01

    When trusted, Community Health Workers (CHWs) can contribute to improving maternal and newborn health outcomes in low- and middle-income countries through education. Issues of acceptability of CHWs by communities were explored through experiences gained in a qualitative study that is part of a cluster randomized trial in East Uganda. Initially,…

  10. Adaptation of the "Ten Questions" to Screen for Autism and other Neurodevelopmental Disorders in Uganda

    ERIC Educational Resources Information Center

    Kakooza-Mwesige, Angelina; Ssebyala, Keron; Karamagi, Charles; Kiguli, Sarah; Smith, Karen; Anderson, Meredith C.; Croen, Lisa A.; Trevathan, Edwin; Hansen, Robin; Smith, Daniel; Grether, Judith K.

    2014-01-01

    Neurodevelopmental disorders are recognized to be relatively common in developing countries but little data exist for planning effective prevention and intervention strategies. In particular, data on autism spectrum disorders are lacking. For application in Uganda, we developed a 23-question screener (23Q) that includes the Ten Questions screener…

  11. Slow Clearance of Plasmodium falciparum in Severe Pediatric Malaria, Uganda, 2011-2013.

    PubMed

    Hawkes, Michael; Conroy, Andrea L; Opoka, Robert O; Namasopo, Sophie; Zhong, Kathleen; Liles, W Conrad; John, Chandy C; Kain, Kevin C

    2015-07-01

    Plasmodium falciparum resistance to artemisinin derivatives is emerging in Asia. We examined molecular markers of resistance in 78 children in Uganda who had severe malaria and were treated with intravenous artesunate. We observed in the K13-propeller domain, A578S, a low-frequency (3/78), nonsynonymous, single-nucleotide polymorphism associated with prolonged parasite clearance.

  12. A Global Investigation of Child Labor: Case Studies from India, Uganda, and the United States.

    ERIC Educational Resources Information Center

    Lai, Selena

    This curriculum guide was developed to help students gain a broader perspective about child labor and become more familiar with the issues, controversies, and debates that surround it. Three case studies are highlighted: (1) a street child in India; (2) child soldiers in Uganda; and (3) a migrant farm worker child in the United States. Each case…

  13. Multiple Knowledges for Agricultural Production: Implications for the Development of Conservation Agriculture in Kenya and Uganda

    ERIC Educational Resources Information Center

    Moore, Keith M.; Lamb, Jennifer N.; Sikuku, Dominic Ngosia; Ashilenje, Dennis S.; Laker-Ojok, Rita; Norton, Jay

    2014-01-01

    Purpose: This article investigates the extent of multiple knowledges among smallholders and connected non-farm agents around Mount Elgon in Kenya and Uganda in order to build the communicative competence needed to scale up conservation agriculture production systems (CAPS). Design/methodology/approach: Our methodological approach examines local…

  14. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda1

    PubMed Central

    Roh, Michelle E.; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N.; Mwanga-Amumpaire, Juliet; Boum, Yap

    2016-01-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections. PMID:27434741

  15. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda(1).

    PubMed

    Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N; Mwanga-Amumpaire, Juliet; Parikh, Sunil; Boum, Yap

    2016-08-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non-P. falciparum malarial infections. PMID:27434741

  16. Slow Clearance of Plasmodium falciparum in Severe Pediatric Malaria, Uganda, 2011-2013.

    PubMed

    Hawkes, Michael; Conroy, Andrea L; Opoka, Robert O; Namasopo, Sophie; Zhong, Kathleen; Liles, W Conrad; John, Chandy C; Kain, Kevin C

    2015-07-01

    Plasmodium falciparum resistance to artemisinin derivatives is emerging in Asia. We examined molecular markers of resistance in 78 children in Uganda who had severe malaria and were treated with intravenous artesunate. We observed in the K13-propeller domain, A578S, a low-frequency (3/78), nonsynonymous, single-nucleotide polymorphism associated with prolonged parasite clearance. PMID:26079933

  17. Slow Clearance of Plasmodium falciparum in Severe Pediatric Malaria, Uganda, 2011–2013

    PubMed Central

    Hawkes, Michael; Conroy, Andrea L.; Opoka, Robert O.; Namasopo, Sophie; Zhong, Kathleen; Liles, W. Conrad; John, Chandy C.

    2015-01-01

    Plasmodium falciparum resistance to artemisinin derivatives is emerging in Asia. We examined molecular markers of resistance in 78 children in Uganda who had severe malaria and were treated with intravenous artesunate. We observed in the K13-propeller domain, A578S, a low-frequency (3/78), nonsynonymous, single-nucleotide polymorphism associated with prolonged parasite clearance. PMID:26079933

  18. International trends in health science librarianship part 14: East Africa (Kenya, Uganda, Rwanda).

    PubMed

    Gathoni, Nasra; Kamau, Nancy; Nannozi, Judith; Singirankabo, Marcel

    2015-06-01

    This is the 14th in a series of articles exploring international trends in health science librarianship in the 21st century. This is the second of four articles pertaining to different regions in the African continent. The present issue focuses on countries in East Africa (Kenya, Uganda and Rwanda). The next feature column will investigate trends in West Africa. JM.

  19. Psychological Capital, Career Identity and Graduate Employability in Uganda: The Mediating Role of Social Capital

    ERIC Educational Resources Information Center

    Ngoma, Muhammad; Dithan Ntale, Peter

    2016-01-01

    This paper seeks to evaluate the relationship between psychological capital, career identity, social capital and graduate employability. We also seek to evaluate the mediating role of social capital on the relationships between psychological capital, career identity and graduate employability in Uganda. A population of 480 unemployed young people…

  20. Scholarly Productivity in Developing Countries: An Analysis of Levels and Patterns among Doctoral Holders in Uganda

    ERIC Educational Resources Information Center

    Wamala, Robert; Ssembatya, Vincent A.

    2013-01-01

    Doctoral holders are considered to be key actors in the creation of innovation and knowledge. However, this generalization may not hold true for doctoral holders in all countries. This study sought to assess the scholarly productivity of these highly qualified individuals in Uganda. The investigation is based on data sourced from the 2012 Careers…

  1. Establishing Junior-Level Colleges in Developing Nations: A Site Selection Process Using Data from Uganda

    ERIC Educational Resources Information Center

    Iaeger, Paula Irene

    2012-01-01

    This research synthesizes data and presents it using mapping software to help to identify potential site locations for community-centered higher education alternatives and more traditional junior-level colleges in Uganda. What factors can be used to quantify one site over another for the location of such an institution and if these factors can be…

  2. Community Knowledge, Beliefs, Attitudes, and Practices towards Children with Spina Bifida and Hydrocephalus in Uganda

    ERIC Educational Resources Information Center

    Bannink, Femke; Stroeken, Koenraad; Idro, Richard; van Hove, Geert

    2015-01-01

    This article describes the findings of a qualitative study on knowledge, beliefs, attitudes, and practices towards children with spina bifida and hydrocephalus in four regions of Uganda. Focus group discussions and semi-structured interviews were held with parents of children with spina bifida and hydrocephalus, policy-makers, and service…

  3. CORRESPONDENCE INSTRUCTION IN ETHIOPIA, KENYA, TANZANIA, MALAWI, ZAMBIA, AND UGANDA--EXPERIENCES, NEEDS, AND INTEREST.

    ERIC Educational Resources Information Center

    EDSTROEM, LARS-OLOF

    THIS REPORT ON THE SALIENT FEATURES AND CONCERNS OF CORRESPONDENCE INSTRUCTION IN ETHIOPIA, KENYA, TANZANIA, MALAWI, ZAMBIA, AND UGANDA--(1) DISCUSSES ADVANTAGES, DISADVANTAGES, AND REQUIREMENTS OF THE CORRESPONDENCE METHOD IN AN AFRICAN CONTEXT, (2) SURVEYS CONDITIONS AND FACILITIES (POSTAL SERVICES, ROADS, INSTRUCTIONAL RADIO AND TELEVISION,…

  4. Structural Dynamics of Education Reforms and Quality of Primary Education in Uganda

    ERIC Educational Resources Information Center

    Nyenje, Aida

    2016-01-01

    This paper examines Uganda's recent undertaking to reform her Primary School education System with a focus on the effect of structural dynamics of education reforms and the quality of primary education. Structural dynamics in the context of this study is in reference to the organizational composition of the education system at the government,…

  5. The Valorisation of African Languages and Policies in the African Education Systems: A Case of Uganda

    ERIC Educational Resources Information Center

    Muzoora, Michael; Terry, Daniel R.; Asiimwe, Agatha A.

    2014-01-01

    This paper highlights the challenges of current language policies in education in Africa, with reference to Uganda. Also examined are the likely challenges to language policy in education, while indicating how these challenges can be curtailed or overcome. The authors suggest a different view is required when approaching this topic with a paradigm…

  6. Competence Challenges of Demand-Led Agricultural Research and Extension in Uganda

    ERIC Educational Resources Information Center

    Kibwika, P.; Wals, A. E. J.; Nassuna-Musoke, M. G.

    2009-01-01

    Governments and development agencies in Sub-Saharan Africa are experimenting alternative approaches within the innovation systems paradigm to enhance relevance of agricultural research and extension to the poverty eradication agenda. Uganda, for example, has recently shifted from the supply driven to demand-led agricultural research and extension.…

  7. Suburban District Leaders' Perception of Their Practices

    ERIC Educational Resources Information Center

    Garcia France, Roxanne

    2013-01-01

    In the field of district leadership, most studies focus only on the context and conditions existing in large urban districts in need of reform. This study examined whether district leadership practices have applicability to district leaders working within the suburban context. In addition, it determined whether district conditions (i.e., district…

  8. Analysis of County School Districts in Arkansas.

    ERIC Educational Resources Information Center

    Budd, Karol B.; Charlton, J.L.

    The 1948, Arkansas School District Reorganization Act was passed in an effort to reduce the 1589 small school districts to a smaller number. Those districts not consolidated would form county districts. As of the 1967-68 school year, 26 of these county districts remained. The purpose of this study was to provide information drawing attention to…

  9. Caregivers’ Attitudes towards HIV Testing and Disclosure of HIV Status to At-Risk Children in Rural Uganda

    PubMed Central

    Lorenz, Rick; Grant, Eisha; Muyindike, Winnie; Maling, Samuel; Card, Claire; Henry, Carol; Nazarali, Adil J.

    2016-01-01

    Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96%) of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers’ communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver’s perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child’s level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to

  10. Power and process: The politics of electricity sector reform in Uganda

    NASA Astrophysics Data System (ADS)

    Gore, Christopher David

    In 2007, Uganda had one of the lowest levels of access to electricity in the world. Given the influence of multilateral and bilateral agencies in Uganda; the strong international reputation and domestic influence of its President; the country's historic achievements in public sector and economic reform; and the intimate connection between economic performance, social well-being and access to electricity, the problems with Uganda's electricity sector have proven deeply frustrating and, indeed, puzzling. Following increased scholarly attention to the relationship between political change, policymaking, and public sector reform in sub-Saharan Africa and the developing world generally, this thesis examines the multilevel politics of Uganda's electricity sector reform process. This study contends that explanations for Uganda's electricity sector reform problems generally, and hydroelectric dam construction efforts specifically, must move beyond technical and financial factors. Problems in this sector have also been the result of a model of reform (promoted by the World Bank) that failed adequately to account for the character of political change. Indeed, the model of reform that was promoted and implemented was risky and it was deeply antagonistic to domestic and international civil society organizations. In addition, it was presented as a linear, technical, apolitical exercise. Finally the model was inconsistent with key principles the Bank itself, and public policy literature generally, suggest are needed for success. Based on this analysis, the thesis contends that policymaking and reform must be understood as deeply political processes, which not only define access to services, but also participation in, and exclusion from, national debates. Future approaches to reform and policymaking must anticipate the complex, multilevel, non-linear character of 'second-generation' policy issues like electricity, and the political and institutional capacity needed to increase

  11. Distribution of haematological and chemical pathology values among infants in Malawi and Uganda

    PubMed Central

    Kumwenda, Newton I.; Khonje, Tiwonge; Mipando, Linda; Nkanaunena, Kondwani; Katundu, Pauline; Lubega, Irene; Elbireer, Ali; Bolton, Steve; Bagenda, Danstan; Mubiru, Michael; Fowler, Mary Glenn; Taha, Taha E.

    2013-01-01

    Background Data on paediatric reference laboratory values are limited for sub-Saharan Africa. Objective To describe the distribution of haematological and chemical pathology values among healthy infants from Malawi and Uganda. Methods A cross-sectional study was conducted among healthy infants, 0–6 months old, born to HIV-uninfected mothers recruited from two settings in Blantyre, Malawi and Kampala, Uganda. Chemical pathology and haematology parameters were determined using standard methods on blood samples. Descriptive analyses by age-group were performed based on 2004 Division of AIDS Toxicity Table age categories. Mean values and interquartile ranges were compared by site and age-group. Results A total of 541 infants were included altogether, 294 from Malawi and 247 from Uganda. Overall, the mean laboratory values were comparable between the two sites. Mean alkaline phosphatase levels were lower among infants aged ≤21 days while aspartate aminotransferase, creatinine, total bilirubin and gamma-glutamyl transferase were higher in those aged 0–7 days than in older infants. Mean haematocrit, haemoglobin and neutrophil counts were higher in the younger age-groups (<35 days) and overall were lower than US norms. Red and white blood cell counts tended to decrease after birth but increased after ~2 months of age. Mean basophil counts were higher in Malawi than in Uganda in infants aged 0–1 and 2–7 days; mean counts for eosinophils (for age groups 8–21 or older) and platelets (for all age groups) were higher in Ugandan than in Malawian infants. Absolute lymphocyte counts increased with infant age. Conclusion The chemical pathology and haematological values in healthy infants born to HIV-uninfected mothers were comparable in Malawi and Uganda and can serve as useful reference values in these settings. PMID:23164296

  12. The Uganda Gravimetric Geoid Model 2014 Computed by The KTH Method

    NASA Astrophysics Data System (ADS)

    Sjöberg, L. E.; Gidudu, A.; Ssengendo, R.

    2015-05-01

    For many developing countries such as Uganda, precise gravimetric geoid determination is hindered by the low quantity and quality of the terrestrial gravity data. With only one gravity data point per 65 km2, gravimetric geoid determination in Uganda appears an impossible task. However, recent advances in geoid modelling techniques coupled with the gravity-field anomalies from the Gravity Field and Steady-State Ocean Circulation Explorer (GOCE) satellite mission have opened new avenues for geoid determination especially for areas with sparse terrestrial gravity. The present study therefore investigates the computation of a gravimetric geoid model overUganda (UGG2014) using the Least Squares Modification of Stokes formula with additive corrections. UGG2014 was derived from sparse terrestrial gravity data from the International Gravimetric Bureau, the 3 arc second SRTM ver4.1 Digital Elevation Model from CGIAR-CSI and the GOCE-only global geopotential model GO_CONS_GCF_2_TIM_R5. To compensate for the missing gravity data in the target area, we used the surface gravity anomalies extracted from the World Gravity Map 2012. Using 10 Global Navigation Satellite System (GNSS)/levelling data points distributed over Uganda, the RMS fit of the gravimetric geoid model before and after a 4-parameter fit is 11 cm and 7 cm respectively. These results show that UGG2014 agrees considerably better with GNSS/levelling than any other recent regional/ global gravimetric geoid model. The results also emphasize the significant contribution of the GOCE satellite mission to the gravity field recovery, especially for areas with very limited terrestrial gravity data.With an RMS of 7 cm, UGG2014 is a significant step forward in the modelling of a "1-cm geoid" over Uganda despite the poor quality and quantity of the terrestrial gravity data used for its computation.

  13. Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

    PubMed Central

    Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

    2013-01-01

    Abstract Objective To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Methods Data were collected from a sample of facilities that participated in five demonstration projects for HPV vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. Findings The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). Conclusion The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services. PMID:23940406

  14. Analysis of the history and spread of HIV-1 in Uganda using phylodynamics

    PubMed Central

    Yebra, Gonzalo; Ragonnet-Cronin, Manon; Ssemwanga, Deogratius; Parry, Chris M.; Logue, Christopher H.; Cane, Patricia A.; Kaleebu, Pontiano

    2015-01-01

    HIV prevalence has decreased in Uganda since the 1990s, but remains substantial within high-risk groups. Here, we reconstruct the history and spread of HIV subtypes A1 and D in Uganda and explore the transmission dynamics in high-risk populations. We analysed HIV pol sequences from female sex workers in Kampala (n = 42), Lake Victoria fisher-folk (n = 46) and a rural clinical cohort (n = 74), together with publicly available sequences from adjacent regions in Uganda (n = 412) and newly generated sequences from samples taken in Kampala in 1986 (n = 12). Of the sequences from the three Ugandan populations, 60 (37.1 %) were classified as subtype D, 54 (33.3 %) as subtype A1, 31 (19.1 %) as A1/D recombinants, six (3.7 %) as subtype C, one (0.6 %) as subtype G and 10 (6.2 %) as other recombinants. Among the A1/D recombinants we identified a new candidate circulating recombinant form. Phylodynamic and phylogeographic analyses using BEAST indicated that the Ugandan epidemics originated in 1960 (1950–1968) for subtype A1 and 1973 (1970–1977) for D, in rural south-western Uganda with subsequent spread to Kampala. They also showed extensive interconnection with adjacent countries. The sequence analysis shows both epidemics grew exponentially during the 1970s–1980s and decreased from 1992, which agrees with HIV prevalence reports in Uganda. Inclusion of sequences from the 1980s indicated the origin of both epidemics was more recent than expected and substantially narrowed the confidence intervals in comparison to previous estimates. We identified three transmission clusters and ten pairs, none of them including patients from different populations, suggesting active transmission within a structured transmission network. PMID:25724670

  15. Tensions in Communication between Children on Antiretroviral Therapy and Their Caregivers: A Qualitative Study in Jinja District, Uganda

    PubMed Central

    Kajubi, Phoebe

    2016-01-01

    Introduction HIV treatment and disclosure guidelines emphasize the importance of communicating diagnosis and treatment to infected children in ways that are appropriate to children’s developmental stage and age. Minimal attention, however, has been given to communication challenges confronted by HIV-infected children and their caregivers. This study examined the tensions between children and their caregivers arising from differing perspectives regarding when and what to communicate about antiretroviral therapy (ART). Methods This qualitative study was conducted between November 2011 and December 2012 and involved 29 HIV-infected children aged 8–17 years on ART and their caregivers. Data were collected through observations and in-depth interviews, which took place in homes, treatment centres and post-test clubs. Children and caregivers were sampled from among the 394 HIV-infected children and (their) 393 caregivers who participated in the cross-sectional survey that preceded the qualitative study. ATLAS.ti. Version 7 was used in the management of the qualitative data and in the coding of the emerging themes. The data were then analyzed using content thematic analysis. Results While the children felt that they were mature enough to know what they were suffering and what the medications were for, the caregivers wanted to delay discussions relating to the children’s HIV diagnosis and medication until they felt that the children were mature enough to deal with the information and keep it a secret and this caused a lot of tension. The children employed different tactics including refusing to take the medicines, to find out what they were suffering from and what the medications were for. Children also had their own ideas about when, where and with whom to discuss their HIV condition, ideas that did not necessarily coincide with those of their caregivers, resulting in tensions. Conclusions Guidelines should take into consideration differing perceptions of maturity when recommending ages at which caregivers should communicate with their children about diagnosis and ART. Health care providers should also encourage caregivers to recognize and respect children’s efforts to learn about and manage their condition. Children’s questions and expressions of feelings should be treated as openings for communication on these issues. PMID:26784904

  16. Participatory Literacy Learning in an African Context: Perspectives from the Ombaderuku Primary School in the Arua District, Uganda

    ERIC Educational Resources Information Center

    Ngaka, Willy; Masaazi, Fred Masagazi

    2015-01-01

    This study documents the experiences of volunteer teacher research assistants in relation to pupils' interaction with parents, texts, and informal literacy practices in the community, and considers how these practices may enhance literacy instruction and production of local reading materials. The research site was located in the context of…

  17. A SINGLE GENOTYPE OF ENCEPHALITOZOON INTESTIINALIS INFECTS FREE-RANGING GORILLAS AND PEOPLE SHARING THEIR HABITATS, UGANDA

    EPA Science Inventory

    For conservation purposes and due to ecotourism free-ranging gorillas of Uganda have been habituated to humans, and molecular epidemiology evidence indicates that this habituation might have enhanced transmission of anthropozoonotic pathogens. Microsporidian spores have been det...

  18. 7 CFR 946.31 - Districts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... included in either the Quincy or South Irrigation Districts which lies east of township vertical line R27E... Irrigation Districts which lies west of township line R28E. (c) District No. 3—The counties of...

  19. The School District Organization Handbook.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This handbook describes procedures for school-district reorganization in California. Following the introductory chapter, chapter 2 offers a historical overview of school-district reorganization in California. Chapters 3 and 4 outline the organization and responsibilities of the county committee and the role and responsibilities of the State Board…

  20. Redesigning the District Operating System

    ERIC Educational Resources Information Center

    Hodas, Steven

    2015-01-01

    In this paper, we look at the inner workings of a school district through the lens of the "district operating system (DOS)," a set of interlocking mutually-reinforcing modules that includes functions like procurement, contracting, data and IT policy, the general counsel's office, human resources, and the systems for employee and family…