Revisiting the Corrosion of the Aluminum Current Collector in Lithium-Ion Batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, Tianyuan; Xu, Gui-Liang; Li, Yan

The corrosion of aluminum current collectors and the oxidation of solvents at a relatively high potential have been widely investigated with an aim to stabilize the electrochemical performance of lithium-ion batteries using such components. The corrosion behavior of aluminum current collectors was revisited using a home-build high-precision electrochemical measurement system, and the impact of electrolyte components and the surface protection layer on aluminum foil was systematically studied. The electrochemical results showed that the corrosion of aluminum foil was triggered by the electrochemical oxidation of solvent molecules, like ethylene carbonate, at a relative high potential. The organic radical cations generated frommore » the electrochemical oxidation are energetically unstable, and readily undergo a deprotonation reaction that generates protons and promote the dissolution of Al3+ from the aluminum foil. This new reaction mechanism can also shed light on the dissolution of transitional metal at high potentials.« less

Revisiting the Corrosion of the Aluminum Current Collector in Lithium-Ion Batteries

DOE PAGES

Ma, Tianyuan; Xu, Gui -Liang; Li, Yan; ...

2017-02-16

The corrosion of aluminum current collectors and the oxidation of solvents at a relatively high potential have been widely investigated with an aim to stabilize the electrochemical performance of lithium-ion batteries using such components. The corrosion behavior of aluminum current collectors was revisited using a home-build high-precision electrochemical measurement system, and the impact of electrolyte components and the surface protection layer on aluminum foil was systematically studied. The electrochemical results showed that the corrosion of aluminum foil was triggered by the electrochemical oxidation of solvent molecules, like ethylene carbonate, at a relative high potential. The organic radical cations generated frommore » the electrochemical oxidation are energetically unstable, and readily undergo a deprotonation reaction that generates protons and promote the dissolution of Al 3+ from the aluminum foil. Finally, this new reaction mechanism can also shed light on the dissolution of transitional metal at high potentials.« less

Revisiting the Corrosion of the Aluminum Current Collector in Lithium-Ion Batteries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, Tianyuan; Xu, Gui -Liang; Li, Yan

The corrosion of aluminum current collectors and the oxidation of solvents at a relatively high potential have been widely investigated with an aim to stabilize the electrochemical performance of lithium-ion batteries using such components. The corrosion behavior of aluminum current collectors was revisited using a home-build high-precision electrochemical measurement system, and the impact of electrolyte components and the surface protection layer on aluminum foil was systematically studied. The electrochemical results showed that the corrosion of aluminum foil was triggered by the electrochemical oxidation of solvent molecules, like ethylene carbonate, at a relative high potential. The organic radical cations generated frommore » the electrochemical oxidation are energetically unstable, and readily undergo a deprotonation reaction that generates protons and promote the dissolution of Al 3+ from the aluminum foil. Finally, this new reaction mechanism can also shed light on the dissolution of transitional metal at high potentials.« less

Revisiting Bioaccumulation Criteria

EPA Science Inventory

The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

A Case Study of Cooperative Learning in Bushenyi District in Uganda: Educational Leaders' and Teachers' Perceptions

ERIC Educational Resources Information Center

Mujuni, John Bosco

2015-01-01

In 2003-2007, the government of Uganda through the Ministry of Education and Sports (MoES), under the umbrella of UPHOLD and in Partnership with USAID, introduced cooperative learning as a "student-centered teaching approach" in some selected districts and schools in Uganda. This dissertation explored the current state and practice of…

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

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.

NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

PubMed

Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

2018-01-01

The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

Uganda rainfall variability and prediction

NASA Astrophysics Data System (ADS)

Jury, Mark R.

2018-05-01

This study analyzes large-scale controls on Uganda's rainfall. Unlike past work, here, a May-October season is used because of the year-round nature of agricultural production, vegetation sensitivity to rainfall, and disease transmission. The Uganda rainfall record exhibits steady oscillations of ˜3 and 6 years over 1950-2013. Correlation maps at two-season lead time resolve the subtropical ridge over global oceans as an important feature. Multi-variate environmental predictors include Dec-May south Indian Ocean sea surface temperature, east African upper zonal wind, and South Atlantic wind streamfunction, providing a 33% fit to May-Oct rainfall time series. Composite analysis indicates that cool-phase El Niño Southern Oscillation supports increased May-Oct Uganda rainfall via a zonal overturning lower westerly/upper easterly atmospheric circulation. Sea temperature anomalies are positive in the east Atlantic and negative in the west Indian Ocean in respect of wet seasons. The northern Hadley Cell plays a role in limiting the northward march of the equatorial trough from May to October. An analysis of early season floods found that moist inflow from the west Indian Ocean converges over Uganda, generating diurnal thunderstorm clusters that drift southwestward producing high runoff.

Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review

PubMed Central

2017-01-01

Background Most developing countries, including Uganda, have embraced the use of e-Health and m-Health applications as a means to improve primary healthcare delivery and public health for their populace. In Uganda, the growth in the information and communications technology industry has benefited the rural communities and also created opportunities for new innovations, and their application into healthcare has reported positive results, especially in the areas of disease control and prevention through disease surveillance. However, most are mere proof-of-concepts, only demonstrated in use within a small context and lack sustainability. This study reviews the literature to understand e-Health’s current implementation status within Uganda and documents the barriers and opportunities to sustainable e-Health intervention programmes in Uganda. Methods A structured literature review of e-Health in Uganda was undertaken between May and December 2015 and was complemented with hand searching and a document review of grey literature in the form of policy documents and reports obtained online or from the Ministry of Health’s Resource Centre. Results The searches identified a total of 293 resources of which 48 articles met the inclusion criteria of being in English and describing e-Health implementation in Uganda. These were included in the study and were examined in detail. Conclusion Uganda has trialled several e-Health and m-Health solutions to address healthcare challenges. Most were donor funded, operated in silos and lacked sustainability. Various barriers have been identified. Evidence has shown that e-Health implementations in Uganda have lacked prior planning stages that the literature notes as essential, for example strategy and need readiness assessment. Future research should address these shortcomings prior to introduction of e-Health innovations. PMID:28582996

Uganda Country Analysis Brief

EIA Publications

2016-01-01

Uganda does not produce hydrocarbons currently, but after discovering oil ten years ago, the country is expected to start producing oil within the next decade. Commercial oil production is expected to start at the earliest in 2020 but most likely beyond this period. The production start date has been pushed back several times in the past. Contractual and tax disputes, differences between the Ugandan government and international investors over the portion of oil production to be exported versus refined locally, and disagreements over the export pipeline route have all contributed to a later-than-expected production start date. Sustained low global oil prices have also contributed to delays.

Spatial-temporal variability in groundwater abstraction across Uganda: Implications to sustainable water resources management

NASA Astrophysics Data System (ADS)

Nanteza, J.; Thomas, B. F.; Mukwaya, P. I.

2017-12-01

The general lack of knowledge about the current rates of water abstraction/use is a challenge to sustainable water resources management in many countries, including Uganda. Estimates of water abstraction/use rates over Uganda, currently available from the FAO are not disaggregated according to source, making it difficult to understand how much is taken out of individual water stores, limiting effective management. Modelling efforts have disaggregated water use rates according to source (i.e. groundwater and surface water). However, over Sub-Saharan Africa countries, these model use estimates are highly uncertain given the scale limitations in applying water use (i.e. point versus regional), thus influencing model calibration/validation. In this study, we utilize data from the water supply atlas project over Uganda to estimate current rates of groundwater abstraction across the country based on location, well type and other relevant information. GIS techniques are employed to demarcate areas served by each water source. These areas are combined with past population distributions and average daily water needed per person to estimate water abstraction/use through time. The results indicate an increase in groundwater use, and isolate regions prone to groundwater depletion where improved management is required to sustainably management groundwater use.

Long-term dominance of Mycobacterium tuberculosis Uganda family in peri-urban Kampala-Uganda is not associated with cavitary disease.

PubMed

Wampande, Eddie M; Mupere, Ezekiel; Debanne, Sara M; Asiimwe, Benon B; Nsereko, Mary; Mayanja, Harriet; Eisenach, Kathleen; Kaplan, Gilla; Boom, Henry W; Gagneux, Sebastien; Joloba, Moses L

2013-10-17

Previous studies have shown that Mycobacterium tuberculosis (MTB) Uganda family, a sub-lineage of the MTB Lineage 4, is the main cause of tuberculosis (TB) in Uganda. Using a well characterized patient population, this study sought to determine whether there are clinical and patient characteristics associated with the success of the MTB Uganda family in Kampala. A total of 1,746 MTB clinical isolates collected from 1992-2009 in a household contact study were genotyped. Genotyping was performed using Single Nucleotide Polymorphic (SNP) markers specific for the MTB Uganda family, other Lineage 4 strains, and Lineage 3, respectively. Out of 1,746 isolates, 1,213 were from patients with detailed clinical data. These data were used to seek associations between MTB lineage/sub-lineage and patient phenotypes. Three MTB lineages were found to dominate the MTB population in Kampala during the last two decades. Overall, MTB Uganda accounted for 63% (1,092/1,746) of all cases, followed by other Lineage 4 strains accounting for 22% (394/1,746), and Lineage 3 for 11% (187/1,746) of cases, respectively. Seventy-three (4 %) strains remained unclassified. Our longitudinal data showed that MTB Uganda family occurred at the highest frequency during the whole study period, followed by other Lineage 4 strains and Lineage 3. To explore whether the long-term success of MTB Uganda family was due to increased virulence, we used cavitary disease as a proxy, as this form of TB is the most transmissible. Multivariate analysis revealed that even though cavitary disease was associated with known risk factors such as smoking (adjusted odds ratio (aOR) 4.8, 95% confidence interval (CI) 3.33-6.84) and low income (aOR 2.1, 95% CI 1.47-3.01), no association was found between MTB lineage and cavitary TB. The MTB Uganda family has been dominating in Kampala for the last 18 years, but this long-term success is not due to increased virulence as defined by cavitary disease.

Widow inheritance and HIV/AIDS in rural Uganda.

PubMed

Mabumba, E D; Mugyenyi, P; Batwala, V; Mulogo, E M; Mirembe, J; Khan, F A; Liljestrand, J

2007-10-01

Despite current efforts to combat HIV/AIDS through behavioural change, ingrained socio-cultural practices such as widow inheritance in south-western Uganda has not changed. Low education, unemployment, dowry, widows' socioeconomic demands and the inheritor's greed for the deceased's wealth, influence widow inheritance. Voluntary counselling and testing is needed for the widows and their inheritors; formal dowry should be removed from marriage and widow inheritance stripped of its sexual component.

Potential cost-effectiveness of universal access to modern contraceptives in Uganda.

PubMed

Babigumira, Joseph B; Stergachis, Andy; Veenstra, David L; Gardner, Jacqueline S; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P

2012-01-01

Over two thirds of women who need contraception in Uganda lack access to modern effective methods. This study was conducted to estimate the potential cost-effectiveness of achieving universal access to modern contraceptives in Uganda by implementing a hypothetical new contraceptive program (NCP) from both societal and governmental (Ministry of Health (MoH)) perspectives. A Markov model was developed to compare the NCP to the status quo or current contraceptive program (CCP). The model followed a hypothetical cohort of 15-year old girls over a lifetime horizon. Data were obtained from the Uganda National Demographic and Health Survey and from published and unpublished sources. Costs, life expectancy, disability-adjusted life expectancy, pregnancies, fertility and incremental cost-effectiveness measured as cost per life-year (LY) gained, cost per disability-adjusted life-year (DALY) averted, cost per pregnancy averted and cost per unit of fertility reduction were calculated. Univariate and probabilistic sensitivity analyses were performed to examine the robustness of results. Mean discounted life expectancy and disability-adjusted life expectancy (DALE) were higher under the NCP vs. CCP (28.74 vs. 28.65 years and 27.38 vs. 27.01 respectively). Mean pregnancies and live births per woman were lower under the NCP (9.51 vs. 7.90 and 6.92 vs. 5.79 respectively). Mean lifetime societal costs per woman were lower for the NCP from the societal perspective ($1,949 vs. $1,987) and the MoH perspective ($636 vs. $685). In the incremental analysis, the NCP dominated the CCP, i.e. it was both less costly and more effective. The results were robust to univariate and probabilistic sensitivity analysis. Universal access to modern contraceptives in Uganda appears to be highly cost-effective. Increasing contraceptive coverage should be considered among Uganda's public health priorities.

Potential Cost-Effectiveness of Universal Access to Modern Contraceptives in Uganda

PubMed Central

Babigumira, Joseph B.; Stergachis, Andy; Veenstra, David L.; Gardner, Jacqueline S.; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P.

2012-01-01

Background Over two thirds of women who need contraception in Uganda lack access to modern effective methods. This study was conducted to estimate the potential cost-effectiveness of achieving universal access to modern contraceptives in Uganda by implementing a hypothetical new contraceptive program (NCP) from both societal and governmental (Ministry of Health (MoH)) perspectives. Methodology/Principal Findings A Markov model was developed to compare the NCP to the status quo or current contraceptive program (CCP). The model followed a hypothetical cohort of 15-year old girls over a lifetime horizon. Data were obtained from the Uganda National Demographic and Health Survey and from published and unpublished sources. Costs, life expectancy, disability-adjusted life expectancy, pregnancies, fertility and incremental cost-effectiveness measured as cost per life-year (LY) gained, cost per disability-adjusted life-year (DALY) averted, cost per pregnancy averted and cost per unit of fertility reduction were calculated. Univariate and probabilistic sensitivity analyses were performed to examine the robustness of results. Mean discounted life expectancy and disability-adjusted life expectancy (DALE) were higher under the NCP vs. CCP (28.74 vs. 28.65 years and 27.38 vs. 27.01 respectively). Mean pregnancies and live births per woman were lower under the NCP (9.51 vs. 7.90 and 6.92 vs. 5.79 respectively). Mean lifetime societal costs per woman were lower for the NCP from the societal perspective ($1,949 vs. $1,987) and the MoH perspective ($636 vs. $685). In the incremental analysis, the NCP dominated the CCP, i.e. it was both less costly and more effective. The results were robust to univariate and probabilistic sensitivity analysis. Conclusion/Significance Universal access to modern contraceptives in Uganda appears to be highly cost-effective. Increasing contraceptive coverage should be considered among Uganda's public health priorities. PMID:22363480

Assessing catastrophic and impoverishing effects of health care payments in Uganda.

PubMed

Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E

2015-01-22

Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day). A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively. The absence of financial protection in Uganda's health system calls for concerted action. Currently, out-of-pocket payments account for a large share of total health financing and there is no pooled prepayment system available. There is therefore a need to move towards mandatory prepayment. In this way, people could access the needed health services without any associated financial consequence.

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2012-10-01 2012-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2013-10-01 2013-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2014-10-01 2014-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2011-10-01 2011-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2010-10-01 2010-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

Patient-level benefits associated with decentralization of antiretroviral therapy services to primary health facilities in Malawi and Uganda.

PubMed

Abongomera, George; Chiwaula, Levison; Revill, Paul; Mabugu, Travor; Tumwesige, Edward; Nkhata, Misheck; Cataldo, Fabian; van Oosterhout, J; Colebunders, Robert; Chan, Adrienne K; Kityo, Cissy; Gilks, Charles; Hakim, James; Seeley, Janet; Gibb, Diana M; Ford, Deborah

2018-01-01

The Lablite project captured information on access to antiretroviral therapy (ART) at larger health facilities ('hubs') and lower-level health facilities ('spokes') in Phalombe district, Malawi and in Kalungu district, Uganda. We conducted a cross-sectional survey among patients who had transferred to a spoke after treatment initiation (Malawi, n=54; Uganda, n=33), patients who initiated treatment at a spoke (Malawi, n=50; Uganda, n=44) and patients receiving treatment at a hub (Malawi, n=44; Uganda, n=46). In Malawi, 47% of patients mapped to the two lowest wealth quintiles (Q1-Q2); patients at spokes were poorer than at a hub (57% vs 23% in Q1-Q2; p<0.001). In Uganda, 7% of patients mapped to Q1-Q2; patients at the rural spoke were poorer than at the two peri-urban facilities (15% vs 4% in Q1-Q2; p<0.001). The median travel time one way to a current ART facility was 60 min (IQR 30-120) in Malawi and 30 min (IQR 20-60) in Uganda. Patients who had transferred to the spokes reported a median reduction in travel time of 90 min in Malawi and 30 min in Uganda, with reductions in distance and food costs. Decentralizing ART improves access to treatment. Community-level access to treatment should be considered to further minimize costs and time. © The Author(s) 2018. Published by Oxford University Press Royal Society of Tropical Medicine and Hygiene.

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…

The Burden of Cholera in Uganda

PubMed Central

Bwire, Godfrey; Malimbo, Mugagga; Maskery, Brian; Kim, Young Eun; Mogasale, Vittal; Levin, Ann

2013-01-01

Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations

Phylogeny of Yellow Fever Virus, Uganda, 2016.

PubMed

Hughes, Holly R; Kayiwa, John; Mossel, Eric C; Lutwama, Julius; Staples, J Erin; Lambert, Amy J

2018-08-17

In April 2016, a yellow fever outbreak was detected in Uganda. Removal of contaminating ribosomal RNA in a clinical sample improved the sensitivity of next-generation sequencing. Molecular analyses determined the Uganda yellow fever outbreak was distinct from the concurrent yellow fever outbreak in Angola, improving our understanding of yellow fever epidemiology.

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).

The Future of Engineering Education--Revisited

ERIC Educational Resources Information Center

Wankat, Phillip C.; Bullard, Lisa G.

2016-01-01

This paper revisits the landmark CEE series, "The Future of Engineering Education," published in 2000 (available free in the CEE archives on the internet) to examine the predictions made in the original paper as well as the tools and approaches documented. Most of the advice offered in the original series remains current. Despite new…

Organic livestock production in Uganda: potentials, challenges and prospects.

PubMed

Nalubwama, Sylvia Muwanga; Mugisha, Anthony; Vaarst, Mette

2011-04-01

Development in organic farming has been stimulated by farmers and consumers becoming interested in healthy food products and sustainable environment. Organic agriculture is a holistic production management system which is based on the principles of health, ecology, care, and fairness. Organic development in Uganda has focused more on the crop sector than livestock sector and has primarily involved the private sector, like organic products export companies and non-governmental organizations. Agriculture in Uganda and many African countries is predominantly traditional, less mechanized, and is usually associated with minimum use of chemical fertilizers, pesticides, and drugs. This low external input agriculture also referred to as "organic by default" can create basis for organic farming where agroecological methods are introduced and present an alternative in terms of intensification to the current low-input/low-output systems. Traditional farming should not be confused with organic farming because in some cases, the existing traditional practices have consequences like overstocking and less attention to soil improvement as well as to animal health and welfare, which is contrary to organic principles of ecology, fairness, health, and care. Challenges of implementing sustainable organic practices in the Ugandan livestock sector threaten its future development, such as vectors and vector-borne diseases, organic feed insufficiency, limited education, research, and support to organic livestock production. The prospects of organic livestock development in Uganda can be enhanced with more scientific research in organic livestock production under local conditions and strengthening institutional support.

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.

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…

United against cancer: prevention to end-of-life care-highlights from the Uganda Cancer Institute-Palliative Care Association of Uganda Joint International Conference on Cancer and Palliative Care and the 7th Palliative Care Conference, 24-25 August 2017, Kampala, Uganda.

PubMed

Downing, Julia; Ddungu, Henry; Kiyange, Fatia; Batuli, Mwazi; Kafeero, James; Kebirungi, Harriet; Kiwanuka, Rose; Mugisha, Noleb; Mwebesa, Eddie; Mwesiga, Mark; Namukwaya, Elizabeth; Niyonzima, Nixon; Phipps, Warren; Orem, Jackson

2017-01-01

The Uganda Cancer Institute (UCI) and the Palliative Care Association of Uganda (PCAU) jointly hosted an international conference on cancer and palliative care in August 2017 in Kampala, Uganda. At the heart of the conference rested a common commitment to see patient care improved across Uganda and the region. The theme - United Against Cancer: Prevention to End-of-Life Care - reflected this joint vision and the drive to remember that cancer care should include prevention, early diagnosis and screening, treatment, rehabilitation and palliative care. The conference brought together 451 delegates from 17 countries. The key themes of the conference included: the importance of the World Health Assembly Resolutions on Palliative Care (2014) and cancer care (2017); the need to develop a National Cancer Control Programme; strategies for effective cancer diagnosis and treatment in low- and middle-income countries; advocacy, human rights and access to essential medicines, including access to opioids and nurse prescribing; paediatric care; leadership and commitment; collaboration; resources (financial and human), the recognition that palliative care is not limited to cancer care and the importance of learning from each other. The conference also gave the opportunity to celebrate the 50th Anniversary of the UCI, with a celebration dinner attended by the Minister of Health and the US Ambassador. Participants reported that the conference was a forum that updated them in all aspects of cancer and palliative care, which challenged their knowledge, and was enlightening in terms of current treatment options for individuals with cancer. The benefits of having a joint conference were recognised, allowing for further networking between cancer and palliative care organisations. This conference, highlighting many developments in cancer and palliative care, served as a unique opportunity to bring people together and unite them in developing cancer and palliative care.

Epidemiology of HPV genotypes in Uganda and the role of the current preventive vaccines: A systematic review

PubMed Central

2011-01-01

uncircumcised adult HIV positive males, HR-HPV prevalence ranged from 55.3% -76.6% compared to 38.6% -47.6% in HIV negative males. Incident and multiple HR-HPV infections were frequent in HIV positive males. Being uncircumcised was the main risk factor for both prevalent and incident HPV infection. Conclusion Infections with HR-HPV genotypes were very common particularly among HIV positive individuals and young women irrespective of HIV status. Given the high prevalence of HIV infection, HPV-associated conditions represent a major public health burden in Uganda. However, although the most common HPV genotypes in ICC cases in Uganda were those targeted by current preventive vaccines, there were a large number of individuals infected with other HR-HPV genotypes. Technology allowing, these other HR-HPV types should be considered in the development of the next generation of vaccines. PMID:21749691

Musculoskeletal trauma services in Uganda.

PubMed

Naddumba, E K

2008-10-01

Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda's population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development.

Consolidating tactical planning and implementation frameworks for integrated vector management in Uganda.

PubMed

Okia, Michael; Okui, Peter; Lugemwa, Myers; Govere, John M; Katamba, Vincent; Rwakimari, John B; Mpeka, Betty; Chanda, Emmanuel

2016-04-14

Integrated vector management (IVM) is the recommended approach for controlling some vector-borne diseases (VBD). In the face of current challenges to disease vector control, IVM is vital to achieve national targets set for VBD control. Though global efforts, especially for combating malaria, now focus on elimination and eradication, IVM remains useful for Uganda which is principally still in the control phase of the malaria continuum. This paper outlines the processes undertaken to consolidate tactical planning and implementation frameworks for IVM in Uganda. The Uganda National Malaria Control Programme with its efforts to implement an IVM approach to vector control was the 'case' for this study. Integrated management of malaria vectors in Uganda remained an underdeveloped component of malaria control policy. In 2012, knowledge and perceptions of malaria vector control policy and IVM were assessed, and recommendations for a specific IVM policy were made. In 2014, a thorough vector control needs assessment (VCNA) was conducted according to WHO recommendations. The findings of the VCNA informed the development of the national IVM strategic guidelines. Information sources for this study included all available data and accessible archived documentary records on VBD control in Uganda. The literature was reviewed and adapted to the local context and translated into the consolidated tactical framework. WHO recommends implementation of IVM as the main strategy to vector control and has encouraged member states to adopt the approach. However, many VBD-endemic countries lack IVM policy frameworks to guide implementation of the approach. In Uganda most VBD coexists and could be managed more effectively if done in tandem. In order to successfully control malaria and other VBD and move towards their elimination, the country needs to scale up proven and effective vector control interventions and also learn from the experience of other countries. The IVM strategy is important in

Substorm Current Wedge Revisited

NASA Astrophysics Data System (ADS)

Kepko, L.; McPherron, R. L.; Amm, O.; Apatenkov, S.; Baumjohann, W.; Birn, J.; Lester, M.; Nakamura, R.; Pulkkinen, T. I.; Sergeev, V.

2015-07-01

Almost 40 years ago the concept of the substorm current wedge was developed to explain the magnetic signatures observed on the ground and in geosynchronous orbit during substorm expansion. In the ensuing decades new observations, including radar and low-altitude spacecraft, MHD simulations, and theoretical considerations have tremendously advanced our understanding of this system. The AMPTE/IRM, THEMIS and Cluster missions have added considerable observational knowledge, especially on the important role of fast flows in producing the stresses that generate the substorm current wedge. Recent detailed, multi-spacecraft, multi-instrument observations both in the magnetosphere and in the ionosphere have brought a wealth of new information about the details of the temporal evolution and structure of the current system. While the large-scale picture remains valid, the new details call for revision and an update of the original view. In this paper we briefly review the historical development of the substorm current wedge, review recent in situ and ground-based observations and theoretical work, and discuss the current active research areas. We conclude with a revised, time-dependent picture of the substorm current wedge that follows its evolution from the initial substorm flows through substorm expansion and recovery.

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.

United against cancer: prevention to end-of-life care—highlights from the Uganda Cancer Institute–Palliative Care Association of Uganda Joint International Conference on Cancer and Palliative Care and the 7th Palliative Care Conference, 24–25 August 2017, Kampala, Uganda

PubMed Central

Downing, Julia; Ddungu, Henry; Kiyange, Fatia; Batuli, Mwazi; Kafeero, James; Kebirungi, Harriet; Kiwanuka, Rose; Mugisha, Noleb; Mwebesa, Eddie; Mwesiga, Mark; Namukwaya, Elizabeth; Niyonzima, Nixon; Phipps, Warren; Orem, Jackson

2017-01-01

The Uganda Cancer Institute (UCI) and the Palliative Care Association of Uganda (PCAU) jointly hosted an international conference on cancer and palliative care in August 2017 in Kampala, Uganda. At the heart of the conference rested a common commitment to see patient care improved across Uganda and the region. The theme – United Against Cancer: Prevention to End-of-Life Care – reflected this joint vision and the drive to remember that cancer care should include prevention, early diagnosis and screening, treatment, rehabilitation and palliative care. The conference brought together 451 delegates from 17 countries. The key themes of the conference included: the importance of the World Health Assembly Resolutions on Palliative Care (2014) and cancer care (2017); the need to develop a National Cancer Control Programme; strategies for effective cancer diagnosis and treatment in low- and middle-income countries; advocacy, human rights and access to essential medicines, including access to opioids and nurse prescribing; paediatric care; leadership and commitment; collaboration; resources (financial and human), the recognition that palliative care is not limited to cancer care and the importance of learning from each other. The conference also gave the opportunity to celebrate the 50th Anniversary of the UCI, with a celebration dinner attended by the Minister of Health and the US Ambassador. Participants reported that the conference was a forum that updated them in all aspects of cancer and palliative care, which challenged their knowledge, and was enlightening in terms of current treatment options for individuals with cancer. The benefits of having a joint conference were recognised, allowing for further networking between cancer and palliative care organisations. This conference, highlighting many developments in cancer and palliative care, served as a unique opportunity to bring people together and unite them in developing cancer and palliative care. PMID:29290759

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. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Nursing care of AIDS patients in Uganda.

PubMed

Fournier, Bonnie; Kipp, Walter; Mill, Judy; Walusimbi, Mariam

2007-07-01

This article reports the findings from a participatory action research study concerning the experience of Ugandan nurses caring for individuals with HIV illness. Six key informants from government and non-governmental organizations were interviewed using a semistructured format. Six nurses from a large national referral hospital in Kampala, Uganda, participated in 10 focus group meetings during a period of 11 months. In-depth interviews, focus groups, and photovoice were used to collect the data. Findings indicate that nurses faced many challenges in their daily care, including poverty, insufficient resources, fear of contagion, and lack of ongoing education. Nurses experienced moral distress due to the many challenges they faced during the care of their patients. Moral distress may lead nurses to quit their jobs, which would exacerbate the acute shortage of nurses in Uganda. This study provides important knowledge for guiding clinical practice and nursing education in resource-constrained countries like Uganda.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam.

PubMed

Levin, Carol E; Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-08-01

To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. 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$). Exclusively project-related expenses and the cost of the vaccine were excluded. The economic delivery cost per vaccine dose ranged from US$ 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). 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.

Isolated Case of Marburg Virus Disease, Kampala, Uganda, 2014.

PubMed

Nyakarahuka, Luke; Ojwang, Joseph; Tumusiime, Alex; Balinandi, Stephen; Whitmer, Shannon; Kyazze, Simon; Kasozi, Sam; Wetaka, Milton; Makumbi, Issa; Dahlke, Melissa; Borchert, Jeff; Lutwama, Julius; Ströher, Ute; Rollin, Pierre E; Nichol, Stuart T; Shoemaker, Trevor R

2017-06-01

In September 2014, a single fatal case of Marburg virus was identified in a healthcare worker in Kampala, Uganda. The source of infection was not identified, and no secondary cases were identified. We describe the rapid identification, laboratory diagnosis, and case investigation of the third Marburg virus outbreak in Uganda.

Past, Present, and Future of Neurosurgery in Uganda.

PubMed

Haglund, Michael M; Warf, Benjamin; Fuller, Anthony; Freischlag, Kyle; Muhumuza, Michael; Ssenyonjo, Hussein; Mukasa, John; Mugamba, John; Kiryabwire, Joel

2017-04-01

Neurosurgery in Uganda was virtually non-existent up until late 1960s. This changed when Dr. Jovan Kiryabwire spearheaded development of a neurosurgical unit at Mulago Hospital in Kampala. His work ethic and vision set the stage for rapid expansion of neurosurgical care in Uganda.At the beginning of the 2000s, Uganda was a country of nearly 30 million people, but had only 4 neurosurgeons. Neurosurgery's progress was plagued by challenges faced by many developing countries, such as difficulty retaining specialists, lack of modern hospital resources, and scarce training facilities. To combat these challenges 2 distinct programs were launched: 1 by Dr. Benjamin Warf in collaboration with CURE International, and the other by Dr. Michael Haglund from Duke University. Dr. Warf's program focused on establishing a facility for pediatric neurosurgery. Dr. Haglund's program to increase neurosurgical capacity was founded on a "4 T's Paradigm": Technology, Twinning, Training, and Top-Down. Embedded within this paradigm was the notion that Uganda needed to train its own people to become neurosurgeons, and thus Duke helped establish the country's first neurosurgery residency training program.Efforts from overseas, including the tireless work of Dr. Benjamin Warf, have saved thousands of children's lives. The influx of the Duke Program caused a dynamic shift at Mulago Hospital with dramatic effects, as evidenced by the substantial increase in neurosurgical capacity. The future looks bright for neurosurgery in Uganda and it all traces back to a rural village where 1 man had a vision to help the people of his country. Copyright © 2017 by the Congress of Neurological Surgeons.

Predominance of Uganda genotype of Mycobacterium tuberculosis isolated from Ugandan patients with tuberculous lymphadenitis.

PubMed

Wamala, Dan; Okee, Moses; Kigozi, Edgar; Couvin, David; Rastogi, Nalin; Joloba, Moses; Kallenius, Gunilla

2015-09-01

In Uganda, the emerging Uganda genotype of Mycobacterium tuberculosis is the most common cause of pulmonary tuberculosis (PTB), and accounts for up to 70% of isolates. Extrapulmonary TB (EPTB) is less studied in Uganda. Molecular characterization using deletion analysis and spoligotyping was performed on 121 M. tuberculosis isolates from lymph node fine needle biopsy aspirates of Ugandan patients with tuberculous lymphadenitis. The evolutionary relationships and worldwide distribution of the spoligotypes were analyzed. Mycobacterium tuberculosis was the only cause of EPTB in this study. The T2 sublineage was the most predominant lineage and the Uganda genotype was the dominant genotype. There were 54 spoligotype patterns among the 121 study isolates. The dominant spoligotypes were shared international types (SIT) SIT420, SIT53, SIT 135, SIT 128 and SIT590 in descending order. All but SIT420 were previously reported in pulmonary TB in this setting. The phylogenetic analysis showed a long descendant branch of spoligotypes belonging to the T2-Uganda sublineage containing specifically SITs 135, 128 and 420. In most cases, the spoligotypes were similar to those causing PTB, but the Uganda genotype was found to be less common in EPTB than previously reported for PTB in Uganda. The phylogenetic analysis and the study of the worldwide distribution of clustered spoligotypes indicate an ongoing evolution of the Uganda genotype, with the country of Uganda at the center of this evolution.

Challenges for the implementation of World Health Organization guidelines for acute stress, PTSD, and bereavement: a qualitative study in Uganda.

PubMed

Kane, Jeremy C; Adaku, Alex; Nakku, Juliet; Odokonyero, Raymond; Okello, James; Musisi, Seggane; Augustinavicius, Jura; Greene, M Claire; Alderman, Steve; Tol, Wietse A

2016-03-15

In 2013, the World Health Organization (WHO) published new guidelines for the management of conditions specifically related to stress, including symptoms of acute stress, bereavement, and post-traumatic stress disorder (PTSD). It is important to evaluate potential challenges for the implementation of these guidelines in low-resource settings, however, there is a dearth of research in this area. The current qualitative study aimed to assess perspectives on the feasibility and acceptability of the new guidelines in four clinics that provide mental health services in post-conflict northern Uganda. In-depth interviews were conducted with 19 mental health-care providers and program developers in northern Uganda to address three major research objectives: (1) describe the current standard practices and guidelines used for treating conditions related to stress in Uganda; (2) identify barriers and challenges associated with implementing the new WHO guidelines; and (3) identify and describe potential strategies for overcoming these barriers and challenges. An emergent thematic analysis was used to develop a coding scheme for the transcribed interviews. Practices for managing conditions related to stress included group psychological interventions, psychoeducation, and medication for clients with severe signs and symptoms. Several themes were identified from the interviews on barriers to guideline implementation. These included (1) a lack of trained and qualified mental health professionals to deliver WHO-recommended psychological interventions; (2) a perception that psychological interventions developed in high-income countries would not be culturally adaptable in Uganda; and (3) reluctance about blanket statements regarding medication for the management of acute stress symptoms and PTSD. Identified strategies for overcoming these barriers included (1) training and capacity building for current mental health staff; (2) a stepped care approach to mental health services; and

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…

A critique of the Uganda district league table using a normative health system performance assessment framework.

PubMed

KirungaTashobya, Christine; Ssengooba, Freddie; Nabyonga-Orem, Juliet; Bataringaya, Juliet; Macq, Jean; Marchal, Bruno; Musila, Timothy; Criel, Bart

2018-05-10

In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality. A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool. Thirty Key Informants were interviewed, purposively selected from the Ugandan health system on the basis of having developed or used the DLT. KII data and information from published and grey literature on the Uganda health system was analyzed using deductive analysis. Stakeholder involvement in the development of the DLT was limited, including MoH officials and development partners, and a few district technical managers. Uganda policy documents articulate a conceptually broad health system whereas the DLT focuses on a healthcare system. The complexity and dynamism of the Uganda health system was insufficiently acknowledged by the HSPA framework. Though DLT objectives and indicators were articulated, there was no conceptual reference model and lack of clarity on the constitutive dimensions. The DLT mechanisms for change were not explicit. The DLT compared markedly different districts and did not identify factors behind observed performance. Uganda lacks a designated institutional unit for the analysis and presentation of HSPA data, and there are challenges in data quality and range. The critique of the DLT using a normative model supported the development of recommendation for Uganda district HSPA and provides lessons for other LMICs. A similar approach can be used by researchers and policy makers elsewhere for the review and development of other frameworks. Adjustments in Uganda district HSPA should consider: wider stakeholder involvement with more district managers including political

Setting the Revisit Interval in Primary Care

PubMed Central

Schwartz, Lisa M; Woloshin, Steven; Wasson, John H; Renfrew, Roger A; Welch, H Gilbert

1999-01-01

OBJECTIVE Although longitudinal care constitutes the bulk of primary care, physicians receive little guidance on the fundamental question of how to time follow-up visits. We sought to identify important predictors of the revisit interval and to describe the variability in how physicians set these intervals when caring for patients with common medical conditions. DESIGN Cross-sectional survey of physicians performed at the end of office visits for consecutive patients with hypertension, angina, diabetes, or musculoskeletal pain. PARTICIPANTS/SETTING One hundred sixty-four patients under the care of 11 primary care physicians in the Dartmouth Primary Care Cooperative Research Network. MEASUREMENTS The main outcome measures were the variability in mean revisit intervals across physicians and the proportion of explained variance by potential determinants of revisit intervals. We assessed the relation between the revisit interval (dependent variable) and three groups of independent variables, patient characteristics (e.g., age, physician perception of patient health), identification of individual physician, and physician characterization of the visit (e.g., routine visit, visit requiring a change in management, or visit occurring on a “hectic” day), using multiple regression that accounted for the natural grouping of patients within physician. MAIN RESULTS Revisit intervals ranged from 1 week to over 1 year. The most common intervals were 12 and 16 weeks. Physicians’ perception of fair-poor health status and visits involving a change in management were most strongly related to shorter revisit intervals. In multivariate analyses, patient characteristics explained about 18% of the variance in revisit intervals, and adding identification of the individual provider doubled the explained variance to about 40%. Physician characterization of the visit increased explained variance to 57%. The average revisit interval adjusted for patient characteristics for each of the 11

Perceptions of risk to HIV infection among adolescents in Uganda: are they related to sexual behaviour?

PubMed

Kibombo, Richard; Neema, Stella; Ahmed, Fatima H

2007-12-01

Uganda has been hailed as a success story in the fight against HIV that has seen a reversal in prevalence from a peak of 15% in 1991 to about 6.5% currently Since 1992, the largest and most consistent declines in HIV have occurred among the 15-19-year-olds. While many studies have examined how key behavior changes (Abstinence, Be faithful and Condom use) have contributed to the decline in HIV prevalence, few have studied the relationship between sexual behaviors and risk perception. Using data from the 2004 National Survey of Adolescents, multivariate logistic regression models were fitted to examine the strength of the association between risky sexual behavior and perceived risk among 12-19-year-old adolescents in Uganda. After controlling for other correlates of sexual behavior such as age, education, residence, region and marital status, the findings indicate highly significant positive association between perceived risk and risky sexual behavior among males but not females. The findings reveal that, regardless of their current sexual behavior, most female adolescents in Uganda feel at great risk of HIV infection. The findings also show that adolescents with broken marriages are much more vulnerable to high risk sexual behaviors than other categories of adolescents. These results further emphasize the need for a holistic approach in addressing the social, economic and contextual factors that continue to put many adolescents at risk of HIV infection.

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

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…

Orthopaedic service lines-revisited.

PubMed

Patterson, Cheryl

2008-01-01

This article revisits the application of orthopaedic service lines from early introduction and growth of this organizational approach in the 1980s, through the 1990s, and into the current decade. The author has experienced and worked in various service-line structures through these three decades, as well as the preservice-line era of 1970s orthopaedics. Past lessons learned during earlier phases and then current trends and analysis by industry experts are summarized briefly, with indication given of the future for service lines. Variation versus consistency of certain elements in service-line definitions and in operational models is discussed. Main components of service-line structures and typical processes are described briefly, along with a more detailed section on the service-line director/manager role. Current knowledge contained here will help guide the reader to more "out-of-the-box" thinking toward comprehensive orthopaedic centers of excellence.

New Measles Genotype, Uganda

PubMed Central

Muwonge, Apollo; Nanyunja, Miriam; Bwogi, Josephine; Lowe, Luis; Liffick, Stephanie L.; Bellini, William J.; Sylvester, Sempala

2005-01-01

We report the first genetic characterization of wildtype measles viruses from Uganda. Thirty-six virus isolates from outbreaks in 6 districts were analyzed from 2000 to 2002. Analyses of sequences of the nucleoprotein (N) and hemagglutinin (H) genes showed that the Ugandan isolates were all closely related, and phylogenetic analysis indicated that these viruses were members of a unique group within clade D. Sequences of the Ugandan viruses were not closely related to any of the World Health Organization reference sequences representing the 22 currently recognized genotypes. The minimum nucleotide divergence between the Ugandan viruses and the most closely related reference strain, genotype D2, was 3.1% for the N gene and 2.6% for the H gene. Therefore, Ugandan viruses should be considered a new, proposed genotype (d10). This new sequence information will expand the utility of molecular epidemiologic techniques for describing measles transmission patterns in eastern Africa. PMID:16318690

Science Teachers' Understanding and Practice of Inquiry-Based Instruction in Uganda

NASA Astrophysics Data System (ADS)

Ssempala, Fredrick

teachers had insufficient understanding of IBI at the beginning of the study. However, teachers from School A improved their understanding and practice of IBI after attending the PD workshop. I also found that the participating chemistry teachers' NOS epistemological views were, to some extent, related to the nature of IBI implemented in their classroom. The main internal factors the participating teachers perceived to influence their understanding and practice of IBI were their attitudes and teaching experience, whereas the external factors were lack of motivation, lack of necessary instructional materials, mode of assessment, class size, the nature of pre-service and in-service training, support from peer teachers and limited time in relation to many lessons and much content to cover Based on the above findings, I conclude that the current science teacher training in Uganda may not be improving science teachers' understanding and practice of IBI, and most of the factors are beyond their control (external). Hence, there is an urgent need for teacher educators and policymakers in Uganda to address the internal and external factors influencing science teachers' understanding and practice of IBI to improve the teaching and learning of science subjects. Additionally, more quantitative and qualitative studies should be done among teachers of different disciplines to establish how the above factors and others affect teachers' understanding and practice of IBI in developing countries like Uganda.

Players and processes behind the national health insurance scheme: a case study of Uganda.

PubMed

Basaza, Robert K; O'Connell, Thomas S; Chapčáková, Ivana

2013-09-22

Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda's proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda's Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals during stakeholder discussions would be an

Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.

PubMed

Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David

2015-05-07

Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national

Perceptions of risk to HIV Infection among Adolescents in Uganda: Are they Related to Sexual Behaviour?

PubMed Central

Kibombo, Richard; Neema, Stella; Ahmed, Fatima H.

2008-01-01

Uganda has been hailed as a success story in the fight against HIV that has seen a reversal in prevalence from a peak of 15% in 1991 to about 6.5% currently. Since 1992, the largest and most consistent declines in HIV have occurred among the 15–19-year-olds. While many studies have examined how key behavior changes (Abstinence, Be faithful and Condom use) have contributed to the decline in HIV prevalence, few have studied the relationship between sexual behaviors and risk perception. Using data from the 2004 National Survey of Adolescents, multivariate logistic regression models were fitted to examine the strength of the association between risky sexual behavior and perceived risk among 12–19-year-old adolescents in Uganda. After controlling for other correlates of sexual behavior such as age, education, residence, region and marital status, the findings indicate highly significant positive association between perceived risk and risky sexual behavior among males but not females. The findings reveal that, regardless of their current sexual behavior, most female adolescents in Uganda feel at great risk of HIV infection. The findings also show that adolescents with broken marriages are much more vulnerable to high risk sexual behaviors than other categories of adolescents. These results further emphasize the need for a holistic approach in addressing the social, economic and contextual factors that continue to put many adolescents at risk of HIV infection. PMID:18458740

Reach and Cost-Effectiveness of the PrePex Device for Safe Male Circumcision in Uganda

PubMed Central

Duffy, Kevin; Galukande, Moses; Wooding, Nick; Dea, Monica; Coutinho, Alex

2013-01-01

Introduction Modelling, supported by the USAID Health Policy Initiative and UNAIDS, performed in 2011, indicated that Uganda would need to perform 4.2 million medical male circumcisions (MMCs) to reach 80% prevalence. Since 2010 Uganda has completed 380,000 circumcisions, and has set a national target of 1 million for 2013. Objective To evaluate the relative reach and cost-effectiveness of PrePex compared to the current surgical SMC method and to determine the effect that this might have in helping to achieve the Uganda national SMC targets. Methods A cross-sectional descriptive cost-analysis study conducted at International Hospital Kampala over ten weeks from August to October 2012. Data collected during the performance of 625 circumcisions using PrePex was compared to data previously collected from 10,000 circumcisions using a surgical circumcision method at the same site. Ethical approval was obtained. Results The moderate adverse events (AE) ratio when using the PrePex device was 2% and no severe adverse events were encountered, which is comparable to the surgical method, thus the AE rate has no effect on the reach or cost-effectiveness of PrePex. The unit cost to perform one circumcision using PrePex is $30.55, 35% ($7.90) higher than the current surgical method, but the PrePex method improves operator efficiency by 60%, meaning that a team can perform 24 completed circumcisions compared to 15 by the surgical method. The cost-effectiveness of PrePex, comparing the cost of performing circumcisions to the future cost savings of potentially averted HIV infections, is just 2% less than the current surgical method, at a device cost price of $20. Conclusion PrePex is a viable SMC tool for scale-up with unrivalled potential for superior reach, however national targets can only be met with effective demand creation and availability of trained human resource. PMID:23717402

The history of syphilis in Uganda

PubMed Central

Davies, J. N. P.

1956-01-01

The circumstances of an alleged first outbreak of syphilis in Uganda in 1897 are examined and attention is drawn to certain features which render possible alternative explanations of the history of syphilis in that country. It is suggested that an endemic form of syphilis was an old disease of southern Uganda and that protective infantile inoculation was practised. The country came under the observation of European clinicians at a time when endemic syphilis was being replaced by true venereal syphilis. This process has now been completed, endemic syphilis has disappeared, and venereal syphilis is now widespread and a more serious problem than ever. This theory explains the observations of other writers and reconciles the apparent discrepancies between various reports. PMID:13404471

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…

Geospatial analysis of unmet pediatric surgical need in Uganda.

PubMed

Smith, Emily R; Vissoci, Joao Ricardo Nickenig; Rocha, Thiago Augusto Hernandes; Tran, Tu M; Fuller, Anthony T; Butler, Elissa K; de Andrade, Luciano; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Namanya, Didacus B; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M

2017-10-01

In low- and middle-income countries (LMICs), an estimated 85% of children do not have access to surgical care. The objective of the current study was to determine the geographic distribution of surgical conditions among children throughout Uganda. Using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey, we enumerated 2176 children in 2315 households throughout Uganda. At the district level, we determined the spatial autocorrelation of surgical need with geographic access to surgical centers variable. The highest average distance to a surgical center was found in the northern region at 14.97km (95% CI: 11.29km-16.89km). Younger children less than five years old had a higher prevalence of unmet surgical need in all four regions than their older counterparts. The spatial regression model showed that distance to surgical center and care availability were the main spatial predictors of unmet surgical need. We found differences in unmet surgical need by region and age group of the children, which could serve as priority areas for focused interventions to alleviate the burden. Future studies could be conducted in the northern regions to develop targeted interventions aimed at increasing pediatric surgical care in the areas of most need. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

PubMed

Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

2015-10-01

Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

Revisiting reflexology: Concept, evidence, current practice, and practitioner training

PubMed Central

Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

2015-01-01

Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided. PMID:26587391

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.

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…

Establishment of revisit user fee program for Medicare survey and certification activities. Final rule.

PubMed

2007-09-19

This final rule will establish a system of revisit user fees applicable to health care facilities that have been cited for deficiencies during initial certification, recertification, or substantiated complaint surveys and require a revisit to confirm that corrections to previously-identified deficiencies have been remedied. Consistent with the President's long-term goal to promote quality of health care and to cut the deficit in half by fiscal year (FY) 2009, the FY 2007 Department of Health and Human Services' (HHS) budget request included both new mandatory savings proposals and a requirement that user fees be applied to health care providers that have failed to comply with Federal quality of care requirements. The "Revisit User Fees" will affect only those providers or suppliers for which a revisit is required to confirm that previously-identified failures to meet federal quality of care requirements have been remedied. The fees are estimated at $37.3 million annually and will recover the costs associated with the Medicare Survey and Certification program's revisit surveys. The fees will take effect on the date of publication of the final rule and will be in effect until the date that the continued authority provided by Congress expires. At the time of publication of this regulation the applicable date is September 30, 2007. If no legislation is enacted, the fees are not retroactive to the beginning of the fiscal year. Any provider or supplier that has a revisit survey conducted on or after the date of publication will be assessed a revisit user fee and will be notified of the assessment upon data system reconciliation which can occur following the closing of the fiscal year. The fees will be available to CMS until expended. The revisit user fee is included in the President's proposed FY 2008 budget. We note through the publication of this final rule that if authority for the revisit user fee is continued, we will use the current fee schedule in this rule for

Changes in prevalence of tobacco use and the factors that may affect use among Uganda youth: the Global Youth Tobacco Survey (GYTS) 2007-2011.

PubMed

Kadobera, Daniel; Chaussard, Martine; Lee, Kyung Ah; Ayebazibwe, Nicholas; Ndyanabangi, Sheila

2016-01-01

To assess changes from 2007 to 2011 in the prevalence of tobacco use and tobacco-related indicators in Uganda by examining results from the Global Youth Tobacco Survey (GYTS). Both the 2007 (n=2,251) and 2011 (n=2,026) Uganda GYTS were conducted among students in primary seven, secondary one, two, and three. A two-stage cluster sample design was used to generate a representative sample of students for the surveys. Stata 12 software was used to provide weighted prevalence estimates and logistic regression models were developed to examine the relationship between factors that influence tobacco use and current tobacco use. The percentage of students who had ever smoked a cigarette, even just one or two puffs, declined from 15.6% in 2007 to 10.9% in 2011 (p=0.03). From 2007 to 2011, neither the percentage of current use of any tobacco (16.6% to 17.3%, p=0.75), nor the percentage of current (past 30 day) cigarette smoking (5.5% to 4.8%,p=0.59) changed significantly. Following adjustment, having parents [Adjusted Odds Ratio (AOR):1.9, 95% Confidence Interval (CI):1.3-2.8] and friends [AOR 2.5, 95% CI: 1.5-4.0)] who smoke, and having seen tobacco advertisements in print media [AOR 1.8(1.3-2.4)], were associated with greater odds of current tobacco use among students in 2007.Having parents who smoke [AOR;1.8, 95% CI: 1.1-3.0] was associated with greater odds of current tobacco use among students in 2011. From 2007 to 2011, no significant change occurred in the prevalence of current tobacco use or cigarette smoking among youth in Uganda. These findings underscore the importance of implementing effective population-level public health interventions, as outlined in the articles of the World Health Organization's Framework Convention on Tobacco Control, to prevent and reduce the use of tobacco among youth in Uganda.

Midwives' provision of antimalaria services to pregnant women in Uganda.

PubMed

Bbosa, Richard Serunkuma; Ehlers, Valerie Janet

2017-04-01

malaria causes complications during 80% of all pregnancies in Uganda. However, only 48% of Ugandan pregnant women took one dose of intermittent preventive therapy while merely 27% took the second dose during 2011. This study investigated midwives' provision of anti-malaria services in the Buikwe District of Uganda. a quantitative exploratory descriptive design was used. prenatal clinics (n=16) in the Buikwe District of Uganda RESPONDENTS: questionnaires were completed by 40 (out of a population of 45) midwives. midwives' provision of malaria-preventive services to pregnant women were associated with the midwives' education level and professional experience as well as by the availability of safe drinking water and drugs for intermittent preventive treatment. Midwives who provided frequent health education to pregnant women, cooperated with village health team members and received in-service training were likely to provide effective anti-malaria services to pregnant women. regular audits of midwives' records should identify strengths and weaknesses related to the prevention of malaria during pregnancy. Relevant in- service education should be provided. Drugs for intermittent preventive therapy and clean drinking water must be available at all prenatal clinics so that pregnant women can take these drugs under direct observation of the midwives. malaria-related health education should be provided during every prenatal clinic visit, and every pregnant women should take two doses of intermittent preventive therapy drugs during every pregnancy (as prescribed by Uganda's Ministry of Health) in order to reduce the reported impact of malaria on 80% of pregnancies in Uganda. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data.

PubMed

Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

2016-03-10

To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15-49 years) in East Africa. Demographic and Health Surveys data from Burundi (2010), Kenya (2008-2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Burundi, Kenya, Rwanda, Tanzania and Uganda. 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15-49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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…

Revisit rates and associated costs after an emergency department encounter: a multistate analysis.

PubMed

Duseja, Reena; Bardach, Naomi S; Lin, Grace A; Yazdany, Jinoos; Dean, Mitzi L; Clay, Theodore H; Boscardin, W John; Dudley, R Adams

2015-06-02

Return visits to the emergency department (ED) or hospital after an index ED visit strain the health system, but information about rates and determinants of revisits is limited. To describe revisit rates, variation in revisit rates by diagnosis and state, and associated costs. Observational study using the Healthcare Cost and Utilization Project databases. 6 U.S. states. Adults with ED visits between 2006 and 2010. Revisit rates and costs. Within 3 days of an index ED visit, 8.2% of patients had a revisit; 32% of those revisits occurred at a different institution. Revisit rates varied by diagnosis, with skin infections having the highest rate (23.1% [95% CI, 22.3% to 23.9%]). Revisit rates also varied by state. For skin infections, Florida had higher risk-adjusted revisit rates (24.8% [CI, 23.5% to 26.2%]) than Nebraska (10.6% [CI, 9.2% to 12.1%]). In Florida, the only state with complete cost data, total revisit costs for the 19.8% of patients with a revisit within 30 days were 118% of total index ED visit costs for all patients (including those with and without a revisit). Whether a revisit reflects inadequate access to primary care, a planned revisit, the patient's nonadherence to ED recommendations, or poor-quality care at the initial ED visit remains unknown. Revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits. Agency for Healthcare Research and Quality.

Deliberate self-harm as seen in Kampala, Uganda - a case-control study.

PubMed

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2004-04-01

A study to investigate deliberate self-harm (DSH) in an African context was undertaken in Uganda. A case-control study in which 100 cases of DSH and 300 controls matched on age and sex were recruited from three general hospitals in Kampala and subjected to a structured interview using a modified version of the European Parasuicide Study Interview Schedule I. Among the cases, 63% were males, with a male to female ratio of 1.7:1 and a peak age range of 20-24 years. Higher educational attainment, higher socio-economic class and poor housing were significantly associated with DSH. District of current residence, district of birth, religion, ethnicity, marital status, number of children, current living arrangement, area of usual residence, employment status of respondent and partner were not significantly associated with DSH. Pesticides and medications, mainly antimalarials and diazepam, were the main methods of DSH used. The most commonly reported psychiatric disorders were adjustment disorder, acute stress reactions and depression. DSH in Uganda appears to predominantly afflict the young. Disturbed interpersonal relationships, poverty and loneliness were important factors in the immediate precipitation of this behaviour. The fact that pesticide poisoning is still the predominantly used method in DSH in this area calls for a review of the legislation that controls the sale and availability of these agricultural chemicals.

Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.

PubMed

Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth

2014-09-01

There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.

Availability, prices and affordability of UN Commission's lifesaving medicines for reproductive and maternal health in Uganda.

PubMed

Kibira, Denis; Kitutu, Freddy Eric; Merrett, Gemma Buckland; Mantel-Teeuwisse, Aukje K

2017-01-01

current study. Efforts should be undertaken by the Ministry of Health and stakeholders to improve availability, prices and affordability of MRH commodities in Uganda to ensure that sustainable Development Goals are met.

Possession and Usage of Insecticidal Bed Nets among the People of Uganda: Is BRAC Uganda Health Programme Pursuing a Pro-Poor Path?

PubMed Central

Ahmed, Syed Masud; Zerihun, Abebual

2010-01-01

Background The use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy. Methodology/Principal Findings Information on possession of LLINs and relevant knowledge on its proper use and maintenance was collected from households either with an under-five child and/or a pregnant woman. The sample included three villages from each of the 10 branch offices where BRAC Uganda's community-based health programme was operating. Data were collected by trained enumerators through face-to-face interviews using a hand-held personal digital assistant (PDA). Findings reveal that the study population had superficial knowledge on malaria and its transmission, including the use and maintenance of LLINs. The households' rate of possession of bed nets (41–59%), and the proportion of under-five children (17–19%) and pregnant women (25–27%) who reported sleeping under an LLIN were not encouraging. Inequity was observed in the number of LLINs possessed by the households, in the knowledge on its use and maintenance, and between the two programme areas. Conclusions/Significance The BRAC Uganda's LLINs distribution at a subsidized price appeared to be inadequate and inequitable, and BRAC's knowledge dissemination is insufficient for initiating preventive actions such as proper use of LLINs to interrupt malaria transmission. Findings contribute to the on-going debate on LLINs

The Substorm Current Wedge Revisited

NASA Astrophysics Data System (ADS)

Kepko, Larry; McPherron, Robert; Apatenkov, Sergey; Baumjohann, Wolfgang; Birn, Joachim; Lester, Mark; Nakamura, Rumi; Pulkkinen, Tuija; Sergeev, Victor

2015-04-01

Almost 40 years ago the concept of the substorm current wedge was developed to explain the magnetic signatures observed on the ground and in geosynchronous orbit during substorm expansion. In the ensuing decades new observations, including radar and low-altitude spacecraft, MHD simulations, and theoretical considerations have tremendously advanced our understanding of this system. The AMPTE/IRM, THEMIS and Cluster missions have added considerable observational knowledge, especially on the important role of fast flows in producing the stresses that generate the substorm current wedge. Recent detailed, multi-spacecraft, multi-instrument observations both in the magnetosphere and in the ionosphere have brought a wealth of new information about the details of the temporal evolution and structure of the current system. In this paper, we briefly review recent in situ and ground-based observations and theoretical work that have demonstrated a need for an update of the original picture. We present a revised, time-dependent picture of the substorm current wedge that follows its evolution from the initial substorm flows through substorm expansion and recovery, and conclude by identifying open questions.

Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda.

PubMed

Atuyambe, Lynn M; Kibira, Simon P S; Bukenya, Justine; Muhumuza, Christine; Apolot, Rebecca R; Mulogo, Edgar

2015-04-22

Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available. A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software. Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase. Adolescents in Uganda have multiple sexual and reproductive health needs

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

Uganda: Perfection of Post-Conflict Stability or Ticking Time Bomb

DTIC Science & Technology

2016-01-01

1 UGANDA: PERFECTION OF POST-CONFLICT STABILITY OR TICKING TIME BOMB ? By Kristin M. Pearson and Alex S. Pedersen, United States Air...Force Academy 2015 INSS RESEARCH PAPER 2016 2 UGANDA: PERFECTION OF POST-CONFLICT STABILITY OR TICKING TIME BOMB ? By Kristin M. Pearson and Alex...likely. “The area is a ticking time bomb without ongoing efforts. There’s an entire group of young men trained in military tactics that have said

Nodding syndrome (NS) and Onchocerca Volvulus (OV) in Northern Uganda.

PubMed

Lagoro, David Kitara; Arony, Denis Anywar

2017-01-01

Nodding Syndrome (NS) is a childhood neurological disorder characterized by atonic seizures, cognitive decline, school dropout, muscle weakness, thermal dysfunction, wasting and stunted growth. There are recent published information suggesting associations between Nodding Syndrome (NS) with cerebrospinal fluid (CSF) VGKC antibodies and serum leiomidin-1 antibody cross reacting with Onchocerca Volvulus ( OV ). These findings suggest a neuro-inflammatory cause of NS and they are important findings in the search for the cause of Nodding Syndrome. These observations perhaps provide further, the unique explanation for the association between Nodding Syndrome and Onchocerca Volvulus . Many clinical and epidemiological studies had shown a significant correlation between NS and infestation with a nematode, Onchocerca volvulus which causes a disease, Onchocerciasis , some of which when left untreated can develop visual defect ("River Blindness"). While these studies conducted in Northern Uganda and Southern Sudan indicate a statistically significant association with ( OV infection (using positive skin snips), we observe that ( OV is generally endemic in many parts of Sub Saharan Africa and Latin America and that to date, no NS cases have been recorded in those regions. This letter to the Editor is to provide additional information on the current view about the relationship between Nodding Syndrome and Onchocerca Volvulus as seen in Northern Uganda.

Nodding syndrome (NS) and Onchocerca Volvulus (OV) in Northern Uganda

PubMed Central

Lagoro, David Kitara; Arony, Denis Anywar

2017-01-01

Nodding Syndrome (NS) is a childhood neurological disorder characterized by atonic seizures, cognitive decline, school dropout, muscle weakness, thermal dysfunction, wasting and stunted growth. There are recent published information suggesting associations between Nodding Syndrome (NS) with cerebrospinal fluid (CSF) VGKC antibodies and serum leiomidin-1 antibody cross reacting with Onchocerca Volvulus (OV). These findings suggest a neuro-inflammatory cause of NS and they are important findings in the search for the cause of Nodding Syndrome. These observations perhaps provide further, the unique explanation for the association between Nodding Syndrome and Onchocerca Volvulus. Many clinical and epidemiological studies had shown a significant correlation between NS and infestation with a nematode, Onchocerca volvulus which causes a disease, Onchocerciasis, some of which when left untreated can develop visual defect ("River Blindness"). While these studies conducted in Northern Uganda and Southern Sudan indicate a statistically significant association with (OV infection (using positive skin snips), we observe that (OV is generally endemic in many parts of Sub Saharan Africa and Latin America and that to date, no NS cases have been recorded in those regions. This letter to the Editor is to provide additional information on the current view about the relationship between Nodding Syndrome and Onchocerca Volvulus as seen in Northern Uganda. PMID:29138647

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…

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda.

PubMed

Hörbst, Viola; Gerrits, Trudie

2016-08-01

Based on our comparative fieldwork in two private fertility clinics in Accra (Ghana) and Kampala (Uganda), we explore the transnational mobility of providers involved in assisted reproductive technologies (ARTs) and analyze how resulting transnational networks influence the realization and appropriation of these therapeutic treatments. By exploring these case studies from developing countries, this article intends to contribute to the field of studies that examine the diversification and complexity of migration and health care. We first summarize the dynamics affecting the health-care systems in Ghana and Uganda over the last decades. Then, we describe the transnational mobility engaged in the two clinics. Through the case studies, we highlight how ARTs are realized and appropriated in the two receiving countries, and the role transnational contacts play within the negotiations of medical ethos and financial interests. By using the concept of medicoscapes, we analyze the worldwide connections between ART providers, the institutions they work in, their medical practices, artifacts, and their regimes of medical knowledge. Transnational professional contacts have been essential to the setup of both clinics offering ARTs in Ghana and Uganda. These contacts developed along colonial and post-colonial links, integrating also south-south relationship. The clinics' directors act as entrepreneurs and creative decision-makers who capitalize on their transnational professional network. The case studies show the diverse transnational entanglements in both clinics and demonstrate the frictions between the doctors' entrepreneurial interests, medical concerns and cultural values. The transnational professional contacts expose both clinics to varying practices and debates, and make them into sites for negotiating distinct clinical practices. They provoke frictions between entrepreneurial interests and medical concerns including cultural values. In current medicoscapes, in a

Science-based health innovation in Uganda: creative strategies for applying research to development.

PubMed

Kamunyori, Sheila; Al-Bader, Sara; Sewankambo, Nelson; Singer, Peter A; Daar, Abdallah S

2010-12-13

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. 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. 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. Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the

Spatial Distribution of Underweight, Overweight and Obesity among Women and Children: Results from the 2011 Uganda Demographic and Health Survey

PubMed Central

Turi, Kedir N.; Christoph, Mary J.; Grigsby-Toussaint, Diana S.

2013-01-01

While undernutrition and infectious diseases are still persistent in developing countries, overweight, obesity, and associated comorbidities have become more prevalent. Uganda, a developing sub-Saharan African country, is currently experiencing the public health paradox of undernutrition and overnutrition. We utilized the 2011 Uganda Demographic and Health Survey (DHS) to examine risk factors and hot spots for underweight, overweight, and obesity among adult females (N = 2,420) and their children (N = 1,099) using ordinary least squares and multinomial logit regression and the ArcGIS Getis-Ord Gi* statistic. Overweight and obese women were significantly more likely to have overweight children, and overweight was correlated with being in the highest wealth class (OR = 2.94, 95% CI = 1.99–4.35), and residing in an urban (OR = 1.76, 95% CI = 1.34–2.29) but not a conflict prone (OR = 0.48, 95% CI = 0.29–0.78) area. Underweight clustered significantly in the Northern and Northeastern regions, while overweight females and children clustered in the Southeast. We demonstrate that the DHS can be used to assess geographic clustering and burden of disease, thereby allowing for targeted programs and policies. Further, we pinpoint specific regions and population groups in Uganda for targeted preventive measures and treatment to reduce the burden of overweight and chronic diseases in Uganda. PMID:24157515

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…

The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.

PubMed

Behrman, Julia Andrea

2015-02-01

This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p < 0.01) in Malawi and by 0.03 (p < 0.05) in Uganda. These results are robust to a variety of model specifications. In a series of supplementary analyses a number of potential pathways through which such effects may occur are explored. Findings indicate increased primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases.

PubMed

Schwartz, Jeremy I; Dunkle, Ashley; Akiteng, Ann R; Birabwa-Male, Doreen; Kagimu, Richard; Mondo, Charles K; Mutungi, Gerald; Rabin, Tracy L; Skonieczny, Michael; Sykes, Jamila; Mayanja-Kizza, Harriet

2015-01-01

The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda.

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.…

Sunday School Revisited: An Alternative to Christian Education of the Church Today?

ERIC Educational Resources Information Center

Song, Nam Soon

2013-01-01

This article attempts to demonstrate similarities between the socioeconomic, cultural, and religious contexts of 18th-century England and 21st-century Canada. Revisiting the Sunday School movement in 18th-century England provides insights for the development of renewed Sunday School models in the current Canadian context of transnational…

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.

Road traffic incidents in Uganda: a systematic review of a five-year trend

PubMed Central

Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Munanura, Kasiima Stephen

2017-01-01

Abstract: Background: Over the years, Uganda has been one of the low and middle-income countries bearing the heaviest burden of road traffic incidents (RTI). Since the proclamation of the United Nations Decade of Action for Road Safety 2011 – 2020, a number of measures have been taken to reduce the burden. However, they ought to be premised on existing evidence-based research; therefore, the present review ventures to report the most recent five-year trend of RTI in Uganda. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-Data Analysis (PRISMA) guidelines, a systematic review was employed. Using a thematic analysis, the articles were grouped into: trauma etiology, trauma care, mortality, cost, trauma registry and communication, intervention and treatment for final analysis. Results: Of the nineteen articles that were identified to be relevant to the study, the etiology of RTI was inevitably observed to be an important cause of injuries in Uganda. The risk factors cut across: the crash type, injury physiology, cause, victims, setting, age, economic status, and gender. All studies that were reviewed have advanced varying recommendations aimed at responding to the trend of RTIs in Uganda, of which some are in tandem with the five pillars of the United Nations Decade of Action for Road Safety 2011 – 2020. Conclusions: Peripheral measures of the burden of RTIs in Uganda were undertaken within a five-year timeframe (2011-2015) of implementing the United Nations Decade of Action for Road Safety. The measures however, ought to be scaled-up on robust evidence based research available from all the concerned stakeholders beyond Kampala or central region to other parts of Uganda. PMID:28039687

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

Emotional and behavioural disorders in HIV seropositive adolescents in urban Uganda.

PubMed

Musisi, S; Kinyanda, E

2009-01-01

To investigate the emotional and behavioral problems of HIV sero-positive adolescents. A cross-sectional descriptive study. A specialised HIV/AIDS Health Care Centre, the Mildmay Centre, in Kampala, Uganda. Eighty two HIV sero-positive adolescents were consecutively enrolled for the study. Over half (55.6%) of the subjects were females. They were mostly (88.9%) under the age of 15 years, orphans (97.6%) and stayed with non-parental relatives (68.3%). Almost two thirds (60.9%) of them were in the HIV/AIDS clinical disease stage III or IV and were not on ARVs drugs. Forty two (51.2%) of the subjects had significant psychological distress (SRQ-25 scores > or = 6) and 14 (17.1%) had attempted suicide within the last 12 months. Their specific psychiatric disorders, made using ICD-10 criteria, were: Anxiety 45.6%, depression 40.8%, somatisation 18.0%, seizures 8.4%, mania 1.2% and HIV-associated progressive encephalopathy 4.8%. HIV/AIDS infection in adolescence was associated with considerable psychological problems and the presence of major psychiatric disorders. With the current increasing availability of effective antiretroviral therapy, many of these children are surviving into adolescence, thus calling for the development of adolescent friendly HIV medical and psychological support and treatment services in developing countries such as Uganda.

Lakatos Revisited.

ERIC Educational Resources Information Center

Court, Deborah

1999-01-01

Revisits and reviews Imre Lakatos' ideas on "Falsification and the Methodology of Scientific Research Programmes." Suggests that Lakatos' framework offers an insightful way of looking at the relationship between theory and research that is relevant not only for evaluating research programs in theoretical physics, but in the social…

Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

PubMed

Rudrum, Sarah

2016-01-01

The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases

PubMed Central

Schwartz, Jeremy I.; Dunkle, Ashley; Akiteng, Ann R.; Birabwa-Male, Doreen; Kagimu, Richard; Mondo, Charles K.; Mutungi, Gerald; Rabin, Tracy L.; Skonieczny, Michael; Sykes, Jamila; Mayanja-Kizza, Harriet

2015-01-01

Background The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Methods Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. Results In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Discussion Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda. PMID:25563451

The complexities of educating nurses in Uganda.

PubMed

Andrews, C M; Rottman, C J; Lematia, R M

1996-01-01

Imagine that you are a woman living in rural Uganda. Your husband has returned to the city to work as a manual labourer. With a toddler playing alongside, you work long hot hours in the field to provide for your family. For weeks you have run a low-grade fever which you suspect is related to your advancing pregnancy. As traditional medicines have provided no relief, you sacrifice a day in the field and wait in line for care at a medical clinic outpost that is staffed one day a week. Nearing your turn, you hear a rumour that the government now requires payment in advance for care. As you and most of the others waiting in line do not have money, you leave together and arrange to pool resources from a community project so that you can all return to the clinic next week. Your pain increases and your productivity goes down. When the clinic day finally comes, the nurse does not show up because her own children need food and she prefers to earn ready cash by selling crafts in the market rather than work at the clinic for barely subsistence pay. The story does not end here, nor does that of countless other women in Uganda, including the caregivers. The difficulties are ongoing. And meeting health needs in Uganda as in many countries in Sub-Sahara Africa is complex and challenging.

Postgraduate training for trauma prevention, injury surveillance and research, Uganda.

PubMed

Bachani, Abdulgafoor M; Paichadze, Nino; Bentley, Jacob A; Tumwesigye, Nazarius Mbona; Bishai, David; Atuyambe, Lynn; Wegener, Stephen; Guwatudde, David; Kobusingye, Olive C; Hyder, Adnan A

2018-06-01

The burden of trauma and injuries in Uganda is substantial and growing. Two important gaps that need addressing are the shortage of trained people and a lack of national data on noncommunicable diseases and their risk factors in Uganda. We developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. We also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability. The Chronic Consequences of Trauma, Injuries and Disability in Uganda programme was implemented in 2012 at Makerere University School of Public Health in Kampala, Uganda, in conjunction with Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America. Over the years 2012 to 2017 we supported four cohorts of master's students, with a total of 14 students (9 females and 5 males; mean age 30 years). Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums. Institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes. Integration of training components within existing academic structures is key to sustainability. Appropriate mentorship for highly motivated and talented students is valuable for guiding students through the programme.

Factors Associated with Incomplete Reporting of HIV and AIDS by Uganda's Surveillance System

ERIC Educational Resources Information Center

Akankunda, Denis B.

2014-01-01

Background: Over the last 20 years, Uganda has piloted and implemented various management information systems (MIS) for better surveillance of HIV/AIDS. With support from the United States Government, Uganda introduced the District Health Information Software 2 (DHIS2) in 2012. However, districts have yet to fully adapt to this system given a…

Addressing HIV/AIDS challenges in Uganda: does social capital generation by NGOs matter?

PubMed

Muriisa, Roberts Kabeba; Jamil, Ishtiaq

2011-01-01

HIV/AIDS has had devastating impacts in many countries, Uganda in particular. However, Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others, Uganda's success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition, the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard, HIV/AIDS NGOs play a central role in the way individuals, groups and communities interact, and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs' success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels, and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda.

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…

Obesity as a form of malnutrition: over-nutrition on the Uganda "malnutrition" agenda.

PubMed

Ngaruiya, Christine; Hayward, Alison; Post, Lori; Mowafi, Hani

2017-01-01

The objectives were to highlight the burden of overweight and obesity as an additional area of importance for the malnutrition agenda in Uganda and to provide evidence-based considerations for stakeholders involved. Mirroring other Low- and Middle-Income Countries (LMICs), Uganda is experiencing a "double burden" of over-nutrition related issues - both obesity and overweight, and related non-communicable diseases (NCDs) alongside the under-nutrition that has long plagued the country. Despite the commonplace assumption that under-nutrition is the predominant form of malnutrition in Uganda, we explore recent literature that in fact, challenges this notion. While food insecurity has contributed to the under-nutrition problem, a lack of dietary diversity also has a demonstrated role in increasing over-nutrition. We cannot afford to ignore over-nutrition concomitant with stunting and wasting in the country. Increase in the burden of this less acknowledged form of malnutrition in Uganda is critical to investigate, and yet poorly understood. A move towards increased regionally targeted over-nutrition research, funding, government prioritization and advocacy is needed.

Strategies for Faith Engagement within One's Career: The Role of Uganda Christian University in Preparing Students for Postgraduation Life

ERIC Educational Resources Information Center

Rugyendo, Medard

2015-01-01

This article examines the role of Uganda Christian University (UCU) in devising strategies for the sustenance of Christian faith in one's career for the betterment of the society despite its social ills. The current theme of UCU is "A Complete Education for a Complete Person." As a Christian university, UCU seeks to provide a positive…

Circular revisit orbits design for responsive mission over a single target

NASA Astrophysics Data System (ADS)

Li, Taibo; Xiang, Junhua; Wang, Zhaokui; Zhang, Yulin

2016-10-01

The responsive orbits play a key role in addressing the mission of Operationally Responsive Space (ORS) because of their capabilities. These capabilities are usually focused on supporting specific targets as opposed to providing global coverage. One subtype of responsive orbits is repeat coverage orbit which is nearly circular in most remote sensing applications. This paper deals with a special kind of repeating ground track orbit, referred to as circular revisit orbit. Different from traditional repeat coverage orbits, a satellite on circular revisit orbit can visit a target site at both the ascending and descending stages in one revisit cycle. This typology of trajectory allows a halving of the traditional revisit time and does a favor to get useful information for responsive applications. However the previous reported numerical methods in some references often cost lots of computation or fail to obtain such orbits. To overcome this difficulty, an analytical method to determine the existence conditions of the solutions to revisit orbits is presented in this paper. To this end, the mathematical model of circular revisit orbit is established under the central gravity model and the J2 perturbation. A constraint function of the circular revisit orbit is introduced, and the monotonicity of that function has been studied. The existent conditions and the number of such orbits are naturally worked out. Taking the launch cost into consideration, optimal design model of circular revisit orbit is established to achieve a best orbit which visits a target twice a day in the morning and in the afternoon respectively for several days. The result shows that it is effective to apply circular revisit orbits in responsive application such as reconnoiter of natural disaster.

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.

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…

Prevalence of African swine fever virus in apparently healthy domestic pigs in Uganda.

PubMed

Atuhaire, David Kalenzi; Afayoa, Mathias; Ochwo, Sylvester; Mwesigwa, Savannah; Mwiine, Frank Norbert; Okuni, Julius Boniface; Olaho-Mukani, William; Ojok, Lonzy

2013-12-26

African swine fever (ASF) is a contagious viral disease which can cause up to 100% mortality among domestic pigs leading to serious socio-economic impact on people's livelihoods. ASF is endemic in Uganda and there is paucity of information on the epidemiology of the disease. The major aim of this study was to determine the seroprevalence and prevalence of African swine fever virus (ASFV) in apparently healthy slaughter pigs at Wambizi slaughterhouse in Kampala city, Uganda. We also estimated the presence of ASFV antibodies and circulating viral antigens in pigs from selected districts of Uganda during targeted surveillance. We analysed 540 and 181 blood samples collected from slaughter pigs and pigs from targeted surveillance districts respectively. The prevalence of ASFV in slaughter pigs was 52.96% (95% CI, 48.75-57.14) and 11.5% (95% CI, 9.06-14.45) by ELISA and PCR respectively. In surveillance districts, the proportion of ASFV positive pigs was 53.59% (95% CI, 46.33-60.71) and 0.55% (95% CI, 0.1-3.06) by ELISA and PCR respectively. The study has found out a high seroprevalence of ASFV antibodies in apparently healthy slaughter pigs and also a high proportion of ASFV antibody seropositive pigs in surveyed districts in Uganda indicating exposure to ASFV. However, there was a lower prevalence of ASFV infection implying that there could be low virulent strains of ASFV circulating in domestic pigs in Uganda which requires further investigation.

Clinico-pathological features of tuberculosis due to Mycobacterium tuberculosis Uganda genotype in patients with tuberculous lymphadenitis: a cross sectional study.

PubMed

Wamala, Dan; Asiimwe, Benon; Kigozi, Edgar; Mboowa, Gerald; Joloba, Moses; Kallenius, Gunilla

2014-04-02

Tuberculous lymphadenitis is next to pulmonary tuberculosis as the most common cause of tuberculosis. Uganda genotype, one of the sub-lineages of Mycobacterium tuberculosis, is the most prevalent cause of pulmonary tuberculosis in Uganda. We here investigate the clinicopathological characteristics of patients with tuberculous lymphadenitis infected with M. tuberculosis Uganda genotype compared with those infected with M. tuberculosis non-Uganda genotype strains. Between 2010 and 2012, we enrolled 121 patients (mean age 28.5 yrs, male 48%; female 52%) with tuberculous lymphadenitis, and categorized them by their M. tuberculosis genotypes. The clinical features and lymph node cytopathological parameters were compared between patients in the Uganda and non-Uganda categories using a crude and multivariable logistic regression model with adjustment for confounding factors. Of the 121participants, 56 (46%) were infected with strains of Uganda genotype. Patients infected with this genotype had significantly lower frequency of abdominal lymphadenopathy (odds ratio 0.4, p = 0.046) after adjusting for sex, age and HIV. Abdominal lymphadenopathy was also significantly associated with abnormal chest X-ray (p = 0.027). Tuberculous lymphadenitis patients infected with M. tuberculosis Uganda genotype were significantly less prone to have abdominal lymphadenopathy indicating potential reduced ability to disseminate and supporting the concept that differences in M. tuberculosis genotype may have clinical implications.

Helicobacter pylori and cancer among adults in Uganda

PubMed Central

Newton, Robert; Ziegler, John L; Casabonne, Delphine; Carpenter, Lucy; Gold, Benjamin D; Owens, Marilyn; Beral, Valerie; Mbidde, Edward; Parkin, D Maxwell; Wabinga, Henry; Mbulaiteye, Sam; Jaffe, Harold

2006-01-01

Data from Africa on infection with Helicobacter pylori (H. pylori) are sparse. Therefore, as part of an epidemiological study of cancer in Uganda, we investigated the prevalence and determinants of antibodies against H. pylori among 854 people with different cancer types and benign tumours. Patients were recruited from hospitals in Kampala, Uganda, interviewed about various demographic and lifestyle factors and tested for antibodies against H. pylori. In all patients combined, excluding those with stomach cancer (which has been associated with H. pylori infection), the prevalence of antibodies was 87% (723/833) overall, but declined with increasing age (p = 0.02) and was lower among people who were HIV seropositive compared to seronegative (p < 0.001). Otherwise, there were few consistent epidemiological associations. Among those with stomach cancer, 18/21 (86%) had anti-H. pylori antibodies (odds ratio 0.8, 95% confidence intervals 0.2–2.9, p = 0.7; estimated using all other patients as controls, with adjustment for age, sex and HIV serostatus). No other cancer site or type was significantly associated with anti-H. pylori antibodies. The prevalence of H. pylori reported here is broadly in accord with results from other developing countries, although the determinants of infection and its' role in the aetiology of gastric cancer in Uganda remain unclear. PMID:17150134

The Palliative Care Journey in Kenya and Uganda.

PubMed

Kamonyo, Emmanuel S

2018-02-01

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems. This update is aimed at examining palliative care development/achievements and challenges in Kenya and Uganda and the role of various actors in palliative care establishment in the region. It assesses the policy environment, progress in education, access to essential medicines, palliative care implementation efforts, and legal and human rights work. East African nations have huge disease burdens, both communicable and noncommunicable. HIV and cancer are the major causes of mortality in Kenya and Uganda and put huge demands on the health care system and on the country's economies. All these conditions will require palliative care services as the disease burden increases. Unfortunately, for many African countries, accessing palliative care services, including access to pain relief, remains very limited resulting in serious suffering for patients and their families. The interventions in Kenya and Uganda help palliative care organizations engage with their respective governments to ensure that the social and legal barriers impeding access to palliative care services are removed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Performance of a High-Sensitivity Rapid Diagnostic Test for Plasmodium falciparum Malaria in Asymptomatic Individuals from Uganda and Myanmar and Naive Human Challenge Infections.

PubMed

Das, Smita; Jang, Ihn Kyung; Barney, Becky; Peck, Roger; Rek, John C; Arinaitwe, Emmanuel; Adrama, Harriet; Murphy, Maxwell; Imwong, Mallika; Ling, Clare L; Proux, Stephane; Haohankhunnatham, Warat; Rist, Melissa; Seilie, Annette M; Hanron, Amelia; Daza, Glenda; Chang, Ming; Nakamura, Tomoka; Kalnoky, Michael; Labarre, Paul; Murphy, Sean C; McCarthy, James S; Nosten, Francois; Greenhouse, Bryan; Allauzen, Sophie; Domingo, Gonzalo J

2017-11-01

Sensitive field-deployable diagnostic tests can assist malaria programs in achieving elimination. The performance of a new Alere™ Malaria Ag P.f Ultra Sensitive rapid diagnostic test (uRDT) was compared with the currently available SD Bioline Malaria Ag P.f RDT in blood specimens from asymptomatic individuals in Nagongera, Uganda, and in a Karen Village, Myanmar, representative of high- and low-transmission areas, respectively, as well as in pretreatment specimens from study participants from four Plasmodium falciparum -induced blood-stage malaria (IBSM) studies. A quantitative reverse transcription PCR (qRT-PCR) and a highly sensitive enzyme-linked immunosorbent assay (ELISA) test for histidine-rich protein II (HRP2) were used as reference assays. The uRDT showed a greater than 10-fold lower limit of detection for HRP2 compared with the RDT. The sensitivity of the uRDT was 84% and 44% against qRT-PCR in Uganda and Myanmar, respectively, and that of the RDT was 62% and 0% for the same two sites. The specificities of the uRDT were 92% and 99.8% against qRT-PCR for Uganda and Myanmar, respectively, and 99% and 99.8% against the HRP2 reference ELISA. The RDT had specificities of 95% and 100% against qRT-PCR for Uganda and Myanmar, respectively, and 96% and 100% against the HRP2 reference ELISA. The uRDT detected new infections in IBSM study participants 1.5 days sooner than the RDT. The uRDT has the same workflow as currently available RDTs, but improved performance characteristics to identify asymptomatic malaria infections. The uRDT may be a useful tool for malaria elimination strategies.

Performance of a High-Sensitivity Rapid Diagnostic Test for Plasmodium falciparum Malaria in Asymptomatic Individuals from Uganda and Myanmar and Naive Human Challenge Infections

PubMed Central

Das, Smita; Jang, Ihn Kyung; Barney, Becky; Peck, Roger; Rek, John C.; Arinaitwe, Emmanuel; Adrama, Harriet; Murphy, Maxwell; Imwong, Mallika; Ling, Clare L.; Proux, Stephane; Haohankhunnatham, Warat; Rist, Melissa; Seilie, Annette M.; Hanron, Amelia; Daza, Glenda; Chang, Ming; Nakamura, Tomoka; Kalnoky, Michael; Labarre, Paul; Murphy, Sean C.; McCarthy, James S.; Nosten, Francois; Greenhouse, Bryan; Allauzen, Sophie; Domingo, Gonzalo J.

2017-01-01

Abstract. Sensitive field-deployable diagnostic tests can assist malaria programs in achieving elimination. The performance of a new Alere™ Malaria Ag P.f Ultra Sensitive rapid diagnostic test (uRDT) was compared with the currently available SD Bioline Malaria Ag P.f RDT in blood specimens from asymptomatic individuals in Nagongera, Uganda, and in a Karen Village, Myanmar, representative of high- and low-transmission areas, respectively, as well as in pretreatment specimens from study participants from four Plasmodium falciparum-induced blood-stage malaria (IBSM) studies. A quantitative reverse transcription PCR (qRT-PCR) and a highly sensitive enzyme-linked immunosorbent assay (ELISA) test for histidine-rich protein II (HRP2) were used as reference assays. The uRDT showed a greater than 10-fold lower limit of detection for HRP2 compared with the RDT. The sensitivity of the uRDT was 84% and 44% against qRT-PCR in Uganda and Myanmar, respectively, and that of the RDT was 62% and 0% for the same two sites. The specificities of the uRDT were 92% and 99.8% against qRT-PCR for Uganda and Myanmar, respectively, and 99% and 99.8% against the HRP2 reference ELISA. The RDT had specificities of 95% and 100% against qRT-PCR for Uganda and Myanmar, respectively, and 96% and 100% against the HRP2 reference ELISA. The uRDT detected new infections in IBSM study participants 1.5 days sooner than the RDT. The uRDT has the same workflow as currently available RDTs, but improved performance characteristics to identify asymptomatic malaria infections. The uRDT may be a useful tool for malaria elimination strategies. PMID:28820709

Road traffic incidents in Uganda: a systematic review study of a five-year trend.

PubMed

Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Munanura, Kasiima Stephen

2017-01-01

Over the years, Uganda has been one of the low and middle-income countries bearing the heaviest burden of road traffic incidents (RTI). Since the proclamation of the United Nations Decade of Action for Road Safety 2011 - 2020, a number of measures have been taken to reduce the burden. However, they ought to be premised on existing evidence-based research; therefore, the present review ventures to report the most recent five-year trend of RTI in Uganda. Based on Preferred Reporting Items for Systematic Reviews and Meta-Data Analysis (PRISMA) guidelines, a systematic review was employed. Using a thematic analysis, the articles were grouped into: trauma etiology, trauma care, mortality, cost, trauma registry and communication, intervention and treatment for final analysis. Of the nineteen articles that were identified to be relevant to the study, the etiology of RTI was inevitably observed to be an important cause of injuries in Uganda. The risk factors cut across: the crash type, injury physiology, cause, victims, setting, age, economic status, and gender. All studies that were reviewed have advanced varying recommendations aimed at responding to the trend of RTIs in Uganda, of which some are in tandem with the five pillars of the United Nations Decade of Action for Road Safety 2011 - 2020. Peripheral measures of the burden of RTIs in Uganda were undertaken within afive-year timeframe (2011-2015) of implementing the United Nations Decade of Action for Road Safety. The measures however, ought to be scaled-up on robust evidence based research available from all the concerned stakeholders beyond Kampala or central region to other parts of Uganda. © 2017 KUMS, All rights reserved.

Chemotherapy Use at the End of Life in Uganda

PubMed Central

Merkel, Emily C.; Menon, Manoj; Lyman, Gary H.; Ddungu, Henry; Namukwaya, Elizabeth; Leng, Mhoira; Casper, Corey

2017-01-01

Purpose Avoiding chemotherapy during the last 30 days of life has become a goal of cancer care in the United States and Europe, yet end-of-life chemotherapy administration remains a common practice worldwide. The purpose of this study was to determine the frequency of and factors predicting end-of-life chemotherapy administration in Uganda. Methods Retrospective chart review and surveys and interviews of providers were performed at the Uganda Cancer Institute (UCI), the only comprehensive cancer center in the area, which serves a catchment area of greater than 100 million people. All adult patients at the UCI with reported cancer deaths between January 1, 2014, and August 31, 2015 were included. All UCI physicians were offered a survey, and a subset of physicians were also individually interviewed. Results Three hundred ninety-two patients (65.9%) received chemotherapy. Age less than 55 years (odds ratio [OR], 2.30; P = .004), a cancer diagnosis greater than 60 days before death (OR, 9.13; P < .001), and a presenting Eastern Cooperative Oncology Group performance status of 0 to 2 (OR, 2.47; P = .001) were associated with the administration of chemotherapy. More than 45% of patients received chemotherapy in the last 30 days of life. No clinical factors were predictive of chemotherapy use in the last 30 days of life, although doctors reported using performance status, cancer stage, and tumor chemotherapy sensitivity to determine when to administer chemotherapy. Patient expectations and a lack of outcomes data were important nonclinical factors influencing chemotherapy administration. Conclusion Chemotherapy is administered to a high proportion of patients with terminal cancer in Uganda, raising concern about efficacy. Late presentation of cancer in Uganda complicates end-of-life chemotherapy recommendations, necessitating guidelines specific to sub-Saharan Africa. PMID:29244988

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…

Prevalence of African swine fever virus in apparently healthy domestic pigs in Uganda

PubMed Central

2013-01-01

Background African swine fever (ASF) is a contagious viral disease which can cause up to 100% mortality among domestic pigs leading to serious socio-economic impact on people’s livelihoods. ASF is endemic in Uganda and there is paucity of information on the epidemiology of the disease. The major aim of this study was to determine the seroprevalence and prevalence of African swine fever virus (ASFV) in apparently healthy slaughter pigs at Wambizi slaughterhouse in Kampala city, Uganda. We also estimated the presence of ASFV antibodies and circulating viral antigens in pigs from selected districts of Uganda during targeted surveillance. We analysed 540 and 181 blood samples collected from slaughter pigs and pigs from targeted surveillance districts respectively. Results The prevalence of ASFV in slaughter pigs was 52.96% (95% CI, 48.75-57.14) and 11.5% (95% CI, 9.06-14.45) by ELISA and PCR respectively. In surveillance districts, the proportion of ASFV positive pigs was 53.59% (95% CI, 46.33-60.71) and 0.55% (95% CI, 0.1-3.06) by ELISA and PCR respectively. Conclusion The study has found out a high seroprevalence of ASFV antibodies in apparently healthy slaughter pigs and also a high proportion of ASFV antibody seropositive pigs in surveyed districts in Uganda indicating exposure to ASFV. However, there was a lower prevalence of ASFV infection implying that there could be low virulent strains of ASFV circulating in domestic pigs in Uganda which requires further investigation. PMID:24369729

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…

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…

Obesity as a form of malnutrition: over-nutrition on the Uganda “malnutrition” agenda

PubMed Central

Ngaruiya, Christine; Hayward, Alison; Post, Lori; Mowafi, Hani

2017-01-01

The objectives were to highlight the burden of overweight and obesity as an additional area of importance for the malnutrition agenda in Uganda and to provide evidence-based considerations for stakeholders involved. Introduction: Mirroring other Low- and Middle-Income Countries (LMICs), Uganda is experiencing a “double burden” of over-nutrition related issues - both obesity and overweight, and related non-communicable diseases (NCDs) alongside the under-nutrition that has long plagued the country. Despite the commonplace assumption that under-nutrition is the predominant form of malnutrition in Uganda, we explore recent literature that in fact, challenges this notion. While food insecurity has contributed to the under-nutrition problem, a lack of dietary diversity also has a demonstrated role in increasing over-nutrition. We cannot afford to ignore over-nutrition concomitant with stunting and wasting in the country. Increase in the burden of this less acknowledged form of malnutrition in Uganda is critical to investigate, and yet poorly understood. A move towards increased regionally targeted over-nutrition research, funding, government prioritization and advocacy is needed. PMID:29184601

Uganda--rehabilitation, or redefinition of health services?

PubMed

Dodge, C P

1986-01-01

Uganda had one of the best health care delivery systems in Africa. The decade of misrule by Amin saw a collapse of the country and an exodus of doctors and other professions. The 1979 liberation war and subsequent political instability and insecurity further aggravated the poor health services then available. When political stability was temporarily restored in December 1980 the cash crop export sector took priority over social services and the health budget declined to only 3.5% compared to a former level of 7.5% of government budget. Emergencies in West Nile, Karamoja and the Luwero triangle continued to plague rehabilitation efforts upto 1985. Alternate strategies for improving health are proposed including female education, increased budget allocations, food and nutrition policy and health information. Uganda's prospect for rebuilding the health services has begun with immunization, control of diarrhoeal diseases, nutrition surveillance in Karamoja and an essential drugs programme, but the success of these is dependent upon political stability and improvement in overall security.

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…

Structuralism's Relevance in a Post-Structural Era: Re-Visiting Research on Multicultural Curricular Studies

ERIC Educational Resources Information Center

Shim, Jenna Min

2011-01-01

At the current historical juncture in which differences and inequalities are surfacing greater than ever in the world, societies, and schools, the main goal of this essay is to revisit the aspects of structuralism that can potentially contribute productively to understanding the invisible structures and forces that everyone carries (mostly…

Expiry of medicines in supply outlets in Uganda.

PubMed

Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein; Kamba, Pakoyo Fadhiru

2010-02-01

The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country's pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered.

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

"Homosexuality/Homophobia Is Un-African"?: Un-Mapping Transnational Discourses in the Context of Uganda's Anti-Homosexuality Bill/Act.

PubMed

Wahab, Amar

2016-01-01

This article un-maps the recent impasse between pro- and antigay mobilization around Uganda's Anti-Homosexuality Act (AHA, 2009-2014). Drawing on scholarly and social media sources, it summarizes the increasing influence of (U.S.) transnational evangelism that has precipitated a state-religious complex of "anticipatory political homophobia" in Uganda. If transnational evangelism against same-sex sexuality in Uganda has generated a strong reaction from global LGBT human-rights advocates, this article critiques this Western homotransnationalist response by analyzing its limited terms of operation, focusing on the ways in which Uganda is hailed into the biopolitical project of a Western queer modernity. The author focuses on the copresence between homotransnationalist mobilization and "homophobic anticipatory countermobilization" as (re)organizing/suturing a global ordering project that is deeply invested in biopolitics and necropolitics. This suggests that the global flashpointing of Uganda in the context of the AHA incites further questions concerning the transnationality of "gay human rights" discourse under neoliberalism.

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…

Stakeholders' Perceptions of Agronomic Iodine Biofortification: A SWOT-AHP Analysis in Northern Uganda.

PubMed

Olum, Solomon; Gellynck, Xavier; Okello, Collins; Webale, Dominic; Odongo, Walter; Ongeng, Duncan; De Steur, Hans

2018-03-24

Agronomic biofortification (i.e., the application of fertilizer to elevate micronutrient concentrations in staple crops) is a recent strategy recommended for controlling Iodine Deficiency Disorders (IDDs). However, its success inevitably depends on stakeholders' appreciation and acceptance of it. By taking Northern Uganda as a case, this study aimed to capture and compare the perceptions of seven key stakeholder groups with respect to agronomic iodine biofortification. Therefore, we employed a SWOT (Strength, Weaknesses, Opportunities & Threats) analysis in combination with an Analytical Hierarchy Process (AHP). Findings show that stakeholders ( n = 56) are generally positive about agronomic iodine biofortification in Uganda, as its strengths and opportunities outweighed weaknesses and threats. Cultural acceptance and effectiveness are considered the most important strengths while the high IDD prevalence rate and the availability of iodine deficient soils are key opportunities for further developing agronomic iodine biofortification. Environmental concerns about synthetic fertilizers as well as the time needed to supply iodine were considered crucial weaknesses. The limited use of fertilizer in Uganda was the main threat. While this study provides insight into important issues and priorities for iodine biofortification technology in Uganda, including differences in stakeholder views, the application of the SWOT-AHP method will guide future researchers and health planners conducting stakeholder analysis in similar domains.

Stakeholders’ Perceptions of Agronomic Iodine Biofortification: A SWOT-AHP Analysis in Northern Uganda

PubMed Central

Olum, Solomon; Gellynck, Xavier; Okello, Collins; Webale, Dominic; Odongo, Walter; Ongeng, Duncan

2018-01-01

Agronomic biofortification (i.e., the application of fertilizer to elevate micronutrient concentrations in staple crops) is a recent strategy recommended for controlling Iodine Deficiency Disorders (IDDs). However, its success inevitably depends on stakeholders’ appreciation and acceptance of it. By taking Northern Uganda as a case, this study aimed to capture and compare the perceptions of seven key stakeholder groups with respect to agronomic iodine biofortification. Therefore, we employed a SWOT (Strength, Weaknesses, Opportunities & Threats) analysis in combination with an Analytical Hierarchy Process (AHP). Findings show that stakeholders (n = 56) are generally positive about agronomic iodine biofortification in Uganda, as its strengths and opportunities outweighed weaknesses and threats. Cultural acceptance and effectiveness are considered the most important strengths while the high IDD prevalence rate and the availability of iodine deficient soils are key opportunities for further developing agronomic iodine biofortification. Environmental concerns about synthetic fertilizers as well as the time needed to supply iodine were considered crucial weaknesses. The limited use of fertilizer in Uganda was the main threat. While this study provides insight into important issues and priorities for iodine biofortification technology in Uganda, including differences in stakeholder views, the application of the SWOT-AHP method will guide future researchers and health planners conducting stakeholder analysis in similar domains. PMID:29587370

Uganda: condoms provoke an AIDS storm.

PubMed

Tebere, R

1991-03-01

An advertisement in the Uganda weekly Topic printed in 1990 is the center of the controversy over whether promoting condom use to prevent AIDS is really promoting immorality and promiscuity. The ad states: "The bible may save your soul but this condom will save you life." Critics have called the ad blasphemy for showing a condom package alongside the Bible; claimed the condom fools people into thinking they are safe from AIDS; and blamed the practice of supplying condoms for the moral decadence that is destroying the country. In contrast the national AIDS Control Program (ACP) believes that supplying university students, who may be the group at highest risk, with condoms, is wise because they at lest know how to use them properly. A spokesman for the ACP said that the condom is one of the limited options that exist to fight the life-threatening epidemic. Present Museven changed his views to November 1990 from a policy of encouraging abstinence and monogamy, to promoting condoms. This change in government policy coincided with the report of 17,422 cases of AIDS, and the estimate that 1.3 million people in Uganda are infected with HIV.

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…

Tobacco use among high shool students in Kampala, Uganda: questionnaire study.

PubMed

Mpabulungi, Lillian; Muula, Adamson S

2004-02-01

To determine the prevalence of tobacco-use and describe tobacco-related knowledge, perceptions, and behavior of high school students aged 13-15 years in Kampala, Uganda. A cross-sectional questionnaire study was carried out among 2,789 students in 19 high schools in Kampala District, Uganda, in 2002. In each school, three classes from Senior One to Senior Three (average student age, 13 to 15 years, respectively) were randomly selected. All students who consented to participate in the study filled out a questionnaire consisting of 58 questions, with core items selected from the Global Youth Tobacco Survey. The questions were grouped into categories relating to tobacco use, knowledge and attitudes toward smoking, exposure to second hand smoke, attitude toward cessation of smoking, exposure to tobacco-related advertisements in the media, and education on tobacco and smoking in school. Out of 2,789 students, 488 (17.5%) reported to have smoked tobacco, with 185 (37.9%) of them trying or starting smoking before the age of 10. There were 148 (5.3%) current smokers. More than two-thirds (77.9%) of current smokers expressed a desire to stop smoking, 76.9% had tried to stop, and 84.1% had received help or advice to stop smoking. At least two-thirds of the students reported seeing both anti-tobacco and pro-tobacco advertisements in the preceding month. About 15.7 % of the students had an item with a cigarette brand logo, whereas 11.1% had been offered free cigarettes by a tobacco company representative. Current smokers usually smoked at home (30.2%), at a friend's place (29.3%), in public places (12.1%), at social events (10.4%), and at workplace (1.5%). Current smokers were also more likely than non-smokers to be exposed to passive smoking at home (56.4% vs at 15.9%, respectively; p<0.001). Many high school students in Kampala are exposed to tobacco advertising, especially through the media. Efforts to control smoking in this age-group should also target their parents and

Contraceptive knowledge, perceptions, and concerns among men in Uganda.

PubMed

Thummalachetty, Nityanjali; Mathur, Sanyukta; Mullinax, Margo; DeCosta, Kelsea; Nakyanjo, Neema; Lutalo, Tom; Brahmbhatt, Heena; Santelli, John S

2017-10-10

Low contraceptive uptake and high unmet need for contraception remain significant issues in Uganda compared to neighboring countries such as Kenya, Ethiopia, and Rwanda. Although prior research on contraceptive uptake has indicated that male partners strongly influence women's decisions around contraceptive use, there is limited in-depth qualitative research on knowledge and concerns regarding modern contraceptive methods among Ugandan men. Using in-depth interviews (N = 41), this qualitative study investigated major sources of knowledge about contraception and perceptions of contraceptive side effects among married Ugandan men. Men primarily reported knowledge of contraceptives based on partner's experience of side effects, partner's knowledge from health providers and mass media campaigns, and partner's knowledge from her peers. Men were less likely to report contraceptive knowledge from health care providers, mass media campaigns, or peers. Men's concerns about various contraceptive methods were broadly associated with failure of the method to work properly, adverse health effects on women, and severe adverse health effects on children. Own or partner's human immunodeficiency virus (HIV) status did not impact on contraceptive knowledge. Overall, we found limited accurate knowledge about contraceptive methods among men in Uganda. Moreover, fears about the side effects of modern contraceptive methods appeared to be common among men. Family planning services in Uganda could be significantly strengthened by renewed efforts to focus on men's knowledge, fears, and misconceptions.

Midlevel Maternity Providers' Preferences of a Childbirth Monitoring Tool in Low-Income Health Units in Uganda.

PubMed

Balikuddembe, Michael S; Wakholi, Peter K; Tumwesigye, Nazarius M; Tylleskär, Thorkild

2018-01-01

A third of women in childbirth are inadequately monitored, partly due to the tools used. Some stakeholders assert that the current labour monitoring tools are not efficient and need improvement to become more relevant to childbirth attendants. The study objective was to explore the expectations of maternity service providers for a mobile childbirth monitoring tool in maternity facilities in a low-income country like Uganda. Semi-structured interviews of purposively selected midwives and doctors in rural-urban childbirth facilities in Uganda were conducted before thematic data analysis. The childbirth providers expected a tool that enabled fast and secure childbirth record storage and sharing. They desired a tool that would automatically and conveniently register patient clinical findings, and actively provide interactive clinical decision support on a busy ward. The tool ought to support agreed upon standards for good pregnancy outcomes but also adaptable to the patient and their difficult working conditions. The tool functionality should include clinical data management and real-time decision support to the midwives, while the non-functional attributes include versatility and security.

Association of emergency department albuterol dispensing with pediatric asthma revisits and readmissions.

PubMed

Hall, A Brad; Novotny, April; Bhisitkul, Donna M; Melton, James; Regan, Tim; Leckie, Maureen

2017-06-01

Although pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. We conducted a retrospective cohort study of pediatric patients discharged from the pediatric ED with a diagnosis of asthma. Our primary outcome measured the rate of asthma revisits to the ED or admissions to the hospital within 28 days. Logistic regression analysis was used to assess ED beta-agonist MDI dispensing and revisit and/or readmission as the outcome. A total of 853 patients met eligibility for inclusion in the study, with 657 enrolled in the Baseline group and 196 enrolled in the ED-MDI group. The Baseline group experienced a revisit and readmission rate of 7.0% (46/657) versus 2.6% (5/196) in the ED-MDI group, (p = 0.026). ED direct dispensing of MDIs was found to be independently associated with a decreased risk of revisit or readmission (odds ratio 0.37; 95% confidence interval 0.14-0.95). In our study, ED direct dispensing of beta-agonist MDIs resulted in a reduction in 28-day revisit and readmission to the hospital. Further studies should be performed to evaluate the economic impact of reducing these revisits and readmissions against the costs of maintaining a dispensing program. Our findings may support modification of asthma programs to include dispensing MDIs from the emergency department.

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

The Simulium nigritarse subgroup (Diptera: Simuliidae) in Uganda: New species and country records.

PubMed

Krüger, Andreas

2016-06-07

Amongst blackfly samples from western Uganda three different morphospecies of the Simulium (Nevermannia) nigritarse Coquillett subgroup were identified. Of these, S. perforatum Fain & Dujardin showed the widest distribution and is reported from Uganda for the first time. In addition, two new species are described: S. bwambanum sp. nov. and S. itwariense sp. nov. Diagnostic characters are the different structures of the pupal cocoon, the configurations of the gill filaments and adult colour features.

AIDS communications through social networks: catalyst for behaviour changes in Uganda.

PubMed

Low-Beer, Daniel; Stoneburner, Rand L

2004-05-01

To investigate distinctive communications through social networks which may be associated with population behaviour changes and HIV prevalence declines in Uganda compared to other countries. We undertook a comparative analysis of demographic and HIV behavioural data collected in Demographic and Health Surveys (DHS III) in Uganda, Kenya, Tanzania, Malawi, Zambia and Zimbabwe as well as Knowledge, Attitudes and Behaviours (KABP) surveys in Uganda in 1989 and 1995. AIDS behaviours, social communications and channels for communication about AIDS and people with AIDS were analysed by age, sex and country. Modelling was developed to investigate at what stage of the epidemic a majority of people will know someone with AIDS, given differing communication patterns through social networks. Finally AIDS reporting and Voluntary Counselling and Testing (VCT) trends were analysed to assess if the impact of social communications worked through clinical services and interventions or more directly at the population level in community contexts. Uganda showed unique patterns of communications through social networks including a shift from mass and institutional to personal channels for communicating about AIDS, 1989-1995. This was associated with higher levels of knowing someone with AIDS through social networks and, in turn, positive risk ratios for behaviour change including reducing casual sex and condom use. Youth had distinctively high levels of knowing someone with AIDS in Uganda, suggesting widespread community communication across age groups. Patterns of disclosure, AIDS diagnosis and reporting were influential on social communications about AIDS. Over 90%, 45% or under 20% of people know someone with AIDS at peak HIV incidence and high AIDS mortality, depending on whether communications through social networks are extensive or restricted. There are distinctive patterns for communicating through social networks about AIDS and people with AIDS in Uganda. They appear to work

Patterns of Human Plague in Uganda, 2008-2016.

PubMed

Forrester, Joseph D; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J; Schriefer, Martin; Sexton, Christopher; Ben Beard, C; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph; Mead, Paul S

2017-09-01

Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008-2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient's village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague.

Cost effectiveness of facility-based care, home-based care and mobile clinics for provision of antiretroviral therapy in Uganda.

PubMed

Babigumira, Joseph B; Sethi, Ajay K; Smyth, Kathleen A; Singer, Mendel E

2009-01-01

Stakeholders in HIV/AIDS care currently use different programmes for provision of antiretroviral therapy (ART) in Uganda. It is not known which of these represents the best value for money. To compare the cost effectiveness of home-based care (HBC), facility-based care (FBC) and mobile clinic care (MCC) for provision of ART in Uganda. Incremental cost-effectiveness analysis was performed using decision and Markov modeling of adult AIDS patients in WHO Clinical Stage 3 and 4 from the perspective of the Ugandan healthcare system. The main outcome measures were cost (year 2008 values), life expectancy in life-years (LY) and the incremental cost-effectiveness ratio (ICER) measured as cost per QALY or LY gained over 10 years. Ten-year mean undiscounted life expectancy was lowest for FBC (3.6 LY), followed by MCC (4.3 LY) and highest for HBC (5.3 LY), while the mean discounted QALYs were also lowest for FBC (2.3), followed by MCC (2.9) and highest for HBC (3.7). The 10-year mean costs per patient were lowest for FBC ($US3212), followed by MCC ($US4782) and highest for HBC ($US7033). The ICER was lower for MCC versus FBC ($US2241 per LY and $US2615 per QALY) than for HBC versus MCC ($US2251 per LY and $US2814 per QALY). FBC remained cost effective in univariate and probabilistic sensitivity analyses. FBC appears to be the most cost-effective programme for provision of ART in Uganda. This analysis supports the implementation of FBC for scale-up and sustainability of ART in Uganda. HBC and MCC would be competitive only if there is increased access, increased adherence or reduced cost.

Cost Effectiveness of Facility-Based Care, Home-Based Care and Mobile Clinics for Provision of Antiretroviral Therapy in Uganda

PubMed Central

Babigumira, Joseph B.; Sethi, Ajay K.; Smyth, Kathleen A.; Singer, Mendel E.

2012-01-01

Background Stakeholders in HIV/AIDS care currently use different programmes for provision of antiretroviral therapy (ART) in Uganda. It is not known which of these represents the best value for money. Objective To compare the cost effectiveness of home-based care (HBC), facility-based care (FBC) and mobile clinic care (MCC) for provision of ART in Uganda. Methods Incremental cost-effectiveness analysis was performed using decision and Markov modeling of adult AIDS patients in WHO Clinical Stage 3 and 4 from the perspective of the Ugandan healthcare system. The main outcome measures were cost (year 2008 values), life expectancy in life-years (LY) and the incremental cost-effectiveness ratio (ICER) measured as cost per QALY or LY gained over 10 years. Results Ten-year mean undiscounted life expectancy was lowest for FBC (3.6 LY), followed by MCC (4.3 LY) and highest for HBC (5.3 LY), while the mean discounted QALYs were also lowest for FBC (2.3), followed by MCC (2.9) and highest for HBC (3.7). The 10-year mean costs per patient were lowest for FBC ($US3212), followed by MCC ($US4782) and highest for HBC ($US7033). The ICER was lower for MCC versus FBC ($US2241 per LY and $US2615 per QALY) than for HBC versus MCC ($US2251 per LY and $US2814 per QALY). FBC remained cost effective in univariate and probabilistic sensitivity analyses. Conclusions FBC appears to be the most cost-effective programme for provision of ART in Uganda. This analysis supports the implementation of FBC for scale-up and sustainability of ART in Uganda. HBC and MCC would be competitive only if there is increased access, increased adherence or reduced cost. PMID:19888795

Expiry of medicines in supply outlets in Uganda

PubMed Central

Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein

2010-01-01

Abstract Problem The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. Approach We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. Local setting The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country’s pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Relevant changes Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Lessons learned Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered. PMID:20428373

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

Extended families and perceived caregiver support to AIDS orphans in Rakai district of Uganda

PubMed Central

Karimli, Leyla; Ssewamala, Fred M.; Ismayilova, Leyla

2012-01-01

Purpose To understand the role of extended family in responding to problems of AID-orphaned children and adolescents in Uganda, the study examines who are the primary caregivers of AIDS-orphaned children and adolescents, what are the types of caregiving provided to orphans and whether the quality of caregiving varies by the primary caregiver’s gender and type. Methods The study uses bivariate analyses and mixed effects models utilizing baseline data from a cluster randomized experimental design including 283 orphaned adolescents in Uganda. Results The analysis revealed a generally dominating role of female caregivers for both single and double orphans. In the absence of biological parents – as in the case of double orphans – grandparents’ role as caregivers prevail. On average, the study participants indicated receiving the high level of perceived caregiver support: the average score of 3.56 out of 4 (95% CI=3.5, 3.65). Results of mixed effect models (adjusting for school effects) revealed significant differences in perceived caregiver support by caregiver’s gender. Compared to their male counterparts, female participants with whom the child/adolescent lives (B=0.22, 95% CI=0.11, 0.34) and women who are currently taking care of a child/adolescent (B=0.15, 95% CI=0.05, 0.26) provide greater caregiver support as perceived and reported by a child/adolescent. Similarly, female financiers – compared to male source of financial support - provide greater caregiver support as perceived and reported by a child/adolescent (B=0.16, 95% CI=0.04, 0.3). Conclusions Our findings demonstrate that extended families are still holding up as an important source of care and support for AIDS orphaned children and adolescents in Uganda. The findings support the argument about importance of matrilineal and grandparental care for AIDS orphans. PMID:23188930

The effect of facility-based antiretroviral therapy programs on outpatient services in Kenya and Uganda.

PubMed

Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C

2017-08-16

Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations

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.

Predictors and Outcomes of Revisits in Older Adults Discharged from the Emergency Department.

PubMed

de Gelder, Jelle; Lucke, Jacinta A; de Groot, Bas; Fogteloo, Anne J; Anten, Sander; Heringhaus, Christian; Dekkers, Olaf M; Blauw, Gerard J; Mooijaart, Simon P

2018-04-01

To study predictors of emergency department (ED) revisits and the association between ED revisits and 90-day functional decline or mortality. Multicenter cohort study. One academic and two regional Dutch hospitals. Older adults discharged from the ED (N=1,093). At baseline, data on demographic characteristics, illness severity, and geriatric parameters (cognition, functional capacity) were collected. All participants were prospectively followed for an unplanned revisit within 30 days and for functional decline and mortality 90 days after the initial visit. The median age was 79 (interquartile range 74-84), and 114 participants (10.4%) had an ED revisit within 30 days of discharge. Age (hazard ratio (HR)=0.96, 95% confidence interval (CI)=0.92-0.99), male sex (HR=1.61, 95% CI=1.05-2.45), polypharmacy (HR=2.06, 95% CI=1.34-3.16), and cognitive impairment (HR=1.71, 95% CI=1.02-2.88) were independent predictors of a 30-day ED revisit. The area under the receiver operating characteristic curve to predict an ED revisit was 0.65 (95% CI=0.60-0.70). In a propensity score-matched analysis, individuals with an ED revisit were at higher risk (odds ratio=1.99 95% CI=1.06-3.71) of functional decline or mortality. Age, male sex, polypharmacy, and cognitive impairment were independent predictors of a 30-day ED revisit, but no useful clinical prediction model could be developed. However, an early ED revisit is a strong new predictor of adverse outcomes in older adults. © 2018 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Partners' controlling behaviors and intimate partner sexual violence among married women in Uganda.

PubMed

Wandera, Stephen Ojiambo; Kwagala, Betty; Ndugga, Patricia; Kabagenyi, Allen

2015-03-04

Studies on the association between partners' controlling behaviors and intimate partner sexual violence (IPSV) in Uganda are limited. The aim of this paper was to investigate the association between IPSV and partners' controlling behaviors among married women in Uganda. We used the 2011 Uganda Demographic and Health Survey (UDHS) data, and selected a weighted sample of 1,307 women who were in a union, out of those considered for the domestic violence module. We used chi-squared tests and multivariable logistic regressions to investigate the factors associated with IPSV, including partners' controlling behaviors. More than a quarter (27%) of women who were in a union in Uganda reported IPSV. The odds of reporting IPSV were higher among women whose partners were jealous if they talked with other men (OR = 1.81; 95% CI: 1.22-2.68), if their partners accused them of unfaithfulness (OR = 1.50; 95% CI: 1.03-2.19) and if their partners did not permit them to meet with female friends (OR = 1.63; 95% CI: 1.11-2.39). The odds of IPSV were also higher among women whose partners tried to limit contact with their family (OR = 1.73; 95% CI: 1.11-2.67) and often got drunk (OR = 1.80; 95% CI: 1.15-2.81). Finally, women who were sometimes or often afraid of their partners (OR = 1.78; 95% CI: 1.21-2.60 and OR = 1.56; 95% CI: 1.04-2.40 respectively) were more likely to report IPSV. In Uganda, women's socio-economic and demographic background and empowerment had no mitigating effect on IPSV in the face of their partners' dysfunctional behaviors. Interventions addressing IPSV should place more emphasis on reducing partners' controlling behaviors and the prevention of problem drinking.

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.

Health worker experiences of and movement between public and private not-for-profit sectors-findings from post-conflict Northern Uganda.

PubMed

Namakula, Justine; Witter, Sophie; Ssengooba, Freddie

2016-05-05

Northern Uganda suffered 20 years of conflict which devastated lives and the health system. Since 2006, there has been investment in reconstruction, which includes efforts to rebuild the health workforce. This article has two objectives: first, to understand health workers' experiences of working in public and private not-for-profit (PNFP) sectors during and after the conflict in Northern Uganda, and second, to understand the factors that influenced health workers' movement between public and PNFP sectors during and after the conflict. A life history approach was used with 26 health staff purposively selected from public and PNFP facilities in four districts of Northern Uganda. Staff with at least 10 years' experience were selected, which resulted in a sample which was largely female and mid-level. Two thirds were currently employed in the public sector and just over a third in the PNFP sector. A thematic data analysis was guided by the framework analysis approach, analysis framework stages and ATLAS.ti software version 7.0. Analysis reveals that most of the current staff were trained in the PNFP sector, which appears to offer higher quality training experiences. During the conflict period, the PNFP sector also functioned more effectively and was relatively better able to support its staff. However, since the end of the conflict, the public sector has been reconstructed and is now viewed as offering a better overall package for staff. Most reported movement has been in that direction, and many in the PNFP sector state intention to move to the public sector. While there is sectoral loyalty on both sides and some bonds created through training, the PNFP sector needs to become more competitive to retain staff so as to continue delivering services to deprived communities in Northern Uganda. There has been limited previous longitudinal analysis of how health staff perceive different sectors and why they move between them, particularly in conflict-affected contexts

14 CFR 1214.205 - Revisit and/or retrieval services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Revisit and/or retrieval services. 1214.205... Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who Have Made Substantial Investment in the STS Program § 1214.205 Revisit and/or retrieval services. These services will be...

Cost-effectiveness of traffic enforcement: case study from Uganda.

PubMed

Bishai, D; Asiimwe, B; Abbas, S; Hyder, A A; Bazeyo, W

2008-08-01

In October 2004, the Ugandan Police department deployed enhanced traffic safety patrols on the four major roads to the capital Kampala. To assess the costs and potential effectiveness of increasing traffic enforcement in Uganda. Record review and key informant interviews were conducted at 10 police stations along the highways that were patrolled. Monthly data on traffic citations and casualties were reviewed for January 2001 to December 2005; time series (ARIMA) regression was used to assess for a statistically significant change in traffic deaths. Costs were computed from the perspective of the police department in $US 2005. Cost offsets from savings to the health sector were not included. The annual cost of deploying the four squads of traffic patrols (20 officers, four vehicles, equipment, administration) is estimated at $72,000. Since deployment, the number of citations has increased substantially with a value of $327 311 annually. Monthly crash data pre- and post-intervention show a statistically significant 17% drop in road deaths after the intervention. The average cost-effectiveness of better road safety enforcement in Uganda is $603 per death averted or $27 per life year saved discounted at 3% (equivalent to 9% of Uganda's $300 GDP per capita). The costs of traffic safety enforcement are low in comparison to the potential number of lives saved and revenue generated. Increasing enforcement of existing traffic safety norms can prove to be an extremely cost-effective public health intervention in low-income countries, even from a government perspective.

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…

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…

The Role of Private Universities in the Provision of Higher Education in Uganda: Growth and Challenges

ERIC Educational Resources Information Center

Mugabi, H.

2012-01-01

Although the first private university in Uganda was founded in 1988 and the private university sector has since grown rapidly to become one of the most prominent features of higher education (HE) in Uganda, the contribution of private universities (PUs) to the provision of HE has remained largely unexplored and as such, less understood. The…

Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda.

PubMed

Meacham, Elizabeth; Orem, Jackson; Nakigudde, Gertrude; Zujewski, Jo Anne; Rao, Deepa

2016-10-01

To understand the role of stigma in the delay of cancer service engagement by women with breast cancer in Kampala, Uganda. Women in Sub-Saharan African countries are twice as likely to die from cancer as women in high-income countries, which is largely attributable to late diagnosis. While breast cancer-related stigma has been identified in Sub-Saharan Africa, limited research focuses on how stigma impacts the behavior of breast cancer patients in Uganda. This qualitative study used a grounded theory approach to examine illness narratives from 20 breast cancer survivors in Uganda, gathered through semistructured interviews. Thematic analysis showed that perceived and internalized stigma associated with breast cancer influenced care engagement throughout illness, delaying engagement and inhibiting treatment completion. Women identified key factors for overcoming stigma including acceptance of diagnosis, social support, and understanding of breast cancer. The growing burden of mortality associated with breast cancer in Uganda can be mitigated by improving early detection and treatment engagement through interventions which account for key psychosocial barriers such as stigma. Copyright © 2016 John Wiley & Sons, Ltd.

Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study.

PubMed

Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

2016-01-01

Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda ( in English ) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda ( both in English and Luganda ) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement

Learning Barriers among Grade 6 Pupils Attending Rural Schools in Uganda: Implications to Policy and Practice

ERIC Educational Resources Information Center

Hungi, Njora; Ngware, Moses; Mahuro, Gerald; Muhia, Nelson

2017-01-01

The paper uses multilevel analysis procedures to examine individual- and group-level learning barriers that have the greatest impact on pupil achievement in Uganda. The data for this study were collected in 2014 among 2711 Grade 6 pupils attending 82 schools in two rural districts of Iganga and Mayuge in Uganda. Data used in this paper are part of…

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…

What variables should be considered in allocating Primary health care Pharmaceutical budgets to districts in Uganda?

PubMed

Mujasi, Paschal N; Puig-Junoy, Jaume

2015-01-01

A key policy question for the government of Uganda is how to equitably allocate primary health care pharmaceutical budgets to districts. This paper seeks to identify variables influencing current primary health care pharmaceutical expenditure and their usefulness in allocating prospective pharmaceutical budgets to districts. This was a cross sectional, retrospective observational study using secondary administrative data. We collected data on the value of pharmaceuticals procured by primary health care facilities in each district from National Medical Stores for the financial year 2011/2012. The dependent variable was expressed as per capita district pharmaceutical expenditure. By reviewing literature we identified 26 potential explanatory variables. They include supply, need and demand, and health system organization variables that may influence the demand and supply of health services and the corresponding pharmaceutical expenditure. We collected secondary data for these variables for all the districts in Uganda (n = 112). We performed econometric analysis to estimate parameters of various regression models. There is a significant correlation between per capita district pharmaceutical expenditure and total district population, rural poverty, access to drinking water and outpatient department (OPD) per capita utilisation.(P < 0.01). The percentage of health centre IIIs (HC III) among each district's health facilities is significantly correlated with per capita pharmaceutical expenditure (P < 0.05). OPD per capita utilisation has a relatively strong correlation with per capita pharmaceutical expenditure (r = 0.498); all the other significant factors are weakly correlated with per capita pharmaceutical expenditure (r < 0.5). From several iterations of an initially developed model, the proposed final model for explaining per capita pharmaceutical expenditure explains about 53% of the variation in pharmaceutical expenditure among districts in

A situational analysis of priority disaster hazards in Uganda: findings from a hazard and vulnerability analysis.

PubMed

Mayega, R W; Wafula, M R; Musenero, M; Omale, A; Kiguli, J; Orach, G C; Kabagambe, G; Bazeyo, W

2013-06-01

Most countries in sub-Saharan Africa have not conducted a disaster risk analysis. Hazards and vulnerability analyses provide vital information that can be used for development of risk reduction and disaster response plans. The purpose of this study was to rank disaster hazards for Uganda, as a basis for identifying the priority hazards to guide disaster management planning. The study as conducted in Uganda, as part of a multi-country assessment. A hazard, vulnerability and capacity analysis was conducted in a focus group discussion of 7 experts representing key stakeholder agencies in disaster management in Uganda. A simple ranking method was used to rank the probability of occurance of 11 top hazards, their potential impact and the level vulnerability of people and infrastructure. In-terms of likelihood of occurance and potential impact, the top ranked disaster hazards in Uganda are: 1) Epidemics of infectious diseases, 2) Drought/famine, 3) Conflict and environmental degradation in that order. In terms of vulnerability, the top priority hazards to which people and infrastructure were vulnerable were: 1) Conflicts, 2) Epidemics, 3) Drought/famine and, 4) Environmental degradation in that order. Poverty, gender, lack of information, and lack of resilience measures were some of the factors promoting vulnerability to disasters. As Uganda develops a disaster risk reduction and response plan, it ought to prioritize epidemics of infectious diseases, drought/famine, conflics and environmental degradation as the priority disaster hazards.

Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda.

PubMed

Kwagala, Betty; Nankinga, Olivia; Wandera, Stephen Ojiambo; Ndugga, Patricia; Kabagenyi, Allen

2016-05-04

There is limited research on how the empowerment of women and intimate partner violence (IPV) are associated with skilled birth attendance (SBA) among rural women in Uganda. Therefore, the aim of this paper was to investigate the association between women's empowerment, their experience of IPV and SBA in rural Uganda. Using data from the Uganda Demographic and Health Survey (UDHS), we selected 857 rural women who were in union, had given birth in the last 5 years preceding the survey and were selected for the domestic violence (DV) module. Frequency distributions were used to describe the background characteristics of the women and their partners. Pearson's chi-squared (χ (2)) tests were used to investigate the associations between SBA and women's empowerment; and partners' and women's socio-demographic factors including sexual violence. Multivariable logistic regression analyses were used to examine the association between SBA and explanatory variables. More than half (55 %) of the women delivered under the supervision of skilled birth attendant. Women's empowerment with respect to participation in household decision-making, property (land and house) (co)ownership, IPV, and sexual empowerment did not positively predict SBA among rural women in Uganda. Key predictors of SBA were household wealth status, partners' education, ANC attendance and parity. For enhancement of SBA in rural areas, there is a need to encourage a more comprehensive ANC attendance irrespective of number of children a woman has; and design interventions to enhance household wealth and promote men's education.

Action for child survival: elimination of Haemophilus influenzae type b meningitis in Uganda.

PubMed

Lewis, Rosamund F; Kisakye, Annet; Gessner, Bradford D; Duku, Chaplain; Odipio, John Bosco; Iriso, Robert; Nansera, Denis; Braka, Fiona; Makumbi, Issa; Kekitiinwa, Addy

2008-04-01

To guide immunization policy, we determined the public health benefit of introducing Haemophilus influenzae type b (Hib) vaccine in Uganda and estimated the vaccine effectiveness. Surveillance data for acute bacterial meningitis among children aged 0-59 months were reviewed from three hospital sentinel sites, for July 2001 to June 2007, to determine the incidence of Hib meningitis, the effectiveness of Hib vaccine with a case-control design, and the number of vaccine-preventable cases and deaths of Hib disease in Uganda. Of the 13 978 children from 17 districts with suspected bacterial meningitis, 269 had confirmed Hib meningitis, declining from 69 patients in the prevaccine year (2001-2002) to three in 2006-2007. Hib meningitis incidence dropped from 88 cases per 100,000 children aged < 5 years in the year before vaccine introduction to 13 within 4 years, and to near zero in the fifth year. Vaccine effectiveness for 2 or more doses was 93% (95% confidence interval, CI: 69-99) against confirmed Hib meningitis and 53% (95% CI: 11-68) against purulent meningitis of unknown cause. In Uganda, Hib vaccine prevents an estimated 28 000 cases of pneumonia and meningitis, 5000 deaths and 1000 severe meningitis sequelae each year. Infant immunization with Hib vaccine has virtually eliminated Hib meningitis in Uganda within 5 years. Ensuring long-term benefits of Hib vaccine urgently requires sustainable vaccine financing, high-quality ongoing surveillance, and a health sector able to deliver a robust immunization programme.

Empowerment, partner's behaviours and intimate partner physical violence among married women in Uganda.

PubMed

Kwagala, Betty; Wandera, Stephen Ojiambo; Ndugga, Patricia; Kabagenyi, Allen

2013-12-01

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. 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. 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. 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.

Surgeons OverSeas Assessment of Surgical Need (SOSAS) Uganda: Update for Household Survey.

PubMed

Fuller, Anthony T; Butler, Elissa K; Tran, Tu M; Makumbi, Fredrick; Luboga, Samuel; Muhumza, Christine; Chipman, Jeffrey G; Groen, Reinou S; Gupta, Shailvi; Kushner, Adam L; Galukande, Moses; Haglund, Michael M

2015-12-01

The first step in improving surgical care delivery in low- and middle-income countries (LMICs) is quantifying surgical need. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a validated household survey that has been previously implemented in three LMICs with great success. We implemented the SOSAS survey in Uganda, a medium-sized country with comparatively more language and ethnic group diversity. The investigators partnered with the Performance Monitoring and Accountability 2020 (PMA2020) Uganda to access a data collection platform sampling 2520 households in 105 randomly selected enumeration areas. Due to geographic size consideration and language diversity, SOSAS's methodology was updated in three significant dimensions (1) technology, (2) staff management, and (3) questionnaire adaptations. The SOSAS survey was successfully implemented with non-medically trained but field proven research assistants. We sampled 2315 of 2402 eligible households (response rate 96.4 %) and 4248 of 4374 eligible individual respondents (response rate 97.1 %). The female-to-male ratio was 51.1-48.9 %. Total survey cost was USD 73,145 and data collection occurred in 14 days. SOSAS Uganda has demonstrated that non-medically trained, but university-educated, experienced researchers supervised by academic surgeons can successfully perform accurate data collection of SOSAS. SOSAS can be successfully implemented within larger and more diverse LMICs using existing national survey platforms, and SOSAS Uganda provides insights on how SOSAS can be executed specifically within other PMA2020 program countries.

Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda.

PubMed

Woodhall, Dana M; Mkwanda, Square; Dembele, Massitan; Lwanga, Harriet; Drexler, Naomi; Dubray, Christine; Harris, Jennifer; Worrell, Caitlin; Mathieu, Els

2014-04-01

Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3-73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4-70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0-65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4-72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient. Published by Elsevier B.V.

Patterns of Human Plague in Uganda, 2008–2016

PubMed Central

Forrester, Joseph D.; Apangu, Titus; Griffith, Kevin; Acayo, Sarah; Yockey, Brook; Kaggwa, John; Kugeler, Kiersten J.; Schriefer, Martin; Sexton, Christopher; Ben Beard, C.; Candini, Gordian; Abaru, Janet; Candia, Bosco; Okoth, Jimmy Felix; Apio, Harriet; Nolex, Lawrence; Ezama, Geoffrey; Okello, Robert; Atiku, Linda; Mpanga, Joseph

2017-01-01

Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008–2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient’s village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague. PMID:28820134

High Resolution Rapid Revisits Insar Monitoring of Surface Deformation

NASA Astrophysics Data System (ADS)

Singhroy, V.; Li, J.; Charbonneau, F.

2014-12-01

Monitoring surface deformation on strategic energy and transportation corridors requires high resolution spatial and temporal InSAR images for mitigation and safety purposes. High resolution air photos, lidar and other satellite images are very useful in areas where the landslides can be fatal. Recently, radar interferometry (InSAR) techniques using more rapid revisit images from several radar satellites are increasingly being used in active deformation monitoring. The Canadian RADARSAT Constellation (RCM) is a three-satellite mission that will provide rapid revisits of four days interferometric (InSAR) capabilities that will be very useful for complex deformation monitoring. For instance, the monitoring of surface deformation due to permafrost activity, complex rock slide motion and steam assisted oil extraction will benefit from this new rapid revisit capability. This paper provide examples of how the high resolution (1-3 m) rapid revisit InSAR capabilities will improve our monitoring of surface deformation and provide insights in understanding triggering mechanisms. We analysed over a hundred high resolution InSAR images over a two year period on three geologically different sites with various configurations of topography, geomorphology, and geology conditions. We show from our analysis that the more frequent InSAR acquisitions are providing more information in understanding the rates of movement and failure process of permafrost triggered retrogressive thaw flows; the complex motion of an asymmetrical wedge failure of an active rock slide and the identification of over pressure zones related to oil extraction using steam injection. Keywords: High resolution, InSAR, rapid revisits, triggering mechanisms, oil extraction.

A global social contract to reduce maternal mortality: the human rights arguments and the case of Uganda.

PubMed

Ooms, Gorik; Mulumba, Moses; Hammonds, Rachel; Latif Laila, Abdul; Waris, Attiya; Forman, Lisa

2013-11-01

Progress towards Millennium Development Goal 5a, reducing maternal deaths by 75% between 1990 and 2015, has been substantial; however, it has been too slow to hope for its achievement by 2015, particularly in sub-Saharan Africa, including Uganda. This suggests that both the Government of Uganda and the international community are failing to comply with their right-to-health-related obligations towards the people of Uganda. This country case study explores some of the key issues raised when assessing national and international right-to-health-related obligations. We argue that to comply with their shared obligations, national and international actors will have to take steps to move forward together. The Government of Uganda should not expect additional international assistance if it does not live up to its own obligations; at the same time, the international community must provide assistance that is more reliable in the long run to create the 'fiscal space' that the Government of Uganda needs to increase recurrent expenditure for health - which is crucial to addressing maternal mortality. We propose that the 'Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa', adopted by the African Union in July 2012, should be seen as an invitation to the international community to conclude a global social contract for health. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Cryptococcal disease and the burden of other fungal diseases in Uganda; Where are the knowledge gaps and how can we fill them?

PubMed

Parkes-Ratanshi, R; Achan, B; Kwizera, R; Kambugu, A; Meya, D; Denning, D W

2015-10-01

The HIV epidemic in Uganda has highlighted Cryptococcus and Candida infections as important opportunistic fungal infections. However, the burden of other fungal diseases is not well described. We aimed to estimate the burden of fungal infections in Uganda. All epidemiological papers of fungal diseases in Uganda were reviewed. Where there is no Ugandan data, global or East African data were used. Recurrent vaginal candidiasis is estimated to occur in 375 540 Uganda women per year; Candida in pregnant women affects up to 651,600 women per year. There are around 45,000 HIV-related oral and oesophageal candidosis cases per year. There are up to 3000 cases per year of post-TB chronic pulmonary aspergillosis. There are an estimated 40,392 people with asthma-related fungal conditions. An estimated 1,300,000 cases of tinea capitis occur in school children yearly in Uganda. There are approximately 800 HIV-positive adults with Pneumocystis jirovecii pneumonia (PJP) annually and up to 42 000 children with PJP per year. There are an estimated 4000 cryptococcal cases annually. There are an estimated 2.5 million fungal infections per year in Uganda. Cryptococcus and PJP cause around 28,000 deaths in adults and children per year. We propose replicating the model of research around cryptococcal disease to investigate and development management strategies for other fungal diseases in Uganda. © 2015 Blackwell Verlag GmbH.

Sexual behavior of female sex workers and access to condoms in Kenya and Uganda on the Trans-Africa highway.

PubMed

Morris, Chester N; Morris, Sheldon R; Ferguson, Alan G

2009-10-01

Female sex workers and their clients remain a high risk core group for HIV in Africa. We measured sexual behavior of a snowball sample of female sex workers (FSW) along the Trans Africa highway from Mombasa, Kenya to Kampala, Uganda and surveyed the availability of male condoms at 1,007 bars and lodgings in Kenya along the highway trucking stops where transactional sex occurs. There were 578 FSW one month sex diaries analyzed, 403 from Kenya and 175 from Uganda. Kenyan FSW had a median of 45 sexual acts per 28 days compared to 39 sex acts per 28 days by Ugandan FSW (P < 0.05). Condom use by FSW for all sexual liaisons was 79% in Kenya compared to 74% in Uganda. In multivariate analysis, adjusting for repeated measures, Kenyan FSW were more likely to use a condom by an adjusted odds ratio of 2.54 (95% confidence interval 1.89-3.41) compared to Ugandan FSW. Condom use with regular clients was 50.8% in Uganda compared with 68.7% in Kenya (P < 0.01). The number of sex workers reporting 100% condom use was 26.8% in Kenya and 18.9% in Uganda (P < 0.01). Bars and lodges in Kenya compared to Uganda were more likely to: have condom dispensers, 25% versus 1%, respectively (P < 0.01); distribute or sell condoms, 73.9% versus 47.6% (P < 0.01); and have more weekly condom distribution, 4.92 versus 1.27 condoms per seating capacity (P < 0.01). Our data indicate that in both countries condom use for FSW is suboptimal, particularly with regular partners, and greater condom use by Trans African highway FSW in Kenya compared to Uganda may be related to availability. Targeted interventions are warranted for FSW and truck drivers to prevent transmission in this important core group.

Annual cost of antiretroviral therapy among three service delivery models in Uganda

PubMed Central

Vu, Lung; Waliggo, Samuel; Zieman, Brady; Jani, Nrupa; Buzaalirwa, Lydia; Okoboi, Stephen; Okal, Jerry; Borse, Nagesh N; Kalibala, Samuel

2016-01-01

Introduction In response to the increasing burden of HIV, the Ugandan government has employed different service delivery models since 2004 that aim to reduce costs and remove barriers to accessing HIV care. These models include community-based approaches to delivering antiretroviral therapy (ART) and delegating tasks to lower-level health workers. This study aimed to provide data on annual ART cost per client among three different service delivery models in Uganda. Methods Costing data for the entire year 2012 were retrospectively collected as part of a larger task-shifting study conducted in three organizations in Uganda: Kitovu Mobile (KM), the AIDS Support Organisation (TASO) and Uganda Cares (UC). A standard cost data capture tool was developed and used to retrospectively collect cost information regarding antiretroviral (ARV) drugs and non-ARV drugs, ART-related lab tests, personnel and administrative costs. A random sample of four TASO centres (out of 11), four UC clinics (out of 29) and all KM outreach units were selected for the study. Results Cost varied across sites within each organization as well as across the three organizations. In addition, the number of annual ART visits was more frequent in rural areas and through KM (the community distribution model), which played a major part in the overall annual ART cost. The annual cost per client (in USD) was $404 for KM, $332 for TASO and $257 for UC. These estimates were lower than previous analyses in Uganda or the region compared to data from 2001 to 2009, but comparable with recent estimates using data from 2010 to 2013. ARVs accounted for the majority of the total cost, followed by personnel and operational costs. Conclusions The study provides updated data on annual cost per ART visit for three service delivery models in Uganda. These data will be vital for in-country budgetary efforts to ensure that universal access to ART, as called for in the 2015 World Health Organization (WHO) guidelines, is

Family caregivers in rural Uganda: the hidden reality.

PubMed

Kipp, Walter; Tindyebwa, Denis; Rubaale, Tom; Karamagi, Ednah; Bajenja, Ellen

2007-01-01

We conducted 16 in-depth interviews with family caregivers of AIDS patients in three rural districts in western Uganda. They were selected from a client visitation list of the home-based care program for AIDS patients, based on volunteer participation. Family caregivers reported huge problems associated with providing the necessary psychological, social, and economic care. They also said that the physical and emotional demands of caregiving are overwhelming daily challenges. Most support to AIDS patients provided by family, friends, and the churches. The study highlights the great burden of caregivers, in sub-Saharan Africa who most often are elderly women and young girls. This study examine, the burden and related health issues of family caregivers, primarily women, for AIDS patients in Uganda. It was part of a broad research project using qualitative methods on family caregiving in the home environment in sub-Saharan Africa. As the requirements for family care giving are often overwhelming for women under the conditions as they exist in Uganda and in other developing countries, it constitutes a gender issue of great importance that has not been appreciated fully in the international literature. Family caregiving is also of international relevance, as HIV/AIDS is a global pandemic of previously unknown proportions. In many poor countries, family caregiving is the most common and often the only care that AIDS patients receive, because clinic-based care often is not available close to home or is not affordable. Therefore, family caregiver support programs to alleviate this burden are essential for all those countries where HIV/AIDS is prevalent. Family caregiver burden encompasses medical, social, and economic issues at the household level, which requires an interdisciplinary approach in order to fully understand and appreciate the different dimensions of the family caregiver burden and its negative impact on the lives of so many women in so many countries.

Reemerging Sudan Ebola Virus Disease in Uganda, 2011

PubMed Central

Shoemaker, Trevor; Balinandi, Stephen; Campbell, Shelley; Wamala, Joseph Francis; McMullan, Laura K.; Downing, Robert; Lutwama, Julius; Mbidde, Edward; Ströher, Ute; Rollin, Pierre E.; Nichol, Stuart T.

2012-01-01

Two large outbreaks of Ebola hemorrhagic fever occurred in Uganda in 2000 and 2007. In May 2011, we identified a single case of Sudan Ebola virus disease in Luwero District. The establishment of a permanent in-country laboratory and cooperation between international public health entities facilitated rapid outbreak response and control activities. PMID:22931687

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,…

Ecological Niche Modeling for Filoviruses: A Risk Map for Ebola and Marburg Virus Disease Outbreaks in Uganda.

PubMed

Nyakarahuka, Luke; Ayebare, Samuel; Mosomtai, Gladys; Kankya, Clovice; Lutwama, Julius; Mwiine, Frank Norbert; Skjerve, Eystein

2017-09-05

Uganda has reported eight outbreaks caused by filoviruses between 2000 to 2016, more than any other country in the world. We used species distribution modeling to predict where filovirus outbreaks are likely to occur in Uganda to help in epidemic preparedness and surveillance. The MaxEnt software, a machine learning modeling approach that uses presence-only data was used to establish filovirus - environmental relationships. Presence-only data for filovirus outbreaks were collected from the field and online sources. Environmental covariates from Africlim that have been downscaled to a nominal resolution of 1km x 1km were used. The final model gave the relative probability of the presence of filoviruses in the study area obtained from an average of 100 bootstrap runs. Model evaluation was carried out using Receiver Operating Characteristic (ROC) plots. Maps were created using ArcGIS 10.3 mapping software. We showed that bats as potential reservoirs of filoviruses are distributed all over Uganda. Potential outbreak areas for Ebola and Marburg virus disease were predicted in West, Southwest and Central parts of Uganda, which corresponds to bat distribution and previous filovirus outbreaks areas. Additionally, the models predicted the Eastern Uganda region and other areas that have not reported outbreaks before to be potential outbreak hotspots. Rainfall variables were the most important in influencing model prediction compared to temperature variables. Despite the limitations in the prediction model due to lack of adequate sample records for outbreaks, especially for the Marburg cases, the models provided risk maps to the Uganda surveillance system on filovirus outbreaks. The risk maps will aid in identifying areas to focus the filovirus surveillance for early detection and responses hence curtailing a pandemic. The results from this study also confirm previous findings that suggest that filoviruses are mainly limited by the amount of rainfall received in an area.

Ecological Niche Modeling for Filoviruses: A Risk Map for Ebola and Marburg Virus Disease Outbreaks in Uganda

PubMed Central

Nyakarahuka, Luke; Ayebare, Samuel; Mosomtai, Gladys; Kankya, Clovice; Lutwama, Julius; Mwiine, Frank Norbert; Skjerve, Eystein

2017-01-01

Introduction: Uganda has reported eight outbreaks caused by filoviruses between 2000 to 2016, more than any other country in the world. We used species distribution modeling to predict where filovirus outbreaks are likely to occur in Uganda to help in epidemic preparedness and surveillance. Methods: The MaxEnt software, a machine learning modeling approach that uses presence-only data was used to establish filovirus – environmental relationships. Presence-only data for filovirus outbreaks were collected from the field and online sources. Environmental covariates from Africlim that have been downscaled to a nominal resolution of 1km x 1km were used. The final model gave the relative probability of the presence of filoviruses in the study area obtained from an average of 100 bootstrap runs. Model evaluation was carried out using Receiver Operating Characteristic (ROC) plots. Maps were created using ArcGIS 10.3 mapping software. Results: We showed that bats as potential reservoirs of filoviruses are distributed all over Uganda. Potential outbreak areas for Ebola and Marburg virus disease were predicted in West, Southwest and Central parts of Uganda, which corresponds to bat distribution and previous filovirus outbreaks areas. Additionally, the models predicted the Eastern Uganda region and other areas that have not reported outbreaks before to be potential outbreak hotspots. Rainfall variables were the most important in influencing model prediction compared to temperature variables. Conclusions: Despite the limitations in the prediction model due to lack of adequate sample records for outbreaks, especially for the Marburg cases, the models provided risk maps to the Uganda surveillance system on filovirus outbreaks. The risk maps will aid in identifying areas to focus the filovirus surveillance for early detection and responses hence curtailing a pandemic. The results from this study also confirm previous findings that suggest that filoviruses are mainly limited by

Clinical ethics revisited

PubMed Central

Singer, Peter A; Pellegrino, Edmund D; Siegler, Mark

2001-01-01

A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems. PMID:11346456

Colloquial Hebrew Imperatives Revisited

ERIC Educational Resources Information Center

Bolozky, Shmuel

2009-01-01

In revisiting Bolozky's [Bolozky, Shmuel, 1979. "On the new imperative in colloquial Hebrew." "Hebrew Annual Review" 3, 17-24] and Bat-El's [Bat-El, Outi, 2002. "True truncation in colloquial Hebrew imperatives." "Language" 78(4), 651-683] analyses of colloquial Hebrew imperatives, the article argues for restricting Imperative Truncation to the…

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…

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 analysis of…

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…

Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study

PubMed Central

Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

2016-01-01

Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point

Perceptions of sexual coercion among young women in Uganda.

PubMed

Hayer, Manvir Kaur

2010-01-01

This paper sets out to explore Ugandan young women's definitions and perceptions of sexual coercion. A qualitative study was conducted with seven young women in rural Uganda. Participants filmed videos, wrote stories, made drawings and participated in transect walks before analysing their data through formal and informal discussions. Forced sex is defined narrowly to mean only rape. Verbal forms of sexual coercion were recognised, but only after some discussion. Verbal coercion is referred to as "abusing" or "convincing". Young women are commonly pressured into consenting to have sex, despite what they really want, owing to the socio-cultural circumstances. Young women in Uganda are significantly tolerant of sexual coercion. This tolerance appears to arise from power differentials between genders, and the socio-cultural environment shaping their lives. The paper improves understanding of young women's definitions and perceptions of sexual coercion, which is essential to provide effective violence prevention programmes. It also suggests that further research is warranted in this field.

Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

PubMed

Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2014-11-29

There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

The Linguistic Repertoire Revisited

ERIC Educational Resources Information Center

Busch, Brigitta

2012-01-01

This article argues for the relevance of poststructuralist approaches to the notion of a linguistic repertoire and introduces the notion of language portraits as a basis for empirical study of the way in which speakers conceive and represent their heteroglossic repertoires. The first part of the article revisits Gumperz's notion of a linguistic…

Revisiting Professional Teacher Standards

ERIC Educational Resources Information Center

Watson, Amanda

2016-01-01

The Australian Society for Music Education's (ASME) involvement in the development of professional standards for music educators was a significant and active research time in the history of the Society. As ASME celebrates its golden jubilee, it is appropriate to revisit that history and consider the future prospects of subject-specific standards.…

Revisiting the Rhetorical Curriculum

ERIC Educational Resources Information Center

Rutten, Kris; Soetaert, Ronald

2012-01-01

The aim of the special strand on "Revisiting the rhetorical curriculum" is to explore the educational potential of a new rhetorical perspective, specifically in relation to different traditions within educational and rhetorical studies. This implies that we do not only look at education "in" rhetoric, but that we position education also "as" a…

Taxes and Bribes in Uganda.

PubMed

Jagger, Pamela; Shively, Gerald

Using data from 433 firms operating along Uganda's charcoal and timber supply chains we investigate patterns of bribe payment and tax collection between supply chain actors and government officials responsible for collecting taxes and fees. We examine the factors associated with the presence and magnitude of bribe and tax payments using a series of bivariate probit and Tobit regression models. We find empirical support for a number of hypotheses related to payments, highlighting the role of queuing, capital-at-risk, favouritism, networks, and role in the supply chain. We also find that taxes crowd-in bribery in the charcoal market.

Country watch. Tanzania / Uganda / Zaire.

PubMed

Senturias, E N

1994-01-01

A participatory action research program was implemented in Tanzania, Uganda, and Zaire to sensitize and encourage church leaders and members to more actively participate in HIV/AIDS prevention and care. Communities had a major role in the process, even defining research questions. The program effectively helped sensitize individuals at the community and international levels, with its effects ongoing even though the program has officially ended. Collective community consciousness was raised on the need to address the epidemic, while identifying important issues to confront. Focus group discussions and the conference generated open and frank discussions on condom use, culture, and sexual behavior.

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…

A qualitative study of caregivers' expectations and communication desires during medical consultation for sick children in Uganda.

PubMed

Kiguli, Sarah; Mafigiri, David; Nakigudde, Janet; van Dalen, Jan; van der Vleuten, Cees

2011-08-01

Little data exist on patients' expectations and communication desires during medical consultation in Non-Western settings. We conducted a qualitative study to compare expectations and communication desires of sick children's caregivers at Mulago Hospital, Uganda, to those of patients in Western countries. Three Focus Group Interviews and three Key Informant Interviews were conducted with 24 caregivers of sick children in Mulago Hospital Kampala, Uganda. An interview guide adapted from the Calgary-Cambridge Guide was used to conduct focus group and Key Informant Interviews. Two investigators worked independently to review transcripts and analyse them for content and emerging themes. Caregivers of sick children in Mulago Hospital expect attending doctors to build a relationship with them, by demonstrating the verbal and nonverbal skills outlined in the CCG including maintaining eye contact, using appropriate gestures and voice during communication, and being nonjudgmental. The communication needs and expectations of caregivers of sick children in Mulago Hospital are similar to those of patients and caregivers in Western countries. The CCG can be used as a training guide to enhance the communication skills of current and future doctors in Mulago Hospital. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Factors Associated With Length of Stay and 30-Day Revisits in Pediatric Acute Pancreatitis.

PubMed

Gay, Anna C; Barreto, Nicolas; Schrager, Sheree M; Russell, Christopher J

2018-05-30

Identify factors associated with length of stay (LOS) and 30-day hospital revisit for patients hospitalized with acute pancreatitis (AP). Multicenter, retrospective cohort study using the Pediatric Health Information System database. Multilevel linear and logistic regression was used to identify factors independently associated with the primary outcome variables of LOS and 30-day hospital revisit in children aged 1-18 years discharged with a primary discharge diagnosis of AP from participating hospitals between 2008 and 2013. For the 7693 discharges, median LOS was 4 days (interquartile range 3-7 days) and 30-day revisit rate 17.6% (n = 1356). Discharges were primarily female (55%), Caucasian (46%), and six years old or older (85%). On multilevel regression, factors independently associated with both longer LOS and higher revisit odds included malignant and gastrointestinal complex chronic conditions and total parenteral nutrition (TPN) use while hospitalized. Male gender was associated with both lower LOS (aLOS = -0.6 days, 95% CI = -0.8, -0.4) and decreased revisit odds (aOR 0.85; 95% CI = 0.74, 0.97). Hispanic ethnicity was associated with increased LOS (aLOS = +0.8 days, 95% CI = +0.5, +1.1) but no change in revisit odds. Certain demographic and clinical factors, including gender, ethnicity, and type of complex chronic condition, were independently associated with LOS and risk of 30-day hospital revisit for pediatric AP. Children with malignant and gastrointestinal complex chronic conditions who require TPN are at highest risk for both longer LOS and hospital revisit when admitted with AP. These patient populations may benefit from intensive care coordination when hospitalized for AP.

Mycobacterium bovis infections in slaughter pigs in Mubende district, Uganda: a public health concern.

PubMed

Muwonge, Adrian; Johansen, Tone B; Vigdis, Edvardsen; Godfroid, Jacques; Olea-Popelka, Francisco; Biffa, Demelash; Skjerve, Eystein; Djønne, Berit

2012-09-21

Bovine tuberculosis (TB) caused by Mycobacterium bovis is primarily a disease of ruminants, particularly cattle (Bos primigenius) and buffalo (Syncerus caffer), and is endemic in most developing countries. To date, studies done in Uganda have documented the prevalence of M. bovis in cattle, humans and wild life, in addition to non-tuberculous mycobacteria in pigs. Pigs are increasingly becoming an important component of the livestock sector and share the human ecosystem in rural Uganda. It is therefore of public health interest that they are not a source of human infections. As a follow up to previously published findings on mycobacteria in pigs, this study was aimed at investigating the occurrence and molecular characteristics of M. bovis detected in slaughter pigs in Mubende district, Uganda. One hundred fifty mesenteric lymph nodes with lesions suggestive of mycobacterial infections were collected from approximately one thousand slaughtered pigs in Mubende district over a period of five months. The isolation and identification of M. bovis was done using conventional mycobacteriological methods. Mycobacteria belonging to the Mycobacterium tuberculosis complex (MTC) were identified to species level using deletion analysis. Molecular typing was done using Spoligotyping and MIRU-VNTR analysis. Molecular data were analysed and interpreted using MIRU-VNTR plus, SpolDB4.0 and the Mycobacterium bovis spoligo database. Of the examined animals, one boar and two sows from Madudu Sub County were infected with M. bovis which presented as lesions of a deep yellow colour and a grit-like texture in the mesenteric lymph nodes. This represents 2% (3/150) of the lymph nodes where lesions suggestive of mycobacterial infections were detected. Molecular analysis revealed that the isolates from the infected pigs showed identical MIRU-VNTR profile and spoligotype (SB1469). This is the first study documenting the occurrence of M. bovis in slaughter pigs in Uganda, revealing that one in

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…

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 cultural…

Bereavement Counselling in Uganda and Northern Ireland: A Comparison

ERIC Educational Resources Information Center

Montgomery, Lorna; Owen-Pugh, Valerie

2018-01-01

Therapeutic interventions for bereavement in Northern Ireland and in the Sub-Saharan African country of Uganda are compared. Semi-structured interviews were conducted with Ugandan (n = 18) and Northern Irish (n = 20) therapists. These were thematically analysed. The findings focused on: the counselling context, the characteristics of counsellors,…

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

Multisectoral prioritization of zoonotic diseases in Uganda, 2017: A One Health perspective

PubMed Central

Bulage, Lilian; Kihembo, Christine; Nantima, Noelina; Monje, Fred; Ndumu, Deo; Sentumbwe, Juliet; Mbolanyi, Betty; Aruho, Robert; Kaboyo, Winyi; Mutonga, David; Basler, Colin; Paige, Sarah; Barton Behravesh, Casey

2018-01-01

Background Zoonotic diseases continue to be a public health burden globally. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Agenda conducted a One Health Zoonotic Disease Prioritization Workshop to identify zoonotic diseases of greatest national concern to the Ugandan government. Materials and methods The One Health Zoonotic Disease Prioritization tool, a semi-quantitative tool developed by the U.S. Centers for Disease Control and Prevention, was used for the prioritization of zoonoses. Workshop participants included voting members and observers representing multiple government and non-governmental sectors. During the workshop, criteria for prioritization were selected, and questions and weights relevant to each criterion were determined. We used a decision tree to provide a ranked list of zoonoses. Participants then established next steps for multisectoral engagement for the prioritized zoonoses. A sensitivity analysis demonstrated how criteria weights impacted disease prioritization. Results Forty-eight zoonoses were considered during the workshop. Criteria selected to prioritize zoonotic diseases were (1) severity of disease in humans in Uganda, (2) availability of effective control strategies, (3) potential to cause an epidemic or pandemic in humans or animals, (4) social and economic impacts, and (5) bioterrorism potential. Seven zoonotic diseases were identified as priorities for Uganda: anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, African trypanosomiasis, plague, and rabies. Sensitivity analysis did not indicate significant changes in zoonotic disease prioritization based on criteria weights. Discussion One Health approaches and multisectoral collaborations are crucial to the surveillance, prevention, and control strategies for zoonotic diseases. Uganda used such an approach to identify zoonoses of

Predator-prey interactions, resource depression and patch revisitation

USGS Publications Warehouse

Erwin, R.M.

1989-01-01

Generalist predators may be confronted by different types of prey in different patches: sedentary and conspicuous, cryptic (with or without refugia), conspicuous and nonsocial, or conspicuous and social. I argue that, where encounter rates with prey are of most importance, patch revisitation should be a profitable tactic where prey have short 'recovery' times (conspicuous, nonsocial prey), or where anti-predator response (e.g. shoaling) may increase conspicuousness. Predictions are made for how temporal changes in prey encounter rates should affect revisit schedules and feeding rates for the 4 different prey types.

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…

The "Mushroom Cloud" Demonstration Revisited

ERIC Educational Resources Information Center

Panzarasa, Guido; Sparnacci, Katia

2013-01-01

A revisitation of the classical "mushroom cloud" demonstration is described. Instead of aniline and benzoyl peroxide, the proposed reaction involves household chemicals such as alpha-pinene (turpentine oil) and trichloroisocyanuric acid ("Trichlor") giving an impressive demonstration of oxidation and combustion reactions that…

Smoking cessation after engagement in HIV care in rural Uganda.

PubMed

Mitton, Julian A; North, Crystal M; Muyanja, Daniel; Okello, Samson; Vořechovská, Dagmar; Kakuhikire, Bernard; Tsai, Alexander C; Siedner, Mark J

2018-06-07

People living with HIV (PLWH) are more likely to smoke compared to HIV-uninfected counterparts, but little is known about smoking behaviors in sub-Saharan Africa. To address this gap in knowledge, we characterized smoking cessation patterns among people living with HIV (PLWH) compared to HIV-uninfected individuals in rural Uganda. PLWH were at least 40 years of age and on antiretroviral therapy for at least three years, and HIV-uninfected individuals were recruited from the clinical catchment area. Our primary outcome of interest was smoking cessation, which was assessed using an adapted WHO STEPS smoking questionnaire. We fit Cox proportional hazards models to compare time to smoking cessation between PLWH pre-care, PLWH in care, and HIV-uninfected individuals. We found that, compared to HIV-uninfected individuals, PLWH in care were less likely to have ever smoked (40% vs. 49%, p = 0.04). The combined sample of 267 ever-smokers had a median age of 56 (IQR 49-68), 56% (n = 150) were male, and 26% (n = 70) were current smokers. In time-to-event analyses, HIV-uninfected individuals and PLWH prior to clinic enrollment ceased smoking at similar rates (HR 0.8, 95% CI 0.5-1.2). However, after enrolling in HIV care, PLWH had a hazard of smoking cessation over twice that of HIV-uninfected individuals and three times that of PLWH prior to enrollment (HR 2.4, 95% CI 1.3-4.6, p = 0.005 and HR 3.0, 95% CI 1.6-5.5, p = 0.001, respectively). In summary, we observed high rates of smoking cessation among PLWH after engagement in HIV care in rural Uganda. While we hypothesize that greater access to primary care services and health counseling might contribute, future studies should better investigate the mechanism of this association.

“First and foremost the evangelist”? Mission and government priorities for the treatment of leprosy in Uganda, 1927-1948

PubMed Central

Vongsathorn, Kathleen

2014-01-01

Early historiography on medicine in British colonial Africa suggests that colonial government and missionary medicine occupied two relatively distinct spheres, and that government officials viewed medical missionaries with suspicion and distrust. Contrary to this paradigm, this article suggests that missionaries and colonial government officials collaborated extensively and amicably in the treatment of leprosy in Uganda. Mission, medical, and government correspondence and reports are drawn upon in order to demonstrate that the suspicion and tension that characterised so many other interactions between British colonial government officials and missionaries was largely absent in the treatment of leprosy in Uganda. The mutual social and cultural priorities of missionaries and government administrators led to a system of isolated, in-patient leprosy care that was limited in scope and reflective not of a goal for the public health of Uganda, but rather a vision for the future of Uganda as a “civilised” and Christian country. PMID:24949084

Awareness of, responsiveness to and practice of patients' rights at Uganda's national referral hospital.

PubMed

Kagoya, Harriet Rachel; Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C

2013-06-21

The realisation of patients' rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients' Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. The study aimed to assess level of awareness of, responsiveness to and practice of patients' rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May-June 2012, 2.5 years after the launch of the Uganda Patients' Charter. At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients' Charter. Awareness of patients' rights was significantly higher amongst HWs (70%) than patients (40%) ( p < 0.01). Patients' awareness was associated with education level (χ 2 = 42.4, p < 0.001), employment status (χ 2 = 33.6, p < 0.001) and hospital visits (χ 2 = 3.9, p = 0.048). For HWs it was associated with education level (χ 2 = 155.6, p < 0.001) and length of service (χ 2 = 154.5, p <0.001). Patients feel powerless to negotiate for their rights and fear being discriminated against based on their ability to bribe HWs with money to access care, and political, socio-economic and tribal status. Awareness of, responsiveness to and practice of patients' rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses

Awareness of, responsiveness to and practice of patients’ rights at Uganda's national referral hospital

PubMed Central

Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C.

2013-01-01

Abstract Background The realisation of patients’ rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients’ Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. Aim The study aimed to assess level of awareness of, responsiveness to and practice of patients’ rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. Methods A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May–June 2012, 2.5 years after the launch of the Uganda Patients’ Charter. Results At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients’ Charter. Awareness of patients’ rights was significantly higher amongst HWs (70%) than patients (40%) (p < 0.01). Patients’ awareness was associated with education level (χ2 = 42.4, p < 0.001), employment status (χ2 = 33.6, p < 0.001) and hospital visits (χ2 = 3.9, p = 0.048). For HWs it was associated with education level (χ2 = 155.6, p < 0.001) and length of service (χ2 = 154.5, p <0.001). Patients feel powerless to negotiate for their rights and fear being discriminated against based on their ability to bribe HWs with money to access care, and political, socio-economic and tribal status. Conclusion and recommendations Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel

Undergraduate student mental health at Makerere University, Uganda

PubMed Central

OVUGA, EMILIO; BOARDMAN, JED; WASSERMAN, DANUTA

2006-01-01

There is little information on the current mental health of University students in Uganda. The present study was carried out to determine the prevalence of depressed mood and suicidal ideation among students at Makerere University. Two student samples participated. Sample I comprised 253 fresh students admitted to all faculties at the University in the academic year 2000/2001, selected by a simple random sampling procedure. Sample II comprised 101 students admitted to the Faculty of Medicine during the academic year 2002/2003. The prevalence of depressed mood was measured using the 13-item Beck Depression Inventory (BDI). The prevalence of depressed mood (BDI score 10 or more) was significantly higher in sample I (16.2%) than sample II (4.0%). Sample I members were significantly more likely than those of sample II to report lifetime and past week suicide ideation. Thus, there is a high prevalence of mental health problems among the general population of new students entering Makerere University and this is significantly higher than for new students in the Faculty of Medicine. PMID:16757997

Public discourse on HIV/AIDS: an archival analysis of national newspaper reporting in Uganda, 1996-2011.

PubMed

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 analysis of New Vision reporting by Kirby (1986-1995). We examined the continuing evolution in the public discourse in Uganda, focusing on reporting about young people. An increase in reporting on HIV and AIDS occurred after 2003, as antiretroviral treatment was becoming available. While the emphasis in newspaper reporting about adults and the population at large evolved to reflect the development of new HIV treatment and prevention methods, the majority of the articles focused on young people did not change. Articles about young people continued to emphasise HIV acquisition due to early and premarital sexual activity and the need for social support services for children affected by HIV and AIDS. Articles often did not report on the complex social conditions that shape HIV-related risk among young people, or address young people who are sexually active, married, and/or HIV infected. With HIV prevalence now increasing among young people and adults in Uganda, greater attention to HIV prevention is needed.

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda

PubMed Central

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Introduction Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. Methods A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. Results The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. Conclusion KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country. PMID:25667699

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda.

PubMed

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country.

A Hydrostatic Paradox Revisited

ERIC Educational Resources Information Center

Ganci, Salvatore

2012-01-01

This paper revisits a well-known hydrostatic paradox, observed when turning upside down a glass partially filled with water and covered with a sheet of light material. The phenomenon is studied in its most general form by including the mass of the cover. A historical survey of this experiment shows that a common misunderstanding of the phenomenon…

The Arts and Health Communication in Uganda: A Light Under the Table.

PubMed

Sonke, Jill; Pesata, Virginia; Nakazibwe, Venny; Ssenyonjo, Jude; Lloyd, Robert; Espino, Danielle; Nieves, Mia; Khandakji, Samantha; Hahn, Phillip; Kerrigan, Maria

2018-04-01

This qualitative interview study brings the voices of 27 public health leaders, health communication experts, and artists who work in public health in Uganda together to articulate the principles and practices that make the country a shining example of effective, evidence-based use of the arts for health communication. The specific aim of the study was to identify best practices, theoretical foundations, and other factors that contribute to the success of arts-based health communication campaigns in Uganda. The study presents four primary themes related to use of the arts for health communication in Uganda: (1) the arts empower health communication; (2) the arts engage people emotionally; (3) effective programs are highly structured; and (4) professionalism is critical to program effectiveness. The findings suggest that the arts humanize, clarify, and empower health communication. The arts can attract attention and engage target populations, reduce hierarchical divisions and tensions that can challenge communication between health professionals and community members, make concepts clearer and more personally and culturally relevant, and communicate at an emotional level wherein concepts can be embodied and made actionable. The findings articulate why and how the arts are an effective means for health communication and can guide best practices.

Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania.

PubMed

Mutero, Clifford M; Kramer, Randall A; Paul, Christopher; Lesser, Adriane; Miranda, Marie Lynn; Mboera, Leonard E G; Kiptui, Rebecca; Kabatereine, Narcis; Ameneshewa, Birkinesh

2014-08-08

Policy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST). Country-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate. Important findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides. Malaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment.

PubMed

Adaku, Alex; Okello, James; Lowry, Blakeley; Kane, Jeremy C; Alderman, Stephen; Musisi, Seggane; Tol, Wietse A

2016-01-01

Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions. We conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45). Data from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included "overthinking", ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were

Towards improving hospital performance in Uganda and Zambia: reflections and opportunities for autonomy.

PubMed

Hanson, Kara; Atuyambe, Lynn; Kamwanga, Jolly; McPake, Barbara; Mungule, Oswald; Ssengooba, Freddie

2002-07-01

Hospitals have been relatively neglected although their high resource consumption implies that gains from improving the services they deliver may be substantial. Nevertheless, the challenges posed by hospital reforms are great. Hospital autonomy usually consists of both decentralisation, and a greater measure of exposure to market forces. In Uganda and Zambia, more traditional 'decentralisation' of authority to district level authorities includes district hospitals; and some measure of 'autonomy' (known as 'self-accounting status' in Uganda) has been applied to some or all second and third level referral hospitals. The hospital policies pursued in both countries present opportunities to tackle their hospital sectors. In Zambia, purchasing of services means that new incentives and policy mechanisms can come into play. Little advantage has been taken of these opportunities to date. In Uganda, there is no financial link between districts and higher levels of the system, but decentralisation of control over personnel is more advanced. These two components--the alignment of incentives (to promote access and quality for those intended to be covered by the public budget) and the effective decentralisation of control over key resources--seem to us the key tools to address the stubborn problems of hospitals.

A short review on the potential of coffee husk gasification for sustainable energy in Uganda.

PubMed

Miito, Gilbert John; Banadda, Noble

2017-01-01

Agricultural biomass is widely recognized as a clean and renewable energy source, with increasing potential to replace conventional fossil fuels in the energy market. Uganda, like other developing countries, has a high dependency (91%) on wood fuel, leading to environmental degradation. With a coffee production of 233 Metric Tonnes per annum, relating to 46.6 Mega Tonnes of coffee husks from processing, transforming these husks into syngas through gasification can contribute to resolving the existing energy challenges. The objective of this article is to briefly review the energy potential of coffee husks through gasification, and how the gasification process could increase energy recoveries for coffee farmers. Previous  findings indicate that the 46.6 Mega Tonnes per year of coffee husks generated in Uganda, with a heating value of 18.34 MJ/kg, is capable of generating 24 GWh of energy. This will address a 0.7% portion of the energy situation in Uganda, while protecting the environment.

A short review on the potential of coffee husk gasification for sustainable energy in Uganda

PubMed Central

Miito, Gilbert John; Banadda, Noble

2017-01-01

Agricultural biomass is widely recognized as a clean and renewable energy source, with increasing potential to replace conventional fossil fuels in the energy market. Uganda, like other developing countries, has a high dependency (91%) on wood fuel, leading to environmental degradation. With a coffee production of 233 Metric Tonnes per annum, relating to 46.6 Mega Tonnes of coffee husks from processing, transforming these husks into syngas through gasification can contribute to resolving the existing energy challenges. The objective of this article is to briefly review the energy potential of coffee husks through gasification, and how the gasification process could increase energy recoveries for coffee farmers. Previous  findings indicate that the 46.6 Mega Tonnes per year of coffee husks generated in Uganda, with a heating value of 18.34 MJ/kg, is capable of generating 24 GWh of energy. This will address a 0.7% portion of the energy situation in Uganda, while protecting the environment. PMID:29259766

Prevalence and Factors Associated with Anemia among Children under 5 Years of Age—Uganda, 2009

PubMed Central

Menon, Manoj P.; Yoon, Steven S.

2015-01-01

Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

Another condom uproar in Uganda.

PubMed

Musoke, D

1991-11-01

A campaign to promote safe sex through the use of condoms has sparked a heated controversy in Uganda, as influential religious leaders have come out in opposition to a practice which they fear will lead to sexual promiscuity. The campaign, backed by the Ugandan government, is designed to halt the rapidly spreading AIDS epidemic. With 20,000 AIDS cases as of June 1991, Uganda leads all African countries in the number of reported cases. Additionally, it is estimated that some 7 million of the country's 17 million inhabitants are HIV-positive. This alarming situation forced President Yoweri Museveni to reverse his stance and come out in favor of the condom campaign. The campaign is being launched by the Ugandan pharmaceutical firm Armtrades Ltd with financial and technical support from USAID and the Ugandan government. The condom campaign, however, has aroused strong opposition from the religious community. Angered by advertisements advising Ugandans to "love carefully" by wearing condoms, Catholic Archbishop Emmanuel Wamala urged his followers in August to reject condoms, calling then an insult to the dignity of man. Following Wamala's lead, other top churchmen came out in opposition to the condom campaign at a recent AIDS prevention leadership conference. One of the clergymen present at the conference told Health Minister James Makumbi that the condom campaign will make young people indulge in uncontrolled sexual immorality. Moslem clerics have also stated their opposition to condoms, fearing sexual promiscuity. But the religious community itself has come under criticism for their opposition to condoms. Stressing that lives are at stake, the popular weekly Topic recently cautioned churchmen that this is not the time to engage in academic and moralistic debates.

Alcohol use among adults in Uganda: findings from the countrywide non-communicable diseases risk factor cross-sectional survey

PubMed Central

Kabwama, Steven Ndugwa; Ndyanabangi, Sheila; Mutungi, Gerald; Wesonga, Ronald; Bahendeka, Silver K.; Guwatudde, David

2016-01-01

Background There are limited data on levels of alcohol use in most sub-Saharan African countries. Objective We analyzed data from Uganda's non-communicable diseases risk factor survey conducted in 2014, to identify alcohol use prevalence and associated factors. Design The survey used the World Health Organization STEPS tool to collect data, including the history of alcohol use. Alcohol users were categorized into low-, medium-, and high-end users. Participants were also classified as having an alcohol-use-related disorder if, over the past 12 months, they were unable to stop drinking alcohol once they had started drinking, and/or failed to do what was normally expected of them because of drinking alcohol, and/or needed an alcoholic drink first in the morning to get going after a heavy drinking session the night before. Weighted logistic regression analysis was used to identify factors associated with medium- to high-end alcohol use. Results Of the 3,956 participants, 1,062 (26.8%) were current alcohol users, including 314 (7.9%) low-end, 246 (6.2%) medium-end, and 502 (12.7%) high-end users. A total of 386 (9.8%) were classified as having an alcohol-use-related disorder. Male participants were more likely to be medium- to high-end alcohol users compared to females; adjusted odds ratio (AOR)=2.34 [95% confidence interval (CI)=1.88–2.91]. Compared to residents in eastern Uganda, participants in central and western Uganda were more likely to be medium- to high-end users; AOR=1.47 (95% CI=1.01–2.12) and AOR=1.89 (95% CI=1.31–2.72), respectively. Participants aged 30–49 years and those aged 50–69 years were more likely to be medium- to high-end alcohol users, compared to those aged 18–29 years, AOR=1.49 (95% CI=1.16–1.91) and AOR=2.08 (95% CI=1.52–2.84), respectively. Conclusions The level of alcohol use among adults in Uganda is high, and 9.8% of the adult population has an alcohol-use-related disorder. PMID:27491961

Psychological correlates of suicidality in HIV/AIDS in semi-urban south-western Uganda.

PubMed

Rukundo, Godfrey Zari; Mishara, Brian; Kinyanda, Eugene

2016-10-01

There is a paucity of data on the prevalence of suicidality in HIV/AIDS, and associated psychological factors in sub-Saharan Africa, shown to be high in Uganda. Yet, the region accounts for over 70% of the world HIV burden. Our study used a cross-sectional survey of 226 HIV-positive (HIV+) adults and adolescents (aged 15-17 years) in Mbarara, Uganda. The relationship between suicidality and depressed mood, anxiety symptoms, state anger, self-esteem, trait anger and hopelessness was examined; anger was the predominant factor in suicidality, suggesting that anger management could potentially lower the prevalence of suicidality. © The Author(s) 2016.

Introducing rapid diagnostic tests for malaria into registered drug shops in Uganda: lessons learned and policy implications.

PubMed

Mbonye, Anthony K; Clarke, Sîan E; Lal, Sham; Chandler, Clare I; Hutchinson, Eleanor; Hansen, Kristian S; Magnussen, Pascal

2015-11-14

Malaria is a major public health problem in Uganda and the current policy recommends introduction of rapid diagnostic tests for malaria (RDTs) to facilitate effective case management. However, provision of RDTs in drug shops potentially raises a new set of issues, such as adherence to RDTs results, management of severe illnesses, referral of patients, and relationship with caretakers. The main objective of the study was to examine the impact of introducing RDTs in registered drug shops in Uganda and document lessons and policy implications for future scale-up of malaria control in the private health sector. A cluster-randomized trial introducing RDTs into registered drug shops was implemented in central Uganda from October 2010 to July 2012. An evaluation was undertaken to assess the impact and the processes involved with the introduction of RDTs into drug shops, the lessons learned and policy implications. Introducing RDTs into drug shops was feasible. To scale-up this intervention however, drug shop practices need to be regulated since the registration process was not clear, supervision was inadequate and record keeping was poor. Although initially it was anticipated that introducing a new practice of record keeping would be cumbersome, but at evaluation this was not found to be a constraint. This presents an important lesson for introducing health management information system into drug shops. Involving stakeholders, especially the district health team, in the design was important for ownership and sustainability. The involvement of village health teams in community sensitization to the new malaria treatment and diagnosis policy was a success and this strategy is recommended for future interventions. Introducing RDTs into drug shops was feasible and it increased appropriate treatment of malaria with artemisinin-based combination therapy. It is anticipated that the lessons presented will help better implementation of similar interventions in the private sector.

Acknowledgment Tokens and Speakership Incipiency Revisited.

ERIC Educational Resources Information Center

Zimmerman, Don H.

1993-01-01

Drummond and Hopper's article in this issue, "Back Channels Revisited," is argued to have decontextualized Jefferson's acknowledgement token phenomenon. The need for careful coding protocols for research on conversational practices is discussed. (eight references) (LB)

Evaluation of HIV-1 rapid tests and identification of alternative testing algorithms for use in Uganda.

PubMed

Kaleebu, Pontiano; Kitandwe, Paul Kato; Lutalo, Tom; Kigozi, Aminah; Watera, Christine; Nanteza, Mary Bridget; Hughes, Peter; Musinguzi, Joshua; Opio, Alex; Downing, Robert; Mbidde, Edward Katongole

2018-02-27

The World Health Organization recommends that countries conduct two phase evaluations of HIV rapid tests (RTs) in order to come up with the best algorithms. In this report, we present the first ever such evaluation in Uganda, involving both blood and oral based RTs. The role of weak positive (WP) bands on the accuracy of the individual RT and on the algorithms was also investigated. In total 11 blood based and 3 oral transudate kits were evaluated. All together 2746 participants from seven sites, covering the four different regions of Uganda participated. Two enzyme immunoassays (EIAs) run in parallel were used as the gold standard. The performance and cost of the different algorithms was calculated, with a pre-determined price cut-off of either cheaper or within 20% price of the current algorithm of Determine + Statpak + Unigold. In the second phase, the three best algorithms selected in phase I were used at the point of care for purposes of quality control using finger stick whole blood. We identified three algorithms; Determine + SD Bioline + Statpak; Determine + Statpak + SD Bioline, both with the same sensitivity and specificity of 99.2% and 99.1% respectively and Determine + Statpak + Insti, with sensitivity and specificity of 99.1% and 99% respectively as having performed better and met the cost requirements. There were 15 other algorithms that performed better than the current one but rated more than the 20% price. None of the 3 oral mucosal transudate kits were suitable for inclusion in an algorithm because of their low sensitivities. Band intensity affected the performance of individual RTs but not the final algorithms. We have come up with three algorithms we recommend for public or Government procurement based on accuracy and cost. In case one algorithm is preferred, we recommend to replace Unigold, the current tie breaker with SD Bioline. We further recommend that all the 18 algorithms that have shown better performance than the current one are made

Pedestrian traffic injuries among school children in Kawempe, Uganda.

PubMed

Nakitto, Mable T; Mutto, Milton; Howard, Andrew; Lett, Ronald

2008-09-01

Traffic injuries are an important problem in low income countries. In Uganda road traffic is the largest single cause of injury in Kampala; pedestrians, and children are most affected. Pedestrian injury affects school children in Uganda. To determine the overall risk of pedestrian traffic injury among school children in Kawempe, Uganda. A cohort was assembled at 35 primary schools and followed for 3 terms. Ten of the schools had participated in previous injury programs, others were systematically selected. Injuries were recorded by teachers using a questionnaire. Data collected included ID, school, age, grade, gender, incident date, vehicle type, and injury outcome. Demographic characteristics are described and cumulative incidences calculated. The cohort included 8,165 children (49% male) from 35 primary schools. The mean age was 9 years (Sd=2.78). Of the 35 schools, 92% were day; the others mixed day and boarding. 53 children (27 girls) were involved in a traffic incident. 25% of the injuries reported were serious and warranted care in a health facility. No deaths occurred. Forty % of incidents involved commercial motorcycles, 41% bicycles, 9% cars, 8% taxis, and 2% trucks. The cumulative incidence was 0.168% each term. Over the 3 terms of the year the cumulative incidence was 0.5 +/- 0.02. There were no gender differences in the cumulative incidence. Each school year about 1/2 % of Kawempe school children are involved in a traffic incident. Interventions are necessary to reduce the unacceptably high incidents of pedestrian traffic. Interventions to alleviate this situation including safer routes, teaching skills of road crossing to children as well as better regulation and road safety education to two wheelers could reduce the unacceptably high incidents of pedestrian traffic injury.

Maternal red blood cell alloimmunisation in south western Uganda.

PubMed

Natukunda, B; Mugyenyi, G; Brand, A; Schonewille, H

2011-08-01

To identify the frequency and nature of maternal red blood cell (RBC) alloimmunisation in Uganda and to determine the prevalence of RhD negativity and the rate of RBC alloimmunisation in Ugandan pregnant women. Haemolytic disease of the foetus and newborn (HDFN) results from maternal alloimmunisation following exposure to allogeneic RBCs during pregnancy or blood transfusion. The prevalence of maternal RBC alloimmunisation in Ugandans is not known. Pregnant women at Mbarara Hospital, South Western Uganda, were investigated in a cross-sectional study. Demographics, transfusion and obstetric histories were recorded. Maternal RBC alloimmunisation was demonstrated using immunohaematological techniques. A total of 2001 pregnant women were recruited; 3.6% of them being RhD negative. Forty-five women (2.2%; 95% CI: 1.6-2.9) were found to be alloimmunised to RBC antigens. There were 38 RBC alloantibodies of known specificity including anti-S, 12; anti-M, 11; anti-Le(a) , 6; anti-D, 4 and 1 each of anti-K, anti-Fy(b) , anti-Jk(a) , anti-Lu(a) and anti-Kp(a) . In two women (4.4%), there were antibody combinations (anti-M+S and anti-K+Kp(a) ). Obstetric history, gestational age and previous immunising events were not significantly associated with the rate of alloimmunisation. This study revealed a maternal RBC alloimmunisation rate of 2.2% which was comparable with findings from a Zimbabwean study where the prevalence was 1.7%. Given the 6·0% prevalence of anti-D among RhD-negative women in our study and the high immunogenicity of the D antigen, programmes for preventing anti-D alloimmunisation and HDFN in Uganda should be considered seriously. © 2011 The Authors. Transfusion Medicine © 2011 British Blood Transfusion Society.

Revisiting Dialogues and Monologues

ERIC Educational Resources Information Center

Kvernbekk, Tone

2012-01-01

In educational discourse dialogue tends to be viewed as being (morally) superior to monologue. When we look at them as basic forms of communication, we find that dialogue is a two-way, one-to-one form and monologue is a one-way, one-to-many form. In this paper I revisit the alleged (moral) superiority of dialogue. First, I problematize certain…

Traditional male circumcision in Uganda: a qualitative focus group discussion analysis.

PubMed

Sabet Sarvestani, Amir; Bufumbo, Leonard; Geiger, James D; Sienko, Kathleen H

2012-01-01

The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision (VMMC). Even though it is recommended to consider collaboration with traditional male circumcision (TMC) providers when planning for VMMC, there is limited knowledge available about the TMC landscape and traditional beliefs. During 2010-11 over 25 focus group discussions (FGDs) were held with clan leaders, traditional cutters, and their assistants to understand the practice of TMC in four ethnic groups in Uganda. Cultural significance and cost were among the primary reasons cited for preferring TMC over VMMC. Ethnic groups in western Uganda circumcised boys at younger ages and encountered lower rates of TMC related adverse events compared to ethnic groups in eastern Uganda. Cutting styles and post-cut care also differed among the four groups. The use of a single razor blade per candidate instead of the traditional knife was identified as an important and recent change. Participants in the focus groups expressed interest in learning about methods to reduce adverse events. This work reaffirmed the strong cultural significance of TMC within Ugandan ethnic groups. Outcomes suggest that there is an opportunity to evaluate the involvement of local communities that still perform TMC in the national VMMC roll-out plan by devising safer, more effective procedures through innovative approaches.

Sexual rights in Uganda and the struggle for meaning in community.

PubMed

Wa Tushabe, Tushabe

2017-04-03

Drawing on lessons from the experiences of women who exchange same-sex erotic energies, this article suggests that advocates of same-sex human rights should take into account epistemic erasures colonized people experience when activism and policies regarding sexual freedom ignore various linguistic and community structures that create spaces for diverse ways of knowing and being. Since the late 1990s, the discourse on homosexuality in Uganda has motivated important debates concerning human values of sovereignty, rights, and family, and has expanded freedoms of sexual expression while at the same time conditioning these freedoms to be experienced in colonial ways of self-knowledge. The language that frames these debates continues to locate human rights for Ugandans who exchange same-sex erotic energies outside the locales-family, history, and language-of intelligible episteme for them. To make sense of this claim, I draw "exchange of same-sex erotic energies" from a saying in Rukiga language spoken by Bakiga in southwestern Uganda, okugira omukago mukika nikwokunywaana oruganda, to think about family and community in which same-sex erotic energies are lived and experienced. This article attempts to redirect attention from colonial constructions of homosexuality to indigenous and decolonial perspectives in relation to women in Uganda who exchange same-sex erotic energies in their struggle for meaning in community. I argue for pedagogies and epistemologies of place and memory in the struggle for human rights and sexual rights.

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…

Chemical tick control practices in southwestern and northwestern Uganda.

PubMed

Vudriko, Patrick; Okwee-Acai, James; Byaruhanga, Joseph; Tayebwa, Dickson Stuart; Okech, Samuel George; Tweyongyere, Robert; Wampande, Eddie M; Okurut, Anna Rose Ademun; Mugabi, Kenneth; Muhindo, Jeanne Bukeka; Nakavuma, Jesca Lukanga; Umemiya-Shirafuji, Rika; Xuan, Xuenan; Suzuki, Hiroshi

2018-05-01

Tick acaricide failure is one of the leading challenges to cattle production in Uganda. To gain an understanding into the possible drivers of acaricide failure, this study characterized the current chemical tick control practices in the southwestern (Mbarara, Mitooma and Rukungiri districts) and northwestern (Adjumani district) regions of Uganda. A total of 85 farms participated in a survey that utilized a semi-structured questionnaire. Moreover, ticks were collected to determine the most common species on the farms. Tick acaricide failure was mainly encountered in the districts where 95% (60/63) of the farms reared exotic cattle (dairy cross-breeds) under a paddocking (fenced) system. In the northwestern region, local cattle were reared in communal grazing areas. All farms used chemical acaricides for tick control, predominantly amidine (amitraz) (48%, 41/85) and co-formulated organophosphates and pyrethroids (38%, 32/85). The spraying method was the most common (91%, 77/85) acaricide application technique, with cattle crush (81%, 69/85) as a common means of physical restraint. Less than optimal tick control practices encountered included use of substandard equipment for spraying, inappropriate dilutions, frequent interaction between animals in neighboring farms despite lack of synchronized chemical tick control and malpractices in acaricide rotation. Only Rhipicephalus appendiculatus and R. (Boophilus) decoloratus ticks were found in the southwestern region, where 51% (32/63) of the farmers used high acaricide concentrations above the manufacturers' recommendation. Farmers in the northwestern region used 2.2 times less acaricide volume per cattle than those in the southwestern region, and more diverse tick species were encountered. Toxic effects of acaricide to cattle and workers were reported by 13% (11/85) and 32% (27/85) of the respondents, respectively. All 27 cases of human acaricide toxicity reported were from the southwestern region. Overall, our findings

Re-visiting the electrophysiology of language.

PubMed

Obleser, Jonas

2015-09-01

This editorial accompanies a special issue of Brain and Language re-visiting old themes and new leads in the electrophysiology of language. The event-related potential (ERP) as a series of characteristic deflections ("components") over time and their distribution on the scalp has been exploited by speech and language researchers over decades to find support for diverse psycholinguistic models. Fortunately, methodological and statistical advances have allowed human neuroscience to move beyond some of the limitations imposed when looking at the ERP only. Most importantly, we currently witness a refined and refreshed look at "event-related" (in the literal sense) brain activity that relates itself more closely to the actual neurobiology of speech and language processes. It is this imminent change in handling and interpreting electrophysiological data of speech and language experiments that this special issue intends to capture. Copyright © 2015 Elsevier Inc. All rights reserved.

A practical method of predicting client revisit intention in a hospital setting.

PubMed

Lee, Kyun Jick

2005-01-01

Data mining (DM) models are an alternative to traditional statistical methods for examining whether higher customer satisfaction leads to higher revisit intention. This study used a total of 906 outpatients' satisfaction data collected from a nationwide survey interviews conducted by professional interviewers on a face-to-face basis in South Korea, 1998. Analyses showed that the relationship between overall satisfaction with hospital services and outpatients' revisit intention, along with word-of-mouth recommendation as intermediate variables, developed into a nonlinear relationship. The five strongest predictors of revisit intention were overall satisfaction, intention to recommend to others, awareness of hospital promotion, satisfaction with physician's kindness, and satisfaction with treatment level.

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.

Cost-Effectiveness of Peer Counselling for the Promotion of Exclusive Breastfeeding in Uganda.

PubMed

Chola, Lumbwe; Fadnes, Lars T; Engebretsen, Ingunn M S; Nkonki, Lungiswa; Nankabirwa, Victoria; Sommerfelt, Halvor; Tumwine, James K; Tylleskar, Thorkild; Robberstad, Bjarne

2015-01-01

Community based breastfeeding promotion programmes have been shown to be effective in increasing breastfeeding prevalence. However, there is limited data on the cost-effectiveness of these programmes in sub-Saharan Africa. This paper evaluates the cost-effectiveness of a breastfeeding promotion intervention targeting mothers and their 0 to 6 month old children. Data were obtained from a community randomized trial conducted in Uganda between 2006-2008, and supplemented with evidence from several studies in sub-Saharan Africa. In the trial, peer counselling was offered to women in intervention clusters. In the control and intervention clusters, women could access standard health facility breastfeeding promotion services (HFP). Thus, two methods of breastfeeding promotion were compared: community based peer counselling (in addition to HFP) and standard HFP alone. A Markov model was used to calculate incremental cost-effectiveness ratios between the two strategies. The model estimated changes in breastfeeding prevalence and disability adjusted life years. Costs were estimated from a provider perspective. Uncertainty around the results was characterized using one-way sensitivity analyses and a probabilistic sensitivity analysis. Peer counselling more than doubled the breastfeeding prevalence as reported by mothers, but there was no observable impact on diarrhoea prevalence. Estimated incremental cost-effectiveness ratios were US$68 per month of exclusive or predominant breastfeeding and U$11,353 per disability adjusted life year (DALY) averted. The findings were robust to parameter variations in the sensitivity analyses. Our strategy to promote community based peer counselling is unlikely to be cost-effective in reducing diarrhoea prevalence and mortality in Uganda, because its cost per DALY averted far exceeds the commonly assumed willingness-to-pay threshold of three times Uganda's GDP per capita (US$1653). However, since the intervention significantly increases

Socio-Economic and Cultural Determinants of Human African Trypanosomiasis at the Kenya – Uganda Transboundary

PubMed Central

Rutto, Jane Jemeli; Osano, Odipo; Thuranira, Elias Gitonga; Kurgat, Richard Kiptum; Odenyo, Victor Agab Omondi

2013-01-01

Background Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than

Characteristics of revisits of children at risk for serious infections in pediatric emergency care.

PubMed

de Vos-Kerkhof, Evelien; Geurts, Dorien H F; Steyerberg, Ewout W; Lakhanpaul, Monica; Moll, Henriette A; Oostenbrink, Rianne

2018-04-01

In this study, we aimed to identify characteristics of (unscheduled) revisits and its optimal time frame after Emergency Department (ED) discharge. Children with fever, dyspnea, or vomiting/diarrhea (1 month-16 years) who attended the ED of Erasmus MC-Sophia, Rotterdam (2010-2013), the Netherlands, were prospectively included. Three days after ED discharge, we applied standardized telephonic questionnaires on disease course and revisits. Multivariable logistic regression analysis was used to identify independent characteristics of revisits. Young age, parental concern, and alarming signs and symptoms (chest wall retractions, ill appearance, clinical signs of dehydration, and tachypnea) were associated with revisits (n = 527) in children at risk for serious infections discharged from the ED (n = 1765). Children revisited the ED within a median of 2 days (IQR 1.0-3.0), but this was proven to be shorter in children with vomiting/diarrhea (1.0 day (IQR 1.0-2.0)) compared to children with fever or dyspnea (2.0 (IQR 1.0-3.0)). Young age, parental concern, and alarming signs and symptoms (chest wall retractions, ill appearance, clinical signs of dehydration, and tachypnea) were associated with emergency health care revisits in children with fever, dyspnea, and vomiting/diarrhea. These characteristics could help to define targeted review of children during post-discharge period. We observed a disease specific and differential timing of control revisits after ED discharge. What is Known • Fever, dyspnea, and vomiting/diarrhea are major causes of emergency care attendance in children. • As uncertainty remains on uneventful recovery, patients at risk need to be identified on order to improve safety netting after discharge from the ED. What is New • In children with fever, dyspnea, and vomiting/diarrhea, young age, parental concern and chest wall retractions, ill appearance, clinical signs of dehydration, and tachypnea help to define targeted review of

The Effect of Armed Conflict on the Utilization of Maternal Health Services in Uganda: A Population-based Study.

PubMed

Namasivayam, Amrita; Arcos González, Pedro; Castro Delgado, Rafael; Chi, Primus Che

2017-10-03

Maternal mortality rates can be adversely affected by armed conflict, implying a greater level of vulnerability among women, and is often linked to the lack of or limited access to maternal healthcare during conflict. Previous research in Uganda has shown that armed conflict negatively impacts women's utilization of maternal healthcare services for a multitude of reasons at the individual, health-system and political levels. This study compared aggregated Demographic and Health Surveys data from 13 districts in Northern Uganda, a conflict-affected region, with data from the rest of the country, for the use of maternal healthcare services for the years 1988, 1995, 2000, 2006 and 2011, using statistical analyses and logistic regression. Specific indicators for maternal healthcare utilization included contraceptive use, antenatal care, skilled assistance at birth and institutional delivery. Use of contraception and institutional deliveries among women in Northern Uganda was significantly lower compared to the rest of the country. However, skilled assistance at birth among women in Northern Uganda was significantly higher. The findings in this study show that armed conflict can have a negative impact on aspects of maternal healthcare such as contraceptive use and institutional deliveries; however, other indicators such as skilled assistance at birth were seen to be better among conflict-affected populations. This reiterates the complex nature of armed conflict and the interplay of different factors such as conflict intensity, existing health systems and services, and humanitarian interventions that could influence maternal healthcare utilization. Armed conflict, maternal health utilization, Northern Uganda, contraception, skilled assistance at birth, antenatal care, institutional delivery.

Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda

PubMed Central

Maly, Christina; McClendon, Katherine A.; Baumgartner, Joy Noel; Nakyanjo, Neema; Ddaaki, William George; Serwadda, David; Nalugoda, Fred Kakaire; Wawer, Maria J.; Bonnevie, Erika; Wagman, Jennifer A.

2017-01-01

The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies. PMID:28835911

The need to reemphasize behavior change for HIV prevention in Uganda: a qualitative study.

PubMed

Green, Edward C; Kajubi, Phoebe; Ruark, Allison; Kamya, Sarah; D'Errico, Nicole; Hearst, Norman

2013-03-01

Uganda has long been considered an AIDS success story, although in recent years declines in prevalence and incidence appear to have stalled or even reversed. During the early stages of Uganda's AIDS prevention program, health messages emphasized behavior change, especially fidelity. Ugandans were made to fear AIDS and feel personally at risk of dying from a new, poorly understood disease. In this research, six focus group discussions with 64 participants in peri-urban and rural areas outside Kampala suggest that HIV prevention messages have shifted in the direction of risk reduction: condoms, testing, and drugs. Ugandans now seem less afraid of becoming infected with HIV, at least in part because antiretroviral therapy is available, and this diminished fear may be having a disinhibiting effect on sexual behavior. Participants believe that HIV rates are on the rise, that more individuals are engaged in multiple and concurrent sexual partnerships, and that sexual behavior is less restrained than a generation ago. These findings suggest that AIDS-prevention programs in Uganda would benefit from refocusing on the content that yielded success previously-sexual behavior change strategies. © 2013 The Population Council, Inc.

Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda.

PubMed

Ononge, Sam; Campbell, Oona; Mirembe, Florence

2014-10-10

Anaemia in pregnancy is a major public health problem especially in the low-income countries where it is highly prevalent. There has been no recent study in Uganda about the factors associated with anaemia in pregnancy. We aimed to assess the current haemoglobin (Hb) status and factors associated with anaemia (Hb < 11.0 g/dl) in pregnant women in Mpigi, Uganda. We assessed Hb levels of 2436 pregnant women at 28+ weeks of gestation at six health facilities, who were approached to participate in a stepped-wedge cluster-randomised trial of antenatal distribution of misoprostol (for self-administration after home birth or when oxytocin is not available). Women were administered a questionnaire and their baseline blood haemoglobin was examined using portable HemoCueR Hb 301 system. Predictors of anaemia were estimated using linear and logistic regression analysis. The mean Hb was 11.5 (± 1.38) g/dl and prevalence of anaemia (Hb < 11.0 g/dl) was 32.5% (95% CI 30.6%, 34.3%). After adjusting for measured confounders, factors associated with increased risk of anaemia in pregnancy were malaria infection (OR: 1.32, 95% CI: 1.11, 1.58), Human Immuno-deficiency Virus infection (OR: 2.13, 95% CI: 1.36, 2.90) and lack of iron supplementation (OR: 1.66, 95% CI: 1.36, 2.03). Intermittent presumptive treatment of malaria, maternal age and parity showed a weak association with anaemia in pregnancy The high prevalence of anaemia in pregnancy in our setting highlights the need to put more effort in the fight against malaria and HIV, and also ensure that pregnant women access iron supplements early in pregnancy.

Trends and determinants of condom use in Uganda.

PubMed

De Coninck, Zaake; Marrone, Gaetano

2012-01-01

Documenting trends in condom use and exploring factors associated with their utilization are important for broadening the information base for the design of HIV intervention programs. This paper aims to document Uganda's nationwide trends in condom use from 1995 to 2006 and seeks to understand some of the socio-demographic variables that may be associated with their use, using Uganda Demographic Health Surveys (UDHSs). Data from UDHSs conducted in 1995, 2000/2001 and 2006 were analyzed. Socio-demographic variables as well as 'survey year' were selected to assess their interaction with condom use. Multivariate regression analyses were performed. Odds ratios and confidence intervals were computed. Socio-demographic factors such as being male and living in an urban setting were significantly associated with an increased likelihood of reported use of condoms. All results indicated a far greater increase in condom use between 1995 and 2000/2001 than between 2000/2001 and 2006. Policies need to intensify condom use campaigns especially among women and rural populations. The wane in increase in condom use between 2000/2001 and 2006 may be due to the large-scale influx of antiretrovirals (starting in 2004) which may be lowering the anxiety associated with the social construct of HIV/AIDS.

Synergistic vulnerabilities: antiretroviral treatment among women in Uganda.

PubMed

Winchester, Margaret S

2015-01-01

Despite being an early success story in the reduction of HIV infection rates, Uganda faces myriad challenges in the recent era of accelerated antiretroviral treatment (ARV) scale-up. For those able to access treatment, ongoing vulnerabilities of poverty and violence compound treatment-related costs and concerns. This paper explores experiences of one particularly vulnerable population - women on ARVs who have also experienced intimate partner violence (IPV). Data were collected over 12 months in Uganda. They include ethnographic interviews (n = 40) drawn from a larger sample of women on ARV and semi-structured interviews with policy-makers and service providers (n = 42), examining the intersection of experiences and responses to treatment from multiple perspectives. Women's narratives show that due to treatment, immediate health concerns take on secondary importance, while other forms of vulnerability, including IPV and poverty, can continue to shape treatment experiences and the decision to stay in violent relationships. Providers likewise face difficulties in overburdened clinics, though they recognise women's concerns and the importance of considering other forms of vulnerability in treatment. This analysis makes the case for integrating treatment with other types of social services and demonstrates the importance of understanding the ways in which synergistic and compounding vulnerabilities confound treatment scale-up efforts.

Interview with Jacques Bwira Hope Primary School Kampala, Uganda

ERIC Educational Resources Information Center

Harvard Educational Review, 2009

2009-01-01

Jacques Bwira arrived in Uganda in 2000, having fled the violent conflict in his native country, the Democratic Republic of Congo. Though he had trained and worked as a teacher in Congo, he feared that speaking only French would prevent him from making a living in his new home. The police officer who interrogated Jacques on arrival in the capital…

Players and processes behind the national health insurance scheme: a case study of Uganda

PubMed Central

2013-01-01

Background Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda’s proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. Methods The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda’s Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. Results The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. Conclusions This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals

Investigating predictors of visiting, using, and revisiting an online health-communication program: a longitudinal study.

PubMed

Van 't Riet, Jonathan; Crutzen, Rik; De Vries, Hein

2010-09-02

Online health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions. In the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population. A webpage was created providing the public with information about health and healthy behavior. The website included a "physical activity check," which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed. Analyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants (odds ratio [OR] = 2.81, 95% confidence interval [CI] = 1.16-6.81, P = .02) and participants with a strong motivation to be healthy (OR = 1.46, CI = 1

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

Factors associated with modern contraceptive use among young and older women in Uganda; a comparative analysis.

PubMed

Asiimwe, John Bosco; Ndugga, Patricia; Mushomi, John; Manyenye Ntozi, James Patrick

2014-09-08

Much of the research literature about the use of family planning generalizes contraceptive use among all women, using age as a covariate. In Uganda, a country with divergent trends in modern family planning use, this study was set to explore whether or not the predictors of contraceptive use differ by age. This was assessed by using data from the 2011 Uganda Demographic and Health Survey (UDHS). We restricted the sample from each round to fecund, non-pregnant married women age 15-34 who were sexually active within one year prior to the survey, resulting in a sample of 2,814 women. We used logistic regression with age variable used as an interaction term to model the relationship between selected independent variables and the outcome variable (modern contraception use) for each group of women. We found that the key factors associated with use of modern contraceptives varied among young and older married women age 15-24 and 25-34 respectively. Results showed that perception on distance to health facility, listening to radio and geographical differences exhibited significant variability in contraceptive use among the young and the older women. Other key factors that were important for both age groups in explaining contraceptive use were; desire to have children after two years and education level. Addressing contraceptive use among old and young women in Uganda requires concerted efforts that target such women to address the socio economic barriers that exist. There is need for increased access of family planning service to the population through strengthening the use of Village Health Teams (VHTs) whose service is currently limited in coverage (MoH, 2009). Given the variation in contraceptive use between the two age groups, our findings further suggest that there is need for variability in media targeting among the young and the older women categories for improved use of modern contraceptives, for instance using alternative media strategies to reach the young women

Vaginal Practices among Women at High Risk of HIV Infection in Uganda and Tanzania: Recorded Behaviour from a Daily Pictorial Diary

PubMed Central

Francis, Suzanna C.; Baisley, Kathy; Lees, Shelley S.; Andrew, Bahati; Zalwango, Flavia; Seeley, Janet; Vandepitte, Judith; Ao, Trong T.; van de Wijgert, Janneke; Watson-Jones, Deborah; Kapiga, Saidi; Grosskurth, Heiner; Hayes, Richard J.

2013-01-01

Background Intravaginal practices (IVP) are highly prevalent in sub-Saharan African and have been implicated as risk factors for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary. Methodology/Principal Findings Two hundred women were recruited from a HIV prevention intervention feasibility study in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal cleansing during the six week study period. The most common types of cleansing were with water only or water and soap. In both countries, intravaginal insertion (e.g. with herbs) was less common than cleansing, but insertion was practiced by more participants in Uganda (46%) than in Tanzania (10%). In Uganda, participants also reported more frequent sex, and more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse after sex if they reported no condom use. Conclusions While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant different approaches to

Modernization and development: impact on health care decision-making in Uganda.

PubMed

Singh, Debra Anne Kaur; Earnest, Jaya; Lample, May

2015-01-01

Uganda has faced numerous challenges over the past 50 years from overcoming political conflict and civil unrest, to rapid population growth, to combating the HIV epidemic and ever-growing health needs. Women in Uganda have had a major role to play in the health of families and communities. The researchers' purpose in this study, undertaken in rural Uganda, was to a) identify a people-centered definition of development, b) compare it to the process of modernization, and c) investigate how these processes have changed the role women play in decision-making, in areas directly and indirectly related to their health and that of their families. Twenty-two men and women participated in focus group discussion and completed questionnaires. Based on our analysis of discussions it appears that both modernization and development have impacted health positively and negatively. Key themes distilled from interviews included that modernization has led to the breakdown of families; increased maternal responsibility for children; diminished land and economic resources; and an erosion of cultural values and practices that had previously provided stability for the society. In terms of development, women play an increasing role in decision-making processes in the household and are gaining increasing respect for their expertise in a number of areas, notably health care. We propose a movement of grassroots discourse on modernization. Development, and its effect on health, is necessary if the positive aspects of Ugandan culture and those of similar emerging societies are not to be lost (International Covenant on Economic, Social and Cultural Rights, 1966).

Problem Drinking, Alcohol-Related Violence, and Homelessness among Youth Living in the Slums of Kampala, Uganda.

PubMed

Swahn, Monica H; Culbreth, Rachel; Tumwesigye, Nazarius Mbona; Topalli, Volkan; Wright, Eric; Kasirye, Rogers

2018-05-24

This paper examines problem drinking, alcohol-related violence, and homelessness among youth living in the slums of Kampala—an understudied population at high-risk for both alcohol use and violence. This study is based on a cross-sectional survey conducted in 2014 with youth living in the slums and streets of Kampala, Uganda ( n = 1134), who were attending Uganda Youth Development Link drop-in centers. The analyses for this paper were restricted to youth who reported current alcohol consumption ( n = 346). Problem drinking patterns were assessed among youth involved in alcohol-related violence. Mediation analyses were conducted to examine the impact of homelessness on alcohol-related violence through different measures of problem drinking. Nearly 46% of youth who consumed alcohol were involved in alcohol-related violence. Problem drinkers were more likely to report getting in an accident (χ² = 6.8, df = 1, p = 0.009), having serious problems with parents (χ² = 21.1, df = 1, p < 0.0001) and friends (χ² = 18.2, df = 1, p < 0.0001), being a victim of robbery (χ² = 8.8, df = 1, p = 0.003), and going to a hospital (χ² = 15.6, df = 1, p < 0.0001). For the mediation analyses, statistically significant models were observed for frequent drinking, heavy drinking, and drunkenness. Interventions should focus on delaying and reducing alcohol use in this high-risk population.

The Species Problem in Myxomycetes Revisited.

PubMed

Walker, Laura M; Stephenson, Steven L

2016-08-01

Species identification in the myxomycetes (plasmodial slime molds or myxogastrids) poses particular challenges to researchers as a result of their morphological plasticity and frequent alteration between sexual and asexual life strategies. Traditionally, myxomycete morphology has been used as the primary method of species delimitation. However, with the increasing availability of genetic information, traditional myxomycete taxonomy is being increasingly challenged, and new hypotheses continue to emerge. Due to conflicts that sometimes occur between traditional and more modern species concepts that are based largely on molecular data, there is a pressing need to revisit the discussion surrounding the species concept used for myxomycetes. Biological diversity is being increasingly studied with molecular methods and data accumulates at ever-faster rates, making resolution of this matter urgent. In this review, currently used and potentially useful species concepts (biological, morphological, phylogenetic and ecological) are reviewed, and an integrated approach to resolve the myxomycete species problem is discussed. Copyright © 2016 Elsevier GmbH. All rights reserved.

The Evil of Banality: Arendt Revisited

ERIC Educational Resources Information Center

Minnich, Elizabeth

2014-01-01

"The banality of evil" (Arendt) remains controversial and useful. Ironically, the concept is now itself a banality. To revisit and extend it, we consider the "evil of banality", the profound dangers of cliched thoughtlessness. A distinction is proposed: "intensive" versus "extensive evils". The former takes…

Neuropsychiatric perspectives on nodding syndrome in northern Uganda: a case series study and a review of the literature.

PubMed

Musisi, S; Akena, D; Nakimuli-Mpungu, E; Abbo, C; Okello, J

2013-06-01

Nodding Syndrome (NS), previously called Nodding Disease, is a chronic and debilitating illness affecting thousands of children aged 3-18 years in post-conflict Northern Uganda and South Sudan. Characterised by malnutrition, stunted growth, mental retardation and seizures, some researchers have designated it as epilepsy. With reports appearing in Northern Uganda in1997, NS reached epidemic proportions around 2000-2003 when people were moved into Internally Displaced People's (IDP) camps. Investigations for infections (onchocerciasis) and toxins have been inconclusive as to cause, treatment or outcome. No study has addressed the possible relationship of NS to childhood war-trauma experiences. To explore a possible relationship of exposure to prolonged war-trauma and the emergence of epidemic NS in Northern Uganda. This study was a case-series descriptive psychiatric naturalistic field observations of NS cases from homesteads in Northern Uganda and psychiatric investigations and treatment of NS cases referred to Mulago National Referral and Teaching Hospital. Detailed Psychiatric clinical evaluations and field observations revealed that NS children had been exposed to severe war-related psychological and physical trauma as well as non-specific CNS insults including untreated CNS infections/infestations and malnutrition possibly causing seizures. Many children suffered post-traumatic stress disorder (PTSD) and depression. NS could present as an association of childhood complex PTSD, (called Developmental Trauma Disorder), occurring in the chronically war-traumatised children of Northern Uganda, complicated by severe prolonged depression with its characteristic symptoms of psychomotor retardation, anxiety, anhedonia and anorexia. This, coupled with food shortages, resulted in malnutrition, wasting and stunted growth with severe avitaminoses. Many children had seizures. All this calls for multi-disciplinary treatment approaches.

What the papers say: Reading therapeutic landscapes of women's health and empowerment in Uganda.

PubMed

MacKian, Sara C

2008-03-01

The Ugandan Ministry of Health emphasises the pivotal position of women in securing the nation's health. Drawing on the concept of therapeutic landscapes, this paper explores media constructions of health in Uganda in order to question what role these may play in creating or undermining a 'therapeutic landscape' which supports women's empowerment in a health context. The paper argues for the importance of understanding discursively constructed notions of health in order to ground the promotion of a health care strategy in the everyday lives and discourses of the users implicated. Given the Ugandan government's current drive to both empower women and push an agenda of formally provided health care, this paper provides an exploratory analysis of how far newspapers facilitate or hinder this vision.

The Socioeconomic Impact of HIV/AIDS on Education Outcomes in Uganda: School Enrolment and the Schooling Gap in 2002/2003

ERIC Educational Resources Information Center

Kasirye, Ibrahim; Hisali, Eria

2010-01-01

Due to high prime-age mortality--a result of the HIV/AIDS scourge, the number of orphans in Uganda continues to rise. Using the 2002/2003 Uganda National Household Survey, this paper investigates how HIV/AIDS orphan status affects schooling enrolment and grade progression. Our results show that HIV/AIDS orphans are not significantly less likely to…

Genetic diversity and population structure of the tsetse fly Glossina fuscipes fuscipes (Diptera: Glossinidae) in Northern Uganda: Implications for vector control

PubMed Central

Echodu, Richard; Opiyo, Elizabeth A.; Dion, Kirstin; Halyard, Alexis; Dunn, Augustine W.; Aksoy, Serap; Caccone, Adalgisa

2017-01-01

Uganda is the only country where the chronic and acute forms of human African Trypanosomiasis (HAT) or sleeping sickness both occur and are separated by < 100 km in areas north of Lake Kyoga. In Uganda, Glossina fuscipes fuscipes is the main vector of the Trypanosoma parasites responsible for these diseases as well for the animal African Trypanosomiasis (AAT), or Nagana. We used highly polymorphic microsatellite loci and a mitochondrial DNA (mtDNA) marker to provide fine scale spatial resolution of genetic structure of G. f. fuscipes from 42 sampling sites from the northern region of Uganda where a merger of the two disease belts is feared. Based on microsatellite analyses, we found that G. f. fuscipes in northern Uganda are structured into three distinct genetic clusters with varying degrees of interconnectivity among them. Based on genetic assignment and spatial location, we grouped the sampling sites into four genetic units corresponding to northwestern Uganda in the Albert Nile drainage, northeastern Uganda in the Lake Kyoga drainage, western Uganda in the Victoria Nile drainage, and a transition zone between the two northern genetic clusters characterized by high level of genetic admixture. An analysis using HYBRIDLAB supported a hybrid swarm model as most consistent with tsetse genotypes in these admixed samples. Results of mtDNA analyses revealed the presence of 30 haplotypes representing three main haplogroups, whose location broadly overlaps with the microsatellite defined clusters. Migration analyses based on microsatellites point to moderate migration among the northern units located in the Albert Nile, Achwa River, Okole River, and Lake Kyoga drainages, but not between the northern units and the Victoria Nile drainage in the west. Effective population size estimates were variable with low to moderate sizes in most populations and with evidence of recent population bottlenecks, especially in the northeast unit of the Lake Kyoga drainage. Our

Prevention messages and AIDS risk behavior in Kampala, Uganda.

PubMed

Hearst, Norman; Kajubi, Phoebe; Hudes, Esther Sid; Maganda, Albert K; Green, Edward C

2012-01-01

Uganda was one of the first countries to substantially reduce HIV rates through behavior change, but these gains have not continued in recent years. Little is known about what messages Ugandans are currently hearing about AIDS prevention, what they themselves believe to be important prevention strategies, and how these beliefs are associated with behavior. We interviewed men and women aged between 20 and 39 in two poor peri-urban areas of Kampala, using a random sample, cross-sectional household survey design. Respondents provided detailed reports of sexual behavior over the past six months, the main prevention message they are currently hearing about AIDS, and their own ranking of the importance of prevention strategies. Condom use was the main AIDS prevention message that respondents reported hearing, followed by getting tested. These were also what respondents themselves considered most important, followed closely by faithfulness. Abstinence was the lowest ranked strategy, but a higher ranking for this prevention strategy was the only one consistently associated with less risky behavior. A higher ranking for condoms was associated with higher levels of risk behavior, while the ranking of testing made no difference in any behavior. These results present challenges for AIDS prevention strategies that rely primarily on promoting condoms and testing. HIV prevention programs need to assess their impact on behavior.

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)…

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

PubMed

Bwire, Godfrey; Munier, Aline; Ouedraogo, Issaka; Heyerdahl, Leonard; Komakech, Henry; Kagirita, Atek; Wood, Richard; Mhlanga, Raymond; Njanpop-Lafourcade, Berthe; Malimbo, Mugagga; Makumbi, Issa; Wandawa, Jennifer; Gessner, Bradford D; Orach, Christopher Garimoi; Mengel, Martin A

2017-03-01

The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities. We conducted a prospective study between 2011-15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5-10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5-9 years had increased risk. Cholera was endemic in some villages with well-defined "hotspots". Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty. Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015

PubMed Central

Ouedraogo, Issaka; Heyerdahl, Leonard; Komakech, Henry; Kagirita, Atek; Wood, Richard; Mhlanga, Raymond; Njanpop-Lafourcade, Berthe; Malimbo, Mugagga; Makumbi, Issa; Wandawa, Jennifer; Gessner, Bradford D.; Orach, Christopher Garimoi; Mengel, Martin A.

2017-01-01

Background The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities. Methodology/Principal findings We conducted a prospective study between 2011–15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5–10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5–9 years had increased risk. Cholera was endemic in some villages with well-defined “hotspots”. Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty. Conclusions/Significance Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services

Addressing Obstetrical Challenges at 12 Rural Ugandan Health Facilities: Findings from an International Ultrasound and Skills Development Training for Midwives in Uganda.

PubMed

Kinnevey, Christina; Kawooya, Michael; Tumwesigye, Tonny; Douglas, David; Sams, Sarah

2016-01-01

Like much of Sub-Saharan Africa, Uganda is facing significant maternal and fetal health challenges. Despite the fact that the majority of the Uganda population is rural and the major obstetrical care provider is the midwife, there is a lack of data in the literature regarding rural health facilities' and midwives' knowledge of ultrasound technology and perspectives on important maternal health issues such as deficiencies in prenatal services. A survey of the current antenatal diagnostic and management capabilities of midwives at 12 rural Ugandan health facilities was performed as part of an international program initiated to provide ultrasound machines and formal training in their use to midwives at antenatal care clinics. The survey revealed that the majority of pregnant women attend less than the recommended minimum of four antenatal care visits. There were significant knowledge deficits in many prenatal conditions that require ultrasound for early diagnosis, such as placenta previa and macrosomia. The cost of providing ultrasound machines and formal training to 12 midwives was $6,888 per powered rural health facility and $8,288 for non-powered rural health facilities in which solar power was required to maintain ultrasound. In order to more successfully meet Millennium Development Goal 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV) through decreasing maternal to child transmission of HIV, the primary healthcare provider, which is the midwife in Uganda, must be competent at the diagnosis and management of a wide spectrum of obstetrical challenges. A trained ultrasound-based approach to obstetrical care is a cost effective method to take on these goals.

Prevalence of K13-propeller gene polymorphisms among Plasmodium falciparum parasites isolated from adult symptomatic patients in northern Uganda.

PubMed

Ocan, Moses; Bwanga, Freddie; Okeng, Alfred; Katabazi, Fred; Kigozi, Edgar; Kyobe, Samuel; Ogwal-Okeng, Jasper; Obua, Celestino

2016-08-19

In the absence of an effective vaccine, malaria treatment and eradication is still a challenge in most endemic areas globally. This is especially the case with the current reported emergence of resistance to artemisinin agents in Southeast Asia. This study therefore explored the prevalence of K13-propeller gene polymorphisms among Plasmodium falciparum parasites in northern Uganda. Adult patients (≥18 years) presenting to out-patients department of Lira and Gulu regional referral hospitals in northern Uganda were randomly recruited. Laboratory investigation for presence of plasmodium infection among patients was done using Plasmodium falciparum exclusive rapid diagnostic test, histidine rich protein-2 (HRP2) (Pf). Finger prick capillary blood from patients with a positive malaria test was spotted on a filter paper Whatman no. 903. The parasite DNA was extracted using chelex resin method and sequenced for mutations in K13-propeller gene using Sanger sequencing. PCR DNA sequence products were analyzed using in DNAsp 5.10.01software, data was further processed in Excel spreadsheet 2007. A total of 60 parasite DNA samples were sequenced. Polymorphisms in the K13-propeller gene were detected in four (4) of the 60 parasite DNA samples sequenced. A non-synonymous polymorphism at codon 533 previously detected in Cambodia was found in the parasite DNA samples analyzed. Polymorphisms at codon 522 (non-synonymous) and codon 509 (synonymous) were also found in the samples analyzed. The study found evidence of positive selection in the Plasmodium falciparum population in northern Uganda (Tajima's D = -1.83205; Fu and Li's D = -1.82458). Polymorphism in the K13-propeller gene previously reported in Cambodia has been found in the Ugandan Plasmodium falciparum parasites. There is need for continuous surveillance for artemisinin resistance gene markers in the country.

Religious views on suicide among the Baganda, Uganda: a qualitative study.

PubMed

Mugisha, James; Hjelmeland, Heidi; Kinyanda, Eugene; Knizek, Birthe Loa

2013-04-01

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 as a breach of God's doctrine life is sacred, God's commandment thou shall not kill, and God's rule of agape. The study also focuses on the consequences of breaching God's divine providence: punishment from God and the Church. Religion still has a lot of influence on people's views on suicide in Uganda despite the challenges highlighted in the study. A recommendation from these results is that suicide prevention should cater to divergent views on religion and suicide. More qualitative research should be conducted in this area to facilitate theoretical comparison with this study.

Alcohol Use and Food Insecurity among People Living with HIV in Mbarara, Uganda and St. Petersburg, Russia

PubMed Central

Patts, Gregory J.; Cheng, Debbie M.; Emenyonu, Nneka; Bridden, Carly; Gnatienko, Natalia; Lloyd-Travaglini, Christine A.; Ngabirano, Christine; Yaroslavtseva, Tatiana; Muyindike, Winnie R.; Weiser, Sheri D.; Krupitsky, Evgeny M.; Hahn, Judith A.; Samet, Jeffrey H.

2016-01-01

Food insecurity (FI) is a documented problem associated with adverse health outcomes among HIV-infected populations. Little is known about the relationship between alcohol use and FI. We assessed whether heavy alcohol use was associated with FI among HIV-infected, antiretroviral therapy (ART)-naïve cohorts in Uganda and Russia. Inverse probability of treatment weighted logistic regression models were used to evaluate the association using cross-sectional baseline data. FI was experienced by half of the Russia cohort (52%) and by a large majority of the Uganda cohort (84%). We did not detect an association between heavy alcohol use and FI in either cohort (Russia: AOR = 0.80, 95% CI = 0.46, 1.40; Uganda: AOR = 1.00, 95% CI = 0.57, 1.74) or based on the overall combined estimate (AOR = 0.89, 95% CI = 0.60, 1.33). Future studies should explore the determinants of FI in HIV-infected populations to inform strategies for its mitigation. PMID:27699595

The potential impact on farmer health of enhanced export horticultural trade between the U.K. and Uganda.

PubMed

Cross, Paul; Edwards, Rhiannon T; Nyeko, Philip; Edwards-Jones, Gareth

2009-05-01

The export of vegetables from African countries to European markets presents consumers with an ethical dilemma: should they support local, but relatively well-off farmers, or poorer farmers from distant countries? This paper considers the issue of farm worker health in the U.K. and Uganda, and considers the dilemma facing U.K. consumers if Uganda achieves their aim of exporting more vegetables to the U.K. Self-reported health scores of 1,200 farm workers in the U.K. and Uganda were measured with the internationally recognised SF-36 questionnaire and compared to an international population norm. The age-corrected health status of U.K. farm workers was significantly lower than the population norm, whereas Ugandans scored significantly higher (indicating good health) for physical health and lower for mental health. If Ugandan produce enters U.K. markets, then consumers may wish to consider both the potential benefits that enhanced trade could offer Ugandan farmers compared with its impacts on U.K. workers.

Alcohol Use and Food Insecurity Among People Living with HIV in Mbarara, Uganda and St. Petersburg, Russia.

PubMed

Patts, Gregory J; Cheng, Debbie M; Emenyonu, Nneka; Bridden, Carly; Gnatienko, Natalia; Lloyd-Travaglini, Christine A; Ngabirano, Christine; Yaroslavtseva, Tatiana; Muyindike, Winnie R; Weiser, Sheri D; Krupitsky, Evgeny M; Hahn, Judith A; Samet, Jeffrey H

2017-03-01

Food insecurity (FI) is a documented problem associated with adverse health outcomes among HIV-infected populations. Little is known about the relationship between alcohol use and FI. We assessed whether heavy alcohol use was associated with FI among HIV-infected, antiretroviral therapy (ART)-naïve cohorts in Uganda and Russia. Inverse probability of treatment weighted logistic regression models were used to evaluate the association using cross-sectional baseline data. FI was experienced by half of the Russia cohort (52 %) and by a large majority of the Uganda cohort (84 %). We did not detect an association between heavy alcohol use and FI in either cohort (Russia: AOR = 0.80, 95 % CI 0.46, 1.40; Uganda: AOR = 1.00, 95 % CI 0.57, 1.74) or based on the overall combined estimate (AOR = 0.89, 95 % CI 0.60, 1.33). Future studies should explore the determinants of FI in HIV-infected populations to inform strategies for its mitigation.

Prevalence of maternal near miss and community-based risk factors in Central Uganda.

PubMed

Nansubuga, Elizabeth; Ayiga, Natal; Moyer, Cheryl A

2016-11-01

To examine the prevalence of maternal near-miss (MNM) and its associated risk factors in a community setting in Central Uganda. A cross-sectional research design employing multi-stage sampling collected data from women aged 15-49 years in Rakai, Uganda, who had been pregnant in the 3years preceding the survey, conducted between August 10 and December 31, 2013. Additionally, in-depth interviews were conducted. WHO-based disease and management criteria were used to identify MNM. Binary logistic regression was used to predict MNM risk factors. Content analysis was performed for qualitative data. Survey data were collected from 1557 women and 40 in-depth interviews were conducted. The MNM prevalence was 287.7 per 1000 pregnancies; the majority of MNMs resulted from hemorrhage. Unwanted pregnancies, a history of MNM, primipara, pregnancy danger signs, Banyakore ethnicity, and a partner who had completed primary education only were associated with increased odds of MNM (all P<0.05). MNM morbidity is a significant burden in Central Uganda. The present study demonstrated higher MNM rates compared with studies employing organ-failure MNM-diagnostic criteria. These findings illustrate the need to look beyond mortality statistics when assessing maternal health outcomes. Concerted efforts to increase supervised deliveries, access to emergency obstetric care, and access to contraceptives are warranted. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Determinants of infant growth in Eastern Uganda: a community-based cross-sectional study.

PubMed

Engebretsen, Ingunn Marie Stadskleiv; Tylleskär, Thorkild; Wamani, Henry; Karamagi, Charles; Tumwine, James K

2008-12-22

Child under-nutrition is a leading factor underlying child mortality and morbidity in Sub-Saharan Africa. Several studies from Uganda have reported impaired growth, but there have been few if any community-based infant anthropometric studies from Eastern Uganda. The aim of this study was to describe current infant growth patterns using WHO Child Growth Standards and to determine the extent to which these patterns are associated with infant feeding practices, equity dimensions, morbidity and use of primary health care for the infants. A cross-sectional survey of infant feeding practices, socio-economic characteristics and anthropometric measurements was conducted in Mbale District, Eastern Uganda in 2003; 723 mother-infant (0-11 months) pairs were analysed. Infant anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Dependent dichotomous variables were constructed using WLZ < -2 (wasting) and LAZ < -2 (stunting) as cut-off values. A conceptual hierarchical framework was used as the basis for controlling for the explanatory factors in multivariate analysis. Household wealth was assessed using principal components analysis. The prevalences of wasting and stunting were 4.2% and 16.7%, respectively. Diarrhoea during the previous 14 days was associated with wasting in the crude analysis, but no factors were significantly associated with wasting in the adjusted analysis. The adjusted analysis for stunting showed associations with age and gender. Stunting was more prevalent among boys than girls, 58.7% versus 41.3%. Having brothers and/or sisters was a protective factor against stunting (OR 0.4, 95% CI 0.2-0.8), but replacement or mixed feeding was not (OR 2.7, 95% CI 1.0-7.1). Lowest household wealth was the most prominent factor associated with stunting with a more than three-fold increase in odds ratio (OR 3.5, 95% CI 1.6-7.8). This pattern was also seen when the mean LAZ was investigated across

Health financing reform in Uganda: How equitable is the proposed National Health Insurance scheme?

PubMed

Orem, Juliet Nabyonga; Zikusooka, Charlotte Muheki

2010-10-13

Uganda is proposing introduction of the National Health Insurance scheme (NHIS) in a phased manner with the view to obtaining additional funding for the health sector and promoting financial risk protection. In this paper, we have assessed the proposed NHIS from an equity perspective, exploring the extent to which NHIS would improve existing disparities in the health sector. We reviewed the proposed design and other relevant documents that enhanced our understanding of contextual issues. We used the Kutzin and fair financing frameworks to critically assess the impact of NHIS on overall equity in financing in Uganda. The introduction of NHIS is being proposed against the backdrop of inequalities in the distribution of health system inputs between rural and urban areas, different levels of care and geographic areas. In this assessment, we find that gradual implementation of NHIS will result in low coverage initially, which might pose a challenge for effective management of the scheme. The process for accreditation of service providers during the first phase is not explicit on how it will ensure that a two-tier service provision arrangement does not emerge to cater for different types of patients. If the proposed fee-for-service mechanism of reimbursing providers is pursued, utilisation patterns will determine how resources are allocated. This implies that equity in resource allocation will be determined by the distribution of accredited providers, and checks put in place to prohibit frivolous use. The current design does not explicitly mention how these two issues will be tackled. Lastly, there is no clarity on how the NHIS will fit into, and integrate within existing financing mechanisms. Under the current NHIS design, the initial low coverage in the first years will inhibit optimal achievement of the important equity characteristics of pooling, cross-subsidisation and financial protection. Depending on the distribution of accredited providers and utilisation

A systematic review of the clinical and social epidemiological research among sex workers in Uganda.

PubMed

Muldoon, Katherine A

2015-12-09

In response to the high burden of disease among sex workers and their position as a population heavily affected by the HIV epidemic, there has been a growing body of literature investigating the prevalence and risk factors associated with HIV risk among sex workers. To contextualize and summarize the existing research evidence base, a systematic review was conducted to synthesize the epidemiological literature on sex workers in Uganda. Database selection and search strategy development followed the Cochrane Collaboration's standards for conducting systematic review searches. All studies that included sex workers as the primary research participants were included in the review. The search was then geographically restricted to the country of Uganda. Items were identified from 18 databases (grey and peer-review) on March 10-11, 2015. A total of 484 articles were retrieved from the database search. After removal of duplicates, a total of 353 articles were screened for eligibility and 64 full-text articles were assessed. The final review included 24 studies with quantitative methodology conducted among sex workers in Uganda. The HIV prevalence among female sex workers ranged from 32.4-52.0 % and between 8.2-9.0 % had multiple HIV infections. Both multi-drug resistance to antiretroviral therapy (2.6 %) and antibiotics (83.1 %) were observed. Between 33.3-55.1 % reported inconsistent condom use in the past month. In the previous 6 months, over 80 % of sex workers experienced client-perpetrated violence and 18 % experienced intimate partner violence. Over 30 % had a history of extreme war-related trauma. There was limited information on socio-structural factors that affect sex workers' commercial working environments in Uganda, including the role of policing and criminalization, as well as the prevalence and factors associated with violence. The majority of the existing evidence is based in Kampala, highlighting a need for information on sex work in other regions

Physical Activity Levels Among Adults in Uganda: Findings From a Countrywide Cross-Sectional Survey.

PubMed

Guwatudde, David; Kirunda, Barbara E; Wesonga, Ronald; Mutungi, Gerald; Kajjura, Richard; Kasule, Hafisa; Muwonge, James; Bahendeka, Silver K

2016-09-01

Being physically active is associated with lower risk of many noncommunicable diseases (NCDs). We analyzed physical activity (PA) data collected as part of Uganda's countrywide NCD risk factor survey conducted in 2014, to describe PA levels in Uganda. PA data were collected on the domains of work, travel and leisure. We calculated the percentage of participants meeting the World Health Organization (WHO) PA recommendations, and the types of intense-specific duration of PA. Prevalence ratios (PR) were used to identify factors associated with meeting WHO PA recommendations. Of the 3987 participants, 3758 (94.3%) met the WHO PA recommendations. Work-related PA of moderate intensity, and travel-related PA contributed most to participants' overall weekly duration of PA, each contributing 49.6% and 25.2% respectively. The median weekly duration of all moderate-intensity PA was 1470 minutes (interquartile range [IQR] = 540 to 2460). Weekly duration of all vigorous-intensity PA was low with a median of 0 minutes (IQR = 0 to 1080). The median daily sedentary time was 120 minutes (IQR = 60 to 240). Factors significantly associated with meeting WHO PA recommendations were body mass index and level of education. PA levels in Uganda are high, mostly achieved through travel and work-related activities of moderate intensity.

'A bridge to the hospice': the impact of a Community Volunteer Programme in Uganda.

PubMed

Jack, Barbara A; Kirton, J; Birakurataki, J; Merriman, A

2011-10-01

In Africa, the need for palliative care provision is escalating with an increasing number of people living with HIV/AIDS, coupled with rising cancer and AIDS-related cancer diagnoses. In Uganda there is a shortage of doctors, particularly in rural areas. To address this Hospice Africa Uganda developed a Community Volunteer Programme to train volunteers to help by providing support to patients in their own homes. The aim of this qualitative study was to evaluate the impact of the Community Volunteer Programme. Sixty-four interviews, with patients (21), community volunteer workers (CVWs) (32), and the hospice clinical teams (11) were conducted, using semi-structured digitally recorded individual, group and focus group interviews, at the Hospice Africa Uganda sites. The results reported the value of the Community Volunteer Programme, including the impact on patients and families, and how the CVWs acted as a 'bridge to the hospice' in identifying patients. Developing financial challenges that are emerging which could potentially impact on the programme were reported. The Community Volunteer Programme appears to be having a positive impact on patients, families and the hospice team, and is a model worthy of consideration by other developing countries to allow the expansion of palliative care.

Sleeping sickness in southeastern Uganda: a spatio-temporal analysis of disease risk, 1970-2003.

PubMed

Berrang-Ford, Lea; Berke, Olaf; Sweeney, Sean; Abdelrahman, Lubowa

2010-12-01

Sleeping sickness is a major threat to human health in sub-Saharan Africa. Southeastern Uganda has experienced a number of significant epidemics in the past 100 years, most recently from 1976 to 1989. Recent and continued spread of the disease has highlighted gaps in the ability of current research to explain and predict the distribution of infection. Vegetation cover and changes in vegetation may be important determinants of transmission and disease risk because of the habitat preferences of the tsetse fly vector. This study examines the determinants of sleeping sickness distribution and incidence in southeastern Uganda from 1970 to 2003, spanning the full epidemic region and cycle, and focusing in particular on vegetation cover and change. Sleeping sickness data were collected from records of the Ugandan Ministry of Health, individual sleeping sickness treatment centers, and interviews with public health officials. Vegetation data were acquired from satellite imagery for four dates spanning the epidemic period, 1973, 1986, 1995, and 2001. Zero-inflated regression models were used to model predictors of disease presence and magnitude. Correlations between disease incidence and the normalized difference vegetation index (NDVI) at the subcounty level were evaluated. Results indicate that sleeping sickness infection is predominantly associated with proximity to water and spatial location, while disease incidence is highest in subcounties with moderate to high NDVI. The vegetation density (NDVI) at which sleeping sickness incidence peaked differed throughout the study period. The optimal vegetation density capable of supporting sleeping sickness transmission may be lower than indicated by data from endemic regions, indicating increased potential for disease spread under suitable conditions.

Early relationships and marriage in conflict and post-conflict settings: vulnerability of youth in Uganda.

PubMed

Schlecht, Jennifer; Rowley, Elizabeth; Babirye, Juliet

2013-05-01

While there is increased attention to child marriage, defined as marriage before 18 years of age, in countries where the practice is especially prevalent, less attention has been directed at understanding the factors affecting relationships, marriage and cohabitation among adolescents affected by conflict and displacement. This article presents factors which contribute to early relationships and informal marriages in conflict and post-conflict settings, based on qualitative research undertaken among two distinct populations in Uganda: internally displaced persons in Mucwini transit camp in northern Uganda and Congolese refugees in the Nakivale refugee settlement in southwestern Uganda. Themes were examined through a social-ecological framework. Findings indicate that fundamental shifts in economies, family relationships, and communication combined with structural changes encountered in settlements resulted in changed relationships and marriage patterns. Participants reported that poverty, splintering of family, and lack of education - which they believed to be exacerbated by conflict in both settings - had profoundly affected the views, perceptions and behaviours of youth around relationships and marriage. We identify interventions applicable to humanitarian settings that would offer refugee and internally displaced adolescents greater and more meaningful opportunities for development. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

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…

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.…

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

Resilient patriarchy: public authority and women's (in)security in Karamoja, Uganda.

PubMed

Hopwood, Julian; Porter, Holly; Saum, Nangiro

2018-01-01

This paper draws on fieldwork conducted in 2011 and 2016 to explore the differing experiences of Karamojong women following the Government of Uganda's most recent disarmament programme. Besides being deprived of their guns, Karamojong communities have lost most of the cattle on which their livelihoods and way of life were centred. The study assesses whether or not women's experience of patriarchy has changed in these new circumstances, and, if so, how this impacts on their security and control of resources, or the absence of them. It maps, using information primarily supplied by women, public authorities from below, and evaluates if and how they respond to women's protection and survival needs, as well as if current development/humanitarian interventions are of sustainable benefit to Karamojong women. The paper concludes that apparent shifts in gender relations are probably superficial, contingent on continuing food aid, and that economic development and positive social change for women remain elusive. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Benjamin Franklin and Mesmerism, revisited.

PubMed

McConkey, Kevin M; Perry, Campbell

2002-10-01

The authors revisit and update their previous historiographical note (McConkey & Perry, 1985) on Benjamin Franklin's involvement with and investigation of animal magnetism or mesmerism. They incorporate more recent literature and offer additional comment about Franklin's role in and views about mesmerism. Franklin had a higher degree of personal involvement with and a more detailed opinion of mesmerism than has been previously appreciated.

THE CONCEPT OF REFERENCE CONDITION, REVISITED ...

EPA Pesticide Factsheets

Ecological assessments of aquatic ecosystems depend on the ability to compare current conditions against some expectation of how they could be in the absence of significant human disturbance. The concept of a ‘‘reference condition’’ is often used to describe the standard or benchmark against which current condition is compared. If assessments are to be conducted consistently, then a common understanding of the definitions and complications of reference condition is necessary. A 2006 paper (Stoddard et al., 2006, Ecological Applications 16:1267-1276) made an early attempt at codifying the reference condition concept; in this presentation we will revisit the points raised in that paper (and others) and examine how our thinking has changed in a little over 10 years.Among the issues to be discussed: (1) the “moving target” created when reference site data are used to set thresholds in large scale assessments; (2) natural vs. human disturbance and their effects on reference site distributions; (3) circularity and the use of biological data to assist in reference site identification; (4) using site-scale (in-stream or in-lake) measurements vs. landscape-level human activity to identify reference conditions. Ecological assessments of aquatic ecosystems depend on the ability to compare current conditions against some expectation of how they could be in the absence of significant human disturbance. The concept of a ‘‘reference condition’’ is often use

Who pays for and who benefits from health care services in Uganda?

PubMed

Kwesiga, Brendan; Ataguba, John E; Abewe, Christabel; Kizza, Paul; Zikusooka, Charlotte M

2015-02-01

Equity in health care entails payment for health services according to the capacity to pay and the receipt of benefits according to need. In Uganda, as in many African countries, although equity is extolled in government policy documents, not much is known about who pays for, and who benefits from, health services. This paper assesses both equity in the financing and distribution of health care benefits in Uganda. Data are drawn from the most recent nationally representative Uganda National Household Survey 2009/10. Equity in health financing is assessed considering the main domestic health financing sources (i.e., taxes and direct out-of-pocket payments). This is achieved using bar charts and standard concentration and Kakwani indices. Benefit incidence analysis is used to assess the distribution of health services for both public and non-public providers across socio-economic groups and the need for care. Need is assessed using limitations in functional ability while socioeconomic groups are created using per adult equivalent consumption expenditure. Overall, health financing in Uganda is marginally progressive; the rich pay more as a proportion of their income than the poor. The various taxes are more progressive than out-of-pocket payments (e.g., the Kakwani index of personal income tax is 0.195 compared with 0.064 for out-of-pocket payments). However, taxes are a much smaller proportion of total health sector financing compared with out-of-pocket payments. The distribution of total health sector services benefitsis pro-rich. The richest quintile receives 19.2% of total benefits compared to the 17.9% received by the poorest quintile. The rich also receive a much higher share of benefits relative to their need. Benefits from public health units are pro-poor while hospital based care, in both public and non-public sectors are pro-rich. There is a renewed interest in ensuring equity in the financing and use of health services. Based on the results in this paper

The impact of the African Youth Alliance program on the sexual behavior of young people in Uganda.

PubMed

Karim, Ali Mehryar; Williams, Timothy; Patykewich, Leslie; Ali, Disha; Colvin, Charlotte E; Posner, Jessica; Rutaremwa, Gideon

2009-12-01

This study evaluates the impact of the African Youth Alliance (AYA) program on the sexual behavior of young people aged 17-22 in Uganda. Between 2000 and 2005, the comprehensive multicomponent AYA program implemented behavior-change communication and youth-friendly clinical services, and it coordinated policy and advocacy. The program provided institutional capacity building and established coordination mechanisms between agencies that implemented programs for young people. The analysis of findings from both a self-reported exposure design and a static group comparison design indicated that AYA had a positive impact on sexual behavior among young females but not among young males. AYA-exposed girls were at least 13 percentage points more likely to report having used a condom at last sex, at least 10 percentage points more likely to report that they had consistently used condoms with their current partner, at least 10 percentage points more likely to have used contraceptives at last sex, and 13 percentage points more likely to have had fewer sex partners during the past 12 months, compared with girls who were not exposed to the AYA program. Scaling up the AYA program in Uganda could, therefore, be expected to improve significantly the sexual and reproductive health of young women. Effective strategies for promoting safer sexual behaviors among boys and young men must be identified, however.

Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion

PubMed Central

Chan, Brian T.; Weiser, Sheri D.; Boum, Yap; Siedner, Mark J.; Mocello, A. Rain; Haberer, Jessica E.; Hunt, Peter W.; Martin, Jeffrey N.; Mayer, Kenneth H.; Bangsberg, David R.; Tsai, Alexander C.

2014-01-01

Objective Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion. Design Serial cross-sectional surveys. Methods We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We fitted regression models adjusted for socio-demographic characteristics, with year of data collection as the primary explanatory variable. Results We estimated an upward trend in internalized stigma among PLHIV presenting for treatment initiation (adjusted b=0.18; 95% CI, 0.06 to 0.30). In the general population, the odds of reporting anticipated stigma were greater in 2011 compared to 2006 (adjusted OR=1.80; 95% CI, 1.51 to 2.13), despite an apparent decline in stigmatizing attitudes (adjusted OR=0.62; 95% CI, 0.52 to 0.74). Conclusions Internalized stigma has increased over time among PLHIV in the setting of worsening anticipated stigma in the general population. Further study is needed to better understand the reasons for increasing HIV-related stigma in Uganda and its impact on HIV prevention efforts. PMID:25268886

Institutional Dynamics of Education Reforms and Quality of Primary Education in Uganda

ERIC Educational Resources Information Center

Nyenje, Aida; James, Nkata L.

2016-01-01

This article scans Uganda's topical responsibility to transformation of the country's primary school education arrangement with attention to the institutional dynamics that constitute school factors such as the curriculum, assessment methods, course content, subject composition, teaching methods, and instructional materials; among others that…

Comparative genomics of archived pyrazinamide resistant Mycobacterium tuberculosis complex isolates from Uganda

USDA-ARS?s Scientific Manuscript database

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...

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

A qualitative analysis of health professionals' job descriptions for surgical service delivery in Uganda.

PubMed

Buwembo, William; Munabi, Ian G; Galukande, Moses; Kituuka, Olivia; Luboga, Samuel A

2014-01-01

The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda. A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software. It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified. There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals' current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment

Attendance and Utilization of Antenatal Care (ANC) Services: Multi-Center Study in Upcountry Areas of Uganda.

PubMed

Kawungezi, Peter Chris; AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah

2015-03-01

Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda. Cross-sectional study design with mixed methods of interviewer administered questionnaires, focus group discussions and key informant interviews. Data was entered using Epidata and analyzed using Stata into frequency tables using actual tallies and percentages. Ethical approval was sought from SOM-REC MakCHS under approval number "#REC REF 2012-117" before conducting the study. A total of four hundred one were enrolled with the majority being in the age group 20 - 24 years (mean age, 25.87 ± 6.26). Health workers played a great role (72.04%), followed by the media (15.46%) and friends (12.50%) in creating awareness about ANC. A significant number of respondents went to TBAs with reasons such as "near and accessible", "my husband decided", and "they are the only people I know". 37.63% of the respondents considered getting an antenatal Card as an importance of ANC. 71 (19.67%) respondents gave a wrong opinion (late) on booking time with reasons like demands at work, no problems during pregnancy, advised by friends, just to get a card, long distance and others didn't know

Intestinal helminths in Luweero district, Uganda.

PubMed

Dumba, Robinah; Kaddu, John B; Wabwire Mangen, Fred

2008-06-01

Intestinal helminthiasis is a debilitating parasitic disease found in many parts of Uganda including Luweero district. In the district, the disease causes as high as 9% morbidity in children below five years. There was very scanty district information on the disease based mainly on hospital records despite this figure. The current study was carried out to provide data to plan for its effective control. To investigate risk factors that promote helminth infections among children under five years of age in Luweero district. Stool samples from 727 children were examined for presence of helminth ova using Kato-Katz technique. The subjects' parents or guardians were interviewed using a semi-structured questionnaire to establish their demographic, social-cultural characteristics; information on water accessibility and usage; child toileting practices and knowledge about helminthiasis. Risk factors strongly associated with helminth infections included methods of anal cleaning, how compounds and latrines were maintained, keeping of pigs and age of the subjects, (P <0.001). In addition, methods of hand washing after latrine visits, the respondents' education level, type of house floor and household compound as well as accessibility to water were associated with worm infection. The hygiene practices of the parents/guardians and environmental surroundings in which the child grows play a big part in determining his or her helminth status. The District Health workers, community leaders and extension staff should educate the community on the importance of personal hygiene and environmental sanitation to minimize the risks of helminth infections.

Estimating the costs of induced abortion in Uganda: A model-based analysis

PubMed Central

2011-01-01

Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical. PMID:22145859

Estimating the costs of induced abortion in Uganda: a model-based analysis.

PubMed

Babigumira, Joseph B; Stergachis, Andy; Veenstra, David L; Gardner, Jacqueline S; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P

2011-12-06

The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

Uganda's Universal Secondary Education Policy and Its Effect on "Empowered" Women: How Reduced Income and Moonlighting Activities Differentially Impact Male and Female Teachers

ERIC Educational Resources Information Center

Molyneaux, Kristen J.

2011-01-01

In January 2007 Uganda embarked on a strategy to implement a nationwide Universal Secondary Education (USE) policy. This article investigates how gender differences in Uganda's informal and formal teaching markets, that went unexamined during the implementation process of USE, differentially affected male and female teachers' incomes. In…

'Counterfeit deviance' revisited.

PubMed

Griffiths, Dorothy; Hingsburger, Dave; Hoath, Jordan; Ioannou, Stephanie

2013-09-01

The field has seen a renewed interest in exploring the theory of 'counterfeit deviance' for persons with intellectual disability who sexually offend. The term was first presented in 1991 by Hingsburger, Griffiths and Quinsey as a means to differentiate in clinical assessment a subgroup of persons with intellectual disability whose behaviours appeared like paraphilia but served a function that was not related to paraphilia sexual urges or fantasies. Case observations were put forward to provide differential diagnosis of paraphilia in persons with intellectual disabilities compared to those with counterfeit deviance. The brief paper was published in a journal that is no longer available and as such much of what is currently written on the topic is based on secondary sources. The current paper presents a theoretical piece to revisit the original counterfeit deviance theory to clarify the myths and misconceptions that have arisen and evaluate the theory based on additional research and clinical findings. The authors also propose areas where there may be a basis for expansion of the theory. The theory of counterfeit deviance still has relevance as a consideration for clinicians when assessing the nature of a sexual offence committed by a person with an intellectual disability. Clinical differentiation of paraphilia from counterfeit deviance provides a foundation for intervention that is designed to specifically treat the underlying factors that contributed to the offence for a given individual. Counterfeit deviance is a concept that continues to provide areas for consideration for clinicians regarding the assessment and treatment of an individual with an intellectual disability who has sexually offended. It is not and never was an explanation for all sexually offending behavior among persons with intellectual disabilities. © 2013 John Wiley & Sons Ltd.

AIDS and the company: 3. Uganda's parastatals quantify the manpower losses, while condom sales run into criticism.

PubMed

1992-01-01

Railway, postal, and telecommunications companies in Uganda are experiencing a manpower crisis due to AIDS. Uganda's Railway Corporation reports for 1991 a loss of 10% of staff due to AIDS. AIDS has also contributed to a high turnover of staff (15%/year). AIDS has affected all levels of employment in the industry and there is concern about the shortage of skilled staff. Already there are staff shortages in the marine division where 132 out of 252 posts are unfilled. High absenteeism rates are also associated with AIDS. Hospital bills have risen. In the Uganda Post and Telecommunications Corporation, it is reported that 8% of the 3000 work force carry the HIV infection and 94 staff have died of AIDS between May 1991 and March 31, 1992. 238 have tested positive for HIV. The company has begun an AIDS awareness and sensitization campaign through unions and its clinic. Major mortality groups in Uganda are maria (14%), AIDS (9%), diarrhea (8.7%), pneumonia (7.9%), anemia (7.3%), and meningitis (6%) as reported in a survey of 20 hospitals and 5439 cases. Condoms are not readily accepted. Complaints arose when a firm imported condoms in Kabarole district in western Uganda when AIDS was more prevalent elsewhere. The public and public officials are against introducing condoms. Education and information should be emphasized. Objections are based on sexual practices which are abrasive and may rupture the condom. Women object due to fears of condoms falling off and exposure to the viruses in condoms. People are reckless even when family members have died of AIDS. Sexual behavior does not appear to have changed. It is suggested that condom distribution methods should change. IEC may be effective if properly implemented. Research by the International Population Services has shown that 100% acceptance is possible if the price is cheap and the product fits. A Malaysian manufactured condom seems to be appropriate for fit and is packed in quantities of 5 because 5 is the average

Assessing supply-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study and document and record review in two regions of Uganda.

PubMed

Rassi, Christian; Graham, Kirstie; Mufubenga, Patrobas; King, Rebecca; Meier, Joslyn; Gudoi, Sam Siduda

2016-07-04

Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), provided as part of routine antenatal care (ANC), is one of three malaria-in-pregnancy prevention and control mechanisms recommended by the World Health Organization (WHO). However, despite high ANC attendance and increased efforts to address known obstacles, IPTp uptake figures have remained low. This study aimed to identify and assess barriers that continue to impede IPTp uptake in Uganda, in particular for women who attend ANC. The paper focuses on supply-side barriers, i.e., challenges relating to the health service provider. In-depth interviews were conducted in two regions of Uganda in November 2013 and April/May 2014 with four different target audiences: seven district health officials, 15 health workers, 19 women who had attended ANC, and five opinion leaders. In addition, a document and record review was carried out at four health facilities. Guidelines with regard to IPTp provision in Uganda have been shown to be inconsistent and, at the time of the research, did not reflect the most recent WHO policy recommendation. There is a lack of training and supervision opportunities for health workers, resulting in poor knowledge of IPTp guidelines and uncertainty about the safety and efficacy of SP. ANC is not consistently offered in health facilities, leading to some women being denied services. While strengthening of the supply chain appears to have reduced the occurrence of stock-outs of SP in public facilities, stock-outs reportedly continue to occur in the private sector. There are also sources of data inaccuracy along the data recording and reporting chain, limiting policy makers' ability to react adequately to trends and challenges. Given the high ANC attendance rates in Uganda, supply-side barriers are likely to account for many missed opportunities for the provision of IPTp in Uganda. Improvements will require consistent provision of ANC, implementation of current

Post-Kemron, Uganda demands proof of the "Mariandina" drug.

PubMed

1996-12-01

An ethical review committee consisting of medical scientists, social scientists, and lawyers has been established by the Ugandan government to oversee individuals and institutions conducting biomedical research. The research of Professor Sali, who produced and marketed Mariandina as a cure for acquired immunodeficiency syndrome (AIDS), is not recognized, according to Dr. Jeremiah Twa-twa, Registrar of the National Medical Council. Professor Sali had been given six months to produce an acceptable protocol, with controls, that demonstrated the efficacy of the drug. He had stated previously that his patients received a minimum of six tablets daily of Mariandina A, B, or J; thousands are said to have been treated. Professor Sali, who returned to Uganda in 1990 with a 100,000-pound loan to produce the drug, advised his patients to sell everything they owned in order to pay for their treatment, according to Major Ruranga Rubaramira (head of a joint clinical council). The Uganda AIDS Commission is also considering the use of herbs in the treatment of AIDS; nine Western-trained researchers are collaborating with herbalists in studies that have shown promising results. Dr. Donna Kabatesi, who heads a clinic that uses both herbs and Western medicine in the treatment of AIDS patients at Mulago hospital, believes herbs are equally effective for some purposes.

The Rotating Morse-Pekeris Oscillator Revisited

ERIC Educational Resources Information Center

Zuniga, Jose; Bastida, Adolfo; Requena, Alberto

2008-01-01

The Morse-Pekeris oscillator model for the calculation of the vibration-rotation energy levels of diatomic molecules is revisited. This model is based on the realization of a second-order exponential expansion of the centrifugal term about the minimum of the vibrational Morse oscillator and the subsequent analytical resolution of the resulting…

Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey

PubMed Central

Wandera, Stephen O.; Ntozi, James; Kwagala, Betty

2014-01-01

Background Nationally representative evidence on the burden and determinants of disability among older people in sub-Saharan Africa in general, and Uganda in particular, is limited. Objective The aim of this study was to estimate the prevalence and investigate the correlates of disability among older people in Uganda. Design We conducted secondary analysis of data from a sample of 2,382 older persons from the Uganda National Household Survey. Disability was operationalized as either: 1) having a lot of difficulty on any one question; 2) being unable to perform on any one question; or, 3) having some difficulty with two of the six domains. We used frequency distributions for description, chi-square tests for initial associations, and multivariable logistic regressions to assess the associations. Results A third of the older population was disabled. Among all older persons, disability was associated with advancement in age (OR=4.91, 95% CI: 3.38–7.13), rural residence (0.56, 0.37–0.85), living alone (1.56, 1.07–2.27), separated or divorced (1.96, 1.31–2.94) or widowed (1.86, 1.32–2.61) marital status, households’ dependence on remittances (1.48, 1.10–1.98), ill health (2.48, 1.95–3.15), and non-communicable diseases (NCDs) (1.81, 0.80–2.33). Gender was not associated with disability among older persons. Conclusions Disability was associated with advancement in age, rural residence, living alone, divorced/separated/widowed marital status, dependence on remittances, ill health, and NCDs. Interventions to improve health and functioning of older people need to focus on addressing social inequalities and on the early preventive interventions and management of NCDs in old age in Uganda. PMID:25413721

Modeling the Impact of Uganda's Safe Male Circumcision Program: Implications for Age and Regional Targeting.

PubMed

Kripke, Katharine; Vazzano, Andrea; Kirungi, William; Musinguzi, Joshua; Opio, Alex; Ssempebwa, Rhobbinah; Nakawunde, Susan; Kyobutungi, Sheila; Akao, Juliet N; Magala, Fred; Mwidu, George; Castor, Delivette; Njeuhmeli, Emmanuel

2016-01-01

Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15-49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program's progress, and to refine the implementation approach. The Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20-34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10-19 will offer the greatest impact over a 15-year period, while focusing on men ages 15-34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda's SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10-34 as a priority group for SMC in the 2014 application to the Global Fund's new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence.

Increasing Contraceptive Access for Hard-to-Reach Populations With Vouchers and Social Franchising in Uganda.

PubMed

Bellows, Benjamin; Mackay, Anna; Dingle, Antonia; Tuyiragize, Richard; Nnyombi, William; Dasgupta, Aisha

2017-09-27

From 2001 to 2011, modern contraceptive prevalence in Uganda increased from 18% to 26%. However, modern method use, in particular use of long-acting reversible contraceptives (LARCs) and permanent methods (PMs), remained low. In the 2011 Uganda Demographic and Health Survey, only 1 of 5 married women used a LARC or PM even though 34% indicated an unmet need for contraception. Between 2011 and 2014, a social franchise and family planning voucher program, supporting 400 private facilities to provide family planning counseling and broaden contraceptive choice by adding LARCs and PMs to the service mix, offered a voucher to enable poor women to access family planning services at franchised facilities. This study analyzes service trends and voucher client demographics and estimates the contribution of the program to increasing contraceptive prevalence in Uganda, using the Impact 2 model developed by Marie Stopes International. Between March 2011 and December 2014, 330,826 women received a family planning service using the voucher, of which 70% of voucher clients chose an implant and 25% chose an intrauterine device. The median age of voucher users was 28 years; 79% had no education or only a primary education; and 48% reported they were unemployed or a housewife. We estimated that by 2014, 280,000 of the approximately 8,600,000 women of reproductive age in Uganda were using a contraceptive method provided by the program and that 120,000 of the clients were "additional users" of contraception, contributing 1.4 percentage points to the national modern contraceptive prevalence rate. The combination of family planning vouchers and a franchise-based quality improvement initiative can leverage existing private health infrastructure to substantially expand family planning access and choice for disadvantaged populations and potentially improve contraceptive prevalence when scaled nationally. © Bellows et al.

Increasing Contraceptive Access for Hard-to-Reach Populations With Vouchers and Social Franchising in Uganda

PubMed Central

Bellows, Benjamin; Mackay, Anna; Dingle, Antonia; Tuyiragize, Richard; Nnyombi, William; Dasgupta, Aisha

2017-01-01

ABSTRACT From 2001 to 2011, modern contraceptive prevalence in Uganda increased from 18% to 26%. However, modern method use, in particular use of long-acting reversible contraceptives (LARCs) and permanent methods (PMs), remained low. In the 2011 Uganda Demographic and Health Survey, only 1 of 5 married women used a LARC or PM even though 34% indicated an unmet need for contraception. Between 2011 and 2014, a social franchise and family planning voucher program, supporting 400 private facilities to provide family planning counseling and broaden contraceptive choice by adding LARCs and PMs to the service mix, offered a voucher to enable poor women to access family planning services at franchised facilities. This study analyzes service trends and voucher client demographics and estimates the contribution of the program to increasing contraceptive prevalence in Uganda, using the Impact 2 model developed by Marie Stopes International. Between March 2011 and December 2014, 330,826 women received a family planning service using the voucher, of which 70% of voucher clients chose an implant and 25% chose an intrauterine device. The median age of voucher users was 28 years; 79% had no education or only a primary education; and 48% reported they were unemployed or a housewife. We estimated that by 2014, 280,000 of the approximately 8,600,000 women of reproductive age in Uganda were using a contraceptive method provided by the program and that 120,000 of the clients were “additional users” of contraception, contributing 1.4 percentage points to the national modern contraceptive prevalence rate. The combination of family planning vouchers and a franchise-based quality improvement initiative can leverage existing private health infrastructure to substantially expand family planning access and choice for disadvantaged populations and potentially improve contraceptive prevalence when scaled nationally. PMID:28963175

Investigating Predictors of Visiting, Using, and Revisiting an Online Health-Communication Program: A Longitudinal Study

PubMed Central

Crutzen, Rik; De Vries, Hein

2010-01-01

Background Online health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions. Objective In the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population. Methods A webpage was created providing the public with information about health and healthy behavior. The website included a “physical activity check,” which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed. Results Analyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants (odds ratio [OR] = 2.81, 95% confidence interval [CI] = 1.16-6.81, P = .02) and participants with a strong

"It is my business": A Mixed-Methods Analysis of Covert Contraceptive Use among Women in Rakai, Uganda.

PubMed

Heck, Craig J; Grilo, Stephanie A; Song, Xiaoyu; Lutalo, Tom; Nakyanjo, Neema; Santelli, John S

2018-03-04

Covert contraceptive use (CCU) is the use of family planning without a partner's knowledge. This study sought to examine CCU prevalence among women living in Rakai, Uganda, predictors of CCU, and why women resort to CCU. We used data from women (15-49years) currently using contraceptives (oral contraceptives, Depo Provera, implants, intrauterine devices, and periodic abstinence) during Round 15 (2011-2013) of the Rakai Community Cohort Survey (n=2206). We utilized logistic regressions to analyze the association between self-reported CCU and current contraceptive method, sexual activity, experience of violence, and demographic data. We also used data from in-depth interviews (IDI) on HIV and reproductive health conducted in 2013-2016. CCU prevalence was 26%. In the multivariable model, being previously married (aOR=2.2 [1.7-2.9]), having no formal education (aOR=2.1 [1.1-3.9]), and experiencing physical violence (aOR=1.7 [1.3-2.2]) or having more than 1 sex partner (aOR=1.6 [1.2-2.2]) in the past 12months were CCU predictors. Advancing past primary school decreased the odds of CCU (aOR=0.7 [0.6-0.9]). HIV was positively associated with CCU in the unadjusted model, but not the adjusted. In the IDIs, women primarily resorted to CCU because of discordant fertility desires-coupled with financial insecurity, negative stereotypes towards contraceptives use, deteriorating health, and familial pressure to reproduce. One woman employed CCU because she feared being ostracized from her community. CCU is common amongst users of contraception and is used to hide family planning from partners and communities. Women that diverge from Uganda's cultural norms had higher odds of CCU. Clinicians and practitioners should be aware of CCU among their patients and should educate women on the wide variety of contraceptive methods to help them decide if their current covert method is best for their health and safety. Copyright © 2018 Elsevier Inc. All rights reserved.

Revisiting the Capture of Mercury into Its 3:2 Spin-orbit Resonance

DTIC Science & Technology

2014-01-01

well before differentiation. Keywords. celestial mechanics, planets and satellites: individual ( Mercury ) 1. Previous studies In the literature hitherto...2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Revisiting the capture of Mercury into its 3:2 spin-orbit...Astronomical Union 2014 doi:10.1017/S1743921314007765 Revisiting the capture of Mercury into its 3:2 spin-orbit resonance Benôıt Noyelles1, Julien

Hospital revisit rate after a diagnosis of conversion disorder.

PubMed

Merkler, Alexander E; Parikh, Neal S; Chaudhry, Simriti; Chait, Alanna; Allen, Nicole C; Navi, Babak B; Kamel, Hooman

2016-04-01

To estimate the hospital revisit rate of patients diagnosed with conversion disorder (CD). Using administrative data, we identified all patients discharged from California, Florida and New York emergency departments (EDs) and acute care hospitals between 2005 and 2011 with a primary discharge diagnosis of CD. Patients discharged with a primary diagnosis of seizure or transient global amnesia (TGA) served as control groups. Our primary outcome was the rate of repeat ED visits and hospital admissions after initial presentation. Poisson regression was used to compare rates between diagnosis groups while adjusting for demographic characteristics. We identified 7946 patients discharged with a primary diagnosis of CD. During a mean follow-up of 3.0 (±1.6) years, patients with CD had a median of three (IQR, 1-9) ED or inpatient revisits, compared with 0 (IQR, 0-2) in patients with TGA and 3 (IQR, 1-7) in those with seizures. Revisit rates were 18.25 (95% CI, 18.10 to 18.40) visits per 100 patients per month in those with CD, 3.90 (95% CI, 3.84 to 3.95) in those with TGA and 17.78 (95% CI, 17.75 to 17.81) in those with seizures. As compared to CD, the incidence rate ratio for repeat ED visits or hospitalisations was 0.89 (95% CI, 0.86 to 0.93) for seizure disorder and 0.32 (95% CI 0.31 to 0.34) for TGA. CD is associated with a substantial hospital revisit rate. Our findings suggest that CD is not an acute, time-limited response to stress, but rather that CD is a manifestation of a broader pattern of chronic neuropsychiatric disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Cigarette smoking prevalence among school-going adolescents in two African capital cities: Kampala Uganda and Lilongwe Malawi.

PubMed

Muula, Adamson S; Mpabulungi, Lillian

2007-03-01

Non communicable diseases are a growing public health concern. Globally tobacco-related deaths surpass malaria deaths and yet developing countries' data are lacking. To compare prevalence of tobacco use and exposure to tobacco and tobacco-related issues among adolescents in Kampala, Uganda and Lilongwe, Malawi. Cross sectional data from the Global Youth Tobacco Survey (GYTS) w used. Data were collected in 2001 in Lilongwe and in 2002 in Uganda using a standardized questionnaire tool. The study was aimed to enrolled schoolchildren aged 13-17 years. The prevalence of tobacco smoking in Kampala and Lilongwe among adolescents was 5.6% and 6.2% (p >0.05) respectively. However, adolescents in Lilongwe were statistically significantly more likely to have ever smoked, use other tobacco products and perceived themselves as likely to initiate smoking in the coming year. Exposure to tobacco-related advertisements through billboards, newspapers and magazines was high in both settings. Adolescents are increasingly being exposed to tobacco and tobacco-related advertisements in Lilongwe, Malawi and Kampala, Uganda. There is need to enhance tobacco prevention efforts in developing nations.

You pray to your God: A qualitative analysis of challenges in the provision of safe, timely, and affordable surgical care in Uganda.

PubMed

Albutt, Katherine; Yorlets, Rachel R; Punchak, Maria; Kayima, Peter; Namanya, Didacus B; Anderson, Geoffrey A; Shrime, Mark G

2018-01-01

Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care. The framework approach was used for thematic and explanatory data analysis. The Ugandan public health care sector continues to face significant challenges in the provision of safe, timely, and affordable surgical care. These challenges can be broadly grouped into preparedness and policy, service delivery, and the financial burden of surgical care. Hospital staff reported challenges including: (1) significant delays in accessing surgical care, compounded by a malfunctioning referral system; (2) critical workforce shortages; (3) operative capacity that is limited by inadequate infrastructure and overwhelmed by emergency and obstetric volume; (4) supply chain difficulties pertaining to provision of essential medications, equipment, supplies, and blood; (5) significant, variable, and sometimes catastrophic expenditures for surgical patients and their families; and (6) a lack of surgery-specific policies and priorities. Despite these challenges, innovative strategies are being used in the public to provide surgical care to those most in need. Barriers to the provision of surgical care are cross-cutting and involve constraints in infrastructure, service delivery, workforce, and financing. Understanding current strengths and shortfalls of Uganda's surgical system is a critical first step in developing effective, targeted policy and programming that will build and strengthen its surgical capacity.

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

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey.

PubMed

Alves, Kristin; Penny, Norgrove; Kobusingye, Olive; Olupot, Robert; Katz, Jeffrey N; Sabatini, Coleen S

2018-04-02

The purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation. We conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age < 18 years) seen at Kumi Hospital in Kumi, Uganda, between January 2013 and December 2015. For each patient, we recorded the age, sex, diagnosis, and treatment recommendation. Of the 4852 children, the most common diagnoses were gluteal and quadriceps contractures (29.4% (95% CI 28.1-30.7%), 96% of which were gluteal fibrosis), post-injection paralysis (12.7% (95% CI 11.8-13.6%)), infection (10.5% (95% CI 9.7-11.4%)), trauma (6.9% (95% CI 6.2-7.6%)), cerebral palsy (6.9% (95% CI 6.2-7.7%)), and clubfoot (4.3% (95% CI 3.8-4.9%)). Gluteal fibrosis, musculoskeletal infections, and angular knee deformities create a large surgical burden with 88.1%, 59.1%, and 54.1% of patients seen with these diagnoses referred for surgery, respectively. Post-injection paralysis, clubfoot, and cerebral palsy were treated non-operatively in over 75% of cases. While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa. We estimate that 50% of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda.

Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda.

PubMed

Saylor, Deanna; Nakigozi, Gertrude; Nakasujja, Noeline; Robertson, Kevin; Gray, Ronald H; Wawer, Maria J; Sacktor, Ned

2017-08-01

To determine the prevalence, risk factors, and functional impairment associated with peripheral neuropathy in a prospective cohort of adults in rural Uganda. Eight hundred participants (400 HIV- and 400 antiretroviral-naive HIV+) in the Rakai Community Cohort Study underwent detailed neurologic evaluations including assessment of neuropathy symptoms, functional measures (Patient Assessment of Own Functioning Inventory and Karnofsky Performance Status scores), and neurologic evaluation by a trained medical officer. Neuropathy was defined as ≥1 subjective symptom and ≥1 sign of neuropathy on examination. Neuropathy risk factors were assessed using log binomial regression. Fifty-three percent of participants were men, with a mean (SD) age of 35 (8) years. Neuropathy was present in 13% of the cohort and was more common in HIV+ vs HIV- participants (19% vs 7%, p < 0.001). Older age (relative risk [RR] 1.04, 95% confidence interval [CI] 1.02-1.06), female sex (RR 1.49, 95% CI 1.04-2.15), HIV infection (RR 2.82, 95% CI 1.86-4.28), tobacco use (RR 1.59, 95% CI 1.02-2.48), and prior neurotoxic medication use (RR 2.08, 95% CI 1.07-4.05) were significant predictors of neuropathy in the overall cohort. Only older age was associated with neuropathy risk in the HIV+ (RR 1.03, 95% CI 1.01-1.05) and HIV- (RR 1.06, 95% CI 1.02-1.10) cohorts. Neuropathy was associated with impaired functional status on multiple measures across all participant groups. Peripheral neuropathy is relatively common and associated with impaired functional status among adults in rural Uganda. Older age, female sex, and HIV infection significantly increase the risk of neuropathy. Neuropathy may be an underrecognized but important condition in rural Uganda and warrants further study. © 2017 American Academy of Neurology.

Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda

PubMed Central

Nakigozi, Gertrude; Nakasujja, Noeline; Robertson, Kevin; Gray, Ronald H.; Wawer, Maria J.; Sacktor, Ned

2017-01-01

Objective: To determine the prevalence, risk factors, and functional impairment associated with peripheral neuropathy in a prospective cohort of adults in rural Uganda. Methods: Eight hundred participants (400 HIV− and 400 antiretroviral-naive HIV+) in the Rakai Community Cohort Study underwent detailed neurologic evaluations including assessment of neuropathy symptoms, functional measures (Patient Assessment of Own Functioning Inventory and Karnofsky Performance Status scores), and neurologic evaluation by a trained medical officer. Neuropathy was defined as ≥1 subjective symptom and ≥1 sign of neuropathy on examination. Neuropathy risk factors were assessed using log binomial regression. Results: Fifty-three percent of participants were men, with a mean (SD) age of 35 (8) years. Neuropathy was present in 13% of the cohort and was more common in HIV+ vs HIV− participants (19% vs 7%, p < 0.001). Older age (relative risk [RR] 1.04, 95% confidence interval [CI] 1.02–1.06), female sex (RR 1.49, 95% CI 1.04–2.15), HIV infection (RR 2.82, 95% CI 1.86–4.28), tobacco use (RR 1.59, 95% CI 1.02–2.48), and prior neurotoxic medication use (RR 2.08, 95% CI 1.07–4.05) were significant predictors of neuropathy in the overall cohort. Only older age was associated with neuropathy risk in the HIV+ (RR 1.03, 95% CI 1.01–1.05) and HIV− (RR 1.06, 95% CI 1.02–1.10) cohorts. Neuropathy was associated with impaired functional status on multiple measures across all participant groups. Conclusions: Peripheral neuropathy is relatively common and associated with impaired functional status among adults in rural Uganda. Older age, female sex, and HIV infection significantly increase the risk of neuropathy. Neuropathy may be an underrecognized but important condition in rural Uganda and warrants further study. PMID:28679596

Newborn survival in Uganda: a decade of change and future implications.

PubMed

Mbonye, Anthony K; Sentongo, Miriam; Mukasa, Gelasius K; Byaruhanga, Romano; Sentumbwe-Mugisa, Olive; Waiswa, Peter; Naamala Sengendo, Hanifah; Aliganyira, Patrick; Nakakeeto, Margaret; Lawn, Joy E; Kerber, Kate

2012-07-01

Each year in Uganda 141 000 children die before reaching their fifth birthday; 26% of these children die in their first month of life. In a setting of persistently high fertility rates, a crisis in human resources for health and a recent history of civil unrest, Uganda has prioritized Millennium Development Goals 4 and 5 for child and maternal survival. As part of a multi-country analysis we examined change for newborn survival over the past decade through mortality and health system coverage indicators as well as national and donor funding for health, and policy and programme change. Between 2000 and 2010 Uganda's neonatal mortality rate reduced by 2.2% per year, which is greater than the regional average rate of decline but slower than national reductions in maternal mortality and under-five mortality after the neonatal period. While existing population-based data are insufficient to measure national changes in coverage and quality of services, national attention for maternal and child health has been clear and authorized from the highest levels. Attention and policy change for newborn health is comparatively recent. This recognized gap has led to a specific focus on newborn health through a national Newborn Steering Committee, which has been given a mandate from the Ministry of Health to advise on newborn survival issues since 2006. This multi-disciplinary and inter-agency network of stakeholders has been able to preside over a number of important policy changes at the level of facility care, education and training, community-based service delivery through Village Health Teams and changes to essential drugs and commodities. The committee's comprehensive reach has enabled rapid policy change and increased attention to newborn survival in a relatively short space of time. Translating this favourable policy environment into district-level implementation and high quality services is now the priority.

Outbreak of type A foodborne botulism at a boarding school, Uganda, 2008.

PubMed

Viray, M A; Wamala, J; Fagan, R; Luquez, C; Maslanka, S; Downing, R; Biggerstaff, M; Malimbo, M; Kirenga, J B; Nakibuuka, J; Ddumba, E; Mbabazi, W; Swerdlow, D L

2014-11-01

Botulism has rarely been reported in Africa. In October 2008, botulism was reported in three Ugandan boarding-school students. All were hospitalized and one died. A cohort study was performed to assess food exposures among students, and clinical specimens and available food samples were tested for botulinum toxin. Three case-patients were identified; a homemade, oil-based condiment was eaten by all three. In the cohort study, no foods were significantly associated with illness. Botulinum toxin type A was confirmed in clinical samples. This is the first confirmed outbreak of foodborne botulism in Uganda. A homemade, oil-based condiment was the probable source. Consumption of homemade oil-based condiments is widespread in Ugandan schools, putting children at risk. Clinicians and public health authorities in Uganda should consider botulism when clusters of acute flaccid paralysis are seen. Additionally, schools should be warned of the hazard of homemade oil-based condiments, and take steps to prevent their use.

Independent Origin of Plasmodium falciparum Antifolate Super-Resistance, Uganda, Tanzania, and Ethiopia

PubMed Central

Alifrangis, Michael; Schousboe, Mette L.; Ishengoma, Deus; Lusingu, John; Pota, Hirva; Kavishe, Reginald A.; Pearce, Richard; Ord, Rosalynn; Lynch, Caroline; Dejene, Seyoum; Cox, Jonathan; Rwakimari, John; Minja, Daniel T.R.; Lemnge, Martha M.; Roper, Cally

2014-01-01

Super-resistant Plasmodium falciparum threatens the effectiveness of sulfadoxine–pyrimethamine in intermittent preventive treatment for malaria during pregnancy. It is characterized by the A581G Pfdhps mutation on a background of the double-mutant Pfdhps and the triple-mutant Pfdhfr. Using samples collected during 2004–2008, we investigated the evolutionary origin of the A581G mutation by characterizing microsatellite diversity flanking Pfdhps triple-mutant (437G+540E+581G) alleles from 3 locations in eastern Africa and comparing it with double-mutant (437G+540E) alleles from the same area. In Ethiopia, both alleles derived from 1 lineage that was distinct from those in Uganda and Tanzania. Uganda and Tanzania triple mutants derived from the previously characterized southeastern Africa double-mutant lineage. The A581G mutation has occurred multiple times on local Pfdhps double-mutant backgrounds; however, a novel microsatellite allele incorporated into the Tanzania lineage since 2004 illustrates the local expansion of emergent triple-mutant lineages. PMID:25061906

Seroprevalence of Leptospira hardjo in cattle and African buffalos in southwestern Uganda.

PubMed

Atherstone, Christine; Picozzi, Kim; Kalema-Zikusoka, Gladys

2014-02-01

Leptospirosis, caused by the spirochete bacterium Leptospira spp. is a zoonosis, distributed worldwide and classified as an emerging infectious disease. Fatal outcomes to leptospiral infection do occur and the disease can cause abortion and other reproductive problems in cattle, goats, and pigs. In humans the symptoms range from subclinical infection to acute febrile illness, pulmonary hemorrhage and renal failure. Leptospirosis has never been officially reported to the World Health Organization (WHO) or the World Animal Health Organization in animals or humans in Uganda. However, favorable ecological conditions and suitable animal hosts can be found within the country. A commercially available enzyme-linked immunosorbent (ELISA) kit was used to screen sera samples from domesticated cattle and African buffalo (Syncerus caffer) at two locations in southwestern Uganda, collected over a 4-year period. Positive samples were found in both cattle and African buffalo samples, from both locations and across the sampling period. Overall seroprevalence was 42.39% in African buffalo and 29.35% in cattle.

Knowledge and practices related to plague in an endemic area of Uganda.

PubMed

Kugeler, Kiersten J; Apangu, Titus; Forrester, Joseph D; Griffith, Kevin S; Candini, Gordian; Abaru, Janet; Okoth, Jimmy F; Apio, Harriet; Ezama, Geoffrey; Okello, Robert; Brett, Meghan; Mead, Paul

2017-11-01

Plague is a virulent zoonosis reported most commonly from Sub-Saharan Africa. Early treatment with antibiotics is important to prevent mortality. Understanding knowledge gaps and common behaviors informs the development of educational efforts to reduce plague mortality. A multi-stage cluster-sampled survey of 420 households was conducted in the plague-endemic West Nile region of Uganda to assess knowledge of symptoms and causes of plague and health care-seeking practices. Most (84%) respondents were able to correctly describe plague symptoms; approximately 75% linked plague with fleas and dead rats. Most respondents indicated that they would seek health care at a clinic for possible plague; however plague-like symptoms were reportedly common, and in practice, persons sought care for those symptoms at a health clinic infrequently. Persons in the plague-endemic region of Uganda have a high level of understanding of plague, yet topics for targeted educational messages are apparent. Published by Elsevier Ltd.

Challenges of surgery in developing countries: a survey of surgical and anesthesia capacity in Uganda's public hospitals.

PubMed

Linden, Allison F; Sekidde, Francis Serufusa; Galukande, Moses; Knowlton, Lisa Marie; Chackungal, Smita; McQueen, K A Kelly

2012-05-01

There are large disparities in access to surgical services due to a multitude of factors, including insufficient health human resources, infrastructure, medicines, equipment, financing, logistics, and information reporting. This study aimed to assess these important factors in Uganda's government hospitals as part of a larger study examining surgical and anesthesia capacity in low-income countries in Africa. A standardized survey tool was administered via interviews with Ministry of Health officials and key health practitioners at 14 public government hospitals throughout the country. Descriptive statistics were used to analyze the data. There were a total of 107 general surgeons, 97 specialty surgeons, 124 obstetricians/gynecologists (OB/GYNs), and 17 anesthesiologists in Uganda, for a rate of one surgeon per 100,000 people. There was 0.2 major operating theater per 100,000 people. Altogether, 53% of all operations were general surgery cases, and 44% were OB/GYN cases. In all, 73% of all operations were performed on an emergency basis. All hospitals reported unreliable supplies of water and electricity. Essential equipment was missing across all hospitals, with no pulse oximeters found at any facilities. A uniform reporting mechanism for outcomes did not exist. There is a lack of vital human resources and infrastructure to provide adequate, safe surgery at many of the government hospitals in Uganda. A large number of surgical procedures are undertaken despite these austere conditions. Many areas that need policy development and international collaboration are evident. Surgical services need to become a greater priority in health care provision in Uganda as they could promise a significant reduction in morbidity and mortality.

Adverse drug reaction reporting among health care workers at Mulago National Referral and Teaching hospital in Uganda.

PubMed

Katusiime, Barbra; Semakula, Daniel; Lubinga, Solomon J

2015-12-01

Adverse Drug Reactions (ADRs) are an important contributor to patient morbidity and hospitalisation in Uganda. Under-reporting of ADRs may increase medicine-induced morbidity and mortality among patients. This study determined the extent of ADR reporting, and associated factors, among healthcare workers in Uganda. A quantitative, cross-sectional, study was conducted. Pretested, semi-structured questionnaires were administered to 289 randomly sampled healthcare workers over a three-month period in Mulago National Referral Hospital, Uganda. The primary outcome was the proportion of healthcare workers who had ever reported an ADR. Data was double-entered in Epidata version 3.0, cleaned and exported to STATA version 10.1 for analysis. The overall response rate was 77.2% (n=223). The majority of the respondents were females (139, 62.3%). The median age of all respondents was 32.6 years (min-23; max-65). Only about 16.6% (n=37) of healthcare workers had ever reported an ADR. Very few (n= 84, 37.7%) healthcare workers knew the tools used in ADR reporting. Less than a quarter (n=41, 18.4%) of the healthcare workers knew where to report ADRs. Lack of training was reported as the major (56.5%, 126) deterrent to reporting ADRs by healthcare workers. Adverse drug reactions are under-reported in Uganda, and healthcare workers have insufficient knowledge of existing pharmacovigilance systems, including ADR reporting systems. To address these challenges, there is need to sensitize and train healthcare workers in patient-centred aspects of medicine surveillance, so as to provide appropriate care while optimising patient safety.

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. © The Author(s) 2013.

Implementation of Patient-Centered Education for Chronic-Disease Management in Uganda: An Effectiveness Study.

PubMed

Siddharthan, Trishul; Rabin, Tracy; Canavan, Maureen E; Nassali, Faith; Kirchhoff, Phillip; Kalyesubula, Robert; Coca, Steven; Rastegar, Asghar; Knauf, Felix

2016-01-01

The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. Mixed-methods, prospective cohort. A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. Adults with a primary diagnosis of heart failure. PocketDoktor Educational Booklets with patient-centered health education. The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, p<0.001 for all values) after exposure to the intervention; this effect was significantly larger among indigent patients. Participants reported that materials were easy to read, that they had improved knowledge of disease, and stated improved communication with physicians. Patient-centered medical education can improve confidence in self-management as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results

Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda.

PubMed

Ngonzi, Joseph; Tornes, Yarine Fajardo; Mukasa, Peter Kivunike; Salongo, Wasswa; Kabakyenga, Jerome; Sezalio, Masembe; Wouters, Kristien; Jacqueym, Yves; Van Geertruyden, Jean-Pierre

2016-08-05

Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH). The sample included pregnant women aged 15-49 years admitted to the Maternity unit between January 2011 and November 2014. Data from patient charts of 139 maternal deaths (cases) and 417 controls was collected using a standard audit/data extraction form. Multivariable logistic regression analysis was used to assess for the factors associated with maternal mortality. Direct causes of mortality accounted for 77.7 % while indirect causes contributed 22.3 %. The most frequent cause of maternal mortality was puerperal sepsis (30.9 %), followed by obstetric hemorrhage (21.6 %), hypertensive disorders in pregnancy (14.4 %), abortion complications (10.8 %). Malaria was the commonest indirect cause of mortality accounting for 8.92 %. On multivariable logistic regression analysis, the factors associated with maternal mortality were: primary or no education (OR 1.9; 95 % CI, 1.0-3.3); HIV positive sero-status (OR, 3.6; 95 % CI, 1.9-7.0); no antenatal care attendance (OR 3.6; 95 % CI, 1.8-7.0); rural dwellers (OR, 4.5; 95 % CI, 2.5-8.3); having been referred from another health facility (OR 5.0; 95 % CI, 2.9-10.0); delay to seek health care (delay-1) (OR 36.9; 95 % CI, 16.2-84.4). Most maternal deaths occur among mothers from rural areas, uneducated, HIV positive, unbooked mothers (lack of antenatal care), referred mothers in critical conditions and mothers delaying to seek health care. Puerperal sepsis is

Pregnant women's experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study.

PubMed

Rujumba, Joseph; Neema, Stella; Tumwine, James K; Tylleskär, Thorkild; Heggenhougen, Harald K

2013-05-24

Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women's experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for primary and post exposure HIV prevention

Revisiting the Regenerative Possibilities of Ortiz

ERIC Educational Resources Information Center

Duques, Matthew

2004-01-01

The author of this article revisits Simon Ortiz's poem, "From Sand Creek," in which the latter can in so few words convey both the horrific tragedy of conquest and colonization, while at the same time find a space for possibility, a means for recovery that is never about forgetting but always occurs as a kind of recuperative remembering. Ortiz…

Injected with controversy: sales and administration of injectable contraceptives in drug shops in Uganda.

PubMed

Stanback, John; Otterness, Conrad; Bekiita, Martha; Nakayiza, Olivia; Mbonye, Anthony K

2011-03-01

Informal drug shops are the first line of health care in many poor countries. In Uganda, these facilities commonly sell and administer the injectable contraceptive depot medroxyprogesterone acetate (DMPA), even though they are prohibited by law from selling any injectable drugs. It is important to understand drug shop operators' current practices and their potential to provide DMPA to hard-to-reach populations. Between November 2007 and January 2008, 157 drug shops were identified in three rural districts of Uganda, and the operators of the 124 facilities that sold DMPA were surveyed. Data were analyzed with descriptive methods. Only 35% of operators reported that the facility in which they worked was a licensed drug shop and another 9% reported that the facility was a private clinic; all claimed to have some nursing, midwifery, or other health or medical qualification. Ninety-six percent administered DMPA in the shop. Operators gave a mean of 10 injections (including three of DMPA) per week. Forty-three percent of those who administered DMPA reported disposing of used syringes in sharps containers; in the previous 12 months, 24% had had a needle-stick injury and 17% had had a patient with an injection-related abscess. Eleven percent said they had ever reused a disposable syringe. Overall, contraceptive knowledge was low, and attitudes toward family planning reflected common traditional biases. Provision of DMPA is common in rural drug shops, but needs to be made safer. Absent stronger regulation and accreditation, drug shop operators can be trained as community-based providers to help meet the extensive unmet demand for family planning in rural areas.

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,…

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…

Is it time to revisit the role of psychedelic drugs in enhancing human creativity?

PubMed

Sessa, B

2008-11-01

Human creativity is difficult to define and measure, but it is undoubtedly an important cognitive process. This makes it an interesting challenge for modern neuroscientific exploration - especially given the current interest in developing cognitive enhancers for commercial and clinical uses. There are similarities between the typical traits of creative people and the subjective psychological characteristics of the psychedelic (hallucinogenic) drug experience. This phenomenon was studied in a number of small trials and case studies in the 1960s. Results were inconclusive, and the quality of these studies - by modern research standards - was merely anecdotal. Nevertheless, with today's current renaissance in psychedelic drug research and the growing interest in cognitive enhancing drugs, now may be the time to re-visit these studies with contemporary research methods.

Consultancy research as a barrier to strengthening social science research capacity in Uganda.

PubMed

Wight, Daniel; Ahikire, Josephine; Kwesiga, Joy C

2014-09-01

There is a shortage of senior African social scientists available to lead or manage research in Africa, undermining the continent's ability to interpret and solve its socio-economic and public health problems. This is despite decades of investment to strengthen research capacity. This study investigated the role of individually commissioned consultancy research in this lack of capacity. In 2006 structured interviews (N = 95) and two group discussions (N = 16 total) were conducted with a fairly representative sample of Ugandan academic social scientists from four universities. Twenty-four senior members of 22 Ugandan and international commissioning organizations were interviewed. Eight key actors were interviewed in greater depth. Much of Ugandan social science research appears to take the form of small, individually contracted consultancy projects. Researchers perceived this to constrain their professional development and, more broadly, social science research capacity across Uganda. Conversely, most research commissioners seemed broadly satisfied with the research expertise available and felt no responsibility to contribute to strengthening research capacity. Most consultancy research does not involve institutional overheads and there seems little awareness of, or interest in, such overheads. Although inequalities in the global knowledge economy are probably perpetuated primarily by macro-level factors, in line with Dependency Theory, meso-level factors are also important. The current research market and institutional structures in Uganda appear to create career paths that seriously impede the development of high quality social science research capacity, undermining donor investments and professional effort to strengthen this capacity. These problems are probably generic to much of sub-Saharan Africa. However, both commissioning and research organizations seem ready, in principle, to establish national guidelines for institutional research consultancies. These

Phenomenology of n - n ¯ oscillations revisited

DOE PAGES

Gardner, S.; Jafari, E.

2015-05-22

We revisit the phenomenology of n-n¯ oscillations in the presence of external magnetic fields, highlighting the role of spin. We show, contrary to long-held belief, that the n-n¯ transition rate need not be suppressed, opening new opportunities for its empirical study.

Phenomenology of n - n ¯ oscillations revisited

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gardner, S.; Jafari, E.

We revisit the phenomenology of n-n¯ oscillations in the presence of external magnetic fields, highlighting the role of spin. We show, contrary to long-held belief, that the n-n¯ transition rate need not be suppressed, opening new opportunities for its empirical study.

Revisiting separation properties of convex fuzzy sets

USDA-ARS?s Scientific Manuscript database

Separation of convex sets by hyperplanes has been extensively studied on crisp sets. In a seminal paper separability and convexity are investigated, however there is a flaw on the definition of degree of separation. We revisited separation on convex fuzzy sets that have level-wise (crisp) disjointne...

Emergency department revisits for patients with kidney stones in California.

PubMed

Scales, Charles D; Lin, Li; Saigal, Christopher S; Bennett, Carol J; Ponce, Ninez A; Mangione, Carol M; Litwin, Mark S

2015-04-01

Kidney stones affect nearly one in 11 persons in the United States, and among those experiencing symptoms, emergency care is common. In this population, little is known about the incidence of and factors associated with repeat emergency department (ED) visits. The objective was to identify associations between potentially mutable factors and the risk of an ED revisit for patients with kidney stones in a large, all-payer cohort. This was a retrospective cohort study of all patients in California initially treated and released from EDs for kidney stones between February 2008 and November 2009. A multivariable regression model was created to identify associations between patient-level characteristics, area health care resources, processes of care, and the risk of repeat ED visits. The primary outcome was a second ED visit within 30 days of the initial discharge from emergent care. Among 128,564 patients discharged from emergent care, 13,684 (11%) had at least one additional emergent visit for treatment of their kidney stone. In these patients, nearly one in three required hospitalization or an urgent temporizing procedure at the second visit. On multivariable analysis, the risk of an ED revisit was associated with insurance status (e.g., Medicaid vs. private insurance; odds ratio [OR] = 1.52, 95% confidence interval [CI] = 1.43 to 1.61; p < 0.001). Greater access to urologic care was associated with lower odds of an ED revisit (highest quartile OR = 0.88, 95% CI = 0.80 to 0.97; p < 0.01 vs. lowest quartile). In exploratory models, performance of a complete blood count was associated with a decreased odds of revisit (OR = 0.86, 95% CI = 0.75 to 0.97; p = 0.02). Repeat high-acuity care affects one in nine patients discharged from initial emergent evaluations for kidney stones. Access to urologic care and processes of care are associated with lower risk of repeat emergent encounters. Efforts are indicated to identify preventable causes of ED revisits for kidney stone

Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control.

PubMed

Kirenga, Bruce J; Ssengooba, Willy; Muwonge, Catherine; Nakiyingi, Lydia; Kyaligonza, Stephen; Kasozi, Samuel; Mugabe, Frank; Boeree, Martin; Joloba, Moses; Okwera, Alphonse

2015-01-21

Slow decline in the incidence of tuberculosis (TB) has been observed in most high TB burden countries. Knowledge of the prevalence of different TB risk factors can help expand TB control strategies. However with the exception of Human Immunodeficiency Virus (HIV) the prevalence of the other TB risk factors are poorly studied in Uganda. We aimed to determine the prevalence of different TB risk factors and TB disease presentation among TB patients in Kampala Uganda. We assessed 365 adult TB patients and used descriptive statistics to summarize their socio-demographic, clinical, radiological, sputum mycobacteriology and TB risk factors (HIV, diabetes, TB contact, alcohol use, tobacco smoking, poverty and overcrowding) data. A total of 158 (43.3%) patients were male and the median age was 29 (IQR 28-30). Majority of the patients (89.2%) had pulmonary TB, 86.9% were new and 13.2% were retreatment. Wasting (i.e. body mass index of <18.5 kg/m(2)) was found in 38.5% of the patients and 63% presented with cough. Constitutional symptoms (fever, anorexia, night sweats and weight loss) were reported by 32.1%. Most patients (78.6%) presented with non-cavity lung parenchyma disease (infiltrates, nodules, masses) but 35.2% had cavity disease. Pleural disease was detected in 19.3% of patients. Positive smear microscopy and culture (irrespective of month of treatment) was found in 52.7% and 36.5% of patients respectively. Any drug resistance was detected in 21.1% of patients while multidrug resistance (MDR) TB defined as resistance to rifampicin and isoniazid was detected in 6.3% of patients. All MDR patients were new patients. The prevalence of TB risk factors were as follows: HIV 41.4%, diabetes 5.4%, close contact 11.5%, family history 17.5%, smoking 26.37%, poverty 39.5%, overcrowding 57.3% and alcohol use 50.7%. Overcrowding increased smear positive rate, prevalence ratio 1.22, p = 0.09 but all the other studied risk factors did not affect clinical, radiological and

Attendance and Utilization of Antenatal Care (ANC) Services: Multi-Center Study in Upcountry Areas of Uganda

PubMed Central

AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W.; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah

2015-01-01

Introduction Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda. Method Cross-sectional study design with mixed methods of interviewer administered questionnaires, focus group discussions and key informant interviews. Data was entered using Epidata and analyzed using Stata into frequency tables using actual tallies and percentages. Ethical approval was sought from SOM-REC MakCHS under approval number “#REC REF 2012-117” before conducting the study. Results A total of four hundred one were enrolled with the majority being in the age group 20 – 24 years (mean age, 25.87 ± 6.26). Health workers played a great role (72.04%), followed by the media (15.46%) and friends (12.50%) in creating awareness about ANC. A significant number of respondents went to TBAs with reasons such as “near and accessible”, “my husband decided”, and “they are the only people I know”. 37.63% of the respondents considered getting an antenatal Card as an importance of ANC. 71 (19.67%) respondents gave a wrong opinion (late) on booking time with reasons like demands at work, no problems during pregnancy, advised by friends, just to get a

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

PubMed

Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

2011-08-01

Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening

PubMed Central

2011-01-01

Background Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match

Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

PubMed Central

Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

2017-01-01

Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

Geography, Not Health System Affiliations, Determines Patients' Revisits to the Emergency Department.

PubMed

Rising, Kristin L; Karp, David N; Powell, Rhea E; Victor, Timothy W; Carr, Brendan G

2018-04-01

To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region. Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost and Utilization Project. This is a retrospective cohort study of emergency department return visits among Florida adults over an 18-month period. We evaluated pairs of index and 30-day return emergency department visits and compared capture rates for hospital, health system, and geographic units. Data were obtained from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey Database. Among 9,416,212 emergency department visits, 22.6 percent (2,124,441) were associated with a 30-day return. Seventy percent (1,477,772) of 30-day returns occurred to the same hospital. The 30-day return capture rates were highest within the same geographic area: county-level capture at 92 percent (IQR=86-96 percent) versus health system capture at 75 percent (IQR = 68-81 percent). Acute care utilization patterns are often independent of health system boundaries. Current population-based health care models that attribute patients to a single provider or health system may be strengthened by considering geographic patterns of acute care utilization. © Health Research and Educational Trust.

Attitudinal Variables Affecting Education Reforms and Quality of Primary Education in Uganda

ERIC Educational Resources Information Center

Nyenje, Aida; Nkata, James

2016-01-01

This paper establishes the extent to which attitudinal variables affect the education reforms and subsequently the quality of primary education in Uganda. The paper is based on the views of a wide spectrum of different education stakeholders including: policy analysts, Members of Parliament (MPs), education officers, Headteachers, teaching staff,…

A categorization of water system breakdowns: Evidence from Liberia, Nigeria, Tanzania, and Uganda.

PubMed

Klug, Tori; Cronk, Ryan; Shields, Katherine F; Bartram, Jamie

2018-04-01

In rural sub-Saharan Africa, one in three handpumps are non-functional at any time. While there is some evidence describing factors associated with non-functional water systems, there is little evidence describing the categories of water system breakdowns that commonly occur. Insufficient water availability from broken down systems can force people to use unimproved water sources, which undermines the health benefits of an improved water source. We categorized common water system breakdowns using quantitative and qualitative monitoring data from Liberia, Nigeria, Tanzania, and Uganda (each N>3600 water systems) and examined how breakdown category varies by water system type and management characteristics. Specific broken parts were mentioned more frequently than all other reasons for breakdown; hardware parts frequently found at fault for breakdown were aprons (Liberia), pipes (Tanzania and Uganda), taps/spouts (Tanzania and Uganda), and lift mechanisms (Nigeria). Statistically significant differences in breakdown category were identified based on system type, age, management type, and fee collection type. Categorization can help to identify common reasons for water system breakdown. The analysis of these data can be used to develop improved monitoring instruments to inform actors of different breakdown types and provide reasons for system non-functionality. Improved monitoring instruments would enable actors to target appropriate resources to address specific breakdowns likely to arise based on system type and management characteristics in order to inform improved implementation of and post-construction support for water systems in sub-Saharan Africa. Copyright © 2017 Elsevier B.V. All rights reserved.

Are reproductive health NGOs in Uganda able to engage in the health SWAp?

PubMed

Mugisha, Frank; Birungi, Harriet; Askew, Ian

2005-01-01

This paper explores the ability for reproductive health (RH) non-governmental organizations (NGO) in Uganda to survive in the context of SWAp and decentralization. The authors argue that, contrary to the perceptions that this context may increase NGO's financial vulnerability, a SWAp and a decentralized system may provide an opportunity that should be embraced by NGOs to enhance their sustainability and effectiveness by reducing their current dependency on donor funding. The paper discusses the systemic weaknesses of many NGOs that currently make them vulnerable, and observes that unless these weaknesses are addressed, such NGOs will lose their space in the SWAp and decentralization arena. The authors suggest that NGOs need to recognize the opportunities that participating in public-private partnerships through a SWAp can offer them for long-term and significant funding. They need also to develop their capacity to pro-actively participate in a SWAp and decentralized context by becoming more entrepreneurial in nature, through re-orienting their organizational philosophies and strategic planning and budgeting so as to be able to partner effectively with the public sector in accessing funds made available through health sector reform.

Evidence-based tick acaricide resistance intervention strategy in Uganda: Concept and feedback of farmers and stakeholders.

PubMed

Vudriko, Patrick; Okwee-Acai, James; Byaruhanga, Joseph; Tayebwa, Dickson Stuart; Omara, Robert; Muhindo, Jeanne Bukeka; Lagu, Charles; Umemiya-Shirafuji, Rika; Xuan, Xuenan; Suzuki, Hiroshi

2018-02-01

The emergence of multi-acaricide resistant ticks has led to unprecedented level of acaricide failure in central and western Uganda. In the absence of a national acaricide resistance management strategy, the country's dairy sector is threatened by upsurge of ticks and tick-borne diseases. In this study, we developed a short-to-medium-term intervention approach called Evidence-Based Acaricide Tick Control (EBATIC): Identify, Test, Intervene and Eradicate (IT-IE). Furthermore, the perception of 199 farmers and extension workers, 12 key informants in four districts and 47 stakeholders in the animal industry in Uganda were assessed using semi-structured questionnaires. We report that the establishment of a specialized laboratory is pivotal in identifying and testing (IT) acaricide resistant ticks for prompt intervention and eradication (IE). The laboratory test results and the farm tick control gaps identified are very important in guiding acaricide resistance management strategies such as evidence-based acaricide rotation, development and dissemination of extension materials, training of farmers and extension workers, and stakeholders' engagement towards finding sustainable solutions. All the 47 stakeholders and 91.0% (181/199) of the farmers and extension workers reported that the EBATIC approach will help in solving the tick acaricide resistance crisis in Uganda. Similarly, all the 12 key informants and 92.5% (184/199) of the farmers and extension workers suggested that the EBATIC approach should be sustained and rolled out to other districts. The EBATIC stakeholders' dialogue generated both short-to-medium and long-term strategies for sustainable management of tick acaricide resistance in the country. Overall, the positive feedback from farmers, district veterinarians and stakeholders in the animal industry suggest that the EBATIC approach is a useful proof-of-concept on scalable intervention pathway against tick acaricide resistance in Uganda with possibility of

How equitable is social franchising? Case studies of three maternal healthcare franchises in Uganda and India

PubMed Central

Haemmerli, Manon; Santos, Andreia; Penn-Kekana, Loveday; Lange, Isabelle; Matovu, Fred; Benova, Lenka; Wong, Kerry LM

2018-01-01

Abstract Substantial investments have been made in clinical social franchising to improve quality of care of private facilities in low- and middle-income countries but concerns have emerged that the benefits fail to reach poorer groups. We assessed the distribution of franchise utilization and content of care by socio-economic status (SES) in three maternal healthcare social franchises in Uganda and India (Uttar Pradesh and Rajasthan). We surveyed 2179 women who had received antenatal care (ANC) and/or delivery services at franchise clinics (in Uttar Pradesh only ANC services were offered). Women were allocated to national (Uganda) or state (India) SES quintiles. Franchise users were concentrated in the higher SES quintiles in all settings. The percent in the top two quintiles was highest in Uganda (over 98% for both ANC and delivery), followed by Rajasthan (62.8% for ANC, 72.1% for delivery) and Uttar Pradesh (48.5% for ANC). The percent of clients in the lowest two quintiles was zero in Uganda, 7.1 and 3.1% for ANC and delivery, respectively, in Rajasthan and 16.3% in Uttar Pradesh. Differences in SES distribution across the programmes may reflect variation in user fees, the average SES of the national/state populations and the range of services covered. We found little variation in content of care by SES. Key factors limiting the ability of such maternal health social franchises to reach poorer groups may include the lack of suitable facilities in the poorest areas, the inability of the poorest women to afford any private sector fees and competition with free or even incentivized public sector services. Moreover, there are tensions between targeting poorer groups, and franchise objectives of improving quality and business performance and enhancing financial sustainability, meaning that middle income and poorer groups are unlikely to be reached in large numbers in the absence of additional subsidies. PMID:29373681

How equitable is social franchising? Case studies of three maternal healthcare franchises in Uganda and India.

PubMed

Haemmerli, Manon; Santos, Andreia; Penn-Kekana, Loveday; Lange, Isabelle; Matovu, Fred; Benova, Lenka; Wong, Kerry L M; Goodman, Catherine

2018-04-01

Substantial investments have been made in clinical social franchising to improve quality of care of private facilities in low- and middle-income countries but concerns have emerged that the benefits fail to reach poorer groups. We assessed the distribution of franchise utilization and content of care by socio-economic status (SES) in three maternal healthcare social franchises in Uganda and India (Uttar Pradesh and Rajasthan). We surveyed 2179 women who had received antenatal care (ANC) and/or delivery services at franchise clinics (in Uttar Pradesh only ANC services were offered). Women were allocated to national (Uganda) or state (India) SES quintiles. Franchise users were concentrated in the higher SES quintiles in all settings. The percent in the top two quintiles was highest in Uganda (over 98% for both ANC and delivery), followed by Rajasthan (62.8% for ANC, 72.1% for delivery) and Uttar Pradesh (48.5% for ANC). The percent of clients in the lowest two quintiles was zero in Uganda, 7.1 and 3.1% for ANC and delivery, respectively, in Rajasthan and 16.3% in Uttar Pradesh. Differences in SES distribution across the programmes may reflect variation in user fees, the average SES of the national/state populations and the range of services covered. We found little variation in content of care by SES. Key factors limiting the ability of such maternal health social franchises to reach poorer groups may include the lack of suitable facilities in the poorest areas, the inability of the poorest women to afford any private sector fees and competition with free or even incentivized public sector services. Moreover, there are tensions between targeting poorer groups, and franchise objectives of improving quality and business performance and enhancing financial sustainability, meaning that middle income and poorer groups are unlikely to be reached in large numbers in the absence of additional subsidies.

Area Handbook Series. Uganda: A Country Study, 2nd Edition

DTIC Science & Technology

1992-01-01

groups in each of these categories, their different responses to the colonial experience, and the impact of world religions. xxi | I I--A Uganda had...government and private-sector initiatives to reduce the rate of transmission and the impact of the disease. In 1991 the internationally funded AIDS...created a moving "ivory frontier" as elephant herds near the coast were nearly exterminated. Leading large caravans financed by Indian moneylenders

SWAp dynamics in a decentralized context: experiences from Uganda.

PubMed

Jeppsson, Anders

2002-12-01

This paper examines the role of the Ministry of Health (MoH) in Uganda in the process of developing a Sector-Wide Approach (SWAp) within the health sector. Power dynamics are integral to any understanding of development assistance, and SWAps bring with them new opportunities for the deployment of influence. The SWAp process has changed the interaction between the donors and the Government, and the perspective of this interaction has shifted from various technical areas to the entire health sector. It is argued that although the decentralization of the public sector has transferred considerable responsibilities and duties from the central level to the districts, significant power, defined as a social construct, has been generated by the MoH in the very process of developing SWAps. The MoH has been able to exercise significant influence on defining the content and boundaries of the SWAp process, as well as the direction it is taking. This development has largely followed blueprints drawn by donors. Through the institutional framework associated with SWAps, the MoH has redefined the interaction between the central level and the districts as well as between the MoH and the donors. While the SWAp process is now moving from the planning to the implementation phase in Uganda, we see a number of new, changing, ambiguous and contradictory strategies emerging.

Transactional sex and HIV risks - evidence from a cross-sectional national survey among young people in Uganda.

PubMed

Choudhry, Vikas; Ambresin, Anne-Emmanuelle; Nyakato, Viola Nilah; Agardh, Anette

2015-01-01

Transactional sex is associated with the HIV epidemic among young people in Uganda. Few quantitative studies based on nationally representative survey data explored the relationship between sexual behaviors, HIV infection, and transactional sex. This study aimed to determine the associations between risky sexual behaviors, participation in transactional sex, and HIV sero-status among men and women aged 15-24 in Uganda. The study uses data from the Uganda AIDS Indicator Survey, a cross-sectional national HIV serological study conducted in 2011. We analyzed data on 1,516 men and 2,824 women aged 15-24 who had been sexually active in the 12 months preceding the survey. Private, face-to-face interviews were also conducted to record the sociodemographics, sexual history, and experiences of sexual coercion. Logistic regression analysis was performed to measure associations between sexual behaviors and transactional sex, and associations between HIV sero-status and transactional sex. Among young people who had been sexually active in the 12 months prior to the survey, 5.2% of young men reported paying for sex while 3.7% of young women reported receiving gifts, favors, or money for sex. Lower educational attainment (ORadjusted 3.25, CI 1.10-9.60) and experience of sexual coercion (ORadjusted 2.83, CI 1.07-7.47) were significantly associated with paying for sex among men. Multiple concurrent sexual relationships were significantly associated with paying for sex among young men (ORadjusted 5.60, CI 2.08-14.95) and receiving something for sex among young women (ORadjusted 8.04, CI 2.55-25.37). Paying for sex among young men and having three to five lifetime sexual partners among young women were associated with increased odds of testing positive for HIV. Transactional sex is associated with sexual coercion and HIV risk behaviors such as multiple concurrent sexual partnerships among young people in Uganda. In addition, transactional sex appears to place young men at increased

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.

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…

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…

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…

Alcohol Types and HIV Disease Progression Among HIV-Infected Drinkers Not Yet on Antiretroviral Therapy in Russia and Uganda.

PubMed

Asiimwe, Stephen B; Fatch, Robin; Patts, Gregory; Winter, Michael; Lloyd-Travaglini, Christine; Emenyonu, Nneka; Muyindike, Winnie; Kekibiina, Allen; Blokhina, Elena; Gnatienko, Natalia; Kruptisky, Evgeny; Cheng, Debbie M; Samet, Jeffrey H; Hahn, Judith A

2017-11-01

In HIV-infected drinkers, alcohol types more likely to cause inflammation could plausibly increase the risk of HIV disease progression. We therefore assessed the association between alcohol type and plasma HIV RNA level (HIV viral load) among HIV-infected drinkers not on antiretroviral therapy (ART) in Russia and Uganda. We analyzed the data of participants from cohorts in Russia and Uganda and assessed their HIV viral load at enrollment by the alcohol type predominantly consumed. We defined predominant alcohol type as the alcohol type contributing >50% of total alcohol consumption in the 1 month (Russia) or 3 months (Uganda) prior to enrollment. Using multiple linear regression, we compared log 10 HIV viral load by predominant alcohol type, controlling for age, gender, socioeconomic status, total number of standard drinks, frequency of drinking ≥6 drinks/occasion, and in Russia, history of injection drug use. Most participants (99.2% of 261 in Russia and 98.9% of 352 in Uganda) predominantly drank one alcohol type. In Russia, we did not find evidence for differences in viral load levels between drinkers of fortified wine (n = 5) or hard liquor (n = 49), compared to drinkers of beer/low-ethanol-content cocktails (n = 163); however, wine/high-ethanol-content cocktail drinkers (n = 42) had higher mean log 10 viral load than beer/low-ethanol-content cocktail drinkers (β = 0.38, 95% CI 0.07-0.69; p = 0.02). In Uganda, we did not find evidence for differences in viral load levels between drinkers of locally-brewed beer (n = 41), commercially-distilled spirits (n = 38), or locally-distilled spirits (n = 43), compared to drinkers of commercially-made beer (n = 218); however, wine drinkers (n = 8) had lower mean log 10 HIV viral load (β = -0.65, 95% CI -1.36 to 0.07, p = 0.08), although this did not reach statistical significance. Among HIV-infected drinkers not yet on ART in Russia and Uganda, we observed an association between the

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

Total economic value of wetlands products and services in Uganda.

PubMed

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.

Newborn Care Practices among Mother-Infant Dyads in Urban Uganda

PubMed Central

Kayom, Violet Okaba; Kakuru, Abel; Kiguli, Sarah

2015-01-01

Background. Most information on newborn care practices in Uganda is from rural communities which may not be generalized to urban settings. Methods. A community based cross-sectional descriptive study was conducted in the capital city of Uganda from February to May 2012. Quantitative and qualitative data on the newborn care practices of eligible mothers were collected. Results. Over 99% of the mothers attended antenatal care at least once and the majority delivered in a health facility. Over 50% of the mothers applied various substances to the cord of their babies to quicken the healing. Although most of the mothers did not bathe their babies within the first 24 hours of birth, the majority had no knowledge of skin to skin care as a thermoprotective method. The practice of bathing babies in herbal medicine was common (65%). Most of the mothers breastfed exclusively (93.2%) but only 60.7% initiated breastfeeding within the first hour of life, while a significant number (29%) used prelacteal feeds. Conclusion. The inadequate newborn care practices in this urban community point to the need to intensify the promotion of universal coverage of the newborn care practices irrespective of rural or urban communities and irrespective of health care seeking indicators. PMID:26713096

Accessing diabetes care in rural Uganda: Economic and social resources.

PubMed

Nielsen, Jannie; Bahendeka, Silver K; Bygbjerg, Ib C; Meyrowitsch, Dan W; Whyte, Susan R

2017-07-01

Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients' journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more effectively, if they and their family have money, useful social relations, and knowledge, together with the capacity to communicate with health staff. Patients coming from households with high socio-economic status (SES) are more likely to have all of these resources, while for patients with low or medium SES, lack of economic resources increases the importance of connections within the health system.

Pregnant women’s experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study

PubMed Central

2013-01-01

Background Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women’s experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. Methods This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. Results Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. Conclusions In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for

The causal effect of education on HIV stigma in Uganda: Evidence from a natural experiment.

PubMed

Tsai, Alexander C; Venkataramani, Atheendar S

2015-10-01

HIV is highly stigmatized in sub-Saharan Africa. This is an important public health problem because HIV stigma has many adverse effects that threaten to undermine efforts to control the HIV epidemic. The implementation of a universal primary education policy in Uganda in 1997 provided us with a natural experiment to test the hypothesis that education is causally related to HIV stigma. For this analysis, we pooled publicly available, population-based data from the 2011 Uganda Demographic and Health Survey and the 2011 Uganda AIDS Indicator Survey. The primary outcomes of interest were negative attitudes toward persons with HIV, elicited using four questions about anticipated stigma and social distance. Standard least squares estimates suggested a statistically significant, negative association between years of schooling and HIV stigma (each P < 0.001, with t-statistics ranging from 4.9 to 14.7). We then used a natural experiment design, exploiting differences in birth cohort exposure to universal primary education as an instrumental variable. Participants who were <13 years old at the time of the policy change had 1.36 additional years of schooling compared to those who were ≥13 years old. Adjusting for linear age trends before and after the discontinuity, two-stage least squares estimates suggested no statistically significant causal effect of education on HIV stigma (P-values ranged from 0.21 to 0.69). Three of the four estimated regression coefficients were positive, and in all cases the lower confidence limits convincingly excluded the possibility of large negative effect sizes. These instrumental variables estimates have a causal interpretation and were not overturned by several robustness checks. We conclude that, for young adults in Uganda, additional years of education in the formal schooling system driven by a universal primary school intervention have not had a causal effect on reducing negative attitudes toward persons with HIV. Copyright © 2015

Motivators of couple HIV counseling and testing (CHCT) uptake in a rural setting in Uganda.

PubMed

Nannozi, Victoria; Wobudeya, Eric; Matsiko, Nicholas; Gahagan, Jacqueline

2017-01-23

Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53) and 49% (26/53) of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC) attendance and preparation for marriage. The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater attention to enhancers of CHCT programming is needed in trying to

The causal effect of education on HIV stigma in Uganda: evidence from a natural experiment

PubMed Central

Tsai, Alexander C.; Venkataramani, Atheendar S.

2015-01-01

Rationale HIV is highly stigmatized in sub-Saharan Africa. This is an important public health problem because HIV stigma has many adverse effects that threaten to undermine efforts to control the HIV epidemic. Objective The implementation of a universal primary education policy in Uganda in 1997 provided us with a natural experiment to test the hypothesis that education is causally related to HIV stigma. Methods For this analysis, we pooled publicly available, population-based data from the 2011 Uganda Demographic and Health Survey and the 2011 Uganda AIDS Indicator Survey. The primary outcomes of interest were negative attitudes toward persons with HIV, elicited using four questions about anticipated stigma and social distance. Results Standard least squares estimates suggested a statistically significant, negative association between years of schooling and HIV stigma (each P<0.001, with t-statistics ranging from 4.9 to 14.7). We then used a natural experiment design, exploiting differences in birth cohort exposure to universal primary education as an instrumental variable. Participants who were <13 years old at the time of the policy change had 1.36 additional years of schooling compared to those who were ≥13 years old. Adjusting for linear age trends before and after the discontinuity, two-stage least squares estimates suggested no statistically significant causal effect of education on HIV stigma (P-values ranged from 0.21 to 0.69). Three of the four estimated regression coefficients were positive, and in all cases the lower confidence limits convincingly excluded the possibility of large negative effect sizes. These instrumental variables estimates have a causal interpretation and were not overturned by several robustness checks. Conclusion We conclude that, for young adults in Uganda, additional years of education in the formal schooling system driven by a universal primary school intervention have not had a causal effect on reducing negative attitudes

Agro-ecology, household economics and malaria in Uganda: empirical correlations between agricultural and health outcomes

PubMed Central

2014-01-01

Background This paper establishes empirical evidence relating the agriculture and health sectors in Uganda. The analysis explores linkages between agricultural management, malaria and implications for improving community health outcomes in rural Uganda. The goal of this exploratory work is to expand the evidence-base for collaboration between the agricultural and health sectors in Uganda. Methods The paper presents an analysis of data from the 2006 Uganda National Household Survey using a parametric multivariate Two-Limit Tobit model to identify correlations between agro-ecological variables including geographically joined daily seasonal precipitation records and household level malaria risk. The analysis of agricultural and environmental factors as they affect household malaria rates, disaggregated by age-group, is inspired by a complimentary review of existing agricultural malaria literature indicating a gap in evidence with respect to agricultural management as a form of malaria vector management. Crop choices and agricultural management practices may contribute to vector control through the simultaneous effects of reducing malaria transmission, improving housing and nutrition through income gains, and reducing insecticide resistance in both malaria vectors and agricultural pests. Results The econometric results show the existence of statistically significant correlations between crops, such as sweet potatoes/yams, beans, millet and sorghum, with household malaria risk. Local environmental factors are also influential- daily maximum temperature is negatively correlated with malaria, while daily minimum temperature is positively correlated with malaria, confirming trends in the broader literature are applicable to the Ugandan context. Conclusions Although not necessarily causative, the findings provide sufficient evidence to warrant purposefully designed work to test for agriculture health causation in vector management. A key constraint to modeling the

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.

Pneumonic Plague Cluster, Uganda, 2004

PubMed Central

Asiki, Gershim; Anywaine, Zaccheus; Yockey, Brook; Schriefer, Martin E.; Aleti, Philliam; Ogen-Odoi, Asaph; Staples, J. Erin; Sexton, Christopher; Bearden, Scott W.; Kool, Jacob L.

2006-01-01

The public and clinicians have long-held beliefs that pneumonic plague is highly contagious; inappropriate alarm and panic have occurred during outbreaks. We investigated communicability in a naturally occurring pneumonic plague cluster. We defined a probable pneumonic plague case as an acute-onset respiratory illness with bloody sputum during December 2004 in Kango Subcounty, Uganda. A definite case was a probable case with laboratory evidence of Yersinia pestis infection. The cluster (1 definite and 3 probable cases) consisted of 2 concurrent index patient–caregiver pairs. Direct fluorescent antibody microscopy and polymerase chain reaction testing on the only surviving patient's sputum verified plague infection. Both index patients transmitted pneumonic plague to only 1 caregiver each, despite 23 additional untreated close contacts (attack rate 8%). Person-to-person transmission was compatible with transmission by respiratory droplets, rather than aerosols, and only a few close contacts, all within droplet range, became ill. PMID:16704785

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,…

Multidistrict Outbreak of Marburg Virus Disease-Uganda, 2012.

PubMed

Knust, Barbara; Schafer, Ilana J; Wamala, Joseph; Nyakarahuka, Luke; Okot, Charles; Shoemaker, Trevor; Dodd, Kimberly; Gibbons, Aridth; Balinandi, Stephen; Tumusiime, Alex; Campbell, Shelley; Newman, Edmund; Lasry, Estrella; DeClerck, Hilde; Boum, Yap; Makumbi, Issa; Bosa, Henry Kyobe; Mbonye, Anthony; Aceng, Jane Ruth; Nichol, Stuart T; Ströher, Ute; Rollin, Pierre E

2015-10-01

In October 2012, a cluster of illnesses and deaths was reported in Uganda and was confirmed to be an outbreak of Marburg virus disease (MVD). Patients meeting the case criteria were interviewed using a standard investigation form, and blood specimens were tested for evidence of acute or recent Marburg virus infection by reverse transcription-polymerase chain reaction (RT-PCR) and antibody enzyme-linked immunosorbent assay. The total count of confirmed and probable MVD cases was 26, of which 15 (58%) were fatal. Four of 15 laboratory-confirmed cases (27%) were fatal. Case patients were located in 4 different districts in Uganda, although all chains of transmission originated in Ibanda District, and the earliest case detected had an onset in July 2012. No zoonotic exposures were identified. Symptoms significantly associated with being a MVD case included hiccups, anorexia, fatigue, vomiting, sore throat, and difficulty swallowing. Contact with a case patient and attending a funeral were also significantly associated with being a case. Average RT-PCR cycle threshold values for fatal cases during the acute phase of illness were significantly lower than those for nonfatal cases. Following the institution of contact tracing, active case surveillance, care of patients with isolation precautions, community mobilization, and rapid diagnostic testing, the outbreak was successfully contained 14 days after its initial detection. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Uganda gets set for vaccine trials, but the ethical debate continues.

PubMed

1997-04-01

An HIV vaccine trial scheduled for 1997 involves 2000 male and female members of the Uganda People's Defence Force. The volunteers are 18-40 years old and have been evaluated for 18 months. The trial of Alvac-HIV vaccine developed by Pasteur Manieux Connaught will be conducted by the Joint Clinical Research Council, a joint venture of Makerere University and the Ministries of Health and Defence, in collaboration with the Johns Hopkins University. The vaccine has already been tested on 300 volunteers in France and the US. The initial stage of testing will involve a randomized, placebo-controlled, double-blind trial comparing the safety and immunogenicity of four successive injections in 20 HIV-negative and 20 HIV-positive volunteers. Follow-up will continue for a year. While volunteers will get free medical attention if they develop a severe reaction to the vaccine and will receive a full explanation about the experimental nature of the vaccine, it has not been determined how volunteers will be compensated if something unforeseen goes wrong. Additional concerns revolve around Uganda's readiness to institute proper legal controls and ethical standards in cases of biomedical research.

Recommendations for control of East african sleeping sickness in Uganda.

PubMed

Kotlyar, Simon

2010-01-01

East African sleeping sickness, caused by Trypanosoma brucei rhodesiense, is prominent in Uganda and poses a serious public health challenge in the region. This publication attempts to provide key components for designing a strategy for a nationwide initiative to provide insecticide-treatment of the animal reservoir to control T. b. rhodesiense. The contents of this article will focus on insecticide-based vector control strategies, monitoring and evaluation framework, and knowledge gaps required for future initiatives.

Knowledge and Behavioural Factors Associated with Gender Gap in Acquiring HIV Among Youth in Uganda.

PubMed

Patra, Shraboni; Singh, Rakesh Kumar

2015-07-16

The increasing prevalence of HIV in Uganda during the last decade (7.5% in 2004-05 to 8.3% in 2011 among women and 5.0% in 2004-05 to 6.1% among men in 2011 of 15 to 49 years) clearly shows that women are disproportionately affected by HIV epidemic. Hence, we assessed the prevalence of HIV and focused on differences in risky sexual behaviour and knowledge of HIV among Ugandan youth. Uganda AIDS Indicator Survey 2011 data was used. The total samples of men and women (15 to 24 years), interviewed and tested for HIV, were 3450 and 4504 respectively. The analysis of risky sexual behaviour was based on 1941 men and 3127 women who had ever had sex and were tested for HIV. Pearson's Chi-square test and multivariate logistic regression analysis were used. Findings showed that young women were almost two times more vulnerable than young men in acquiring HIV (OR=1.762, P<0.001). Women who had first sex under age 15 (7.3%), had more than 2 sexual partners (9.2%) and did not use condom during last sex (6.4%) were more HIV-positive. Higher risk was found among women (6.3%) than men (2.2%). Significantly (P<0.01) less percentage (81.3%) of women as compared to men (83.8%) perceived that the probability of HIV transmission may be reduced by correct and consistent use of the condom during sex. Hence, there is an urgent need for effective strategies and programmes to raise awareness on sexual health and risky behaviour, particularly targeting the youth, which will reduce the gender gap in risky sexual behaviour and new transmission of HIV in Uganda. Significance for public healthThe present study represents the evidence of a recent increase in HIV infection in Uganda from the latest round of AIDs indicator survey. This manuscript describes how young women (15-24 years-old) are disproportionately HIV-infected compared to young men in Uganda. They are more vulnerable to HIV than young men. Moreover, it is also observed that young women are at greater risk of acquiring HIV because of

Molecular characterization and phylogenetic study of African swine fever virus isolates from recent outbreaks in Uganda (2010–2013)

PubMed Central

2013-01-01

Background African swine fever (ASF) is a highly lethal and economically significant disease of domestic pigs in Eastern Africa particularly in Uganda where outbreaks regularly occur. Sequence analysis of variable genome regions have been extensively used for molecular epidemiological studies of African swine fever virus (ASFV) isolates. By combining p72, P54 and pB602L (CVR), a high level resolution approach is achieved for viral discrimination. The major aim of this study therefore, was to investigate the genetic relatedness of ASF outbreaks that occurred between 2010 and 2013 in Uganda to contribute to the clarification of the epidemiological situation over a four year period. Methods Tissue samples from infected domestic pigs associated with an ASF outbreak from 15 districts in Uganda were confirmed as being infected with ASFV using a p72 gene-based polymerase chain reaction amplification (PCR) assay recommended by OIE. The analysis was conducted by genotyping based on sequence data from three single copy ASFV genes. The E183L gene encoding the structural protein P54 and part of the gene encoding the p72 protein was used to delineate genotypes. Intra-genotypic resolution of viral relationships was achieved by analysis of tetramer amino acid repeats within the hypervariable CVR of the B602L gene. Results Twenty one (21) ASF outbreaks were confirmed by the p72 ASF diagnostic PCR, however; only 17 isolates were successfully aligned after sequencing. Our entire isolates cluster with previous ASF viruses in genotype IX isolated in Uganda and Kenya using p72 and P54 genes. Analysis of the CVR gene generated three sub-groups one with 23 tetrameric amino acid repeats (TRS) with an additional CAST sequence, the second with 22 TRS while one isolate Ug13. Kampala1 had 13 TRS. Conclusion We identified two new CVR subgroups different from previous studies. This study constitutes the first detailed assessment of the molecular epidemiology of ASFV in domestic pigs in the

The Global Fund Secretariat's suspension of funding to Uganda: how could this have been avoided?

PubMed Central

Kapiriri, Lydia; Martin, Douglas K.

2006-01-01

In August 2005, the Global Fund to fight AIDS, Tuberculosis and Malaria (the Global Fund) Secretariat suspended its five grants to Uganda following a PricewaterhouseCoopers audit report that exposed gross mismanagement in the Project Management Unit. How could this have been avoided? How can other countries avoid a similar pitfall? We argue that if a legitimate and fair decision-making process were used, the suspension of funding to Uganda could have been avoided, and that this lesson should be applied to other countries. The "accountability for reasonableness" framework of relevance, publicity, revisions and enforcement would help in implementing legitimate and fair decision-making processes, which would improve effectiveness, accountability and transparency in the implementation of Global Fund programmes, preventing future suspension of funding to any Global Fund projects. PMID:16878232

A lifetime as TBA in Uganda.

PubMed

Kanabahita, C

1993-01-01

A 64-year old traditional birth attendant (TBA), Zowe Namasiga, in Kyobe county in the Rakai district of Uganda, delivered her 1st baby when she was 12 years old. She learned how to deliver babies by watching her father deliver babies. She married at 14 and had 7 children of her own. She delivered 2 of her own children all alone. She attended a 1-week workshop for TBAs hosted by World Vision International and attended by 52 other TBAs. The medical services that exist in rural Uganda and tend to be of low quality. The leading problem for pregnant women in Rakai district in insufficient transport. The closest clinic is 8 miles away from where the workshop was held, but it has no midwives and the staff are not trained to deliver babies. The ratio of midwife to women of reproductive age in Rakai district is 1:5000. Ms. Namasiga has to refer high risk patients to Kitovu Hospital, a distance of 62 km. In the workshop, illustrations of male and female reproductive systems helped them learn that the uterus is not connected to the digestive system. The TBAs learned about the importance of hygiene and of encouraging women to seek prenatal care and to receive tetanus toxoid injections. The workshop taught them how to identify high risk women and to refer them to the hospital. Few women go to the hospital, though, because town midwives do not treat them kindly. One participant described how she keeps premature babies alive: wraps them and places them in a circle of 5-liter metal cans filled with warm water. TBAs are concerned about AIDS. In fact, the last grandchild Ms. Namasiga delivered was born to parents with AIDS. She delivers babies with her bare hands, but now asks for payment so she can buy gloves to protect her cracked hands. Most TBAs care for AIDS orphans. TBAs assist at 90% of deliveries in this rural district.

Sexually transmitted diseases in the history of Uganda.

PubMed

Lyons, M

1994-04-01

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.

Disease diagnosis in primary care in Uganda.

PubMed

Mbonye, Martin Kayitale; Burnett, Sarah M; Colebunders, Robert; Naikoba, Sarah; Van Geertruyden, Jean-Pierre; Weaver, Marcia R; Ronald, Allan

2014-10-08

The overall burden of disease (BOD) especially for infectious diseases is higher in Sub-Saharan Africa than other regions of the world. Existing data collected through the Health Management Information System (HMIS) may not be optimal to measure BOD. The Infectious Diseases Capacity Building Evaluation (IDCAP) cooperated with the Ugandan Ministry of Health to improve the quality of HMIS data. We describe diagnoses with associated clinical assessments and laboratory investigations of outpatients attending primary care in Uganda. IDCAP supported HMIS data collection at 36 health center IVs in Uganda for five months (November 2009 to March 2010) prior to implementation of the IDCAP interventions. Descriptive analyses were performed on a cross-sectional dataset of 209,734 outpatient visits during this period. Over 500 illnesses were diagnosed. Infectious diseases accounted for 76.3% of these and over 30% of visits resulted in multiple diagnoses. Malaria (48.3%), cough/cold (19.4%), and intestinal worms (6.6%) were the most frequently diagnosed illnesses. Body weight was recorded for 36.8% of patients and less than 10% had other clinical assessments recorded. Malaria smears (64.2%) and HIV tests (12.2%) accounted for the majority of 84,638 laboratory tests ordered. Fewer than 30% of patients for whom a laboratory investigation was available to confirm the clinical impression had the specific test performed. We observed a broad range of diagnoses, a high percentage of multiple diagnoses including true co-morbidities, and underutilization of laboratory support. This emphasizes the complexity of illnesses to be addressed by primary healthcare workers. An improved HMIS collecting timely, quality data is needed. This would adequately describe the burden of disease and processes of care at primary care level, enable appropriate national guidelines, programs and policies and improve accountability for the quality of care.

Cognitive Abilities of Pre- and Primary School Children with Spina Bifida in Uganda

ERIC Educational Resources Information Center

Bannink, Femke; Fontaine, Johnny R. J.; Idro, Richard; van Hove, Geert

2016-01-01

This study investigates cognitive abilities of pre/primary school children without and with spina bifida in Uganda. Qualitative semi structured interviews and quantitative functioning scales measurements were combined and conducted with 133 parents, 133 children with spina bifida, and 35 siblings. ANCOVA was used to test for differences in…

Prevalence of cerebral palsy in Uganda: a population-based study.

PubMed

Kakooza-Mwesige, Angelina; Andrews, Carin; Peterson, Stefan; Wabwire Mangen, Fred; Eliasson, Ann Christin; Forssberg, Hans

2017-12-01

Few population-based studies of cerebral palsy have been done in low-income and middle-income countries. We aimed to examine cerebral palsy prevalence and subtypes, functional impairments, and presumed time of injury in children in Uganda. In this population-based study, we used a nested, three-stage, cross-sectional method (Iganga-Mayuge Health and Demographic Surveillance System [HDSS]) to screen for cerebral palsy in children aged 2-17 years in a rural eastern Uganda district. A specialist team confirmed the diagnosis and determined the subtype, motor function (according to the Gross Motor Function Classification System [GMFCS]), and possible time of brain injury for each child. Triangulation and interviews with key village informants were used to identify additional cases of suspected cerebral palsy. We estimated crude and adjusted cerebral palsy prevalence. We did χ 2 analyses to examine differences between the group screened at stage 1 and the entire population and regression analyses to investigate associations between the number of cases and age, GMFCS level, subtype, and time of injury. We used data from the March 1, 2015, to June 30, 2015, surveillance round of the Iganga-Mayuge HDSS. 31 756 children were screened for cerebral palsy, which was confirmed in 86 (19%) of 442 children who screened positive in the first screening stage. The crude cerebral palsy prevalence was 2·7 (95% CI 2·2-3·3) per 1000 children, and prevalence increased to 2·9 (2·4-3·6) per 1000 children after adjustment for attrition. The prevalence was lower in older (8-17 years) than in younger (<8 years) children. Triangulation added 11 children to the cohort. Spastic unilateral cerebral palsy was the most common subtype (45 [46%] of 97 children) followed by bilateral cerebral palsy (39 [40%] of 97 children). 14 (27%) of 51 children aged 2-7 years had severe cerebral palsy (GMFCS levels 4-5) compared with only five (12%) of 42 children aged 8-17 years. Few children (two [2%] of

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

Magnetic Braking Revisited: Activities for the Undergraduate Laboratory

ERIC Educational Resources Information Center

Ireson, Gren; Twidle, John

2008-01-01

This paper revisits the demonstration of Lenz by dropping magnets down a non-magnetic tube. Recent publications are reviewed and ideas for undergraduate laboratory investigations are suggested. Finally, an example of matching theory to observation is presented. (Contains 4 tables, 5 figures and 3 footnotes.)

Country watch: Uganda.

PubMed

Namutebi, S K

1996-01-01

During its work in Rakai district, CONCERN recognized that women lack property/inheritance rights, a situation which increases their vulnerability to HIV infection. Widows are being disinherited of all their properties, including their marital homes. Since many of these women lack both education and skills, their survival often depends upon either marrying again or engaging in sex work. Many women are ignorant of their rights under the national law. Lawyers from the Ugandan Women Lawyers Association help women and children understand their rights, but they do not provide continuously available services. CONCERN therefore initiated a program of community-based legal educators (paralegals) selected by village communities and recommended by local leaders. The paralegals must be over age 28 years, respected by the community, able to maintain confidentiality, and have participated in previous HIV/AIDS sensitization work. Selected candidates are subsequently trained by lawyers from a governmental ministry in the basics of the law pertaining to sexual abuse, marriage, inheritance, divorce, domestic violence, children's rights and responsibilities, and the legal system in Uganda, as well as referrals, gender sensitization, and adult education methods. The paralegals now provide awareness seminars in their communities which include brainstorming, role plays, use of picture codes, group discussions, and lectures.

The Effects of Korean Medical Service Quality and Satisfaction on Revisit Intention of the United Arab Emirates Government Sponsored Patients.

PubMed

Lee, Seoyoung; Kim, Eun-Kyung

2017-06-01

The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.

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…

Instructional Supervision and the Pedagogical Practices of Secondary School Teachers in Uganda

ERIC Educational Resources Information Center

Malunda, Paul; Onen, David; Musaazi, John C. S.; Oonyu, Joseph

2016-01-01

This paper looks at the effect of instructional supervision by school authorities on the pedagogical practices of teachers in public secondary schools in Uganda. To date, research into this field in the country has focused more on the technicalities of supervision rather than on how the teachers have been responding to it. The study employed a…

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

Characterization and distribution of a Potyvirus associated with passion fruit woodiness disease in Uganda

USDA-ARS?s Scientific Manuscript database

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...

'Better medicines for children' within the Integrated Management of Childhood Illness framework: a qualitative inquiry in Uganda.

PubMed

Nsabagasani, Xavier; Ogwal-Okeng, Japer; Hansen, Ebba Holme; Mbonye, Anthony; Muyinda, Herbert; Ssengooba, Freddie

2016-01-01

The Integrated Management of Childhood Illnesses is the main approach for treating children in more than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate 'better medicines for children' into their essential medicines lists and treatment guidelines. WHO regularly provides generic algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based on new evidence for member countries to adopt. However, the status of 'better medicines for children' within the Integrated Management of Childhood Illnesses approach in Uganda has not been studied. Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Child-appropriate dosage formulations were not included in the package for the Integrated Management of Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance from the World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do support supervision and update treatment guidelines to reflect 'better medicines for children'. Health workers reported difficulties in administering tablets and capsules to under-five children and that's why they preferred liquid oral dosage formulations, suppositories and injections. The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations - a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for the Integrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List of Uganda, the Uganda Clinical Guidelines and, the Treatment Charts for the

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

PubMed

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

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. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. 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. 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 planning and thus reduce the rapid population growth and poverty.

Current algebra, statistical mechanics and quantum models

NASA Astrophysics Data System (ADS)

Vilela Mendes, R.

2017-11-01

Results obtained in the past for free boson systems at zero and nonzero temperatures are revisited to clarify the physical meaning of current algebra reducible functionals which are associated to systems with density fluctuations, leading to observable effects on phase transitions. To use current algebra as a tool for the formulation of quantum statistical mechanics amounts to the construction of unitary representations of diffeomorphism groups. Two mathematical equivalent procedures exist for this purpose. One searches for quasi-invariant measures on configuration spaces, the other for a cyclic vector in Hilbert space. Here, one argues that the second approach is closer to the physical intuition when modelling complex systems. An example of application of the current algebra methodology to the pairing phenomenon in two-dimensional fermion systems is discussed.

Carbon emission from global hydroelectric reservoirs revisited.

PubMed

Li, Siyue; Zhang, Quanfa

2014-12-01

Substantial greenhouse gas (GHG) emissions from hydropower reservoirs have been of great concerns recently, yet the significant carbon emitters of drawdown area and reservoir downstream (including spillways and turbines as well as river reaches below dams) have not been included in global carbon budget. Here, we revisit GHG emission from hydropower reservoirs by considering reservoir surface area, drawdown zone and reservoir downstream. Our estimates demonstrate around 301.3 Tg carbon dioxide (CO2)/year and 18.7 Tg methane (CH4)/year from global hydroelectric reservoirs, which are much higher than recent observations. The sum of drawdown and downstream emission, which is generally overlooked, represents 42 % CO2 and 67 % CH4 of the total emissions from hydropower reservoirs. Accordingly, the global average emissions from hydropower are estimated to be 92 g CO2/kWh and 5.7 g CH4/kWh. Nonetheless, global hydroelectricity could currently reduce approximate 2,351 Tg CO2eq/year with respect to fuel fossil plant alternative. The new findings show a substantial revision of carbon emission from the global hydropower reservoirs.

The Testimony of Neoliberal Contradiction in Education Choice and Privatisation in a Poor Country: The Case of a Private, Undocumented Rural Primary School in Uganda

ERIC Educational Resources Information Center

Mayengo, Nathaniel; Namusoke, Jane; Dennis, Barbara

2015-01-01

With international momentum to achieve "Education for All" by 2015, global attention is being paid to those parts of the world where mass formal primary schooling is relatively new. Uganda is such a place. In the context of ethnographic fieldwork at a poor, undocumented, private primary school in rural Uganda, parents were interviewed in…

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…

The Effect of 5S-Continuous Quality Improvement-Total Quality Management Approach on Staff Motivation, Patients’ Waiting Time and Patient Satisfaction with Services at Hospitals in Uganda

PubMed Central

Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru

2015-01-01

This study aimed at analyzing the effect of 5S practice on staff motivation, patients’ waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement. PMID:28299136

The Effect of 5S-Continuous Quality Improvement-Total Quality Management Approach on Staff Motivation, Patients' Waiting Time and Patient Satisfaction with Services at Hospitals in Uganda.

PubMed

Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru

2015-03-31

This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.

Brucellosis in cattle and micro-scale spatial variability of pastoral household income from dairy production in south western Uganda.

PubMed

Nina, Pius Mbuya; Mugisha, Samuel; Leirs, Herwig; Basuta, Gilbert Isabirye; Van Damme, Patrick

2017-11-01

Brucellosis in cattle and humans has received world-wide research attention as a neglected and re-emerging zoonotic disease with many routes of transmission. Studies of brucellosis in Uganda have emphasized occupational exposures and also revealed variations in prevalence levels by region and cattle production systems. To date, research linking pastoralist household income from dairy production to brucellosis and its transmission risk pathways do not exist in Uganda. We assessed whether spatial differences in unit milk prices can be explained by brucellosis prevalence in cattle along a distance gradient from Lake Mburo National Park in Uganda. Semi-structured interviews administered to 366 randomly selected household heads were supplemented with serological data on brucellosis in cattle. Statistical analysis included Pearson correlation test, multiple regression and analysis of variance (ANOVA) using SPSS version 17. Serological results showed that 44% of cattle blood samples were sero-positive for brucellosis. The results obtained from interviews put the statistical mean of household reported cattle abortions at 5.39 (5.08-5.70 at 95% CI, n=366). Post-hoc analysis of variance revealed that both sero-positive cattle and reported cattle abortions significantly were much lower when moving outwards from the park boundary (p<0.05), while the price of milk increased significantly (p<0.05) along the same distance gradient. Further studies should identify public and private partnerships needed to create and strengthen good zoonotic brucellosis management practices at the nexus of wildlife and livestock in Uganda. Copyright © 2016 Elsevier B.V. All rights reserved.

Economic evaluation of the Good School Toolkit: an intervention for reducing violence in primary schools in Uganda.

PubMed

Greco, Giulia; Knight, Louise; Ssekadde, Willington; Namy, Sophie; Naker, Dipak; Devries, Karen

2018-01-01

This paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda. The effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider's perspective to estimate total and unit costs. The total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial. The GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region.

Against a sea of troubles: AIDS control in Uganda.

PubMed

Magezi, M G

1991-01-01

HIV infection has spread at an alarming rate in Uganda and is continuing to do so. Polygamy and other long-standing cultural practices on the one hand, and certain life-styles adopted under Western influence on the other, have done much to make the AIDS epidemic so severe. Women are potentially a force for confronting the situation, provided that they are made aware of their rights and empowered to take decisive action in education and other fields in defence of themselves, their children and, indeed, the whole of society.

Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV

PubMed Central

Schuyler, Ashley C.; Edelstein, Zoe R.; Mathur, Sanyukta; Sekasanvu, Joseph; Nalugoda, Fred; Gray, Ronald; Wawer, Maria J.; Serwadda, David M.; Santelli, John S.

2015-01-01

Mobility, including migration and travel, influences risk of HIV. This study examined time trends and characteristics among mobile youth (15-24 years) in rural Uganda, and the relationship between mobility and risk factors for HIV. We used data from an annual household census and population-based cohort study in the Rakai district, Uganda. Data on in-migration and out-migration were collected among youth (15-24 years) from 43 communities from 1999-2011 (N=112,117 observations) and travel among youth residents from 2003-2008 (N=18,318 observations). Migration and travel were more common among young women than young men. One in five youth reported out-migration. Over time, out-migration increased among youth and in-migration remained largely stable. Primary reasons for migration included work, living with friends or family, and marriage. Recent travel within Uganda was common and increased slightly over time in teen women (15-19 years old), and young adult men and women (20-24 years old). Mobile youth were more likely to report HIV risk behaviours including: alcohol use, sexual experience, multiple partners, and inconsistent condom use. Our findings suggest that among rural Ugandan youth, mobility is increasingly common and associated with HIV risk factors. Knowledge of patterns and characteristics of a young, high-risk mobile population has important implications for HIV interventions. PMID:26313708

Epidemiological and laboratory characterization of a yellow fever outbreak in northern Uganda, October 2010-January 2011.

PubMed

Wamala, Joseph F; Malimbo, Mugagga; Okot, Charles L; Atai-Omoruto, Ann D; Tenywa, Emmanuel; Miller, Jeffrey R; Balinandi, Stephen; Shoemaker, Trevor; Oyoo, Charles; Omony, Emmanuel O; Kagirita, Atek; Musenero, Monica M; Makumbi, Issa; Nanyunja, Miriam; Lutwama, Julius J; Downing, Robert; Mbonye, Anthony K

2012-07-01

In November 2010, following reports of an outbreak of a fatal, febrile, hemorrhagic illness in northern Uganda, the Uganda Ministry of Health established multisector teams to respond to the outbreak. This was a case-series investigation in which the response teams conducted epidemiological and laboratory investigations on suspect cases. The cases identified were line-listed and a data analysis was undertaken regularly to guide the outbreak response. Overall, 181 cases met the yellow fever (YF) suspected case definition; there were 45 deaths (case fatality rate 24.9%). Only 13 (7.5%) of the suspected YF cases were laboratory confirmed, and molecular sequencing revealed 92% homology to the YF virus strain Couma (Ethiopia), East African genotype. Suspected YF cases had fever (100%) and unexplained bleeding (97.8%), but jaundice was rare (11.6%). The overall attack rate was 13 cases/100000 population, and the attack rate was higher for males than females and increased with age. The index clusters were linked to economic activities undertaken by males around forests. This was the largest YF outbreak ever reported in Uganda. The wide geographical case dispersion as well as the male and older age preponderance suggests transmission during the outbreak was largely sylvatic and related to occupational activities around forests. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.

PubMed

Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif

2012-01-01

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.

Should the recommended number of IUD revisits be reduced?

PubMed

Janowitz, B; Hubacher, D; Petrick, T; Dighe, N

1994-01-01

This study uses data from clinical trials of intrauterine devices to examine the effect of reducing the recommended number of IUD follow-up visits. Over 11,000 follow-up forms were analyzed to estimate the number of health problems that would have escaped detection if women with no or mild symptoms had not made recommended revisits. Less than one percent of woman-visits with no or only mild symptoms had an underlying health risk that could have gone undetected if the follow-up visits that were made in the clinic trial setting had not been made. The results from this analysis suggest that a reduction in the number of recommended follow-up visits is safe, when measured according to selected conditions. Additional research is necessary to determine whether any revisits should be recommended in the absence of signs or symptoms.

Low Contraceptive Use among Young Females in Uganda: Does Birth History and Age at Birth have an Influence? Analysis of 2011 Demographic and Health Survey.

PubMed

Kabagenyi, Allen; Habaasa, Gilbert; Rutaremwa, Gideon

2016-01-26

Globally adolescent fertility has been associated with increased risk to maternal and child health morbidity and mortality. The low use of contraception has been associated with high fertility levels, which is remains a public health concern that efforts have been raised to avert this. We examine the influence history of a previous birth and age at first birth would have on young women's use of contraception. Using the 2011 Uganda Demographic and Health Survey data, we examine the predictors of contraceptive use on a sample of 3692 young females in Uganda. While controlling for education and age of respondents, logistic regression analyses were run to provide the net effect of the examined predictors on contraceptive use. The study variables included age of respondents, marital status, age at first birth, births in past five years, socioeconomic status, residence, region, education level, religion, occupation and whether the last child was wanted. The findings show that only 12% of the adolescents were using contraception at the time of the survey. The key predictors of contraceptive use among young women in Uganda were age at first birth, history of previous birth, current age, and place of residence, education and socioeconomic status. Respondents who had a birth in the 5 years prior to the survey had five times (OR = 5.0, 95% CI = 3.7-6.5) the odds of contraceptive use compared to those who had never had a birth. Further, adolescent females with at least a secondary education were more likely to use contraceptives (OR = 1.55, 95% CI = 1.2-2.0) than those with primary education. The odds of contraceptive use were least among adolescents from Northern region (OR = 0.39, 95% CI = 0.2-0.6) compared to those from central region of Uganda. Muslim adolescent females were more likely to use contraceptives compared to Catholics (OR = 1.59, 95% CI = 1.1-2.3). There is great need to address issues that hinder young people from using contraception. Use of contraception and

Factors associated with occupancy of pharmacist positions in public sector hospitals in Uganda: a cross-sectional study.

PubMed

Obua, Thomas Ocwa; Adome, Richard Odoi; Kutyabami, Paul; Kitutu, Freddy Eric; Kamba, Pakoyo Fadhiru

2017-01-05

Pharmacists are invaluable resources in health care. Their expertise in pharmacotherapy and medicine management both ensures that medicines of appropriate quality are available in health facilities at the right cost and are used appropriately. Unfortunately, some countries like Uganda have shortage of pharmacists in public health facilities, the dominant providers of care. This study investigated the factors that affect the occupancy of pharmacist positions in Uganda's public hospitals, including hiring patterns and job attraction and retention. A cross-sectional survey of 91 registered pharmacists practicing in Uganda and desk review of records from the country's health care worker (HCW) recruiting agency was done in the months of May, June, and July, 2016. Pharmacist interviews were done using self-administered structured questionnaire and analyzed by descriptive statistics and chi-square test. Slight majority (53%) of the interviewed pharmacists work in two sectors. About 60% of the pharmacists had ever applied for public hospital jobs. Of those who received offers (N = 46), 30% had declined them. Among those who accepted the offers (N = 41), 41% had already quit. Meanwhile, the pace of hiring pharmacists into Uganda's public sector is too slow. Low socio-economic status of family in childhood (χ 2  = 2.77, p = 0.10), admission through matriculation and diploma scheme (χ 2  = 2.37, p = 0.12), internship in countryside hospitals (χ 2  = 2.24, p = 0.13), working experience before pharmacy school (χ 2  = 2.21, p = 0.14), salary expectation (χ 2  = 1.76, p = 0.18), and rural secondary education (χ 2  = 1.75, p = 0.19) favored attraction but in a statistically insignificant manner. Retention was most favored by zero postgraduate qualification (χ 2  = 4.39, p = 0.04), matriculation and diploma admission scheme (χ 2  = 2.57, p = 0.11), and working experience in private sector (χ 2  = 2

Revisiting the positive DC corona discharge theory: Beyond Peek's and Townsend's law

NASA Astrophysics Data System (ADS)

Monrolin, Nicolas; Praud, Olivier; Plouraboué, Franck

2018-06-01

The classical positive Corona Discharge theory in a cylindrical axisymmetric configuration is revisited in order to find analytically the influence of gas properties and thermodynamic conditions on the corona current. The matched asymptotic expansion of Durbin and Turyn [J. Phys. D: Appl. Phys. 20, 1490-1495 (1987)] of a simplified but self-consistent problem is performed and explicit analytical solutions are derived. The mathematical derivation enables us to express a new positive DC corona current-voltage characteristic, choosing either a dimensionless or dimensional formulation. In dimensional variables, the current voltage law and the corona inception voltage explicitly depend on the electrode size and physical gas properties such as ionization and photoionization parameters. The analytical predictions are successfully confronted with experiments and Peek's and Townsend's laws. An analytical expression of the corona inception voltage φ o n is proposed, which depends on the known values of physical parameters without adjustable parameters. As a proof of consistency, the classical Townsend current-voltage law I = C φ ( φ - φ o n ) is retrieved by linearizing the non-dimensional analytical solution. A brief parametric study showcases the interest in this analytical current model, especially for exploring small corona wires or considering various thermodynamic conditions.

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…

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.…

Proportion of Deaths and Clinical Features in Bundibugyo Ebola Virus Infection, Uganda

PubMed Central

Farnon, Eileen C.; Wamala, Joseph; Okware, Sam; Cannon, Deborah L.; Reed, Zachary; Towner, Jonathan S.; Tappero, Jordan W.; Lutwama, Julius; Downing, Robert; Nichol, Stuart T.; Ksiazek, Thomas G.; Rollin, Pierre E.

2010-01-01

The first known Ebola hemorrhagic fever (EHF) outbreak caused by Bundibugyo Ebola virus occurred in Bundibugyo District, Uganda, in 2007. Fifty-six cases of EHF were laboratory confirmed. Although signs and symptoms were largely nonspecific and similar to those of EHF outbreaks caused by Zaire and Sudan Ebola viruses, proportion of deaths among those infected was lower (≈40%). PMID:21122234

The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda.

PubMed

Chi, Primus Che; Urdal, Henrik

2018-01-01

Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of 'birth companions'. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on

Science education policy for emergency, conflict, and post-conflict: An analysis of trends and implications for the science education program in Uganda

NASA Astrophysics Data System (ADS)

Udongo, Betty Pacutho

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 guided by the following questions: (1) What is the level of government funding towards improving science education program in Uganda? (2) Have recent initiatives, such as free Primary and Secondary education, compulsory science, and 75% sponsorship for science-based courses, had a measurable impact on the proportion of students from the conflict-affected regions who enter tertiary institutions to pursue science and technology programs? (3) To what extent do the Ugandan Education Policy and, in particular, the Science Education Policy effectively address the educational needs of students affected by armed conflicts? The study employed a mixed method design where both quantitative and qualitative data were collected and analyzed. Quantitative data were obtained from a comprehensive search of policy documents and content analysis of literature on education policy, science education programs, and impact of conflicts on educational delivery. Qualitative data were obtained from surveys and interviews distributed to policy makers, central government and the local government officials, teachers, and students from the war-ravaged Northern Uganda. Analysis of policy documents and respondents' views revealed that Uganda does not have a science education policy, and the present education policy does not fully address the educational needs of students studying in conflict-affected regions. It was further observed that fewer students from the conflict-affected regions qualify for government scholarship to study science courses in higher institutions of learning. The study recommended the following policy interventions: (a) affirmative

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

Personal accounts of 'near-miss' maternal mortalities in Kampala, Uganda.

PubMed

Weeks, Andrew; Lavender, Tina; Nazziwa, Enid; Mirembe, Florence

2005-09-01

To explore the socio-economic determinants of maternal mortality in Uganda through interviews with women who had 'near-misses'. Observational study using qualitative research methods. The postnatal and gynaecology wards of a large government hospital in Kampala, Uganda. Thirty women who had narrowly avoided maternal deaths with diagnoses of obstructed labour (7), severe pre-eclampsia/eclampsia (3), post caesarean infection (6), haemorrhage (5), ectopic pregnancy (5) and septic abortion (4). The semi-structured interviews were conducted in the local language by a woman unconnected to the hospital, and were recorded before being translated and transcribed. Analysis was conducted in duplicate using commercial software. The predominant theme was powerlessness, which occurred both within and outside the hospital. It was evident in the women's attempts to get both practical and financial help from those around them as well as in their failure to gain rapid access to care. Financial barriers and problems with transport primarily governed health-seeking behaviour. Medical mistakes and delays in referral were evident in many interviews, especially in rural health centres. Women were appreciative of the care they received from the central government hospital, although there were reports of overcrowding, long delays, shortages and inhumane care. There were no reports of bribery. Women with near-miss maternal mortalities experience institutional and social powerlessness: these factors may be a major contributor to maternal mortality.

Household perceptions and subjective valuations of indoor residual spraying programmes to control malaria in northern Uganda.

PubMed

Brown, Zachary S; Kramer, Randall A; Ocan, David; Oryema, Christine

2016-10-06

Insecticide-based tools remain critical for controlling vector-borne diseases in Uganda. Securing public support from targeted populations for such tools is an important component in sustaining their long-run effectiveness. Yet little quantitative evidence is available on the perceived benefits and costs of vector control programmes among targeted households. A survey was administered to a clustered random sample of 612 households in Gulu and Oyam districts of northern Uganda during a period of very high malaria transmission and following a pilot indoor residual spray (IRS) programme. A discrete choice experiment was conducted within the survey, in which respondents indicated their preferences for different IRS programmes relative to money compensation in a series of experimentally controlled, hypothetical choice sets. The data were analysed using conditional logit regression models to estimate respondents' willingness to accept (WTA) some amount of money compensation in lieu of foregone malaria risk reductions. Latent class models were used to analyse whether respondent characteristics predicted WTA. Average WTA is estimated at $8.94 annually for a 10 % reduction in malaria risk, and additional co-benefits of IRS were estimated to be worth on average $54-$56 (depending on insecticide type) per round of IRS. Significant heterogeneity is observed: Four in five household heads in northern Uganda have high valuations for IRS programmes, while the remaining 20 % experience costly side effects of IRS (valued at between $2 and $3 per round). Statistically significant predictors of belonging to the high-value group include respondent gender, mean age of household members, participation in previous IRS, basic knowledge of mosquito reproduction, and the number of mosquito nets owned. Proxies for household income and wealth are not found to be statistically significant predictors of WTA. This study suggests that the majority of people in areas of high malaria transmission

Cell phone usage among adolescents in Uganda: acceptability for relaying health information

PubMed Central

Mitchell, Kimberly J.; Bull, Sheana; Kiwanuka, Julius; Ybarra, Michele L.

2011-01-01

The increase in cell phone use has manifested a growing interest in using this technology for health promotion. The portability and ‘always on’ features of the cell phone, along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years. Self-reported quantitative survey data from 1503 secondary school students in Mbarara, Uganda collected in 2008–2009 suggest that 27% currently have cell phones and about half (51%) of all students and 61% of those who owned a cell phone believe that they would access a text messaging-based HIV prevention program if it were available. Other forms of program delivery modality (e.g. Internet, religious organizations, schools) were preferred to text messaging however. We are in need of effective HIV prevention programs that can reach large audiences at low cost and are culturally relevant for the East African context. Researchers are encouraged to consider translation of effective HIV prevention programs for cell phone delivery in Africa. PMID:21536715

The Association Between Limited English Proficiency and Unplanned Emergency Department Revisit Within 72 Hours.

PubMed

Ngai, Ka Ming; Grudzen, Corita R; Lee, Roy; Tong, Vicky Y; Richardson, Lynne D; Fernandez, Alicia

2016-08-01

Language barriers are known to negatively affect many health outcomes among limited English proficiency patient populations, but little is known about the quality of care such patients receive in the emergency department (ED). This study seeks to determine whether limited English proficiency patients experience different quality of care than English-speaking patients in the ED, using unplanned revisit within 72 hours as a surrogate quality indicator. We conducted a retrospective cohort study in an urban adult ED in 2012, with a total of 41,772 patients and 56,821 ED visits. We compared 2,943 limited English proficiency patients with 38,829 English-speaking patients presenting to the ED after excluding patients with psychiatric complaints, altered mental status, and nonverbal states, and those with more than 4 ED visits in 12 months. Two main outcomes-the risk of inpatient admission from the ED and risk of unplanned ED revisit within 72 hours-were measured with odds ratios from generalized estimating equation multivariate models. Limited English proficiency patients were more likely than English speakers to be admitted (32.0% versus 27.2%; odds ratio [OR]=1.20; 95% confidence interval [CI] 1.11 to 1.30). This association became nonsignificant after adjustments (OR=1.04; 95% CI 0.95 to 1.15). Included in the analysis of ED revisit within 72 hours were 32,857 patients with 45,546 ED visits; 4.2% of all patients (n=1,380) had at least 1 unplanned revisit. Limited English proficiency patients were more likely than English speakers to have an unplanned revisit (5.0% versus 4.1%; OR=1.19; 95% CI 1.02 to 1.45). This association persisted (OR=1.24; 95% CI 1.02 to 1.53) after adjustment for potential confounders, including insurance status. We found no difference in hospital admission rates between limited English proficiency patients and English-speaking patients. Yet limited English proficiency patients were 24% more likely to have an unplanned ED revisit within 72 hours

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

PubMed

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

2012-05-31

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. 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". 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. 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.

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

Satellite failures revisited

NASA Astrophysics Data System (ADS)

Balcerak, Ernie

2012-12-01

In January 1994, the two geostationary satellites known as Anik-E1 and Anik-E2, operated by Telesat Canada, failed one after the other within 9 hours, leaving many northern Canadian communities without television and data services. The outage, which shut down much of the country's broadcast television for hours and cost Telesat Canada more than $15 million, generated significant media attention. Lam et al. used publicly available records to revisit the event; they looked at failure details, media coverage, recovery effort, and cost. They also used satellite and ground data to determine the precise causes of those satellite failures. The researchers traced the entire space weather event from conditions on the Sun through the interplanetary medium to the particle environment in geostationary orbit.

Uganda's HIV prevention success: the role of sexual behavior change and the national response.

PubMed

Green, Edward C; Halperin, Daniel T; Nantulya, Vinand; Hogle, Janice A

2006-07-01

There has been considerable interest in understanding what may have led to Uganda's dramatic decline in HIV prevalence, one of the world's earliest and most compelling AIDS prevention successes. Survey and other data suggest that a decline in multi-partner sexual behavior is the behavioral change most likely associated with HIV decline. It appears that behavior change programs, particularly involving extensive promotion of "zero grazing" (faithfulness and partner reduction), largely developed by the Ugandan government and local NGOs including faith-based, women's, people-living-with-AIDS and other community-based groups, contributed to the early declines in casual/multiple sexual partnerships and HIV incidence and, along with other factors including condom use, to the subsequent sharp decline in HIV prevalence. Yet the debate over "what happened in Uganda" continues, often involving divisive abstinence-versus-condoms rhetoric, which appears more related to the culture wars in the USA than to African social reality.

Teachers' conflicting cultural schemas of teaching comprehensive school-based sexuality education in Kampala, Uganda.

PubMed

de Haas, Billie; Hutter, Inge

2018-05-08

Teachers can feel uncomfortable teaching sexuality education when the content conflicts with their cultural values and beliefs. However, more research is required to understand how to resolve conflicts between teachers' values and beliefs and those implicit in comprehensive approaches to sexuality education. This study uses cultural schema theory to identify teachers' cultural schemas of teaching sexuality education and the internal conflicts arising between them. In-depth interviews were conducted with 40 secondary school teachers in Kampala, the capital city of Uganda. Embedded in a context of morality, conflicting cultural schemas of sexuality education and young people's sexual citizenship in traditional and present-day Ugandan society were found: young people are both innocent and sexually active; sexuality education both encourages and prevents sexual activity; and teachers need to teach sexuality education, but it is considered immoral for them to do so. In countries such as Uganda, supportive school regulations and a mandate from society could help teachers feel more comfortable adopting comprehensive approaches to sexuality education.

OBSERVATIONS ON THE EFFECT OF RESIDUAL INSECTICIDES IN EXPERIMENTAL HUTS IN MASAKA DISTRICT, UGANDA.

PubMed

CULLEN, J R; DEZULUETA, J

1964-01-01

Observations made in Kigezi District, Uganda, had shown a great reduction in the number of Anopheles gambiae entering an experimental hut treated with DDT. The work reported in this paper confirms the phenomenon of reduced entry by A. gambiae and A. funestus in two experiments carried out in Masaka, another district of Uganda, using mud-walled huts, roofed with thatch or corrugated-iron sheets and sprayed with DDT and dieldrin. The fact that no similar reduction was observed with Mansonia (mansonioides) uniformis, a common species in the area, indicates the need to determine and take into account any reduction in the number of entering mosquitos when assessing the effect of residual insecticides. Of interest in these experiments was the finding that DDT and dieldrin produced satisfactory kills with all the local anopheline species in spite of their rapid sorption by the mud walls, an indication of the importance of thatch or metal roofs as a source of active insecticide.

Observations on the effect of residual insecticides in experimental huts in Masaka District, Uganda*

PubMed Central

Cullen, J. R.; de Zulueta, J.

1964-01-01

Observations made in Kigezi District, Uganda, had shown a great reduction in the number of Anopheles gambiae entering an experimental hut treated with DDT. The work reported in this paper confirms the phenomenon of reduced entry by A. gambiae and A. funestus in two experiments carried out in Masaka, another district of Uganda, using mud-walled huts, roofed with thatch or corrugated-iron sheets and sprayed with DDT and dieldrin. The fact that no similar reduction was observed with Mansonia (mansonioides) uniformis, a common species in the area, indicates the need to determine and take into account any reduction in the number of entering mosquitos when assessing the effect of residual insecticides. Of interest in these experiments was the finding that DDT and dieldrin produced satisfactory kills with all the local anopheline species in spite of their rapid sorption by the mud walls, an indication of the importance of thatch or metal roofs as a source of active insecticide. PMID:14153414

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. © The American Society of Tropical Medicine and Hygiene.

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

Parental stress and support of parents of children with spina bifida in Uganda.

PubMed

Bannink, Femke; Idro, Richard; van Hove, Geert

2016-01-01

Children with disabilities in Sub-Saharan Africa depend for a large part of their functioning on their parent or caregiver. This study explores parental stress and support of parents of children with spina bifida in Uganda. The study aimed to explore perceived stress and support of parents of children with spina bifida living in Uganda and the factors that influence them. A total of 134 parents were interviewed. Focus group discussions were held with four parent support groups in four different regions within the country. The Vineland Adaptive Behaviour Scales, Daily Functioning Subscales and Parental Stress Index Short Form (PSI/SF) were administered to measure the child's daily functioning level and parental stress levels. Parental stress was high in our study population with over half of the parents having a > 90% percentile score on the PSI/SF. Stress outcomes were related to the ability to walk (Spearman's correlation coefficient [ ρ ] = -0.245), continence ( ρ = -0.182), use of clean intermittent catheterisation (ρ = -0.181) and bowel management ( ρ = -0.213), receiving rehabilitative care ( ρ = -0.211), household income ( ρ = -0.178), geographical region ( ρ = -0.203) and having support from another parent in taking care of the child ( ρ = -0.234). Linear regression showed parental stress was mostly explained by the child's inability to walk ( β = -0.248), practicing bowel management ( β = -0.468) and having another adult to provide support in caring for the child ( β = -0.228). Parents in northern Uganda had significantly higher scores compared to parents in other regions (Parental Distress, F = 5.467*; Parent-Child Dysfunctional Interaction, F = 8.815**; Difficult Child score, F = 10.489**). Parents of children with spina bifida experience high levels of stress. To reduce this stress, rehabilitation services should focus on improving mobility. Advocacy to reduce stigmatisation and peer support networks also need to be strengthened and developed.

Molecular Epidemiology of Influenza A/H3N2 Viruses Circulating in Uganda

PubMed Central

Byarugaba, Denis K.; Ducatez, Mariette F.; Erima, Bernard; Mworozi, Edison A.; Millard, Monica; Kibuuka, Hannah; Lukwago, Luswa; Bwogi, Josephine; Kaira, Blanche B.; Mimbe, Derrick; Schnabel, David C.; Krauss, Scott; Darnell, Daniel; Webby, Richard J.; Webster, Robert G.; Wabwire-Mangen, Fred

2011-01-01

The increasing availability of complete influenza virus genomes is deepening our understanding of influenza evolutionary dynamics and facilitating the selection of vaccine strains. However, only one complete African influenza virus sequence is available in the public domain. Here we present a complete genome analysis of 59 influenza A/H3N2 viruses isolated from humans in Uganda during the 2008 and 2009 season. Isolates were recovered from hospital-based sentinel surveillance for influenza-like illnesses and their whole genome sequenced. The viruses circulating during these two seasons clearly differed from each other phylogenetically. They showed a slow evolution away from the 2009/10 recommended vaccine strain (A/Brisbane/10/07), instead clustering with the 2010/11 recommended vaccine strain (A/Perth/16/09) in the A/Victoria/208/09 clade, as observed in other global regions. All of the isolates carried the adamantane resistance marker S31N in the M2 gene and carried several markers of enhanced transmission; as expected, none carried any marker of neuraminidase inhibitor resistance. The hemagglutinin gene of the 2009 isolates differed from that of the 2008 isolates in antigenic sites A, B, D, and to a lesser extent, C and E indicating evidence of an early phylogenetic shift from the 2008 to 2009 viruses. The internal genes of the 2009 isolates were similar to those of one 2008 isolate, A/Uganda/MUWRP-050/2008. Another 2008 isolate had a truncated PB1-F2 protein. Whole genome sequencing can enhance surveillance of future seasonal changes in the viral genome which is crucial to ensure that selected vaccine strains are protective against the strains circulating in Eastern Africa. This data provides an important baseline for this surveillance. Overall the influenza virus activity in Uganda appears to mirror that observed in other regions of the southern hemisphere. PMID:22132146

Molecular Characterization of Salmonella from Human and Animal Origins in Uganda

PubMed Central

Kagirita, Atek Atwiine; Owalla, Tonny Jimmy; Majalija, Samuel

2017-01-01

Sporadic Salmonella outbreaks with varying clinical presentations have been on the rise in various parts of Uganda. The sources of outbreaks and factors underlying the different clinical manifestation are curtailed by paucity of information on Salmonella genotypes and the associated virulence genes. This study reports molecular diversity of Salmonella enterica and their genetic virulence profiles among human and animal isolates. Characterization was done using Kauffman-White classification scheme and virulence genes analysis using multiplex PCR. Overall, 52% of the isolates belonged to serogroup D, 16% to serogroup E, 15% to poly F, H-S, and 12% to serogroup B. Serogroups A, C1, and C2 each consisted of only one isolate representing 5%. Virulence genes located on SPI-1 [spaN and sipB] and on SPI-2 [spiA] in addition to pagC and msgA were equally distributed in isolates obtained from all sources. Plasmid encoded virulence gene spvB was found in <5% of isolates from both human epidemic and animal origins whereas it occurred in 80% of clinical isolates. This study reveals that serogroup D is the predominant Salmonella serogroup in circulation and it is widely shared among animals and humans and calls for joint and coordinated surveillance for one health implementation in Uganda. PMID:28634597

Identifying cholera "hotspots" in Uganda: An analysis of cholera surveillance data from 2011 to 2016

PubMed Central

Bwire, Godfrey; Sack, David A.; Nakinsige, Anne; Naigaga, Martha; Debes, Amanda K.; Ngwa, Moise C.; Brooks, W. Abdullah; Garimoi Orach, Christopher

2017-01-01

Background Despite advance in science and technology for prevention, detection and treatment of cholera, this infectious disease remains a major public health problem in many countries in sub-Saharan Africa, Uganda inclusive. The aim of this study was to identify cholera hotspots in Uganda to guide the development of a roadmap for prevention, control and elimination of cholera in the country. Methodology/Principle findings We obtained district level confirmed cholera outbreak data from 2011 to 2016 from the Ministry of Health, Uganda. Population and rainfall data were obtained from the Uganda Bureau of Statistics, and water, sanitation and hygiene data from the Ministry of Water and Environment. A spatial scan test was performed to identify the significantly high risk clusters. Cholera hotspots were defined as districts whose center fell within a significantly high risk cluster or where a significantly high risk cluster was completely superimposed onto a district. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. In total 11,030 cases of cholera were reported during the 6-year period. 37(33%) of 112 districts reported cholera outbreaks in one of the six years, and 20 (18%) districts experienced cholera at least twice in those years. We identified 22 districts as high risk for cholera, of which 13 were near a border of Democratic Republic of Congo (DRC), while 9 districts were near a border of Kenya. The relative risk of having cholera inside the high-risk districts (hotspots) were 2 to 22 times higher than elsewhere in the country. In total, 7 million people were within cholera hotspots. The negative binomial component of the ZINB model shows people living near a lake or the Nile river were at increased risk for cholera (incidence rate ratio, IRR = 0.98, 95% CI: 0.97 to 0.99, p < .01); people living near the border of DRC/Kenya or higher incidence rate in the neighboring districts were increased

Identifying cholera "hotspots" in Uganda: An analysis of cholera surveillance data from 2011 to 2016.

PubMed

Bwire, Godfrey; Ali, Mohammad; Sack, David A; Nakinsige, Anne; Naigaga, Martha; Debes, Amanda K; Ngwa, Moise C; Brooks, W Abdullah; Garimoi Orach, Christopher

2017-12-01

Despite advance in science and technology for prevention, detection and treatment of cholera, this infectious disease remains a major public health problem in many countries in sub-Saharan Africa, Uganda inclusive. The aim of this study was to identify cholera hotspots in Uganda to guide the development of a roadmap for prevention, control and elimination of cholera in the country. We obtained district level confirmed cholera outbreak data from 2011 to 2016 from the Ministry of Health, Uganda. Population and rainfall data were obtained from the Uganda Bureau of Statistics, and water, sanitation and hygiene data from the Ministry of Water and Environment. A spatial scan test was performed to identify the significantly high risk clusters. Cholera hotspots were defined as districts whose center fell within a significantly high risk cluster or where a significantly high risk cluster was completely superimposed onto a district. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. In total 11,030 cases of cholera were reported during the 6-year period. 37(33%) of 112 districts reported cholera outbreaks in one of the six years, and 20 (18%) districts experienced cholera at least twice in those years. We identified 22 districts as high risk for cholera, of which 13 were near a border of Democratic Republic of Congo (DRC), while 9 districts were near a border of Kenya. The relative risk of having cholera inside the high-risk districts (hotspots) were 2 to 22 times higher than elsewhere in the country. In total, 7 million people were within cholera hotspots. The negative binomial component of the ZINB model shows people living near a lake or the Nile river were at increased risk for cholera (incidence rate ratio, IRR = 0.98, 95% CI: 0.97 to 0.99, p < .01); people living near the border of DRC/Kenya or higher incidence rate in the neighboring districts were increased risk for cholera in a district (IRR = 0

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,…

Children's Social Play Sequence: Parten's Classic Theory Revisited

ERIC Educational Resources Information Center

Xu, Yaoying

2010-01-01

The purpose of this article is to revisit Parten's study on social play from cultural, environmental, social and economic aspects. Young children's social play is viewed as a critical means to foster and enhance language, cognitive, social and emotional development. Social play theory has been predominately viewed from developmental perspectives.…

Synchronous distance anesthesia education by Internet videoconference between Uganda and the United States.

PubMed

Kiwanuka, J K; Ttendo, S S; Eromo, E; Joseph, S E; Duan, M E; Haastrup, A A; Baker, K; Firth, P G

2015-09-01

We evaluated the effectiveness of anesthesia education delivered via Internet videoconferencing between the Massachusetts General Hospital, Boston, MA, and Mbarara Regional Referral Hospital, Uganda. This is a prospective educational study. The setting is the education in 2 hospitals in Uganda and the United States. The subjects are anesthesia residents. The interventions are anesthesia education lectures delivered in person and via Internet videoconferencing. The average pre-lecture and post-lecture scores of the local, remote, and combined audiences were compared. Post-lecture test scores improved over pre-lecture scores: local audience, 59% ± 22% to 81% ± 16%, P = .0002, g = 1.144; remote audience, 51% ± 19% to 81% ± 8%, P < .0001, g = 2.058; and combined scores, 56% ± 14% to 82% ± 8%, P < .0001, g = 2.069). Transfer of anesthetic knowledge occurs via small group lectures delivered both in person and remotely via synchronous Internet videoconferencing. This technique may be useful to expand educational capacity and international cooperation between academic institutions, a particular priority in the growing field of global health. Copyright © 2015 Elsevier Inc. All rights reserved.

Women survivors and their children born of wartime sexual violence in northern Uganda.

PubMed

Atim, Teddy; Mazurana, Dyan; Marshak, Anastasia

2018-01-01

Girls and women who bear children owing to wartime sexual violence committed by armed actors face challenges in gaining acceptance on return to their families and societies. This study analyses the lives of women survivors and their children born of wartime sexual violence in Uganda. It draws on a population-based survey of 1,844 households in the Acholi and Lango sub-regions of northern Uganda, as well as on in-depth qualitative interviews conducted in 2014 and 2015 with 67 purposefully selected women survivors of wartime sexual violence. The study finds that: stigma is linked to broader gender discriminatory sociocultural norms and practices and changes under different circumstances; women's economic agency is essential to reducing stigma; households with members who suffered war-related sexual violence experienced significantly higher rates of violence post conflict than did other households; and the passage of time is less of a determining factor in their acceptance and reintegration than previously thought. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

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

PubMed

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

2016-07-11

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. 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. 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. 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 implementation partners were shown to be effective

The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda.

PubMed

Musinguzi, Conrad; Namale, Leticia; Rutebemberwa, Elizeus; Dahal, Aruna; Nahirya-Ntege, Patricia; Kekitiinwa, Adeodata

2018-01-01

Leadership is key to strengthening performance of Health Systems. Leadership styles are important organizational antecedents, especially in influencing employee's motivation, job satisfaction, and teamwork. There is limited research exploring this relationship among health workers in resource-limited settings such as Uganda. The aim of this study was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and motivation, job satisfaction, and teamwork of health workers in Uganda. We conducted a cross-sectional study in 3 geographic regions of Uganda in November 2015, using self-administered questionnaires with 564 health workers from 228 health facilities. Data were collected on health workers' perception of leadership styles displayed by their facility leaders, their level of motivation, job satisfaction, and team work. Using Pearson correlation, relationships among variables were identified and associations of the components of leadership styles with motivation, job satisfaction, and teamwork was found using multivariable logistic regression. Health workers in Uganda preferred leaders who were transformational (62%) compared with being transactional (42%) or laissez-faire (14%). Transformational leadership was positively correlated with motivation ( r =0.32), job satisfaction ( r =0.38), and team work ( r =0.48), while transactional leadership was positively correlated with job satisfaction ( r =0.21) and teamwork ( r =0.18). Motivation was positively associated with leaders who displayed idealized influence-behavior (odds ratio [OR]=3.7; 95% CI, 1.33-10.48) and intellectual stimulation (OR=2.4; 95% CI, 1.13-5.15) but negatively associated with management by exception (OR=0.4; 95% CI, 0.19-0.82). Job satisfaction was positively associated with intellectual stimulation (OR=5.7; 95% CI, 1.83-17.79). Teamwork was positively associated with idealized influence-behavior (OR=1.07-8.57), idealized influence-attributed (OR

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

Temporal Dynamic Controllability Revisited

NASA Technical Reports Server (NTRS)

Morris, Paul H.; Muscettola, Nicola

2005-01-01

An important issue for temporal planners is the ability to handle temporal uncertainty. We revisit the question of how to determine whether a given set of temporal requirements are feasible in the light of uncertain durations of some processes. In particular, we consider how best to determine whether a network is Dynamically Controllable, i.e., whether a dynamic strategy exists for executing the network that is guaranteed to satisfy the requirements. Previous work has shown the existence of a pseudo-polynomial algorithm for testing Dynamic Controllability. Here, we greatly simplify the previous framework, and present a true polynomial algorithm with a cutoff based only on the number of nodes.

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. Project HOPE—The People-to-People Health Foundation, Inc.

Effects of Teaching Health Care Workers on Diagnosis and Treatment of Pesticide Poisonings in Uganda.

PubMed

Sibani, Claudia; Jessen, Kristian Kjaer; Tekin, Bircan; Nabankema, Victoria; Jørs, Erik

2017-01-01

Acute pesticide poisoning in developing countries is a considerable problem, requiring diagnosis and treatment. This study describes how training of health care workers in Uganda affects their ability to diagnose and manage acute pesticide poisoning. A postintervention cross-sectional study was conducted using a standardized questionnaire. A total of 326 health care workers in Uganda were interviewed on knowledge and handling of acute pesticide poisoning. Of those, 173 health care workers had received training, whereas 153 untrained health care workers from neighboring regions served as controls. Trained health care workers scored higher on knowledge of pesticide toxicity and handling of acute pesticide poisoning. Stratification by sex, profession, experience, and health center level did not have any influence on the outcome. Training health care workers can improve their knowledge and treatment of pesticide poisonings. Knowledge of the subject is still insufficient among health care workers and further training is needed.

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.

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...

Institutionalizing and sustaining social change in health systems: the case of Uganda

PubMed Central

Hage, Jerald; Valadez, Joseph J

2017-01-01

Abstract The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C’s: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized ‘stability’, whereas in global health, the issue is determining how to improve the impact of services by ‘changing’ programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0–11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the

Biomass waste-to-energy valorisation technologies: a review case for banana processing in Uganda.

PubMed

Gumisiriza, Robert; Hawumba, Joseph Funa; Okure, Mackay; Hensel, Oliver

2017-01-01

Uganda's banana industry is heavily impeded by the lack of cheap, reliable and sustainable energy mainly needed for processing of banana fruit into pulp and subsequent drying into chips before milling into banana flour that has several uses in the bakery industry, among others. Uganda has one of the lowest electricity access levels, estimated at only 2-3% in rural areas where most of the banana growing is located. In addition, most banana farmers have limited financial capacity to access modern solar energy technologies that can generate sufficient energy for industrial processing. Besides energy scarcity and unreliability, banana production, marketing and industrial processing generate large quantities of organic wastes that are disposed of majorly by unregulated dumping in places such as swamps, thereby forming huge putrefying biomass that emit green house gases (methane and carbon dioxide). On the other hand, the energy content of banana waste, if harnessed through appropriate waste-to-energy technologies, would not only solve the energy requirement for processing of banana pulp, but would also offer an additional benefit of avoiding fossil fuels through the use of renewable energy. The potential waste-to-energy technologies that can be used in valorisation of banana waste can be grouped into three: Thermal (Direct combustion and Incineration), Thermo-chemical (Torrefaction, Plasma treatment, Gasification and Pyrolysis) and Biochemical (Composting, Ethanol fermentation and Anaerobic Digestion). However, due to high moisture content of banana waste, direct application of either thermal or thermo-chemical waste-to-energy technologies is challenging. Although, supercritical water gasification does not require drying of feedstock beforehand and can be a promising thermo-chemical technology for gasification of wet biomass such as banana waste, it is an expensive technology that may not be adopted by banana farmers in Uganda. Biochemical conversion technologies are

Household water insecurity, missed schooling, and the mediating role of caregiver depression in rural Uganda.

PubMed

Cooper-Vince, C E; Kakuhikire, B; Vorechovska, D; McDonough, A Q; Perkins, J; Venkataramani, A S; Mushavi, R C; Baguma, C; Ashaba, S; Bangsberg, D R; Tsai, A C

2017-01-01

School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children's water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations. We conducted a population-based, cross-sectional study of female household heads ( N = 257) and their children ages 5-17 ( N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression. Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls. Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth.

Prevalence of cannabis residues in psychiatric patients: a case study of two mental health referral hospitals in Uganda.

PubMed

Awuzu, Epaenetus A; Kaye, Emmanuel; Vudriko, Patrick

2014-01-08

Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ(9)-THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ(9)-THC immunochromatographic kit (Standard Diagnostics(®), South Korea). Seventeen percent of the patients tested positive for Δ(9)-THC residues in their urine. There was strong association (P < 0.05) between history of previous abuse of cannabis and presence of Δ(9)-THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

Carbon dioxide emissions from peat soils under potato cultivation in Uganda

NASA Astrophysics Data System (ADS)

Farmer, Jenny; Langan, Charlie; Smith, Jo

2017-04-01

Organic wetland soils in south western Uganda are found in valley bottom wetlands, surrounded by steep, mineral soil hill slopes. Land use change in these papyrus dominated wetlands has taken place over the past forty years, seeing wetland areas cleared of papyrus, rudimentary drainage channel systems dug, and soil cultivated and planted with crops, predominantly potatoes. There has been little research into the cultivation of organic wetlands soils in Uganda, or the impacts on soil carbon dynamics and associated carbon dioxide (CO2) emissions. This study used two rounds of farmer interviews to capture the land management practices on these soils and how they vary over the period of a year. Three potato fields were also randomly selected and sampled for CO2 emissions at four points in time during the year; 1) just after the potato beds had been dug, 2) during the potato growing period, 3) after the potato harvest, and 4) at the end of the fallow season. Carbon dioxide emissions, soil and air temperatures, water table depth, vegetation cover and land use were all recorded in situ in each field on each sampling occasion, from both the raised potato beds and the trenches in between them. There appeared to be a delay in the disturbance effect of digging the peat, with heterotrophic CO2 emissions from the raised beds not immediately increasing after being exposed to the air. Excluding these results, there was a significant linear relationship between mean emissions and water table depth from the raised beds and trenches in each field over time (p<0.001, r2=0.85), as well as between emissions and soil moisture content (p<0.001, r2=0.85). Temporal variability was observed, with significant differences in the means of emissions measured at the different sampling times (p<0.001, one-way ANOVA); this was the case in both raised beds and trenches in all fields studied, except for the trenches in one field which showed no significant difference between sampling times (p=0

Emerging Filoviral Disease in Uganda: Proposed Explanations and Research Directions

PubMed Central

Polonsky, Jonathan A.; Wamala, Joseph F.; de Clerck, Hilde; Van Herp, Michel; Sprecher, Armand; Porten, Klaudia; Shoemaker, Trevor

2014-01-01

Outbreaks of Ebola and Marburg virus diseases have recently increased in frequency in Uganda. This increase is probably caused by a combination of improved surveillance and laboratory capacity, increased contact between humans and the natural reservoir of the viruses, and fluctuations in viral load and prevalence within this reservoir. The roles of these proposed explanations must be investigated in order to guide appropriate responses to the changing epidemiological profile. Other African settings in which multiple filoviral outbreaks have occurred could also benefit from such information. PMID:24515940

Attracting Youth to Agriculture: The Career Interests of Young Farmers Club Members in Uganda

ERIC Educational Resources Information Center

Mukembo, Stephen C.; Edwards, M. Craig; Ramsey, Jon W.; Henneberry, Shida R.

2014-01-01

This embedded, quantitative case study included 102 participants who were members of Young Farmers Clubs (YFCs) from two secondary schools in eastern Uganda. The study's multifold purpose was to describe YFC members' personal characteristics and their reasons for joining the clubs. In addition, the study sought to determine the career…

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…

Integration of Web-Based Learning into Higher Education Institutions in Uganda: Teachers' Perspectives

ERIC Educational Resources Information Center

Asuman, Baguma; Khan, Md. Shahadat Hossain; Clement, Che Kum

2018-01-01

This article reports on the barriers encountered by teachers and the possible solutions to the integration of web-based learning (WBL) into higher educational institutions in Uganda. A total of 50 teachers in the departments of ICT, management, and social sciences from five different universities were purposively selected. A self-designed…

Revisiting the Role of Organizational Effectiveness in Educational Evaluation.

ERIC Educational Resources Information Center

Lotto, Linda S.

Organizational effectiveness ought to play a role in educational evaluation, and the development of alternative perspectives for viewing organizations could be a starting point for revisiting organizational evaluation in education. Five possible perspectives and criteria for evaluating organizations have been developed. If an organization is…

Moral Judgment Development across Cultures: Revisiting Kohlberg's Universality Claims

ERIC Educational Resources Information Center

Gibbs, John C.; Basinger, Karen S.; Grime, Rebecca L.; Snarey, John R.

2007-01-01

This article revisits Kohlberg's cognitive developmental claims that stages of moral judgment, facilitative processes of social perspective-taking, and moral values are commonly identifiable across cultures. Snarey [Snarey, J. (1985). "The cross-cultural universality of social-moral development: A critical review of Kohlbergian research."…

Patterns of usage and preferences of users for tuberculosis-related text messages and voice calls in Uganda.

PubMed

Ggita, J M; Ojok, C; Meyer, A J; Farr, K; Shete, P B; Ochom, E; Turimumahoro, P; Babirye, D; Mark, D; Dowdy, D; Ackerman, S; Armstrong-Hough, M; Nalugwa, T; Ayakaka, I; Moore, D; Haberer, J E; Cattamanchi, A; Katamba, A; Davis, J L

2018-05-01

Little information exists about mobile phone usage or preferences for tuberculosis (TB) related health communications in Uganda. We surveyed household contacts of TB patients in urban Kampala, Uganda, and clinic patients in rural central Uganda. Questions addressed mobile phone access, usage, and preferences for TB-related communications. We collected qualitative data about messaging preferences. We enrolled 145 contacts and 203 clinic attendees. Most contacts (58%) and clinic attendees (75%) owned a mobile phone, while 42% of contacts and 10% of clinic attendees shared one; 94% of contacts and clinic attendees knew how to receive a short messaging service (SMS) message, but only 59% of contacts aged 45 years (vs. 96% of contacts aged <45 years, P = 0.0001) did so. All contacts and 99% of clinic attendees were willing and capable of receiving personal-health communications by SMS. Among contacts, 55% preferred detailed messages disclosing test results, while 45% preferred simple messages requesting a clinic visit to disclose results. Most urban household TB contacts and rural clinic attendees reported having access to a mobile phone and willingness to receive TB-related personal-health communications by voice call or SMS. However, frequent phone sharing and variable messaging abilities and preferences suggest a need to tailor the design and monitoring of mHealth interventions to target recipients.

Economic evaluation of the Good School Toolkit: an intervention for reducing violence in primary schools in Uganda

PubMed Central

Knight, Louise; Ssekadde, Willington; Namy, Sophie; Naker, Dipak; Devries, Karen

2018-01-01

Introduction This paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda. Methods The effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider’s perspective to estimate total and unit costs. Results The total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial. Conclusions The GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region. PMID:29707243

Evaluation and modification of off-host flea collection techniques used in northwest Uganda: laboratory and field studies.

PubMed

Borchert, Jeff N; Eisen, Rebecca J; Holmes, Jennifer L; Atiku, Linda A; Mpanga, Joseph T; Brown, Heidi E; Graham, Christine B; Babi, Nackson; Montenieri, John A; Enscore, Russell E; Gage, Kenneth L

2012-01-01

Quantifying the abundance of host-seeking fleas is critical for assessing risk of human exposure to flea-borne disease agents, including Yersinia pestis, the etiological agent of plague. Yet, reliable measures of the efficacy of existing host-seeking flea collection methods are lacking. In this study, we compare the efficacy of passive and active methods for the collection of host-seeking fleas in both the laboratory and human habitations in a plague-endemic region of northwest Uganda. In the laboratory, lighted "Kilonzo" flea traps modified with either blinking lights, the creation of shadows or the generation of carbon dioxide were less efficient at collecting Xenopsylla cheopis Rothchild and Ctenocephalides felis Bouché fleas than an active collection method using white cotton socks or cotton flannel. Passive collection using Kilonzo light traps in the laboratory collected significantly more X. cheopis than C. felis and active collection, using white socks and flannel, collected significantly more C. felis than X. cheopis. In field studies conducted in Uganda, Kilonzo traps using a flashlight were similar in their collection efficacy to Kilonzo traps using kerosene lamps. However, in contrast to laboratory studies, Kilonzo flea traps using flashlights collected a greater number of fleas than swabbing. Within human habitations in Uganda, Kilonzo traps were especially useful for collecting C. felis, the dominant species found in human habitations in this area.

Transactional sex and HIV risks – evidence from a cross-sectional national survey among young people in Uganda

PubMed Central

Choudhry, Vikas; Ambresin, Anne-Emmanuelle; Nyakato, Viola Nilah; Agardh, Anette

2015-01-01

Background Transactional sex is associated with the HIV epidemic among young people in Uganda. Few quantitative studies based on nationally representative survey data explored the relationship between sexual behaviors, HIV infection, and transactional sex. Objective This study aimed to determine the associations between risky sexual behaviors, participation in transactional sex, and HIV sero-status among men and women aged 15–24 in Uganda. Design The study uses data from the Uganda AIDS Indicator Survey, a cross-sectional national HIV serological study conducted in 2011. We analyzed data on 1,516 men and 2,824 women aged 15–24 who had been sexually active in the 12 months preceding the survey. Private, face-to-face interviews were also conducted to record the sociodemographics, sexual history, and experiences of sexual coercion. Logistic regression analysis was performed to measure associations between sexual behaviors and transactional sex, and associations between HIV sero-status and transactional sex. Results Among young people who had been sexually active in the 12 months prior to the survey, 5.2% of young men reported paying for sex while 3.7% of young women reported receiving gifts, favors, or money for sex. Lower educational attainment (ORadjusted 3.25, CI 1.10–9.60) and experience of sexual coercion (ORadjusted 2.83, CI 1.07–7.47) were significantly associated with paying for sex among men. Multiple concurrent sexual relationships were significantly associated with paying for sex among young men (ORadjusted 5.60, CI 2.08–14.95) and receiving something for sex among young women (ORadjusted 8.04, CI 2.55–25.37). Paying for sex among young men and having three to five lifetime sexual partners among young women were associated with increased odds of testing positive for HIV. Conclusions Transactional sex is associated with sexual coercion and HIV risk behaviors such as multiple concurrent sexual partnerships among young people in Uganda. In addition

Radiative corrections to double-Dalitz decays revisited

NASA Astrophysics Data System (ADS)

Kampf, Karol; Novotný, Jiři; Sanchez-Puertas, Pablo

2018-03-01

In this study, we revisit and complete the full next-to-leading order corrections to pseudoscalar double-Dalitz decays within the soft-photon approximation. Comparing to the previous study, we find small differences, which are nevertheless relevant for extracting information about the pseudoscalar transition form factors. Concerning the latter, these processes could offer the opportunity to test them—for the first time—in their double-virtual regime.

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."

Early childhood transmission of hepatitis B prior to the first hepatitis B vaccine dose is rare among babies born to HIV-infected and non-HIV infected mothers in Gulu, Uganda

PubMed Central

Van Geertruyden, J.P.; Ssenyonga, R.; Opio, C.K.; Kaducu, J.M.; Sempa, J.B.; Colebunders, R.; Ocama, P.

2017-01-01

Background Hepatitis B (HBV) in sub-Saharan Africa is believed to be horizontally acquired. However, because of the high HBV prevalence in northern Uganda, no hepatitis B vaccination at birth and no access to HBV immunoglobulin, we hypothesize that vertical transmission also could also play an important role. We therefore investigated the incidence of HBV among babies presenting for their first HBV vaccine dose in Gulu, Uganda. Methods We recruited mothers and their babies (at least 6-week old) presenting for their postnatal care and first HBV vaccine dose respectively. Socio-demographic and risk factors for HBV transmission were recorded. Mothers were tested for Hepatitis B core antibody (anti-HBc-IgG) and hepatitis B surface antigen (HBsAg). HBsAg-positive sera were tested for hepatitis B e antigen (HBeAg) and HBV viral load (HBVDNA). Babies were tested for HBsAg at presentation and at the last immunization visit. A sample of HBsAg-negative babies were tested for HBVDNA. Incident HBV infection was defined by either a positive HBsAg or HBVDNA test. Chi-square or fisher's exact tests were utilized to investigate associations and t-tests or Wilcoxon rank-sum test for continuous differences. Results We recruited 612 mothers, median age 23 years (IQR 20–28). 53 (8.7%) were HBsAg-positive and 339 (61.5%) were anti-HBc-IgG-positive. Ten (18.9%) of the HBsAg-positive mothers were HBeAg-positive. Median HBVDNA levels of HBV-infected mothers was 5.7log (IQR 4.6–7.0) IU/mL with 9 (17.6%) having levels ≥105 IU/mL. Eighty (13.3%) mothers were HIV-infected of whom 9 (11.5%) were co-infected with HBV. No baby tested HBsAg or HBVDNA positive. Conclusion Vertical transmission does not seem to contribute substantially to the high HBV endemicity in northern Uganda. The current practice of administering the first HBV vaccine to babies in Uganda at six weeks of age may be adequate in control of HBV transmission. PMID:28434689

Revisiting Feminist Identity Development Theory, Research, and Practice

ERIC Educational Resources Information Center

Moradi, Bonnie; Subich, Linda Mezydlo; Phillips, Julia C.

2002-01-01

The model of feminist identity development proposed by Downing and Roush in 1985 is revisited as a potentially useful framework in counseling psychology theory, research, and practice. An examination of the historical context from which the model arose illustrates how it advanced theory in the psychology of women. A critical review of the extant…

A Feminist Revisit to the First-Year Curriculum.

ERIC Educational Resources Information Center

Bernstein, Anita

1996-01-01

A seminar at Chicago-Kent College of Law (Illinois) that reviews six first-year law school courses by focusing on feminist issues in course content and structure is described. The seminar functions as both a review and a shift in perspective. Courses revisited include civil procedure, contracts, criminal law, justice and the legal system,…

Revisiting the Trust Effect in Urban Elementary Schools

ERIC Educational Resources Information Center

Adams, Curt M.; Forsyth, Patrick B.

2013-01-01

More than a decade after Goddard, Tschannen-Moran, and Hoy (2001) found that collective faculty trust in clients predicts student achievement in urban elementary schools, we sought to identify a plausible link for this relationship. Our purpose in revisiting the trust effect was twofold: (1) to test the main effect of collective faculty trust on…

Energy Efficiency Roadmap for Uganda, Making Energy Efficiency Count. Executive Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; Pudleiner, David; Jones, David

Like many countries in Sub-Saharan Africa, Uganda has focused its energy sector investments largely on increasing energy access by increasing energy supply. The links between energy efficiency and energy access, the importance of energy efficiency in new energy supply, and the multiple benefits of energy efficiency for the level and quality of energy available, have been largely overlooked. Implementing energy efficiency in parallel with expanding both the electricity grid and new clean energy generation reduces electricity demand and helps optimize the power supply so that it can serve more customers reliably at minimum cost. Ensuring efficient appliances are incorporated intomore » energy access efforts provides improved energy services to customers. Energy efficiency is an important contributor to access to modern energy. This Energy Efficiency Roadmap for Uganda (Roadmap) is a response to the important role that electrical energy efficiency can play in meeting Uganda’s energy goals. Power Africa and the United Nations Sustainable Energy for All (SEforALL) initiatives collaborated with more than 24 stakeholders in Uganda to develop this document. The document estimates that if the most efficient technologies on the market were adopted, 2,224 gigawatt hours could be saved in 2030 across all sectors, representing 31% of the projected load. This translates into 341 megawatts of peak demand reductions, energy access to an additional 6 million rural customers and reduction of carbon dioxide emissions by 10.6 million tonnes in 2030. The Roadmap also finds that 91% of this technical potential is cost-effective, and 47% is achievable under conservative assumptions. The Roadmap prioritizes recommendations for implementing energy efficiency and maximizing benefits to meet the goals and priorities established in Uganda’s 2015 SEforALL Action Agenda. One important step is to create and increase demand for efficiency through long-term enabling policies and financial

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2010-01-29

for forced conscription and sexual exploitation.7 According to the United Nations the most disturbing aspect of this humanitarian crisis is the fact...have improved. These children are known as “Night Commuters.” Education for many of these children seems out of reach, since many are unable to stay...Children are losing vital educational opportunities; they are at greater risk for contracting HIV/AIDS and other STDs; and they are forced into child

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2009-07-31

children over the past decade for forced conscription and sexual exploitation.6 According to the United Nations “the most disturbing aspect of this...the past year conditions have improved. These children are known as “Night Commuters.” Education for many of these children seems out of reach...development activities. Children are losing vital educational opportunities; they are at greater risk for contracting HIV/AIDS and other STDs; and they

Revisiting the role of erythropoietin for treatment of ocular disorders

PubMed Central

Shirley Ding, S L; Leow, S N; Munisvaradass, R; Koh, E H; Bastion, M L C; Then, K Y; Kumar, S; Mok, P L

2016-01-01

Erythropoietin (EPO) is a glycoprotein hormone conventionally thought to be responsible only in producing red blood cells in our body. However, with the discovery of the presence of EPO and EPO receptors in the retinal layers, the EPO seems to have physiological roles in the eye. In this review, we revisit the role of EPO in the eye. We look into the biological role of EPO in the development of the eye and the physiologic roles that it has. Apart from that, we seek to understand the mechanisms and pathways of EPO that contributes to the therapeutic and pathological conditions of the various ocular disorders such as diabetic retinopathy, retinopathy of prematurity, glaucoma, age-related macular degeneration, optic neuritis, and retinal detachment. With these understandings, we discuss the clinical applications of EPO for treatment of ocular disorders, modes of administration, EPO formulations, current clinical trials, and its future directions. PMID:27285322

Disability inclusion in higher education in Uganda: Status and strategies.

PubMed

Emong, Paul; Eron, Lawrence

2016-01-01

Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.

Leber's Hereditary Optic Neuropathy: The Mitochondrial Connection Revisited.

PubMed

Abu-Amero, Khaled K

2011-01-01

Our current understanding of Leber's hereditary optic neuropathy (LHON)-mitochondrial connection falls short of comprehensive. Twenty years of intensive investigation have yielded a wealth of information about mitochondria, the mitochondrial genome, the metabolism of the optic nerve and other structures, and the phenotypic variability of classic LHON. However, we still cannot completely explain how primary LHON mutations injure the optic nerve or why the optic nerve is particularly at risk. We cannot explain the incomplete penetrance or the male predominance of LHON, the typical onset in young adult life without warning, or the synchronicity of visual loss. Moreover, primary LHON mutations clearly are not present in every family with the LHON phenotype (including multigenerational maternal inheritance), and they are present in only a minority of individuals who have the LHON optic neuropathy phenotype without a family history. All lines of evidence point to abnormalities of the mitochondria as the direct or indirect cause of LHON. Therefore, the mitochondria-LHON connection needs to be revisited and examined closely. This review will attempt to do that and provide an update on various aspects of LHON.

The Importance of Being a Complement: CED Effects Revisited

ERIC Educational Resources Information Center

Jurka, Johannes

2010-01-01

This dissertation revisits subject island effects (Ross 1967, Chomsky 1973) cross-linguistically. Controlled acceptability judgment studies in German, English, Japanese and Serbian show that extraction out of specifiers is consistently degraded compared to extraction out of complements, indicating that the Condition on Extraction domains (CED,…

University Leadership during Times of Significant Transformation: A Case of Kyambogo University in Uganda

ERIC Educational Resources Information Center

Namubiru, Gertrude; Onen, David; Oonyu, Joseph

2017-01-01

This study investigated how leadership was exercised at Kyambogo University [KyU] (in Uganda) during its formation that involved the merger of three tertiary institutions and the period immediately thereafter. This was regarded as a period of significant transformation at the institution. The study was prompted by the rampant strikes and protests…

Engineering drag currents in Coulomb coupled quantum dots

NASA Astrophysics Data System (ADS)

Lim, Jong Soo; Sánchez, David; López, Rosa

2018-02-01

The Coulomb drag phenomenon in a Coulomb-coupled double quantum dot system is revisited with a simple model that highlights the importance of simultaneous tunneling of electrons. Previously, cotunneling effects on the drag current in mesoscopic setups have been reported both theoretically and experimentally. However, in both cases the sequential tunneling contribution to the drag current was always present unless the drag level position were too far away from resonance. Here, we consider the case of very large Coulomb interaction between the dots, whereby the drag current needs to be assisted by cotunneling events. As a consequence, a quantum coherent drag effect takes place. Further, we demonstrate that by properly engineering the tunneling probabilities using band tailoring it is possible to control the sign of the drag and drive currents, allowing them to flow in parallel or antiparallel directions. We also show that the drag current can be manipulated by varying the drag gate potential and is thus governed by electron- or hole-like transport.

The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda

PubMed Central

Urdal, Henrik

2018-01-01

Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their

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.

Adolescents Caught between Fires: Cognitive Emotion Regulation in Response to War Experiences in Northern Uganda

ERIC Educational Resources Information Center

Amone-P'Olak, Kennedy; Garnefski, Nadia; Kraaij, Vivian

2007-01-01

This study aimed to assess the prevalence of war experiences and the use of specific cognitive emotion regulation strategies in response to these experiences among 294 formerly abducted adolescents at three rehabilitation centres in Uganda. Cognitive strategies were measured by Cognitive Emotion Regulation Questionnaire (CERQ). Symptoms of…

A Multi-Level Model of Moral Functioning Revisited

ERIC Educational Resources Information Center

Reed, Don Collins

2009-01-01

The model of moral functioning scaffolded in the 2008 "JME" Special Issue is here revisited in response to three papers criticising that volume. As guest editor of that Special Issue I have formulated the main body of this response, concerning the dynamic systems approach to moral development, the problem of moral relativism and the role of…

Literary Origins of the Term "School Psychologist" Revisited

ERIC Educational Resources Information Center

Fagan, Thomas K.

2005-01-01

Previous research on the literary origins of the term "school psychologist" is revisited, and conclusions are revised in light of new evidence. It appears that the origin of the term in the American literature occurred as early as 1898 in an article by Hugo Munsterberg, predating the usage by Wilhelm Stern in 1911. The early references to the…

Hepatitis E as a Cause of Acute Jaundice Syndrome in Northern Uganda, 2010–2012

PubMed Central

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

2015-01-01

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

Effects of Teaching Health Care Workers on Diagnosis and Treatment of Pesticide Poisonings in Uganda

PubMed Central

Sibani, Claudia; Jessen, Kristian Kjaer; Tekin, Bircan; Nabankema, Victoria; Jørs, Erik

2017-01-01

Background: Acute pesticide poisoning in developing countries is a considerable problem, requiring diagnosis and treatment. This study describes how training of health care workers in Uganda affects their ability to diagnose and manage acute pesticide poisoning. Method: A postintervention cross-sectional study was conducted using a standardized questionnaire. A total of 326 health care workers in Uganda were interviewed on knowledge and handling of acute pesticide poisoning. Of those, 173 health care workers had received training, whereas 153 untrained health care workers from neighboring regions served as controls. Results: Trained health care workers scored higher on knowledge of pesticide toxicity and handling of acute pesticide poisoning. Stratification by sex, profession, experience, and health center level did not have any influence on the outcome. Conclusions: Training health care workers can improve their knowledge and treatment of pesticide poisonings. Knowledge of the subject is still insufficient among health care workers and further training is needed. PMID:28890656

Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda

PubMed Central

2013-01-01

Background Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda. Objective To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda. Methods Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3–19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents. Results The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14–19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR�

Toward a North-South dialogue: revisiting nursing theory (from the South).

PubMed

Santos Salas, Anna

2005-01-01

In nursing, the current world situation calls us to revisit our knowledge schemes and revise the extent to which they assist us in improving the health of the world peoples. In this discussion, I offer a Latin American nursing perspective to knowledge development in our discipline. I suggest that a persistent concern to develop elaborate conceptualizations has distracted our attention from the realities practicing nurses face throughout the world. In their abstractness, (North) American nursing theories have conveyed a view that presumingly universal imposes itself as hegemonic in the international nursing community. Yet the exportation of these theories to other countries introduces a view that is foreign to practicing nurses. The world situation as well as the disparate and concurrent human paths that we witness and experience calls for approaches that are more in tune with the local realities of nursing practices.

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. © The Author 2016. Published by Oxford University Press on behalf of the Entomological Society of America.

SAPS/SAID revisited: A causal relation to the substorm current wedge

NASA Astrophysics Data System (ADS)

Mishin, Evgeny; Nishimura, Yukitoshi; Foster, John

2017-08-01

We present multispacecraft observations of enhanced flow/electric field channels in the inner magnetosphere and conjugate subauroral ionosphere, i.e., subauroral polarization streams (SAPS) near dusk and subauroral ion drifts (SAID) near midnight. The channels collocate with ring current (RC) injections lagging the onset of substorms by a few to ˜20 min, i.e., significantly shorter than the gradient-curvature drift time of tens of keV ions. The time lag is of the order of the propagation time of reconnection-injected hot plasma jets to the premidnight plasmasphere and the substorm current wedge (SCW) to dusk. The observations confirm and expand on the previous results on the SAID features that negate the paradigm of voltage and current generators. Fast-time duskside SAPS/RC injections appear intimately related to a two-loop circuit of the substorm current wedge (SCW2L). We suggest that the poleward electric field inherent in the SCW2L circuit, which demands closure of the Region 1 and Region 2 sense field-aligned currents via meridional currents, is the ultimate cause of fast RC injections and SAPS on the duskside.

SAID/SAPS Revisited: A Causal Relation to the Substorm Current Wedge

NASA Astrophysics Data System (ADS)

Mishin, E. V.

2017-12-01

We present multi-spacecraft observations of enhanced flow/electric field channels in the inner magnetosphere and conjugate subauroral ionosphere, i.e., subauroral polarization streams (SAPS) near dusk and subauroral ion drifts (SAID) near midnight. The channels collocate with ring current (RC) injections lagging the onset of substorms by a few to ˜20 minutes, i.e., significantly shorter than the gradient-curvature drift time of tens of keV ions. The time lag is of the order of the propagation time of reconnection-injected hot plasma jets to the premidnight plasmasphere and the substorm current wedge (SCW) to dusk. The observations confirm and expand on the previous results on the SAID features that negate the paradigm of voltage and current generators. Fast-time duskside SAPS/RC injections appear intimately related to a two-loop circuit of the substorm current wedge (SCW2L). We suggest that the poleward electric field inherent in the SCW2L circuit, which demands closure of the Region 1- and Region 2-sense field-aligned currents via meridional currents, is the ultimate cause of fast RC injections and SAPS on the duskside.