Variable microsatellite loci for population genetic analysis of Old World monkey lice (Pedicinus sp.).

PubMed

Scholl, Katlyn; Allen, Julie M; Leendertz, Fabian H; Chapman, Colin A; Reed, David L

2012-10-01

Parasitic lice have been valuable informants of their host's evolutionary history because they complete their entire life cycle on the host and move between hosts primarily through direct host-to-host contact. Therefore, lice are confined to their hosts both in ecological and evolutionary time. Lice on great apes have been studied to examine details of their host's evolutionary history; however, species of Pedicinus, which parasitize the Old World monkeys, are less well known. We sampled lice from 2 groups of red colobus (Procolobus spp.) in Kibale National Park in Uganda and from red colobus and black and white colobus (Procolobus polycomos) in Taï National Park in Côte d'Ivoire. We used next-generation sequencing data analysis and the human body louse (Pediculus humanus humanus) genome to search for microsatellites for population genetic studies of Pedicinus lice. The 96 primer sets for microsatellite loci designed from the human body louse genome failed to amplify microsatellites in Pedicinus sp., perhaps due to the fast rate of evolution in parasitic lice. Of 63 microsatellites identified by next-generation sequencing data analysis of Pedicinus sp., 12 were variable among populations and 9 were variable within a single population. Our results suggest that these loci will be useful across the genus Pedicinus. We found that the lice in Uganda are not structured according to their hosts' social group; rather, 2 non-interbreeding populations of lice were found on both groups of red colobus. Because direct host-to-host contact is usually required for lice to move among hosts, these lice could be useful for identification and study of behavioral interactions between primate species.

No evidence for transmission of SIVwrc from western red colobus monkeys (piliocolobus badius badius) to wild west african chimpanzees (pan troglodytes verus) despite high exposure through hunting

PubMed Central

2011-01-01

Background Simian Immunodeficiency Viruses (SIVs) are the precursors of Human Immunodeficiency Viruses (HIVs) which have lead to the worldwide HIV/AIDS pandemic. By studying SIVs in wild primates we can better understand the circulation of these viruses in their natural hosts and habitat, and perhaps identify factors that influence susceptibility and transmission within and between various host species. We investigated the SIV status of wild West African chimpanzees (Pan troglodytes verus) which frequently hunt and consume the western red colobus monkey (Piliocolobus badius badius), a species known to be infected to a high percentage with its specific SIV strain (SIVwrc). Results Blood and plasma samples from 32 wild chimpanzees were tested with INNO-LIA HIV I/II Score kit to detect cross-reactive antibodies to HIV antigens. Twenty-three of the samples were also tested for antibodies to 43 specific SIV and HIV lineages, including SIVwrc. Tissue samples from all but two chimpanzees were tested for SIV by PCRs using generic SIV primers that detect all known primate lentiviruses as well as primers designed to specifically detect SIVwrc. Seventeen of the chimpanzees showed varying degrees of cross-reactivity to the HIV specific antigens in the INNO-LIA test; however no sample had antibodies to SIV or HIV strain - and lineage specific antigens in the Luminex test. No SIV DNA was found in any of the samples. Conclusions We could not detect any conclusive trace of SIV infection from the red colobus monkeys in the chimpanzees, despite high exposure to this virus through frequent hunting. The results of our study raise interesting questions regarding the host-parasite relationship of SIVwrc and wild chimpanzees in their natural habitat. PMID:21284842

Host density and human activities mediate increased parasite prevalence and richness in primates threatened by habitat loss and fragmentation.

PubMed

Mbora, David N M; McPeek, Mark A

2009-01-01

1. Habitat loss and fragmentation are the principal causes of the loss of biological diversity. In addition, parasitic diseases are an emerging threat to many animals. Nevertheless, relatively few studies have tested how habitat loss and fragmentation influence the prevalence and richness of parasites in animals. 2. Several studies of nonhuman primates have shown that measures of human activity and forest fragmentation correlate with parasitism in primates. However, these studies have not tested for the ecological mechanism(s) by which human activities or forest fragmentation influence the prevalence and richness of parasites. 3. We tested the hypothesis that increased host density due to forest fragmentation and loss mediates increases in the prevalence and richness of gastrointestinal parasites in two forest primates, the Tana River red colobus (Procolobus rufomitratus, Peters 1879) and mangabey (Cercocebus galeritus galeritus, Peters 1879). We focused on population density because epidemiological theory states that host density is a key determinant of the prevalence and richness of directly transmitted parasites in animals. 4. The Tana River red colobus and mangabey are endemic to a highly fragmented forest ecosystem in eastern Kenya where habitat changes are caused by a growing human population increasingly dependent on forest resources and on clearing forest for cultivation. 5. We found that the prevalence of parasites in the two monkeys was very high compared to primates elsewhere. Density of monkeys was positively associated with forest area and disturbance in forests. In turn, the prevalence and richness of parasites was significantly associated with monkey density, and attributes indicative of human disturbance in forests. 6. We also found significant differences in the patterns of parasitism between the colobus and the mangabey possibly attributable to differences in their behavioural ecology. Colobus are arboreal folivores while mangabeys are terrestrial habitat generalists.

Absence of Frequent Herpesvirus Transmission in a Nonhuman Primate Predator-Prey System in the Wild

PubMed Central

Murthy, Sripriya; Couacy-Hymann, Emmanuel; Metzger, Sonja; Nowak, Kathrin; De Nys, Helene; Boesch, Christophe; Wittig, Roman; Jarvis, Michael A.; Leendertz, Fabian H.

2013-01-01

Emergence of viruses into the human population by transmission from nonhuman primates (NHPs) represents a serious potential threat to human health that is primarily associated with the increased bushmeat trade. Transmission of RNA viruses across primate species appears to be relatively frequent. In contrast, DNA viruses appear to be largely host specific, suggesting low transmission potential. Herein, we use a primate predator-prey system to study the risk of herpesvirus transmission between different primate species in the wild. The system was comprised of western chimpanzees (Pan troglodytes verus) and their primary (western red colobus, Piliocolobus badius badius) and secondary (black-and-white colobus, Colobus polykomos) prey monkey species. NHP species were frequently observed to be coinfected with multiple beta- and gammaherpesviruses (including new cytomegalo- and rhadinoviruses). However, despite frequent exposure of chimpanzees to blood, organs, and bones of their herpesvirus-infected monkey prey, there was no evidence for cross-species herpesvirus transmission. These findings suggest that interspecies transmission of NHP beta- and gammaherpesviruses is, at most, a rare event in the wild. PMID:23885068

Absence of frequent herpesvirus transmission in a nonhuman primate predator-prey system in the wild.

PubMed

Murthy, Sripriya; Couacy-Hymann, Emmanuel; Metzger, Sonja; Nowak, Kathrin; De Nys, Helene; Boesch, Christophe; Wittig, Roman; Jarvis, Michael A; Leendertz, Fabian H; Ehlers, Bernhard

2013-10-01

Emergence of viruses into the human population by transmission from nonhuman primates (NHPs) represents a serious potential threat to human health that is primarily associated with the increased bushmeat trade. Transmission of RNA viruses across primate species appears to be relatively frequent. In contrast, DNA viruses appear to be largely host specific, suggesting low transmission potential. Herein, we use a primate predator-prey system to study the risk of herpesvirus transmission between different primate species in the wild. The system was comprised of western chimpanzees (Pan troglodytes verus) and their primary (western red colobus, Piliocolobus badius badius) and secondary (black-and-white colobus, Colobus polykomos) prey monkey species. NHP species were frequently observed to be coinfected with multiple beta- and gammaherpesviruses (including new cytomegalo- and rhadinoviruses). However, despite frequent exposure of chimpanzees to blood, organs, and bones of their herpesvirus-infected monkey prey, there was no evidence for cross-species herpesvirus transmission. These findings suggest that interspecies transmission of NHP beta- and gammaherpesviruses is, at most, a rare event in the wild.

Occurrence of Giardia and Cryptosporidium in captive chimpanzees (Pan troglodytes), mandrills (Mandrillus sphinx) and wild Zanzibar red colobus monkeys (Procolobus kirkii).

PubMed

Debenham, John J; Atencia, Rebeca; Midtgaard, Fred; Robertson, Lucy J

2015-04-01

The aim of this study was to investigate the occurrence of Giardia duodenalis and Cryptosporidium spp. in primates and determine their zoonotic or anthropozoonotic potential. Direct immunofluorescence was used to identify Giardia and Cryptosporidium from faecal samples. PCR and DNA sequencing was performed on positive results. Giardia cysts were identified from 5.5% (5/90) of captive chimpanzees and 0% (0/11) of captive mandrills in the Republic of Congo; 0% (0/10) of captive chimpanzees in Norway; and 0% of faecal samples (n = 49) from wild Zanzibar red colobus monkeys. Two Giardia positive samples were also positive on PCR, and sequencing revealed identical isolates of Assemblage B. Cryptosporidium oocysts were not detected in any of the samples. In these primate groups, in which interactions with humans and human environments are quite substantial, Giardia and Cryptosporidium are rare pathogens. In chimpanzees, Giardia may have a zoonotic or anthropozoonotic potential. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A survey for Cyclospora spp. in Kenyan primates, with some notes on its biology.

PubMed

Eberhard, M L; Njenga, M N; DaSilva, A J; Owino, D; Nace, E K; Won, K Y; Mwenda, J M

2001-12-01

From March 1999 through August 2000, 511 stool samples collected from 11 different primate species in 10 geographically distinct locations in Kenya, East Africa, were screened for the presence of Cyclospora spp. oocysts. Positive samples (43/102, 42%) were identified in vervet monkeys (Cercopithecus aethiops) in 4 of 4 locations; 19/206 (9%) in yellow and olive baboons (Papio cynocephalus, P. anubis, respectively) in 5 of 5 locations; and 19/76 (25%) in black and white colobus monkeys (Colobus angolensis, C. guereza, respectively) from 2 of 3 locations. DNA sequences obtained from 18 S rRNA coding regions from respective subsets of these positive samples were typed as Cyclospora cercopitheci (samples from Cercopithecus aethiops). Cyclospora papionis (samples from Papio cynocephalus and P. anubis), and Cyclospora colobi (samples from Colobus angolensis and C. guereza). Cyclospora oocysts were not detected in samples collected from patas, highland sykes, lowland sykes, blue sykes, DeBrazza, or red-tailed monkeys. A coded map showing the geographic location of the collected samples is given. Stool samples from 1 troop of vervet monkeys were collected over a 12-mo period. Positive samples ranged between 21 and 63%. These results suggest that there is no strongly marked seasonality evident in Cyclospora infection in monkeys as has been noted in human infection. This is further confirmed by the recovery of positive samples collected from vervet monkeys, baboons, and colobus monkeys at all times of the year during this survey. This absence of seasonality in infection is especially notable because of the extreme weather patterns typical of Kenya, where marked rainy and dry seasons occur. A second noteworthy observation is that the striking host specificity of the Cyclospora species initially described was confirmed in this survey. Baboons were only infected with C. papionis, vervet monkeys with C. cercopitheci, and colobus monkeys with C. colobi, despite geographic overlaps of both the monkey and parasite species and wide geographic distribution of each parasite and monkey host.

Within-Host Evolution of Simian Arteriviruses in Crab-Eating Macaques

PubMed Central

Moncla, Louise H.; Weiler, Andrea M.; Barry, Gabrielle; Weinfurter, Jason T.; Dinis, Jorge M.; Charlier, Olivia; Lauck, Michael; Bailey, Adam L.; Wahl-Jensen, Victoria; Nelson, Chase W.; Johnson, Joshua C.; Caì, Yíngyún; Goldberg, Tony L.; O'Connor, David H.; Jahrling, Peter B.

2016-01-01

ABSTRACT Simian arteriviruses are a diverse clade of viruses infecting captive and wild nonhuman primates. We recently reported that Kibale red colobus virus 1 (KRCV-1) causes a mild and self-limiting disease in experimentally infected crab-eating macaques, while simian hemorrhagic fever virus (SHFV) causes lethal viral hemorrhagic fever. Here we characterize how these viruses evolved during replication in cell culture and in experimentally infected macaques. During passage in cell culture, 68 substitutions that were localized in open reading frames (ORFs) likely associated with host cell entry and exit became fixed in the KRCV-1 genome. However, we did not detect any strong signatures of selection during replication in macaques. We uncovered patterns of evolution that were distinct from those observed in surveys of wild red colobus monkeys, suggesting that these species may exert different adaptive challenges for KRCV-1. During SHFV infection, we detected signatures of selection on ORF 5a and on a small subset of sites in the genome. Overall, our data suggest that patterns of evolution differ markedly among simian arteriviruses and among host species. IMPORTANCE Certain RNA viruses can cross species barriers and cause disease in new hosts. Simian arteriviruses are a diverse group of related viruses that infect captive and wild nonhuman primates, with associated disease severity ranging from apparently asymptomatic infections to severe, viral hemorrhagic fevers. We infected nonhuman primate cell cultures and then crab-eating macaques with either simian hemorrhagic fever virus (SHFV) or Kibale red colobus virus 1 (KRCV-1) and assessed within-host viral evolution. We found that KRCV-1 quickly acquired a large number of substitutions in its genome during replication in cell culture but that evolution in macaques was limited. In contrast, we detected selection focused on SHFV ORFs 5a and 5, which encode putative membrane proteins. These patterns suggest that in addition to diverse pathogenic phenotypes, these viruses may also exhibit distinct patterns of within-host evolution both in vitro and in vivo. PMID:27974564

Comparison of habitat quality and diet of Colobus vellerosus in forest fragments in Ghana.

PubMed

Wong, Sarah N P; Saj, Tania L; Sicotte, Pascale

2006-10-01

The forest fragments surrounding the Boabeng-Fiema Monkey Sanctuary (BFMS) in central Ghana shelter small populations of Colobus vellerosus. Little is known about these populations or the ability of the fragments to support them, despite the fact that these fragments represent potentially important habitat for the colobus in this region. We compared the diet of three groups of C. vellerosus in the fragments to two groups in BFMS. We also examined the differences in plant species composition and food abundance among fragments. The study took place from June to November 2003. Dietary data were collected using scan sampling. Plant species composition and food abundance were evaluated using tree plots and large tree surveys. As in BFMS groups, leaves constituted the highest proportion of the diet of fragment groups, yet the colobus in fragments fed on more lianas than did those in BFMS. Over 50% of all species observed eaten by colobus in the fragments were not consumed in BFMS groups during the same season. Food abundance was similar between fragments and BFMS, although species composition differed. There was no relationship between the density of colobus and the density of food trees or percentage of food species, suggesting that other factors may be influencing the number of colobus present. This study highlights the broad dietary range of C. vellerosus, which may be a factor allowing its survival in these fragments.

Characterization of a novel simian immunodeficiency virus from guereza colobus monkeys (Colobus guereza) in Cameroon: a new lineage in the nonhuman primate lentivirus family.

PubMed

Courgnaud, V; Pourrut, X; Bibollet-Ruche, F; Mpoudi-Ngole, E; Bourgeois, A; Delaporte, E; Peeters, M

2001-01-01

Exploration of the diversity among primate lentiviruses is necessary to elucidate the origins and evolution of immunodeficiency viruses. During a serological survey in Cameroon, we screened 25 wild-born guereza colobus monkeys (Colobus guereza) and identified 7 with HIV/SIV cross-reactive antibodies. In this study, we describe a novel lentivirus, named SIVcol, prevalent in guereza colobus monkeys. Genetic analysis revealed that SIVcol was very distinct from all other known SIV/HIV isolates, with average amino acid identities of 40% for Gag, 50% for Pol, 28% for Env, and around 25% for proteins encoded by five other genes. Phylogenetic analyses confirmed that SIVcol is genetically distinct from other previously characterized primate lentiviruses and clusters independently, forming a novel lineage, the sixth in the current classification. Cercopithecidae monkeys (Old World monkeys) are subdivided into two subfamilies, the Colobinae and the Cercopithecinae, and, so far, all Cercopithecidae monkeys from which lentiviruses have been isolated belong to the Cercopithecinae subfamily. Therefore, SIVcol from guereza colobus monkeys (C. guereza) is the first primate lentivirus identified in the Colobinae subfamily and the divergence of SIVcol may reflect divergence of the host lineage.

The alarm call system of two species of black-and-white colobus monkeys (Colobus polykomos and Colobus guereza).

PubMed

Schel, Anne Marijke; Tranquilli, Sandra; Zuberbühler, Klaus

2009-05-01

Vervet monkey alarm calling has long been the paradigmatic example of how primates use vocalizations in response to predators. In vervets, there is a close and direct relationship between the production of distinct alarm vocalizations and the presence of distinct predator types. Recent fieldwork has however revealed the use of several additional alarm calling systems in primates. Here, the authors describe playback studies on the alarm call system of two colobine species, the King colobus (Colobus polykomos) of Taï Forest, Ivory Coast, and the Guereza colobus (C. guereza) of Budongo Forest, Uganda. Both species produce two basic alarm call types, snorts and acoustically variable roaring phrases, when confronted with leopards or crowned eagles. Neither call type is given exclusively to one predator, but the authors found strong regularities in call sequencing. Leopards typically elicited sequences consisting of a snort followed by few phrases, while eagles typically elicited sequences with no snorts and many phrases. The authors discuss how these call sequences have the potential to encode information at different levels, such as predator type, response-urgency, or the caller's imminent behavior. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Characterization of a Novel Simian Immunodeficiency Virus from Guereza Colobus Monkeys (Colobus guereza) in Cameroon: a New Lineage in the Nonhuman Primate Lentivirus Family

PubMed Central

Courgnaud, Valérie; Pourrut, Xavier; Bibollet-Ruche, Frédéric; Mpoudi-Ngole, Eitel; Bourgeois, Anke; Delaporte, Eric; Peeters, Martine

2001-01-01

Exploration of the diversity among primate lentiviruses is necessary to elucidate the origins and evolution of immunodeficiency viruses. During a serological survey in Cameroon, we screened 25 wild-born guereza colobus monkeys (Colobus guereza) and identified 7 with HIV/SIV cross-reactive antibodies. In this study, we describe a novel lentivirus, named SIVcol, prevalent in guereza colobus monkeys. Genetic analysis revealed that SIVcol was very distinct from all other known SIV/HIV isolates, with average amino acid identities of 40% for Gag, 50% for Pol, 28% for Env, and around 25% for proteins encoded by five other genes. Phylogenetic analyses confirmed that SIVcol is genetically distinct from other previously characterized primate lentiviruses and clusters independently, forming a novel lineage, the sixth in the current classification. Cercopithecidae monkeys (Old World monkeys) are subdivided into two subfamilies, the Colobinae and the Cercopithecinae, and, so far, all Cercopithecidae monkeys from which lentiviruses have been isolated belong to the Cercopithecinae subfamily. Therefore, SIVcol from guereza colobus monkeys (C. guereza) is the first primate lentivirus identified in the Colobinae subfamily and the divergence of SIVcol may reflect divergence of the host lineage. PMID:11134299

Lack of Evidence of Simian Immunodeficiency Virus Infection Among Nonhuman Primates in Taï National Park, Côte d’Ivoire: Limitations of Noninvasive Methods and SIV Diagnostic Tools for Studies of Primate Retroviruses

PubMed Central

Roeder, Amy D.; Bruford, Michael W.; Noë, Ronald; Delaporte, Eric; Peeters, Martine

2013-01-01

It is now well established that the human immunodeficiency viruses, HIV-1 and HIV-2, are the results of cross-species transmissions of simian immunodeficiency viruses (SIV) naturally infecting nonhuman primates in sub-Saharan Africa. SIVs are found in many African primates, and humans continue to be exposed to these viruses by hunting and handling primate bushmeat. Sooty mangabeys (Cercocebus atys) and western red colobus (Piliocolobus badius badius) are infected with SIV at a high rate in the Taï Forest, Côte d’Ivoire. We investigated the SIV infection and prevalence in 6 other monkey species living in the Taï Forest using noninvasive methods. We collected 127 fecal samples from 2 colobus species (Colobus polykomos and Procolobus verus) and 4 guenon species (C. diana, C. campbelli, C. petaurista, and C. nictitans). We tested these samples for HIV cross-reactive antibodies and performed reverse transcriptase-polymerase chain reactions (RT-PCR) targeting the gag, pol, and env regions of the SIV genome. We screened 16 human microsatellites for use in individual discrimination and identified 4–6 informative markers per species. Serological analysis of 112 samples yielded negative (n=86) or uninterpretable (n=26) results. PCR analysis on 74 samples confirmed the negative results. These results may reflect either the limited number of individuals sampled or a low prevalence of infection. Further research is needed to improve the sensitivity of noninvasive methods for SIV detection. PMID:23950618

Behavioral thermoregulation in a group of zoo-housed colobus monkeys (Colobus guereza).

PubMed

Wark, Jason D; Kuhar, Christopher W; Lukas, Kristen E

2014-01-01

Although wild primates are known to modify behavior in response to thermal stress, less is known about behavioral thermoregulation in zoo-housed primates. Zoo exhibits expose individuals to unique thermal environments and may constrain the thermoregulatory strategies available to individual animals. In this study, we observed a group of seven colobus monkeys (Colobus guereza) living on a concrete "Monkey Island" style exhibit that featured limited shade and limited arboreal space. Behaviors were recorded using continuous focal animal sampling (n = 63 days, 97.7 hr). Logistic regression revealed 23°C was the temperature at which monkeys began resting more in shade than in sun. When temperatures exceeded 23°C, animals spent more time in open sitting postures with limbs extended from the body; sat less frequently in closed, hunched postures; spent more time in social contact; and performed more self-directed behaviors. Exhibit use also shifted under higher temperatures, with more time spent in areas with shade and lower surface temperatures. Lastly, when provided with access to an indoor holding area, the colobus monkeys spent more than half the time indoors when temperatures exceeded 23°C, yet only 10% of their time indoors when the temperature was below this value. Although postural changes have been reported in wild colobus, the postural and other behavioral changes observed in the current study occurred at temperatures lower than expected based on the published thermoneutral zone of colobus monkeys and highlight the importance of considering the specific thermoregulatory responses of zoo animals. © 2014 Wiley Periodicals, Inc.

Passage marker excretion in red kangaroo (Macropus rufus), collared peccary (Pecari tajacu) and colobine monkeys (Colobus angolensis, C. polykomos, Trachypithecus johnii).

PubMed

Schwarm, Angela; Ortmann, Sylvia; Wolf, Christian; Streich, W Jürgen; Clauss, Marcus

2009-11-01

Ruminants are characterized by an efficient particle-sorting mechanism in the forestomach (FRST) followed by selective rechewing of large food particles. For the nonruminating foregut fermenter pygmy hippo it was demonstrated that large particles are excreted as fast as, or faster than, the small particles. The same has been suggested for other nonruminating foregut fermenters. We determined the mean retention time of fluids and different-sized particles in six red kangaroos (Macropus rufus), seven collared peccaries (Pecari tajacu) and three colobine monkeys (Colobus angolensis, C. polykomos, Trachypithecus johnii). We fed Co-EDTA as fluid and mordanted fiber as particle markers (Cr, Ce). Mean (+ or - SD) total tract retention time for fluids, small and large particles was 14 + or - 2, 29 + or - 10 and 30 + or - 9 hr in red kangaroos, 26 + or - 2, 34 + or - 5 and 32 + or - 3 hr in collared peccaries and 57 + or - 17, 55 + or - 19 and 54 + or - 19 hr in colobine monkeys, respectively. Large and small particles were excreted simultaneously in all species. There was no difference in the excretion of fluids and particles in the colobine monkeys, in contrast to the other foregut fermenters. In the nonprimate, nonruminant foregut fermenters, the difference in the excretion of fluids and small particles decreases with increasing food intake. On the contrary, ruminants keep this differential excretion constant at different intake levels. This may be a prerequisite for the sorting of particles in their FRST and enable them to achieve higher food intake rates. The functional significance of differential excretion of fluids and particles from the FRST requires further investigations.

Taxonomy and phylogeny of black-and-white colobus monkeys. Inferences from an analysis of loud call variation.

PubMed

Oates, J F; Trocco, T F

1983-01-01

Field recordings of male loud calls (or roars) from each major form of black-and-white colobus monkey have been analyzed spectrographically, and features of tempo and pitch measured. Considered together with data on cranial dimensions, coat pattern, and geographical distribution, the results of this analysis suggest that there are five species of black-and-white colobus: Colobus angolensis, C. guereza, C. polykomos, C. satanas, and C. vellerosus. C. guereza and C. vellerosus may have differentiated most recently during a major arid event prior to the last Pleistocene glacial maximum; they have an identical low-pitched roar which we consider to be a shared, derived character. The other species, of which C. satanas has the most distinct roar, may belong to older lineages.

Population size and density of Colobus vellerosus at the Boabeng-Fiema Monkey Sanctuary and surrounding forest fragments in Ghana.

PubMed

Wong, Sarah N P; Sicotte, Pascale

2006-05-01

The Boabeng-Fiema Monkey Sanctuary (BFMS) is inhabited by a growing population of Ursine colobus (Colobus vellerosus), a species that is listed as vulnerable. Smaller, degraded forest fragments that surround the BFMS also contain C. vellerosus and may provide an important habitat for the monkeys. Our objectives were to 1) determine the current population size and density of C. vellerosus at BFMS and in five surrounding fragments, 2) examine the differences in demographics between the fragments and BFMS, and 3) determine whether a relationship exists between population density and fragment size and isolation distance from BFMS. The census was a complete count and was conducted for 1 month (July 2003) by S.W. and trained research assistants. Seven census routes were walked simultaneously on 13 days. The 2003 population estimate of C. vellerosus at BFMS was 217-241 individuals (15 groups), a slight increase from the 2000 census. Numbers in the fragments (58-62, six groups) have remained stable since 1997, when the only other census of these fragments was conducted. Mean group size did not differ between the fragments and BFMS. Larger fragments had larger numbers of colobus, but there was no relationship between fragment size and colobus density. Isolation distance had no effect on population density. Our data suggest that colobus probably travel between fragments. Conservation efforts should focus on treating the small forests and their connecting areas as a single conservation unit. 2005 Wiley-Liss, Inc.

Variation in hunting behaviour in neighbouring chimpanzee communities in the Budongo forest, Uganda

PubMed Central

Hobaiter, Catherine; Samuni, Liran; Mullins, Caroline; Akankwasa, Walter John; Zuberbühler, Klaus

2017-01-01

Hunting and sharing of meat is seen across all chimpanzee sites, with variation in prey preferences, hunting techniques, frequencies, and success rates. Here, we compared hunting and meat-eating behaviour in two adjacent chimpanzee communities (Pan troglodytes schweinfurthii) of Budongo Forest, Uganda: the Waibira and Sonso communities. We observed consistent between-group differences in prey-species preferences and in post-hunting behaviour. Sonso chimpanzees show a strong prey preference for Guereza colobus monkeys (Colobus guereza occidentalis; 74.9% hunts), and hunt regularly (1–2 times a month) but with large year-to-year and month-to-month variation. Waibira chimpanzee prey preferences are distributed across primate and duiker species, and resemble those described in an early study of Sonso hunting. Waibira chimpanzees (which include ex-Sonso immigrants) have been observed to feed on red duiker (Cephalophus natalensis; 25%, 9/36 hunts), a species Sonso has never been recorded to feed on (18 years data, 27 years observations), despite no apparent differences in prey distribution; and show less rank-related harassment of meat possessors. We discuss the two most likely and probably interrelated explanations for the observed intergroup variation in chimpanzee hunting behaviour, that is, long-term disruption of complex group-level behaviour due to human presence and possible socially transmitted differences in prey preferences. PMID:28636646

A comparative study of basal metabolism and thermoregulation in a folivorous (Colobus guereza) and an omnivorous (Cercopithecus mitis) primate species.

PubMed

Müller, E F; Kamau, J M; Maloiy, G M

1983-01-01

1. Abdominal temperatures (Tab) and oxygen consumption (VO2) were measured in two males each of colobus and Sykes monkeys. 2. Tab in both species had the same range (36 38.5 C), but there were marked differences in the daily rhythms. 3. Low ambient temperatures (Ta) had little effect on Tab; at Ta = 33.5 35.5 C. however, Tab rose quickly to above 40 C. 4. The thermoneutral zone (TNZ) extended from about 5 to 28 C in both species. 5. In the colobus monkeys the basal metabolic rate (BMR) was considerably lower than in the Sykes monkeys: 85% vs 113% of the value predicted from body mass.

Naturally transmitted herpesvirus papio-2 infection in a black and white colobus monkey.

PubMed

Troan, Brigid V; Perelygina, Ludmila; Patrusheva, Irina; Wettere, Arnaud J van; Hilliard, Julia K; Loomis, Michael R; Voe, Ryan S De

2007-12-15

A 6.5-year-old female eastern black and white colobus monkey (Colobus guereza) was evaluated after acute onset of ataxia and inappetence. The monkey was ataxic and lethargic, but no other abnormalities were detected via physical examination, radiography, or clinicopathologic analyses. During the next 2 days, the monkey's clinical condition deteriorated, and its WBC count decreased dramatically. Cytologic examination of a CSF sample revealed marked lymphohistiocytic inflammation. Despite supportive care, the monkey became apneic; after 20 hours of mechanical ventilation, fatal cardiac arrest occurred. At necropsy, numerous petechiae were detected within the white matter tracts of the brain; microscopic lesions of multifocal necrosis and hemorrhage with intranuclear inclusions identified in the brain and adrenal glands were consistent with an acute herpesvirus infection. A specific diagnosis of herpesvirus papio-2 (HVP-2) infection was made on the basis of results of serologic testing; PCR assay of tissue specimens; live virus isolation from the lungs; and immunohistochemical identification of the virus within brain, spinal cord, and adrenal gland lesions. Via phylogenetic tree analysis, the colobus HVP-2 isolate was grouped with neuroinvasive strains of the virus. The virus was most likely transmitted to the colobus monkey through toys shared with a nearby colony of baboons (the natural host of HVP-2). To the authors' knowledge, this is the first reported case of natural transmission of HVP-2 to a nonhost species. Infection with HVP-2 should be a differential diagnosis for acute encephalopathy in primate monkeys and humans, particularly following exposure to baboons.

A craniometric study of the black and white Colobus Illiger 1811 (Primates: Ceropithecoidea).

PubMed

Hull, D B

1979-08-01

This study examines the craniometry of Black and White Colobus monkeys using 1072 specimens representing all the recognized subspecies (after Rahm, '70) of the genus. Seventy-six measurements were taken on each individual, and examined using canonical variates analysis and clustering by Ward's Error Sum method. The assumptions of the analytical techniques are shown to be met, and the results demonstrated to be stable. Examination of the populations for statistical difference and taxonomic distinctiveness using a multivariate extension of Mayr's Rule indicates that the taxonomy presented by Rahm ('70) is essentially correct, except that the subspecies of guereza across the northern part of Central Africa should be lumped into a single group--C. g. occidentalis--and the subspecies of montane angolan colobus in Eastern Zaire should all be lumped into C. a. ruwenzorii. The systematic patterns of the genus illustrate the whole range of the process of speciation, from barely distinct subspecies, to subspecies almost as distinct as allopatric species of the genus, and on the fully sympatric species Three major zoogeographic areas may be delineated: an East African area dominated by the effects of the Rift Valley, with a large number of subspecies isolated in forest islands; a Central African area with little subspeciation and sympatric overlap of the major species of Colobus; and a West African area with a clinal pattern of distribution of subspecies, and secondary intergradation. The arbitrary nature of Mary's Rule is also apparent. Lastly, the CVA indicated major differences across the genus to be located in the teeth and jaws, suggesting diet might be an important distinguishing feature in Colobus.

Proximity and grooming patterns reveal opposite-sex bonding in Rwenzori Angolan colobus monkeys (Colobus angolensis ruwenzorii).

PubMed

Arseneau-Robar, T Jean M; Joyce, Megan M; Stead, Samantha M; Teichroeb, Julie A

2018-05-01

Close proximity and social grooming are important bonding mechanisms in primates. These behaviors show the social structure of a species and many studies have found positive correlations between the degree of kinship and grooming and proximity. We used 1 year of data collected via instantaneous scan sampling on a large "supertroop" of Colobus angolensis ruwenzorii at Lake Nabugabo, Uganda, to examine partner preferences for grooming and nearest neighbors in each age-sex class. Little is known about this species, so we based our hypotheses on congeners. Of the five species of black-and-white colobus, data on sex-biased dispersal patterns are available for three (C. guereza, C. vellerosus, and C. polykomos), all of which show male-biased dispersal with occasional female dispersal. We thus predicted that female C. a. ruwenzorii would be more strongly bonded than males, showing greater proximity and grooming. We did not expect bonding between the sexes since congeners do not show this pattern. We found that among adult dyads, males and females were more likely to be found in loose proximity, and to groom, than would be expected given group composition. Conversely, both males and females had relatively weak same-sex relationships. Between the sexes, adult males had higher proximity and grooming indices with adult females without infants than with females with infants. These observations indicate that this subspecies is cross-bonded and that both sexes may disperse. Furthermore, our findings suggest that the social organization and social structure of C. a. ruwenzorii differ greatly from other black-and-white colobus species.

Discovery and full genome characterization of two highly divergent simian immunodeficiency viruses infecting black-and-white colobus monkeys (Colobus guereza) in Kibale National Park, Uganda.

PubMed

Lauck, Michael; Switzer, William M; Sibley, Samuel D; Hyeroba, David; Tumukunde, Alex; Weny, Geoffrey; Taylor, Bill; Shankar, Anupama; Ting, Nelson; Chapman, Colin A; Friedrich, Thomas C; Goldberg, Tony L; O'Connor, David H

2013-10-21

African non-human primates (NHPs) are natural hosts for simian immunodeficiency viruses (SIV), the zoonotic transmission of which led to the emergence of HIV-1 and HIV-2. However, our understanding of SIV diversity and evolution is limited by incomplete taxonomic and geographic sampling of NHPs, particularly in East Africa. In this study, we screened blood specimens from nine black-and-white colobus monkeys (Colobus guereza occidentalis) from Kibale National Park, Uganda, for novel SIVs using a combination of serology and "unbiased" deep-sequencing, a method that does not rely on genetic similarity to previously characterized viruses. We identified two novel and divergent SIVs, tentatively named SIVkcol-1 and SIVkcol-2, and assembled genomes covering the entire coding region for each virus. SIVkcol-1 and SIVkcol-2 were detected in three and four animals, respectively, but with no animals co-infected. Phylogenetic analyses showed that SIVkcol-1 and SIVkcol-2 form a lineage with SIVcol, previously discovered in black-and-white colobus from Cameroon. Although SIVkcol-1 and SIVkcol-2 were isolated from the same host population in Uganda, SIVkcol-1 is more closely related to SIVcol than to SIVkcol-2. Analysis of functional motifs in the extracellular envelope glycoprotein (gp120) revealed that SIVkcol-2 is unique among primate lentiviruses in containing only 16 conserved cysteine residues instead of the usual 18 or more. Our results demonstrate that the genetic diversity of SIVs infecting black-and-white colobus across equatorial Africa is greater than previously appreciated and that divergent SIVs can co-circulate in the same colobine population. We also show that the use of "unbiased" deep sequencing for the detection of SIV has great advantages over traditional serological approaches, especially for studies of unknown or poorly characterized viruses. Finally, the detection of the first SIV containing only 16 conserved cysteines in the extracellular envelope protein gp120 further expands the range of functional motifs observed among SIVs and highlights the complex evolutionary history of simian retroviruses.

Discovery and full genome characterization of two highly divergent simian immunodeficiency viruses infecting black-and-white colobus monkeys (Colobus guereza) in Kibale National Park, Uganda

PubMed Central

2013-01-01

Background African non-human primates (NHPs) are natural hosts for simian immunodeficiency viruses (SIV), the zoonotic transmission of which led to the emergence of HIV-1 and HIV-2. However, our understanding of SIV diversity and evolution is limited by incomplete taxonomic and geographic sampling of NHPs, particularly in East Africa. In this study, we screened blood specimens from nine black-and-white colobus monkeys (Colobus guereza occidentalis) from Kibale National Park, Uganda, for novel SIVs using a combination of serology and “unbiased” deep-sequencing, a method that does not rely on genetic similarity to previously characterized viruses. Results We identified two novel and divergent SIVs, tentatively named SIVkcol-1 and SIVkcol-2, and assembled genomes covering the entire coding region for each virus. SIVkcol-1 and SIVkcol-2 were detected in three and four animals, respectively, but with no animals co-infected. Phylogenetic analyses showed that SIVkcol-1 and SIVkcol-2 form a lineage with SIVcol, previously discovered in black-and-white colobus from Cameroon. Although SIVkcol-1 and SIVkcol-2 were isolated from the same host population in Uganda, SIVkcol-1 is more closely related to SIVcol than to SIVkcol-2. Analysis of functional motifs in the extracellular envelope glycoprotein (gp120) revealed that SIVkcol-2 is unique among primate lentiviruses in containing only 16 conserved cysteine residues instead of the usual 18 or more. Conclusions Our results demonstrate that the genetic diversity of SIVs infecting black-and-white colobus across equatorial Africa is greater than previously appreciated and that divergent SIVs can co-circulate in the same colobine population. We also show that the use of “unbiased” deep sequencing for the detection of SIV has great advantages over traditional serological approaches, especially for studies of unknown or poorly characterized viruses. Finally, the detection of the first SIV containing only 16 conserved cysteines in the extracellular envelope protein gp120 further expands the range of functional motifs observed among SIVs and highlights the complex evolutionary history of simian retroviruses. PMID:24139306

Characterization of the Fecal Microbiome from Non-Human Wild Primates Reveals Species Specific Microbial Communities

PubMed Central

Yildirim, Suleyman; Yeoman, Carl J.; Sipos, Maksim; Torralba, Manolito; Wilson, Brenda A.; Goldberg, Tony L.; Stumpf, Rebecca M.; Leigh, Steven R.; White, Bryan A.; Nelson, Karen E.

2010-01-01

Background Host-associated microbes comprise an integral part of animal digestive systems and these interactions have a long evolutionary history. It has been hypothesized that the gastrointestinal microbiome of humans and other non-human primates may have played significant roles in host evolution by facilitating a range of dietary adaptations. We have undertaken a comparative sequencing survey of the gastrointestinal microbiomes of several non-human primate species, with the goal of better understanding how these microbiomes relate to the evolution of non-human primate diversity. Here we present a comparative analysis of gastrointestinal microbial communities from three different species of Old World wild monkeys. Methodology/Principal Findings We analyzed fecal samples from three different wild non-human primate species (black-and-white colobus [Colubus guereza], red colobus [Piliocolobus tephrosceles], and red-tailed guenon [Cercopithecus ascanius]). Three samples from each species were subjected to small subunit rRNA tag pyrosequencing. Firmicutes comprised the vast majority of the phyla in each sample. Other phyla represented were Bacterioidetes, Proteobacteria, Spirochaetes, Actinobacteria, Verrucomicrobia, Lentisphaerae, Tenericutes, Planctomycetes, Fibrobacateres, and TM7. Bray-Curtis similarity analysis of these microbiomes indicated that microbial community composition within the same primate species are more similar to each other than to those of different primate species. Comparison of fecal microbiota from non-human primates with microbiota of human stool samples obtained in previous studies revealed that the gut microbiota of these primates are distinct and reflect host phylogeny. Conclusion/Significance Our analysis provides evidence that the fecal microbiomes of wild primates co-vary with their hosts, and that this is manifested in higher intraspecies similarity among wild primate species, perhaps reflecting species specificity of the microbiome in addition to dietary influences. These results contribute to the limited body of primate microbiome studies and provide a framework for comparative microbiome analysis between human and non-human primates as well as a comparative evolutionary understanding of the human microbiome. PMID:21103066

Use of sleeping trees by ursine colobus monkeys (Colobus vellerosus) demonstrates the importance of nearby food.

PubMed

Teichroeb, Julie A; Holmes, Teresa D; Sicotte, Pascale

2012-07-01

Examination of the characteristics and locations of sleeping sites helps to document the social and ecological pressures acting on animals. We investigated sleeping tree choice for four groups of Colobus vellerosus, an arboreal folivore, on 298 nights at the Boabeng-Fiema Monkey Sanctuary, Ghana using five non-mutually exclusive hypotheses: predation avoidance, access to food, range and resource defense, thermoregulation, and a null hypothesis of random selection. C. vellerosus utilized 31 tree species as sleeping sites and the species used differed per group depending on their availability. Groups used multiple sleeping sites and minimized their travel costs by selecting trees near feeding areas. The percentage that a food species was fed upon annually was correlated with the use of that species as a sleeping tree. Ninety percent of the sleeping trees were in a phenophase with colobus food items. Entire groups slept in non-food trees on only one night. These data strongly support the access to food hypothesis. Range and resource defense was also important to sleeping site choice. Groups slept in exclusively used areas of their home range more often than expected, but when other groups were spotted on the edge of the core area, focal groups approached the intruders, behaved aggressively, and slept close to them, seemingly to prevent an incursion into their core range. However, by sleeping high in the canopy, in large, emergent trees with dense foliage, positioning themselves away from the main trunk on medium-sized branches, and by showing low rates of site reuse, C. vellerosus also appeared to be avoiding predation in their sleeping site choices. Groups left their sleep sites later after cooler nights but did not show behavioral thermoregulation, such as huddling. This study suggests that access to food, range and resource defense, and predation avoidance were more important considerations in sleeping site selection than thermoregulation for ursine colobus.

Test of the ecological-constraints model on ursine colobus monkeys (Colobus vellerosus) in Ghana.

PubMed

Teichroeb, Julie A; Sicotte, Pascale

2009-01-01

For group-living mammals, the ecological-constraints model predicts that within-group feeding competition will increase as group size increases, necessitating more daily travel to find food and thereby constraining group size. It provides a useful tool for detecting scramble competition any time it is difficult to determine whether or not food is limiting. We tested the ecological-constraints model on highly folivorous ursine colobus monkeys (Colobus vellerosus) at the Boabeng-Fiema Monkey Sanctuary in Ghana. Three differently sized groups were followed for 13 months and two others were followed for 6 months each in 2004-2005 using focal-animal sampling and ranging scans; ecological plots and phenology surveys were used to determine home-range quality and food availability. There was relatively little difference in home-range quality, monthly food availability, diet, adult female ingestion rates, and rate of travel within food patches between the groups. However, home-range size, day-range length, and percent of time spent feeding all increased with group size. We performed a single large test of the ecological-constraints model by combining several separate Spearman correlations, each testing different predictions under the model, using Fisher's log-likelihood method. It showed that the ecological-constraints model was supported in this study; scramble competition in this population is manifesting in increased ranging and time spent feeding. How costly this increased energy expenditure is for individuals in larger groups remains to be determined. (c) 2008 Wiley-Liss, Inc.

Between-Group Variation in Female Dispersal, Kin Composition of Groups, and Proximity Patterns in a Black-and-White Colobus Monkey (Colobus vellerosus)

PubMed Central

Wikberg, Eva C.; Sicotte, Pascale; Campos, Fernando A.; Ting, Nelson

2012-01-01

A growing body of evidence shows within-population variation in natal dispersal, but the effects of such variation on social relationships and the kin composition of groups remain poorly understood. We investigate the link between dispersal, the kin composition of groups, and proximity patterns in a population of black-and-white colobus (Colobus vellerosus) that shows variation in female dispersal. From 2006 to 2011, we collected behavioral data, demographic data, and fecal samples of 77 males and 92 females residing in eight groups at Boabeng-Fiema, Ghana. A combination of demographic data and a genetic network analysis showed that although philopatry was female-biased, only about half of the females resided in their natal groups. Only one group contained female-female dyads with higher average relatedness than randomly drawn animals of both sexes from the same group. Despite between-group variation in female dispersal and kin composition, female-female dyads in most of the study groups had higher proximity scores than randomly drawn dyads from the same group. We conclude that groups fall along a continuum from female dispersed, not kin-based, and not bonded to female philopatric, kin-based, and bonded. We found only partial support for the predicted link between dispersal, kin composition, and social relationships. In contrast to most mammals where the kin composition of groups is a good predictor of the quality of female-female relationships, this study provides further support for the notion that kinship is not necessary for the development and maintenance of social bonds in some gregarious species. PMID:23144951

Ecology of the gastrointestinal parasites of Colobus vellerosus at Boabeng-Fiema, Ghana: possible anthropozoonotic transmission.

PubMed

Teichroeb, Julie A; Kutz, Susan J; Parkar, Unaiza; Thompson, R C Andrew; Sicotte, Pascale

2009-11-01

Parasite richness and prevalence in wild animals can be used as indicators of population and ecosystem health. In this study, the gastrointestinal parasites of ursine colobus monkeys (Colobus vellerosus) at the Boabeng-Fiema Monkey Sanctuary (BFMS), Ghana, were investigated. BFMS is a sacred grove where monkeys and humans have long lived in relatively peaceful proximity. Fecal samples (n = 109) were collected opportunistically from >27 adult and subadult males in six bisexual groups and one all-male band from July 2004 to August 2005. Using fecal floatation, we detected three protozoans (two Entamoeba sp., Isospora sp.), five nematodes (Ascaris sp., Enterobius sp., Trichuris sp., two strongyle sp.), and one digenean trematode. Using fluorescein labeled antibodies, we detected an additional protozoan (Giardia sp.), and with PCR techniques, we characterized this as G. duodenalis Assemblage B and also identified a protistan (Blastocystis sp., subtype 2). The most prevalent parasite species were G. duodenalis and Trichuris sp. Parasites were more prevalent in the long wet season than the long dry. Parasite prevalence did not vary by age, and average parasite richness did not differ by rank for males whose status remained unchanged. However, males that changed rank tended to show higher average parasite richness when they were lower ranked. Individuals that spent more time near human settlements had a higher prevalence of Isospora sp. that morphologically resembled the human species I. belli. The presence of this parasite and G. duodenalis Assemblage B indicates possible anthropozoonotic and/or zoonotic transmission between humans and colobus monkeys at this site.

The single species hypothesis: truly dead and pushing up bushes, or still twitching and ripe for resuscitation?

PubMed

Hunt, Kevin D

2003-08-01

Frank Livingstone proclaims himself to be the last living proponent of the single species hypothesis. In sharp contrast, a species-rich, bushy phylogeny is favored by most human paleontologists. Is Livingstone's proclamation merely contrarian posturing, or does closer inspection warrant reconsideration of just how speciose the hominin lineage is? The high-speciation perspective draws on evidence of speciosity in the Cercopithecoidea and punctuated equilibria theory for support. If blue monkeys and redtail monkeys are indistinguishable skeletally, this reasoning goes, or if red colobus and black and white colobus are likewise indistinguishable, should we not expect that there are more species of hominin than is apparent from skeletal evidence alone? A contrarian perspective notes that not all monkey taxa are speciose. Importantly, two broadly distributed, partly terrestrial monkeys have not speciated at all: vervets and baboons. Nor are monkeys the first choice as a hominin speciation model. If expectations of species numbers are based on the Hominoidea, a taxon more closely related to hominins, more similar in body size, and found in more hominin-like habitats than monkeys, a single-species perspective is more appealing. No great ape genus has even two sympatric species. Moreover, despite a separation of 1.6 Ma, West African chimpanzees have not speciated from Pt. troglodytes nor Pt. schweinfurthii. It is notable that no two contemporaneous species of hominin were separated by significantly more than this interval. A biological--as opposed to an ecological or geographical--species definition would place all hominins in a single, phenotypically diverse species. Since divergence from the chimpanzee, "species" distinctness in hominins may have been maintained by temporary allopatry and centripetal niche separation. The hominin lineage may have evolved as a single, phenotypically diverse, reticulately evolving species.

Novel simian foamy virus infections from multiple monkey species in women from the Democratic Republic of Congo

PubMed Central

2012-01-01

Background Zoonotic transmission of simian retroviruses in Central Africa is ongoing and can result in pandemic human infection. While simian foamy virus (SFV) infection was reported in primate hunters in Cameroon and Gabon, little is known about the distribution of SFV in Africa and whether human-to-human transmission and disease occur. We screened 3,334 plasmas from persons living in rural villages in central Democratic Republic of Congo (DRC) using SFV-specific EIA and Western blot (WB) tests. PCR amplification of SFV polymerase sequences from DNA extracted from buffy coats was used to measure proviral loads. Phylogenetic analysis was used to define the NHP species origin of SFV. Participants completed questionnaires to capture NHP exposure information. Results Sixteen (0.5%) samples were WB-positive; 12 of 16 were from women (75%, 95% confidence limits 47.6%, 92.7%). Sequence analysis detected SFV in three women originating from Angolan colobus or red-tailed monkeys; both monkeys are hunted frequently in DRC. NHP exposure varied and infected women lived in distant villages suggesting a wide and potentially diverse distribution of SFV infections across DRC. Plasmas from 22 contacts of 8 WB-positive participants were all WB negative suggesting no secondary viral transmission. Proviral loads in the three women ranged from 14 – 1,755 copies/105 cells. Conclusions Our study documents SFV infection in rural DRC for the first time and identifies infections with novel SFV variants from Colobus and red-tailed monkeys. Unlike previous studies, women were not at lower risk for SFV infection in our population, providing opportunities for spread of SFV both horizontally and vertically. However, limited testing of close contacts of WB-positive persons did not identify human-to-human transmission. Combined with the broad behavioral risk and distribution of NHPs across DRC, our results suggest that SFV infection may have a wider geographic distribution within DRC. These results also reinforce the potential for an increased SFV prevalence throughout the forested regions of Africa where humans and simians co-exist. Our finding of endemic foci of SFV infection in DRC will facilitate longitudinal studies to determine the potential for person-to-person transmissibility and pathogenicity of these zoonotic retroviral infections. PMID:23217108

Primates decline rapidly in unprotected forests: evidence from a monitoring program with data constraints.

PubMed

Rovero, Francesco; Mtui, Arafat; Kitegile, Amani; Jacob, Philipo; Araldi, Alessandro; Tenan, Simone

2015-01-01

Growing threats to primates in tropical forests make robust and long-term population abundance assessments increasingly important for conservation. Concomitantly, monitoring becomes particularly relevant in countries with primate habitat. Yet monitoring schemes in these countries often suffer from logistic constraints and/or poor rigor in data collection, and a lack of consideration of sources of bias in analysis. To address the need for feasible monitoring schemes and flexible analytical tools for robust trend estimates, we analyzed data collected by local technicians on abundance of three species of arboreal monkey in the Udzungwa Mountains of Tanzania (two Colobus species and one Cercopithecus), an area of international importance for primate endemism and conservation. We counted primate social groups along eight line transects in two forest blocks in the area, one protected and one unprotected, over a span of 11 years. We applied a recently proposed open metapopulation model to estimate abundance trends while controlling for confounding effects of observer, site, and season. Primate populations were stable in the protected forest, while the colobines, including the endemic Udzungwa red colobus, declined severely in the unprotected forest. Targeted hunting pressure at this second site is the most plausible explanation for the trend observed. The unexplained variability in detection probability among transects was greater than the variability due to observers, indicating consistency in data collection among observers. There were no significant differences in both primate abundance and detectability between wet and dry seasons, supporting the choice of sampling during the dry season only based on minimizing practical constraints. Results show that simple monitoring routines implemented by trained local technicians can effectively detect changes in primate populations in tropical countries. The hierarchical Bayesian model formulation adopted provides a flexible tool to determine temporal trends with full account for any imbalance in the data set and for imperfect detection.

Habitat fragmentation is associated to gut microbiota diversity of an endangered primate: implications for conservation

PubMed Central

Barelli, Claudia; Albanese, Davide; Donati, Claudio; Pindo, Massimo; Dallago, Chiara; Rovero, Francesco; Cavalieri, Duccio; Michael Tuohy, Kieran; Christine Hauffe, Heidi; De Filippo, Carlotta

2015-01-01

The expansion of agriculture is shrinking pristine forest areas worldwide, jeopardizing the persistence of their wild inhabitants. The Udzungwa red colobus monkey (Procolobus gordonorum) is among the most threatened primate species in Africa. Primarily arboreal and highly sensitive to hunting and habitat destruction, they provide a critical model to understanding whether anthropogenic disturbance impacts gut microbiota diversity. We sampled seven social groups inhabiting two forests (disturbed vs. undisturbed) in the Udzungwa Mountains of Tanzania. While Ruminococcaceae and Lachnospiraceae dominated in all individuals, reflecting their role in extracting energy from folivorous diets, analysis of genus composition showed a marked diversification across habitats, with gut microbiota α-diversity significantly higher in the undisturbed forest. Functional analysis suggests that such variation may be associated with food plant diversity in natural versus human-modified habitats, requiring metabolic pathways to digest xenobiotics. Thus, the effects of changes in gut microbiota should not be ignored to conserve endangered populations. PMID:26445280

Frequent water drinking by Zanzibar red colobus (Procolobus kirkii) in a mangrove forest refuge.

PubMed

Nowak, Katarzyna

2008-11-01

Isolated populations of Procolobus kirkii on Uzi Island, Zanzibar, use Rhizophora mucronata-dominated mangrove forest for refuge. Three groups, observed over 14 months, spent up to 85% of total observation time in mangroves with brief excursions to adjacent upland coral rag forest, habitat degraded by human cutting. A large proportion of monkeys' diets consisted of plant parts of five mangrove species. Water drinking was common and 326 water-drinking events were recorded at a rate of up to 0.87 drinks hr(-1). Groups used different strategies to obtain water including licking dew, drinking from treeholes, licking rain off leaves and tree trunks, and drinking from coral rock crevices with Cercopithecus mitis albogularis. Drinking frequency increased with time spent in and consumption of mangroves. Strategies for obtaining water were group-specific and likely the result of learning. Drinking appeared to be an acquired behavior in movement-restricted groups living in a habitat with low plant species diversity and limited salty foods. Copyright 2008 Wiley-Liss, Inc.

Stomach Fermentation in East African Colobus Monkeys in Their Natural State

PubMed Central

Ohwaki, Kyoko; Hungate, R. E.; Lotter, Leonard; Hofmann, R. R.; Maloiy, Geoffrey

1974-01-01

The microbial fermentation in the stomachs of two monkeys, Colobus polykomos, collected in Kenya, was studied. The gas accumulated within the stomach contained H2 but no CH4. Volatile fatty acid concentrations were high, but accumulated acid prevented determination of the fermentation rate in untreated, incubated stomach contents. Upon addition of bicarbonate, a very rapid rate could be demonstrated. Some D- and L-lactate were in the stomach contents. Starchy seeds or fruits rather than leaves appeared to have been consumed. Microscopically, the most prominent microorganisms seen were large, very refringent cocci, possibly Sarcina ventriculi, and various smaller cocci and rods. The 28 cultured strains of bacteria included 14 Staphylococcus, 2 Streptococcus, 10 Propionibacterium, and 2 Peptostreptococcus. The culture count constituted 10 to 20% of the direct count. No protozoa or cellulolytic bacteria were found. Images PMID:4207763

Activity budget and ranging patterns of Colobus vellerosus in forest fragments in central Ghana.

PubMed

Wong, Sarah N P; Sicotte, Pascale

2007-01-01

The forest fragments surrounding the 192-ha Boabeng-Fiema Monkey Sanctuary (BFMS) in central Ghana contain small populations of Colobus vellerosus. Data were collected on activity budget, ranging patterns and habitat use of 3 groups living in these small fragments in August-November 2003, and compared to 3 BFMS groups. Fragment groups spent less time moving and more time resting than BFMS groups. Home ranges of fragment groups tended to be smaller than those of BFMS groups. Fragment and BFMS groups used similarly sized trees. Comparisons of activity budget and ranging between fragments and the BFMS suggest that fragment habitat quality was sufficient to sustain current numbers. These behavioral trends are consistent with a concurrent study that we conducted investigating ecological quality in the same fragments. Copyright 2007 S. Karger AG, Basel.

A Novel Hepacivirus with an Unusually Long and Intrinsically Disordered NS5A Protein in a Wild Old World Primate

PubMed Central

Lauck, Michael; Sibley, Samuel D.; Lara, James; Purdy, Michael A.; Khudyakov, Yury; Hyeroba, David; Tumukunde, Alex; Weny, Geoffrey; Switzer, William M.; Chapman, Colin A.; Hughes, Austin L.; Friedrich, Thomas C.; O'Connor, David H.

2013-01-01

GB virus B (GBV-B; family Flaviviridae, genus Hepacivirus) has been studied in New World primates as a model for human hepatitis C virus infection, but the distribution of GBV-B and its relatives in nature has remained obscure. Here, we report the discovery of a novel and highly divergent GBV-B-like virus in an Old World monkey, the black-and-white colobus (Colobus guereza), in Uganda. The new virus, guereza hepacivirus (GHV), clusters phylogenetically with GBV-B and recently described hepaciviruses infecting African bats and North American rodents, and it shows evidence of ancient recombination with these other hepaciviruses. Direct sequencing of reverse-transcribed RNA from blood plasma from three of nine colobus monkeys yielded near-complete GHV genomes, comprising two distinct viral variants. The viruses contain an exceptionally long nonstructural 5A (NS5A) gene, approximately half of which codes for a protein with no discernible homology to known proteins. Computational structure-based analyses indicate that the amino terminus of the GHV NS5A protein may serve a zinc-binding function, similar to the NS5A of other viruses within the family Flaviviridae. However, the 521-amino-acid carboxy terminus is intrinsically disordered, reflecting an unusual degree of structural plasticity and polyfunctionality. These findings shed new light on the natural history and evolution of the hepaciviruses and on the extent of structural variation within the Flaviviridae. PMID:23740998

Trichuris colobae n. sp. (Nematoda: Trichuridae), a new species of Trichuris from Colobus guereza kikuyensis.

PubMed

Cutillas, Cristina; de Rojas, Manuel; Zurita, Antonio; Oliveros, Rocío; Callejón, Rocío

2014-07-01

In the present work, a morphological and biometrical study of whipworms Trichuris Roederer, 1761 (Nematoda: Trichuridae) parasitizing Colobus guereza kikuyensis has been carried out. Biometrical and statistical data showed that the mean values of individual variables between Trichuris suis and Trichuris sp. from C. g. kikuyensis differed significantly (P < 0.001) when Student's t test was performed: seven male variables (width of esophageal region of body, maximum width of posterior region of body, width in the place of junction of esophagus and the intestine, length of bacillary stripes, length of spicule, length of ejaculatory duct, and distance between posterior part of testis and tail end of body) and three female variables (width of posterior region of body, length of bacillary stripes, and distance of tail end of body and posterior fold of seminal receptacle). The combination of these characters permitted the discrimination of T. suis with respect to Trichuris sp. from C. g. kikuyensis, suggesting a new species of Trichuris. Furthermore, males of Trichuris sp. from C. g. kikuyensis showed a typical subterminal pericloacal papillae associated to a cluster of small papillae that were absent in males of T. suis, while females of Trichuris from Colobus appeared with a vulval region elevated/over-mounted showing a crater-like appearance. The everted vagina showed typical triangular sharp spines by optical microscopy and SEM. Thus, the existence of a new species of Trichuris parasitizing C. g. kikuyensis has been proposed.

A novel hepacivirus with an unusually long and intrinsically disordered NS5A protein in a wild Old World primate.

PubMed

Lauck, Michael; Sibley, Samuel D; Lara, James; Purdy, Michael A; Khudyakov, Yury; Hyeroba, David; Tumukunde, Alex; Weny, Geoffrey; Switzer, William M; Chapman, Colin A; Hughes, Austin L; Friedrich, Thomas C; O'Connor, David H; Goldberg, Tony L

2013-08-01

GB virus B (GBV-B; family Flaviviridae, genus Hepacivirus) has been studied in New World primates as a model for human hepatitis C virus infection, but the distribution of GBV-B and its relatives in nature has remained obscure. Here, we report the discovery of a novel and highly divergent GBV-B-like virus in an Old World monkey, the black-and-white colobus (Colobus guereza), in Uganda. The new virus, guereza hepacivirus (GHV), clusters phylogenetically with GBV-B and recently described hepaciviruses infecting African bats and North American rodents, and it shows evidence of ancient recombination with these other hepaciviruses. Direct sequencing of reverse-transcribed RNA from blood plasma from three of nine colobus monkeys yielded near-complete GHV genomes, comprising two distinct viral variants. The viruses contain an exceptionally long nonstructural 5A (NS5A) gene, approximately half of which codes for a protein with no discernible homology to known proteins. Computational structure-based analyses indicate that the amino terminus of the GHV NS5A protein may serve a zinc-binding function, similar to the NS5A of other viruses within the family Flaviviridae. However, the 521-amino-acid carboxy terminus is intrinsically disordered, reflecting an unusual degree of structural plasticity and polyfunctionality. These findings shed new light on the natural history and evolution of the hepaciviruses and on the extent of structural variation within the Flaviviridae.

Tribal ethnicity and CYP2B6 genetics in Ugandan and Zimbabwean populations in the UK: implications for efavirenz dosing in HIV infection.

PubMed

Jamshidi, Y; Moreton, M; McKeown, D A; Andrews, S; Nithiyananthan, T; Tinworth, L; Holt, D W; Sadiq, S T

2010-12-01

To determine differences in CYP2B6 loss of function (LoF) single nucleotide polymorphisms (SNPs) and haplotypes between Zimbabweans and Ugandans, and within Ugandan populations (Bantu and Nilotic). Genetic epidemiological study enrolling adult black African Ugandan and Zimbabwean patients attending a UK HIV-1 clinic, irrespective of antiretroviral therapy status. Genomic DNA was extracted from whole blood and the presence of CYP2B6 alleles was determined by direct sequencing of all nine exons of the CYP2B6 gene. Blood was also collected, where appropriate, for determination of efavirenz concentrations. Frequency of SNPs in all patients and LoF haplotype frequencies were calculated. The relationship between the number of LoF haplotype alleles possessed and efavirenz trough concentration (ETC) was determined. Thirty-six Zimbabweans and 74 Ugandans (58 Bantu and 16 Nilotic) were recruited. The definite haplotypes determined were *6, *18, *20 and *27 as LoF and *4 as gain of function. Among those with definite genotypes, the frequency of LoF alleles was 65% [95% confidence interval (95% CI): 51-80] of Zimbabweans versus 22% (95% CI: 12-31) of Ugandan Bantus (P = 10(-6)) and versus 39% (95% CI: 14-64) of Ugandan Nilotics (P = 0.09). Among the 19 patients with definite genotype and with available ETCs, log ETCs were associated with a greater number of LoF haplotype alleles [848 ng/mL (n = 12), 1069 ng/mL (n = 4) and 1813 ng/mL (n = 3) for 0, 1 or 2 LoF haplotypes, respectively (P = 0.016)]. Among Zimbabweans, LoF haplotypes constitute the majority of CYP2B6 alleles and are significantly higher in prevalence compared with Ugandans. Frequencies of LoF haplotypes and SNPs in Ugandan Nilotics appear to lie between those of Zimbabweans and Ugandan Bantus. These findings may have relevance to pharmacokinetics and dosing of efavirenz in African populations.

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.

Plant DNA sequences from feces: potential means for assessing diets of wild primates.

PubMed

Bradley, Brenda J; Stiller, Mathias; Doran-Sheehy, Diane M; Harris, Tara; Chapman, Colin A; Vigilant, Linda; Poinar, Hendrik

2007-06-01

Analyses of plant DNA in feces provides a promising, yet largely unexplored, means of documenting the diets of elusive primates. Here we demonstrate the promise and pitfalls of this approach using DNA extracted from fecal samples of wild western gorillas (Gorilla gorilla) and black and white colobus monkeys (Colobus guereza). From these DNA extracts we amplified, cloned, and sequenced small segments of chloroplast DNA (part of the rbcL gene) and plant nuclear DNA (ITS-2). The obtained sequences were compared to sequences generated from known plant samples and to those in GenBank to identify plant taxa in the feces. With further optimization, this method could provide a basic evaluation of minimum primate dietary diversity even when knowledge of local flora is limited. This approach may find application in studies characterizing the diets of poorly-known, unhabituated primate species or assaying consumer-resource relationships in an ecosystem. (c) 2007 Wiley-Liss, Inc.

Kinship and similarity in residency status structure female social networks in black-and-white colobus monkeys (Colobus vellerosus).

PubMed

Wikberg, Eva C; Ting, Nelson; Sicotte, Pascale

2014-03-01

Kinship shapes female social networks in many primate populations in which females remain in their natal group to breed. In contrast, it is unclear to which extent kinship affects the social networks in populations with female dispersal. Female Colobus vellerosus show routine facultative dispersal (i.e., some females remain philopatric and others disperse). This dispersal pattern allowed us to evaluate if facultative dispersed females form social networks shaped by an attraction to kin, to social partners with a high resource holding potential, or to similar social partners in terms of maturational stage, dominance rank, and residency status. During 2008 and 2009, we collected behavioral data via focal and ad libitum sampling of 61 females residing in eight groups at Boabeng-Fiema, Ghana. We determined kinship based on partial pedigrees and genotypes at 17 short tandem repeat loci. Kinship influenced coalition and affiliation networks in three groups consisting of long-term resident females with access to a relatively high number of female kin. In contrast, similar residency status was more important than kinship in structuring the affiliation network in one of two groups that contained recent female immigrants. In populations with female dispersal, the occurrence of kin structured social networks may not only depend on the kin composition of groups but also on how long the female kin have resided together. We found no consistent support for females biasing affiliation toward partners with high resource holding potential, possibly due to low levels of contest competition and small inter-individual differences in resource holding potential. Copyright © 2013 Wiley Periodicals, Inc.

On the Limits of Sexual Health Literacy: Insights from Ugandan Schoolgirls

ERIC Educational Resources Information Center

Jones, Shelley; Norton, Bonny

2007-01-01

This article makes the case that current conceptions of sexual health literacy have limited relevance to the Ugandan context because they assume that knowledge of unsafe sexual practices will lead to changes in behavior and lifestyle. Drawing on a longitudinal case study with 15 Ugandan schoolgirls in rural Uganda from August 2004 to September…

The effect of malnutrition on the pharmacokinetics and virologic outcomes of lopinavir, efavirenz and nevirapine in food insecure HIV-infected children in Tororo, Uganda.

PubMed

Bartelink, Imke H; Savic, Rada M; Dorsey, Grant; Ruel, Theodore; Gingrich, David; Scherpbier, Henriette J; Capparelli, Edmund; Jullien, Vincent; Young, Sera L; Achan, Jane; Plenty, Albert; Charlebois, Edwin; Kamya, Moses; Havlir, Diane; Aweeka, Francesca

2015-03-01

Malnutrition may impact the pharmacokinetics (PKs) of antiretroviral medications and virologic responses in HIV-infected children. The authors therefore evaluated the PK of nevirapine (NVP), efavirenz (EFV) and lopinavir (LPV) in associations with nutritional status in a cohort of HIV-infected Ugandan children. Sparse dried blood spot samples from Ugandan children were used to estimate plasma concentrations. Historical PK data from children from 3 resource-rich countries (RRC) were utilized to develop the PK models. Concentrations in 330 dried blood spot from 163 Ugandan children aged 0.7-7 years were analyzed in reference to plasma PK data (1189 samples) from 204 children from RRC aged 0.5-12 years. Among Ugandan children, 48% was malnourished (underweight, thin or stunted). Compared to RRC, Ugandan children exhibited reduced bioavailability of EFV and LPV; 11% (P=0.045) and 18% (P=0.008), respectively. In contrast, NVP bioavailability was 46% higher in Ugandan children (P<0.001) with a trend toward greater bioavailability when malnourished. Children receiving LPV, EFV or NVP had comparable risk of virologic failure. Among children on NVP, low height and weight for age Z scores were associated with reduced risk of virologic failure (P=0.034, P=0.068, respectively). Ugandan children demonstrated lower EFV and LPV and higher NVP exposure compared to children in RRC, perhaps reflecting the consequence of malnutrition on bioavailability. In children receiving NVP, the relation between exposure, malnutrition and outcome turned out to be marginally significant. Further investigations are warranted using more intensive PK measurements and adequate adherence assessments, to further assess causes of virologic failure in Ugandan children.

Fatal infections with Balamuthia mandrillaris (a free-living amoeba) in gorillas and other Old World primates.

PubMed

Rideout, B A; Gardiner, C H; Stalis, I H; Zuba, J R; Hadfield, T; Visvesvara, G S

1997-01-01

Balamuthia mandrillaris is a newly described free-living amoeba capable of causing fatal meningoencephalitis in humans and animals. Because the number of human cases is rapidly increasing, this infection is now considered an important emerging disease by the medical community. A retrospective review of the pathology database for the Zoological Society of San Diego (the San Diego Zoo and San Diego Wild Animal Park) for the period July 1965 through December 1994 revealed five cases of amoebic meningoencephalitis, all in Old World primates. The infected animals were a 3-year, 10-month-old female mandrill (Papio sphinx), from which the original isolation of B. mandrillaris was made, a 5-year-old male white-cheeked gibbon (Hylobates concolor leucogenys), a 1-year-old female western lowland gorilla (Gorilla gorilla gorilla), a 13-year, 5-month-old male western lowland gorilla, and a 6-year-old female Kikuyu colobus monkey (Colobus guereza kikuyuensis). Two different disease patterns were identified: the gibbon, mandrill, and 1-year-old gorilla had an acute to subacute necrotizing amoebic meningoencephalitis with a short clinical course, and the adult gorilla and colobus monkey had a granulomatous amoebic meningoencephalitis with extraneural fibrogranulomatous inflammatory lesions and a long clinical course. Indirect immunofluorescent staining of amoebas in brain sections with a Balamuthia-specific polyclonal antibody was positive in all five animals. Indirect immunofluorescent staining for several species of Acanthamoeba, Naegleria fowleri, and Hartmanella vermiformis was negative. Direct examination of water and soil samples from the gorilla and former mandrill enclosures revealed unidentified amoebas in 11/27 samples, but intraperitoneal inoculations in mice failed to induce disease. Attempts to isolate amoebas from frozen tissues from the adult male gorilla were unsuccessful.

Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China.

PubMed

Davis, Alissa; Meyerson, Beth E; Aghaulor, Blessing; Brown, Katherine; Watson, Adisyn; Muessig, Kathryn E; Yang, Ligang; Tucker, Joseph D

2016-10-14

Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes. Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals. Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.

Developing a model of midwifery mentorship for Uganda: The MOMENTUM project 2015-2017.

PubMed

Kemp, Joy; Shaw, Eleanor; Musoke, Mary Gorret

2018-04-01

MOMENTUM was a 20 month midwifery twinning project between the Royal College of Midwives UK and the Ugandan Private Midwives Association. It ran from 2015-2017 and was funded by UK-Aid through THET. MOMENTUM aimed to develop a model of mentorship for Ugandan midwifery students. The project achieved its objectives. 41 Ugandan midwives were trained as mentors following a work-based learning curriculum. 142 student midwives from 8 midwifery schools received mentorship in 7 participating clinical sites. All sites showed measured improvement in the clinical learning environment. 7 UK midwives were twinned with Ugandan counterparts and engaged in peer-exchange visits and virtual support via smart-phones. The model is context-specific and may not be replicable in other countries or professions. However it will inform midwifery education in the UK and elsewhere. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

Evaluating the suitability of planted forests for African forest monkeys: a case study from Kakamega forest, Kenya.

PubMed

Fashing, Peter J; Nguyen, Nga; Luteshi, Patrick; Opondo, Winstone; Cash, Julie F; Cords, Marina

2012-01-01

As natural forest cover declines, planted forests have come to occupy an increasing percentage of the earth's surface, yet we know little about their suitability as alternative habitat for wildlife. Although some primate species use planted forests, few studies have compared primate populations in natural and nearby planted forests. From March 2006 to July 2010, we conducted line transect surveys and assessed group sizes and compositions in natural and nearby 60-70 year old mixed indigenous planted forest to determine the densities of diurnal primate species (Colobus guereza, Cercopithecus mitis, C. ascanius) in these two forest types at Isecheno, Kakamega Forest, Kenya. Line transect data were analyzed using the Encounter Rate, Whitesides, and Distance sampling methods, which all provided broadly consistent results. We found that all three diurnal primate species occupy both natural and planted forest at Isecheno. However, group densities of the two Cercopithecus species were 42-46% lower in planted than in natural forest. Colobus guereza achieved comparable group densities in the two forest types, although the species is found in smaller groups, and thus at lower (35%) individual density, in planted than in natural forest. Following a logging episode in the planted forest mid-way through our study, Cercopithecus ascanius group densities fell by 60% while C. mitis and Colobus guereza group densities remained stable over the next two years. Overall, our results suggest that while primate species vary in their response to habitat disturbance, planted forest has the potential to contribute to the conservation of some African monkey species. Even for the relatively flexible taxa in our study, however, 60-70 year old mixed indigenous planted forest failed to support densities comparable to those in nearby natural forest. From the perspective of Kakamega's primates, planted forests may supplement natural forest, but are not an adequate replacement for it. © 2011 Wiley Periodicals, Inc.

Posttraumatic Resilience in Former Ugandan Child Soldiers

ERIC Educational Resources Information Center

Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Post, Manuela; Hoyer, Catrin; Adam, Hubertus

2010-01-01

The present research examines posttraumatic resilience in extremely exposed children and adolescents based on interviews with 330 former Ugandan child soldiers (age = 11-17, female = 48.5%). Despite severe trauma exposure, 27.6% showed posttraumatic resilience as indicated by the absence of posttraumatic stress disorder, depression, and clinically…

'They wrote "gay" on her file': transgender Ugandans in HIV prevention and treatment.

PubMed

Minor Peters, Melissa

2016-01-01

This paper examines the ways in which HIV-related programmes for heterosexual Ugandans and also for men who have sex with men work to deny healthcare services to transgender people in Uganda. Contrary to current conventional wisdom, the study found that the widespread use of the term 'men who have sex with men' produces greater barriers to healthcare for queer Ugandans than identity categories such as 'lesbian' or 'transgender'. Interventions for men who have sex with men assume a male-identified sexual subject with agency over sexual practices, such as frequency of condom use. Based on two years of ethnographic research in Kampala, I suggest that the focus on individual sexual practices harms transgender people in two ways. First, current HIV prevention and treatment programmes fail to account for risk factors that accrue to both male and female transgender Ugandans due to the social enforcement of gender norms. Second, the term men who have sex with men directs attention towards stigmatised sexual practices, producing the neglect and abuse of non-heteronormative individuals. In the context of Ugandan healthcare, terms such as 'transgender' and kuchu instead focus attention on the dignity and humanity of the rights-bearing person. These findings emphasise how health practitioners must pay attention to emic categories in order to address the ways in which vulnerability is distributed along social vectors of difference.

Distance Learning Library Services in Ugandan Universities

ERIC Educational Resources Information Center

Mayende, Jackline Estomihi Kiwelu; Obura, Constant Okello

2013-01-01

The study carried out at Makerere University and Uganda Martyrs University in 2010 aimed at providing strategies for enhanced distance learning library services in terms of convenience and adequacy. The study adopted a cross sectional descriptive survey design. The study revealed services provided in branch libraries in Ugandan universities were…

Incisor microwear and diet in three species of Colobus.

PubMed

Kelley, J

1990-01-01

Examination of incisor microwear in three species of Colobus revealed that the predominantly folivorous C. badius more closely resembles C. satanas, a seed predator/folivore, than C. guereza, another predominantly folivorous species. This demonstrates that species of the same broad dietary category can have very different patterns of incisor microwear, indicative of differences in food procurement behavior and/or the physical properties of dietary items for some portion of the diet. Conversely, species of different categories can have microwear patterns that, superficially at least, are quite similar. The dissimilarity in incisor microwear between C. badius and C. guereza is mirrored to a certain extent in molar microwear, although the differences are not nearly so great on the molars. The differences between C. badius and C. guereza may involve different food items in the major, folivorous portions of their diets, or they may relate to differences in the very minor fruit and bark components. The similar microwear patterns of C. badius and C. satanas demonstrate that incisor microwear by itself is unreliable for assigning fossil species to broad dietary categories. Incisor microwear can be used to infer finer dietary distinctions in fossil species for which dietary category has been determined by other means.

Academic Achievement of Ugandan Sixth Grade Students: Influence of Parents' Education Levels

ERIC Educational Resources Information Center

Wamala, Robert; Kizito, Omala Saint; Jjemba, Evans

2013-01-01

The study investigates the influence of a father and mother's education on the academic achievement of their child. The investigation is based on data sourced from the 2009 Southern African Consortium for Monitoring Education Quality survey comprising 5,148 records of sixth grade students enrolled in Ugandan primary schools. Students' percentage…

Striding Forward: Girls and Women in Ugandan Schools

ERIC Educational Resources Information Center

Rosenberg, David

2006-01-01

This article looks at the important role that teachers and headteachers can have as role models for children living with challenging circumstances. It focuses particularly on girls struggling against the odds to complete their education in Ugandan schools and improve their life chances. The commitment to women's rights espoused by Uganda's…

Ugandan Adolescents' Sources, Interpretation and Evaluation of Sexual Content in Entertainment Media Programming

ERIC Educational Resources Information Center

Miller, Ann Neville; Nalugya, Evangeline; Gabolya, Charles; Lagot, Sarah; Mulwanya, Richard; Kiva, Joseph; Nabasaaka, Grace; Chibita, Monica

2016-01-01

Although mounting evidence in Western nations indicates that entertainment media influence young people's sexual socialisation, virtually no research has addressed the topic in sub-Saharan Africa. The present study employed 14 focus groups of Ugandan high school students to identify media through which they were exposed to sexual content, how they…

‘Impact hunters’ catalyse cooperative hunting in two wild chimpanzee communities

PubMed Central

Gilby, Ian C.; Machanda, Zarin P.; Mjungu, Deus C.; Rosen, Jeremiah; Muller, Martin N.; Pusey, Anne E.; Wrangham, Richard W.

2015-01-01

Even when hunting in groups is mutually beneficial, it is unclear how communal hunts are initiated. If it is costly to be the only hunter, individuals should be reluctant to hunt unless others already are. We used 70 years of data from three communities to examine how male chimpanzees ‘solve’ this apparent collective action problem. The ‘impact hunter’ hypothesis proposes that group hunts are sometimes catalysed by certain individuals that hunt more readily than others. In two communities (Kasekela and Kanyawara), we identified a total of five males that exhibited high hunt participation rates for their age, and whose presence at an encounter with red colobus monkeys increased group hunting probability. Critically, these impact hunters were observed to hunt first more often than expected by chance. We argue that by hunting first, these males dilute prey defences and create opportunities for previously reluctant participants. This by-product mutualism can explain variation in group hunting rates within and between social groups. Hunting rates declined after the death of impact hunter FG in Kasekela and after impact hunter MS stopped hunting frequently in Kanyawara. There were no impact hunters in the third, smaller community (Mitumba), where, unlike the others, hunting probability increased with the number of females present at an encounter with prey. PMID:26503679

Voice discrimination in four primates.

PubMed

Candiotti, Agnès; Zuberbühler, Klaus; Lemasson, Alban

2013-10-01

One accepted function of vocalisations is to convey information about the signaller, such as its age-sex class, motivation, or relationship with the recipient. Yet, in natural habitats individuals not only interact with conspecifics but also with members of other species. This is well documented for African forest monkeys, which form semi-permanent mixed-species groups that can persist for decades. Although members of such groups interact with each other on a daily basis, both physically and vocally, it is currently unknown whether they can discriminate familiar and unfamiliar voices of heterospecific group members. We addressed this question with playbacks on monkey species known to form polyspecific associations in the wild: red-capped mangabeys, Campbell's monkeys and Guereza colobus monkeys. We tested subjects' discrimination abilities of contact calls of familiar and unfamiliar female De Brazza monkeys. When pooling all species, subjects looked more often towards the speaker when hearing contact calls of unfamiliar than familiar callers. When testing De Brazza monkeys with their own calls, we found the same effect with the longest gaze durations after hearing unfamiliar voices. This suggests that primates can discriminate, not only between familiar and unfamiliar voices of conspecifics, but also between familiar and unfamiliar voices of heterospecifics living within a close proximity. Copyright © 2013 Elsevier B.V. All rights reserved.

Cytomegaloviruses in a Community of Wild Nonhuman Primates in Taï National Park, Côte D’Ivoire

PubMed Central

Anoh, Augustin Etile; Murthy, Sripriya; Akoua-Koffi, Chantal; Couacy-Hymann, Emmanuel; Leendertz, Fabian Hubertus; Calvignac-Spencer, Sébastien; Ehlers, Bernhard

2017-01-01

Cytomegaloviruses (CMVs) are known to infect many mammals, including a number of nonhuman primates (NHPs). However, most data available arose from studies led on captive individuals and little is known about CMV diversity in wild NHPs. Here, we analyzed a community of wild nonhuman primates (seven species) in Taï National Park (TNP), Côte d’Ivoire, with two PCR systems targeting betaherpesviruses. CMV DNA was detected in 17/87 primates (4/7 species). Six novel CMVs were identified in sooty mangabeys, Campbell’s monkeys and Diana monkeys, respectively. In 3/17 positive individuals (from three NHP species), different CMVs were co-detected. A major part of the glycoprotein B coding sequences of the novel viruses was amplified and sequenced, and phylogenetic analyses were performed that included three previously discovered CMVs of western red colobus from TNP and published CMVs from other NHP species and geographic locations. We find that, despite this locally intensified sampling, NHP CMVs from TNP are completely host-specific, pinpointing the absence or rarity of cross-species transmission. We also show that on longer timescales the evolution of CMVs is characterized by frequent co-divergence with their hosts, although other processes, including lineage duplication and host switching, also have to be invoked to fully explain their evolutionary relationships. PMID:29286318

Susceptibility of three breeds of Ugandan goats to experimental infection with Trypanosoma congolense.

PubMed

Katunguka-Rwakishaya, E; Murray, M; Holmes, P H

1997-02-01

This study has indicated that differences in susceptibility to Trypanosoma congolense infection exist among the 3 main breeds of goats in Uganda namely, Kigezi, Mubende and Small East African (SEA). The Kigezi goats appeared to be the most susceptible suffering more severe anaemia, greater retardation of growth and more deaths than the other 2 breeds following experimental infection with Try-panosoma congolense. The Small East African goats appeared to be least susceptible. Following treatment after 84 days of infection, the SEA goats responded much better than the other 2 breeds. By 4 weeks after treatment with diminazene aceturate, the packed red cell volumes of the treated SEA goats were similar to those of control SEA goats while those of the Mubende and Kigezi goats were still much lower than those of control animals.

Integrating Emerging Technologies in Teaching Ugandan Traditional Dances in K-12 Schools in New York City

ERIC Educational Resources Information Center

Mabingo, Alfdaniels

2015-01-01

Schools in New York City have made attempts to embrace and support the strand of "making connections", which is laid out in the New York City Department of Dance blueprint for teaching and learning in dance for grades PreK-12. Accordingly, some schools have integrated Ugandan traditional dances into the dance curriculum, and dance…

Creativity across Cultures: A Comparison between Ugandan and Italian Students

ERIC Educational Resources Information Center

Tomassoni, Rosella; Treglia, Eugenia; Tomao, Manuela

2018-01-01

The purpose of this research was to compare the creative performance of students belonging to 2 different cultures, Italian and Ugandan. The participants were 462 children between the ages of 6 and 14 (231 in each group). The children were distributed across the age groups, between the 1st and 7th years of primary school. This study used a…

Deep Sequencing Reveals a Divergent Ugandan cassava brown streak virus Isolate from Malawi

PubMed Central

Winter, Stephan; Mukasa, Settumba; Tairo, Fred; Sseruwagi, Peter; Ndunguru, Joseph; Duffy, Siobain

2017-01-01

ABSTRACT Illumina sequencing of RNA from a cassava cutting from northern Malawi produced a genome of Ugandan cassava brown streak virus (UCBSV-MW-NB7_2013). Sequence comparisons revealed stronger similarity to an isolate from nearby Tanzania (93.4% pairwise nucleotide identity) than to those previously reported from Malawi (86.9 to 87.0%). PMID:28818908

Constructing English as a Ugandan Language through an English Textbook

ERIC Educational Resources Information Center

Stranger-Johannessen, Espen

2015-01-01

English is a national language in Uganda and is widely used in elite areas such as politics and business, but most Ugandans master English to only a limited degree. In this situation, English can be seen as either a foreign language or a second language--influencing how English is taught. One goal of language teaching espoused in this article is…

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.

Lentivirus Restriction by Diverse Primate APOBEC3A Proteins

PubMed Central

Schmitt, Kimberly; Guo, Kejun; Katuwal, Miki; Wilson, Darayu; Prochnow, Courtney; Bransteitter, Ronda; Chen, Xiaojiang S.; Santiago, Mario L.; Stephens, Edward B.

2016-01-01

Rhesus macaque APOBEC3A (rhA3A) is capable of restricting both simian-human immunodeficiency virus (SHIVΔvif) and human immunodeficiency virus (HIV-1Δvif) greater extent than hA3A. We constructed chimeric A3A proteins to define the domains required for differential lentivirus restriction. Substitution of amino acids 25–33 from rhA3A into hA3A was sufficient to restrict HIVΔvif to levels similar to rhA3A restriction of SHIVΔvif. We tested if differential lentivirus restriction is conserved between A3A from Old World monkey and hominid lineages. A3A from African green monkey restricted SHIVΔvif but not HIV-1Δvif and colobus monkey A3A restricted both wild type and SHIVΔvif and HIV-1Δvif. In contrast the gibbon ape A3A restricted neither SHIVΔvif nor HIV-1Δvif. Restriction of SHIVΔvif and HIV-1Δvif by New World monkey A3A proteins was not conserved as the A3A from the squirrel monkey but not the northern owl monkey restricted SHIVΔvif. Finally, the colobus A3A protein appears to restrict by a novel post-entry mechanism. PMID:23648232

Culture, Context and Stereotype Threat: A Comparative Analysis of Young Ugandan Women in Coed and Single-Sex Schools

ERIC Educational Resources Information Center

Picho, Katherine; Stephens, Jason M.

2012-01-01

Stereotype threat (ST) has been linked to under performance and academic disidentification among girls in mathematics and science as well as African Americans in academics. However, it is still unclear whether ST and its negative effects extend to non-Western cultures. The authors explored the effects of ST on Ugandan females in coed and…

"Talk What Others Think You Can't Talk": HIV/AIDS Clubs as Peer Education in Ugandan Schools

ERIC Educational Resources Information Center

Norton, Bonny; Mutonyi, Harriet

2007-01-01

In this article, we make the case that HIV/AIDS clubs in Ugandan schools provide valuable information to students who may not have easy access to health services. As one club motto suggests, the clubs "talk what others think you can't talk". The innovative peer education methods, which include drama, popular culture and community…

The discourses on induced abortion in Ugandan daily newspapers: a discourse analysis.

PubMed

Larsson, Sofia; Eliasson, Miriam; Klingberg Allvin, Marie; Faxelid, Elisabeth; Atuyambe, Lynn; Fritzell, Sara

2015-06-25

Ugandan law prohibits abortion under all circumstances except where there is a risk for the woman's life. However, it has been estimated that over 250 000 illegal abortions are being performed in the country yearly. Many of these abortions are carried out under unsafe conditions, being one of the most common reasons behind the nearly 5000 maternal deaths per year in Uganda. Little research has been conducted in relation to societal views on abortion within the Ugandan society. This study aims to analyze the discourse on abortion as expressed in the two main daily Ugandan newspapers. The conceptual content of 59 articles on abortion between years 2006-2012, from the two main daily English-speaking newspapers in Uganda, was studied using principles from critical discourse analysis. A religious discourse and a human rights discourse, together with medical and legal sub discourses frame the subject of abortion in Uganda, with consequences for who is portrayed as a victim and who is to blame for abortions taking place. It shows the strong presence of the Catholic Church within the medial debate on abortion. The results also demonstrate the absence of medial statements related to abortion made by political stakeholders. The Catholic Church has a strong position within the Ugandan society and their stance on abortion tends to have great influence on the way other actors and their activities are presented within the media, as well as how stakeholders choose to convey their message, or choose not to publicly debate the issue in question at all. To decrease the number of maternal deaths, we highlight the need for a more inclusive and varied debate that problematizes the current situation, especially from a gender perspective.

Ready for School? Trauma Exposure and Mental Health in a Group of War-Affected Ugandan Adolescents Re-Attending School

ERIC Educational Resources Information Center

Schultz, Jon-Hakon; Sorensen, Peer Moller; Waaktaar, Trine

2012-01-01

The objective of this study was to assess trauma-related symptoms and mental health among war-exposed Ugandan adolescents (n = 81) as a basis for planning their re-attendance at school. Self-reports of exposure to traumatic events, trauma-related symptoms, and indicators of mental health were collected. While about half of the youths (51.9%)…

Knowledge and Attitudes of Ugandan Preservice Science and Mathematics Teachers toward Global and Ugandan Science--and Technology-Based Problems and/or Threats

ERIC Educational Resources Information Center

Robinson, Michael; Tibanyendera, Basil; Seltzer-Kelly, Debbie

2007-01-01

This article reports the effects of a science, technology, and society (STS) teaching approach on the knowledge and attitudes of preservice science and mathematics teachers in Uganda toward global science and technology-based problems and/or threats. The responses of a baseline or control group (N = 50) and an experimental group (N = 50) to five…

Even Lesbian Youths or Those Presumed to Be Lesbians Are Protected by the Constitution of Uganda--But to a Limited Extent: Rules the High Court

ERIC Educational Resources Information Center

Mujuzi, Jamil Ddamulira

2009-01-01

The Ugandan Penal Code criminalizes same-sex relationships. The author analyzes the Ugandan High Court decision where the judge relied on the Constitution and international human rights instruments to hold that law enforcement officers must respect the rights to privacy and human dignity even of those people presumed to be in same-sex…

Finding a path through the health unit: practical experience of Ugandan patients.

PubMed

Mogensen, Hanne O

2005-01-01

Finding one's way through a health facility is not necessarily an easy task for Ugandan patients. Our understanding of how people succeed in doing so, and of the obstacles they encounter on their way, is incomplete if we focus only on the cognitive level of the clinical encounter. Much research in public health and medical anthropology implicitly works with the notion that agency is located in the mind and that cognitive understanding is a precondition for practice. Based on material from eastern Uganda, this article explores the practical experience of Ugandan patients and their relatives and reflects upon the ways in which this notion of agency has often caused us to confuse the spectator's point of view with the actor's point of view. Thus, as Pierre Bourdieu has argued, we are made to look for answers to "questions that practice never asks because it has no need to ask them."

"...No stone left unturned:" how the public explains the Ugandan success story.

PubMed

Chapman, Elizabeth; Kipp, Walter; Rubaale, Tom

2008-01-01

We conducted a public poll to assess the public's perception about changes in HIV prevalence and its causes in a township in western Uganda. The main questions related to the declining HIV prevalence and its interpretation, as well as to the "Ugandan success story." The study used a qualitative methodology; we interviewed 68 citizens in eight focus group discussions. The majority stated that the HIV prevalence had declined in their town. Of those respondents, most cited behaviour changes related to Uganda's ABC strategy as their explanation of the declining trends. Those who said that a decline in HIV had taken place also stated that they believed in the Ugandan success story. Our study concludes that it is important to involve the public on important health issues such as HIV/AIDS in order to obtain more valid results by combining scientific findings with public/indigenous knowledge.

The politics of protection: aid, human rights discourse, and power relations in Kyaka II settlement, Uganda.

PubMed

Clark-Kazak, Christina R

2010-01-01

This paper explores the conceptualisation and application of 'protection' by the United Nations High Commissioner (UNHCR), Ugandan government, and Congolese refugees in Kyaka II refugee settlement, Uganda. Analysing the origins and consequences of a demonstration against school fees, and drawing on other ethnographic data, it explores how different interpretations of this incident reflect different conceptions of, and approaches to, protection. Ugandan government officials viewed the demonstration as a security incident; Congolese and Ugandan adults responded with increased monitoring and 'sheltering' of children and young people; students justified the demonstration as a legitimate manifestation of their rights; while UNHCR promoted assistance and resettlement. The paper argues that prevailing protection responses, including 'sensitisation', sheltering, and resettlement, are de-contextualised from daily realities and fail to address the underlying power relations that undermine protection. It concludes with recommendations on how international refugee agencies can reorient assistance to address protection concerns in refugee contexts.

Papio cynocephalus endogenous retrovirus among old world monkeys: evidence for coevolution and ancient cross-species transmissions.

PubMed

Mang, R; Maas, J; van Der Kuyl, A C; Goudsmit, J

2000-02-01

To study the evolutionary history of Papio cynocephalus endogenous retrovirus (PcEV), we analyzed the distribution and genetic characteristics of PcEV among 17 different species of primates. The viral pol-env and long terminal repeat and untranslated region (LTR-UTR) sequences could be recovered from all Old World species of the papionin tribe, which includes baboons, macaques, geladas, and mangabeys, but not from the New World monkeys and hominoids we tested. The Old World genera Cercopithecus and Miopithecus hosted either a PcEV variant with an incomplete genome or a virus with substantial mismatches in the LTR-UTR. A complete PcEV was found in the genome of Colobus guereza-but not in Colobus badius-with a copy number of 44 to 61 per diploid genome, comparable to that seen in papionins, and with a sequence most closely related to a virus of the papionin tribe. Analysis of evolutionary distances among PcEV sequences for synonymous and nonsynonymous sites indicated that purifying selection was operational during PcEV evolution. Phylogenetic analysis suggested that possibly two subtypes of PcEV entered the germ line of a common ancestor of the papionins and subsequently coevolved with their hosts. One strain of PcEV was apparently transmitted from a papionin ancestor to an ancestor of the central African lowland C. guereza.

Papio cynocephalus Endogenous Retrovirus among Old World Monkeys: Evidence for Coevolution and Ancient Cross-Species Transmissions

PubMed Central

Mang, Rui; Maas, Jolanda; van der Kuyl, Antoinette C.; Goudsmit, Jaap

2000-01-01

To study the evolutionary history of Papio cynocephalus endogenous retrovirus (PcEV), we analyzed the distribution and genetic characteristics of PcEV among 17 different species of primates. The viral pol-env and long terminal repeat and untranslated region (LTR-UTR) sequences could be recovered from all Old World species of the papionin tribe, which includes baboons, macaques, geladas, and mangabeys, but not from the New World monkeys and hominoids we tested. The Old World genera Cercopithecus and Miopithecus hosted either a PcEV variant with an incomplete genome or a virus with substantial mismatches in the LTR-UTR. A complete PcEV was found in the genome of Colobus guereza—but not in Colobus badius—with a copy number of 44 to 61 per diploid genome, comparable to that seen in papionins, and with a sequence most closely related to a virus of the papionin tribe. Analysis of evolutionary distances among PcEV sequences for synonymous and nonsynonymous sites indicated that purifying selection was operational during PcEV evolution. Phylogenetic analysis suggested that possibly two subtypes of PcEV entered the germ line of a common ancestor of the papionins and subsequently coevolved with their hosts. One strain of PcEV was apparently transmitted from a papionin ancestor to an ancestor of the central African lowland C. guereza. PMID:10627573

Beyond bushmeat: animal contact, injury, and zoonotic disease risk in Western Uganda.

PubMed

Paige, Sarah B; Frost, Simon D W; Gibson, Mhairi A; Jones, James Holland; Shankar, Anupama; Switzer, William M; Ting, Nelson; Goldberg, Tony L

2014-12-01

Zoonotic pathogens cause an estimated 70% of emerging and re-emerging infectious diseases in humans. In sub-Saharan Africa, bushmeat hunting and butchering is considered the primary risk factor for human-wildlife contact and zoonotic disease transmission, particularly for the transmission of simian retroviruses. However, hunting is only one of many activities in sub-Saharan Africa that bring people and wildlife into contact. Here, we examine human-animal interaction in western Uganda, identifying patterns of injuries from animals and contact with nonhuman primates. Additionally, we identify individual-level risk factors associated with contact. Nearly 20% (246/1,240) of participants reported either being injured by an animal or having contact with a primate over their lifetimes. The majority (51.7%) of injuries were dog bites that healed with no long-term medical consequences. The majority (76.8%) of 125 total primate contacts involved touching a carcass; however, butchering (20%), hunting (10%), and touching a live primate (10%) were also reported. Red colobus (Piliocolobus rufomitratus tephrosceles) accounted for most primate contact events. Multivariate logistic regression indicated that men who live adjacent to forest fragments are at elevated risk of animal contact and specifically primate contact. Our results provide a useful comparison to West and Central Africa where "bushmeat hunting" is the predominant paradigm for human-wildlife contact and zoonotic disease transmission.

Beyond bushmeat: Animal contact, injury, and zoonotic disease risk in western Uganda

PubMed Central

Paige, Sarah B.; Frost, Simon D.W.; Gibson, Mhairi A.; Holland, James; Shankar, Anupama; Switzer, William M.; Ting, Nelson

2014-01-01

Zoonotic pathogens cause an estimated 70% of emerging and re-emerging infectious diseases in humans. In sub-Saharan Africa, bushmeat hunting and butchering is considered the primary risk factor for human-wildlife contact and zoonotic disease transmission, particularly for the transmission of simian retroviruses. However, hunting is only one of many activities in sub-Saharan Africa that bring people and wildlife into contact. Here, we examine human-animal interaction in western Uganda, identifying patterns of injuries from animals and contact with nonhuman primates. Additionally, we identify individual-level risk factors associated with contact. Nearly 20% (246/ 1,240) of participants reported either being injured by an animal or having contact with a primate over their lifetimes. The majority (51.7%) of injuries were dog bites that healed with no long term medical consequences. The majority (76.8%) of 125 total primate contacts involved touching a carcass; however, butchering (20%), hunting (10%), and touching a live primate (10%) were also reported. Red colobus (Piliocolobus rufomitratus tephrosceles) accounted for most primate contact events. Multivariate logistic regression indicated that men who live adjacent to forest fragments are at elevated risk of animal contact and specifically primate contact. Our results provide a useful comparison to West and Central Africa where “bushmeat hunting” is the predominant paradigm for human-wildlife contact and zoonotic disease transmission. PMID:24845574

Hunting, law enforcement, and African primate conservation.

PubMed

N'Goran, Paul K; Boesch, Christophe; Mundry, Roger; N'Goran, Eliezer K; Herbinger, Ilka; Yapi, Fabrice A; Kühl, Hjalmar S

2012-06-01

Primates are regularly hunted for bushmeat in tropical forests, and systematic ecological monitoring can help determine the effect hunting has on these and other hunted species. Monitoring can also be used to inform law enforcement and managers of where hunting is concentrated. We evaluated the effects of law enforcement informed by monitoring data on density and spatial distribution of 8 monkey species in Taï National Park, Côte d'Ivoire. We conducted intensive surveys of monkeys and looked for signs of human activity throughout the park. We also gathered information on the activities of law-enforcement personnel related to hunting and evaluated the relative effects of hunting, forest cover and proximity to rivers, and conservation effort on primate distribution and density. The effects of hunting on monkeys varied among species. Red colobus monkeys (Procolobus badius) were most affected and Campbell's monkeys (Cercopithecus campbelli) were least affected by hunting. Density of monkeys irrespective of species was up to 100 times higher near a research station and tourism site in the southwestern section of the park, where there is little hunting, than in the southeastern part of the park. The results of our monitoring guided law-enforcement patrols toward zones with the most hunting activity. Such systematic coordination of ecological monitoring and law enforcement may be applicable at other sites. ©2012 Society for Conservation Biology.

Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair.

PubMed

Luyten, Anke; D'haeseleer, Evelien; Budolfsen, Dorte; Hodges, Andrew; Galiwango, George; Vermeersch, Hubert; Van Lierde, Kristiane

2013-01-01

The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair. Copyright © 2013 Elsevier Inc. All rights reserved.

Valued experiences of graduate students in their role as educators in undergraduate training in Ugandan medical schools.

PubMed

Rukundo, Godfrey Zari; Kasozi, Jannat; Burani, Aluonzi; Byona, Wycliff; Kirimuhuzya, Claude; Kiguli, Sarah

2017-11-25

In most medical schools, graduate students, sometimes referred to as graduate teaching assistants, often participate in the training of undergraduate students. In developing countries like Uganda, are typically involved in undergraduate training. However, prior to this study there were no standard guidelines for this involvement. At the same time, the views and experiences of the graduate students in their role as educators had not been documented. Therefore, the aim of this study was to explore the views and experiences of graduate students about their involvement in undergraduate training in three Ugandan medical schools. The findings of this study will contribute to the development of policies for training in Ugandan medical schools. This was a qualitative study in which thirty in-depth-interviews were conducted among second and third year graduate students in three Ugandan medical schools in the MESAU consortium (Medical Education Services to all Ugandans) including Mbarara University of Science and Technology, Makerere College of Health Sciences and Kampala International University, Western Campus. All graduate students from all the three medical schools viewed their involvement in undergraduate training as important. The study also revealed that graduate students increase available human resources and often compensate for the teaching missed when senior educators were absent. The graduate students expressed important views that need to be considered in the design of educational programs where they are to be involved. The respondents also reported a number of challenges in this undertaking that included lack of motivation, lack of orientation and having heavy workloads. The presence and commitment of senior educators to guide and support the graduate students in teaching activities was viewed as one significant intervention that would increase the effectiveness of their educational contributions. Graduate students enjoy their involvement in the training of undergraduate students despite the various challenges they face. In some departments, the involvement of postgraduate trainees is critical to the viability of undergraduate medical training.

Vaginal Prostate Specific Antigen (PSA) Is a Useful Biomarker of Semen Exposure Among HIV-Infected Ugandan Women.

PubMed

Woolf-King, Sarah E; Muyindike, Winnie; Hobbs, Marcia M; Kusasira, Adrine; Fatch, Robin; Emenyonu, Nneka; Johnson, Mallory O; Hahn, Judith A

2017-07-01

The practical feasibility of using prostate specific antigen (PSA) as a biomarker of semen exposure was examined among HIV-infected Ugandan women. Vaginal fluids were obtained with self-collected swabs and a qualitative rapid test (ABAcard ® p30) was used to detect PSA. Trained laboratory technicians processed samples on-site and positive PSA tests were compared to self-reported unprotected vaginal sex (UVS) in the last 48 h. A total of 77 women submitted 126 samples for PSA testing at up to three study visits. Of these samples, 31 % (n = 39/126) were PSA positive, and 64 % (n = 25/39) of the positive PSA samples were accompanied by self-report of no UVS at the study visit the PSA was collected. There were no reported difficulties with specimen collection, storage, or processing. These findings provide preliminary data on high levels of misreported UVS among HIV-infected Ugandan women using practically feasible methods for PSA collection and processing.

Homophobia as a barrier to comprehensive media coverage of the Ugandan anti-homosexual bill.

PubMed

Strand, Cecilia

2012-01-01

The Ugandan Anti-Homosexuality Bill of October 2009 caused an international outcry and sparked intense debate in the local media. This article explores to what degree a discriminatory social environment manifests itself in the Ugandan print media and discusses the potential implications for media's coverage of contentious policy options such as the Anti-Homosexuality Bill. A content analysis of 115 items from two daily newspapers (the government-owned New Vision and the privately owned the Daily Monitor, between October and December 2009) indicates the existence of two separate house styles; this is in spite of the fact that both newspapers reproduce the surrounding society's homophobia, albeit with different frequency. Unlike the New Vision, the Daily Monitor includes coverage on homophobia and discrimination, as well as provides space for criticism of the Bill. By acknowledging discrimination and its negative impact, the newspaper de-legitimizes homophobia and problematizes the proposed Anti-homosexuality Bill for their readers.

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.

Near-peer mentorship for undergraduate training in Ugandan medical schools: views of undergraduate students

PubMed Central

Rukundo, Godfrey Zari; Burani, Aluonzi; Kasozi, Jannat; Kirimuhuzya, Claude; Odongo, Charles; Mwesigwa, Catherine; Byona, Wycliff; Kiguli, Sarah

2016-01-01

Introduction Masters Students are major stakeholders in undergraduate medical education but their contribution has not been documented in Uganda. The aim of the study was to explore and document views and experiences of undergraduate students regarding the role of masters students as educators in four Ugandan medical schools. Methods This was a cross-sectional descriptive study using qualitative data collection methods. Eight Focus Group Discussions were conducted among eighty one selected preclinical and clinical students in the consortium of four Ugandan medical schools: Mbarara University of Science and Technology, Makerere College of Health Sciences, Gulu University and Kampala International University, Western Campus. Data analysis was done using thematic analysis. Participants’ privacy and confidentiality were respected and participant identifiers were not included in data analysis. Results Undergraduate students from all the medical schools viewed the involvement of master's students as very important. Frequent contact between masters and undergraduate students was reported as an important factor in undergraduate students’ motivation and learning. Despite the useful contribution, master’ students face numerous challenges like heavy workload and conflicting priorities. Conclusion According to undergraduate students in Ugandan medical schools, involvement of master's students in the teaching and learning of undergraduate students is both useful and challenging to masters and undergraduate students. Masters students provide peer mentorship to the undergraduate students. The senior educators are still needed to do their work and also to support the master's students in their teaching role. PMID:27347289

Mental rotation of primate hands: human-likeness and thumb saliency.

PubMed

Bläsing, Bettina; de Castro Campos, Marcella; Schack, Thomas; Brugger, Peter

2012-08-01

Mental rotation of human hands has been found to differ essentially from mental rotation of objects in such a way that reaction times and error rates of handedness judgements are influenced by the comfort and familiarity of the presented hand postures. To investigate the role of the similarity of the presented hands to the participant's own hand, we used different primates' hands as stimuli in a mental rotation task. Five out of 24 primate hands were chosen for their ratings in human-likeness and saliency of the thumb according to a questionnaire study and presented in two mental rotation experiments; in the second experiment, they were modified in such a way that all hands appeared thumbless. Results of both experiments revealed effects of species and orientation on reaction times, and an interaction between species and hand side occurred in the second experiment. In the first experiment, the thumbless Colobus hand differed from all other hands, showing the highest reaction times and error rates and failing to show the expected medial-over-lateral advantage. In the second experiment, the eccentricity of the Colobus hand was decreased and the facilitating effect of human-likeness was slightly increased. We conclude that motor strategies were applied that relied less on the asymmetry of the stimuli but rather on their similarity to the human hand. We argue that motor simulation might facilitate the processing of incomplete stimuli by mentally completing them, especially if all stimuli can be processed in a consistent manner.

Quantifying soluble carbohydrates in tropical leaves using a portable mid-infrared sensor: Implications for primate feeding ecology.

PubMed

Dunham, Noah T; Kane, Erin E; Rodriguez-Saona, Luis E

2016-07-01

Identifying the nutritional composition of food items has significant ramifications for primate feeding ecology, which, in turn, influences investigations of primate sociality, cognition, and conservation. The aim of our study was to analyze water soluble carbohydrate (WSC) concentrations in the leaves of trees common to the Diani Forest of Kenya. Many of these leaves are consumed by black and white colobus monkeys (Colobus angolensis palliatus). We assessed whether the infrared spectral data collected using a portable spectrometer can be used to accurately predict WSC concentrations. WSC content was first quantified using the phenol-sulfuric acid method for young and mature leaves of 24 species and ranged from 1.15% to 9.16% dry weight. Spectral data were recorded with a spectrometer equipped with an attenuated total reflectance accessory (Agilent Cary 630) and analyzed using partial least squares regression. The spectral region from 1600 cm(-1) to 1000 cm(-1) gave unique polysaccharide bands associated with carboxyl, acetyl, and glycosidic linkages of sugar residues. The multivariate analysis gave excellent performance parameters with correlation coefficient (r(2) ) of 0.95 and standard error of cross-validation of 0.6% WSC. We found that IR spectroscopy provides a rapid and accurate technique for analyzing WSC concentrations and offers primatologists many advantages over wet chemistry methods for analyzing nutritional composition. Am. J. Primatol. 78:701-706, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The influence of male takeovers on female dispersal in Colobus vellerosus.

PubMed

Sicotte, Pascale; Teichroeb, Julie A; Vayro, Josie V; Fox, Stephanie A; Bădescu, Iulia; Wikberg, Eva C

2017-07-01

Male takeovers affect male tenure, female mate choice and ultimately, individual reproductive success in group-living primates. In social systems with female philopatry and high male reproductive skew, male takeovers largely determine female mate choice, whereas in species with female dispersal, females have the option of deserting a new male. We focused on a species with facultative female dispersal to investigate which factors promote female desertion of males after takeover, using 15 cases (12 for which we have complete data on the takeover process and the female dispersal outcome). These cases took place in nine groups of Colobus vellerosus between 2001 and 2013 at the Boabeng-Fiema Monkey Sanctuary, Ghana. Quick takeovers were usually achieved by single adult males and were never followed by female dispersal. Slow takeovers involved several males, and these takeovers were regularly accompanied by female emigration. Infant attacks and infanticide by males occurred during both kinds of takeovers, but females with dependent offspring never dispersed, regardless of whether their infant was attacked or killed by the new male(s). Subadult females, who were not constrained by the presence of infants, dispersed more often after slow takeovers than after quick takeovers. Whether female dispersal post-takeover is an expression of female mate choice, or occurs to avoid the social upheaval surrounding slow takeovers, remains to be investigated. Am. J. Primatol. 79:e22436, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Perceptual Influence of Ugandan Biology Students' Understanding of HIV/AIDS

NASA Astrophysics Data System (ADS)

Mutonyi, Harriet; Nashon, Samson; Nielsen, Wendy S.

2010-08-01

In Uganda, curbing the spread of HIV/AIDS has largely depended on public and private media messages about the disease. Media campaigns based on Uganda’s cultural norms of communication are metaphorical, analogical and simile-like. The topic of HIV/AIDS has been introduced into the Senior Three (Grade 11) biology curriculum in Uganda. To what extent do students’ pre-conceptions of the disease, based on these media messages influence students’ development of conceptual understanding of the disease, its transmission and prevention? Of significant importance is the impact the conceptions students have developed from the indirect media messages on classroom instruction on HIV/AIDS. The study is based in a theoretical framework of conceptual change in science learning. An interpretive case study to determine the impact of Ugandan students’ conceptions or perceptions on classroom instruction about HIV/AIDS, involving 160 students aged 15-17, was conducted in four different Ugandan high schools: girls boarding, boys boarding, mixed boarding, and mixed day. Using questionnaires, focus group discussions, recorded biology lessons and informal interviews, students’ preconceptions of HIV/AIDS and how these impact lessons on HIV/AIDS were discerned. These preconceptions fall into four main categories: religious, political, conspiracy and traditional African worldviews. Results of data analysis suggest that students’ prior knowledge is persistent even after biology instructions. This has implications for current teaching approaches, which are mostly teacher-centred in Ugandan schools. A rethinking of the curriculum with the intent of offering science education programs that promote understanding of the science of HIV/AIDS as opposed to what is happening now—insensitivity to misconceptions about the disease—is needed.

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study.

PubMed

Huang, Keng-Yen; Nakigudde, Janet; Rhule, Dana; Gumikiriza-Onoria, Joy Louise; Abura, Gloria; Kolawole, Bukky; Ndyanabangi, Sheila; Kim, Sharon; Seidman, Edward; Ogedegbe, Gbenga; Brotman, Laurie Miller

2017-11-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (USA) in a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health professionals to Ugandan primary school teachers. It included large-group experiential training and small-group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model, and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and the use of EBPs were assessed at baseline and immediately post-intervention (4-5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and the use of EBPs in the classroom, and child social competence.

Effect of mating activity and dominance rank on male masturbation among free-ranging male rhesus macaques

PubMed Central

Dubuc, Constance; Coyne, Sean P.; Maestripieri, Dario

2013-01-01

The adaptive function of male masturbation is still poorly understood, despite its high prevalence in humans and other animals. In non-human primates, male masturbation is most frequent among anthropoid monkeys and apes living in multimale-multifemale groups with a promiscuous mating system. In these species, male masturbation may be a non-functional by-product of high sexual arousal or be adaptive by providing advantages in terms of sperm competition or by decreasing the risk of sexually transmitted infections. We investigated the possible functional significance of male masturbation using behavioral data collected on 21 free-ranging male rhesus macaques (Macaca mulatta) at the peak of the mating season. We found some evidence that masturbation is linked to low mating opportunities: regardless of rank, males were most likely to be observed masturbating on days in which they were not observed mating, and lower-ranking males mated less and tended to masturbate more frequently than higher-ranking males. These results echo the findings obtained for two other species of macaques, but contrast those obtained in red colobus monkeys (Procolobus badius) and Cape ground squirrels (Xerus inauris). Interestingly, however, male masturbation events ended with ejaculation in only 15% of the observed masturbation time, suggesting that new hypotheses are needed to explain masturbation in this species. More studies are needed to establish whether male masturbation is adaptive and whether it serves similar or different functions in different sexually promiscuous species. PMID:24187414

Effect of mating activity and dominance rank on male masturbation among free-ranging male rhesus macaques.

PubMed

Dubuc, Constance; Coyne, Sean P; Maestripieri, Dario

2013-11-01

The adaptive function of male masturbation is still poorly understood, despite its high prevalence in humans and other animals. In non-human primates, male masturbation is most frequent among anthropoid monkeys and apes living in multimale-multifemale groups with a promiscuous mating system. In these species, male masturbation may be a non-functional by-product of high sexual arousal or be adaptive by providing advantages in terms of sperm competition or by decreasing the risk of sexually transmitted infections. We investigated the possible functional significance of male masturbation using behavioral data collected on 21 free-ranging male rhesus macaques ( Macaca mulatta ) at the peak of the mating season. We found some evidence that masturbation is linked to low mating opportunities: regardless of rank, males were most likely to be observed masturbating on days in which they were not observed mating, and lower-ranking males mated less and tended to masturbate more frequently than higher-ranking males. These results echo the findings obtained for two other species of macaques, but contrast those obtained in red colobus monkeys ( Procolobus badius ) and Cape ground squirrels ( Xerus inauris ). Interestingly, however, male masturbation events ended with ejaculation in only 15% of the observed masturbation time, suggesting that new hypotheses are needed to explain masturbation in this species. More studies are needed to establish whether male masturbation is adaptive and whether it serves similar or different functions in different sexually promiscuous species.

Large-scale human immunodeficiency virus rapid test evaluation in a low-prevalence ugandan blood bank population.

PubMed

Eller, Leigh A; Eller, Michael A; Ouma, Benson J; Kataaha, Peter; Bagaya, Bernard S; Olemukan, Robert L; Erima, Simon; Kawala, Lilian; de Souza, Mark S; Kibuuka, Hannah; Wabwire-Mangen, Fred; Peel, Sheila A; O'Connell, Robert J; Robb, Merlin L; Michael, Nelson L

2007-10-01

The use of rapid tests for human immunodeficiency virus (HIV) has become standard in HIV testing algorithms employed in resource-limited settings. We report an extensive HIV rapid test validation study conducted among Ugandan blood bank donors at low risk for HIV infection. The operational characteristics of four readily available commercial HIV rapid test kits were first determined with 940 donor samples and were used to select a serial testing algorithm. Uni-Gold Recombigen HIV was used as the screening test, followed by HIV-1/2 STAT-PAK for reactive samples. OraQuick HIV-1 testing was performed if the first two test results were discordant. This algorithm was then tested with 5,252 blood donor samples, and the results were compared to those of enzyme immunoassays (EIAs) and Western blotting. The unadjusted algorithm sensitivity and specificity were 98.6 and 99.9%, respectively. The adjusted sensitivity and specificity were 100 and 99.96%, respectively. This HIV testing algorithm is a suitable alternative to EIAs and Western blotting for Ugandan blood donors.

Variability of metapodials in primates with rudimentary digits: Ateles geoffroyi, Colobus guereza, and Perodicticus potto.

PubMed

Tague, Robert G

2002-03-01

A tenet of evolutionary theory is that, within a species, phenotypic variability is inversely related to the intensity of stabilizing selection. A corollary is that a rudimentary or vestigial structure should be highly variable. This relationship between rudimentation and variability, however, may simply be part of a continuum, as several studies have shown that variability and size of a structure are inversely related. This study tests whether the first metacarpal (MC1) in Ateles geoffroyi and Colobus guereza and the second metacarpal (MC2) in Perodicticus potto are highly variable in their lengths relative to their other metapodials. The former two species have rudimentary thumbs, and the latter species has a rudimentary index finger. Fourteen other species of primates are included in the comparison. The results show that MC1 in A. geoffroyi and C. guereza and MC2 in P. potto are the relatively shortest first and second metapodials, respectively, in this sample of primates. However, an intraspecific analysis shows that neither MC1 in A. geoffroyi and C. guereza nor MC2 in P. potto is significantly more variable than the other metapodials. Nevertheless, an interspecific analysis shows that MC1 in A. geoffroyi and C. guereza is relatively the most variable among the first metapodials (i.e., MC1 and first metatarsal) in this study. MC2 in P. potto, however, is of relatively low variability compared with the other primates. These contrasting results are interpreted in terms of the developmental and evolutionary biology of digits. Copyright 2002 Wiley-Liss, Inc.

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

PubMed

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

2015-03-01

This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to interactions between: a) international, external actors not engaging with the Ugandan state; b) actors setting up structures and activities parallel to those of the state; c) actors deciding when emergencies begin and end without consultation; d) weak Ugandan state capacity to coordinate its own integrated response to disease; e) limited collaboration between core Ugandan planning activities and a weak, increasingly devolved district health system. These interrelated dynamics result in the global, international interventionalist mode of OWOH undermining the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU), the body within the Ugandan state mandated expressly with managing a sustainable One Health response to trypanosomiasis outbreaks in Uganda. This does two things, firstly it suggests we need a more grounded, national perspective of OWOH, where states and health systems are acknowledged and engaged with by international actors and initiatives. Secondly, it suggests that more support needs to be given to core coordinating capacity in resource-poor contexts. Supporting national coordinating bodies, focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Using multiple travel paths to estimate daily travel distance in arboreal, group-living primates.

PubMed

Steel, Ruth Irene

2015-01-01

Primate field studies often estimate daily travel distance (DTD) in order to estimate energy expenditure and/or test foraging hypotheses. In group-living species, the center of mass (CM) method is traditionally used to measure DTD; a point is marked at the group's perceived center of mass at a set time interval or upon each move, and the distance between consecutive points is measured and summed. However, for groups using multiple travel paths, the CM method potentially creates a central path that is shorter than the individual paths and/or traverses unused areas. These problems may compromise tests of foraging hypotheses, since distance and energy expenditure could be underestimated. To better understand the magnitude of these potential biases, I designed and tested the multiple travel paths (MTP) method, in which DTD was calculated by recording all travel paths taken by the group's members, weighting each path's distance based on its proportional use by the group, and summing the weighted distances. To compare the MTP and CM methods, DTD was calculated using both methods in three groups of Udzungwa red colobus monkeys (Procolobus gordonorum; group size 30-43) for a random sample of 30 days between May 2009 and March 2010. Compared to the CM method, the MTP method provided significantly longer estimates of DTD that were more representative of the actual distance traveled and the areas used by a group. The MTP method is more time-intensive and requires multiple observers compared to the CM method. However, it provides greater accuracy for testing ecological and foraging models.

Children's inequity aversion depends on culture: a cross-cultural comparison.

PubMed

Paulus, Markus

2015-04-01

Recent work showed the presence of strong forms of inequity aversion in young children. When presented with an uneven number of items, children would rather tend to throw one item away than to distribute them unequally between two anonymous others. The current study examined whether or not this pattern is a universal part of typical development by investigating 6- and 7-year-old Ugandan children. Results revealed that the Ugandan children, in contrast to their U.S. peers, tended to distribute the resources unequally rather than to throw the remaining resource away. This points to cross-cultural differences in the development of children's fairness-related decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

Concordance Between Laboratory Diagnosed Sexually Transmitted Infections and Self-Reported Measures of Risky Sex by Partner Type Among Rural Ugandan Outpatients.

PubMed

Kiene, Susan M; Lule, Haruna; Hughes, Peter; Wanyenze, Rhoda K

2017-07-01

Numerous HIV risk reduction interventions which show effects on sexual risk behaviors fail to find effects on STIs. We examined the concordance between laboratory diagnosed STIs and sexual risk behavior among Ugandan outpatients (n = 328). We screened for STIs and assessed sexual behavior at baseline and 6 month follow-up. Less risk was associated with an STI at baseline. At follow-up more unprotected sex with casual partners was associated with incident Syphilis, more unprotected sex with primary and secondary regular partners was associated with incident Chlamydia or Gonorrhea. Our results suggest ways to improve concordance between behavioral measures and STIs.

Contrasts in livelihoods and protein intake between commercial and subsistence bushmeat hunters in two villages on Bioko Island, Equatorial Guinea.

PubMed

Vega, María Grande; Carpinetti, Bruno; Duarte, Jesús; Fa, John E

2013-06-01

Across West and Central Africa, wildlife provides a source of food and income. We investigated the relation between bushmeat hunting and household wealth and protein consumption in 2 rural communities in Bioko Island, Equatorial Guinea. One village was dedicated to commercial hunting, the other trapped game primarily for food. We tested whether commercial-hunter households were nutritionally advantaged over subsistence-hunter households due to their higher income from the bushmeat trade and greater access to wild-animal protein. We conducted bushmeat-offtake surveys in both villages (captures by hunters and carcasses arriving to each village). Mammals (including threatened primates: black colobus [Colobus satanas], Preussi's guenon [Allochrocebus preussi], and russet-eared guenon [Cercopithecus erythrotis]), birds, and reptiles were hunted. The blue duiker (Philantomba monticola), giant pouched rat (Cricetomys emini), and brush-tailed porcupine (Atherurus africanus) contributed almost all the animal biomass hunted, consumed, or sold in both villages. Monkeys and Ogilbyi's duikers (Cephalophus ogilbyi) were hunted only by commercial hunters. Commercial hunters generated a mean of US$2000/year from bushmeat sales. Households with commercial hunters were on average wealthier, generated more income, spent more money on nonessential goods, and bought more products they did not grow. By contrast, households with subsistence hunters spent less on market items, spent more on essential products, and grew more of their own food. Despite these differences, average consumption of vegetable protein and domestic meat and bushmeat protein did not differ between villages. Our results highlight the importance of understanding the socioeconomic and nutritional context of commercial and subsistence bushmeat hunting to correctly interpret ways of reducing their effects on threatened species and to enable the sustainable offtake of more productive taxa. © 2013 Society for Conservation Biology.

Nutrient intake and balancing among female Colobus angolensis palliatus inhabiting structurally distinct forest areas: Effects of group, season, and reproductive state.

PubMed

Dunham, Noah T; Rodriguez-Saona, Luis E

2018-06-08

Understanding intraspecific behavioral and dietary variation is critical for assessing primate populations' abilities to persist in habitats characterized by increasing anthropogenic disturbances. While it is evident that some species exhibit considerable dietary flexibility (in terms of species-specific plant parts) in relation to habitat disturbance, it is unclear if primates are characterized by similar variation and flexibility regarding nutrient intake. This study examined the effects of group, season, and reproductive state on nutrient intake and balancing in adult female Colobus angolensis palliatus in the Diani Forest, Kenya. During July 2014 to December 2015, estimates of nutrient intake were recorded for eight females from three groups inhabiting structurally and ecologically distinct forest areas differing in tree species composition and density. There were differences in metabolizable energy (ME) and macronutrient intakes among groups, seasons, and reproductive states. Most notably, females inhabiting one of the more disturbed forest areas consumed less ME and macronutrients compared to females in the more intact forest area. Contrary to prediction, females in early lactation consumed significantly less ME and macronutrients compared to non-lactating and late lactation females. Despite differences in macronutrient intake, the relative contribution of macronutrients to ME were generally more conservative among groups, seasons, and reproductive states. Average daily intake ratios of non-protein energy to available protein ranged from approximately 3.5:1-4.3:1 among groups. These results indicate that female C. a. palliatus demonstrate a consistent nutrient balancing strategy despite significant intergroup differences in consumption of species-specific plant parts. Data from additional colobine species inhabiting different forest types are required to assess the extent to which nutrient balancing is constrained by phylogeny or is more flexible to local ecological conditions. © 2018 Wiley Periodicals, Inc.

Macronutrient balancing affects patch departure by guerezas (Colobus guereza).

PubMed

Johnson, Caley A; Raubenheimer, David; Chapman, Colin A; Tombak, Kaia J; Reid, Andrea J; Rothman, Jessica M

2017-04-01

Foraging strategies are central in shaping social structure and grouping patterns in primates. We address Colobus guereza foraging strategies by investigating their patch departure decisions in relation to diet composition and nutrition. We examine whether guerezas are constrained in their intake of food in patches and thereby forage according to a fixed amount strategy that dictates patch departure. Additionally, we assess whether guereza employ a fixed time strategy or attempt to balance nutrients when foraging. We measured food patch occupancy time, intake rates, and analyzed foods for macronutrients, fiber, and condensed tannins. We determined that guerezas do not employ a fixed time foraging strategy; patch residence time varied widely between 1 and 290 min. They also did not depart patches or stop eating when they reached a specific intake of dry mass, macronutrients, or condensed tannins. However, guerezas maintained a macronutrient balance when feeding across patches, and the balance of protein to non-protein energy (fats and carbohydrates) in patches is the best indicator of time adult guerezas spent feeding in patches. Previous studies have shown that the protein-to-fiber ratio is important in predicting food selection for folivores and their biomass; however, we found that guerezas did not maximize protein and minimize fiber intake while foraging in patches, nor did they stay longer in patches with the highest ratio of protein to fiber concentrations. This study raises questions about the nutritional and social implications of patch depletion as a foraging strategy in folivorous monkeys where food limitation predicts competitive and social regimes. Am. J. Primatol. 79:e22495, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Physical Activity, Sleep, and BMI Percentile in Rural and Urban Ugandan Youth.

PubMed

Christoph, Mary J; Grigsby-Toussaint, Diana S; Baingana, Rhona; Ntambi, James M

Uganda is experiencing a dual burden of over- and undernutrition, with overweight prevalence increasing while underweight remains common. Potential weight-related factors, particularly physical activity, sleep, and rural/urban status, are not currently well understood or commonly assessed in Ugandan youth. The purpose of this study was to pilot test a survey measuring weight-related factors in rural and urban Ugandan schoolchildren. A cross-sectional survey measured sociodemographics, physical activity, sleep patterns, and dietary factors in 148 rural and urban schoolchildren aged 11-16 in central Uganda. Height and weight were objectively measured. Rural and urban youth were compared on these factors using χ 2 and t tests. Regression was used to identify correlates of higher body mass index (BMI) percentile in the full sample and nonstunted youth. Youth were on average 12.1 ± 1.1 years old; underweight (10%) was more common than overweight (1.4%). Self-reported sleep duration and subjective sleep quality did not differ by rural/urban residence. Rural children overall had higher BMI percentile and marginally higher stunting prevalence. In adjusted analyses in both the full and nonstunted samples, higher BMI percentile was related to living in a rural area, higher frequency of physical activity, and higher subjective sleep quality; it was negatively related to being active on weekends. In the full sample, higher BMI percentile was also related to female gender, whereas in nonstunted youth, higher BMI was related to age. BMI percentile was unrelated to sedentary time, performance of active chores and sports, and dietary factors. This study is one of the first to pilot test a survey assessing weight-related factors, particularly physical activity and sleep, in Ugandan schoolchildren. BMI percentile was related to several sociodemographic, sleep, and physical activity factors among primarily normal-weight school children in Uganda, providing a basis for understanding weight status in the context of the nutrition transition. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Diagnosis of imported Ugandan typhoid fever based on local outbreak information: A case report.

PubMed

Ota, Shinichiro; Maki, Yohei; Mori, Kazuma; Hamamoto, Takaaki; Kurokawa, Atsushi; Ishihara, Masashi; Yamamoto, Takayuki; Imai, Kazuo; Misawa, Kazuhisa; Yuki, Atsushi; Fujikura, Yuji; Maeda, Takuya; Kawana, Akihiko

2016-11-01

Re-emerging multidrug-resistant typhoid fever is becoming a worldwide threat, especially in East Africa. At the beginning of 2015, an outbreak of typhoid fever started in the capital city of Uganda, and 1940 suspected cases were reported by 5 March 2015. In this report, we describe a case of typhoid fever caused by a MDR strain with HIV infection and hemoglobin S-syndrome thalassemia in an Ugandan from Kampala City. It is essential to consider MDR strains of Salmonella enterica serovar Typhi infections, including fluoroquinolone-resistant strains, in patients from Africa and Southeast Asia. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Tuberculosis incidence and treatment completion among Ugandan prison inmates

PubMed Central

Schwitters, A.; Kaggwa, M.; Omiel, P.; Nagadya, G.; Kisa, N.; Dalal, S.

2016-01-01

SUMMARY BACKGROUND The Uganda Prisons Service (UPS) is responsible for the health of approximately 32 500 inmates in 233 prisons. In 2008 a rapid UPS assessment estimated TB prevalence at 654/100 000, three times that of the general population (183/100 000). Although treatment programs exist, little is known about treatment completion in sub-Saharan African prisons. METHODS We conducted a retrospective study of Ugandan prisoners diagnosed with TB from June 2011 to November 2012. We analyzed TB diagnosis, TB-HIV comorbidity and treatment completion from national registers and tracked prison transfers and releases. RESULTS A total of 469 prisoners were diagnosed with TB over the 1.5-year period (incidence 955/100 000 person-years). Of 466 prisoners starting treatment, 48% completed treatment, 43% defaulted, 5% died and 4% were currently on treatment. During treatment, 12% of prisoners remaining in the same prison defaulted, 53% of transfers defaulted and 81% of those released were lost to follow-up. The odds of defaulting were 8.36 times greater among prisoners who were transferred during treatment. CONCLUSIONS TB incidence and treatment default are high among Ugandan prisoners. Strategies to improve treatment completion and prevent multidrug resistance could include avoiding transfer of TB patients, improving communications between prisons to ensure treatment follow-up after transfer and facilitating transfer to community clinics for released prisoners. PMID:24902552

Breast Cancer Risk Factors among Ugandan Women at a Tertiary Hospital: A Case-Control Study

PubMed Central

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2016-01-01

Background Although East Africa, like other countries in sub-Saharan Africa, has a lower incidence of breast cancer than high-income countries, the disease rate is rising steeply in Africa; it has nearly tripled in the past few decades in Uganda. There is a paucity of studies that have examined the relation between reproductive factors and breast cancer risk factors in Ugandan women. Objective To determine breast cancer risk factors among indigenous Ugandan women. Methods This is a hospital-based unmatched case-control study. Interviews were conducted between 2011 and 2012 using structured questionnaires. Patients with histologyproven breast cancer were recruited over a 2-year period. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 350 women were recruited; 113 were cases and 237 were controls. The mean age was 47.5 years (SD 14) for the cases and 45.5 years (SD 14.1) for the controls. The odds of breast cancer risk seemed lower for those who breastfed (adjusted OR = 0.04; 95% CI: 0.01, 0.18). There was no significance for early age at first full-term birth (adjusted OR = 1.96; 95% CI: 0.97, 3.96; p = 0.061), and urban residence carried no increased odds of breast cancer either (p = 0.201). Conclusion Breastfeeding seems to be associated with reduced odds of breast cancer. PMID:27104645

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.

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance.

PubMed

Yildirim, Suleyman; Yeoman, Carl J; Janga, Sarath Chandra; Thomas, Susan M; Ho, Mengfei; Leigh, Steven R; White, Bryan A; Wilson, Brenda A; Stumpf, Rebecca M

2014-12-01

Bacterial communities colonizing the reproductive tracts of primates (including humans) impact the health, survival and fitness of the host, and thereby the evolution of the host species. Despite their importance, we currently have a poor understanding of primate microbiomes. The composition and structure of microbial communities vary considerably depending on the host and environmental factors. We conducted comparative analyses of the primate vaginal microbiome using pyrosequencing of the 16S rRNA genes of a phylogenetically broad range of primates to test for factors affecting the diversity of primate vaginal ecosystems. The nine primate species included: humans (Homo sapiens), yellow baboons (Papio cynocephalus), olive baboons (Papio anubis), lemurs (Propithecus diadema), howler monkeys (Alouatta pigra), red colobus (Piliocolobus rufomitratus), vervets (Chlorocebus aethiops), mangabeys (Cercocebus atys) and chimpanzees (Pan troglodytes). Our results indicated that all primates exhibited host-specific vaginal microbiota and that humans were distinct from other primates in both microbiome composition and diversity. In contrast to the gut microbiome, the vaginal microbiome showed limited congruence with host phylogeny, and neither captivity nor diet elicited substantial effects on the vaginal microbiomes of primates. Permutational multivariate analysis of variance and Wilcoxon tests revealed correlations among vaginal microbiota and host species-specific socioecological factors, particularly related to sexuality, including: female promiscuity, baculum length, gestation time, mating group size and neonatal birth weight. The proportion of unclassified taxa observed in nonhuman primate samples increased with phylogenetic distance from humans, indicative of the existence of previously unrecognized microbial taxa. These findings contribute to our understanding of host-microbe variation and coevolution, microbial biogeography, and disease risk, and have important implications for the use of animal models in studies of human sexual and reproductive diseases.

Human rights dimensions of food, health and care in children's homes in Kampala, Uganda - a qualitative study.

PubMed

Vogt, Line Erikstad; Rukooko, Byaruhanga; Iversen, Per Ole; Eide, Wenche Barth

2016-03-18

More than 14 % of Ugandan children are orphaned and many live in children's homes. Ugandan authorities have targeted adolescent girls as a priority group for nutrition interventions as safeguarding nutritional health before pregnancy can reduce the chance of passing on malnutrition to the offspring and thus future generations. Ugandan authorities have obligations under international human rights law to progressively realise the rights to adequate food, health and care for all Ugandan children. Two objectives guided this study in children's homes: (a) To examine female adolescent residents' experiences, attitudes and views regarding: (i) eating patterns and food, (ii) health conditions, and (iii) care practices; and (b) to consider if the conditions in the homes comply with human rights standards and principles for the promotion of the rights to adequate food, health and care. A human rights-based approach guided the planning and conduct of this study. Five children's homes in Kampala were included where focus group discussions were held with girls aged 12-14 and 15-17 years. These discussions were analysed through a phenomenological approach. The conditions of food, health and care as experienced by the girls, were compared with international standards for the realisation of the human rights to adequate food, health and care. Food, health and care conditions varied greatly across the five homes. In some of these the girls consumed only one meal per day and had no access to clean drinking water, soap, toilet paper and sanitary napkins. The realisation of the right to adequate food for the girls was not met in three homes, the realisation of the right to health was not met in two homes, and the realisation of the right to care was not met in one home. In three of the selected children's homes human rights standards for food, health or care were not met. Care in the children's homes was an important contributing factor for whether standards for the rights to adequate food and health were met.

Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women

PubMed Central

Natureeba, Paul; Nyafwono, Dorcas; Plenty, Albert; Mwesigwa, Julia; Nzarubara, Bridget; Clark, Tamara D.; Ruel, Theodore D.; Achan, Jane; Charlebois, Edwin D.; Cohan, Deborah; Kamya, Moses R.; Havlir, Diane V.; Young, Sera L.

2016-01-01

Abstract: Food insecurity is associated with poor virologic outcomes, but this has not been studied during pregnancy and breastfeeding. We assessed sustained viral suppression from 8 weeks on antiretroviral therapy to 48 weeks postpartum among 171 pregnant and breastfeeding Ugandan women; 74.9% experienced food insufficiency. In multivariable analysis, food insufficiency [adjusted odds ratio (aOR) 0.38, 95% confidence interval (CI): 0.16 to 0.91], higher pretreatment HIV-1 RNA (aOR 0.55 per 10-fold increase, 95% CI: 0.37 to 0.82), and lopinavir/ritonavir versus efavirenz (aOR 0.49, 95% CI: 0.24 to 0.96) were associated with lower odds of sustained viral suppression. Interventions to address food security may improve virologic outcomes among HIV-infected women. PMID:26397935

Malnutrition is common in Ugandan children with cerebral palsy, particularly those over the age of five and those who had neonatal complications.

PubMed

Kakooza-Mwesige, Angelina; Tumwine, James K; Eliasson, Ann-Christin; Namusoke, Hanifa K; Forssberg, Hans

2015-12-01

Poor growth and malnutrition are frequently reported in children with cerebral palsy in developed countries, but there is limited information from developing countries. We investigated the nutritional status of Ugandan children with cerebral palsy and described the factors associated with poor nutrition. We examined 135 children from two to 12 years with cerebral palsy, who attended Uganda's national referral hospital. A child was considered underweight, wasted, stunted or thin if the standard deviation scores for their weight for age, weight for height, height for age and body mass index for age were ≤-2.0 using World Health Organization growth standards. Multivariable logistic regression identified the factors associated with nutritional indicators. Over half (52%) of the children were malnourished, with underweight (42%) being the most common category, followed by stunting (38%), thinness (21%) and wasting (18%). Factors that were independently associated with being malnourished were as follows: presence of cognitive impairment, with an adjusted odds ratio (aOR) of 4.5, being 5 years or older (aOR = 3.4) and feeding difficulties in the perinatal period (aOR = 3.2). Malnutrition was common in Ugandan children with cerebral palsy and more likely if they were 5 years or more or had experienced neonatal complications. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

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.

Breast Cancer Risk Factors among Ugandan Women at a Tertiary Hospital: A Case-Control Study.

PubMed

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2016-01-01

Although East Africa, like other countries in sub-Saharan Africa, has a lower incidence of breast cancer than high-income countries, the disease rate is rising steeply in Africa; it has nearly tripled in the past few decades in Uganda. There is a paucity of studies that have examined the relation between reproductive factors and breast cancer risk factors in Ugandan women. To determine breast cancer risk factors among indigenous Ugandan women. This is a hospital-based unmatched case-control study. Interviews were conducted between 2011 and 2012 using structured questionnaires. Patients with histology-proven breast cancer were recruited over a 2-year period. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 350 women were recruited; 113 were cases and 237 were controls. The mean age was 47.5 years (SD 14) for the cases and 45.5 years (SD 14.1) for the controls. The odds of breast cancer risk seemed lower for those who breastfed (adjusted OR = 0.04; 95% CI: 0.01, 0.18). There was no significance for early age at first full-term birth (adjusted OR = 1.96; 95% CI: 0.97, 3.96; p = 0.061), and urban residence carried no increased odds of breast cancer either (p = 0.201). Breastfeeding seems to be associated with reduced odds of breast cancer. © 2016 The Author(s) Published by S. Karger AG, Basel.

Female parity, maternal kinship, infant age and sex influence natal attraction and infant handling in a wild colobine (Colobus vellerosus).

PubMed

Bădescu, Iulia; Sicotte, Pascale; Ting, Nelson; Wikberg, Eva C

2015-04-01

Primate females often inspect, touch and groom others' infants (natal attraction) and they may hold and carry these infants in a manner resembling maternal care (infant handling). While natal attraction and infant handling occur in most wild colobines, little is known about the factors influencing the expression of these behaviors. We examined the effects of female parity, kinship, and dominance rank, as well as infant age and sex in wild Colobus vellerosus at Boabeng-Fiema Monkey Sanctuary, Ghana. We collected data via focal sampling of females in 2008 and 2009 (N = 61) and of infants in 2010 (N = 12). Accounting for the individuals who interacted with our focal subjects, this study includes 74 females and 66 infants in 8 groups. We recorded female agonistic interactions ad libitum to determine dominance ranks. We used partial pedigree information and genotypes at 17 short tandem repeat loci to determine kinship. We knew female parity, infant age and sex from demographic records. Nulliparous females showed more natal attraction and infant handling than parous females, which may suggest that interactions with infants are more adaptive for nulliparous females because they learn mothering skills through these behaviors. Compared to non-kin, maternal kin were more likely to handle infants. Maternal kin may be permitted greater access to infants because mothers are most familiar with them. Handlers may incur inclusive fitness benefits from infant handling. Dominance rank did not affect female interactions with infants. The youngest infants received the most natal attraction and infant handling, and male infants were handled more than female infants. The potential benefits of learning to mother and inclusive fitness, in combination with the relatively low costs of natal attraction and infant handling, may explain the high rates of these behaviors in many colobines. © 2014 Wiley Periodicals, Inc.

Referral practices and perceived barriers to timely obstetric care among Ugandan traditional birth attendants (TBA).

PubMed

Keri, L; Kaye, D; Sibylle, K

2010-03-01

To assess current beliefs, knowledge and practices of Ugandan traditional birth attendants (TBAs) and their pregnant patients regarding referral of obstructed labors and fistula cases. Six focus groups were held in rural areas surrounding Kampala, the capital city of Uganda. While TBAs, particularly those with previous training, appear willing to refer problematic pregnancies and labors, more serious problems exist that could lessen any positive effects of training. These problems include reported abuse by doctors and nurses, and seeing fistula as a disease caused by hospitals. Training of TBAs can be helpful to standardize knowledge about and encourage timely emergency obstetric referrals, as well as increase knowledge about the causes and preventions of obstetric fistula. However, for full efficacy, training must be accompanied by greater collaboration between biomedical and traditional health personnel, and increased infrastructure to prevent mistreatment of pregnant patients by medical staff.

The Influence of Beliefs About Health and Illness on Foot Care in Ugandan Persons with Diabetic Foot Ulcers

PubMed Central

Hjelm, Katarina; Beebwa, Esther

2013-01-01

Diabetes mellitus is becoming pandemic, particularly affecting Sub-Saharan Africa, and the prevalence of complications is increasing. Diabetic foot disorders are a major source of morbidity and disability. Delay in the health care process due to patients’ beliefs may have deleterious consequences for limb and life in persons with diabetic foot ulcers. No previous studies of beliefs about health and illness in persons with diabetic foot ulcers living in Africa have been found. The aim of the study was to explore beliefs about health and illness among Ugandans with diabetic foot ulcers that might affect self-care and care seeking behaviour. In an explorative study with consecutive sample semi-structured interviews were held with 14 Ugandan men and women, aged 40-79, with diabetic foot ulcer. Knowledge was limited about causes, management and prevention of diabetic foot ulcers. Foot ulcers were often detected as painful sores, perceived to heal or improve, and led to stress and social isolation due to smell and reduced mobility. Most lacked awareness of the importance of complete daily foot care and seldom practised self-care. Health was described as absence of disease and pain. Many feared future health and related it to contact with nurses in the professional sector from whom they sought information, blood tests and wound dressings and desired better organised diabetes clinics offering health education and more opening hours. Many have an underutilised potential for self-care and need education urgently, delivered in well-organised diabetes clinics working to raise awareness of the threat and prevent foot ulcers. PMID:24039644

Thyroid autoimmunity and function among Ugandan children and adolescents with type-1 diabetes mellitus.

PubMed

Muhame, Rugambwa Michael; Mworozi, Edison Arwanire; McAssey, Karen; Lubega, Irene

2014-01-01

Up to 30% of type-1 diabetes mellitus (T1DM) patients have co-existent thyroid autoimmunity with up to 50% of them having associated thyroid dysfunction. Routine screening for thyroid autoimmunity and dysfunction is recommended in all T1DM patients. However, this was not currently practiced in Ugandan paediatric diabetes clinics. There was also paucity of data regarding thyroid autoimmunity and dysfunction in African children and adolescents with diabetes mellitus. The objective of this study was to quantify the magnitude of thyroid autoimmunity and dysfunction in Ugandan children with TIDM. This was a cross sectional descriptive study to determine the prevalence of thyroid autoantibodies and describe thyroid function among children and adolescents aged 1-19 years with diabetes mellitus attending the paediatric diabetes clinic at Mulago National Referral Hospital, Kampala, Uganda. Following enrollment, we obtained details of clinical history and performed physical examination. Blood (plasma) was assayed to determine levels of antibodies to thyroid peroxidase (antiTPO), free thyroxine (FT4) and thyrotropin (TSH). The prevalence of thyroid autoimmunity was 7.3% (5/69). All antiTPO positive subjects were post pubertal, aged between 13-17 years with females comprising 3/5 of the antiTPO positive subjects. All study subjects were clinically euthyroid; however, 7.3% (5/69) of the study subjects had subclinical hypothyroidism. These data strengthen the argument for routine screening of all diabetic children and adolescents for thyroid autoimmunity (particularly anti-TPO) as recommended by international guidelines. We also recommend evaluation of thyroid function in diabetic children and adolescents to minimize the risk of undiagnosed thyroid dysfunction.

Relationship between maternal pelvis height and other anthropometric measurements in a multisite cohort of Ugandan mothers

PubMed Central

Munabi, Ian Guyton; Byamugisha, Josaphat; Luboobi, Livingstone; Luboga, Samuel Abilemech; Mirembe, Florence

2016-01-01

Introduction In sub Saharan Africa, childbirth remains a challenge that creates the need for additional screening tools. Maternal pelvis height, which is currently in use by automotive engineers has previously been shown to have significant associations with various childbirth related outcomes and events. This study set out to determine the associations between maternal: Age, height, weight and number of pregnancies with maternal pelvis height in Ugandan mothers. Methods This was a secondary analysis of maternal birth records from nine Ugandan hospitals, of mothers with singleton pregnancies. Data was analyzed using multilevel regression with respect to maternal pelvis height and additional analysis for tribe and site of childbirth intraclass correlations (ICCs). Results The mean maternal pelvis height was 7.30cm for the 2068 records. Maternal pelvis height was associated with: a 0.01cm reduction per centimeter of maternal height (P=0.02), 0.01cm increase per kg of maternal weight (P<0.01), 0.04cm increase for each additional pregnancy (P=0.03) and 0.03cm increase with respect to tribe of mother (P=0.27), for a constant of 7.97cm (P<0.01). The ICC for tribe was 0.20 (SE=0.08) and 0.37 (SE=0.11) for site. Conclusion Maternal pelvis height was associated with maternal height, maternal weight and number of pregnancies. The site of childbirth had a moderate effect on the above associations with maternal pelvis height. More study on the public health screening value of these measurements in these settings is required. PMID:27800110

Relationship between maternal pelvis height and other anthropometric measurements in a multisite cohort of Ugandan mothers.

PubMed

Munabi, Ian Guyton; Byamugisha, Josaphat; Luboobi, Livingstone; Luboga, Samuel Abilemech; Mirembe, Florence

2016-01-01

In sub Saharan Africa, childbirth remains a challenge that creates the need for additional screening tools. Maternal pelvis height, which is currently in use by automotive engineers has previously been shown to have significant associations with various childbirth related outcomes and events. This study set out to determine the associations between maternal: Age, height, weight and number of pregnancies with maternal pelvis height in Ugandan mothers. This was a secondary analysis of maternal birth records from nine Ugandan hospitals, of mothers with singleton pregnancies. Data was analyzed using multilevel regression with respect to maternal pelvis height and additional analysis for tribe and site of childbirth intraclass correlations (ICCs). The mean maternal pelvis height was 7.30cm for the 2068 records. Maternal pelvis height was associated with: a 0.01cm reduction per centimeter of maternal height (P=0.02), 0.01cm increase per kg of maternal weight (P<0.01), 0.04cm increase for each additional pregnancy (P=0.03) and 0.03cm increase with respect to tribe of mother (P=0.27), for a constant of 7.97cm (P<0.01). The ICC for tribe was 0.20 (SE=0.08) and 0.37 (SE=0.11) for site. Maternal pelvis height was associated with maternal height, maternal weight and number of pregnancies. The site of childbirth had a moderate effect on the above associations with maternal pelvis height. More study on the public health screening value of these measurements in these settings is required.

Doping knowledge, attitudes, and practices of Ugandan athletes': a cross-sectional study.

PubMed

Muwonge, Haruna; Zavuga, Robert; Kabenge, Peninnah Aligawesa

2015-09-22

Despite the development of advanced drug testing systems, both deliberate and inadvertent doping in sports is increasing in elite, amateur and school sports. As a result, alternative approaches that seek to influence an athlete's attitudes are needed to address the growing doping concerns that threaten both the health and well being of the athlete as well as the legitimacy of the sport. Therefore, the current study set out to establish the doping attitudes, knowledge and practices of professional Ugandan athletes, gathering information that may guide the design of more efficient doping prevention programs. This was a cross-sectional study of 384 professional Ugandan athletes from four contact team sports (basketball, football, handball and rugby) and two individual sports (athletics and cycling). An Interviewer administered questionnaire used contained; questions about the doping behavior, the performance enhancement attitude scale (PEAS), and doping use belief (DUB) statements. Approximately 60 % of the athletes reported familiarity with information on doping and that most of this information came from fellow colleagues (41.9 %), individual or team coaches (29.7 %) or the media (15.6 %). However, nearly 80 % of these athletes could not correctly define doping. The overall mean PEAS score, a measure of doping attitudes, for all study participants was 39.8 ± 14.8. Female athletes (PEAS: 41.1 ± 15.1), athletes with a prior doping history (PEAS: 44.1 ± 15.6) and athletes from the sport of athletics (PEAS: 56.6 ± 17.4) had higher mean PEAS scores than their respective counterparts. Regarding doping behaviors/practices, 9.3 % of the study participants had been offered a doping agent at some point, although only 3.9 % of the athletes acknowledged recent use. The confessed use of doping agents in this study was low, which may suggest that fewer athletes use doping agents in Uganda. However, there is still an urgent need for educational anti-doping programs to address the knowledge gaps observed amongst athletes in this study. Modifying the existing Physical education curriculum for inclusion of more content about doping in sport could provide the basis for doping prevention programs amongst amateur athletes in Ugandan primary and secondary schools.

Nutritional supplement practices of professional Ugandan athletes: a cross-sectional study.

PubMed

Muwonge, Haruna; Zavuga, Robert; Kabenge, Peninnah Aligawesa; Makubuya, Timothy

2017-01-01

The use of nutritional supplements (NS) places athletes at great risk for inadvertent doping. Due to the paucity of data on supplement use, this study aimed to determine the proportion of Ugandan athletes using nutritional supplements and to investigate the athletes' motivation to use these supplements. A cross-sectional study was conducted in which an interviewer-administered questionnaire was used to collect data from 359 professional athletes participating in individual (boxing, cycling, athletics) and team (basketball, rugby, football, netball, and volleyball) sports. The data were categorized, and a Chi-square test was used for statistical analysis. Of the 359 athletes, 48 (13.4%) used nutritional supplements. Carbohydrate supplements, energy drinks, vitamin and mineral supplements, fish oils, and protein supplements were the most common supplements used by athletes. NS use was significantly more common among athletes who played rugby and basketball ( X 2 = 61.101, p < 0.0001), athletes who had played the sport for 5-10 years ( X 2 = 7.460, p = 0.024), and athletes who had attained a tertiary education ( X 2 = 33.377, p < 0.0001). The athletes' occupation had no bearing on whether they used supplements. Nutritionists/dieticians, retail stores and pharmacies were the most common sources of NS products, whereas health practitioners, online media and teammates were the most common sources of information regarding NS. Most athletes used NS to improve their physical performance and health. Compared to NS use by athletes elsewhere, NS use among Ugandan athletes was low. However, determinants of athlete NS use in the current study (category of sport and duration of time spent playing the sport) are similar to those reported elsewhere.

Genome-wide population structure and admixture analysis reveals weak differentiation among Ugandan goat breeds.

PubMed

Onzima, R B; Upadhyay, M R; Mukiibi, R; Kanis, E; Groenen, M A M; Crooijmans, R P M A

2018-02-01

Uganda has a large population of goats, predominantly from indigenous breeds reared in diverse production systems, whose existence is threatened by crossbreeding with exotic Boer goats. Knowledge about the genetic characteristics and relationships among these Ugandan goat breeds and the potential admixture with Boer goats is still limited. Using a medium-density single nucleotide polymorphism (SNP) panel, we assessed the genetic diversity, population structure and admixture in six goat breeds in Uganda: Boer, Karamojong, Kigezi, Mubende, Small East African and Sebei. All the animals had genotypes for about 46 105 SNPs after quality control. We found high proportions of polymorphic SNPs ranging from 0.885 (Kigezi) to 0.928 (Sebei). The overall mean observed (H O ) and expected (H E ) heterozygosity across breeds was 0.355 ± 0.147 and 0.384 ± 0.143 respectively. Principal components, genetic distances and admixture analyses revealed weak population sub-structuring among the breeds. Principal components separated Kigezi and weakly Small East African from other indigenous goats. Sebei and Karamojong were tightly entangled together, whereas Mubende occupied a more central position with high admixture from all other local breeds. The Boer breed showed a unique cluster from the Ugandan indigenous goat breeds. The results reflect common ancestry but also some level of geographical differentiation. admixture and f 4 statistics revealed gene flow from Boer and varying levels of genetic admixture among the breeds. Generally, moderate to high levels of genetic variability were observed. Our findings provide useful insights into maintaining genetic diversity and designing appropriate breeding programs to exploit within-breed diversity and heterozygote advantage in crossbreeding schemes. © 2018 The Authors. Animal Genetics published by John Wiley & Sons Ltd on behalf of Stichting International Foundation for Animal Genetics.

Water, socioeconomic factors, and human herpesvirus 8 infection in Ugandan children and their mothers.

PubMed

Mbulaiteye, Sam M; Biggar, Robert J; Pfeiffer, Ruth M; Bakaki, Paul M; Gamache, Christine; Owor, Anchilla M; Katongole-Mbidde, Edward; Ndugwa, Christopher M; Goedert, James J; Whitby, Denise; Engels, Eric A

2005-04-01

Human herpesvirus 8 (HHV-8) infection is common in sub-Saharan Africa, but its distribution is uneven. Transmission occurs during childhood within families by unclear routes. We evaluated 600 Ugandan children with sickle cell disease and their mothers for factors associated with HHV-8 seropositivity in a cross-sectional study. HHV-8 serostatus was determined using an HHV-8 K8.1 glycoprotein enzyme immunoassay. Odds ratios for seropositivity were estimated using logistic regression, and factor analysis was used to identify clustering among socioeconomic variables. One hundred seventeen (21%) of 561 children and 166 (34%) of 485 mothers with definite HHV-8 serostatus were seropositive. For children, seropositivity was associated with age, mother's HHV-8 serostatus (especially for children aged 6 years or younger), lower maternal education level, mother's income, and low-status father's occupation (P < 0.05 for all). Using communal standpipe or using surface water sources were both associated with seropositivity (OR 2.70, 95% CI 0.80-9.06 and 4.02, 95% CI 1.18-13.7, respectively) as compared to using private tap water. These associations remained, albeit attenuated, after adjusting for maternal education and child's age (P = 0.08). In factor analysis, low scores on environmental and family factors, which captured household and parental characteristics, respectively, were positively associated with seropositivity (P(trend) < 0.05 for both). For mothers, HHV-8 seropositivity was significantly associated with water source and maternal income. HHV-8 infection in Ugandan children was associated with lower socioeconomic status and using surface water. Households with limited access to water may have less hygienic practices that increase risk for HHV-8 infection.

The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women.

PubMed

Baingana, Rhona K; Enyaru, John K; Tjalsma, Harold; Swinkels, Dorine W; Davidsson, Lena

2015-06-01

To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population. Cross-sectional study in which Hb, ferritin, transferrin receptor (sTfR), C-reactive protein, α-1 acid glycoprotein, hepcidin, malaria, hookworm infestation, syphilis and Helicobacter pylori infection were assessed. Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda. HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation. The prevalence of anaemia was 29·1 %. Fe deficiency was 40·4 % and 14·6 % based on ferritin 8·3 μg/ml. The prevalence of Fe-deficiency anaemia was 9·3 % based on ferritin 8·3 μg/ml. Hepcidin concentration was positively correlated with ferritin concentration (n 151, r=0·578, P1 g/l and/or C-reactive protein >5 mg/l. Malaria parasitaemia (OR=6·85; 95 % CI 1·25, 37·41, P=0·026) and Fe deficiency defined using sTfR (OR=5·58; 95 % CI 1·26, 24·80, P=0·024) were independently and positively associated with anaemia. Population-attributable risk factors for anaemia for raised C-reactive protein, Fe deficiency defined by sTfR >8·3 μg/ml and presence of malaria parasites were 41·6 (95 % CI 11·1, 72·2) %, 13·5 (95 % CI 2·0, 25·0) % and 12·0 (95 % CI 1·4, 22·6) %, respectively. Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester.

Examining the relationship between psychological distress and adherence to anti-retroviral therapy among Ugandan adolescents living with HIV.

PubMed

Mutumba, Massy; Musiime, Victor; Lepkwoski, James M; Harper, Gary W; Snow, Rachel C; Resnicow, Ken; Bauermeister, Jose A

2016-07-01

Psychological distress is common among adolescents living with HIV (ALHIV) worldwide, and has been associated with non-adherence to anti-retroviral therapy (ART), leading to poor virologic suppression, drug resistance, and increased risk for AIDS morbidity and mortality. However, only a few studies have explored the relationship between psychological distress and ART adherence among adolescents in sub-Saharan Africa. The paper examines the relationship between psychological distress and ART adherence, and effect of psychosocial resources on ART adherence. We conducted a cross-sectional survey of 464 ALHIV (aged 12-19; 53% female) seeking HIV care at a large HIV treatment center in Kampala, Uganda. ALHIV were recruited during routine clinic visits. Three self-reported binary adherence measures were utilized: missed pills in the past three days, non-adherence to the prescribed medical regimen, and self-rated adherence assessed using a visual analog scale. Psychological distress was measured as a continuous variable, and computed as the mean score on a locally developed and validated 25-item symptom checklist for Ugandan ALHIV. Psychosocial resources included spirituality, religiosity, optimism, social support, and coping strategies. After adjusting for respondents' socio-demographic characteristics and psychosocial resources, a unit increase in psychological distress was associated with increased odds of missing pills in past 3 days (Odds Ratio(OR) = 1.75; Confidence Interval (CI): 1.04-2.95), not following the prescribed regimen (OR = 1.63; CI: 1.08-2.46), and lower self-rated adherence (OR = 1.79; CI: 1.19-2.69). Psychosocial resources were associated with lower odds for non-adherence on all three self-report measures. There is a need to strengthen the psychosocial aspects of adolescent HIV care by developing interventions to identify and prevent psychological distress among Ugandan ALHIV.

Brighter Smiles Africa--translation of a Canadian community-based health-promoting school program to Uganda.

PubMed

Macnab, A J; Radziminski, N; Budden, H; Kasangaki, A; Zavuga, R; Gagnon, F A; Mbabali, M

2010-08-01

PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership. Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students. MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules. Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care delivery.

Media ownership and news framing: an analysis of HIV/AIDS coverage by Ugandan press.

PubMed

Kiwanuka-Tondo, James; Albada, Kelly F; Payton, Fay Cobb

2012-12-01

Applying framing theory, the present research analyzes trends in Ugandan news coverage and the prominent issue frames for HIV/AIDS-related stories. In order to determine the influence of other factors, such as media ownership and journalist origin, nearly 800 articles, from 2000 to 2004, were gathered from the major private newspaper and government-owned newspaper in Uganda. After systematic sampling, 365 articles constitute the sample. The results indicate that print news coverage of HIV and AIDS followed a non-linear trajectory, declining from 2000-2002 and then increasing from 2003-2004. Curative medicine emerged as the most prominent issue frame. Higher-risk behaviour was the least prominent issue frame overall. The 'solutions' issue frame nearly doubled in prominence from 2000-2004, while the HIV-prevention frame decreased from 2000-2002 and then rebounded from 2003-2004. Concerning HIV-related topics, the private newspaper included more features, printed lengthier articles, incorporated a greater variety of news frames, and published more articles by foreign journalists than the government-owned newspaper. The private newspaper employed the 'HIV-prevention,' 'action,' and 'victims' frames more often than the government-owned newspaper. Journalists at the government-owned newspaper adopted a 'solutions' frame more often than their private-press counterparts. Though foreign journalists were more likely than local journalists to employ the HIV-prevention frame, additional tests revealed that the news organisation for which the journalists worked contributed to issue framing to a greater extent than did either a local or foreign reporting origin. Local (Ugandan) journalists working for the two news organisations differed in their tendencies to apply the HIV-prevention, action, victims, and tragedy frames in news stories on HIV and AIDS, with journalists at the private newspaper using these frames more often than did journalists at the government-owned newspaper.

Non-use of contraception: determinants among Ugandan university students.

PubMed

Mehra, Devika; Agardh, Anette; Petterson, Karen Odberg; Östergren, Per-Olof

2012-10-08

In Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical. The objective was to determine the relationship between non-use of contraception and sociodemographic factors, alcohol consumption, and types of partner(s) among Ugandan university students. In 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess sociodemographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex. 1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2-2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception. Non-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account.

Non-use of contraception: determinants among Ugandan university students

PubMed Central

Mehra, Devika; Agardh, Anette; Petterson, Karen Odberg; Östergren, Per-Olof

2012-01-01

Background In Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical. Objective The objective was to determine the relationship between non-use of contraception and socio-demographic factors, alcohol consumption, and types of partner(s) among Ugandan university students. Design In 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess socio-demographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex. Results 1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2–2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception. Conclusion Non-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account. PMID:23058273

Analysis of nevirapine (NVP) resistance in Ugandan infants who were HIV infected despite receiving single-Dose (SD) NVP versus SD NVP plus daily NVP up to 6 weeks of age to prevent HIV vertical transmission.

PubMed

Church, Jessica D; Omer, Saad B; Guay, Laura A; Huang, Wei; Lidstrom, Jessica; Musoke, Philippa; Mmiro, Francis; Jackson, J Brooks; Eshleman, Susan H

2008-10-01

Single-dose nevirapine (SD NVP) at birth plus NVP prophylaxis for the infant up to 6 weeks of age is superior to SD NVP alone for prevention of vertical transmission of human immunodeficiency virus (HIV) through breastfeeding. We analyzed NVP resistance in HIV-infected Ugandan infants who received either SD NVP or extended NVP prophylaxis. We tested plasma HIV by using a genotyping assay (ViroSeq; Celera Diagnostics), a phenotypic resistance assay (PhenoSense; Monogram Biosciences), and sensitive point mutation assay (LigAmp, for K103N, Y181C, and G190A). When infants were 6 weeks old, ViroSeq detected NVP resistance in a higher proportion of infants in the extended NVP arm than in the SD NVP arm (21 of 25 [84%] vs. 12 of 24 [50%]; P = .01). Similar results were obtained with LigAmp and PhenoSense. In both study arms, infants who were HIV infected at birth frequently had NVP resistance detected. In contrast, infants in the extended NVP arm who were HIV infected after birth were more likely to have resistance detected at 6 weeks, compared with infants in the SD NVP arm. The use of extended NVP prophylaxis was also associated with detection of NVP resistance by ViroSeq at 6 months (7 of 7 [100%] infants in the extended NVP arm had resistance detected, compared with 1 of 6 [16.7%] infants in the SD NVP arm; P = .005). The use of extended NVP prophylaxis was associated with increased selection for and persistence of NVP resistance in HIV-infected Ugandan infants.

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV.

PubMed

Boivin, Michael J; Nakasujja, Noeline; Sikorskii, Alla; Opoka, Robert O; Giordani, Bruno

2016-08-01

Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a "limited CCRT" with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment.

A year-long caregiver training program improves cognition in preschool Ugandan children with human immunodeficiency virus.

PubMed

Boivin, Michael J; Bangirana, Paul; Nakasujja, Noeline; Page, Connie F; Shohet, Cilly; Givon, Deborah; Bass, Judith K; Opoka, Robert O; Klein, Pnina S

2013-11-01

To evaluate mediational intervention for sensitizing caregivers (MISC). MISC biweekly caregiver training significantly enhanced child development compared with biweekly training on health and nutrition (active control) and to evaluate whether MISC training improved the emotional well-being of the caregivers compared with controls. Sixty of 120 rural Ugandan preschool child/caregiver dyads with HIV were assigned by randomized clusters to biweekly MISC training, alternating between home and clinic for 1 year. Control dyads received a health and nutrition curriculum. Children were evaluated at baseline, 6 months, and 1 year with the Mullen Early Learning Scales and the Color-Object Association Test for memory. Caldwell Home Observation for Measurement of the Environment and videotaped child/caregiver MISC interactions also were evaluated. Caregivers were evaluated for depression and anxiety with the Hopkins Symptoms Checklist. Between-group repeated-measures ANCOVA comparisons were made with age, sex, CD4 levels, viral load, material socioeconomic status, physical development, and highly active anti-retroviral therapy treatment status as covariates. The children given MISC had significantly greater gains compared with controls on the Mullen Visual Reception scale (visual-spatial memory) and on Color-Object Association Test memory. MISC caregivers significantly improved on Caldwell Home Observation for Measurement of the Environment scale and total frequency of MISC videotaped interactions. MISC caregivers also were less depressed. Mortality was less for children given MISC compared with controls during the training year. MISC was effective in teaching Ugandan caregivers to enhance their children's cognitive development through practical and sustainable techniques applied during daily interactions in the home. Copyright © 2013 Mosby, Inc. All rights reserved.

A randomized controlled trial to increase information, motivation, and behavioral skills in Ugandan adolescents

PubMed Central

Ybarra, Michele L.; Korchmaros, Josephine D.; Prescott, Tonya L.; Birungi, Ruth

2015-01-01

Background One in twenty-five Ugandan adolescents is HIV positive. Purpose Examine the impact of an Internet-based HIV prevention program on Information-Motivation-Behavior Skills Model-related constructs. Methods Three hundred and sixty-six sexually experienced and inexperienced students 12-18+ years-old in Mbarara, Uganda were randomly assigned to: the five-lesson CyberSenga program or treatment-as-usual. Half of the intervention participants were further randomized to a booster session. Assessments were collected at three and six months post-baseline. Results Participants’ HIV-related information improved over time at a greater rate for the intervention groups compared to the control group. Motivation for condom use changed to a greater degree over time for the intervention group – especially those in the intervention+booster group - compared to the control group. Behavioral skills for condom use, and motivation and behavioral skills for abstinence were statistically similar over time for both groups. Conclusions CyberSenga improves HIV preventive information and motivation to use condoms. PMID:25633626

Enterotoxigenic Escherichia coli strains are highly prevalent in Ugandan piggeries but disease outbreaks are masked by antibiotic prophylaxis.

PubMed

Okello, Emmanuel; Moonens, Kristof; Erume, Joseph; De Greve, Henri

2015-01-01

Post-weaning diarrhea (PWD) caused by enterotoxigenic Escherichia coli (ETEC) is an important disease of newly weaned piglets. ETEC strains commonly express F4 and/or F18 fimbriae that attach to carbohydrate receptors present on the intestinal epithelium during colonization. The disease status in the Ugandan piggeries had previously not been studied. In this cross-sectional sero-survey and clinical outbreak monitoring, we found very high sero-prevalence levels of both anti-F4 (70.5%) and anti-F18 (73.7%) antibodies, despite limited cases of clinical outbreaks. Strains isolated from these cases were typically F18(+) ETEC. High antibiotic resistance and multi-drug resistance were characteristics of the isolates, with highest resistance level of over 95% to commonly used antibiotics such as penicillin and tetracycline. We conclude that ETEC infections are widely spread on farms in Central Uganda but clinical disease outbreaks were masked by the management practices on these farms, like the use of extensive antibiotic prophylaxis.

Antiretroviral Therapy is Associated with Increased Fertility Desire, but not Pregnancy or Live Birth, among HIV+ Women in an Early HIV Treatment Program in Rural Uganda

PubMed Central

Andia, Irene; Emenyonu, Nneka; Guzman, David; Kaida, Angela; Pepper, Larry; Hogg, Robert; Bangsberg, David R.

2013-01-01

To assess the association between antiretroviral therapy (ART) and fertility history and desire among HIV-positive Ugandan women, we conducted a cross-sectional study among HIV-positive Ugandan women aged 18–50 years who attended an HIV clinic at Mbarara University in western Uganda between November 1, 2005 and June 6, 2006. Of 538 women approached, 501 were enrolled. ART use was associated with increased odds of fertility desire (AOR 2.99, 95% CI 1.38–6.28), and decreased odds of pregnancy (AOR 0.56, 95% CI 0.33–0.95) and live birth (AOR 0.30, 95% CI 0.13–0.66). ART was associated with an increase in fertility desire, but was not associated with an increase in fertility. Additional studies will be needed to determine if this greater fertility desire among ART-treated women leads to an increase in fertility as ART use expands. PMID:18389364

Antiretroviral therapy is associated with increased fertility desire, but not pregnancy or live birth, among HIV+ women in an early HIV treatment program in rural Uganda.

PubMed

Maier, Marissa; Andia, Irene; Emenyonu, Nneka; Guzman, David; Kaida, Angela; Pepper, Larry; Hogg, Robert; Bangsberg, David R

2009-06-01

To assess the association between antiretroviral therapy (ART) and fertility history and desire among HIV-positive Ugandan women, we conducted a cross-sectional study among HIV-positive Ugandan women aged 18-50 years who attended an HIV clinic at Mbarara University in western Uganda between November 1, 2005 and June 6, 2006. Of 538 women approached, 501 were enrolled. ART use was associated with increased odds of fertility desire (AOR 2.99, 95% CI 1.38-6.28), and decreased odds of pregnancy (AOR 0.56, 95% CI 0.33-0.95) and live birth (AOR 0.30, 95% CI 0.13-0.66). ART was associated with an increase in fertility desire, but was not associated with an increase in fertility. Additional studies will be needed to determine if this greater fertility desire among ART-treated women leads to an increase in fertility as ART use expands.

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.

Correlates of Use of Timed Unprotected Intercourse to Reduce Horizontal Transmission Among Ugandan HIV Clients with Fertility Intentions

PubMed Central

Wagner, Glenn J.; Goggin, Kathy; Mindry, Deborah; Beyeza-Kashesya, Jolly; Finocchario-Kessler, Sarah; Woldetsadik, Mahlet Atakilt; Khanakwa, Sarah; Wanyenze, Rhoda K.

2014-01-01

We examined the correlates of use of safer conception methods (SCM) in a sample of 400 Ugandan HIV clients (75% female; 61% on antiretroviral therapy; 61% with HIV-negative or unknown status partners) in heterosexual relationships with fertility intentions. SCM assessed included timed unprotected intercourse, manual self-insemination, sperm washing, and pre-exposure prophylaxis (PrEP). In the 6 months prior to baseline, 47 (12%) reported using timed unprotected intercourse to reduce risk of HIV infection (or re-infection), none had used manual self-insemination or sperm washing, and 2 had used PrEP. In multiple regression analysis, correlates of use of timed unprotected intercourse included greater perceptions of partner’s willingness to use SCM and providers’ stigma of childbearing among people living with HIV, higher SCM knowledge, and desire for a child within the next 6 months. These findings highlight the need for policy and provider training regarding integration of couples’ safer conception counselling into HIV care. PMID:25280448

Cooperative Networks: Altruism, Group Solidarity, Reciprocity, and Sanctioning in Ugandan Producer Organizations.

PubMed

Baldassarri, Delia

2015-09-01

Repeated interaction and social networks are commonly considered viable solutions to collective action problems. This article identifies and systematically measures four general mechanisms--that is, generalized altruism, group solidarity, reciprocity, and the threat of sanctioning--and tests which of them brings about cooperation in the context of Ugandan producer organizations. Using an innovative methodological framework that combines "lab-in-the-field" experiments with survey interviews and complete social networks data, the article goes beyond the assessment of a relationship between social networks and collective outcomes to study the mechanisms that favor cooperative behavior. The article first establishes a positive relationship between position in the network structure and propensity to cooperate in the producer organization and then uses farmers' behavior in dictator and public goods games to test different mechanisms that may account for such a relationship. Results show that cooperation is induced by patterns of reciprocity that emerge through repeated interaction rather than other-regarding preferences like altruism or group solidarity.

Voices from Uganda. African Voices Series.

ERIC Educational Resources Information Center

Warner, Rachel, Ed.

This multi-language collection of autobiographical writing from Ugandan children and young adults who are living in Britain as refugees is illustrated with photographs and children's drawings and includes comprehensive country introductions. In the collection, young people give their accounts of migration and explore how their identities are…

AIDS and Democratic Education in Uganda.

ERIC Educational Resources Information Center

Mirembe, Robina

2002-01-01

Reflecting Ugandan culture, the national curriculum on HIV/AIDS and sex education was authoritarian and conformist, and students considered it irrelevant to their lives. An action research project that allowed student choice of classroom procedures and content concerning AIDS and sexuality not only increased student knowledge but also increased…

Mental Health Practitioners' Reflections on Psychological Work in Uganda: Exploring Perspectives from Different Professions

ERIC Educational Resources Information Center

Hall, Jennifer; d'Ardenne, Patricia; Nsereko, James; Kasujja, Rosco; Baillie, Dave; Mpango, Richard; Birabwa, Harriet; Hunter, Elaine

2014-01-01

The Butabika-East London Link collaborated with Ugandan mental health services to train mental health professionals (psychiatric clinical officers, "PCOs", and clinical psychologists and psychiatrists, "Core Group") in psychological therapies. The aims of this research were to investigate how professionals were applying and…

Schooling Ugandan Girls: A Policy Historiography

ERIC Educational Resources Information Center

Kabesiime, Mary

2010-01-01

This is an abstract about Uganda. When the National Resistance Movement (NRM) government came to power in 1986, it had to address many challenges in order to achieve its objectives among which were: poverty eradication, eradication of illiteracy, reducing unemployment, bringing peace and prosperity for all. However, the government realised that in…

Rethinking Early Learning and Development Standards in the Ugandan Context

ERIC Educational Resources Information Center

Ejuu, Godfrey

2013-01-01

Concerns that the African child is being tailored to be a "global child," alongside other homogenizing and dominating projections, such as early learning and development standards (ELDS), have increased. African communities need to be assured that global standards and global indicators will not further homogenize nations and thereby risk…

A Year in the Life of an Open University Student in the United Kingdom.

ERIC Educational Resources Information Center

Ismail, Nazira

1988-01-01

Describes a Ugandan student's first-year experiences at the Open University in the United Kingdom. Discusses how the University operates; comments on course texts and supplementary materials; and presents a month-by-month breakdown of university and course activities and requirements. (GEA)

The Role of Culture in Rural Ugandan Mathematics Teaching and Learning

ERIC Educational Resources Information Center

Kaahwa, Janet

2011-01-01

Education systems are culturally embedded and, therefore, difficult to improve without understanding actions, beliefs, and attitudes related to education existing within the culture. This article discusses the role culture plays in the teaching and learning of mathematics. It specifically dwells on the ways culture could benefit learners from…

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,…

The Strange, Expanding World of Animal Hepaciviruses

PubMed Central

Hartlage, Alex S.; Cullen, John M.; Kapoor, Amit

2017-01-01

Hepaciviruses and pegiviruses constitute two closely related sister genera of the family Flaviviridae. In the past five years, the known phylogenetic diversity of the hepacivirus genera has absolutely exploded. What was once an isolated infection in humans (and possibly other primates) has now expanded to include horses, rodents, bats, colobus monkeys, cows, and, most recently, catsharks, shedding new light on the genetic diversity and host range of hepaciviruses. Interestingly, despite the identification of these many animal and primate hepaciviruses, the equine hepaciviruses remain the closest genetic relatives of the human hepaciviruses, providing an intriguing clue to the zoonotic source of hepatitis C virus. This review summarizes the significance of these studies and discusses current thinking about the origin and evolution of the animal hepaciviruses as well as their potential usage as surrogate models for the study of hepatitis C virus. PMID:27741408

Biting Midges of the Genus Culicoides in South Carolina Zoos

PubMed Central

Nelder, Mark P.; Swanson, Dustin A.; Adler, Peter H.; Grogan, William L.

2010-01-01

Biting midges of the genus Culicoides (Diptera: Ceratopogonidae) were collected during the summer of 2007 at the Greenville and Riverbanks Zoos in South Carolina with Centers for Disease Control and Prevention (CDC) traps equipped with ultraviolet or incandescent lights and baited with carbon dioxide. Sixteen species of Culicoides were collected, four of which represented more than 80%. They were Culicoides guttipennis (Coquillett), Culicoides mulrenanni Beck, Culicoides obsoletus (Meigen), and Culicoides sanguisuga (Coquillett). C. guttipennis was found on a dead colobus monkey and a dead golden-headed lion tamarin; Culicoides husseyi Wirth & Blanton was collected from an unidentified, abandoned bird's nest. Ultraviolet light-equipped traps captured significantly more Culicoides specimens than traps with incandescent light. Half of the collected species previously have been associated with vertebrate pathogens, indicating a potential risk to captive animals. PMID:20569132

Ugandan Mathematics: An Unsolvable Problem?

ERIC Educational Resources Information Center

Eveleigh, Tobias

2011-01-01

This author is on a journey--hoping that his expertise might have some small local impact. He shares his experiences that might relate to those who are thinking about volunteering abroad, or trying to modernise a system that is cemented in place. Creating change, developing teaching styles, and working for a charity are some of the challenges he…

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

ERIC Educational Resources Information Center

Kendrick, Maureen; Kakuru, Doris

2012-01-01

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

Ethical Tensions and Dilemmas Experienced in a Northern Ugandan Social Work Internship

ERIC Educational Resources Information Center

Corbin, Joanne

2012-01-01

This article explores the ethical tensions and dilemmas that arose for 2 U.S. social work students during an 8-month international clinical internship in northern Uganda. These students encountered cultural differences related to issues of confidentiality, autonomy, and self-determination. Student experiences were analyzed using the cultural…

Students and Scientists Connect with Nature in Uganda, East Africa

ERIC Educational Resources Information Center

Johnson-Pynn, Julie S.; Johnson, Laura R.; Kityo, Robert; Lugumya, Douglas

2014-01-01

We studied the impact of environmental education (EE) workshops on Ugandan youth's (N = 84) perceptions of their relationship with nature, self efficacy, and civic attitudes and skills. Two nature-related measures and two measures related to social competencies were administered before and after EE workshops that were designed to educate youth…

Teaching Ugandan Traditional Dances and Drumming in Summer Camps

ERIC Educational Resources Information Center

Mabingo, Alfdaniels

2017-01-01

Dances and drum rhythms from African traditions have been integrated into summer camp activities in the United States as a response to the ever-globalized environments in which these camps are located and the diversity of the campers and teachers that they attract. This reflective article draws on critical reflections, observations and experiences…

Student Characteristics and Learning Outcomes in a Blended Learning Environment Intervention in a Ugandan University

ERIC Educational Resources Information Center

Kintu, Mugenyi Justice; Zhu, Chang

2016-01-01

This paper explores the design of a blended learning environment in a transition from face-to-face and seeks to determine whether learner characteristics and background together with blended learning design elements are significant factors for learning outcomes such as intrinsic motivation, satisfaction, knowledge construction and learning…

Professional Development Status of Teaching Staff in a Ugandan Public University

ERIC Educational Resources Information Center

Kasule, George Wilson; Wesselink, Renate; Mulder, Martin

2016-01-01

A study was conducted to determine general professional development activities perceived to be important in enhancing university teaching staff's job performance, and the extent to which teaching staff participate in these activities in Uganda. Data were collected through semi-structured interviews with faculty deans and department heads (n = 20),…

Education Sector Reform: The Ugandan Experience

ERIC Educational Resources Information Center

Penny, Alan; Ward, Michael; Read, Tony; Bines, Hazel

2008-01-01

In 1998 the Government of Uganda (GoU) began implementing an ambitious reform programme called the Education Strategic Investment Plan (ESIP) in order to effect Universal Primary Education (UPE). This paper offers a perspective on how the GoU has met the challenge of financing education reform, addressed the need to improve the quality of basic…

Evaluation of the Ugandan sorghum accessions for grain mold and anthracnose resistance

USDA-ARS?s Scientific Manuscript database

Sorghum accessions from Uganda were evaluated for grain mold and anthracnose resistance during the 2005 and 2006 growing seasons at the Texas A&M University Research Farm, near College Station, TX. Accession PI534117 and SC719-11E exhibited the lowest grain mold severities of 2.4, whereas, accessio...

Screening for abnormal vaginal microflora by self-assessed vaginal pH does not enable detection of sexually transmitted infections in Ugandan women.

PubMed

Donders, Gilbert G G; Donders, Francesca; Bellen, Gert; Depuydt, Christophe; Eggermont, Natalie; Michiels, Thirsa; Lule, John; Byamughisa, Jacobat

2016-06-01

Is self-assessed vaginal pH measurement to detect abnormal vaginal bacterial microflora (AVF) an adequate prescreening method for detection of genital sexually transmitted infections (STIs)? A total of 360 Ugandan women tested themselves with a gloved finger and a pH color strip. PCR for bacterial vaginosis (BV)-associated bacteria was tested by PCR for Mycoplasma hominis, Ureaplasma urealyticum, and/or Atopobium vaginae, while the STIs were diagnosed by positive PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and/or Trichomonas vaginalis. A strong correlation was found between self-assessed pH values and BV-associated bacteria (P<0.0001), but not with STIs, not as single infections, nor in general. Self-measured vaginal pH correlated well with markers of high-risk microflora types such as BV or aerobic vaginitis, but not with STIs. Hence, in a screening program addressing AVF in low-resource countries, extra specific tests are required to exclude STIs. Copyright © 2015 Elsevier Inc. All rights reserved.

Analysis of TP53 codon 72 polymorphism in HPV-positive and HPV-negative penile carcinoma.

PubMed

Tornesello, Maria Lina; Duraturo, Maria Luisa; Guida, Valentina; Losito, Simona; Botti, Gerardo; Pilotti, Silvana; Stefanon, Bernardina; De Palo, Giuseppe; Buonaguro, Luigi; Buonaguro, Franco M

2008-09-28

The association of the p53 polymorphism at codon 72 and susceptibility to develop human papillomavirus (HPV)-related cancer has been investigated in several studies with controversial results. In this study, 78 penile squamous cell carcinoma biopsies (n=17 from Uganda, n=61 from Italy) and blood samples from 150 healthy controls (n=57 from Uganda, n=93 from Italy) have been analyzed for the arginine and proline allele distribution. Among Ugandan cases the heterozygous, proline homozygous and arginine homozygous genotype frequency was 41.2%, 52.9% and 5.9%, respectively, and among controls was 40.3%, 54.4%, and 5.3%, respectively (P=0.9917). Conversely, among Italian cases genotype distribution was 42.6%, 4.9%, and 52.5%, and among controls was 34.4%, 7.5%, and 58.1%, respectively (P=0.5343). No significant differences in arginine and proline allele distribution were observed when the cases were stratified by HPV status. Therefore, no evidence of association between homozygosity for p53 arginine and HPV-related or HPV-unrelated penile squamous cell carcinoma was observed neither among Ugandan nor among Italian populations.

The Current Working Conditions in Ugandan Apparel Assembly Plants.

PubMed

Tebyetekerwa, Mike; Akankwasa, Nicholus Tayari; Marriam, Ifra

2017-12-01

The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required. A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work. The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies. The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.

Global Health Initiatives and aid effectiveness: insights from a Ugandan case study

PubMed Central

2011-01-01

Background The emergence of Global Health Initiatives (GHIs) has been a major feature of the aid environment of the last decade. This paper seeks to examine in depth the behaviour of two prominent GHIs in the early stages of their operation in Uganda as well as the responses of the government. Methods The study adopted a qualitative and case study approach to investigate the governance of aid transactions in Uganda. Data sources included documentary review, in-depth and semi-structured interviews and observation of meetings. Agency theory guided the conceptual framework of the study. Results The Ugandan government had a stated preference for donor funding to be channelled through the general or sectoral budgets. Despite this preference, two large GHIs opted to allocate resources and deliver activities through projects with a disease-specific approach. The mixed motives of contributor country governments, recipient country governments and GHI executives produced incentive regimes in conflict between different aid mechanisms. Conclusion Notwithstanding attempts to align and harmonize donor activities, the interests and motives of the various actors (GHIs and different parts of the government) undermine such efforts. PMID:21726431

'As a man I felt small': a qualitative study of Ugandan men's experiences of living with a wife suffering from obstetric fistula.

PubMed

Barageine, Justus Kafunjo; Faxelid, Elisabeth; Byamugisha, Josaphat K; Rubenson, Birgitta

2016-01-01

The effects of obstetric fistula surpass the individual woman and affect husbands, relatives, peers and the community at large. Few studies have documented the experiences of men who live with wives suffering from fistula. In this study, our objective was to understand how fistula affects these men's lives. We conducted 16 in-depth interviews with men in central and western Uganda. We used thematic narrative analysis and discuss our findings based on Connell's theory of hegemonic masculinity. Findings show that the men's experiences conflicted with Ugandan norms of hegemonic masculinity. However, men had to find other ways of explaining their identity, such as portraying themselves as small men but still be responsible, caring husbands and fathers. The few individuals who married a second wife remained married to the wife with the fistula. These men viewed marriage as a lifetime promise before God and a responsibility that should not end because of a fistula. Poverty, love, care for children and social norms in a patriarchal society compelled the men to persevere in their relationship amidst many challenges.

“I have remained strong because of that food”: Acceptability and use of lipid-based nutrient supplements among pregnant HIV-infected Ugandan women receiving combination antiretroviral therapy

PubMed Central

Young, Sera; Natamba, Barnabas; Luwedde, Flavia; Nyafwono, Dorcas; Okia, Ben; Osterbauer, Beth; Natureeba, Paul; Johnson, Lynn; Michel, Chloe; Zheng, Amy; Robine, Marion; Achan, Jane; Charlebois, Edwin; Cohan, Deb; Havlir, Diane

2015-01-01

We evaluated the acceptability and use of macronutrient supplementation among HIV-infected pregnant Ugandan women receiving antiretroviral therapy in a clinical study (NCT 00993031). We first conducted formative research among 56 pregnant and lactating women to select a supplement regimen. Acceptability and use of the supplementation regimen [35 sachets of lipid-based nutrient supplements (LNS) and 4 or 6 kg of instant soy porridge for the household provided monthly] were evaluated among 87 pregnant women. Organoleptic assessments of LNS were favorable. Participants reported consuming LNS a mean of 6.1 days per week, and adherence to recommended consumption behaviors (e.g. frequency, quantity, not sharing) was >80%. Few women reported negative social consequences of supplementation. The majority of participants also consumed most of the porridge intended for the household. In sum, LNS was acceptable and used regularly. Larger studies to evaluate physical and psychosocial consequences of LNS during pregnancy among HIV-infected women are warranted. PMID:25416075

SMS texts on corruption help Ugandan voters hold elected councillors accountable at the polls.

PubMed

Buntaine, Mark T; Jablonski, Ryan; Nielson, Daniel L; Pickering, Paula M

2018-06-11

Many politicians manipulate information to prevent voters from holding them accountable; however, mobile text messages may make it easier for nongovernmental organizations to credibly share information on official corruption that is difficult for politicians to counter directly. We test the potential for texts on budget management to improve democratic accountability by conducting a large ( n = 16,083) randomized controlled trial during the 2016 Ugandan district elections. In cooperation with a local partner, we compiled, simplified, and text-messaged official information on irregularities in local government budgets. Verified recipients of messages that described more irregularities than expected reported voting for incumbent councillors 6% less often; verified recipients of messages conveying fewer irregularities than expected reported voting for incumbent councillors 5% more often. The messages had no observable effect on votes for incumbent council chairs, potentially due to voters' greater reliance on other sources of information for higher profile elections. These mixed results suggest that text messages on budget corruption help voters hold some politicians accountable in settings where elections are not free and fair. Copyright © 2018 the Author(s). Published by PNAS.

Sequence conservation and antibody cross-recognition of clade B human immunodeficiency virus (HIV) type 1 Tat protein in HIV-1-infected Italians, Ugandans, and South Africans.

PubMed

Buttò, Stefano; Fiorelli, Valeria; Tripiciano, Antonella; Ruiz-Alvarez, Maria J; Scoglio, Arianna; Ensoli, Fabrizio; Ciccozzi, Massimo; Collacchi, Barbara; Sabbatucci, Michela; Cafaro, Aurelio; Guzmán, Carlos A; Borsetti, Alessandra; Caputo, Antonella; Vardas, Eftyhia; Colvin, Mark; Lukwiya, Matthew; Rezza, Giovanni; Ensoli, Barbara

2003-10-15

We determined immune cross-recognition and the degree of Tat conservation in patients infected by local human immunodeficiency virus (HIV) type 1 strains. The data indicated a similar prevalence of total and epitope-specific anti-Tat IgG in 578 serum samples from HIV-infected Italian (n=302), Ugandan (n=139), and South African (n=137) subjects, using the same B clade Tat protein that is being used in vaccine trials. In particular, anti-Tat antibodies were detected in 13.2%, 10.8%, and 13.9% of HIV-1-infected individuals from Italy, Uganda, and South Africa, respectively. Sequence analysis results indicated a high similarity of Tat from the different circulating viruses with BH-10 Tat, particularly in the 1-58 amino acid region, which contains most of the immunogenic epitopes. These data indicate an effective cross-recognition of a B-clade laboratory strain-derived Tat protein vaccine by individuals infected with different local viruses, owing to the high similarity of Tat epitopes.

Low prevalence of Pneumocystis jirovecii lung colonization in Ugandan HIV-infected patients hospitalized with non-Pneumocystis pneumonia.

PubMed

Taylor, Steve M; Meshnick, Steven R; Worodria, William; Andama, Alfred; Davis, J Lucian; Cattamanchi, Adithya; den Boon, Saskia; Yoo, Samuel D; Goodman, Carol D; Huang, Laurence

2012-02-01

Pneumocystis jirovecii is an important opportunistic infection in human immunodeficiency virus (HIV)-infected patients. In the developed world, P. jirovecii epidemiology is marked by frequent colonization in immunosuppressed patients, but data on the prevalence of colonization are very limited in sub-Saharan Africa, where the majority of persons living with HIV reside. Our objective was to describe the epidemiology of P. jirovecii colonization among HIV-positive patients in a cross-sectional, hospital-based study of patients admitted with suspected pneumonia in Kampala, Uganda. P. jirovecii was detectable in bronchoalveolar lavage fluid from 7 (6%) of 124 consecutive patients with non-Pneumocystis pneumonia. Colonization was not associated with patient demographic or clinical information. This prevalence is substantially lower than in published studies in the developed world and suggests that there is a limited reservoir of organisms for clinical infections in this Ugandan population. These findings may partially explain the low incidence of Pneumocystis pneumonia in Uganda and other sub-Saharan African countries. Copyright © 2012 Elsevier Inc. All rights reserved.

Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl.

PubMed

Olson, Rose McKeon; Kamurari, Solomon

2017-10-20

A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Internalized homonegativity/homophobia is associated with HIV-risk behaviours among Ugandan gay and bisexual men.

PubMed

Ross, M W; Kajubi, P; Mandel, J S; McFarland, W; Raymond, H F

2013-05-01

We investigated the relationship of internalized homonegativity/homophobia (IH) to sexual risk behaviours among 216 Ugandan gay and bisexual men, using the 7-item IH scale previously developed on this population. IH was significantly associated with unprotected anal intercourse, and more so with unprotected receptive anal intercourse. Higher IH was also associated with more sex while intoxicated. There was a strong association between anal intercourse of any type and IH, suggesting a complex relationship between anal sex and identification with, or internalization of, homonegativity/homophobia. Specifically, it may be the anal component of sex rather than the sex with another man that is seen as labeling one as homosexual or stigmatizing. Those men who stated that they engaged in sex with other men for love, rather than for the physical feeling or for money, had higher IH scores. These data suggest that there may be an interactive relationship between IH and sexual behaviour, with greater internalization being associated with more stereotypically gay activities, which in turn may lead to more self-identification as gay and thus greater susceptibility to internalization.

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 could develop both institutional and individual research capacity, improve output and accountability, and facilitate academic research funding and indigenous research agendas. Copyright © 2014. Published by Elsevier Ltd.

Portrayal of the Human Resource Crisis and Accountability in Healthcare: A Qualitative Analysis of Ugandan Newspapers

PubMed Central

Wojczewski, Silvia; Willcox, Merlin; Mubangizi, Vincent; Hoffmann, Kathryn; Peersman, Wim; Niederkrotenthaler, Thomas; Natukunda, Silvia; Maling, Samuel; Maier, Manfred; Mant, David; Kutalek, Ruth

2015-01-01

Background Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services. Methods We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability. Results The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda. Conclusions The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an “inverse care law” but also an “inverse information law”: those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services. PMID:25837490

A prospective study of trends in consumption of cigarettes and alcohol among adults in a rural Ugandan population cohort, 1994-2011.

PubMed

Asiki, Gershim; Baisley, Kathy; Kamali, Anatoli; Kaleebu, Pontiano; Seeley, Janet; Newton, Robert

2015-04-01

To characterise trends over time in smoking and alcohol consumption in a rural Ugandan population between 1994 and 2011. We used self-reported data from a long-standing population cohort - the General Population Cohort. From 1989 to 1999, the study population comprised about 10 000 residents of 15 adjacent villages. From 1999, 10 more villages were added, doubling the population. Among adults (≥13 years, who comprise about half of the total study population), data on smoking were collected in 1994/1995, 2008/2009 and in 2010/2011. Data on alcohol were collected in 1996/1997, 2000/2001, 2009/2010 and 2010/2011. The reported prevalence of smoking among men was 17% in 1994/1995, 14% in 2008/2009 and 16% in 2010/2011; equivalent figures for women were 1.5%, 1% and 2%. In the most recent time period, for both sexes combined, prevalence of smoking increased from 1.5% in those aged <29 years, to 18% in those 50+ years (P < 0.001); prevalence was 14.8% in the lowest tertile of socio-economic status, decreasing to 3.7% in the highest (P < 0.001). For alcohol consumption, current drinking was reported by 39% in 1996/1997, 35% in 2000/2001 and 28% in 2010/2011; men were more likely to drink than women (32.9% vs. 23.5% in 2010/2011) and consumption increased with age (P < 0.001); and was associated with low socio-economic status, riskier sexual behaviour and being HIV positive (P < 0.001). In this rural Ugandan population, consumption of cigarettes and alcohol is higher among men than women, increases with age and is more frequent among those with low socio-economic status. We find no evidence of increases in either exposure over time. © 2014 John Wiley & Sons Ltd.

Minor drug-resistant HIV type-1 variants in breast milk and plasma of HIV type-1-infected Ugandan women after nevirapine single-dose prophylaxis.

PubMed

Pilger, Daniel; Hauser, Andrea; Kuecherer, Claudia; Mugenyi, Kizito; Kabasinguzi, Rose; Somogyi, Sybille; Harms, Gundel; Kunz, Andrea

2011-01-01

Nevirapine single-dose (NVP-SD) reduces mother-to-child transmission of HIV type-1 (HIV-1), but frequently induces resistance mutations in the HIV-1 genome. Little is known about drug-resistant HIV-1 variants in the breast milk of women who have taken NVP-SD. Blood and breast milk samples of 39 HIV-1-infected Ugandan women were taken 6-12 weeks after NVP-SD intake. Samples were analysed by population sequencing and allele-specific real-time PCR (AS-PCR) with detection limits for NVP-resistant HIV-1 variants (K103N and Y181C) of < 1% of the total viral population. AS-PCR results for both plasma and breast milk were obtained for 19 women who constituted the final study group (HIV-1 subtype frequencies were A1 n = 11, D n = 5, G n = 2 and C n = 1). A total of 7 (37%) and 10 (53%) women carried NVP-resistant virus in breast milk and plasma, respectively. Overall, 71% (5/7) women with NVP-resistant HIV-1 in breast milk displayed >1 drug-resistant variant. Resistance in breast milk was higher at week 6 (6/13 samples [46%]) compared with week 12 (1/6 samples [17%]). In total, 10 drug-resistant populations harbouring the K103N and/or Y181C mutation were detected in the 19 breast milk samples; 7 (70%) were caused by resistant minorities (< 5% of the total HIV-1 population). In the four women with drug-resistant virus in both plasma and breast milk, the mutation patterns differed between the two compartments. Minor populations of drug-resistant HIV-1 were frequently found in breast milk of Ugandan women after exposure to NVP-SD. Further studies need to explore the role of minor drug-resistant variants in the postnatal transmission of (resistant) HIV-1.

Portrayal of the human resource crisis and accountability in healthcare: a qualitative analysis of ugandan newspapers.

PubMed

Wojczewski, Silvia; Willcox, Merlin; Mubangizi, Vincent; Hoffmann, Kathryn; Peersman, Wim; Niederkrotenthaler, Thomas; Natukunda, Silvia; Maling, Samuel; Maier, Manfred; Mant, David; Kutalek, Ruth

2015-01-01

Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services. We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability. The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda. The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an "inverse care law" but also an "inverse information law": those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services.

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV

PubMed Central

Nakasujja, Noeline; Sikorskii, Alla; Opoka, Robert O.; Giordani, Bruno

2016-01-01

Abstract Objectives: Clinically stable children with HIV can have neuromotor, attention, memory, visual–spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. Design: One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. Methods: The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual–spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a “limited CCRT” with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. Results: The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children–second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. Conclusions: CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment. PMID:27045714

Ugandan Immigrant Students' Perceptions of Barriers to Academic Achievement in American High Schools

ERIC Educational Resources Information Center

Ssekannyo, Denis

2010-01-01

In a world that is now a global village, enterprising individuals, especially from Third World countries, who make it to greener pastures do not leave their children behind. But with a long list of barriers to academic achievement associated with immigrant and minority students in American high schools, an understanding of the experiences and…

Relationship between Risk Assessment and Compliance to Health and Safety in Ugandan Secondary Schools

ERIC Educational Resources Information Center

Sekiwu, Denis; Kabanda, Milly; Naluwemba, Esther Frances; Kaggwa, Victoria Tamale

2015-01-01

Health hazards are part and parcel of human life necessitating the provision of safety in every organizational environment (WHO regional Office for Africa, 2004). Likewise, the area of safety and accident prevention is of great concern to school improvement. The study sought to investigate the relationship between Risk Assessment and Compliancy to…

Promoting Local Languages in Ugandan Primary Schools: The Community as Stakeholder

ERIC Educational Resources Information Center

Tembe, Juliet; Norton, Bonny

2008-01-01

The community is an important stakeholder in language education, and community views are critical for the successful implementation of new language policies. This article reports on a study on multilingual language policies conducted in two primary schools in two communities in eastern Uganda, one rural and one urban, from 2005 through 2006. The…

Education as a Public Good: Justification and Avenues of Values Integration into Management of Ugandan School Discipline

ERIC Educational Resources Information Center

Sekiwu, Denis; Botha, M. M.

2014-01-01

This qualitative study employs grounded theory and the Wilsonian concept analysis, as interpretative paradigms, to examine participants' voices on the justification and avenues of values integration into management of school discipline in Uganda. By using John Dewey's educational philosophy [pragmatism] as the theoretical lens for the study, we…

Strengths and Weaknesses of Elementary and Secondary Education in Uganda: Evaluation Based on a Teachers' Survey

ERIC Educational Resources Information Center

Walugembe, Frederick

2009-01-01

This study intends to identify the aspects of the Ugandan teachers' jobs and work environment perceived by selective participants as satisfactory, as well as those perceived as less satisfactory or unsatisfactory. The study is based on the assumption that teachers, being directly involved in the current activities of educational institutions, have…

Examining the Psychosocial Adjustment and School Performance of Ugandan Children with HIV/AIDS

ERIC Educational Resources Information Center

Busman, Rachelle A.

2010-01-01

Human immunodeficiency virus (HIV) has had a devastating impact on the children of Africa. In Uganda, over 100,000 children are infected, mostly through vertical transmission of the disease from their mother. With recent improvements in medical treatment, children are now surviving longer and reaching school age, but there is limited research…

"Virginity Is a Virtue: Prevent Early Sex"--Teacher Perceptions of Sex Education in a Ugandan Secondary School

ERIC Educational Resources Information Center

Iyer, Padmini; Aggleton, Peter

2014-01-01

Sex education is a politically contentious issue in many countries, and there are numerous, competing ideologies relating to the most appropriate methods to teach young people about sexual and reproductive health. This paper examines policy and practice in Uganda in light of two contrasting ideologies, namely morally conservative and comprehensive…

Assessing the Influence of Social Networking Material on Adolescents' Sexual Behavior in Kampala

ERIC Educational Resources Information Center

Nagaddya, Ritah; Kiconco, Sylvia; Komuhangi, Alimah; Akugizibwe, Pardon; Atuhairwe, Christine

2017-01-01

Background: Social media has been used to promote risky sexual behavior in form of unsolicited photos, videos and text from peers and strangers that is not regulated by parents or guardians. Therefore, it's important to investigate the influence of social networking material on adolescents' sexual behavior in Ugandan in order to close the…

Multiple Complicities: Reliving a Life in the Classroom

ERIC Educational Resources Information Center

Gill, Prue

2016-01-01

In this teaching memoir, time with a group of Ugandan teachers becomes the "awakening" or spur to leaf through memories of more than 40 years of life in the classroom. The moments chosen to relive afresh tell of practices which have largely been erased in curriculum discussion in Australia. Together they add up to an argument, more…

Innate and Adaptive Immune Responses Both Contribute to Pathological CD4 T Cell Activation in HIV-1 Infected Ugandans

DTIC Science & Technology

2011-04-01

vivo in macaques results in increased SIV-specific T cell function and longer survival of the animals [29,30]. In summary, uncontrolled activation...infected homosexual men: NIAID Multicenter AIDS cohort study. Clin Immunol Immunopathol 52: 10–18. 2. Hazenberg MD, Otto SA, van Benthem BH, Roos MT

Cross-Cultural Difference in Academic Motivation, Academic Self-Esteem, and Upward Social Mobility within a Student Cohort

ERIC Educational Resources Information Center

Mugabe, C.; Brug, P.; Catling, J. C.

2016-01-01

The relationship between academic motivation, support structures, self-esteem, and social mobility was assessed between three culturally distinct Higher Education student cohorts. Two-hundred-and-sixty-seven students took part in the study: 64 American undergraduates; 100 British undergraduates; and 103 Ugandan undergraduates. Using a number of…

"Then It Will Be Good": Negative Life Events and Resilience in Ugandan Youth

ERIC Educational Resources Information Center

Eggum, Natalie D.; Sallquist, Julie; Eisenberg, Nancy

2011-01-01

Youths (N = 57; mean age = 13.83 years) residing near Tororo, Uganda, were interviewed to obtain quantitative and qualitative data pertaining to negative life events, adjustment problems, coping, social support, self-worth, and hope. On average, they experienced nearly half of the 22 negative life events assessed. The experience of negative life…

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…

Interplay of School Welfare Provision and Teacher Performance: The Case of Ugandan Secondary Schools

ERIC Educational Resources Information Center

Naluwemba, Frances; Sekiwu, Denis; Okwenje, Vicent

2016-01-01

This is an account of a cross-sectional study of how school welfare provision influences teacher performance in six government aided secondary schools in Uganda. The study was largely a mixed method involving semi-structured questionnaires and interviews with a convenience sample of 221 participants in the categories of teachers, head teachers,…

Perceptual Influence of Ugandan Biology Students' Understanding of HIV/AIDS

ERIC Educational Resources Information Center

Mutonyi, Harriet; Nashon, Samson; Nielsen, Wendy S.

2010-01-01

In Uganda, curbing the spread of HIV/AIDS has largely depended on public and private media messages about the disease. Media campaigns based on Uganda's cultural norms of communication are metaphorical, analogical and simile-like. The topic of HIV/AIDS has been introduced into the Senior Three (Grade 11) biology curriculum in Uganda. To what…

The Information-Seeking Behavior of Intrinsically Motivated Elementary School Children of a Collectivist Culture

ERIC Educational Resources Information Center

Crow, Sherry R.

2015-01-01

This study, conducted in June 2014 in Kampala, Uganda, is a follow-up to a similar study conducted in Colorado Springs, Colorado, in 2008. The basic research question addressed is: "What are the experiences in the lives of upper elementary-aged Ugandan children that foster an intrinsic motivation to seek information?" A secondary…

Decolonizing Dance Pedagogy: Application of Pedagogies of Ugandan Traditional Dances in Formal Dance Education

ERIC Educational Resources Information Center

Mabingo, Alfdaniels

2015-01-01

Dances from African communities are gradually getting incorporated into formal education at pre-tertiary and tertiary levels in the United States. Whereas strides have been made to embrace this artistic and cultural diversity, the instructional methodologies that are applied in teaching these dances are commonly founded on Western pedagogic canons…

Adaptation of Western Measures of Cognition for Assessing 5-Year-Old Semi-Urban Ugandan Children

ERIC Educational Resources Information Center

Nampijja, M.; Apule, B.; Lule, S.; Akurut, H.; Muhangi, L.; Elliott, A. M.; Alcock, K. J.

2010-01-01

Background: The majority of available psychometric tests originates from the Western World and was designed to suit the culture, language, and socio-economic status of the respective populations. Few tests have been validated in the developing world despite the growing interest in examining effects of biological and environmental factors on…

ICT on the Margins: Lessons for Ugandan Education

ERIC Educational Resources Information Center

Mutonyi, Harriet; Norton, Bonny

2007-01-01

In this end piece, the authors argue that while this special issue shifts debates on the digital divide to address students' capacity to use Information and Communication Technologies (ICT) for productive social purposes, access to ICT remains a major challenge in countries like Uganda, in which less than 1% of the population has access to the…

The Phenomenon of "Kony 2012": A Teaching Guide

ERIC Educational Resources Information Center

Brown, Barbara B.; Metzler, John; Root, Christine

2012-01-01

"Kony 2012," the video by Invisible Children that went viral in March, offers an extraordinary teaching moment, as millions of teens across the country now know and care about a Ugandan warlord named Joseph Kony and the abducted children forced to serve in his militia. Many of these American young people hope to play a role in bringing…

"I Was Born in the Reign …": Historical Orientation in Ugandan Students' National Narratives

ERIC Educational Resources Information Center

Holmberg, Ulrik

2017-01-01

In 2012, Uganda celebrated 50 years as an independent state following more than half a century under colonial rule. Since independence, Uganda has experienced a period of political turmoil and civil war within its constructed colonial borders. Given these historical experiences, what do students find important about their nation's history and what…

Children's Conceptions of Peace in Two Ugandan Primary Schools: Insights for Peace Curriculum

ERIC Educational Resources Information Center

Kagaari, James; Nakasiita, Kirabo; Ntare, Edward; Atuhaire, Richard; Baguwemu, Ali; Ojok, Gerald; Okumu, Auma S.; Kaahwa, Goretti; Byamugisha, Gastone; Semakula, Paul; Namusoke, Jane; Mayengo, Nathan; Dennis, Barbara; Thompson, Chalmer E.

2017-01-01

Oppenheimer urged communities all over the world to study how children come to understand peace, conflict, and war. Set in various countries, their review of studies, as well as more recent examinations reveal trends in how children view these phenomena, often differing by gender, age, and extent to which they were exposed to highly dangerous and…

Meeting Emergent Needs in Uganda: A Path to Accelerated Development of Community and Work Colleges

ERIC Educational Resources Information Center

Cutright, Marc

2014-01-01

National development conditions and goals in Uganda, as in many nations, are such that the robust establishment of community colleges could provide many solutions. Yet the creation of such has been inhibited by a number of factors including the historic roots of higher education in former colonial contexts and a lack of Ugandan familiarity with…

Contested Terrains: A Personal Journey through Image, (National) Identity and Ethics

ERIC Educational Resources Information Center

Gardner, Viv

2005-01-01

The essay deals with a Ugandan production of Brecht's Mother Courage and her Children and the issues raised when it travelled from Uganda to the United States, South Africa and back to Uganda. It explores the shift in perception and conception that happened/happens to both image and national identity when a production moved from one cultural…

Young People's Perceptions of Relationships and Sexual Practices in the Abstinence-Only Context of Uganda

ERIC Educational Resources Information Center

de Haas, Billie; Hutter, Inge; Timmerman, Greetje

2017-01-01

The Ugandan government has been criticised on several grounds for its abstinence-only policies on sexuality education directed towards young people. These grounds include the failure to recognise the multiple realities faced by young people, some of whom may already be sexually active. In the study reported on this paper, students' perceptions of…

Complete Genome Sequences of the Carlavirus Sweet potato chlorotic fleck virus from East Timor and Australia

PubMed Central

Maina, Solomon; Edwards, Owain R.; de Almeida, Luis; Ximenes, Abel

2016-01-01

We present here the first complete genome sequences of Sweet potato chlorotic fleck virus (SPCFV) from sweet potato in Australia and East Timor, and we compare these with four complete SPCFV genomes from South Korea and one from Uganda. The Australian, East Timorese, South Korean, and Ugandan genomes differed considerably from each other. PMID:27231359

Languaging for Life: African Youth Talk Back to HIV/AIDS Research

ERIC Educational Resources Information Center

Norton, Bonny; Mutonyi, Harriet

2010-01-01

In this article, we present a case study, undertaken in Uganda, in which 12 young people debated and critiqued four research articles on HIV/AIDS relevant to Ugandan youth. The rationale for the study was to provide students with the opportunity to respond to health research that had a direct bearing on their lives. It also complements applied…

Building Safer Secondary Schools in Uganda through Collective Commitment to Health and Safety Compliance

ERIC Educational Resources Information Center

Sekiwu, Denis; Kabanda, Milly

2014-01-01

The area of safety and accident prevention is of great concern to managers, because of the increasing number of deaths and accidents at work places. Using a case of Wakiso district, the study sought to investigate the relationship between collective commitment and management of health and safety in Ugandan secondary schools. The study employed a…

Factors Affecting Mathematics Achievement of First-Year Secondary School Students in Central Uganda

ERIC Educational Resources Information Center

Kiwanuka, Henry Nsubuga; Van Damme, Jan; Van Den Noortgate, Wim; Anumendem, Dickson Nkafu; Namusisi, Speranza

2015-01-01

This study explores the sources of variability in Mathematics achievement of Ugandan students at the student, classroom and school level. The Mathematics score and questionnaire responses of 4,819 first-year secondary school students (Grade Seven, about 14-15 years old) from 78 classrooms of 49 schools were analysed. A three-level linear model was…

Learning about HIV/AIDS in Uganda: Digital Resources and Language Learner Identities

ERIC Educational Resources Information Center

Norton, Bonny; Jones, Shelley; Ahimbisibwe, Daniel

2011-01-01

While the HIV/AIDS epidemic has wrought havoc in the lives of millions of people in sub-Saharan Africa, access to information about the causes, symptoms, and treatment of the disease remains a challenge for many, and particularly for young people. This article reports on an action research study undertaken in a rural Ugandan village in 2006.…

Organisational Responses to Public Sector Reforms in Higher Education in Uganda: A Case Study of Makerere University

ERIC Educational Resources Information Center

Bisaso, Ronald

2010-01-01

This paper analyses changes in university management structures and practices as a response to public sector reforms in Ugandan higher education using Makerere University as a case study. The study uses the organisational learning theory and a review of the higher education literature. Two adaptive responses in the management structures and…

Values for Social Development in the Context of Globalisation: Analysing the Role of the Ugandan School

ERIC Educational Resources Information Center

Sekiwu, Denis; Botha, M. M.

2014-01-01

To make education a profitable enterprise and contributor to social development in the age of globalisation a strong role of the school in values integration, and as part of the ethical construction of learners and citizenship building. A mixed design study was attempted on participants from Kampala district schools. The findings were that…

Who Is Allowed To Speak? An Introductory Commentary on Ugandan and English Experiences of Community Involvement in the Control of Schools.

ERIC Educational Resources Information Center

Nkata, James L.; Thody, Angela M.

This paper investigates the challenges that Uganda and England have faced in beginning to reestablish community participation in the governance of education. It investigates starting points for the possible development of school-governance systems in both countries. Outlined first are the formats for community involvement that have been adopted in…

Dental caries among 10- to 14-year-old children in Ugandan rural areas with 0.5 and 2.5 mg fluoride per liter in drinking water.

PubMed

Rwenyonyi, C M; Birkeland, J M; Haugejorden, O; Bjorvatn, K

2001-03-01

The purpose of this study was to report on dental caries among Ugandan children residing in rural areas with either a low or high fluoride concentration in the drinking water, and to assess factors associated with caries. A random sample of 481 children aged 10-14 years was selected from Mpondwe (n = 81) and Kyabayenze (n = 82) in the Kasese district with 0.5 mg and from Mutolere/Kagera (n = 163) and Kabindi (n = 155) in Kisoro with 2.5 mg fluoride/l in the drinking water. The children were examined for caries using the DMFT index as described by the World Health Organization in 1987. The mean DMFT was 0.34 in the whole material. In one low fluoride area, Kyabayenze, all children were caries-free compared to 75% to 86% in the other areas. In Kyabayenze, tea with sugar was taken significantly less frequently than in the other low-fluoride area. In the high-fluoride district, age and consumption of tea with sugar were positively and significantly correlated with caries. Multivariate analyses showed age to be the only significant risk indicator.

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.

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.

Neutralizing antibodies against flaviviruses, Babanki virus, and Rift Valley fever virus in Ugandan bats.

PubMed

Kading, Rebekah C; Kityo, Robert M; Mossel, Eric C; Borland, Erin M; Nakayiki, Teddie; Nalikka, Betty; Nyakarahuka, Luke; Ledermann, Jeremy P; Panella, Nicholas A; Gilbert, Amy T; Crabtree, Mary B; Peterhans, Julian Kerbis; Towner, Jonathan S; Amman, Brian R; Sealy, Tara K; Nichol, Stuart T; Powers, Ann M; Lutwama, Julius J; Miller, Barry R

2018-01-01

Introduction: A number of arboviruses have previously been isolated from naturally-infected East African bats, however the role of bats in arbovirus maintenance is poorly understood. The aim of this study was to investigate the exposure history of Ugandan bats to a panel of arboviruses. Materials and methods: Insectivorous and fruit bats were captured from multiple locations throughout Uganda during 2009 and 2011-2013. All serum samples were tested for neutralizing antibodies against West Nile virus (WNV), yellow fever virus (YFV), dengue 2 virus (DENV-2), Zika virus (ZIKV), Babanki virus (BBKV), and Rift Valley fever virus (RVFV) by plaque reduction neutralization test (PRNT). Sera from up to 626 bats were screened for antibodies against each virus. Results and Discussion:  Key findings include the presence of neutralizing antibodies against RVFV in 5/52 (9.6%) of little epauletted fruit bats ( Epomophorus labiatus ) captured from Kawuku and 3/54 (5.6%) Egyptian rousette bats from Kasokero cave. Antibodies reactive to flaviviruses were widespread across bat taxa and sampling locations. Conclusion: The data presented demonstrate the widespread exposure of bats in Uganda to arboviruses, and highlight particular virus-bat associations that warrant further investigation.

Characterization of humoral responses to soluble trimeric HIV gp140 from a clade A Ugandan field isolate

PubMed Central

2013-01-01

Trimeric soluble forms of HIV gp140 envelope glycoproteins represent one of the closest molecular structures compared to native spikes present on intact virus particles. Trimeric soluble gp140 have been generated by several groups and such molecules have been shown to induce antibodies with neutralizing activity against homologous and heterologous viruses. In the present study, we generated a recombinant trimeric soluble gp140, derived from a previously identified Ugandan A-clade HIV field isolate (gp14094UG018). Antibodies elicited in immunized rabbits show a broad binding pattern to HIV envelopes of different clades. An epitope mapping analysis reveals that, on average, the binding is mostly focused on the C1, C2, V3, V5 and C5 regions. Immune sera show neutralization activity to Tier 1 isolates of different clades, demonstrating cross clade neutralizing activity which needs to be further broadened by possible structural modifications of the clade A gp14094UG018. Our results provide a rationale for the design and evaluation of immunogens and the clade A gp14094UG018 shows promising characteristics for potential involvement in an effective HIV vaccine with broad activity. PMID:23835244

Characterization of humoral responses to soluble trimeric HIV gp140 from a clade A Ugandan field isolate.

PubMed

Visciano, Maria Luisa; Tagliamonte, Maria; Stewart-Jones, Guillaume; Heyndrickx, Leo; Vanham, Guido; Jansson, Marianne; Fomsgaard, Anders; Grevstad, Berit; Ramaswamy, Meghna; Buonaguro, Franco M; Tornesello, Maria Lina; Biswas, Priscilla; Scarlatti, Gabriella; Buonaguro, Luigi

2013-07-08

Trimeric soluble forms of HIV gp140 envelope glycoproteins represent one of the closest molecular structures compared to native spikes present on intact virus particles. Trimeric soluble gp140 have been generated by several groups and such molecules have been shown to induce antibodies with neutralizing activity against homologous and heterologous viruses. In the present study, we generated a recombinant trimeric soluble gp140, derived from a previously identified Ugandan A-clade HIV field isolate (gp14094UG018). Antibodies elicited in immunized rabbits show a broad binding pattern to HIV envelopes of different clades. An epitope mapping analysis reveals that, on average, the binding is mostly focused on the C1, C2, V3, V5 and C5 regions. Immune sera show neutralization activity to Tier 1 isolates of different clades, demonstrating cross clade neutralizing activity which needs to be further broadened by possible structural modifications of the clade A gp14094UG018. Our results provide a rationale for the design and evaluation of immunogens and the clade A gp14094UG018 shows promising characteristics for potential involvement in an effective HIV vaccine with broad activity.

Analysis of HIV tropism in Ugandan infants

PubMed Central

Church, Jessica D.; Huang, Wei; Mwatha, Anthony; Musoke, Philippa; Jackson, J. Brooks; Bagenda, Danstan; Omer, Saad B.; Donnell, Deborah; Nakabiito, Clemensia; Eure, Chineta; Guay, Laura A.; Taylor, Allan; Bakaki, Paul M.; Matovu, Flavia; McConnell, Michelle; Fowler, Mary Glenn; Eshleman, Susan H.

2010-01-01

HIV-infected infants may have CXCR4-using (X4-tropic) HIV, CCR5-using (R5-tropic) HIV, or a mixture of R5-tropic and X4-tropic HIV (dual/mixed, DM HIV). The level of infectivity for R5 virus (R5-RLU) varies among HIV-infected infants. HIV tropism and R5-RLU were measured in samples from HIV-infected Ugandan infants using a commercial assay. DM HIV was detected in 7/72 (9.7%) infants at the time of HIV diagnosis (birth or 6–8 weeks of age, 4/15 (26.7%) with subtype D, 3/57 (5.3 %) with other subtypes, P=0.013). A transition from R5-tropic to DM HIV was observed in only two (6.7%) of 30 infants over 6–12 months. Six (85.7%) of seven infants with DM HIV died, compared to 21/67 (31.3%) infants with R5-tropic HIV (p=0.09). Higher R5-RLU at 6–8 weeks was not associated with decreased survival. Infants with in utero infection had a higher median R5-RLU than infants who were HIV-uninfected at birth (p=0.025). PMID:21073438

Facilitators and hindrances in the experiences of Ugandans with and without disabilities when seeking access to microcredit schemes.

PubMed

Cramm, Jane Murray; Paauwe, Marthe; Finkenflügel, Harry

2012-01-01

This study aimed to identify facilitators and hindrances in the experiences of Ugandans with and without disabilities when seeking access to microcredit schemes. Thirty-five statements were presented to 80 people, 50 of whom were disabled. Q-methodology was used to identify factors influencing access to microcredit schemes. Running a business independently was solely identified by people with disabilities (PWD) as an important facilitator in accessing microcredit schemes, while relying on business skills was largely mentioned by people without disabilities. The disabled identified family-related items to be inhibiting factors. Having a group loan was ranked negatively by the disabled and ambivalently by the non-disabled. PWD experience different facilitators and barriers to access microcredit schemes compared to the non-disabled. PWD prefer individual loans and believe they can more successfully run a business on their own, instead of relying on family or having a group loan. Furthermore, they would benefit from microcredit schemes that take into account disability-specific circumstances. These are important findings to increase access to microcredit schemes and to let PWD benefit to the same extend from these programmes than do their non-disabled peers.

Comparative analysis of volatiles in traditionally cured Bourbon and Ugandan vanilla bean ( Vanilla planifolia ) extracts.

PubMed

Zhang, Suying; Mueller, Christoph

2012-10-24

Traditionally cured vanilla beans ( Vanilla planifolia ) from Madagascar and Uganda were extracted with organic solvents, and the volatiles were separated from the nonvolatile fraction using the solvent assisted flavor evaporation (SAFE) technique. Concentrated vanilla bean extracts were analyzed using GC-MS and GC-O. Two hundred and forty-six volatile compounds were identified using the Automated Mass Spectral Deconvolution and Identification System (AMDIS) software, of which 13 were confirmed with authentic compounds from commercial sources and the others were tentatively identified on the basis of calibrated linear retention indices and the comparison of deconvoluted mass spectra with the in-house and/or NIST spectra databases. Vanillin was the most abundant constituent followed by guaiacol. The total concentration of the volatile compounds, excluding vanillin, was 301 mg/kg for Bourbon and 398 mg/kg for Ugandan vanilla bean extracts. Analytical comparison between the two vanilla bean extracts was discussed. Seventy-eight compounds were identified as odor-active compounds in the vanilla bean extracts with 10 confirmed with authentic references. It was found that there were substantial analytical differences in the odor-active compounds of the two extracts.

The ambiguities of the 'partnership' between civil society and the state in Uganda's AIDS response during the 1990s and 2000s as demonstrated in the development of TASO.

PubMed

Grebe, Eduard

2016-01-01

This article critically investigates state-civil society relations in the Ugandan AIDS response by tracing the history of Uganda's 'multisectoral' and 'partnership' approaches, particularly as it pertains to The AIDS Support Organisation (TASO). It finds that the Ugandan government's reputation for good leadership on AIDS is more ambiguous than commonly supposed and that the much-vaunted 'partnership' approach has not enabled strong critical civil society voices to emerge or prevented the harmful impact of a socially conservative agenda. By the 1990s, TASO had become the most important provider of medical and psychosocial support services to HIV/AIDS patients, but was less effective in influencing policy or holding the state accountable (because the political context prevented a more activist stance). The effectiveness of civil society has been constrained by an authoritarian political culture and institutions that discourage vocal criticism. Despite these limitations, however, state-civil society partnership did contribute to the emergence of a relatively effective coalition for action against HIV/AIDS. Donors were essential in encouraging the emergence of this coalition.

Creating social policy to support women's agency in coercive settings: A case study from Uganda.

PubMed

Burgess, Rochelle; Campbell, Catherine

2016-01-01

Many emphasise the need for policies that support women's agency in highly coercive settings, and the importance of involving target women in public deliberation to inform policy design. The Ugandan Marriage and Divorce Bill seeks to strengthen women's agency in marriage, but has faced many obstacles, including objections from many women themselves in public consultations. We explore key stakeholders' accounts of the difficulties facing the Bill's progress to date, through focus groups with 24 rural and urban men and women, interviews with 14 gender champions in government, non-governmental organisations and legal sectors, and 25 relevant media and radio reports. Thematic analysis revealed an array of representations of the way the Bill's progress was shaped by the public consultation process, the nature of the Ugandan public sphere, the understanding and manipulation of concepts such as 'culture' and 'custom' in public discourse, the impact of economic inequalities on women's understandings of their gendered interests and low women's trust in the law and the political process. We discuss the complexities of involving highly marginalised women in public debates about gender issues and highlight possible implications for conceptualising agency, gender and social change as tools for gender policy and activism in extreme inequality.

The Current Status of Teaching Staff Innovation Competence in Ugandan Universities: Perceptions of Managers, Teachers, and Students

ERIC Educational Resources Information Center

Kasule, George Wilson; Wesselink, Renate; Noroozi, Omid; Mulder, Martin

2015-01-01

How competent are university teaching staff to deliver effectively their present and future university duties in Uganda? This question was explored in this study by collecting data from managers (n = 90), teachers (n = 126), and students (n = 179) through a questionnaire administered at Kyambogo University. The results show that teacher…

Free Education and Social Inequality in Ugandan Primary Schools: A Step Backward or a Step in the Right Direction?

ERIC Educational Resources Information Center

Zuze, Tia L.; Leibbrandt, Murray

2011-01-01

The intent of this study is to understand both direct and indirect resource effects in the context of a mass education system in Uganda. We find that under certain conditions, policies that promote physical resource availability can lead to substantial equity gains. A school's social composition appears to improve educational quality but it is…

Interpreting Teachers' Perceptions of Contextual Influences on Sexuality Discourses within the School Curriculum: Lessons from Sex Health Education Teachers in Kampala, Uganda

ERIC Educational Resources Information Center

Tushabomwe, Annette; Nashon, Samson Madera

2016-01-01

Analysis of key findings of a study that investigated six Ugandan teachers' perceptions of contextual influences on sexuality discourses revealed that though there is some form of sex education in schools and though teachers are very enthusiastic about its implementation, it is largely constrained by conflicting social stances held by various…

Length of Institutionalization, Contact with Relatives and Previous Hospitalizations as Predictors of Social and Emotional Behavior in Young Ugandan Orphans

ERIC Educational Resources Information Center

Nielsen, Ashley; Coleman, Priscilla K.; Guinn, Matthew; Robb, Clifford

2004-01-01

The objectives of this study were to describe the socially based emotions and behaviors of 33 orphans in Uganda and to examine social history correlates of variability in the outcome measures. The toddlers were generally not very aggressive or prosocially oriented, and they displayed rather limited affect. More time was spent alone than with…

Examination of the roles and capacities of duty bearers responsible for protecting the human rights to adequate food, nutritional health and wellbeing in Ugandan children's homes.

PubMed

Olafsen, Monica; Rukooko, Archangel Byaruhanga; Iversen, Per Ole; Andreassen, Bård A

2018-04-17

The majority of Ugandan children face vulnerability and malnutrition. As a State Party to international human rights treaties, Uganda has legal obligations of guaranteeing the fundamental rights and the best interest of the nation's children. Despite being protected under international and national law, Uganda is not providing adequate child protection, including safeguarding children's food security. Numerous privately owned and unregulated children's homes face this problem. The overall aim of the study was to examine to what extent children's homes' operations are consistent with the right to adequate food, nutritional health and wellbeing of children. We performed a qualitative role- and capacity analysis of duty bearers with human rights duties towards children living in children's homes. We studied three groups of duty bearers: caretakers working in private children's homes, State actors working in government and its institutions, and non-State actors working in civil society organizations. A human rights based approach guided all aspects of the study. An analysis of the roles, performance and capacities of duty bearers was employed, with individual face-to-face structured qualitative in-depth interviews, self-administered structured questionnaires, and a structured observational study, as well as a desk review of relevant literature. The State of Uganda's efforts to respect and realize its obligations towards children living in children's homes is inadequate. There are numerous capacity gaps among the duty bearers, and the concepts of human rights and the best interest of the child are not well understood among the duty bearers. The efforts of the State of Uganda to realize its human rights obligations towards children in children's homes are lacking in important areas. Hence the State does not fulfill its minimum obligations under the International Covenant on Economic, Social and Cultural Rights to ensure all children freedom from hunger. There is a need for capacity development at all levels in the Ugandan state and the international society to delimit capacity gaps in order to realize these human rights' obligations.

Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients.

PubMed

Weisshaar, E; Apfelbacher, C; Jäger, G; Zimmermann, E; Bruckner, T; Diepgen, T L; Gollnick, H

2006-11-01

Pruritus is the most frequent and distressing symptom associated with dermatoses and various internal and neurological diseases. To investigate two different populations of patients with pruritus, one in Germany and one in Uganda, with a particular focus on clinical characteristics, aetiology and quality of life. We investigated by questionnaire 132 patients (59 men, 73 women, mean age 54.5 years) who were referred to the Department of Dermatology at the University Hospital of Magdeburg, Germany, with the diagnosis of pruritus as a leading symptom. The questionnaire was also applied in 84 patients who consulted the Dermatology Clinic at Mbarara, Uganda for pruritus. The questions referred to personal data and disease history of the individual, history and present occurrence of concomitant diseases, present and past therapy, quality, frequency and triggers of itching and scratching, other disorders and complaints, quality of life and impact on work and disability. Seventy-five (57%) of the German patients had pruritus due to dermatoses, 47 patients (36%) had pruritus due to a systemic disease and in 10 patients (8%) pruritus was of unknown origin. Most had a history of pruritus of several months up to years. Pruritus associated with dermatoses mostly affected the whole body and was permanent with an undulatory character. Affective reactions such as aggression and depression occurred more frequently in dermatological patients compared with those with systemic pruritus. The former group felt that pruritus had a greater impact on their lives. Almost all Ugandan patients had pruritus due to dermatoses except for three patients with pruritus of unknown origin. Eczema and prurigo were the most frequently observed dermatoses in both German and Ugandan patients. Patients with pruritus in both populations showed an impaired quality of life. There was no pronounced difference between the populations with regard to feelings of depression and suicidal thoughts. A great deal of helpful information in this complex group of patients can be obtained using this questionnaire. Pruritus has a major impact on quality of life and especially impairs those patients with pruritus associated with dermatoses and pruritus of unknown origin.

Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience.

PubMed

Larsson, Markus; Ross, Michael W; Tumwine, Gilbert; Agardh, Anette

2016-01-01

Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7-5.7; OR 2.0, 95% CI: 1.3-3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1-4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7-3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9-5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04-3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1-8.5; AOR 2.8, 95% CI: 1.3-5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6-7.1; AOR 2.7, 95% CI: 1.4-5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population.

Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU.

PubMed

McAdams, Ryan M; Hedstrom, Anna B; DiBlasi, Robert M; Mant, Jill E; Nyonyintono, James; Otai, Christine D; Lester, Debbie A; Batra, Maneesh

2015-03-01

Respiratory distress is a leading cause of neonatal death in low-income and middle-income countries. CPAP is a simple and effective respiratory support modality used to support neonates with respiratory failure and can be used in low-income and middle-income countries. The goal of this study was to describe implementation of the Silverman-Andersen respiratory severity score (RSS) and bubble CPAP in a rural Ugandan neonatal NICU. We sought to determine whether physicians and nurses in a low-income/middle-income setting would assign similar RSS in neonates after an initial training period and over time. We describe the process of training NICU staff to use the RSS to assist in decision making regarding initiation, titration, and termination of bubble CPAP for neonates with respiratory distress. Characteristics of all neonates with respiratory failure treated with bubble CPAP in a rural Ugandan NICU from January to June 2012 are provided. Nineteen NICU staff members (4 doctors and 15 nurses) received RSS training. After this, the Spearman correlation coefficient for respiratory severity scoring between doctor and nurse was 0.73. Twenty-one infants, all < 3 d of age, were treated with CPAP, with 17 infants starting on the day of birth. The majority of infants (16/21, 76%) were preterm, 10 (48%) were <1,500 g (birthweight), and 13 (62%) were outborn. The most common diagnoses were respiratory distress syndrome (16/21, 76%) and birth asphyxia (5/21, 24%). The average RSS was 7.4 ± 1.3 before starting CPAP, 5.2 ± 2.3 after 2-4 h of CPAP, 4.9 ± 2.7 after 12-24 h of CPAP, and 3.5 ± 1.9 before CPAP was discontinued. Duration of treatment with CPAP averaged 79 ± 43 h. Approximately half (11/21, 52%) of infants treated with CPAP survived to discharge. Implementing bubble CPAP in a low-income/middle-income setting is feasible. The RSS may be a simple and useful tool for monitoring a neonate's respiratory status and for guiding CPAP management. Copyright © 2015 by Daedalus Enterprises.

Kill Bill! Ugandan human rights organizations' attempts to influence the media's coverage of the Anti-Homosexuality Bill.

PubMed

Strand, Cecilia

2011-09-01

The Ugandan Anti-Homosexuality Bill of October 2009 caused an international outcry and sparked intense debate in the local and international media. Particularly contentious was its proposal to impose the death penalty for acts of 'aggravated homosexuality'. Through a quantitative content analysis of 176 items from two main daily newspapers, the government-owned New Vision and the privately-owned Daily Monitor, over the period October 2009-June 2010, combined with qualitative interviews with human rights defenders in Uganda, this study explores attempts made by local human rights advocates to influence the media's coverage of the Bill and the extent to which these attempts were successful. The study finds that while there are significant differences between the frequency of reporting on the Bill in the two newspapers, both papers devoted little editorial space to the public health and human rights concerns put forward by local human rights organizations. Despite Uganda's recent and often lauded history of openly addressing HIV/AIDS, human right organizations' attempts to highlight the Bill's potentially adverse effects on the country's ability to tackle the epidemic effectively were only partially successful and, interestingly, awarded much less attention than the potential human rights implications of the proposed change in legislation.

Analysis of the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis in four countries.

PubMed

Han, Xiang Y; Aung, Fleur M; Choon, Siew Eng; Werner, Betina

2014-10-01

To differentiate the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis and correlate them with geographic distribution and clinicopathologic features. Species-specific polymerase chain reactions were used to detect each bacillus in archived skin biopsy specimens from patients with leprosy from Brazil (n = 52), Malaysia (n = 31), Myanmar (n = 9), and Uganda (n = 4). Findings were correlated with clinical and pathologic data. Etiologic species was detected in 46 of the 52 Brazilian patients, including 36 patients with M leprae, seven with M lepromatosis, and three with both bacilli. The seven patients with sole M lepromatosis all had tuberculoid leprosy, whereas only nine of the 36 patients infected with M leprae exhibited this type, and the rest were lepromatous (P < .001). All patients with dual infections had lepromatous leprosy. Of the nine patients from Myanmar, six were test positive: four with M leprae and two with M lepromatosis. Of the Malaysian and Ugandan patients, only M leprae was detected in 27 of the 31 Malaysians and two of the four Ugandans. The leprosy agents vary in geographic distribution. Finding M lepromatosis in Brazil and Myanmar suggests wide existence of this newly discovered species. The leprosy manifestations likely vary with the etiologic agents. Copyright© by the American Society for Clinical Pathology.

Confirmed local endemicity and putative high transmission of Schistosoma mansoni in the Sesse Islands, Lake Victoria, Uganda.

PubMed

Standley, Claire J; Adriko, Moses; Besigye, Fred; Kabatereine, Narcis B; Stothard, Russell J

2011-03-01

The Sesse Islands, in the Ugandan portion of Lake Victoria, have long been considered a low transmission zone for intestinal schistosomiasis. Based on observations of high prevalence of Schistosoma mansoni infection in the northern-most islands of this archipelago, a follow-up survey was conducted to ascertain whether transmission was endemic to this island group, combining parasitological and malacological surveys. Prevalence of intestinal schistosomiasis was again observed to be high, as was intensity of infections which, combined with low reported incidence of treatment, suggests that chemotherapy-based control initiatives are not being maximally effective in this region as high levels of population movement between islands and districts are confounding. The local disease transmission was confirmed by the observations of high abundance of Biomphalaria, as well as field-caught snails shedding S. mansoni cercariae. DNA sequencing of 12 cercariae revealed common mitochondrial cox1 haplotypes, as well as, novel ones, consistent with the high genetic diversity of this parasite in Lake Victoria. Intestinal schistosomiasis is firmly endemic in parts of the Sesse Islands and more broadly, this island group provides an insight into the future challenges to be faced by the Ugandan National Control Programme in regularly reaching these rather remote, inaccessible and largely itinerant communities.

Virus and host-specific differences in oral human herpesvirus shedding kinetics among Ugandan women and children.

PubMed

Matrajt, Laura; Gantt, Soren; Mayer, Bryan T; Krantz, Elizabeth M; Orem, Jackson; Wald, Anna; Corey, Lawrence; Schiffer, Joshua T; Casper, Corey

2017-10-12

Human herpesviruses (HHV) establish lifelong latent infection and are transmitted primarily via shedding at mucosal surfaces. Each HHV causes a unique spectrum of disease depending on the infected individual's age and immunity. We collected weekly oral swabs from young children and mothers in 32 Ugandan households for a median of one year. We characterized kinetics of oral shedding during primary and chronic infection for each virus. Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and HHV-6 were shed at high rates following primary infection. The rate of oral herpes simplex virus (HSV) shedding was lower overall, and children and mothers with chronic HSV infection had lower shedding rates than children with primary infection. CMV shedding rate and viral load were higher in children with primary infection compared to children with chronic infection, and even lower in mothers with chronic infection. HHV-6 shedding rate and viral load were similar between children with primary or chronic infection, but lower in mothers. EBV shedding rate and quantity decreased less dramatically in mothers versus children, with HIV-positive mothers shedding at a higher rate than HIV-negative mothers. Each HHV has a distinct pattern of oral shedding which depends partially on the age and immune status of the host.

Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees

PubMed Central

Neuner, Frank; Schauer, Maggie; Karunakara, Unni; Klaschik, Christine; Robert, Christina; Elbert, Thomas

2004-01-01

Background Political instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict. Methods In this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed. Results Results show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD. Conclusions There is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold. PMID:15504233

Essential Oils from Ugandan Aromatic Medicinal Plants: Chemical Composition and Growth Inhibitory Effects on Oral Pathogens

PubMed Central

Ocheng, Francis; Bwanga, Freddie; Joloba, Moses; Softrata, Abier; Azeem, Muhammad; Pütsep, Katrin; Borg-Karlson, Anna-Karin; Obua, Celestino; Gustafsson, Anders

2015-01-01

The study assessed the growth inhibitory effects of essential oils extracted from ten Ugandan medicinal plants (Bidens pilosa, Helichrysum odoratissimum, Vernonia amygdalina, Hoslundia opposita, Ocimum gratissimum, Cymbopogon citratus, Cymbopogon nardus, Teclea nobilis, Zanthoxylum chalybeum, and Lantana trifolia) used traditionally in the management of oral diseases against oral pathogens. Chemical compositions of the oils were explored by GC-MS. Inhibitory effects of the oils were assessed on periodontopathic Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and cariogenic Streptococcus mutans and Lactobacillus acidophilus using broth dilution methods at concentrations of 1%, 0.1%, and 0.01%. The most sensitive organism was A. actinomycetemcomitans. Its growth was markedly inhibited by six of the oils at all the concentrations tested. Essential oil from C. nardus exhibited the highest activity with complete growth inhibition of A. actinomycetemcomitans and P. gingivalis at all the three concentrations tested, the major constituents in the oil being mainly oxygenated sesquiterpenes. Most of the oils exhibited limited effects on L. acidophilus. We conclude that essential oils from the studied plants show marked growth inhibitory effects on periodontopathic A. actinomycetemcomitans and P. gingivalis, moderate effects on cariogenic S. mutans, and the least effect on L. acidophilus. The present study constitutes a basis for further investigations and development of certain oils into alternative antiplaque agents. PMID:26170872

Torture and its sequel--a comparison between victims from six countries.

PubMed

Moisander, Pia A; Edston, Erik

2003-11-26

The aim of the study was to compare torture victims from six different nations and analyse differences and similarities. From the files of the Centre for Trauma Victims in Stockholm (KTC), 160 patients were selected: 53 patients from Bangladesh, 21 from Iran, 16 from Peru, 24 from Syria, 25 from Turkey, and 21 from Uganda. The data was classified into: (i) information about social conditions and circumstances pertaining to alleged torture, (ii) type of trauma and torture methods, and (iii) acute and late sequel to torture. Descriptive and non-parametric statistics were used in the analyses. There was a strong male dominance in all but the Ugandan group where 43% were women. The majority in all but the Turkish group had college exams and/or university studies. Over 84% were members of a political organisation except in the Iranian and Syrian groups, where more than 40% had no political affiliation. The majority in all groups had travelled to Sweden alone to apply for asylum, but most refugees from Turkey, Iran, and Syria had close relatives already living in Sweden. The stories of circumstances and torture methods were similar within each group but differed a great deal between groups. Typically, in Bangladesh, Peru, and Turkey, the periods under arrest were short: from a few hours to 3 days. In Iran, Uganda, and Syria, the time in custody varied from several months to several years. A prison sentence preceded by trial was common only in Iran. Many patients, especially from Bangladesh and Turkey, had been arrested several times. Sensory deprivation by isolation and blindfolding was common in all countries except Uganda and Peru. Beating with fists, sticks, truncheons, etc. were reported in 100% in every group. In Bangladesh, police batons (lathi) were used more commonly than in any other group. Whipping with electric cords occurred frequently only in Iran and Syria. Rape was most often reported among the Ugandans. Genital torture was frequently alleged by patients from Bangladesh and Turkey. Suspension was common in all countries except for Uganda. Falaka, i.e. beating of the soles, and electric torture were common (>60%) in Bangladesh, Iran, Syria, and Turkey. Sharp injuries inflicted with knives and bayonets were often seen among the Bangladeshi and Ugandans. Burning injuries due to cigarettes were commonly seen only in patients from Bangladesh. Some methods were found to be almost exclusive for each country: "water treatment" (Bangladesh), the "tyre" (Syria), "telephono" and "submarino" (Peru). The sequel of torture differed in some respects between groups. Fractures were more common among Iranians. Patients from Uganda and Bangladesh had numerous scars. Subjectively reported symptoms were most frequent among Bangladeshi, especially joint pain and ear, nose, and throat symptoms and least frequent among Ugandans. PTSD diagnosed on the basis of a psychiatric interview and psychological tests was found in 69-92% of patients in all groups. The study shows significant differences between countries regarding circumstances, torture methods, and sequel to torture. This knowledge is of value to forensic specialists documenting alleged torture and essential for fair and valid forensic statements.

Glucose-6-phosphate dehydrogenase status and risk of hemolysis in Plasmodium falciparum-infected African children receiving single-dose primaquine.

PubMed

Eziefula, Alice C; Pett, Helmi; Grignard, Lynn; Opus, Salome; Kiggundu, Moses; Kamya, Moses R; Yeung, Shunmay; Staedke, Sarah G; Bousema, Teun; Drakeley, Chris

2014-08-01

Glucose-6-phosphate dehydrogenase (G6PD) enzyme function and genotype were determined in Ugandan children with uncomplicated falciparum malaria enrolled in a primaquine trial after exclusion of severe G6PD deficiency by fluorescent spot test. G6PD A- heterozygotes and hemizygotes/homozygotes experienced dose-dependent lower hemoglobin concentrations after treatment. No severe anemia was observed. Copyright © 2014, Eziefula et al.

Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience

PubMed Central

Larsson, Markus; Ross, Michael W.; Tumwine, Gilbert; Agardh, Anette

2016-01-01

Background Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. Objective To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. Design In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Results Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7–5.7; OR 2.0, 95% CI: 1.3–3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1–4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7–3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9–5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04–3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1–8.5; AOR 2.8, 95% CI: 1.3–5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6–7.1; AOR 2.7, 95% CI: 1.4–5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. Conclusions These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population. PMID:27032809

Detection of sister-species in invasive populations of the fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae) from Uganda

PubMed Central

Tay, Wee Tek; Walsh, Thomas K.; Kanyesigye, Dalton; Adumo, Stella; Abongosi, Joseph; Ochen, Stephen; Sserumaga, Julius; Alibu, Simon; Abalo, Grace; Asea, Godfrey; Agona, Ambrose

2018-01-01

The fall armyworm (FAW) Spodoptera frugiperda (J. E. Smith) is a species native to the Americas. This polyphagous lepidopteran pest was first reported in Nigeria and the Democratic Republic of São Tomé and Principe in 2016, but its presence in eastern Africa has not been confirmed via molecular characterisation. In this study, FAW specimens from western and central Uganda were identified based on the partial mtDNA COI gene sequences, with mtDNA COI haplotypes matching those identified in Nigeria and São Tomé. In this study, we sequence an additional partial mtDNA Cyt b gene and also the partial mtDNA COIII gene in Ugandan FAW samples. We detected identical mitochondrial DNA haplotypes for both the mtDNA Cyt b and COI partial genes, while combining the mtDNA COI/Cyt b haplotypes and mtDNA COIII haplotypes enabled a new maternal lineage in the Ugandan corn-preferred FAW samples to be identified. Our results suggested that the African incursions of S. frugiperda involved at least three maternal lineages. Recent full genome, phylogenetic and microsatellite analyses provided evidence to support S. frugiperda as likely consisted of two sympatric sister species known as the corn-preferred and rice-preferred strains. In our Ugandan FAW populations, we identified the presence of mtDNA haplotypes representative of both sister species. It is not known if both FAW sister species were originally introduced together or separately, and whether they have since spread as a single population. Further analyses of additional specimens originally collected from São Tomé, Nigeria and throughout Africa would be required to clarify this issue. Importantly, our finding showed that the genetic diversity of the African corn-preferred FAW species is higher than previously reported. This potentially contributed to the success of FAW establishment in Africa. Furthermore, with the additional maternal lineages detected, there is likely an increase in paternal lineages, thereby increasing the diversity of the African FAW population. Knowledge of the FAW genetic diversity will be needed to assess the risks of introducing Bt-resistance traits and to understand the FAW incursion pathways into the Old World and its potential onward spread. The agricultural implications of the presence of two evolutionary divergent FAW lineages (the corn and the rice lineage) in the African continent are further considered and discussed. PMID:29614067

Pharmacogenetic-Based Efavirenz Dose Modification: Suggestions for an African Population and the Different CYP2B6 Genotypes

PubMed Central

Mukonzo, Jackson K.; Owen, Joel S.; Ogwal-Okeng, Jasper; Kuteesa, Ronald B.; Nanzigu, Sarah; Sewankambo, Nelson; Thabane, Lehana; Gustafsson, Lars L.; Ross, Colin; Aklillu, Eleni

2014-01-01

Background Pharmacogenetics contributes to inter-individual variability in pharmacokinetics (PK) of efavirenz (EFV), leading to variations in both efficacy and toxicity. The purpose of this study was to assess the effect of genetic factors on EFV pharmacokinetics, treatment outcomes and genotype based EFV dose recommendations for adult HIV-1 infected Ugandans. Methods In total, 556 steady-state plasma EFV concentrations from 99 HIV infected patients (64 female) treated with EFV/lamivudine/zidovidine were analyzed. Patient genotypes for CYP2B6 (*6 & *11), CYP3A5 (*3,*6 & *7) and ABCB1 c.4046A>G, baseline biochemistries and CD4 and viral load change from baseline were determined. A one-compartment population PK model with first-order absorption (NONMEM) was used to estimate genotype effects on EFV pharmacokinetics. PK simulations were performed based upon population genotype frequencies. Predicted AUCs were compared between the product label and simulations for doses of 300 mg, 450 mg, and 600 mg. Results EFV apparent clearance (CL/F) was 2.2 and 1.74 fold higher in CYP2B6*6 (*1/*1) and CYP2B6*6 (*1/*6) compared CYP2B6*6 (*6/*6) carriers, while a 22% increase in F1 was observed for carriers of ABCB1 c.4046A>G variant allele. Higher mean AUC was attained in CYP2B6 *6/*6 genotypes compared to CYP2B6 *1/*1 (p<0.0001). Simulation based AUCs for 600 mg doses were 1.25 and 2.10 times the product label mean AUC for the Ugandan population in general and CYP2B6*6/*6 genotypes respectively. Simulated exposures for EFV daily doses of 300 mg and 450 mg are comparable to the product label. Viral load fell precipitously on treatment, with only six patients having HIV RNA >40 copies/mL after 84 days of treatment. No trend with exposure was noted for these six patients. Conclusion Results of this study suggest that daily doses of 450 mg and 300 mg might meet the EFV treatment needs of HIV-1 infected Ugandans in general and individuals homozygous for CYP2B6*6 mutation, respectively. PMID:24497997

Detection of sister-species in invasive populations of the fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae) from Uganda.

PubMed

Otim, Michael H; Tay, Wee Tek; Walsh, Thomas K; Kanyesigye, Dalton; Adumo, Stella; Abongosi, Joseph; Ochen, Stephen; Sserumaga, Julius; Alibu, Simon; Abalo, Grace; Asea, Godfrey; Agona, Ambrose

2018-01-01

The fall armyworm (FAW) Spodoptera frugiperda (J. E. Smith) is a species native to the Americas. This polyphagous lepidopteran pest was first reported in Nigeria and the Democratic Republic of São Tomé and Principe in 2016, but its presence in eastern Africa has not been confirmed via molecular characterisation. In this study, FAW specimens from western and central Uganda were identified based on the partial mtDNA COI gene sequences, with mtDNA COI haplotypes matching those identified in Nigeria and São Tomé. In this study, we sequence an additional partial mtDNA Cyt b gene and also the partial mtDNA COIII gene in Ugandan FAW samples. We detected identical mitochondrial DNA haplotypes for both the mtDNA Cyt b and COI partial genes, while combining the mtDNA COI/Cyt b haplotypes and mtDNA COIII haplotypes enabled a new maternal lineage in the Ugandan corn-preferred FAW samples to be identified. Our results suggested that the African incursions of S. frugiperda involved at least three maternal lineages. Recent full genome, phylogenetic and microsatellite analyses provided evidence to support S. frugiperda as likely consisted of two sympatric sister species known as the corn-preferred and rice-preferred strains. In our Ugandan FAW populations, we identified the presence of mtDNA haplotypes representative of both sister species. It is not known if both FAW sister species were originally introduced together or separately, and whether they have since spread as a single population. Further analyses of additional specimens originally collected from São Tomé, Nigeria and throughout Africa would be required to clarify this issue. Importantly, our finding showed that the genetic diversity of the African corn-preferred FAW species is higher than previously reported. This potentially contributed to the success of FAW establishment in Africa. Furthermore, with the additional maternal lineages detected, there is likely an increase in paternal lineages, thereby increasing the diversity of the African FAW population. Knowledge of the FAW genetic diversity will be needed to assess the risks of introducing Bt-resistance traits and to understand the FAW incursion pathways into the Old World and its potential onward spread. The agricultural implications of the presence of two evolutionary divergent FAW lineages (the corn and the rice lineage) in the African continent are further considered and discussed.

Near East/South Asia Report.

DTIC Science & Technology

1986-02-11

equipment such as modern artificial kidney systems, modern equipment related to the treatment of cancer by ra- diation, the purchase of ambulances and the...DAGBLADET and Arne Lemberg of EXPRESSEN died in April 1979. They took a boat from Kenya to the Ugandan village of Katosi with the intention of...the act. He came to London last Sunday after having been released the week before from prison in Uganda. After Amin’s fall, he fled to Kenya , only a few

Considerations for preparing collaborative international research: a Ugandan experience.

PubMed

Musil, Carol M; Mutabaazi, Jemimah; Walusimbi, Mariam; Okonsky, Jennifer G; Biribonwa, Yedidah; Eagan, Sabrina; Dimarco, Marguerite A; Mbaballi, Speciosa; Fitzpatrick, Joyce J

2004-08-01

This article describes issues to consider when planning and conducting international research projects. Key considerations include building collaboration, developing a comprehensive and feasible research plan, funding and budgets, addressing human subjects concerns, and analyzing and disseminating project findings. These considerations and related methodological issues are discussed in the context of a replication pilot project conducted outside Kampala, Uganda. Ongoing dialog, flexibility, and collaboration, in addition to good science, are critical to developing successful international research projects.

Shedding Light on the Dark Continent: A Historical Perspective for U.S. Army Regional Alignment

DTIC Science & Technology

2013-12-10

importantly, to identify gaps in understanding, training, and doctrine. In the early stages of regional alignment, operational planners would benefit from a...average soldier could expect access to a steady diet of maize , meat, tea, beans, and rice. In fact, at various times, more Ugandans volunteered than...presence or limited use of paramilitary agencies which yields relative stability. Senegal is a prime example of both ideas given its history of an

The perspectives of in-school youths in Kampala, Uganda, on the role of parents in HIV prevention.

PubMed

Löfgren, Johanna; Byamugisha, Josaphat; Tillgren, Per; Rubenson, Birgitta

2009-06-01

This qualitative study explores how young Ugandans perceive and experience the role of parents in preventing the spread of HIV among youths. Data were gathered from semi-structured face-to-face interviews with 16 in-school youths, ages 18-20, residing in Kampala. A key finding is that the youths perceived parenting styles as influencing HIV prevention among youths. The participants identified several harmful consequences from a lack of parental guidance or inadequate parenting and they discussed the gains of parental support in terms of assisting HIV prevention among youths. The participants expressed the idea that parents can importantly contribute to preventing the spread of HIV among youths by supporting their own adolescent children and discussing topics like sex, relationships, and HIV in an age-appropriate way. However, the participants also felt that Ugandan parents in general are unable to support and talk to youths about sex and HIV in a way that helps protect them from exposure to HIV. The in-school youths felt that parents are unsupportive in terms of HIV prevention among youths by way of fear of talking about sex, parents' lack of time to engage with their children, and authoritarian or indulgent parenting. The participants also described how parents treat girls and boys differently; however, no significant association was found between how girls and boys conceptualised parents' roles.

Pharmacokinetics of lopinavir/ritonavir and efavirenz in food insecure HIV-infected pregnant and breastfeeding women in Tororo, Uganda

PubMed Central

Bartelink, Imke H.; Savic, Rada M.; Mwesigwa, Julia; Achan, Jane; Clark, Tamara; Plenty, Albert; Charlebois, Edwin; Kamya, Moses; Young, Sera L.; Gandhi, Monica; Havlir, Diane; Cohan, Deborah; Aweeka, Francesca

2013-01-01

Pregnancy and food insecurity may impact antiretroviral (ART) pharmacokinetics (PK), adherence and response. We sought to quantify and characterize the PK of lopinavir/ritonavir (LPV/r) and efavirenz (EFV) by pregnancy and nutritional status among HIV-infected women in Tororo, Uganda. In 2011, 62/225 ante-partum/post-partum single dried blood spot samples DBS and 43 post-partum hair samples for LPV/r were derived from 116 women, 51/194 ante-/post-partum DBS and 53 post-partum hair samples for EFV from 105 women. 80% of Ugandan participants were severely food insecure, 26% lost weight ante-partum, and median BMI post-partum was only 20.2 kg/m2. Rich PK-data of normally nourished (pregnant) women and healthy Ugandans established prior information. Overall, drug exposure was reduced (LPV −33%, EFV −15%, ritonavir −17%) compared to well-nourished controls [p < 0.001], attributable to decreased bioavailability. Pregnancy increased LPV/r clearance 68% [p < 0.001], whereas EFV clearance remained unchanged. Hair concentrations correlated with plasma-exposure [p < 0.001], explaining 29% PK-variability. In conclusion, pregnancy and food insecurity were associated with lower ART exposures in this cohort of predominantly underweight women, compared to well-nourished women. Much variability in plasma-exposure was quantified using hair concentrations. Addressing malnutrition as well as ART-PK in this setting should be a priority. PMID:24038035

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.

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.

Satisfaction, motivation, and intent to stay among Ugandan physicians: a survey from 18 national hospitals.

PubMed

Luboga, Sam; Hagopian, Amy; Ndiku, John; Bancroft, Emily; McQuide, Pamela

2011-01-01

Uganda faces a colossal shortages of human resources for health. Previous literature has largely focused on those who leave. This paper reports on a study of physicians working in 18 public and private facilities in Uganda as part of a larger study of more than 641 hospital-based health workers in Uganda. We report what could entice physicians to stay longer, satisfaction with current positions, and future career intentions. This study took place in 18 Ugandan hospitals. We describe the 49 physicians who participated in 11 focus groups and the 63 physicians who completed questionnaires, out of a larger sample of 641 health workers overall. Only 37% of physicians said they were satisfied with their jobs, and 46% reported they were at risk of leaving the health sector or the country. After compensation, the largest contributors to dissatisfaction among physicians were quality of management, availability of equipment and supplies (including drugs), quality of facility infrastructure, staffing and workload, political influence, community location, and professional development. Physicians in our study were highly dissatisfied, with almost half the sample reporting a risk to leave the sector or the country. The established link in literature between physician dissatisfaction and departure from the health system suggests national and regional policy makers should consider interventions that address the contributors to dissatisfaction identified in our study. Copyright © 2010 John Wiley & Sons, Ltd.

Vitamin D insufficiency is common in Ugandan children and is associated with severe malaria.

PubMed

Cusick, Sarah E; Opoka, Robert O; Lund, Troy C; John, Chandy C; Polgreen, Lynda E

2014-01-01

Vitamin D plays an increasingly recognized role in the innate and adaptive immune response to infection. Based on demonstrated roles in up-regulating innate immunity, decreasing inflammation, and reducing the severity of disease in illnesses such as tuberculosis and influenza, we hypothesized that poor vitamin D status would be associated with severe malaria. We measured 25-hydroxyvitamin D [25(OH)D] by immunoassay in a sample of Ugandan children aged 18 months-12 years with severe malaria (cerebral malaria or severe malarial anemia, n = 40) and in healthy community children (n = 20). Ninety-five percent of children with severe malaria (n = 38) and 80% of control children (n = 16) were vitamin D-insufficient [plasma 25(OH)D <30 ng/mL]. Mean plasma 25(OH)D levels were significantly lower in children with severe malaria than in community children (21.2 vs. 25.3 ng/mL, p = 0.03). Logistic regression revealed that for every 1 ng/mL increase in plasma 25(OH)D, the odds of having severe malaria declined by 9% [OR = 0.91 (95% CI: 0.84, 1.0)]. These preliminary results suggest that vitamin D insufficiency may play a role in the development of severe malaria. Further prospective studies in larger cohorts are indicated to confirm the relationship of vitamin D levels to severity of malaria infection and to investigate causality.

Expectations and needs of Ugandan women for improved quality of childbirth care in health facilities: A qualitative study.

PubMed

Kyaddondo, David; Mugerwa, Kidza; Byamugisha, Josaphat; Oladapo, Olufemi T; Bohren, Meghan A

2017-12-01

To describe the experiences, expectations, and needs of urban Ugandan women in relation to good-quality facility childbirth. Women who had given birth in the 12 months prior to the study were purposively sampled and interviewed, or included in focus groups. Thematic analysis was used, and the data were interpreted within the context of an existing quality of care framework. Forty-five in-depth interviews and six focus group discussions were conducted. Respect and dignity, timely communication, competent skilled staff, and availability of medical supplies were central to women's accounts of quality care, or a lack of it. The hope for a live baby motivated women to seek facility-based childbirth. They expected to encounter competent, respectful, and caring staff with appropriate skills. In some cases, they could only fulfill these expectations through additional personal financial payments to staff, for clinical supplies, or to guarantee that they would be attended by someone with suitable skills. Long-term improvement in quality of maternity care in Uganda requires enhancement of the interaction between women and health staff in facilities, and investment in staff and resources to ensure that safe, respectful care is not dependent on willingness and/or capacity to pay. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

The 'indirect costs' of underfunding foreign partners in global health research: A case study.

PubMed

Crane, Johanna T; Andia Biraro, Irene; Fouad, Tamer M; Boum, Yap; R Bangsberg, David

2017-09-16

This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work. MGH: Massachusetts General Hospital; MUST: Mbarara University of Science and Technology; NIH: National Institutes of Health; UCSF: University of California San Francisco; URI: Uganda Research Institute.

Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers.

PubMed

Munabi, Ian Guyton; Luboga, Samuel Abilemech; Mirembe, Florence

2015-01-01

Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers. This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12. It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01). The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings.

Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers

PubMed Central

Munabi, Ian Guyton; Luboga, Samuel Abilemech; Mirembe, Florence

2015-01-01

Introduction Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers. Methods This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12. Results It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01). Conclusion The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings. PMID:26918071

Understanding the meaning and role of gifts given to Ugandan mothers in maternity care settings: 'The help they give when they've seen how different you are'.

PubMed

Rudrum, Sarah; Brown, Helen; Oliffe, John L

2016-11-01

The provision of gifts to new mothers in Uganda is laden with significance that varies by the social location of the giver and receiver and the context and conditions under which the gift is made available. Here, we examine the act of gift giving and receiving within a Ugandan maternity care setting, describing the connections between these material objects and social relations. A study investigating the social organisation of maternity care in post-conflict northern Uganda found that gift-giving to new mothers functioned to create a material and discursive context wherein women's desire to access these goods was leveraged to create an incentive to attend formal maternity care during pregnancy and for delivery. In this article we describe the material and discursive processes surrounding gift-giving to new mothers in this global South health care setting. This article contributes critical analyses of the function of gifts in healthcare settings as constructing shared identities, social differences and normative values about health citizenship, and an incentive politic that affects equitable access to maternity care. Drawing on intersectional theory and analysis of how specific practices function ideologically to reward or incentivise pregnant women, we integrate material culture studies into the sociology of women's reproductive health. © 2016 Foundation for the Sociology of Health & Illness.

Transnational Terrorism in East Africa: A Qualitative and Quantitative Analysis of the Recent Rise in Kenyan Violence

DTIC Science & Technology

2014-06-01

vibrant coastal beach tourism industry that is at odds with the locally dominant Islamic religion and culture; the perception that the country’s...other large scale cross-border attack by Al- Shabaab was the July 2010 twin bombing of a popular sports bar and restaurant in the Ugandan capital...Kenyan nationals from neighboring countries, as the majority of them frequently travel by road to and from Kenya for business, leisure, and tourism , 35

Marfan syndrome presenting with headache and coincidental ophthalmic artery aneurysm.

PubMed

Vandersteen, Anthony Martin; Kenny, Joanna; Khan, Naheed L; Male, Alison

2013-03-15

A 24-year-old Ugandan woman was referred for a neurology opinion after complaining of a year long history of right-sided retro-orbital stabbing pain. Brain imaging revealed a coincidental 3 mm left ophthalmic artery aneurysm. Marfanoid habitus was noted; after further investigations she was diagnosed with mild aortic root dilatation, subtle lens dislocation and Marfan syndrome. Her symptoms were secondary to temporomandibular joint dysfunction, an under-recognised complication of Marfan syndrome. Her ophthalmic artery aneurysm is likely to be a coincidental finding.

Cellular HIV-1 Inhibition by Truncated Old World Primate APOBEC3A Proteins Lacking a Complete Deaminase Domain

PubMed Central

Katuwal, Miki; Wang, Yaqiong; Schmitt, Kimberly; Guo, Kejun; Halemano, Kalani; Santiago, Mario L.; Stephens, Edward B.

2014-01-01

The APOBEC3 (A3) deaminases are retrovirus restriction factors that were proposed as inhibitory components of HIV-1 gene therapy vectors. However, A3 mutational activity may induce undesired genomic damage and enable HIV-1 to evade drugs and immune responses. Here, we show that A3A protein from Colobus guereza (colA3A) can restrict HIV-1 replication in producer cells in a deaminase-independent manner without inducing DNA damage. Neither HIV-1 reverse transcription nor integration were significantly affected by colA3A, but capsid protein synthesis was inhibited. The determinants for colA3A restriction mapped to the N-terminal region. These properties extend to A3A from mandrills and De Brazza’s monkeys. Surprisingly, truncated colA3A proteins expressing only the N-terminal 100 amino acids effectively exclude critical catalytic regions but retained potent cellular restriction activity. These highlight a unique mechanism of cellular HIV-1 restriction by several Old World monkey A3A proteins that may be exploited for functional HIV-1 cure strategies. PMID:25262471

Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda.

PubMed

Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

2014-01-01

Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended.

Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda

PubMed Central

Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

2014-01-01

Introduction Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. Objectives To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. Methods It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Results Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Conclusion Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended. PMID:25995778

Look Who's Talking. Explaining Water-Related Information Sharing and Demand for Action Among Ugandan Villagers

NASA Astrophysics Data System (ADS)

Holvoet, Nathalie; Dewachter, Sara; Molenaers, Nadia

2016-11-01

Many national water policies propagate community-based participatory approaches to overcome weaknesses in supply-driven rural water provision, operation, and maintenance. Citizen involvement is thought to stimulate bottom-up accountability and broaden the information base, which may enrich design and implementation processes and foster improved water accessibility and sustainability. Practices on the ground, however, are embedded in socio-political realities which mediate possible beneficial effects of participatory approaches. This paper builds on full social network data collected in a Ugandan village to study the social and political reality of two distinct levels of participation, i.e. local information sharing among citizens and a more active appeal to fellow citizens to improve water services. We use Logistic Regression Quadratic Assignment Procedure to explore what type of actor and network traits influence information sharing and whether the same factors are in play in the demand for action to remedy water-related problems. Whereas social aspects (social support relations) and homophily (using the same water source, the same gender) play an important role in information sharing, it is the educational level, in particular, of the villager who is called upon that is important when villagers demand action. Our findings also demonstrate that those most in need of safe water do not mobilize their information sharing ties to demand for action. This indicates that building local water policies and practice exclusively on locally existing demand for action may fail to capture the needs of the most deprived citizens.

Preclinical efficacy and safety of herbal formulation for management of wounds.

PubMed

Ogwang, P E; Nyafuono, J; Agwaya, Moses; Omujal, F; Tumusiime, H R; Kyakulaga, A H

2011-09-01

Medicinal plants in Uganda and other developing countries have been scientifically demonstrated to have medicinal benefits but few or none have been translated to products for clinical use. Most herbal products developed by local herbalists and sold to the public are not standardized and lack efficacy and safety data to support use. To formulate from two Ugandan medicinal plants a herbal product for wound management and test its preclinical safety and efficacy using rat models. Thirty (30) Wistar albino rats were randomly divided into three groups and wounds were surgically created on the mid-dorsal region. The wounds were treated topically with distilled water (group I), Jena(®) (group II)and Neomycin sulfate cream (group III). The effects of the treatments on rate of wound closure, epithelialisation time and histological organization of tissue were assessed. The herbal formulation (Jena) had a significantly higher rate of wound closure than neomycin (p<0.05) which itself was better than distilled water. Epithelialisation time was also significantly shorter for the herbal product (p<0.01). Histological picture revealed more collagen fibers, less inflammation and better tissue remodeling for rats treated with herbal product. The herbal formulation Jena(®) systematically designed and formulated based on two Ugandan medicinal plants is according to this study better than neomycin and probably other imported products for wound management in Uganda. We recommend its trial in a clinical setting as an alternative in wound management.

Variation of facial features among three African populations: Body height match analyses.

PubMed

Taura, M G; Adamu, L H; Gudaji, A

2017-01-01

Body height is one of the variables that show a correlation with facial craniometry. Here we seek to discriminate the three populations (Nigerians, Ugandans and Kenyans) using facial craniometry based on different categories of body height of adult males. A total of 513 individuals comprising 234 Nigerians, 169 Ugandans and 110 Kenyans with mean age of 25.27, s=5.13 (18-40 years) participated. Paired and unpaired facial features were measured using direct craniometry. Multivariate and stepwise discriminate function analyses were used for differentiation of the three populations. The result showed significant overall facial differences among the three populations in all the body height categories. Skull height, total facial height, outer canthal distance, exophthalmometry, right ear width and nasal length were significantly different among the three different populations irrespective of body height categories. Other variables were sensitive to body height. Stepwise discriminant function analyses included maximum of six variables for better discrimination between the three populations. The single best discriminator of the groups was total facial height, however, for body height >1.70m the single best discriminator was nasal length. Most of the variables were better used with function 1, hence, better discrimination than function 2. In conclusion, adult body height in addition to other factors such as age, sex, and ethnicity should be considered in making decision on facial craniometry. However, not all the facial linear dimensions were sensitive to body height. Copyright © 2016 Elsevier GmbH. All rights reserved.

Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants

PubMed Central

Gantt, Soren; Orem, Jackson; Krantz, Elizabeth M.; Morrow, Rhoda Ashley; Selke, Stacy; Huang, Meei-Li; Schiffer, Joshua T.; Jerome, Keith R.; Nakaganda, Annet; Wald, Anna; Casper, Corey; Corey, Lawrence

2016-01-01

Background. Human herpesvirus (HHV) infections are common during infancy. Primary infections are frequently asymptomatic and best studied prospectively by using direct viral detection. Methods. Oropharyngeal swab specimens were collected weekly from Ugandan newborn infants, their mothers, and other children in the household. Blood specimens were collected every 4 months. Samples were tested for herpes simplex virus (HSV) types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6A, HHV-6B, and HHV-8, using quantitative polymerase chain reaction. Results. Thirty-two infants, 32 mothers, and 49 other household children were followed for a median of 57 weeks. Seventeen mothers had human immunodeficiency virus type 1 (HIV) infection; no infants acquired HIV-1. The 12-month incidence of postnatal infection was 76% for HHV-6B, 59% for CMV, 47% for EBV, 8% for HSV-1, and 0% for HHV-8. The quantity of oropharyngeal shedding by contacts was associated with HHV-6A or HHV-6B transmission. Maternal HIV-1 infection was associated with EBV transmission, while breastfeeding and younger child contacts were associated with CMV transmission. Except for HSV-1, primary HHV infections were subclinical. Conclusions. By capturing exposures and acquisition events, we found that the incidence and risk factors of infection vary by HHV type. HSV-1 infection, unlike other HHV infections, caused acute clinical illness in these infants. PMID:26917575

Vitamin D Insufficiency Is Common in Ugandan Children and Is Associated with Severe Malaria

PubMed Central

Cusick, Sarah E.; Opoka, Robert O.; Lund, Troy C.; John, Chandy C.; Polgreen, Lynda E.

2014-01-01

Vitamin D plays an increasingly recognized role in the innate and adaptive immune response to infection. Based on demonstrated roles in up-regulating innate immunity, decreasing inflammation, and reducing the severity of disease in illnesses such as tuberculosis and influenza, we hypothesized that poor vitamin D status would be associated with severe malaria. We measured 25-hydroxyvitamin D [25(OH)D] by immunoassay in a sample of Ugandan children aged 18 months –12 years with severe malaria (cerebral malaria or severe malarial anemia, n = 40) and in healthy community children (n = 20). Ninety-five percent of children with severe malaria (n = 38) and 80% of control children (n = 16) were vitamin D-insufficient [plasma 25(OH)D <30 ng/mL]. Mean plasma 25(OH)D levels were significantly lower in children with severe malaria than in community children (21.2 vs. 25.3 ng/mL, p = 0.03). Logistic regression revealed that for every 1 ng/mL increase in plasma 25(OH)D, the odds of having severe malaria declined by 9% [OR = 0.91 (95% CI: 0.84, 1.0)]. These preliminary results suggest that vitamin D insufficiency may play a role in the development of severe malaria. Further prospective studies in larger cohorts are indicated to confirm the relationship of vitamin D levels to severity of malaria infection and to investigate causality. PMID:25470777

HIV Type 1 Disease Progression to AIDS and Death in a Rural Ugandan Cohort Is Primarily Dependent on Viral Load Despite Variable Subtype and T-Cell Immune Activation Levels

PubMed Central

Eller, Michael A.; Opollo, Marc S.; Liu, Michelle; Redd, Andrew D.; Eller, Leigh Anne; Kityo, Cissy; Kayiwa, Joshua; Laeyendecker, Oliver; Wawer, Maria J.; Milazzo, Mark; Kiwanuka, Noah; Gray, Ronald H.; Serwadda, David; Sewankambo, Nelson K.; Quinn, Thomas C.; Michael, Nelson L.; Wabwire-Mangen, Fred; Sandberg, Johan K.; Robb, Merlin L.

2015-01-01

Background. Untreated human immunodeficiency virus type 1 (HIV) infection is associated with persistent immune activation, which is an independent driver of disease progression in European and United States cohorts. In Uganda, HIV-1 subtypes A and D and recombinant AD viruses predominate and exhibit differential rates of disease progression. Methods. HIV-1 seroconverters (n = 156) from rural Uganda were evaluated to assess the effects of T-cell activation, viral load, and viral subtype on disease progression during clinical follow-up. Results. The frequency of activated T cells was increased in HIV-1–infected Ugandans, compared with community matched uninfected individuals, but did not differ significantly between viral subtypes. Higher HIV-1 load, subtype D, older age, and high T-cell activation levels were associated with faster disease progression to AIDS or death. In a multivariate Cox regression analysis, HIV-1 load was the strongest predictor of progression, with subtype also contributing. T-cell activation did not emerge an independent predictor of disease progression from this particular cohort. Conclusions. These findings suggest that the independent contribution of T-cell activation on morbidity and mortality observed in European and North American cohorts may not be directly translated to the HIV epidemic in East Africa. In this setting, HIV-1 load appears to be the primary determinant of disease progression. PMID:25404522

Molecular breast cancer subtypes prevalence in an indigenous Sub Saharan African population

PubMed Central

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2014-01-01

Introduction Sub-Saharan Africa is predicted to face an unprecedented growth of cancers including breast cancer. There are indications of a significant burden of aggressive and late stage breast disease among premenopausal women in sub-Saharan Africa; because hormonal status tests are not routinely done, many women are given anti-hormonal therapy empirically. There is paucity of data on breast cancer molecular subtypes and their characteristics among women in sub Saharan Africa. The objective is to determine the prevalence of breast cancer molecular phenotypes among Ugandan women. Methods This was a cross sectional descriptive study, conducted at a tertiary hospital in Africa. Eligible participants’ formalin fixed and paraffin embedded sections were evaluated. H & E stains and Immunochemistry (Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor Receptor (HER2)) were performed. Ethical approval was obtained. Results A total of 226 patient samples were evaluated. The mean age was 45 years (SD 14);the prevalence of Triple Negative Breast Cancer (TNBC) was 34% (77/226), Luminal A 38% (83/226), HER2 positive was 22% (49/226), and Luminal B was 5% (13/226). High-grade (III) tumors were 68%, stage III and IV constituted 75% of presentations. Histological type was mostly invasive ductal carcinoma. Most patients (55%) were from rural areas. Conclusion Ugandan women had an over representation of TNBC and high-grade breast tumors. Underlying reasons ought to be investigated. The empirical use of tamoxifen (anti-hormonal therapy) should be reexamined. PMID:25309649

Molecular breast cancer subtypes prevalence in an indigenous Sub Saharan African population.

PubMed

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2014-01-01

Sub-Saharan Africa is predicted to face an unprecedented growth of cancers including breast cancer. There are indications of a significant burden of aggressive and late stage breast disease among premenopausal women in sub-Saharan Africa; because hormonal status tests are not routinely done, many women are given anti-hormonal therapy empirically. There is paucity of data on breast cancer molecular subtypes and their characteristics among women in sub Saharan Africa. The objective is to determine the prevalence of breast cancer molecular phenotypes among Ugandan women. This was a cross sectional descriptive study, conducted at a tertiary hospital in Africa. Eligible participants' formalin fixed and paraffin embedded sections were evaluated. H & E stains and Immunochemistry (Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor Receptor (HER2)) were performed. Ethical approval was obtained. A total of 226 patient samples were evaluated. The mean age was 45 years (SD 14);the prevalence of Triple Negative Breast Cancer (TNBC) was 34% (77/226), Luminal A 38% (83/226), HER2 positive was 22% (49/226), and Luminal B was 5% (13/226). High-grade (III) tumors were 68%, stage III and IV constituted 75% of presentations. Histological type was mostly invasive ductal carcinoma. Most patients (55%) were from rural areas. Ugandan women had an over representation of TNBC and high-grade breast tumors. Underlying reasons ought to be investigated. The empirical use of tamoxifen (anti-hormonal therapy) should be reexamined.

The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda.

PubMed

Devries, Karen M; Knight, Louise; Child, Jennifer C; Mirembe, Angel; Nakuti, Janet; Jones, Rebecca; Sturgess, Joanna; Allen, Elizabeth; Kyegombe, Nambusi; Parkes, Jenny; Walakira, Eddy; Elbourne, Diana; Watts, Charlotte; Naker, Dipak

2015-07-01

Violence against children from school staff is widespread in various settings, but few interventions address this. We tested whether the Good School Toolkit-a complex behavioural intervention designed by Ugandan not-for-profit organisation Raising Voices-could reduce physical violence from school staff to Ugandan primary school children. We randomly selected 42 primary schools (clusters) from 151 schools in Luwero District, Uganda, with more than 40 primary 5 students and no existing governance interventions. All schools agreed to be enrolled. All students in primary 5, 6, and 7 (approximate ages 11-14 years) and all staff members who spoke either English or Luganda and could provide informed consent were eligible for participation in cross-sectional baseline and endline surveys in June-July 2012 and 2014, respectively. We randomly assigned 21 schools to receive the Good School Toolkit and 21 to a waitlisted control group in September, 2012. The intervention was implemented from September, 2012, to April, 2014. Owing to the nature of the intervention, it was not possible to mask assignment. The primary outcome, assessed in 2014, was past week physical violence from school staff, measured by students' self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. Analyses were by intention to treat, and are adjusted for clustering within schools and for baseline school-level means of continuous outcomes. The trial is registered at clinicaltrials.gov, NCT01678846. No schools left the study. At 18-month follow-up, 3820 (92·4%) of 4138 randomly sampled students participated in a cross-sectional survey. Prevalence of past week physical violence was lower in the intervention schools (595/1921, 31·0%) than in the control schools (924/1899, 48·7%; odds ratio 0·40, 95% CI 0·26-0·64, p<0·0001). No adverse events related to the intervention were detected, but 434 children were referred to child protective services because of what they disclosed in the follow-up survey. The Good School Toolkit is an effective intervention to reduce violence against children from school staff in Ugandan primary schools. MRC, DfID, Wellcome Trust, Hewlett Foundation. Copyright © 2015 Devries et al. Open access article published under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

The State of Ambient Air Quality in Two Ugandan Cities: A Pilot Cross-Sectional Spatial Assessment.

PubMed

Kirenga, Bruce J; Meng, Qingyu; van Gemert, Frederik; Aanyu-Tukamuhebwa, Hellen; Chavannes, Niels; Katamba, Achilles; Obai, Gerald; van der Molen, Thys; Schwander, Stephan; Mohsenin, Vahid

2015-07-15

Air pollution is one of the leading global public health risks but its magnitude in many developing countries' cities is not known. We aimed to measure the concentration of particulate matter with aerodynamic diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) pollutants in two Ugandan cities (Kampala and Jinja). PM2.5, O3, temperature and humidity were measured with real-time monitors, while NO2 and SO2 were measured with diffusion tubes. We found that the mean concentrations of the air pollutants PM2.5, NO2, SO2 and O3 were 132.1 μg/m3, 24.9 µg/m3, 3.7 µg/m3 and 11.4 μg/m3, respectively. The mean PM2.5 concentration is 5.3 times the World Health Organization (WHO) cut-off limits while the NO2, SO2 and O3 concentrations are below WHO cut-off limits. PM2.5 levels were higher in Kampala than in Jinja (138.6 μg/m3 vs. 99.3 μg/m3) and at industrial than residential sites (152.6 μg/m3 vs. 120.5 μg/m3) but residential sites with unpaved roads also had high PM2.5 concentrations (152.6 μg/m3). In conclusion, air pollutant concentrations in Kampala and Jinja in Uganda are dangerously high. Long-term studies are needed to characterize air pollution levels during all seasons, to assess related public health impacts, and explore mitigation approaches.

Use of the Behavior Rating Inventory of Executive Function and Child Behavior Checklist in Ugandan Children with HIV or a History of Severe Malaria.

PubMed

Familiar, Itziar; Ruisenor-Escudero, Horacio; Giordani, Bruno; Bangirana, Paul; Nakasujja, Noeline; Opoka, Robert; Boivin, Michael

2015-05-01

To assess the structural overlap between the Behavior Rating Inventory of Executive Function (BRIEF) and Achenbach Child Behavior Checklist (CBCL) among children in Uganda. Caregiver ratings for the BRIEF and CBCL were obtained for 2 independent samples of school-aged children: 106 children (5-12 years old, 50% males) with a history of severe malaria and on 144 HIV-infected children (5-12 years old, 58% males) in Uganda. Exploratory factor analysis was used to evaluate the factor structure of the 8 subscales for the BRIEF and the 8 scales of the CBCL to determine correlation. Overall, children in the severe malaria group had higher (increased symptom) BRIEF and CBCL scores than those in the HIV-infected group. Three factors that provided a reasonable fit to the data and could be characterized as 3 specific domains were identified: (1) Metacognition, which consisted of the scales in the BRIEF Metacognition domain, (2) Behavioral Adjustment, which comprised of the scales in the BRIEF Behavioral Regulation domain and the Externalizing Symptoms scales in the CBCL, and (3) Emotional Adjustment, which mainly consisted of the Internalizing Symptoms scales in the CBCL. The BRIEF Behavior Regulation and CBCL Externalizing Symptoms scales, however, did overlap in terms of assessing similar behavior symptoms. These findings were consistent across the severe malaria and HIV-infected samples of children. The BRIEF and CBCL instruments offer distinct, yet complementary, assessments of behavior in clinical pediatric populations in the Ugandan context, supporting the use of these measures for similar research settings.

Association between Self-Reported Academic Performance and Risky Sexual Behavior among Ugandan University Students- A Cross Sectional Study

PubMed Central

Mehra, Devika; Kyagaba, Emmanuel; Östergren, Per-Olof; Agardh, Anette

2014-01-01

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors. PMID:24999121

Use of the BRIEF and CBCL in Ugandan Children with HIV or a History of Severe Malaria

PubMed Central

Itziar, Familiar; Horacio, Ruisenor-Escudero; Bruno, Giordani; Paul, Bangirana; Noeline, Nakasujja; Robert, Opoka; Michael, Boivin

2015-01-01

Objective To assess the structural overlap between the Behavior Rating Inventory of Executive Function (BRIEF) and Achenbach Child Behavior Check List (CBCL) among children in Uganda. Methods Caregiver ratings for the BRIEF and CBCL were obtained for two independent samples of school-aged children: 106 children (5-12 years old, 50% males) with a history of severe malaria, and on 144 HIV-infected children (5-12 years old, 58% males) in Uganda. Exploratory factor analysis was used to evaluate the factor structure of the 8 sub-scales for the BRIEF and the 8 scales of the CBCL to determine correlation. Results Overall, children in the severe malaria group had higher (increased symptom) BRIEF and CBCL scores than children in the HIV-infected group. We identified 3 factors that provided a reasonable fit to the data and could be characterized as 3 specific domains: 1) Metacognition, which consisted of the scales in the BRIEF Metacognition domain; 2) Behavioral Adjustment, which was comprised of the scales in the BRIEF Behavioral Regulation domain and the Externalizing Symptoms scales in the CBCL; and 3) Emotional Adjustment, which mainly consisted of the Internalizing Symptoms scales in the CBCL. The BRIEF Behavior Regulation and CBCL Externalizing Symptoms scales, however, did overlap in terms of assessing similar behavior symptoms. These findings were consistent across the severe malaria and HIV-infected samples of children. Conclusion The BRIEF and CBCL instruments offer distinct, yet complementary, assessments of behavior in clinical pediatric populations in the Ugandan context, supporting the use of these measures for similar research settings. PMID:25738440

Documenting the individual- and household-level cost of unsafe abortion in Uganda.

PubMed

Sundaram, Aparna; Vlassoff, Michael; Mugisha, Frederick; Bankole, Akinrinola; Singh, Susheela; Amanya, Leo; Onda, Tsuyoshi

2013-12-01

Although Uganda has a restrictive abortion law, illegal abortions performed under dangerous conditions are common. Data are lacking, however, on the economic impact of postabortion complications on women and their households. Data from a 2011-2012 survey of 1,338 women who received postabortion care at 27 Ugandan health facilities were used to assess the economic consequences of unsafe abortion and subsequent treatment. Information was obtained on treatment costs and on the impact of abortion complications on children in the household, on the productivity of the respondent and other household members, and on changes in their economic circumstances. Most women reported that their unsafe abortion had had one or more adverse effects, including loss of productivity (73%), negative consequences for their children (60%) and deterioration in economic circumstances (34%). Women who had spent one or more nights in a facility receiving postabortion care were more likely than those who had not needed an overnight stay to experience these three consequences (odds ratios, 1.6-2.8), and women who had incurred higher postabortion care expenses were more likely than those with lower expenses to report deterioration in economic circumstances (1.6). Wealthier women were less likely than the poorest women to report that their children had suffered negative consequences (0.4-0.5). The impact of complications of unsafe abortion and the expense of treating them are substantial for Ugandan women and their households. Strategies to reduce the number of unsafe procedures, such as by expanding access to contraceptives to prevent unintended pregnancies, are urgently needed.

Young African women must have empowering and receptive social environments for HIV prevention.

PubMed

Conn, Cath

2013-01-01

This paper describes a study which explored the lives of young Ugandan women through their voices, and related the findings to HIV prevention paradigms. The research was conducted in the context of the continuing vulnerability of young Ugandan women to HIV; reflected in disproportionately high prevalence compared to young men. The participants of the study were 15 young women aged 15-19 years, from Busoga Region in Eastern Uganda. Given the focus on young women's voices within norms of gender inequality, a narrative methodology was used as a safe space for participants to speak about their lives, expanding on research experiences with young people. The methods used included drawing; written stories and drama; aspirational writing and diary keeping. Forty-eight narratives, in image and word form, represented everyday experiences in young women's lives, as well as difficult experiences of inequality and resistance. Young women portrayed considerable social barriers to empowerment, and a challenging environment of poverty and educational limitations. Young women's representations were analysed using a gender empowerment and positive sexuality framework. The resulting analysis was then critically applied to HIV prevention paradigms. Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment. Alternative approaches need to build young African women's voices in the spaces of homes, schools and communities. It is vital, however, that such efforts are embedded in more radical change leading to social environments receptive to the needs of young women.

Siemens Immulite Aspergillus-specific IgG assay for chronic pulmonary aspergillosis diagnosis.

PubMed

Page, Iain D; Richardson, Malcolm D; Denning, David W

2018-05-14

Chronic pulmonary aspergillosis (CPA) complicates underlying lung disease, including treated tuberculosis. Measurement of Aspergillus-specific immunoglobulin G (IgG) is a key diagnostic step. Cutoffs have been proposed based on receiver operating characteristic (ROC) curve analyses comparing CPA cases to healthy controls, but performance in at-risk populations with underlying lung disease is unclear. We evaluated optimal cutoffs for the Siemens Immulite Aspergillus-specific IgG assay for CPA diagnosis in relation to large groups of healthy and diseased controls with treated pulmonary tuberculosis. Sera from 241 patients with CPA attending the UK National Aspergillosis Centre, 299 Ugandan blood donors (healthy controls), and 398 Ugandans with treated pulmonary tuberculosis (diseased controls) were tested. Radiological screening removed potential CPA cases from diseased controls (234 screened diseased controls). ROC curve analyses were performed and optimal cutoffs identified by Youden J statistic. CPA versus control ROC area under curve (AUC) results were: healthy controls 0.984 (95% confidence interval 0.972-0.997), diseased controls 0.972 (0.959-0.985), screened diseased controls 0.979 (0.967-0.992). Optimal cutoffs were: healthy controls 15 mg/l (94.6% sensitivity, 98% specificity), unscreened diseased controls 15 mg/l (94.6% sensitivity, 94.5% specificity), screened diseased controls 25 mg/l (92.9% sensitivity, 98.7% specificity). Results were similar in healthy and diseased controls. We advocate a cutoff of 20 mg/l as this is the midpoint of the range of optimal cutoffs. Cutoffs calculated in relation to healthy controls for other assays are likely to remain valid for use in a treated tuberculosis population.

"People will say that I am proud": a qualitative study of barriers to bed net use away from home in four Ugandan districts.

PubMed

Monroe, April; Harvey, Steven A; Lam, Yukyan; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel

2014-03-06

Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious "crusades" where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective.

Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers.

PubMed

Goggin, Kathy; Finocchario-Kessler, Sarah; Staggs, Vincent; Woldetsadik, Mahlet Atakilt; Wanyenze, Rhoda K; Beyeza-Kashesya, Jolly; Mindry, Deborah; Khanakwa, Sarah; Wagner, Glenn J

2015-12-01

High rates of childbearing desires (59%) and serodiscordant partnerships (50%) among people living with HIV (PHLA) in Uganda highlight the need for safer conception counseling (SCC). Provider attitudes about counseling PLHA on the use of safer conception methods (SCM) have been explored in qualitative studies, but published quantitative investigations are scarce. Data from 57 Ugandan providers were collected to examine providers' attitudes about childbearing among PLHA and engagement in discussions about childbearing, as well as their knowledge, interest, self-efficacy, and intentions to provide SCC. Correlates of self-efficacy for the provision of SCC were explored to inform the development of training programs. Providers reported a general awareness of most SCM, especially timed unprotected intercourse (TUI); but just over half felt they knew enough to counsel clients in the future and all wanted more training. Childbearing was discussed with less than a third of reproductive aged patients and was mostly initiated by patients. Most providers saw value in providing SCC and believed that most aspects of SCM would be acceptable to their clients, but numerous barriers were endorsed. Self-efficacy was greatest among providers who had had more childbearing conversations, greater SCM awareness, perceived fewer barriers and greater intentions to counsel on TUI. Providers evidence fewer stigmatizing attitudes than in the past. However, those who endorsed more stigmatizing attitudes evidenced a trend for reporting lower self-efficacy for providing SCC. Training will need to simultaneously focus on increasing providers' SCC knowledge and skills while instilling a more realistic appraisal of the risks of assisting couples to employ SCM versus doing nothing.

Gender and representation in refugee communities: the experience of the Ikafe programme.

PubMed

Payne, L; Adoko, J

1997-06-01

The Ikafe camp established in 1994 in Uganda for 45,000 refugees from Sudan was treated as a rural development program by Oxfam UK/1. Refugees and Oxfam staff achieved registration, land allocation, distribution of food, water, sanitation, health care, and livelihood development, and the refugees successfully cleared land for cultivation, established nurseries, and instituted community-managed water and sanitation systems. All programming has been achieved through representative structures linked to Ugandan bodies. Despite Oxfam's attempt to provide women with equal representation and an equal voice in decision-making, only a low participation of women was achieved. Analysis of this situation revealed that women in the Sudan traditionally held positions of responsibility. However, in the refugee settlements women sometimes did not learn about meetings or meetings were held at inconvenient times or women lacked free time for meetings. The men feared that women would appropriate jobs the men considered their rightful positions, and women expressed jealousy of prominent women. The existence of a position entitled "Women's Representative" led the refugees to believe that all the other jobs were for men, and they considered the alien Ugandan structures appropriate only for voicing concerns, not for self-management. Thus, refugee representatives were often the men who could speak English. In response, Oxfam reformed the representative structure to insure sex equality and restructured the committee overseeing discipline on Sudanese lines. Oxfam learned that it is important to establish interim structures that can be adapted later and that it is not enough simply to create democratic election procedures and encourage people to elect women.

Genetic Variation in TLR Genes in Ugandan and South African Populations and Comparison with HapMap Data

PubMed Central

Randhawa, April Kaur; Horne, David J.; Adams, Mark D.; Shey, Muki; Barnholtz-Sloan, Jill; Mayanja-Kizza, Harriet; Kaplan, Gilla; Hanekom, Willem A.; Boom, W. Henry; Hawn, Thomas R.; Stein, Catherine M.

2012-01-01

Genetic epidemiological studies of complex diseases often rely on data from the International HapMap Consortium for identification of single nucleotide polymorphisms (SNPs), particularly those that tag haplotypes. However, little is known about the relevance of the African populations used to collect HapMap data for study populations conducted elsewhere in Africa. Toll-like receptor (TLR) genes play a key role in susceptibility to various infectious diseases, including tuberculosis. We conducted full-exon sequencing in samples obtained from Uganda (n = 48) and South Africa (n = 48), in four genes in the TLR pathway: TLR2, TLR4, TLR6, and TIRAP. We identified one novel TIRAP SNP (with minor allele frequency [MAF] 3.2%) and a novel TLR6 SNP (MAF 8%) in the Ugandan population, and a TLR6 SNP that is unique to the South African population (MAF 14%). These SNPs were also not present in the 1000 Genomes data. Genotype and haplotype frequencies and linkage disequilibrium patterns in Uganda and South Africa were similar to African populations in the HapMap datasets. Multidimensional scaling analysis of polymorphisms in all four genes suggested broad overlap of all of the examined African populations. Based on these data, we propose that there is enough similarity among African populations represented in the HapMap database to justify initial SNP selection for genetic epidemiological studies in Uganda and South Africa. We also discovered three novel polymorphisms that appear to be population-specific and would only be detected by sequencing efforts. PMID:23112821

Genomic analysis of Ugandan and Rwandan chicken ecotypes using a 600 k genotyping array.

PubMed

Fleming, D S; Koltes, J E; Markey, A D; Schmidt, C J; Ashwell, C M; Rothschild, M F; Persia, M E; Reecy, J M; Lamont, S J

2016-05-26

Indigenous populations of animals have developed unique adaptations to their local environments, which may include factors such as response to thermal stress, drought, pathogens and suboptimal nutrition. The survival and subsequent evolution within these local environments can be the result of both natural and artificial selection driving the acquisition of favorable traits, which over time leave genomic signatures in a population. This study's goals are to characterize genomic diversity and identify selection signatures in chickens from equatorial Africa to identify genomic regions that may confer adaptive advantages of these ecotypes to their environments. Indigenous chickens from Uganda (n = 72) and Rwanda (n = 100), plus Kuroilers (n = 24, an Indian breed imported to Africa), were genotyped using the Axiom® 600 k Chicken Genotyping Array. Indigenous ecotypes were defined based upon location of sampling within Africa. The results revealed the presence of admixture among the Ugandan, Rwandan, and Kuroiler populations. Genes within runs of homozygosity consensus regions are linked to gene ontology (GO) terms related to lipid metabolism, immune functions and stress-mediated responses (FDR < 0.15). The genes within regions of signatures of selection are enriched for GO terms related to health and oxidative stress processes. Key genes in these regions had anti-oxidant, apoptosis, and inflammation functions. The study suggests that these populations have alleles under selective pressure from their environment, which may aid in adaptation to harsh environments. The correspondence in gene ontology terms connected to stress-mediated processes across the populations could be related to the similarity of environments or an artifact of the detected admixture.

Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants.

PubMed

Gantt, Soren; Orem, Jackson; Krantz, Elizabeth M; Morrow, Rhoda Ashley; Selke, Stacy; Huang, Meei-Li; Schiffer, Joshua T; Jerome, Keith R; Nakaganda, Annet; Wald, Anna; Casper, Corey; Corey, Lawrence

2016-07-01

Human herpesvirus (HHV) infections are common during infancy. Primary infections are frequently asymptomatic and best studied prospectively by using direct viral detection. Oropharyngeal swab specimens were collected weekly from Ugandan newborn infants, their mothers, and other children in the household. Blood specimens were collected every 4 months. Samples were tested for herpes simplex virus (HSV) types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6A, HHV-6B, and HHV-8, using quantitative polymerase chain reaction. Thirty-two infants, 32 mothers, and 49 other household children were followed for a median of 57 weeks. Seventeen mothers had human immunodeficiency virus type 1 (HIV) infection; no infants acquired HIV-1. The 12-month incidence of postnatal infection was 76% for HHV-6B, 59% for CMV, 47% for EBV, 8% for HSV-1, and 0% for HHV-8. The quantity of oropharyngeal shedding by contacts was associated with HHV-6A or HHV-6B transmission. Maternal HIV-1 infection was associated with EBV transmission, while breastfeeding and younger child contacts were associated with CMV transmission. Except for HSV-1, primary HHV infections were subclinical. By capturing exposures and acquisition events, we found that the incidence and risk factors of infection vary by HHV type. HSV-1 infection, unlike other HHV infections, caused acute clinical illness in these infants. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Effect of the good school toolkit on school staff mental health, sense of job satisfaction and perceptions of school climate: Secondary analysis of a cluster randomised trial.

PubMed

Kayiwa, Joshua; Clarke, Kelly; Knight, Louise; Allen, Elizabeth; Walakira, Eddy; Namy, Sophie; Merrill, Katherine G; Naker, Dipak; Devries, Karen

2017-08-01

The Good School Toolkit, a complex behavioural intervention delivered in Ugandan primary schools, has been shown to reduce school staff-perpetrated physical violence against students. We aimed to assess the effect of this intervention on staff members' mental health, sense of job satisfaction and perception of school climate. We analysed data from a cluster-randomised trial administered in 42 primary schools in Luwero district, Uganda. The trial was comprised of cross-sectional baseline (June/July 2012) and endline (June/July 2014) surveys among staff and students. Twenty-one schools were randomly selected to receive the Toolkit, whilst 21 schools constituted a wait-listed control group. We generated composite measures to assess staff members' perceptions of the school climate and job satisfaction. The trial is registered at clinicaltrials.gov (NCT01678846). No schools dropped out of the study and all 591 staff members who completed the endline survey were included in the analysis. Staff in schools receiving the Toolkit had more positive perspectives of their school climate compared to staff in control schools (difference in mean scores 2.19, 95% Confidence Interval 0.92, 3.39). We did not find any significant differences for job satisfaction and mental health. In conclusion, interventions like the Good School Toolkit that reduce physical violence by school staff against students can improve staff perceptions of the school climate, and could help to build more positive working and learning environments in Ugandan schools. Copyright © 2017 Elsevier Inc. All rights reserved.

Association between self-reported academic performance and risky sexual behavior among Ugandan university students- a cross sectional study.

PubMed

Mehra, Devika; Kyagaba, Emmanuel; Ostergren, Per-Olof; Agardh, Anette

2014-04-16

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors.

Semicircular Canal Size and Locomotion in Colobine Monkeys: A Cautionary Tale.

PubMed

Rae, Todd C; Johnson, Paul Martin; Yano, Wataru; Hirasaki, Eishi

2016-01-01

The semicircular canals of the inner ear constitute the organ of balance, tracking head rotation during movement and facilitating stabilisation of vision. Morphological characteristics of the canals are correlated with agility scores related to locomotion. To date, however, the relationship between canal morphology and specific locomotor behaviours, such as leaping, is unclear. Knowledge of such a relationship could strengthen the inferences of locomotion of extinct taxa. To test this, crania of two sets of closely related primate species (Presbytis melalophos and P. potenziani; Colobus guereza and C. polykomos) that differ in the percentage of leaping in their locomotor repertoire were examined using microscopic computed tomography. Three-dimensional virtual models of the bony labyrinth were derived, and the radius of curvature of each of the three canals was evaluated relative to cranial size. The findings are contradictory; one leaping form (P. melalophos) differs from its congener in possessing significantly larger lateral canals, a pattern seen in previous studies of primates, while the other leaper (C. guereza) has significantly smaller posterior canals than its close relative. These results undermine efforts to determine specific locomotor behaviours from the bony labyrinth of extinct primates. © 2016 S. Karger AG, Basel.

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 professionals. Placed in rural community sites, nurses should function independently as community leaders, health education facilitators, primary health care practitioners, and educators for nursing students. Such intervention in community health care by BScN nurses should improve health care utilization and decrease mortality and morbidity from preventable causes. BScN nurses should make an impact on health care policy, nursing education, and primary health care. The evaluation of this project needs to be as comprehensive as its development and implementation. It will focus on health outcomes, particularly for women and children in rural areas of Uganda. Measurement of the effects of the process of nursing education (the BScN curriculum) in terms of output (nurses educated and placed in rural practice, nursing education, or government policy posts), outcomes (change in health status of rural communities), and broader impacts (changes in the status of women and in government policy toward women, nurses, or health at the local, regional, and national levels) is planned. An element of sustainability is present, as an operations research structure will be left in place at the community level. Timing, as the saying goes, is everything, and this project has had good timing. Our belief in the efforts and the goals of the project also gave us the strength to get support from various funding agencies for "small" things. For example, we got support from churches in the United States for building schools in Uganda; we persisted with the women's income-generating project when other support was pulled; we got books for the library in Uganda and got clothes, books, and furnishings for the students who came to this country. The motivation for project personnel has been altruism. The services that the two consultants provided to their Ugandan colleagues have extended far beyond the scope of the project.

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."

Blood parasites of frogs from an equatorial African montane forest in western Uganda.

PubMed

Readel, Anne M; Goldberg, Tony L

2010-04-01

In a survey of blood parasites in Ugandan frogs, 30 (17%) of 180 frogs were infected with at least 1 species of Hepatozoon or Trypanosoma, or with microfilariae. There were significant differences in the prevalence of parasitism among species, with parasitemia detected in only 3 of 9 species. The intensity of blood parasite infection ranged from 1 to 1,080 infected cells per 5,000 cells examined. Seasonal changes in the prevalence and intensity of parasitemia were not observed, nor was there any association between parasitemia and infection with the pandemic fungus Batrachochytrium dendrobatidis.

Work-related quality of life of Ugandan healthcare workers.

PubMed

Opollo, J G; Gray, J; Spies, L A

2014-03-01

To describe perceived work-related quality of life of Ugandan healthcare workers. A secondary aim was to seek participant input on ways to improve work environments. Poor patient outcomes, decreased employee motivation and decisions to leave the organization have been linked to poor work conditions. Interventions to correct healthcare worker shortage in developing countries require information about work quality of life. Descriptive cross-sectional study conducted in health and educational settings in Uganda in July 2011. Participants completed the Biographical Information Scale demographic questionnaire and the validated 24-item Work-Related Quality of Life scale. Sample included 146 healthcare workers employed in various settings. Participants reported poorer quality of work life on the work conditions, control at work and home-work interface subscales. Participants perceived stress at work to be low and experienced higher job career satisfaction. There was a significant relationship between work-related quality of life, gender and hours worked. Participants' suggestions to improve work life ranged from simple no-cost suggestions to more complex system level interventions. Work-related quality of life was low in this convenience sample. Perceived stress at work was lower than expected, but may have been due to nurses' expectations of a normal work assignment. Predominantly women, the participants had significant caregiving responsibilities. Nurses must acquire a seat at the table where crucial decisions about nursing and its future are made. By advancing leadership skills, nurses can effectively advocate for organizational changes that address broad factors related to increasing job satisfaction, and retaining and attracting nurses. Nurses can influence work quality of life individually and collectively by identifying workplace concerns, demanding safe work environments, fostering teamwork and enhancing professional growth. © 2014 International Council of Nurses.

Short-term effect of short, intensive speech therapy on articulation and resonance in Ugandan patients with cleft (lip and) palate.

PubMed

Luyten, A; Bettens, K; D'haeseleer, E; Hodges, A; Galiwango, G; Vermeersch, H; Van Lierde, K

2016-01-01

The purpose of the current study was to assess the short-term effectiveness of short and intensive speech therapy provided to patients with cleft (lip and) palate (C(L)P) in terms of articulation and resonance. Five Ugandan patients (age: 7.3-19.6 years) with non-syndromic C(L)P received six hours of individualized speech therapy in three to four days. Speech therapy focused on correct phonetic placement and contrasts between oral and nasal airflow and resonance. Speech evaluations performed before and immediately after speech therapy, including perceptual and instrumental assessment techniques, were compared. Post-therapy, improvement of speech was noted for most of the patients, although to varying degrees. Clinically relevant progress of objective nasalance values and/or articulation was obtained in four patients. Overall, two patients showed normal speech intelligibility, while three patients required additional speech therapy. These preliminary short-term results demonstrate that short and intensive speech therapy can be effective for patients with C(L)P in countries with limited access to speech-language therapy. However, further research is needed on the long-term effectiveness and the advantages of applying this treatment protocol in countries with good access to speech therapy. The reader will be able to (1) list the challenges in resource poor-countries to achieve access to speech-language therapy services, (2) describe when the application of speech therapy is appropriate in patients with C(L)P, (3) describe the speech therapy that can be applied to reduce compensatory articulation and resonance disorders in patients with C(L)P, and (4) list the (possible) advantages of short, intensive speech therapy for both resource-poor and developed countries. Copyright © 2016 Elsevier Inc. All rights reserved.

Alcohol Use and Unprotected Sex Among HIV-Infected Ugandan Adults: Findings from an Event-Level Study.

PubMed

Woolf-King, Sarah E; Fatch, Robin; Cheng, Debbie M; Muyindike, Winnie; Ngabirano, Christine; Kekibiina, Allen; Emenyonu, Nneka; Hahn, Judith A

2018-01-11

While alcohol is a known risk factor for HIV infection in sub-Saharan Africa (SSA), studies designed to investigate the temporal relationship between alcohol use and unprotected sex are lacking. The purpose of this study was to determine whether alcohol used at the time of a sexual event is associated with unprotected sex at that same event. Data for this study were collected as part of two longitudinal studies of HIV-infected Ugandan adults. A structured questionnaire was administered at regularly scheduled cohort study visits in order to assess the circumstances (e.g., alcohol use, partner type) of the most recent sexual event (MRSE). Generalized estimating equation logistic regression models were used to examine the association between alcohol use (by the participant, the sexual partner, or both the participant and the partner) and the odds of unprotected sex at the sexual event while controlling for participant gender, age, months since HIV diagnosis, unhealthy alcohol use in the prior 3 months, partner type, and HIV status of partner. A total of 627 sexually active participants (57% women) reported 1817 sexual events. Of these events, 19% involved alcohol use and 53% were unprotected. Alcohol use by one's sexual partner (aOR 1.70; 95% CI 1.14, 2.54) or by both partners (aOR 1.78; 95% CI 1.07, 2.98) during the MRSE significantly increased the odds of unprotected sex at that same event. These results add to the growing event-level literature in SSA and support a temporal association between alcohol used prior to a sexual event and subsequent unprotected sex.

The State of Ambient Air Quality in Two Ugandan Cities: A Pilot Cross-Sectional Spatial Assessment

PubMed Central

Kirenga, Bruce J.; Meng, Qingyu; van Gemert, Frederik; Aanyu-Tukamuhebwa, Hellen; Chavannes, Niels; Katamba, Achilles; Obai, Gerald; van der Molen, Thys; Schwander, Stephan; Mohsenin, Vahid

2015-01-01

Air pollution is one of the leading global public health risks but its magnitude in many developing countries’ cities is not known. We aimed to measure the concentration of particulate matter with aerodynamic diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) pollutants in two Ugandan cities (Kampala and Jinja). PM2.5, O3, temperature and humidity were measured with real-time monitors, while NO2 and SO2 were measured with diffusion tubes. We found that the mean concentrations of the air pollutants PM2.5, NO2, SO2 and O3 were 132.1 μg/m3, 24.9 µg/m3, 3.7 µg/m3 and 11.4 μg/m3, respectively. The mean PM2.5 concentration is 5.3 times the World Health Organization (WHO) cut-off limits while the NO2, SO2 and O3 concentrations are below WHO cut-off limits. PM2.5 levels were higher in Kampala than in Jinja (138.6 μg/m3 vs. 99.3 μg/m3) and at industrial than residential sites (152.6 μg/m3 vs. 120.5 μg/m3) but residential sites with unpaved roads also had high PM2.5 concentrations (152.6 μg/m3). In conclusion, air pollutant concentrations in Kampala and Jinja in Uganda are dangerously high. Long-term studies are needed to characterize air pollution levels during all seasons, to assess related public health impacts, and explore mitigation approaches. PMID:26184273

Incidence of Induced Abortion in Uganda, 2013: New Estimates Since 2003.

PubMed

Prada, Elena; Atuyambe, Lynn M; Blades, Nakeisha M; Bukenya, Justine N; Orach, Christopher Garimoi; Bankole, Akinrinola

2016-01-01

In Uganda, abortion is permitted only when the life of a woman is in danger. This restriction compels the perpetuation of the practice in secrecy and often under unsafe conditions. In 2003, 294,000 induced abortions were estimated to occur each year in Uganda. Since then, no other research on abortion incidence has been conducted in the country. Data from 418 health facilities were used to estimate the number and rate of induced abortion in 2013. An indirect estimation methodology was used to calculate the annual incidence of induced abortions ─ nationally and by major regions. The use of a comparable methodology in an earlier study permits assessment of trends between 2003 and 2013. In 2013, an estimated 128,682 women were treated for abortion complications and an estimated 314,304 induced abortions occurred, both slightly up from 110,000 and 294,000 in 2003, respectively. The national abortion rate was 39 abortions per 1,000 women aged 15-49, down from 51 in 2003. Regional variation in abortion rates is very large, from as high as an estimated 77 per 1,000 women 15-49 in Kampala region, to as low as 18 per 1,000 women in Western region. The overall pregnancy rate also declined from 326 to 288; however the proportion of pregnancies that were unintended increased slightly, from 49% to 52%. Unsafe abortion remains a major problem confronting Ugandan women. Although the overall pregnancy rate and the abortion rate declined in the past decade, the majority of pregnancies to Ugandan women are still unintended. These findings reflect the increase in the use of modern contraception but also suggest that a large proportion of women are still having difficulty practicing contraception effectively. Improved access to contraceptive services and abortion-related care are still needed.

Designing and evaluating Brain Powered Games for cognitive training and rehabilitation in at-risk African children.

PubMed

Giordani, B; Novak, B; Sikorskii, A; Bangirana, P; Nakasujja, N; Winn, B M; Boivin, M J

2015-01-01

Valid, reliable, accessible, and cost-effective computer-training approaches can be important components in scaling up educational support across resource-poor settings, such as sub-Saharan Africa. The goal of the current study was to develop a computer-based training platform, the Michigan State University Games for Entertainment and Learning laboratory's Brain Powered Games (BPG) package that would be suitable for use with at-risk children within a rural Ugandan context and then complete an initial field trial of that package. After game development was completed with the use of local stimuli and sounds to match the context of the games as closely as possible to the rural Ugandan setting, an initial field study was completed with 33 children (mean age = 8.55 ± 2.29 years, range 6-12 years of age) with HIV in rural Uganda. The Test of Variables of Attention (TOVA), CogState computer battery, and the Non-Verbal Index from the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) were chosen as the outcome measures for pre- and post-intervention testing. The children received approximately 45 min of BPG training several days per week for 2 months (24 sessions). Although some improvements in test scores were evident prior to BPG training, following training, children demonstrated clinically significant changes (significant repeated-measures outcomes with moderate to large effect sizes) on specific TOVA and CogState measures reflecting processing speed, attention, visual-motor coordination, maze learning, and problem solving. Results provide preliminary support for the acceptability, feasibility, and neurocognitive benefit of BPG and its utility as a model platform for computerized cognitive training in cross-cultural low-resource settings.

Capacity for diagnosis and treatment of heart failure in sub-Saharan Africa.

PubMed

Carlson, Selma; Duber, Herbert C; Achan, Jane; Ikilezi, Gloria; Mokdad, Ali H; Stergachis, Andy; Wollum, Alexandra; Bukhman, Gene; Roth, Gregory A

2017-12-01

Heart failure is a major cause of disease burden in sub-Saharan Africa (SSA). There is an urgent need for better strategies for heart failure management in this region. However, there is little information on the capacity to diagnose and treat heart failure in SSA. We aim to provide a better understanding of the capacity to diagnose and treat heart failure in Kenya and Uganda to inform policy planning and interventions. We analysed data from a nationally representative survey of health facilities in Kenya and Uganda (197 health facilities in Uganda and 143 in Kenya). We report on the availability of cardiac diagnostic technologies and select medications for heart failure (β-blockers, ACE inhibitors and furosemide). Facility-level data were analysed by country and platform type (hospital vs ambulatory facilities). Functional and staffed radiography, ultrasound and ECG were available in less than half of hospitals in Kenya and Uganda combined. Of the hospitals surveyed, 49% of Kenyan and 77% of Ugandan hospitals reported availability of the heart failure medication package. ACE inhibitors were only available in 51% of Kenyan and 79% of Ugandan hospitals. Almost one-third of the hospitals in each country had a stock-out of at least one of the medication classes in the prior quarter. Few facilities in Kenya and Uganda were prepared to diagnose and manage heart failure. Medication shortages and stock-outs were common. Our findings call for increased investment in cardiac care to reduce the growing burden of heart failure. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Depressive and Anxiety Symptoms Predict Sustained Quality of Life Deficits in HIV-Positive Ugandan Adults Despite Antiretroviral Therapy: A Prospective Cohort Study.

PubMed

Ezeamama, Amara E; Woolfork, Makhabele N; Guwatudde, David; Bagenda, Danstan; Manabe, Yukari C; Fawzi, Wafaie W; Smith Fawzi, Mary C

2016-03-01

The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period. Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in relation to quartiles of each psychosocial status indicator. Repeated measures generalized estimating equations modeling was implemented to assess differences in likelihood of improved versus nonimproved SRH during follow-up.QOL scores and SRH improved significantly for all participants over 18 months (P < 0.0001). The gain in QOL increased dose-dependently as baseline depressive symptoms (time*depression P < 0.001) and anxiety levels (time*anxiety P < 0.001) declined. Lower social support was associated with worse QOL at baseline (P = 0.0005) but QOL improvement during follow-up was not dependent on baseline level of social support (time*social support P = 0.8943) or number of stigmatizing experiences (time*stigma P = 0.8662). Psychosocial determinants did not predict changes in SRH in this study. High levels of depression and anxiety symptoms at HAART initiation predicts lower gains in QOL for HIV-positive patients for as long as 18 months. Long-term QOL improvements in HIV-infected adults may be enhanced by implementation of psychosocial interventions to reduce depression and anxiety in HIV-infected adults.

Initial outcomes of provider-initiated routine HIV testing and counseling during outpatient care at a rural Ugandan hospital: risky sexual behavior, partner HIV testing, disclosure, and HIV care seeking.

PubMed

Kiene, Susan M; Bateganya, Moses; Wanyenze, Rhoda; Lule, Haruna; Nantaba, Harriet; Stein, Michael D

2010-02-01

Provider-initiated routine HIV testing is being scaled up throughout the world, however, little is known about the outcomes of routine HIV testing on subsequent behavior. This study examined the initial outcomes of provider-initiated routine HIV testing at a rural Ugandan hospital regarding partner HIV testing, sexual risk behavior, disclosure, and HIV care seeking. In a prospective cohort study, 245 outpatients receiving routine HIV testing completed baseline and 3-month follow-up interviews. After receiving routine HIV testing the percentage of participants engaging in risky sex decreased from 70.1% to 50.3% among HIV-negative and from 75.0% to 53.5% among HIV-positive participants, the percentage knowing their partner(s)' HIV status increased from 18.7% to 34.3% of HIV-negative and from 14.3% to 35.7% of HIV-positive participants. Among those reporting risky sex at baseline, HIV-positive participants were more likely to eliminate risky sex in general and specifically to become abstinent at follow-up than were HIV-negative participants. Similarly, unmarried participants who were risky at baseline were more likely to become safe in general, become abstinent, and start 100% condom use than were married/cohabitating participants. Rates of disclosure were high. Over 85% of those who tested HIV positive enrolled in care. Routine HIV testing in this setting may promote earlier HIV diagnosis and access to care but leads to only modest reductions in risky sexual behavior. To fully realize the potential HIV prevention benefits of routine HIV testing an emphasis on tailored risk-reduction counseling may be necessary.

The "aid contract" and its compensation scheme: a case study of the performance of the Ugandan health sector.

PubMed

Oliveira Cruz, Valeria; McPake, Barbara

2010-10-01

Current literature on aid effectiveness describes increasing use of a more contractual approach to the relationship between donor and recipient government in which a system of rewards and penalties for good and bad performance operates. The purpose of this case study of the Ugandan health sector was to understand the extent to which this approach is influencing processes and effectiveness. This qualitative study used a conceptual framework based on agency theory and 'realistic evaluation'. Our results showed that the main official mechanism to assess and reward performance established through the Sector Wide Approach lacked objective criteria and was based on an unstructured system of discussions and agreements among donors. The achievement of a satisfactory performance rating was facilitated by the agreeing to undertakings that were under-demanding, vaguely formulated and lacking quantitative benchmarks against which progress could be measured. However, even when poor performance was readily observable, penalties failed to be applied by donors. This was always the case in relation to health sector performance and mostly so in relation to general governance and accountability. Funds continued to be disbursed despite the lack of progress made in achieving targets and undertakings and other evident performance problems (e.g. in the area of governance). A series of explanations of the failure to penalise were put forward by donor representatives in relation to this behaviour including the need to maintain long-term relationships based on trust and not to undermine health sector performance by withdrawing aid. Thus there are likely to be incentives to disburse funds and report success, irrespective of the realities of aid programmes in the context of large foreign aid volumes associated with increased political visibility of aid in donor countries.

Comparison of sexual behavior and HIV risk between two HIV-1 serodiscordant couple cohorts: the CHAVI 002 study.

PubMed

Ritchie, Adam J; Kuldanek, Kristin; Moodie, Zoe; Wang, Z Maggie; Fox, Julie; Nsubuga, Rebecca N; Legg, Kenneth; Birabwa, Esther F; Kaleebu, Pontiano; McMichael, Andrew J; Watera, Christine; Goonetilleke, Nilu; Fidler, Sarah

2012-01-01

The CHAVI002 study was designed to characterize immune responses, particularly HIV-specific T-cell responses, amongst 2 cohorts of HIV-exposed seronegative (HESN) individuals. The absence of a clear definition of HESNs has impaired comparison of research within and between such cohorts. This report describes two distinct HESN cohorts and attempts to quantify HIV exposure using a 'HIV risk index' (RI) model. HIV serodiscordant couples (UK; 24, Uganda; 72) and HIV unexposed seronegative (HUSN) controls (UK; 14, Uganda; 26 couples, 3 individuals) completed sexual behavior questionnaires every 3 months over a 9 month period. The two cohorts were heterogeneous, with most HESNs in the UK men who have sex with men (MSM), while all HESNs in Uganda were in heterosexual relationships. Concordance of responses between partners was determined. Each participant's sexual behavior score (SBS) was estimated based on the number and type of unprotected sex acts carried out in defined time periods. Independent HIV acquisition risk factors (partner plasma viral load, STIs, male circumcision, pregnancy) were integrated with the SBS, generating a RI for each HESN. 96 HIV serodiscordant couples completed 929 SBQs. SBSs remained relatively stable amongst the UK cohort, whilst decreasing from Visit 1 to 2 in the Ugandan cohort. Compared to the Ugandan cohort, SBSs and RIs in the UK cohort were lower at visit 1, and generally higher at later visits. Differences between the cohorts, with lower rates of ART use in Uganda and higher risk per-act sex in the UK, had major impacts on the SBSs and RIs of each cohort. There was one HIV transmission event in the UK cohort. Employment of a risk quantification model facilitated quantification and comparison of HIV acquisition risk across two disparate HIV serodiscordant couple cohorts.

Herbal medicine use and linked suspected adverse drug reactions in a prospective cohort of Ugandan inpatients.

PubMed

Kiguba, Ronald; Ononge, Sam; Karamagi, Charles; Bird, Sheila M

2016-05-26

Clinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients. We sought to identify herbal medicines nominated by Ugandan inpatients; compare nomination rates by ward and gender; confirm the herbs' known pharmacological properties from published literature; and identify ADRs linked to pre-admission use of herbal medicines. Prospective cohort of consented adult inpatients designed to assess medication use and ADRs on one gynaecological and three medical wards of 1790-bed Mulago National Referral Hospital. Baseline and follow-up data were obtained on patients' characteristics, including pre-admission use of herbal medicines. Fourteen percent (26/191) of females in Gynaecology nominated at least one specific herbal medicine compared with 20 % (114/571) of inpatients on medical wards [20 % (69/343) of females; 20 % (45/228) of males]. Frequent nominations were Persea americana (30), Mumbwa/multiple-herb clay rods (23), Aloe barbadensis (22), Beta vulgaris (12), Vernonia amygdalina (11), Commelina africana (7), Bidens pilosa (7), Hoslundia opposita (6), Mangifera indica (4), and Dicliptera laxata (4). Four inpatients experienced 10 suspected ADRs linked to pre-admission herbal medicine use including Commelina africana (4), multiple-herb-mumbwa (1), or unspecified local-herbs (5): three ADR-cases were abortion-related and one kidney-related. The named herbal medicines and their nomination rates generally differed by specialized ward, probably guided by local folklore knowledge of their use. Clinical elicitation from inpatients can generate valuable safety data on herbal medicine use. However, larger routine studies might increase the utility of our method to assess herbal medicine use and detect herb-linked ADRs. Future studies should take testable samples of ADR-implicated herbal medicines for further analysis.

The clinical presentation and early outcomes of necrotizing fasciitis in a Ugandan Tertiary Hospital--a prospective study.

PubMed

Magala, John; Makobore, Patson; Makumbi, Timothy; Kaggwa, Sam; Kalanzi, Edris; Galukande, Moses

2014-07-28

Necrotizing fasciitis is an infectious process characterized by rapidly progressing necrosis of superficial fascia and subcutaneous tissue with subsequent necrosis of overlying skin.Necrotizing fasciitis is a rare but fatal infection. The worldwide incidence is at 0.4 per 100,000. Mortality is up to 80% with no intervention, and 30-50% with intervention. Delay in intervention is associated with poor outcome. The risk factors for necrotizing fasciitis are diabetes mellitus, HIV, malignancy, illicit drug use, malnutrition among others.The aim of this study was to describe the clinical presentation and early outcomes of necrotizing fasciitis amongst Ugandan patients. A prospective descriptive case series study conducted at Mulago National Referral and Teaching hospital from 5th January to 30th April 2011. Patients with necrotizing fasciitis were consecutively recruited after clinical evaluation, laboratory and microbiological tests were performed. Aggressive debridement was done and broad-spectrum antibiotics administered. Patients were followed up on surgical wards. Ethical approval was obtained. Thirty five patients were recruited over a 4 months period. More males were affected with, M: F 3:1. The 20-40 years age group was most affected. Attainment of healthy granulation tissue took 19 days on average. Mortality rate was 14% (5/35). Limbs were the most affected body parts 20/35 (57%), the scrotum and perineum (23%). Among infants the scalp was the most affected. Co-morbidities included HIV 8/35 (17%), and DM (5%) among others. The commonest organisms were gram negative. Split skin grafting was necessary in 74% (26/35) of patients. There were a high number of patients with necrotizing fasciitis; it was associated with low mortality but high morbidity (long hospital stay). There was a high preponderance to males and limbs were the more affected body parts.

Speech characteristics in a Ugandan child with a rare paramedian craniofacial cleft: a case report.

PubMed

Van Lierde, K M; Bettens, K; Luyten, A; De Ley, S; Tungotyo, M; Balumukad, D; Galiwango, G; Bauters, W; Vermeersch, H; Hodges, A

2013-03-01

The purpose of this study is to describe the speech characteristics in an English-speaking Ugandan boy of 4.5 years who has a rare paramedian craniofacial cleft (unilateral lip, alveolar, palatal, nasal and maxillary cleft, and associated hypertelorism). Closure of the lip together with the closure of the hard and soft palate (one-stage palatal closure) was performed at the age of 5 months. Objective as well as subjective speech assessment techniques were used. The speech samples were perceptually judged for articulation, intelligibility and nasality. The Nasometer was used for the objective measurement of the nasalance values. The most striking communication problems in this child with the rare craniofacial cleft are an incomplete phonetic inventory, a severely impaired speech intelligibility with the presence of very severe hypernasality, mild nasal emission, phonetic disorders (omission of several consonants, decreased intraoral pressure in explosives, insufficient frication of fricatives and the use of a middorsum palatal stop) and phonological disorders (deletion of initial and final consonants and consonant clusters). The increased objective nasalance values are in agreement with the presence of the audible nasality disorders. The results revealed that several phonetic and phonological articulation disorders together with a decreased speech intelligibility and resonance disorders are present in the child with a rare craniofacial cleft. To what extent a secondary surgery for velopharyngeal insufficiency, combined with speech therapy, will improve speech intelligibility, articulation and resonance characteristics is a subject for further research. The results of such analyses may ultimately serve as a starting point for specific surgical and logopedic treatment that addresses the specific needs of children with rare facial clefts. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Feasibility and acceptability of mobile phone short message service as a support for patients receiving antiretroviral therapy in rural Uganda: a cross-sectional study.

PubMed

Kim, Jiho; Zhang, Wendy; Nyonyitono, Maureen; Lourenco, Lillian; Nanfuka, Mastula; Okoboi, Stephen; Birungi, Josephine; Lester, Richard T; Kaleebu, Pontiano; Munderi, Paula; Moore, David M

2015-01-01

Mobile phone technologies have been promoted to improve adherence to antiretroviral therapy (ART). We studied the receptiveness of patients in a rural Ugandan setting to the use of short messaging service (SMS) communication for such purposes. We performed a cross-sectional analysis measuring mobile phone ownership and literacy amongst patients of The AIDS Support Organisation (TASO) in Jinja, Uganda. We performed bivariate and multivariate logistic regression analyses to examine associations between explanatory variables and a composite outcome of being literate and having a mobile phone. From June 2012 to August 2013, we enrolled 895 participants, of whom 684 (76%) were female. The median age was 44 years. A total of 576 (63%) were both literate and mobile phone users. Of these, 91% (527/ 576) responded favourably to the potential use of SMS for health communication, while only 38.9% (124/319) of others were favourable to the idea (p<0.001). A lower proportion of literate mobile phone users reported optimal adherence to ART (86.4% vs. 90.6%; p=0.007). Male participants (AOR=2.81; 95% CI 1.83-4.30), sub-optimal adherence (AOR=1.76; 95% CI 1.12-2.77), those with waged or salaried employment (AOR=2.35; 95% CI 1.23-4.49), crafts/trade work (AOR=2.38; 95% CI 1.11-5.12), or involved in petty trade (AOR=1.85; 95% CI 1.09-3.13) (in comparison to those with no income) were more likely to report mobile phone ownership and literacy. In a rural Ugandan setting, we found that over 60% of patients could potentially benefit from a mobile phone-based ART adherence support. However, support for such an intervention was lower for other patients.

Petrogenesis of strongly alkaline primitive volcanic rocks at the propagating tip of the western branch of the East African Rift

NASA Astrophysics Data System (ADS)

Rosenthal, A.; Foley, S. F.; Pearson, D. G.; Nowell, G. M.; Tappe, S.

2009-06-01

Strongly silica-undersaturated potassic lavas (kamafugites) and carbonatitic tuffs are characteristic of the Toro-Ankole volcanic field in southwestern Uganda, forming the youngest and most northward volcanics of the western branch of the East African Rift. Lavas contain exceptionally low SiO 2 (31.8-42.8 wt.%), high CaO (up to 16.6 wt.%) and K 2O (up to 7 wt.%). They exhibit moderately enriched correlated Nd ( ɛNd - 0.1 to - 4.7) and Hf ( ɛHf - 0.1 to - 8.8) isotope signatures, indicating time-integrated enrichment in incompatible elements in the source, attributed to mixing between two metasomatic assemblages, a phlogopite-rich MARID-type and a later carbonate-rich assemblage. The restricted range of 87Sr/ 86Sr (0.704599-0.705402) is due to Sr being dominated by the carbonate-rich assemblage, which also imparts a Nd and Hf signature similar to convecting upper mantle. Os isotopes ( γOs up to 290 and variable Os concentrations of 0.056-1.454 ppb) are curved due to mixing between the carbonate-rich metasome and a second end-member that may be derived from melting peridotite, the MARID assemblage, or a mixture of both. Enrichment of the peridotitic mantle in carbonate and silicate melts at 4-6 GPa occurs also in other areas where geochemically similar ultramafic lamprophyres result. The Ugandan kamafugites thus represent the earliest and deepest-derived magmas in a rift through thick continental lithosphere beneath the continuous Congo-Tanzania craton. The Ugandan rift-related mantle enrichment is older than the earliest known tectonic surface expression of the rift.

Demographic, Socioeconomic, and Geographic Factors Leading to Severe Malaria and Delayed Care Seeking in Ugandan Children: A Case-Control Study.

PubMed

Mpimbaza, Arthur; Ndeezi, Grace; Katahoire, Anne; Rosenthal, Philip J; Karamagi, Charles

2017-11-01

We studied associations between delayed care seeking, demographic, socioeconomic, and geographic factors and likelihood of severe malaria in Ugandan children. The study was based at Jinja Hospital, Uganda. We enrolled 325 severe malaria cases and 325 uncomplicated malaria controls matched by age and residence. Patient details, an itinerary of events in response to illness, household information, and location of participants' residences were captured. Conditional logistic regression was used to determine risk factors for severe malaria and delayed care seeking. Delayed care seeking (≥ 24 hours after fever onset; odds ratio [OR] 5.50; 95% confidence interval [CI] 2.70, 11.1), seeking care at a drug shop as the initial response to illness (OR 3.62; 95% CI 1.86, 7.03), and increasing distance from place of residence to the nearest health center (OR 1.45; 95% CI 1.17, 1.79) were independent risk factors for severe malaria. On subgroup analysis, delayed care seeking was a significant risk factor in children with severe malaria attributable to severe anemia (OR 15.6; 95% CI 3.02, 80.6), but not unconsciousness (OR 1.13; 95% CI 0.30, 4.28). Seeking care at a drug shop (OR 2.84; 95% CI 1.12, 7.21) and increasing distance to the nearest health center (OR 1.18; 95% CI 1.01, 1.37) were independent risk factors for delayed care seeking. Delayed care seeking and seeking care at a drug shop were risk factors for severe malaria. Seeking care at a drug shop was also a predictor of delayed care seeking. The role of drug shops in contributing to delayed care and risk of severe malaria requires further study.

Validity and Reliability of General Nutrition Knowledge Questionnaire for Adults in Uganda

PubMed Central

Bukenya, Richard; Ahmed, Abhiya; Andrade, Jeanette M.; Grigsby-Toussaint, Diana S.; Muyonga, John; Andrade, Juan E.

2017-01-01

This study sought to develop and validate a general nutrition knowledge questionnaire (GNKQ) for Ugandan adults. The initial draft consisted of 133 items on five constructs associated with nutrition knowledge; expert recommendations (16 items), food groups (70 items), selecting food (10 items), nutrition and disease relationship (23 items), and food fortification in Uganda (14 items). The questionnaire validity was evaluated in three studies. For the content validity (study 1), a panel of five content matter nutrition experts reviewed the GNKQ draft before and after face validity. For the face validity (study 2), head teachers and health workers (n = 27) completed the questionnaire before attending one of three focus groups to review the clarity of the items. For the construct and test-rest reliability (study 3), head teachers (n = 40) from private and public primary schools and nutrition (n = 52) and engineering (n = 49) students from Makerere University took the questionnaire twice (two weeks apart). Experts agreed (content validity index, CVI > 0.9; reliability, Gwet’s AC1 > 0.85) that all constructs were relevant to evaluate nutrition knowledge. After the focus groups, 29 items were identified as unclear, requiring major (n = 5) and minor (n = 24) reviews. The final questionnaire had acceptable internal consistency (Cronbach α > 0.95), test-retest reliability (r = 0.89), and differentiated (p < 0.001) nutrition knowledge scores between nutrition (67 ± 5) and engineering (39 ± 11) students. Only the construct on nutrition recommendations was unreliable (Cronbach α = 0.51, test-retest r = 0.55), which requires further optimization. The final questionnaire included topics on food groups (41 items), selecting food (2 items), nutrition and disease relationship (14 items), and food fortification in Uganda (22 items) and had good content, construct, and test-retest reliability to evaluate nutrition knowledge among Ugandan adults. PMID:28230779

Sugar snack consumption in Ugandan schoolchildren: Validity and reliability of a food frequency questionnaire.

PubMed

Kiwanuka, S N; Astrøm, A N; Trovik, T A

2006-10-01

This study assessed the reproducibility and relative validity of an eight-item self-administered food frequency questionnaire (FFQ) on intake of sugared snacks in Ugandan schoolchildren. A 5-day precoded food behaviour checklist (FBC) was used as validation criteria. Sociodemographic correlates of a sum frequency sugar score were explored. The study was conducted in Kampala, Uganda, in 2004. Six hundred and fourteen schoolchildren (mean age 12.4 years) completed the FFQ on cakes/biscuits, chocolate, ice sticks, soft drinks, coffee, tea, sugared desserts and sweets/candies at school. They were examined clinically for dental caries. Forty students completed the FFQ twice, 1 week apart and 325 students completed the 5 day FBC at school. The mean decayed, missing and filled tooth index score was 0.98 (SD 1.6, range 0-15). Reproducibility scores (Cohen's kappa) for the sugar items ranged from 0.17 (ice sticks) to 0.55 (biscuits). No differences were seen between the average intakes at test and retest. Higher intake was reported in FFQ than in FBC across all sugar items. Crude agreement between students reporting intake at least 3-5 times a week/less than three times a week ranged from 50% to 55% (e.g. biscuits, chocolate) to 87% (tea). Spearman's correlation coefficients ranged from 0.14 (desserts) to 0.27 (sweets). anova revealed significant increase (P = 0.001) in the mean FBC sum scores by increasing quartiles of the FFQ sum scores. The average sum FFQ sugar scores were higher in girls than in boys and higher in older than in younger students. Fair reproducibility was established for the FFQ sugar items. The FFQ was acceptable in classifying individuals into broad categories of low and high sugar consumption.

"I beg you…breastfeed the baby, things changed": infant feeding experiences among Ugandan mothers living with HIV in the context of evolving guidelines to prevent postnatal transmission.

PubMed

Dunkley, Emma; Ashaba, Scholastic; Burns, Bridget; O'Neil, Kasey; Sanyu, Naomi; Akatukwasa, Cecilia; Kastner, Jasmine; Berry, Nicole S; Psaros, Christina; Matthews, Lynn T; Kaida, Angela

2018-01-29

For women living with HIV (WLWH) in low- and middle-income countries, World Health Organization (WHO) infant feeding guidelines now recommend exclusive breastfeeding until six months followed by mixed feeding until 24 months, alongside lifelong maternal antiretroviral therapy (ART). These recommendations represent the sixth major revision to WHO infant feeding guidelines since 1992. We explored how WLWH in rural Uganda make infant feeding decisions in light of evolving recommendations. We conducted semi-structured interviews with 20 postpartum Ugandan WLWH accessing ART, who reported pregnancy < 2 years prior to recruitment. Interviews were conducted between February-August 2014 with babies born between March 2012-October 2013, over which time, the regional HIV treatment clinic recommended lifelong ART for all pregnant and breastfeeding women (Option B+). Content analysis was used to identify major themes. Infant feeding experiences was an emergent theme. NVivo 10 software was used to organize analyses. Among 20 women, median age was 33 years [IQR: 28-35], number of livebirths was 3 [IQR: 2-5], years on ART was 2.3 [IQR: 1.5-5.1], and 95% were virally suppressed. Data revealed that women valued opportunities to reduce postnatal transmission. However, women made infant feeding choices that differed from recommendations due to: (1) perception of conflicting recommendations regarding infant feeding; (2) fear of prolonged infant HIV exposure through breastfeeding; and (3) social and structural constraints shaping infant feeding decision-making. WLWH face layered challenges navigating evolving infant feeding recommendations. Further research is needed to examine guidance and decision-making on infant feeding choices to improve postpartum experiences and outcomes. Improved communication about changes to recommendations is needed for WLWH, their partners, community members, and healthcare providers.

Apparently-Different Clearance Rates from Cohort Studies of Mycoplasma genitalium Are Consistent after Accounting for Incidence of Infection, Recurrent Infection, and Study Design.

PubMed

Smieszek, Timo; White, Peter J

2016-01-01

Mycoplasma genitalium is a potentially major cause of urethritis, cervicitis, pelvic inflammatory disease, infertility, and increased HIV risk. A better understanding of its natural history is crucial to informing control policy. Two extensive cohort studies (students in London, UK; Ugandan sex workers) suggest very different clearance rates; we aimed to understand the reasons and obtain improved estimates by making maximal use of the data from the studies. As M. genitalium is a sexually-transmitted infectious disease, we developed a model for time-to-event analysis that incorporates the processes of (re)infection and clearance, and fitted to data from the two cohort studies to estimate incidence and clearance rates under different scenarios of sexual partnership dynamics and study design (including sample handling and associated test sensitivity). In the London students, the estimated clearance rate is 0.80 p.a. (mean duration 15 months), with incidence 1.31%-3.93% p.a. Without adjusting for study design, corresponding estimates from the Ugandan data are 3.44 p.a. (mean duration 3.5 months) and 58% p.a. Apparent differences in clearance rates are probably mostly due to lower testing sensitivity in the Uganda study due to differences in sample handling, with 'true' clearance rates being similar, and adjusted incidence in Uganda being 28% p.a. Some differences are perhaps due to the sex workers having more-frequent antibiotic treatment, whilst reinfection within ongoing sexual partnerships might have caused some of the apparently-persistent infection in the London students. More information on partnership dynamics would inform more accurate estimates of natural-history parameters. Detailed studies in men are also required.

Bigger expenditure on health required.

PubMed

1994-01-01

The most serious health problem in Uganda is AIDS, and prevalence rates range from 2% in remote areas to 30% in cities. AIDS is often seen in infants who were infected by their mothers and who generally die by age 5. The disease is rare in children between age 5 and 14 years, at which time sexual activity begins and infection occurs. By 1993, approximately 115,000 children in Uganda had been orphaned by AIDS. Because of widespread poverty, orphans are at jeopardy for malnutrition and reduced educational opportunities. The health infrastructure, hampered by low spending and an emphasis on curative rather than preventative measures, has been seriously overburdened by the AIDS crisis. The economy has also been affected, since AIDS has taken a particularly heavy toll on those 15-40 years old upon whom economic activities, such as labor intensive farming and growing cash crops, depends. Investments in other areas are in jeopardy also as highly trained professionals leave work to care for the sick or become sick themselves. Declines in domestic income and savings have repercussions throughout the national economy. Widespread poverty also exacerbates the AIDS crisis, especially since poverty drives individuals into adopting risk-taking behavior such as prostitution. Domestic violence has also increased as wives have refused to have sexual intercourse with husbands whom they believe have HIV infections. In order to deal with this crisis, the entire Ugandan society must be mobilized. Alternative sources of income must be sought for the poor, income-generating activities must be available to AIDS patients and their families, health care expenditures must increase, and home-based health care should be promoted. It is absolutely urgent for Ugandans to translate their knowledge about the causes of AIDS into changes in their sexual behavior which will protect them from the disease.

PREVALENCE AND RISK FACTORS ASSOCIATED WITH HEMOPARASITES IN CATTLE AND GOATS AT THE EDGE OF KIBALE NATIONAL PARK, WESTERN UGANDA

PubMed Central

Weny, Geoffrey; Okwee-Acai, James; Okech, Samuel George; Tumwine, Gabriel; Ndyanabo, Susan; Abigaba, Salvatory; Goldberg, Tony L.

2018-01-01

Livestock production is a major sector of the Ugandan economy. Ugandan ruminant livestock (principally cattle and goats) are susceptible to hemoparasites that can cause serious clinical disease and production losses. Kibale National Park, in western Uganda, is a protected forest ecosystem surrounded by small-scale farms where cattle and goats are raised. We conducted a cross-sectional study of cattle and goats in this area and diagnosed hemoparasite infections by microscopy. We collected data on animal characteristics and management practices to assess risk factors associated with infection. We studied 186 cattle and 317 goats from 20 villages, including 16 villages directly adjacent to Kibale and 4 villages ≥ 3 km from the park boundary. Hemoparasites detected in cattle and goats were of the genera Theileria, Anaplasma, and Trypanosoma with a prevalence of 15.1%, 1.6%, and 4.3% respectively in cattle, and 10%, 6.0%, and 0.0%, respectively in goats. Trypanosomes infected approximately 8% of cattle in villages bordering Kibale but were never detected in cattle in “control” villages ≥3 km from the park. Trypanosomes were approximately 7 times more likely to infect animals in households that did not provide veterinary care to their animals than in households that provided routine veterinary care. Within cattle, Theileria infections were approximately 7 times more likely to occur in cross-bred cattle than in indigenous pure breeds. Anaplasma infections were approximately 3.5 times more likely to occur in cattle than in goats (no goats were diagnosed with Trypanosoma infection). These data suggest that proximity to the park, provision of veterinary care, and breed are significant risk factors for hemoparasites in this population of ruminants, and that, in general, cattle are more susceptible than goats. PMID:27611655

Prevalence and Risk Factors Associated with Hemoparasites in Cattle and Goats at the Edge of Kibale National Park, Western Uganda.

PubMed

Weny, Geoffrey; Okwee-Acai, James; Okech, Samuel George; Tumwine, Gabriel; Ndyanabo, Susan; Abigaba, Salvatory; Goldberg, Tony L

2017-02-01

Livestock production is a major sector of the Ugandan economy. Ugandan ruminant livestock (principally cattle and goats) are susceptible to hemoparasites that can cause serious clinical disease and production losses. Kibale National Park, in western Uganda, is a protected forest ecosystem surrounded by small-scale farms where cattle and goats are raised. We conducted a cross-sectional study of cattle and goats in this area and diagnosed hemoparasite infections by microscopy. We collected data on animal characteristics and management practices to assess risk factors associated with infection. We studied 186 cattle and 317 goats from 20 villages, including 16 villages directly adjacent to Kibale and 4 villages ≥3 km from the park boundary. Hemoparasites detected in cattle and goats were of the genera Theileria, Anaplasma, and Trypanosoma with a prevalence of 15.1%, 1.6%, and 4.3% respectively in cattle, and 10%, 6.0%, and 0.0%, respectively in goats. Trypanosomes infected approximately 8% of cattle in villages bordering Kibale but were never detected in cattle in "control" villages ≥3 km from the park. Trypanosomes were approximately 7 times more likely to infect animals in households that did not provide veterinary care to their animals than in households that provided routine veterinary care. Within cattle, Theileria infections were approximately 7 times more likely to occur in cross-bred cattle than in indigenous pure breeds. Anaplasma infections were approximately 3.5 times more likely to occur in cattle than in goats (no goats were diagnosed with Trypanosoma infection). These data suggest that proximity to the park, provision of veterinary care, and breed are significant risk factors for hemoparasites in this population of ruminants, and that, in general, cattle are more susceptible than goats.

Case Management of Severe Malaria - A Forgotten Practice: Experiences from Health Facilities in Uganda

PubMed Central

Achan, Jane; Tibenderana, James; Kyabayinze, Daniel; Mawejje, Henry; Mugizi, Rukaaka; Mpeka, Betty; Talisuna, Ambrose; D'Alessandro, Umberto

2011-01-01

Introduction Severe malaria is a life-threatening medical emergency and requires prompt and effective treatment to prevent death. There is paucity of published information on current practices of severe malaria case management in sub-Saharan Africa; we evaluated the management practices for severe malaria in Ugandan health facilities Methods and Findings We did a cross sectional survey, using multi-stage sampling methods, of health facilities in 11 districts in the eastern and mid-western parts of Uganda. The study instruments were adapted from the WHO hospital care assessment tools. Between June and August 2009, 105 health facilities were surveyed and 181 health workers and 868 patients/caretakers interviewed. None of the inpatient facilities had all seven components of a basic care package for the management of severe malaria consistently available during the 3 months prior to the survey. Referral practices were appropriate for <10% (18/196) of the patients. Prompt care at any health facility was reported by 29% (247/868) of patients. Severe malaria was correctly diagnosed in 27% of patients (233).Though the quinine dose and regimen was correct in the majority (611/868, 70.4%) of patients, it was administered in the correct volumes of 5% dextrose in only 18% (147/815). Most patients (80.1%) had several doses of quinine administered in one single 500 ml bottle of 5% dextrose. Medications were purchased by 385 (44%) patients and medical supplies by 478 patients (70.6%). Conclusions Management of severe malaria in Ugandan health facilities was sub-optimal. These findings highlight the challenges of correctly managing severe malaria in resource limited settings. Priority areas for improvement include triage and emergency care, referral practises, quality of diagnosis and treatment, availability of medicines and supplies, training and support supervision. PMID:21390301

Comparison of maternal milk (breastmilk) expression methods in an African nursery.

PubMed

Slusher, Tina M; Slusher, Ida L; Keating, Elizabeth M; Curtis, Beverly A; Smith, Eleanor A; Orodriyo, Elizabeth; Awori, Sussane; Nakakeeto, Margaret K

2012-04-01

This study compares maternal milk volumes (MMVs) of Ugandan mothers whose infants were in a special care nursery and who used one of three maternal milk expression techniques: double electric breast pump, single non-electric manual breast pump, and hand breastmilk expression. A convenience sample of 161 Ugandan mothers of infants who were either too immature or ill to independently feed from the breast yet healthy enough to survive in an environment without ventilator support (birth weights, 0.84-3.8 kg) were assigned to one of three maternal milk expressions: Group 1, double electric breast pump (n=55); Group 2, single non-electric manual breast pump (n=59); and Group 3, hand breastmilk expression (n=47). Data were collected over a 7-day period (from day 1 postpartum to day 7 postpartum), and mean MMVs were measured and compared among the groups. The mean daily MMVs were as follows: Group 1, mean=647 mL (SD=310); Group 2, mean=520 mL (SD=298); and Group 3, mean=434 mL (SD=291). Results from one-way analysis of variance revealed significant differences in the mean MMV based on the method of maternal milk expression (p=0.0019). Further analysis using Tukey's HSD Test revealed significant differences in the MMV between Groups 1 and 3 (p < 0.01), but not between Groups 1 and 2 or between Groups 2 and 3. Electric breast pumps provided the highest mean MMV; however, many mothers obtained adequate feeding volumes for their infants' daily nutritional needs with the single non-electric manual breast pump and hand breastmilk expression.

Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers

PubMed Central

Finocchario-Kessler, Sarah; Staggs, Vincent; Woldetsadik, Mahlet Atakilt; Wanyenze, Rhoda K.; Beyeza-Kashesya, Jolly; Mindry, Deborah; Khanakwa, Sarah; Wagner, Glenn J.

2015-01-01

Abstract High rates of childbearing desires (59%) and serodiscordant partnerships (50%) among people living with HIV (PHLA) in Uganda highlight the need for safer conception counseling (SCC). Provider attitudes about counseling PLHA on the use of safer conception methods (SCM) have been explored in qualitative studies, but published quantitative investigations are scarce. Data from 57 Ugandan providers were collected to examine providers' attitudes about childbearing among PLHA and engagement in discussions about childbearing, as well as their knowledge, interest, self-efficacy, and intentions to provide SCC. Correlates of self-efficacy for the provision of SCC were explored to inform the development of training programs. Providers reported a general awareness of most SCM, especially timed unprotected intercourse (TUI); but just over half felt they knew enough to counsel clients in the future and all wanted more training. Childbearing was discussed with less than a third of reproductive aged patients and was mostly initiated by patients. Most providers saw value in providing SCC and believed that most aspects of SCM would be acceptable to their clients, but numerous barriers were endorsed. Self-efficacy was greatest among providers who had had more childbearing conversations, greater SCM awareness, perceived fewer barriers and greater intentions to counsel on TUI. Providers evidence fewer stigmatizing attitudes than in the past. However, those who endorsed more stigmatizing attitudes evidenced a trend for reporting lower self-efficacy for providing SCC. Training will need to simultaneously focus on increasing providers' SCC knowledge and skills while instilling a more realistic appraisal of the risks of assisting couples to employ SCM versus doing nothing. PMID:26588429

Reducing Physical Violence Toward Primary School Students With Disabilities.

PubMed

Devries, Karen; Kuper, Hannah; Knight, Louise; Allen, Elizabeth; Kyegombe, Nambusi; Banks, Lena Morgon; Kelly, Susan; Naker, Dipak

2018-03-01

We tested whether the Good School Toolkit reduces physical violence from peers and school staff toward students with and without disabilities in Ugandan primary schools. We conducted a cluster randomized controlled trial, with data collected via cross-sectional surveys in 2012 and 2014. Forty-two primary schools in Luwero District, Uganda, were randomly assigned to receive the Good School Toolkit for 18 months, or to a waitlisted control group. The primary outcome was past week physical violence from school staff, measured by primary 5, 6, and 7 students' (aged 11-14 years) self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. Disability was assessed through the six Short Set Washington Group questions on functioning. Analyses were by intention to treat. At endline, 53% of control group students with no functional difficulties reported violence from peers or school staff, versus 84% of students with a disability. Prevalence of past week physical violence from school staff was lower in intervention schools than in the control schools after the intervention, in students with no functional difficulties (adjusted odds ratio [aOR] = .41, 95% confidence interval [CI .26-.65]), students with some functional difficulties (aOR = .36, 95% CI .21-.63), and students with disabilities (aOR = .29, 95% CI .14-.59). The intervention also reduced violence from peers in young adolescents, with no evidence of a difference in effect by disability status. The Good School Toolkit is an effective intervention to reduce violence perpetrated by peers and school staff against young adolescents with disabilities in Ugandan primary schools. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Validity and diagnostic accuracy of the Luganda version of the 9-item and 2-item Patient Health Questionnaire for detecting major depressive disorder in rural Uganda.

PubMed

Nakku, J E M; Rathod, S D; Kizza, D; Breuer, E; Mutyaba, K; Baron, E C; Ssebunnya, J; Kigozi, F

2016-01-01

The prevalence of depression in rural Ugandan communities is high and yet detection and treatment of depression in the primary care setting is suboptimal. Short valid depression screening measures may improve detection of depression. We describe the validation of the Luganda translated nine- and two-item Patient Health Questionnaires (PHQ-9 and PHQ-2) as screening tools for depression in two rural primary care facilities in Eastern Uganda. A total of 1407 adult respondents were screened consecutively using the nine-item Luganda PHQ. Of these 212 were randomly selected to respond to the Mini International Neuropsychiatric Interview diagnostic questionnaire. Descriptive statistics for respondents' demographic characteristics and PHQ scores were generated. The sensitivity, specificity and positive predictive values (PPVs), and area under the ROC curve were determined for both the PHQ-9 and PHQ-2. The optimum trade-off between sensitivity and PPV was at a cut-off of ≧5. The weighted area under the receiver Operating Characteristic curve was 0.74 (95% CI 0.60-0.89) and 0.68 (95% CI 0.54-0.82) for PHQ-9 and PHQ-2, respectively. The Luganda translation of the PHQ-9 was found to be modestly useful in detecting depression. The PHQ-9 performed only slightly better than the PHQ-2 in this rural Ugandan Primary care setting. Future research could improve on diagnostic accuracy by considering the idioms of distress among Luganda speakers, and revising the PHQ-9 accordingly. The usefulness of the PHQ-2 in this rural population should be viewed with caution.

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.

“People will say that I am proud”: a qualitative study of barriers to bed net use away from home in four Ugandan districts

PubMed Central

2014-01-01

Background Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. Methods To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. Results In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Conclusions Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious “crusades” where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective. PMID:24602371

Cerebrospinal fluid kynurenine and kynurenic acid concentrations are associated with coma duration and long-term neurocognitive impairment in Ugandan children with cerebral malaria.

PubMed

Holmberg, Dag; Franzén-Röhl, Elisabeth; Idro, Richard; Opoka, Robert O; Bangirana, Paul; Sellgren, Carl M; Wickström, Ronny; Färnert, Anna; Schwieler, Lilly; Engberg, Göran; John, Chandy C

2017-07-28

One-fourth of children with cerebral malaria (CM) retain cognitive sequelae up to 2 years after acute disease. The kynurenine pathway of the brain, forming neuroactive metabolites, e.g. the NMDA-receptor antagonist kynurenic acid (KYNA), has been implicated in long-term cognitive dysfunction in other CNS infections. In the present study, the association between the kynurenine pathway and neurologic/cognitive complications in children with CM was investigated. Cerebrospinal fluid (CSF) concentrations of KYNA and its precursor kynurenine in 69 Ugandan children admitted for CM to Mulago Hospital, Kampala, Uganda, between 2008 and 2013 were assessed. CSF kynurenine and KYNA were compared to CSF cytokine levels, acute and long-term neurologic complications, and long-term cognitive impairments. CSF kynurenine and KYNA from eight Swedish children without neurological or infectious disease admitted to Astrid Lindgren's Children's Hospital were quantified and used for comparison. Children with CM had significantly higher CSF concentration of kynurenine and KYNA than Swedish children (P < 0.0001 for both), and CSF kynurenine and KYNA were positively correlated. In children with CM, CSF kynurenine and KYNA concentrations were associated with coma duration in children of all ages (P = 0.003 and 0.04, respectively), and CSF kynurenine concentrations were associated with worse overall cognition (P = 0.056) and attention (P = 0.003) at 12-month follow-up in children ≥5 years old. CSF KYNA and kynurenine are elevated in children with CM, indicating an inhibition of glutamatergic and cholinergic signaling. This inhibition may lead acutely to prolonged coma and long-term to impairment of attention and cognition.

Admission EEG findings in diverse paediatric cerebral malaria populations predict outcomes.

PubMed

Postels, Douglas G; Wu, Xiaoting; Li, Chenxi; Kaplan, Peter W; Seydel, Karl B; Taylor, Terrie E; Kousa, Youssef A; Idro, Richard; Opoka, Robert; John, Chandy C; Birbeck, Gretchen L

2018-05-22

Electroencephalography at hospital presentation may offer important insights regarding prognosis that can inform understanding of cerebral malaria (CM) pathophysiology and potentially guide patient selection and risk stratification for future clinical trials. Electroencephalogram (EEG) findings in children with CM in Uganda and Malawi were compared and associations between admission EEG findings and outcome across this diverse population were assessed. Demographic, clinical and admission EEG data from Ugandan and Malawian children admitted from 2009 to 2012 with CM were gathered, and survivors assessed for neurological abnormalities at discharge. 281 children were enrolled (Uganda n = 122, Malawi n = 159). The Malawian population was comprised only of retinopathy positive children (versus 72.5% retinopathy positive in Uganda) and were older (4.2 versus 3.7 years; p = 0.046), had a higher HIV prevalence (9.0 versus 2.8%; p = 0.042), and worse hyperlactataemia (7.4 versus 5.2 mmol/L; p < 0.001) on admission compared to the Ugandan children. EEG findings differed between the two groups in terms of average voltage and frequencies, reactivity, asymmetry, and the presence/absence of sleep architecture. In univariate analyses pooling EEG and outcomes data for both sites, higher average and maximum voltages, faster dominant frequencies, and retained reactivity were associated with survival (all p < 0.05). Focal slowing was associated with death (OR 2.93; 95% CI 1.77-7.30) and a lower average voltage was associated with neurological morbidity in survivors (p = 0.0032). Despite substantial demographic and clinical heterogeneity between subjects in Malawi and Uganda as well as different EEG readers at each site, EEG findings on admission predicted mortality and morbidity. For CM clinical trials aimed at decreasing mortality or morbidity, EEG may be valuable for risk stratification and/or subject selection.

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.

B-type natriuretic peptide and plasma hemoglobin levels following transfusion of shorter-storage versus longer-storage Red Blood Cells: results from the TOTAL randomized trial

PubMed Central

Dhabangi, Aggrey; Ainomugisha, Brenda; Cserti-Gazdewich, Christine; Ddungu, Henry; Kyeyune, Dorothy; Musisi, Ezra; Opoka, Robert; Stowell, Christopher P.; Dzik, Walter H

2016-01-01

Background Prior studies have suggested that transfusion of stored RBCs with increased levels of cell free hemoglobin might reduce the bioavailability of recipient nitric oxide (NO) and cause myocardial strain. Methods Ugandan children (ages 6 to 60 months) with severe anemia and lactic acidosis were randomly assigned to receive RBCs stored 1-10 days versus 25-35 days. B-type natriuretic peptide (BNP), vital signs, renal function tests, and plasma hemoglobin were measured. Most children had either malaria or sickle cell disease and were thus at risk for reduced NO bioavailability. Results 70 patients received RBCs stored 1-10 days and 77 received RBCs stored 25-35 days. The median (IQR) cell free hemoglobin was nearly three times higher in longer-storage RBCs (26.4 [15.5-43.4] μmol/L) than in shorter-storage RBCs (10.8 [7.8-18.6] μmol/L), p<0.0001. Median (IQR) BNP 2 hours post-transfusion was 156 (59-650) pg/mL (shorter-storage) versus 158 (59-425) pg/mL (longer-storage), p=0.76. BNP values 22 hours post-transfusion were 110 (46-337) pg/mL (shorter-storage) versus 96 (49-310) pg/mL (longer-storage), p=0.76. Changes in BNP within individuals from pre-transfusion to 2-hour (or 22-hour) post-transfusion were not significantly different between the study groups. BNP change following transfusion did not correlate with the concentration of cell free hemoglobin in the RBC supernatant. Blood pressure, BUN, creatinine, and change in plasma hemoglobin were not significantly different in the two groups. Conclusion In a randomized trial among children at risk for reduced NO bioavailability, we found that BNP, blood pressure, creatinine, and plasma hemoglobin were not higher in patients receiving RBCs stored for 25-35 days versus 1-10 days. PMID:27302626

Distribution of Interstitial Telomeric Sequences in Primates and the Pygmy Tree Shrew (Scandentia).

PubMed

Mazzoleni, Sofia; Schillaci, Odessa; Sineo, Luca; Dumas, Francesca

2017-01-01

It has been hypothesized that interstitial telomeric sequences (ITSs), i.e., repeated telomeric DNA sequences found at intrachromosomal sites in many vertebrates, could be correlated to chromosomal rearrangements and plasticity. To test this hypothesis, we hybridized a telomeric PNA probe through FISH on representative species of 2 primate infraorders, Strepsirrhini (Lemur catta, Otolemur garnettii, Nycticebus coucang) and Catarrhini (Erythrocebus patas, Cercopithecus petaurista, Chlorocebus aethiops, Colobus guereza), as well as on 1 species of the order Scandentia, Tupaia minor, used as an outgroup for primates in phylogenetic reconstructions. In almost all primate species analyzed, we found a telomeric pattern only. In Tupaia, the hybridization revealed many bright ITSs on at least 11 chromosome pairs, both biarmed and acrocentric. These ITS signals in Tupaia correspond to fusion points of ancestral human syntenic associations, but are also present in other chromosomes showing synteny to only a single human chromosome. This distribution pattern was compared to that of the heterochromatin regions detected through sequential C-banding performed after FISH. Our results in the analyzed species, compared with literature data on ITSs in primates, allowed us to discuss different mechanisms responsible for the origin and distribution of ITSs, supporting the correlation between rearrangements and ITSs. © 2017 S. Karger AG, Basel.

Craniofacial variation and dietary adaptations of African colobines.

PubMed

Koyabu, Daisuke B; Endo, Hideki

2009-06-01

African colobine monkeys show considerable craniofacial variation among species, although the evolutionary causes of this diversity are unclear. In light of growing evidence that diet varies considerably among colobine species, we investigated whether colobine craniofacial morphology varies as a function of their diet. We compared craniofacial morphology among five African species: Colobus angolensis, C. guereza, C. polykomos, Piliocolobus badius, and P. verus. Matrix correlation analysis indicated a significant correlation between species-specific morphological distance and dietary distance matrices. The mechanical advantage of the masseter muscle was higher in seed-eaters (C. angolensis and C. polykomos) and lower in those that eat mainly young leaves (C. guereza, P. badius, and P. verus). Canonical correspondence analysis revealed that the durophagous colobines possess relatively wider bigonial breadths, anteroposteriorly shorter faces, shorter postcanine tooth rows, more medially positioned dental batteries, wider bizygomatic arches, and anteroposteriorly longer zygomatic arches. Under the constrained lever model, these morphological features suggest that durophagous colobines have the capacity to generate relatively greater maximum bite forces. However, no consistent relationship was observed between diet and variation in the mandibular corpus and symphysis, implying that robust mandibles are not necessarily adaptations for stress resistance. Factors that may influence mandibular robusticity include allometry of symphyseal curvature and canine tooth support. Finally, linear measures of mandibular robusticity may suffer from error.

Unmet medical care and sexual health counseling needs-: a cross-sectional study among university students in Uganda.

PubMed

Kyagaba, Emmanuel; Asamoah, Benedict Oppong; Emmelin, Maria; Agardh, Anette

2014-08-01

In 2010, unmet medical care and sexual health counseling needs were assessed among students at a Ugandan University. Unmet medical care need was associated with poor mental health, experience of sexual coercion, and poor self-rated health. Unmet sexual health counseling need was significantly associated with being female, coming from an urban area, low social participation, poor mental health status, experience of sexual coercion, poor self-rated health, inconsistent condom use, and having multiple sexual partners. Gender differences, poor mental health, sexual coercion, poor self-rated health, and risky sexual behavior must be considered when designing intervention models to reduce unmet health care needs among young people in this setting.

Vocational Training with HIV Prevention for Ugandan Youth

PubMed Central

Rotheram-Borus, Mary Jane; Lightfoot, Marguerita; Kasirye, Rogers; Desmond, Katherine

2013-01-01

In a pilot study, young people in slums in Kampala, Uganda received an HIV prevention program (Street Smart) and were randomized to receive vocational training immediately (Immediate) or four months later (Delayed). Youth were monitored at recruitment, 4 months (85% retention), and 24 months (74% retention). Employment increased dramatically: Only 48% had ever been employed at recruitment, 86% were employed from months 21 to 24 post recruitment. Over two years, decreases were recorded in the number of sexual partners, mental health symptoms, delinquent acts, and drug use; condom use increased. Providing employment in low income countries, in conjunction with HIV prevention, may provide sustained support to young people to prevent HIV acquisition. PMID:21800180

Relationship between Anaemia, Malaria Co-infection and Kaposi Sarcoma-associated Herpesvirus (KSHV) Seropositivity in a Population-based Study in Rural Uganda.

PubMed

Nalwoga, Angela; Cose, Stephen; Nash, Stephen; Miley, Wendell; Asiki, Gershim; Kusemererwa, Sylvia; Yarchoan, Robert; Labo, Nazzarena; Whitby, Denise; Newton, Robert

2018-05-08

We examined anaemia and malaria as risk factors for KSHV seropositivity and antibody levels in a long-standing rural Ugandan cohort, in which KSHV is prevalent. Samples from 4134 children, aged 1-17 years, with a sex ratio of 1:1 and 3149 adults aged 18-103 years, 41% of whom were males, were analysed. Among children, malaria infection was associated with higher KSHV prevalence (61% versus 41% prevalence among malaria infected and uninfected respectively); malaria was not assessed in adults. Additionally, lower haemoglobin level was associated with an increased prevalence of KSHV seropositivity, both in children and in adults.

A Virus-Derived Stacked RNAi Construct Confers Robust Resistance to Cassava Brown Streak Disease

PubMed Central

Beyene, Getu; Chauhan, Raj Deepika; Ilyas, Muhammad; Wagaba, Henry; Fauquet, Claude M.; Miano, Douglas; Alicai, Titus; Taylor, Nigel J.

2017-01-01

Cassava brown streak disease (CBSD) threatens food and economic security for smallholder farmers throughout East and Central Africa, and poses a threat to cassava production in West Africa. CBSD is caused by two whitefly-transmitted virus species: Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) (Genus: Ipomovirus, Family Potyviridae). Although varying levels of tolerance have been achieved through conventional breeding, to date, effective resistance to CBSD within East African cassava germplasm has not been identified. RNAi technology was utilized to integrate CBSD resistance into the Ugandan farmer-preferred cassava cultivar TME 204. Transgenic plant lines were generated expressing an inverted repeat construct (p5001) derived from coat-protein (CP) sequences of CBSV and UCBSV fused in tandem. Northern blots using probes specific for each CP sequence were performed to characterize 169 independent transgenic lines for accumulation of CP-derived siRNAs. Transgenic plant lines accumulating low, medium and high levels of siRNAs were bud graft challenged with the virulent CBSV Naliendele isolate alone or in combination with UCBSV. Resistance to CBSD in the greenhouse directly correlated to levels of CP-derived siRNAs as determined by visual assessment of leaf and storage root symptoms, and RT-PCR diagnosis for presence of the pathogens. Low expressing lines were found to be susceptible to CBSV and UCBSV, while medium to high accumulating plant lines were resistant to both virus species. Absence of detectable virus in the best performing p5001 transgenic lines was further confirmed by back-inoculation via sap or graft challenge to CBSD susceptible Nicotiana benthamiana and cassava cultivar 60444, respectively. Data presented shows robust resistance of transgenic p5001 TME 204 lines to both CBSV and UCBSV under greenhouse conditions. Levels of resistance correlated directly with levels of transgene derived siRNA expression such that the latter can be used as predictor of resistance to CBSD. PMID:28149300

Artemisinin-based combination therapies are efficacious and safe for treatment of uncomplicated malaria in HIV-infected Ugandan children.

PubMed

Kakuru, Abel; Achan, Jane; Muhindo, Mary K; Ikilezi, Gloria; Arinaitwe, Emmanuel; Mwangwa, Florence; Ruel, Theodore; Clark, Tamara D; Charlebois, Edwin; Rosenthal, Philip J; Havlir, Diane; Kamya, Moses R; Tappero, Jordan W; Dorsey, Grant

2014-08-01

Artemisinin-based combination therapies (ACTs) are highly efficacious and safe, but data from human immunodeficiency virus (HIV)-infected children concurrently receiving antiretroviral therapy (ART) and ACTs are limited. We evaluated 28-day outcomes following malaria treatment with artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) in 2 cohorts of HIV-infected Ugandan children taking various ART regimens. In one cohort, children <6 years of age were randomized to lopinavir/ritonavir (LPV/r) or nonnucleoside reverse transcriptase inhibitor-based ART and treated with AL for uncomplicated malaria. In another cohort, children <12 months of age were started on nevirapine-based ART if they were eligible, and randomized to AL or DP for the treatment of their first and all subsequent uncomplicated malaria episodes. There were 773 and 165 treatments for malaria with AL and DP, respectively. Initial response to therapy was excellent, with 99% clearance of parasites and <1% risk of repeat therapy within 3 days. Recurrent parasitemia within 28 days was common following AL treatment. The risk of recurrent parasitemia was significantly lower among children taking LPV/r-based ART compared with children taking nevirapine-based ART following AL treatment (15.3% vs 35.5%, P = .009), and those treated with DP compared with AL (8.6% vs 36.2%, P < .001). Both ACT regimens were safe and well tolerated. Treatment of uncomplicated malaria with AL or DP was efficacious and safe in HIV-infected children taking ART. However, there was a high risk of recurrent parasitemia following AL treatment, which was significantly lower in children taking LPV/r-based ART compared with nevirapine-based ART. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Surveillance of intestinal schistosomiasis during control: a comparison of four diagnostic tests across five Ugandan primary schools in the Lake Albert region.

PubMed

Al-Shehri, Hajri; Koukounari, Artemis; Stanton, Michelle C; Adriko, Moses; Arinaitwe, Moses; Atuhaire, Aaron; Kabatereine, Narcis B; Stothard, J Russell

2018-03-21

Programmatic surveillance of intestinal schistosomiasis during control can typically use four diagnostic tests, either singularly or in combination, but these have yet to be cross-compared directly. Our study assembled a complete diagnostic dataset, inclusive of infection intensities, from 258 children from five Ugandan primary schools. The schools were purposely selected as typical of the endemic landscape near Lake Albert and reflective of high- and low-transmission settings. Overall prevalence was: 44.1% (95% CI 38.0-50.2) by microscopy of duplicate Kato-Katz smears from two consecutive stools, 56.9% (95% CI 50.8-63.0) by urine-circulating cathodic antigen (CCA) dipstick, 67.4% (95% CI 61.6-73.1) by DNA-TaqMan® and 75.1% (95% CI 69.8-80.4) by soluble egg antigen enzyme-linked immunosorbent assay (SEA-ELISA). A cross-comparison of diagnostic sensitivities, specificities, positive and negative predictive values was undertaken, inclusive of a latent class analysis (LCA) with a LCA-model estimate of prevalence by each school. The latter ranged from 9.6% to 100.0%, and prevalence by school for each diagnostic test followed a static ascending order or monotonic series of Kato-Katz, urine-CCA dipstick, DNA-TaqMan® and SEA-ELISA. We confirm that Kato-Katz remains a satisfactory diagnostic standalone in high-transmission settings but in low-transmission settings should be augmented or replaced by urine-CCA dipsticks. DNA-TaqMan® appears suitable in both endemic settings though is only implementable if resources permit. In low-transmission settings, SEA-ELISA remains the method of choice to evidence an absence infection. We discuss the pros and cons of each method concluding that future surveillance of intestinal schistosomiasis would benefit from a flexible, context-specific approach both in choice and application of each diagnostic method, rather than a single one-size fits all approach.

Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda

PubMed Central

Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S

2014-01-01

Objective To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancer screening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Design Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. Participants 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30–69 years, Luganda or Swahili speaking, living or working in the target Ugandan community. Exclusion criteria: unwillingness to sign informed consent. Setting Primary and tertiary low-resource setting in Kampala, Uganda. Results In Luganda, embarrassment relating to cervical cancer is described in two forms. ‘Community embarrassment’ describes discomfort based on how a person may be perceived by others. ‘Personal embarrassment’ relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Conclusions Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes. The role of peer-to-peer education and community authorities on healthcare cannot be overlooked and can have a major impact in overcoming psychosocial and social barriers to screening. PMID:24727360

Incidence of Induced Abortion in Uganda, 2013: New Estimates Since 2003

PubMed Central

Prada, Elena; Atuyambe, Lynn M.; Blades, Nakeisha M.; Bukenya, Justine N.; Orach, Christopher Garimoi; Bankole, Akinrinola

2016-01-01

Background In Uganda, abortion is permitted only when the life of a woman is in danger. This restriction compels the perpetuation of the practice in secrecy and often under unsafe conditions. In 2003, 294,000 induced abortions were estimated to occur each year in Uganda. Since then, no other research on abortion incidence has been conducted in the country. Methods Data from 418 health facilities were used to estimate the number and rate of induced abortion in 2013. An indirect estimation methodology was used to calculate the annual incidence of induced abortions ─ nationally and by major regions. The use of a comparable methodology in an earlier study permits assessment of trends between 2003 and 2013. Results In 2013, an estimated 128,682 women were treated for abortion complications and an estimated 314,304 induced abortions occurred, both slightly up from 110,000 and 294,000 in 2003, respectively. The national abortion rate was 39 abortions per 1,000 women aged 15–49, down from 51 in 2003. Regional variation in abortion rates is very large, from as high as an estimated 77 per 1,000 women 15–49 in Kampala region, to as low as 18 per 1,000 women in Western region. The overall pregnancy rate also declined from 326 to 288; however the proportion of pregnancies that were unintended increased slightly, from 49% to 52%. Conclusion Unsafe abortion remains a major problem confronting Ugandan women. Although the overall pregnancy rate and the abortion rate declined in the past decade, the majority of pregnancies to Ugandan women are still unintended. These findings reflect the increase in the use of modern contraception but also suggest that a large proportion of women are still having difficulty practicing contraception effectively. Improved access to contraceptive services and abortion-related care are still needed. PMID:27802338

Barriers faced by Ugandan university students in seeking medical care and sexual health counselling: a cross-sectional study.

PubMed

Boltena, Andualem Tadesse; Khan, Farhad Ali; Asamoah, Benedict O; Agardh, Anette

2012-11-16

Meeting the medical and sexual health care needs of young people is crucial for sustainable development. In Uganda, youth are faced with a number of challenges related to accessing medical care and sexual health counselling services. This study sought to investigate the barriers faced by Ugandan university students in seeking medical care and sexual health counselling. This study is part of a cross-sectional survey conducted in 2005 among 980 students at Mbarara University of Science and Technology. Data was collected by means of a self-administered 11-page questionnaire. The barriers encountered by respondents in seeking medical care and sexual health counselling were classified into three categories reflecting the acceptability, accessibility, or availability of services. Two out of five students reported unmet medical care needs, and one out of five reported unmet sexual health counselling needs. Acceptability of services was the main barrier faced by students for seeking medical care (70.4%) as well as for student in need of sexual health counselling (72.2%), regardless of age, gender, self-rated health, and rural/peri-urban or urban residence status. However, barriers differed within the various strata. There was a significant difference (p-value 0.01) in barriers faced by students originally from rural versus peri-urban/urban areas in seeking medical care (acceptability: 64.8%/74.5%, accessibility: 22.0% /12.6%, availability 13.2%/12.9%, respectively). Students who reported poor self-rated health encountered barriers in seeking both medical care and sexual health counselling that were significantly different from their other counterparts (p-value 0.001 and 0.007 respectively). Barriers faced by students in seeking medical and sexual health care should be reduced by interventions aimed at boosting confidence in health care services, encouraging young people to seek early treatment, and increasing awareness of where they can turn for services. The availability of medical services should be increased and waiting times and cost reduced for vulnerable groups.

Sexual behavior and HIV transmission risk of Ugandan adults taking antiretroviral therapy: 3 year follow-up.

PubMed

Apondi, Rose; Bunnell, Rebecca; Ekwaru, John Paul; Moore, David; Bechange, Stevens; Khana, Kenneth; King, Rachel; Campbell, James; Tappero, Jordan; Mermin, Jonathan

2011-06-19

Long-term impact of antiretroviral therapy (ART) on sexual HIV-transmission risk in Africa is unknown. We assessed sexual behavior changes and estimated HIV transmission from HIV-infected adults on ART in Uganda. Between 2003 and 2007, we enrolled and followed ART-naive HIV-infected adults in a home-based AIDS program with annual counseling and testing for cohabitating partners, participant transmission risk-reduction plans, condom distribution and prevention support for cohabitating discordant couples. We assessed participants' HIV plasma viral load and partner-specific sexual behaviors. We defined risky sex as intercourse with inconsistent/no condom use with HIV-negative or unknown serostatus partners in previous 3 months. We compared rates using Poisson regression models, estimated transmission risk using established viral load-specific transmission estimates, and documented sero-conversion rates among HIV-discordant couples. Of 928 participants, 755 (81%) had 36 months data: 94 (10%) died and 79 (9%) missing data. Sexual activity increased from 28% (baseline) to 41% [36 months (P < 0.001)]. Of sexually active participants, 22% reported risky sex at baseline, 8% at 6 months (P < 0.001), and 14% at 36 months (P = 0.018). Median viral load among those reporting risky sex was 122,500 [interquartile range (IQR) 45 100-353 000] copies/ml pre-ART at baseline and undetectable at follow-up. One sero-conversion occurred among 62 cohabitating sero-discordant partners (0.5 sero-conversions/100 person-years). At 36 months, consistent condom use was 74% with discordant partners, 55% with unknown and 46% with concordant partners. Estimated HIV transmission risk reduced 91%, from 47.3 to 4.2/1000 person-years. Despite increased sexual activity among HIV-infected Ugandans over 3 years on ART, risky sex and estimated risk of HIV transmission remained lower than baseline levels. Integrated prevention programs could reduce HIV transmission in Africa.

Associations between social support, psychological well-being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months.

PubMed

Ickes, Scott B; Wu, Michael; Mandel, Maia P; Roberts, Alison C

2018-01-01

Maternal capabilities-qualities of mothers that enable them to leverage skills and resources into child health-hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey (n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval (CI)] = 1.38 [1.10, 1.73]), dietary diversity (OR [95% CI] = 1.56 [1.15, 2.11]), iron rich foods, (OR [95% CI] = 1.47 [1.14, 1.89]), and minimally acceptable diet (OR [95% CI] = 1.55 [1.10, 2.21]) indicators. Empowerment was associated with a greater likelihood of feeding a minimally diverse and acceptable diet. The maternal capabilities index was significantly associated with feeding the minimum number of times per day (OR [95% CI] = 1.29 [1.03, 1.63]), dietary diversity (OR [95% CI] = 1.44 [1.06, 1.94]), and minimally acceptable diet (OR [95% CI] = 1.43 [1.01, 2.01]). Mothers with higher psychological satisfaction were more likely to have a stunted child (OR [95% CI] = 1.31 [1.06, 1.63]). No other associations between the capabilities scales and child growth were significant. Strengthening social support for mothers and expanding overall maternal capabilities hold potential for addressing important underlying determinants of child feeding in the Ugandan context. © 2017 John Wiley & Sons Ltd.

The clinical presentation and early outcomes of necrotizing fasciitis in a Ugandan Tertiary Hospital- a prospective study

PubMed Central

2014-01-01

Background Necrotizing fasciitis is an infectious process characterized by rapidly progressing necrosis of superficial fascia and subcutaneous tissue with subsequent necrosis of overlying skin. Necrotizing fasciitis is a rare but fatal infection. The worldwide incidence is at 0.4 per 100,000. Mortality is up to 80% with no intervention, and 30-50% with intervention. Delay in intervention is associated with poor outcome. The risk factors for necrotizing fasciitis are diabetes mellitus, HIV, malignancy, illicit drug use, malnutrition among others. The aim of this study was to describe the clinical presentation and early outcomes of necrotizing fasciitis amongst Ugandan patients. Methods A prospective descriptive case series study conducted at Mulago National Referral and Teaching hospital from 5th January to 30th April 2011. Patients with necrotizing fasciitis were consecutively recruited after clinical evaluation, laboratory and microbiological tests were performed. Aggressive debridement was done and broad-spectrum antibiotics administered. Patients were followed up on surgical wards. Ethical approval was obtained. Results Thirty five patients were recruited over a 4 months period. More males were affected with, M: F 3:1. The 20-40 years age group was most affected. Attainment of healthy granulation tissue took 19 days on average. Mortality rate was 14% (5/35). Limbs were the most affected body parts 20/35 (57%), the scrotum and perineum (23%). Among infants the scalp was the most affected. Co-morbidities included HIV 8/35 (17%), and DM (5%) among others. The commonest organisms were gram negative. Split skin grafting was necessary in 74% (26/35) of patients. Conclusion There were a high number of patients with necrotizing fasciitis; it was associated with low mortality but high morbidity (long hospital stay). There was a high preponderance to males and limbs were the more affected body parts. PMID:25069415

Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya.

PubMed

Kadede, Kevin; Ruel, Theodore; Kabami, Jane; Ssemmondo, Emmanuel; Sang, Norton; Kwarisiima, Dalsone; Bukusi, Elizabeth; Cohen, Craig R; Liegler, Teri; Clark, Tamara D; Charlebois, Edwin D; Petersen, Maya L; Kamya, Moses R; Havlir, Diane V; Chamie, Gabriel

2016-09-10

We sought to increase adolescent HIV testing across rural communities in east Africa and identify predictors of undiagnosed HIV. Hybrid mobile testing. We enumerated 116 326 adolescents (10-24 years) in 32 communities of Uganda and Kenya ( NCT01864603): 98 694 (85%) reported stable (≥6 months of prior year) residence. In each community we performed hybrid testing: 2-week multidisease community health campaign that included HIV testing, followed by home-based testing of community health campaign nonparticipants. We measured adolescent HIV testing coverage and prevalence, and determined predictors of newly diagnosed HIV among HIV-infected adolescents using multivariable logistic regression. A total of 86 421 (88%) stable adolescents tested for HIV; coverage was 86, 90, and 88% in early (10-14), mid (15-17), and late (18-24) adolescents, respectively. Self-reported prior testing was 9, 26, and 55% in early, mid, and late adolescents tested, respectively. HIV prevalence among adolescents tested was 1.6 and 0.6% in Ugandan women and men, and 7.1 and 1.5% in Kenyan women and men, respectively. Prevalence increased in mid-adolescence for women and late adolescence for men. Among HIV-infected adolescents, 58% reported newly diagnosed HIV. In multivariate analysis of HIV-infected adolescents, predictors of newly diagnosed HIV included male sex [odds ratio (OR) = 1.97 (95% confidence interval (CI): 1.42-2.73)], Ugandan residence [OR = 2.63 (95% CI: 2.08-3.31)], and single status [OR = 1.62 (95% CI: 1.23-2.14) vs. married)]. The SEARCH hybrid strategy tested 88% of stable adolescents for HIV, a substantial increase over the 28% reporting prior testing. The majority (57%) of HIV-infected adolescents were new diagnoses. Mobile HIV testing for adults should be leveraged to reach adolescents for HIV treatment and prevention.

Health Risks in Same-Sex Attracted Ugandan University Students: Evidence from Two Cross-Sectional Studies

PubMed Central

Agardh, Anette; Ross, Michael; Östergren, Per-Olof; Larsson, Markus; Tumwine, Gilbert; Månsson, Sven-Axel; Simpson, Julie A.; Patton, George

2016-01-01

Widespread discrimination across much of sub-Saharan Africa against persons with same-sex sexuality, including recent attempts in Uganda to extend criminal sanctions against same-sex behavior, are likely to have profound effects on this group’s health, health care access, and well-being. Yet knowledge of the prevalence of same-sex sexuality in this region is scarce. This study aimed to systematically examine prevalence of same-sex sexuality and related health risks in young Ugandan adults. We conducted two cross-sectional survey studies in south-western Uganda targeting student samples (n = 980, n = 1954) representing 80% and 72% of the entire undergraduate classes attending a university in 2005 and 2010, respectively. A questionnaire assessed items concerning same-sex sexuality (same-sex attraction/fantasies, same-sex sexual relations), mental health, substance use, experience of violence, risky sexual behavior, and sexual health counseling needs. Our findings showed that same-sex sexual attraction/fantasies and behavior were common among male and female students, with 10–25% reporting having sexual attraction/fantasies regarding persons of the same-sex, and 6–16% reporting same-sex sexual relations. Experiences of same-sex sexuality were associated with health risks, e.g. poor mental health (2010, AOR = 1.5; 95% CI: 1.0–2.3), sexual coercion (2010, AOR 2.9; CI: 1.9–4.6), and unmet sexual health counseling needs (2010, AOR 2.2; CI: 1.4–3.3). This first study of young adults in Uganda with same-sex sexuality found high levels of health needs but poor access to health care. Effective response is likely to require major shifts in current policy, efforts to reduce stigmatization, and reorientation of health services to better meet the needs of this vulnerable group of young people. PMID:26982494

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.

Steady State Bioequivalence of Generic and Innovator Formulations of Stavudine, Lamivudine, and Nevirapine in HIV-Infected Ugandan Adults

PubMed Central

Byakika-Tusiime, Jayne; Chinn, Leslie W.; Oyugi, Jessica H.; Obua, Celestino; Bangsberg, David R.; Kroetz, Deanna L.

2008-01-01

Background Generic antiretroviral therapy is the mainstay of HIV treatment in resource-limited settings, yet there is little evidence confirming the bioequivalence of generic and brand name formulations. We compared the steady-state pharmacokinetics of lamivudine, stavudine and nevirapine in HIV-infected subjects who were receiving a generic formulation (Triomune®) or the corresponding brand formulations (Epivir®, Zerit®, and Viramune®). Methodology/Principal Findings An open-label, randomized, crossover study was carried out in 18 HIV-infected Ugandan subjects stabilized on Triomune-40. Subjects received lamivudine (150 mg), stavudine (40 mg), and nevirapine (200 mg) in either the generic or brand formulation twice a day for 30 days, before switching to the other formulation. At the end of each treatment period, blood samples were collected over 12 h for pharmacokinetic analysis. The main outcome measures were the mean AUC0–12h and Cmax. Bioequivalence was defined as a geometric mean ratio between the generic and brand name within the 90% confidence interval of 0.8–1.25. The geometric mean ratios and the 90% confidence intervals were: stavudine Cmax, 1.3 (0.99–1.71) and AUC0–12h, 1.1 (0.87–1.38); lamivudine Cmax, 0.8 (0.63–0.98) and AUC0–12h, 0.8 (0.65–0.99); and nevirapine Cmax, 1.1 (0.95–1.23) and AUC0–12h, 1.1 (0.95–1.31). The generic formulation was not statistically bioequivalent to the brand formulations during steady state, although exposures were comparable. A mixed random effects model identified about 50% intersubject variability in the pharmacokinetic parameters. Conclusions/Significant Findings These findings provide support for the use of Triomune in resource-limited settings, although identification of the sources of intersubject variability in these populations is critical. PMID:19096711

Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda.

PubMed

Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S

2014-04-11

To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancer screening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30-69 years, Luganda or Swahili speaking, living or working in the target Ugandan community. unwillingness to sign informed consent. Primary and tertiary low-resource setting in Kampala, Uganda. In Luganda, embarrassment relating to cervical cancer is described in two forms. 'Community embarrassment' describes discomfort based on how a person may be perceived by others. 'Personal embarrassment' relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes. The role of peer-to-peer education and community authorities on healthcare cannot be overlooked and can have a major impact in overcoming psychosocial and social barriers to screening.

How do carers of disabled children cope? The Ugandan perspective.

PubMed

Hartley, S; Ojwang, P; Baguwemu, A; Ddamulira, M; Chavuta, A

2005-03-01

Community-based rehabilitation (CBR) was recommended by the World Health Organization in 1989 as the strategy for improving the quality of life of disabled people and their families, which should be built on local knowledge and practices. In Uganda, there is no documentation on how services relate to local knowledge. There is a need for increased knowledge and understanding of how family members cope with their disabled children to provide the basis for future service development. A qualitative phenomenological design was used to develop an in-depth understanding of how Ugandan families cope with their disabled children in their own communities. Data were collected from 52 families with children with disabilities from five impairment groups, through interviews and observations in three districts of Uganda, one urban, two rural. There are many children with disabilities who are included, loved and cared for by their families. A lot of time and money is spent on seeking a cure. The extended family systems are breaking down and the main burden of caring for a disabled family member generally falls on one, sometimes two, female carers. Male members act as gatekeepers, controlling the key decisions concerning the child and the associated resources. CBR should move the focus of their services away from the disabled individual towards the whole family. It is important to provide accurate information about causes and prevention of impairments, the realities of a cure, support and respite for the female carers, and opportunities for the involvement of fathers. This methodology is a practical mechanism for collecting data that have the potential to positively influence and guide the development of CBR practice in the locality. At a conceptual level the data support the philosophy of inclusion, social integration, the importance of trust and respect, and utilizing a holistic approach. These are eminently transferable to other settings.

The Impact of Socio-Demographic and Religious Factors upon Sexual Behavior among Ugandan University Students

PubMed Central

Agardh, Anette; Tumwine, Gilbert; Östergren, Per-Olof

2011-01-01

Introduction More knowledge is needed about structural factors in society that affect risky sexual behaviors. Educational institutions such as universities provide an opportune arena for interventions among young people. The aim of this study was to investigate the relationship between sociodemographic and religious factors and their impact on sexual behavior among university students in Uganda. Methods In 2005, 980 university students (response rate 80%) were assessed by a self-administered questionnaire. Validated instruments were used to assess socio-demographic and religious factors and sexual behavior. Logistic regression analyses were applied. Results Our findings indicated that 37% of the male and 49% of the female students had not previously had sex. Of those with sexual experience, 46% of the males and 23% of the females had had three or more sexual partners, and 32% of the males and 38% of the females did not consistently use condoms. For those who rated religion as less important in their family, the probability of early sexual activity and having had a high number of lifetime partners increased by a statistically significant amount (OR = 1.7; 95% CI: 1.2–2.4 and OR = 1.6; 95% CI: 1.1–2.3, respectively). However, the role of religion seemed to have no impact on condom use. Being of Protestant faith interacted with gender: among those who had debuted sexually, Protestant female students were more likely to have had three or more lifetime partners; the opposite was true for Protestant male students. Conclusion Religion emerged as an important determinant of sexual behavior among Ugandan university students. Our findings correlate with the increasing number of conservative religious injunctions against premarital sex directed at young people in many countries with a high burden. of HIV/AIDS. Such influence of religion must be taken into account in order to gain a deeper understanding of the forces that shape sexual behavior in Uganda. PMID:21887292

Prevalence and risk factors for self-reported non-communicable diseases among older Ugandans: a cross-sectional study

PubMed Central

Wandera, Stephen Ojiambo; Kwagala, Betty; Ntozi, James

2015-01-01

Background There is limited evidence about the prevalence and risk factors for non-communicable diseases (NCDs) among older Ugandans. Therefore, this article is aimed at investigating the prevalence of self-reported NCDs and their associated risk factors using a nationally representative sample. Design We conducted a secondary analysis of the 2010 Uganda National Household Survey (UNHS) using a weighted sample of 2,382 older people. Frequency distributions for descriptive statistics and Pearson chi-square tests to identify the association between self-reported NCDs and selected explanatory variables were done. Finally, multivariable complementary log–log regressions to estimate the risk factors for self-reported NCDs among older people in Uganda were done. Results About 2 in 10 (23%) older persons reported at least one NCD [including hypertension (16%), diabetes (3%), and heart disease (9%)]. Among all older people, reporting NCDs was higher among those aged 60–69 and 70–79; Muslims; and Pentecostals and Seventh Day Adventists (SDAs). In addition, the likelihood of reporting NCDs was higher among older persons who depended on remittances and earned wages; owned a bicycle; were sick in the last 30 days; were disabled; and were women. Conversely, the odds of reporting NCDs were lower for those who were relatives of household heads and were poor. Conclusions In Uganda, self-reported NCDs were associated with advanced age, being a woman, having a disability, ill health in the past 30 days, being rich, depended on remittances and earning wages, being Muslim, Pentecostal and SDAs, and household headship. The Ministry of Health should prevent and manage NCDs by creating awareness in the public and improving the supply of essential drugs for these health conditions. Finally, there is a need for specialised surveillance studies of older people to monitor the trends and patterns of NCDs over time. PMID:26205363

Impaired haemophilus influenzae type b transplacental antibody transmission and declining antibody avidity through the first year of life represent potential vulnerabilities for HIV-exposed but -uninfected infants.

PubMed

Gaensbauer, James T; Rakhola, Jeremy T; Onyango-Makumbi, Carolyne; Mubiru, Michael; Westcott, Jamie E; Krebs, Nancy F; Asturias, Edwin J; Fowler, Mary Glenn; McFarland, Elizabeth; Janoff, Edward N

2014-12-01

To determine whether immune function is impaired among HIV-exposed but -uninfected (HEU) infants born to HIV-infected mothers and to identify potential vulnerabilities to vaccine-preventable infection, we characterized the mother-to-infant placental transfer of Haemophilus influenzae type b-specific IgG (Hib-IgG) and its levels and avidity after vaccination in Ugandan HEU infants and in HIV-unexposed U.S. infants. Hib-IgG was measured by enzyme-linked immunosorbent assay in 57 Ugandan HIV-infected mothers prenatally and in their vaccinated HEU infants and 14 HIV-unexposed U.S. infants at birth and 12, 24, and 48 weeks of age. Antibody avidity at birth and 48 weeks of age was determined with 1 M ammonium thiocyanate. A median of 43% of maternal Hib-IgG was transferred to HEU infants. Although its level was lower in HEU infants than in U.S. infants at birth (P < 0.001), Hib-IgG was present at protective levels (>1.0 μg/ml) at birth in 90% of HEU infants and all U.S. infants. HEU infants had robust Hib-IgG responses to a primary vaccination. Although Hib-IgG levels declined from 24 to 48 weeks of age in HEU infants, they were higher than those in U.S. infants (P = 0.002). Antibody avidity, comparable at birth, declined by 48 weeks of age in both populations. Early vaccination of HEU infants may limit an initial vulnerability to Hib disease resulting from impaired transplacental antibody transfer. While initial Hib vaccine responses appeared adequate, the confluence of lower antibody avidity and declining Hib-IgG levels in HEU infants by 12 months support Hib booster vaccination at 1 year. Potential immunologic impairments of HEU infants should be considered in the development of vaccine platforms for populations with high maternal HIV prevalence. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Characterization of Foot-And-Mouth Disease Viruses (FMDVs) from Ugandan Cattle Outbreaks during 2012-2013: Evidence for Circulation of Multiple Serotypes

PubMed Central

Namatovu, Alice; Tjørnehøj, Kirsten; Belsham, Graham J.; Dhikusooka, Moses T.; Wekesa, Sabenzia N.; Muwanika, Vincent B.; Siegismund, Hans R.; Ayebazibwe, Chrisostom

2015-01-01

To investigate the foot-and-mouth disease virus (FMDV) serotypes circulating in Uganda’s cattle population, both serological and virological analyses of samples from outbreaks that occurred during 2012–2013 were performed. Altogether, 79 sera and 60 oropharyngeal fluid (OP)/tissue/oral swab samples were collected from herds with reported FMD outbreaks in seven different Ugandan districts. Overall, 61/79 (77%) of the cattle sera were positive for antibodies against FMDV by PrioCHECK FMDV NS ELISA and solid phase blocking ELISA detected titres ≥ 80 for serotypes O, SAT 1, SAT 2 and SAT 3 in 41, 45, 30 and 45 of these 61 seropositive samples, respectively. Virus neutralisation tests detected the highest levels of neutralising antibodies (titres ≥ 45) against serotype O in the herds from Kween and Rakai districts, against SAT 1 in the herd from Nwoya district and against SAT 2 in the herds from Kiruhura, Isingiro and Ntungamo districts. The isolation of a SAT 2 FMDV from Isingiro was consistent with the detection of high levels of neutralising antibodies against SAT 2; sequencing (for the VP1 coding region) indicated that this virus belonged to lineage I within this serotype, like the currently used vaccine strain. From the Wakiso district 11 tissue/swab samples were collected; serotype A FMDV, genotype Africa (G-I), was isolated from the epithelial samples. This study shows that within a period of less than one year, FMD outbreaks in Uganda were caused by four different serotypes namely O, A, SAT 1 and SAT 2. Therefore, to enhance the control of FMD in Uganda, there is need for efficient and timely determination of outbreak virus strains/serotypes and vaccine matching. The value of incorporating serotype A antigen into the imported vaccines along with the current serotype O, SAT 1 and SAT 2 strains should be considered. PMID:25664876

Quality of Inpatient Pediatric Case Management for Four Leading Causes of Child Mortality at Six Government-Run Ugandan Hospitals

PubMed Central

Sears, David; Mpimbaza, Arthur; Kigozi, Ruth; Sserwanga, Asadu; Chang, Michelle A.; Kapella, Bryan K.; Yoon, Steven; Kamya, Moses R.; Dorsey, Grant; Ruel, Theodore

2015-01-01

Background A better understanding of case management practices is required to improve inpatient pediatric care in resource-limited settings. Here we utilize data from a unique health facility-based surveillance system at six Ugandan hospitals to evaluate the quality of pediatric case management and the factors associated with appropriate care. Methods All children up to the age of 14 years admitted to six district or regional hospitals over 15 months were included in the study. Four case management categories were defined for analysis: suspected malaria, selected illnesses requiring antibiotics, suspected anemia, and diarrhea. The quality of case management for each category was determined by comparing recorded treatments with evidence-based best practices as defined in national guidelines. Associations between variables of interest and the receipt of appropriate case management were estimated using multivariable logistic regression. Results A total of 30,351 admissions were screened for inclusion in the analysis. Ninety-two percent of children met criteria for suspected malaria and 81% received appropriate case management. Thirty-two percent of children had selected illnesses requiring antibiotics and 89% received appropriate antibiotics. Thirty percent of children met criteria for suspected anemia and 38% received appropriate case management. Twelve percent of children had diarrhea and 18% received appropriate case management. Multivariable logistic regression revealed large differences in the quality of care between health facilities. There was also a strong association between a positive malaria diagnostic test result and the odds of receiving appropriate case management for comorbid non-malarial illnesses - children with a positive malaria test were more likely to receive appropriate care for anemia and less likely for illnesses requiring antibiotics and diarrhea. Conclusions Appropriate management of suspected anemia and diarrhea occurred infrequently. Pediatric quality improvement initiatives should target deficiencies in care unique to each health facility, and interventions should focus on the simultaneous management of multiple diagnoses. PMID:25992620

Echocardiography screening for rheumatic heart disease in Ugandan schoolchildren.

PubMed

Beaton, Andrea; Okello, Emmy; Lwabi, Peter; Mondo, Charles; McCarter, Robert; Sable, Craig

2012-06-26

Historically, sub-Saharan Africa has had the highest prevalence rates of clinically detected rheumatic heart disease (RHD). Echocardiography-based screening improves detection of RHD in endemic regions. The newest screening guidelines (2006 World Health Organization/National Institutes of Health) have been tested across India and the Pacific Islands, but application in sub-Saharan Africa has, thus far, been limited to Mozambique. We used these guidelines to determine RHD prevalence in a large cohort of Ugandan school children, to identify risk factors for occult disease, and to assess the value of laboratory testing. Auscultation and portable echocardiography were used to screen randomly selected schoolchildren, 5 to 16 years of age, in Kampala, Uganda. Disease likelihood was defined as definite, probable, or possible in accordance with the 2006 National Institutes of Health/World Health Organization guidelines. Ninety-seven percent of eligible students received screening (4869 of 5006). Among them, 130 children (2.7%) had abnormal screening echocardiograms. Of those 130, secondary evaluation showed 72 (55.4%) with possible, probable, or definite RHD; 18 (13.8%) with congenital heart disease; and 40 (30.8%) with no disease. Echocardiography detected 3 times as many cases of RHD as auscultation: 72 (1.5%) versus 23 (0.5%; P<0.001). Children with RHD were older (10.1 versus 9.3 years; P=0.002). Most cases (98%) involved only the mitral valve. Lower socioeconomic groups had more RHD (2.7% versus 1.4%; P=0.036) and more advanced disease (64% versus 26%; P<0.001). Antistreptolysin O titers were elevated in children with definite RHD. This is one of the largest single-country childhood RHD prevalence studies and the first to be conducted in sub-Saharan Africa. Our data support inclusion of echocardiography in screening protocols, even in the most resource-constrained settings, and identify lower socioeconomic groups as most vulnerable. Longitudinal follow-up of children with echocardiographically diagnosed subclinical RHD is needed.

The Quality and Utility of Surgical and Anesthetic Data at a Ugandan Regional Referral Hospital.

PubMed

Tumusiime, G; Was, A; Preston, M A; Riesel, J N; Ttendo, S S; Firth, P G

2017-02-01

There are little primary data available on the delivery or quality of surgical treatment in rural sub-Saharan African hospitals. To initiate a quality improvement system, we characterized the existing data capture at a Ugandan Regional Referral Hospital. We examined the surgical ward admission (January 2008-December/2011) and operating theater logbooks (January 2010-July 2011) at Mbarara Regional Referral Hospital. There were 6346 admissions recorded over three years. The mean patient age was 31.4 ± 22.3 years; 29.8 % (n = 1888) of admissions were children. Leading causes of admission were general surgical problems (n = 3050, 48.1 %), trauma (n = 2041, 32.2 %), oncology (n = 718, 11.3 %) and congenital condition (n = 193, 3.0 %). Laparotomy (n = 468, 35.3 %), incision and drainage (n = 188, 14.2 %) and hernia repair (n = 90, 6.8 %) were the most common surgical procedures. Of 1325 operative patients, 994 (75 %) had an ASA I-II score. Of patients undergoing 810 procedures booked as non-elective, 583 (72 %) had an ASA "E" rating. Records of 41.3 % (n-403/975) of patients age 5 years or older undergoing non-obstetric operations were missing from the ward logbook. Missing patients were younger (25 [13,40] versus 30 [18,46] years, p = 0.002) and had higher ASA scores (ASA III-V 29.0 % versus 18.9 %, p < 0.001) than patients recorded in the logbbook; there was no diffence in gender (male 62.8 % versus 67.0 %, p = 0.20). The hospital records system measures surgical care, but improved data capture is needed to determine outcomes with sufficient accuracy to guide and record expansion of surgical capacity.

Giving or Receiving Something for Sex: A Cross-Sectional Study of Transactional Sex among Ugandan University Students

PubMed Central

Choudhry, Vikas; Östergren, Per-Olof; Ambresin, Anne-Emmanuelle; Kyagaba, Emmanuel; Agardh, Anette

2014-01-01

Objective This study sought to determine the prevalence of transactional sex among university students in Uganda and to assess the possible relationship between transactional sex and sexual coercion, physical violence, mental health, and alcohol use. Methods In 2010, 1954 undergraduate students at a Ugandan university responded to a self-administered questionnaire that assessed mental health, substance use, physical violence and sexual behaviors including sexual coercion and transactional sex. The prevalence of transactional sex was assessed and logistic regression analysis was performed to measure the associations between various risk factors and reporting transactional sex. Results Approximately 25% of the study sample reported having taken part in transactional sex, with more women reporting having accepted money, gifts or some compensation for sex, while more men reporting having paid, given a gift or otherwise compensated for sex. Sexual coercion in men and women was significantly associated with having accepted money, gifts or some compensation for sex. Men who were victims of physical violence in the last 12 months had higher probability of having accepted money, gifts or some compensation for sex than other men. Women who were victims of sexual coercion reported greater likelihood of having paid, given a gift or otherwise compensated for sex. Respondents who had been victims of physical violence in last 12 months, engaged in heavy episodic drinking and had poor mental health status were more likely to have paid, given a gift or otherwise compensated for sex. Conclusions University students in Uganda are at high risk of transactional sex. Young men and women may be equally vulnerable to the risks and consequences of transactional sex and should be included in program initiatives to prevent transactional sex. The role of sexual coercion, physical violence, mental health, and alcohol use should be considered when designing interventions for countering transactional sex. PMID:25386901

Male circumcision for HIV prevention--a cross-sectional study on awareness among young people and adults in rural Uganda.

PubMed

Wilcken, Andrea; Miiro-Nakayima, Flavia; Hizaamu, Ramadhan N B; Keil, Thomas; Balaba-Byansi, Dorothy

2010-04-26

Medical male circumcision is now part of a comprehensive approach to HIV prevention. It has been shown that awareness of the protective effect of male circumcision leads to high acceptability towards the introduction of medical male circumcision services within countries. The objective of this survey was to identify factors determining awareness of male circumcision for HIV prevention. We interviewed 452 participants (267 adults >24 years of age; 185 youths 14-24 years) living in three rural Ugandan districts in 2008. Using a standardized questionnaire, we assessed socio-demographic parameters, awareness of MC for HIV prevention, general beliefs/attitudes regarding MC and MC status. Determinants for awareness of MC for HIV prevention were examined with multiple logistic regression models. Out of all adults, 52.1% were male (mean +/- SD age 39.8 +/- 11 years), of whom 39.1% reported to be circumcised. Out of all youths, 58.4% were male (18.4 +/- 2.5), 35.0% circumcised.Adults were more aware of MC for HIV prevention than youths (87.1% vs. 76.5%; p = 0.004). In adults, awareness was increased with higher educational level compared to no school: primary school (adjusted OR 9.32; 95%CI 1.80-48.11), secondary (5.04; 1.01-25.25), tertiary (9.91; 0.76-129.18), university education (8.03; 0.59-109.95). Younger age and male sex were further significant determinants of increased awareness, but not marital status, religion, district, ethnicity, employment status, and circumcision status. In youths, we found a borderline statistically significant decrease of awareness of MC for HIV prevention with higher educational level, but not with any other socio-demographic factors. Particularly Ugandans with low education, youths, and women, playing an important role in decision-making of MC for their partners and sons, should be increasingly targeted by information campaigns about positive health effects of MC.

Hair concentrations of antiretrovirals predict viral suppression in HIV-infected pregnant and breastfeeding Ugandan women.

PubMed

Koss, Catherine A; Natureeba, Paul; Mwesigwa, Julia; Cohan, Deborah; Nzarubara, Bridget; Bacchetti, Peter; Horng, Howard; Clark, Tamara D; Plenty, Albert; Ruel, Theodore D; Achan, Jane; Charlebois, Edwin D; Kamya, Moses R; Havlir, Diane V; Gandhi, Monica

2015-04-24

Hair concentrations are a noninvasive measure of cumulative antiretroviral exposure and the strongest predictor of viral suppression in large cohorts of nonpregnant patients. We examined hair concentrations of antiretrovirals in relation to virologic outcomes in pregnant and breastfeeding women for the first time. The Prevention of Malaria and HIV Disease in Tororo trial (NCT00993031) enrolled HIV-infected pregnant Ugandan women at 12-28 weeks gestation who were randomized to lopinavir or efavirenz-based antiretroviral therapy (ART). Small hair samples were collected at 30-34 weeks gestation and 10-25 weeks postpartum. Efavirenz and lopinavir hair concentrations were measured via liquid chromatography/tandem mass spectrometry. Multivariate logistic regression models examined predictors of viral suppression (HIV-1 RNA ≤400 copies/ml) at delivery and 24 weeks postpartum. Among 325 women, median CD4 cell count was 366 cells/μl (interquartile range 270-488) at ART initiation. Mean self-reported 3-day adherence was greater than 97% in each arm. Viral suppression was achieved by 98.0% (efavirenz) and 87.4% (lopinavir) at delivery. At 24 weeks postpartum, 92.5% (efavirenz) and 90.6% (lopinavir) achieved viral suppression; 88% of women were breastfeeding. In multivariate models including self-reported adherence and pretreatment HIV-1 RNA, antiretroviral hair concentrations were the strongest predictor of viral suppression at delivery [efavirenz: adjusted odds ratio (aOR) 1.86 per doubling in concentration, 95% confidence interval (CI) 1.14-3.1, P = 0.013; lopinavir: aOR 1.90, 95% CI 1.33-2.7, P = 0.0004] and 24 weeks postpartum (efavirenz: aOR 1.81, 95% CI 1.22-2.7, P = 0.003; lopinavir: aOR 1.53, 95% CI 1.05-2.2, P = 0.026). Antiretroviral hair concentrations represent an innovative tool that strongly predicts viral suppression among HIV-infected childbearing women during the critical periods of delivery and breastfeeding.

The association between cognition and academic performance in Ugandan children surviving malaria with neurological involvement.

PubMed

Bangirana, Paul; Menk, Jeremiah; John, Chandy C; Boivin, Michael J; Hodges, James S

2013-01-01

The contribution of different cognitive abilities to academic performance in children surviving cerebral insult can guide the choice of interventions to improve cognitive and academic outcomes. This study's objective was to identify which cognitive abilities are associated with academic performance in children after malaria with neurological involvement. 62 Ugandan children with a history of malaria with neurological involvement were assessed for cognitive ability (working memory, reasoning, learning, visual spatial skills, attention) and academic performance (reading, spelling, arithmetic) three months after the illness. Linear regressions were fit for each academic score with the five cognitive outcomes entered as predictors. Adjusters in the analysis were age, sex, education, nutrition, and home environment. Exploratory factor analysis (EFA) and structural equation models (SEM) were used to determine the nature of the association between cognition and academic performance. Predictive residual sum of squares was used to determine which combination of cognitive scores was needed to predict academic performance. In regressions of a single academic score on all five cognitive outcomes and adjusters, only Working Memory was associated with Reading (coefficient estimate = 0.36, 95% confidence interval = 0.10 to 0.63, p<0.01) and Spelling (0.46, 0.13 to 0.78, p<0.01), Visual Spatial Skills was associated with Arithmetic (0.15, 0.03 to 0.26, p<0.05), and Learning was associated with Reading (0.06, 0.00 to 0.11, p<0.05). One latent cognitive factor was identified using EFA. The SEM found a strong association between this latent cognitive ability and each academic performance measure (P<0.0001). Working memory, visual spatial ability and learning were the best predictors of academic performance. Academic performance is strongly associated with the latent variable labelled "cognitive ability" which captures most of the variation in the individual specific cognitive outcome measures. Working memory, visual spatial skills, and learning together stood out as the best combination to predict academic performance.

The impact of socio-demographic and religious factors upon sexual behavior among Ugandan university students.

PubMed

Agardh, Anette; Tumwine, Gilbert; Östergren, Per-Olof

2011-01-01

More knowledge is needed about structural factors in society that affect risky sexual behaviors. Educational institutions such as universities provide an opportune arena for interventions among young people. The aim of this study was to investigate the relationship between sociodemographic and religious factors and their impact on sexual behavior among university students in Uganda. In 2005, 980 university students (response rate 80%) were assessed by a self-administered questionnaire. Validated instruments were used to assess socio-demographic and religious factors and sexual behavior. Logistic regression analyses were applied. Our findings indicated that 37% of the male and 49% of the female students had not previously had sex. Of those with sexual experience, 46% of the males and 23% of the females had had three or more sexual partners, and 32% of the males and 38% of the females did not consistently use condoms. For those who rated religion as less important in their family, the probability of early sexual activity and having had a high number of lifetime partners increased by a statistically significant amount (OR = 1.7; 95% CI: 1.2-2.4 and OR = 1.6; 95% CI: 1.1-2.3, respectively). However, the role of religion seemed to have no impact on condom use. Being of Protestant faith interacted with gender: among those who had debuted sexually, Protestant female students were more likely to have had three or more lifetime partners; the opposite was true for Protestant male students. Religion emerged as an important determinant of sexual behavior among Ugandan university students. Our findings correlate with the increasing number of conservative religious injunctions against premarital sex directed at young people in many countries with a high burden. of HIV/AIDS. Such influence of religion must be taken into account in order to gain a deeper understanding of the forces that shape sexual behavior in Uganda.

Awareness and Need for Knowledge of Health and Safety among Dairy Farmers Interviewed in Uganda.

PubMed

Lunner-Kolstrup, Christina; Ssali, Tonny Kiggundu

2016-01-01

Safe working conditions are essential for healthy living and for ensuring food security among farmers and farm communities in developing countries. There is limited research on this topic, and documentation is essential to understand and change patterns of human health and safety. In May 2014, six male and female farmers on four dairy farms in Uganda and a female veterinarian were interviewed about their awareness and attitudes to agricultural risk factors, health, and safety. In addition, transect walks were conducted on the four dairy farms. The dairy farmers reported health and safety concerns, e.g., diarrhea, coughs, fever, cuts while using machetes in plantations, bruises when handling animals, and dizziness and poisoning symptoms from using different agrochemicals, and considered these an occupational hazard. The most important topic mentioned was the use of agrochemicals and drugs on livestock. The farmers spray their animals with insecticides to prevent ticks, lice, tsetse flies, and other biting nuisance flies, using a backpack or hand sprayer. Spraying is conducted without personal protection equipment, which is considered too expensive and difficult to obtain. The farmers reported that they usually feel dizzy, vomit, and have pain and a burning feeling in their face and eyes after spraying. The symptoms are sometimes so severe that they require treatment. In such cases, the farmers buy medication without a prescription at the local drugstore, where the storekeeper often has limited or no knowledge of agrochemicals or drugs except for dosage. Agricultural health and safety training in the region is non-existent, and the farmers expressed a need and desire for improvements in this area. The level of knowledge and awareness of agricultural health and safety risks, disease, and injury prevention among the Ugandan dairy farmers interviewed was low. The farmers mentioned few agriculture-related complaints, injuries, or diseases except poisoning from using agrochemicals. Training on health and safety in Ugandan agriculture is urgently needed.

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 national concern. Identifying these priority diseases enables Uganda’s National One Health Platform and Zoonotic Disease Coordination Office to address these zoonoses in the future with a targeted allocation of resources. PMID:29715287

The future of financing for HIV services in Uganda and the wider sub-Saharan Africa region: should we ask patients to contribute to the cost of their care?

PubMed

Kakaire, Tom; Schlech, Walter; Coutinho, Alex; Brough, Richard; Parkes-Ratanshi, Rosalind

2016-08-27

Whilst multi-lateral funding for HIV/AIDS dramatically increased from 2004 to 2008, it has largely plateaued in the last 8 years. Across sub-Saharan Africa, up to 20 % of total spending on health is used for HIV services, and of this over 85 % is estimated to come from international funding rather than in-country sources. In Uganda, the fiscal liability to maintain services for all those who are currently receiving it is estimated to be as much as 3 % of Gross Domestic Product (GDP). In order to meet the growing need of increased patient numbers and further ART coverage the projected costs of comprehensive HIV care and treatment services will increase substantially. Current access to HIV care includes free at point of delivery (provided by Ministry of Health clinics), as well as out-of-pocket financing and health insurance provided care at private for- and not for- profit facilities. The HIV response is funded through Ugandan Ministry of Health national budget allocations, as well as multilateral donations such as the President's Emergency Plan for AIDS in Africa (PEPFAR) and Global Fund (GF) and other international funders. We are concerned that current funding mechanism for HIV programs in Uganda may be difficult to sustain and as service providers we are keen to explore ways in which provide lifelong HIV care to as many people living with HIV (PLHIV) as possible. Until such time as the Ugandan economy can support universal, state-supported, comprehensive healthcare, bridging alternatives must be considered. We suggest that offering patients with the sufficient means to assume some of the financial burden for their care in return for more convenient services could be one component of increasing coverage and sustaining services for those living with HIV.

Concealment tactics among HIV-positive nurses in Uganda.

PubMed

Kyakuwa, Margaret; Hardon, Anita

2012-01-01

This paper is based on two-and-a-half years of ethnographic fieldwork in two rural Ugandan health centres during a period of ART scale-up. Around one-third of the nurses in these two sites were themselves HIV-positive but most concealed their status. We describe how a group of HIV-positive nurses set up a secret circle to talk about their predicament as HIV-positive healthcare professionals and how they developed innovative care technologies to overcome the skin rashes caused by ART that threatened to give them away. Together with patients and a traditional healer, the nurses resisted hegemonic biomedical norms denouncing herbal medicines and then devised and advocated for a herbal skin cream treatment to be included in the ART programme.

Characterization of a Novel Simian Immunodeficiency Virus (SIVmonNG1) Genome Sequence from a Mona Monkey (Cercopithecus mona)

PubMed Central

Barlow, Katrina L.; Ajao, Adebowale Oluwafemi; Clewley, Jonathan P.

2003-01-01

A novel simian immunodeficiency virus (SIV) sequence has been recovered from RNA extracted from the serum of a mona monkey (Cercopithecus mona) wild born in Nigeria. The sequence was obtained by using novel generic (degenerate) PCR primers and spans from two-thirds into the gag gene to the 3′ poly(A) tail of the SIVmonNG1 RNA genome. Analysis of the open reading frames revealed that the SIVmonNG1 genome codes for a Vpu protein, in addition to Gag, Pol, Vif, Vpr, Tat, Rev, Env, and Nef proteins. Previously, only lentiviruses infecting humans (human immunodeficiency virus type 1 [HIV-1]) and chimpanzees (SIVcpz) were known to have a vpu gene; more recently, this has also been found in SIVgsn from Cercopithecus nictitans. Overall, SIVmonNG1 most closely resembles SIVgsn: the env gene sequence groups with HIV-1/SIVcpz env sequences, whereas the pol gene sequence clusters closely with the pol sequence of SIVsyk from Cercopithecus albogaris. By bootscanning and similarity plotting, the first half of pol resembles SIVsyk, whereas the latter part is closer to SIVcol from Colobus guereza. The similarities between the complex mosaic genomes of SIVmonNG1 and SIVgsn are consistent with a shared or common lineage. These data further highlight the intricate nature of the relationships between the SIVs from different primate species and will be helpful for unraveling these associations. PMID:12768007

Nonhuman anthropoid primate femoral neck trabecular architecture and its relationship to locomotor mode.

PubMed

Fajardo, Roberto J; Müller, Ralph; Ketcham, Rich A; Colbert, Matthew

2007-04-01

Functional analyses of human and nonhuman anthropoid primate femoral neck structure have largely ignored the trabecular bone. We tested hypotheses regarding differences in the relative distribution and structural anisotropy of trabecular bone in the femoral neck of quadrupedal and climbing/suspensory anthropoids. We used high-resolution X-ray computed tomography to analyze quantitatively the femoral neck trabecular structure of Ateles geoffroyi, Symphalangus syndactylus, Alouatta seniculus, Colobus guereza, Macaca fascicularis, and Papio cynocephalus (n = 46). We analyzed a size-scaled superior and inferior volume of interest (VOI) in the femoral neck. The ratio of the superior to inferior VOI bone volume fraction indicated that the distribution of trabecular bone was inferiorly skewed in most (but not all) quadrupeds and evenly distributed the climbing/suspensory species, but interspecific comparisons indicated that all taxa overlapped in these measurements. Degree of anisotropy values were generally higher in the inferior VOI of all species and the results for the two climbing/suspensory taxa, A. geoffroyi (1.71 +/- 0.30) and S. syndactylus (1.55 +/- 0.04), were similar to the results for the quadrupedal anthropoids, C. guereza (male = 1.64 +/- 0.13; female = 1.68 +/- 0.07) and P. cynocephalus (1.47 +/- 0.13). These results suggest strong trabecular architecture similarity across body sizes, anthropoid phylogenetic backgrounds, and locomotor mode. This structural similarity might be explained by greater similarity in anthropoid hip joint loading mechanics than previously considered. It is likely that our current models of anthropoid hip joint mechanics are overly simplistic.

Diet Versus Phylogeny: a Comparison of Gut Microbiota in Captive Colobine Monkey Species.

PubMed

Hale, Vanessa L; Tan, Chia L; Niu, Kefeng; Yang, Yeqin; Knight, Rob; Zhang, Qikun; Cui, Duoying; Amato, Katherine R

2018-02-01

Both diet and host phylogeny shape the gut microbial community, and separating out the effects of these variables can be challenging. In this study, high-throughput sequencing was used to evaluate the impact of diet and phylogeny on the gut microbiota of nine colobine monkey species (N = 64 individuals). Colobines are leaf-eating monkeys that fare poorly in captivity-often exhibiting gastrointestinal (GI) problems. This study included eight Asian colobines (Rhinopithecus brelichi, Rhinopithecus roxellana, Rhinopithecus bieti, Pygathrix nemaeus, Nasalis larvatus, Trachypithecus francoisi, Trachypithecus auratus, and Trachypithecus vetulus) and one African colobine (Colobus guereza). Monkeys were housed at five different captive institutes: Panxi Wildlife Rescue Center (Guizhou, China), Beijing Zoo, Beijing Zoo Breeding Center, Singapore Zoo, and Singapore Zoo Primate Conservation Breeding Center. Captive diets varied widely between institutions, but within an institution, all colobine monkey species were fed nearly identical or identical diets. In addition, four monkey species were present at multiple captive institutes. This allowed us to parse the effects of diet and phylogeny in these captive colobines. Gut microbial communities clustered weakly by host species and strongly by diet, and overall, colobine phylogenetic relationships were not reflected in gut microbiota analyses. Core microbiota analyses also identified several key taxa-including microbes within the Ruminococcaceae and Lachnospiraceae families-that were shared by over 90% of the monkeys in this study. Microbial species within these families include many butyrate producers that are important for GI health. These results highlight the importance of diet in captive colobines.

Diversity and prevalence of gastrointestinal parasites in seven non-human primates of the Taï National Park, Côte d’Ivoire

PubMed Central

Kouassi, Roland Yao Wa; McGraw, Scott William; Yao, Patrick Kouassi; Abou-Bacar, Ahmed; Brunet, Julie; Pesson, Bernard; Bonfoh, Bassirou; N’goran, Eliezer Kouakou; Candolfi, Ermanno

2015-01-01

Parasites and infectious diseases are well-known threats to primate populations. The main objective of this study was to provide baseline data on fecal parasites in the cercopithecid monkeys inhabiting Côte d’Ivoire’s Taï National Park. Seven of eight cercopithecid species present in the park were sampled: Cercopithecus diana, Cercopithecus campbelli, Cercopithecus petaurista, Procolobus badius, Procolobus verus, Colobus polykomos, and Cercocebus atys. We collected 3142 monkey stool samples between November 2009 and December 2010. Stool samples were processed by direct wet mount examination, formalin-ethyl acetate concentration, and MIF (merthiolate, iodine, formalin) concentration methods. Slides were examined under microscope and parasite identification was based on the morphology of cysts, eggs, and adult worms. A total of 23 species of parasites was recovered including 9 protozoa (Entamoeba coli, Entamoeba histolytica/dispar, Entamoeba hartmanni, Endolimax nana, Iodamoeba butschlii, Chilomastix mesnili, Giardia sp., Balantidium coli, and Blastocystis sp.), 13 nematodes (Oesophagostomum sp., Ancylostoma sp., Anatrichosoma sp., Capillariidae Gen. sp. 1, Capillariidae Gen. sp. 2, Chitwoodspirura sp., Subulura sp., spirurids [cf Protospirura muricola], Ternidens sp., Strongyloides sp., Trichostrongylus sp., and Trichuris sp.), and 1 trematode (Dicrocoelium sp.). Diversity indices and parasite richness were high for all monkey taxa, but C. diana, C. petaurista, C. atys, and C. campbelli exhibited a greater diversity of parasite species and a more equitable distribution. The parasitological data reported are the first available for these cercopithecid species within Taï National Park. PMID:25619957

Assessing community perspectives of the community based education and service model at Makerere University, Uganda: a qualitative evaluation.

PubMed

Mbalinda, Scovia N; Plover, Colin M; Burnham, Gilbert; Kaye, Dan; Mwanika, Andrew; Oria, Hussein; Okullo, Isaac; Muhwezi, Wilson; Groves, Sara

2011-03-09

Community partnerships are defined as groups working together with shared goals, responsibilities, and power to improve the community. There is growing evidence that these partnerships contribute to the success and sustainability of community-based education and service programs (COBES), facilitating change in community actions and attitudes. Makerere University College of Health Sciences (MakCHS) is forging itself as a transformational institution in Uganda and the region. The College is motivated to improve the health of Ugandans through innovative responsive teaching, provision of service, and community partnerships. Evaluating the COBES program from the community perspective can assist the College in refining an innovative and useful model that has potential to improve the health of Ugandans. A stratified random sample of 11 COBES sites was selected to examine the community's perception of the program. Key Informant Interviews of 11 site tutors and 33 community members were completed. The data was manually analyzed and themes developed. Communities stated the students consistently engaged with them with culturally appropriate behaviour. They rated the student's communication as very good even though translators were frequently needed. Half the community stated they received some feedback from the students, but some communities interpreted any contact after the initial visit as feedback. Communities confirmed and appreciated that the students provided a number of interventions and saw positive changes in health and health seeking behaviours. The community reflected that some programs were more sustainable than others; the projects that needed money to implement were least sustainable. The major challenges from the community included community fatigue, and poor motivation of community leaders to continue to take students without compensation. Communities hosting Makerere students valued the students' interventions and the COBES model. They reported witnessing health benefits of fewer cases of disease, increased health seeking behavior and sustainable healthcare programs. The evidence suggests that efforts to standardize objectives, implement structural adjustments, and invest in development of the program would yield even more productive community interactions and a healthcare workforce with public health skills needed to work in rural communities.

Primary school students' mental health in Uganda and its association with school violence, connectedness, and school characteristics: a cross-sectional study.

PubMed

Thumann, Barbara F; Nur, Ula; Naker, Dipak; Devries, Karen M

2016-07-29

Few studies have explored risk factors for poor mental health in Ugandan primary schools. This study investigated whether individual- and contextual-level school-related factors including violence from school staff and other students, connectedness to school and peers, as well as school size and urban/rural location, were associated with mental health difficulties in Ugandan children. We also examined whether associations between violence exposure at school and mental health were mediated by connectedness as well as whether associations were different for boys and girls. The analytic sample consisted of 3,565 students from 42 primary schools participating in the Good Schools Study. Data were collected through individual interviews conducted in June and July 2012. Mental health was measured using the Strengths and Difficulties Questionnaire. Multilevel logistic regression was applied to investigate factors associated with mental health difficulties. Experiences of violence from school staff and other students in the past week were strongly associated with mental health difficulties (OR = 1.58, 95 % CI 1.31 to 1.90 and 1.81, 1.47 to 2.23, respectively). Children with a low school connectedness had 1.43 times (1.11 to 1.83) the odds of mental health difficulties compared to those with a high school connectedness. The OR comparing children never feeling close to other students at their school with those always feeling close was 1.86 (1.18 to 2.93). The effect of violence on mental health was not mediated through the connectedness variables. School size was not related to mental health difficulties, but attending an urban school increased the odds of mental health difficulties after accounting for other factors. We did not find evidence that the effect of one or more of the exposures on the outcome differed between boys and girls. These findings suggest that violence in school and low connectedness to school and peers are independently associated with mental health difficulties and interventions should address both concurrently. Extra support may be needed for students in urban schools. Clinicaltrials.gov NCT01678846 . Registered 24 August 2012.

Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students.

PubMed

Choudhry, Vikas; Agardh, Anette; Stafström, Martin; Östergren, Per-Olof

2014-02-06

As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience. A cross-sectional survey was carried out in 2010 among 1954 students at Mbarara University of Science and Technology, Uganda, using a self-administered questionnaire. Alcohol use was measured as consumption over the previous 12 months, during situations related to sexual activity and on the most recent occasion of sexual intercourse. Risky sexual behavior was defined as having two or more sexual partners in the previous 12 months or inconsistent condom use with new partners. Bivariate and multivariate logistic regression was performed to analyze the association between alcohol use and risky sexual behavior separately for males and females. Even after adjusting for confounders, the odds ratio (OR) of having two or more sexual partners in the past year indicated a statistically significant association with alcohol use on all levels (global, situational, and event) for both males and females. The ORs of inconsistent condom use with a new partner were significant for males who often consumed alcohol in relation to sexual activity--even after adjusting for potential confounders (OR, 1.75; confidence interval, 1.01-3.08). The risk of inconsistent condom use with a new partner was twice as high for females who often consumed alcohol in relation to sexual activity, although this association was not statistically significant. The study supports previous research that alcohol consumption is associated with having multiple sexual partners. Inconsistent condom use was associated with the situational use of alcohol in relation to sexual activity and was similar for both genders. Interventions to reduce alcohol-related risky sexual behavior should target both male and female drinkers, particularly subgroups of students, who often consume alcohol in relation to sexual activity.

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 for universal access to ART, demonstrating that expanding ART services is not inherently linked to declines in other health services in sub-Saharan Africa.

Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students

PubMed Central

2014-01-01

Background As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience. Methods A cross-sectional survey was carried out in 2010 among 1954 students at Mbarara University of Science and Technology, Uganda, using a self-administered questionnaire. Alcohol use was measured as consumption over the previous 12 months, during situations related to sexual activity and on the most recent occasion of sexual intercourse. Risky sexual behavior was defined as having two or more sexual partners in the previous 12 months or inconsistent condom use with new partners. Bivariate and multivariate logistic regression was performed to analyze the association between alcohol use and risky sexual behavior separately for males and females. Results Even after adjusting for confounders, the odds ratio (OR) of having two or more sexual partners in the past year indicated a statistically significant association with alcohol use on all levels (global, situational, and event) for both males and females. The ORs of inconsistent condom use with a new partner were significant for males who often consumed alcohol in relation to sexual activity—even after adjusting for potential confounders (OR, 1.75; confidence interval, 1.01–3.08). The risk of inconsistent condom use with a new partner was twice as high for females who often consumed alcohol in relation to sexual activity, although this association was not statistically significant. Conclusions The study supports previous research that alcohol consumption is associated with having multiple sexual partners. Inconsistent condom use was associated with the situational use of alcohol in relation to sexual activity and was similar for both genders. Interventions to reduce alcohol-related risky sexual behavior should target both male and female drinkers, particularly subgroups of students, who often consume alcohol in relation to sexual activity. PMID:24502331

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda.

PubMed

Nankumbi, Joyce; Groves, Sara; Leontsini, Elli; Kyegombe, Nambusi; Coutinho, Alex; Manabe, Yuka

2011-03-09

Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. This community-university HIV innovative model was successful from the point of view of the nurses and nurse managers. This model shows promise in increasing effective, quality health service; HIV and other programs can build capacity and empower nurses and nurse managers to directly implement such services. It also demonstrates how MakCHS can be instrumental through partnerships in designing and testing effective strategies, building human health resources and improving Ugandan health outcomes.

Therapeutic drug monitoring of nevirapine in saliva in Uganda using high performance liquid chromatography and a low cost thin-layer chromatography technique.

PubMed

Lamorde, Mohammed; Fillekes, Quirine; Sigaloff, Kim; Kityo, Cissy; Buzibye, Allan; Kayiwa, Joshua; Merry, Concepta; Nakatudde-Katumba, Lillian; Burger, David; de Wit, Tobias F Rinke

2014-09-01

In resource limited settings access to laboratory monitoring of HIV treatment is limited and therapeutic drug monitoring is generally unavailable. This study aimed to evaluate nevirapine concentrations in saliva using low-cost thin-layer chromatography (TLC) and nevirapine concentrations in plasma and saliva using high performance liquid chromatography (HPLC) methods; and to correlate nevirapine plasma concentrations to HIV treatment outcomes in Ugandan patients. Paired plasma and stimulated saliva samples were obtained from Ugandan, HIV-infected adults on nevirapine-based ART. Nevirapine concentrations were measured using a validated HPLC method and a novel TLC method. Plasma nevirapine concentrations <3.0 mg/L using HPLC were considered subtherapeutic. Negative/positive predictive values of different thresholds for subtherapeutic nevirapine concentrations in saliva were determined. Virologic testing and, if applicable, HIV drug resistance testing was performed. Median (interquartile range, IQR) age of 297 patients was 39.1 (32.8-45.2) years. Three hundred saliva and 287 plasma samples were available for analysis. Attempts failed to determine nevirapine saliva concentrations by TLC. Using HPLC, median (IQR) nevirapine concentrations in saliva and plasma were 3.40 (2.59-4.47) mg/L and 6.17 (4.79-7.96) mg/L, respectively. The mean (coefficient of variation,%) nevirapine saliva/plasma ratio was 0.58 (62%). A cut-off value of 1.60 mg/L nevirapine in saliva was associated with a negative/positive predictive value of 0.99/0.72 and a sensitivity/specificity of 87%/98% for predicting subtherapeutic nevirapine plasma concentrations, respectively. Only 5% (15/287) of patients had subtherapeutic nevirapine plasma concentrations, of which 3 patients had viral load results > 400 copies/mL. Patients with nevirapine concentrations in plasma <3.0 mg/L had an Odds Ratio of 3.29 (95% CI: 1.00 - 10.74) for virological failure (viral load >400 copies/mL). The low-cost TLC technique for monitoring nevirapine in saliva was unsuccessful but monitoring nevirapine saliva and plasma concentrations using HPLC was shown to be feasible in the research/specialist context in Uganda. Further optimization and validation is required for the low-cost TLC technique.

Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey

PubMed Central

Knight, Louise; Child, Jennifer C; Kyegombe, Nambusi; Hossain, Mazeda; Lees, Shelley; Watts, Charlotte; Naker, Dipak

2017-01-01

Objectives Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home. Design A representative cross-sectional survey of primary schools. Participants 3427 non-boarding primary school students, aged about 11–14 years. Setting Luwero District, Uganda, 2012. Measures Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV. Results 26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves. Conclusions In this sample, witnessing IPV almost never occurred in isolation—almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in homes with no partner violence, highlighting the need for interventions to prevent child maltreatment more broadly. Trial registration number NCT01678846, results. PMID:28246136

Rural and urban Ugandan primary school children's alternative ideas about animals

NASA Astrophysics Data System (ADS)

Otaala, Justine

This study examined rural and urban Ugandan primary children's alternative ideas about animals through the use of qualitative research methods. Thirty-six children were selected from lower, middle, and upper primary grades in two primary schools (rural and urban). Data were collected using interview-about-instance technique. Children were shown 18 color photographs of instances and non-instances of familiar animals and asked to say if the photographed objects were animals or not. They were then asked to give reasons to justify their answers. The interviews were audiotaped and transcribed. The results indicate that children tended to apply the label "animal" to large mammals, usually found at home, on the farm, in the zoo, and in the wild. Humans were not categorized as animals, particularly by children in the lower grades. Although the children in upper grades correctly identified humans as animals, they used reasons that were irrelevant to animal attributes and improperly derived from the biological concept of evolution. Many attributes children used to categorize instances of animals were scientifically unacceptable and included superficial features, such as body outline, anatomical features (body parts), external features (visual cues), presence or absence and number of appendages. Movement and eating (nutrition) were the most popular attributes children used to identify instances of animals. The main differences in children's ideas emanated from the reasons used to identify animals. Older rural children drew upon their cultural and traditional practices more often than urban children. Anthropomorphic thinking was predominant among younger children in both settings, but diminished with progression in children's grade levels. Some of the implications of this study are: (1) teachers, teacher educators and curriculum developers should consider learners' ideas in planning and developing teaching materials and interventions. (2) Teachers should relate humans to other animals during instruction. (3) Textbooks and teaching materials need careful scrutiny to insure they include humans and other small animals as part of the animal kingdom. (4) Teaching interventions should begin with the basic attributes of animals and insure children understand the relationship between the attributes and concepts. (5) Encourage the use of examples and non-examples of the concept "animal" during instruction.

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, administrative and technical; better anchoring within the national health system framework; integration of the notion of complexity in the design of the framework; and emphasis on facilitating district decision-making and learning. There is need to improve data quality and range and additional approaches for data analysis and presentation.

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

PubMed Central

2011-01-01

Background Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. Methods A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Results Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. Conclusions This community-university HIV innovative model was successful from the point of view of the nurses and nurse managers. This model shows promise in increasing effective, quality health service; HIV and other programs can build capacity and empower nurses and nurse managers to directly implement such services. It also demonstrates how MakCHS can be instrumental through partnerships in designing and testing effective strategies, building human health resources and improving Ugandan health outcomes. PMID:21411008

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 interventions targeting IVP. Vaginal practices among women at high risk in Uganda and Tanzania: recorded behaviour from a daily pictorial diary. PMID:23555618

On the road again: concurrency and condom use among Uganda truck drivers.

PubMed

Costenbader, Elizabeth C; Lancaster, Kathryn; Bufumbo, Leonard; Akol, Angela; Guest, Greg

2015-01-01

Long-distance truck drivers have been shown to be a critical population in the spread of HIV in Africa. In 2009, surveys with 385 Ugandan long-distance truck drivers measured concurrency point prevalence with two methods; it ranged from 37.4% (calendar-method) to 50.1% (direct question). The majority (84%) of relationships reported were long-term resulting in a long duration of overlap (average of 58 months) across concurrent partnerships. Only 7% of these men reported using any condoms with their spouses during the past month. Among all non-spousal relationships, duration of relationship was the factor most strongly associated with engaging in unprotected sex in the past month in a multivariable analyses controlling for partner and relationship characteristics. Innovative intervention programs for these men and their partners are needed that address the realities of truck drivers' lifestyles.

Barriers to and acceptability of provider-initiated HIV testing and counselling and adopting HIV-prevention behaviours in rural Uganda: a qualitative study.

PubMed

Kiene, Susan M; Sileo, Katelyn; Wanyenze, Rhoda K; Lule, Haruna; Bateganya, Moses H; Jasperse, Joseph; Nantaba, Harriet; Jayaratne, Kia

2015-02-01

In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings. © The Author(s) 2013.

Clavicle, a neglected bone: morphology and relation to arm movements and shoulder architecture in primates.

PubMed

Voisin, Jean-Luc

2006-09-01

In spite of its importance for movements of the upper limbs, the clavicle is an infrequently studied shoulder bone. The present study compares clavicular morphology among different extant primates. Methods have included the assessment of clavicular curvatures projected on two perpendicular planes that can be assessed overall as cranial and dorsal primary curvatures. Results showed that in cranial view, three morphologies can be defined. One group exhibited an external curvature considerably more pronounced than the internal one (Gorilla, Papio); a second group was characterized by an internal curvature much more pronounced than the external one (Hylobates, Ateles); and a third group contained those with the two curvatures equally pronounced (Pan, Homo, Pongo, Procolobus, Colobus). Clavicle curvatures projected on the dorsal plane could be placed into four groups. The first group is characterized by two curvatures, an inferior and a superior (Apes, Spider monkeys). The second included monkeys, whose clavicles have an inferior curvature much more pronounced than the superior one. The third group includes only Hylobates, whose clavicles possess only the superior curvature. The last group includes only modern humans, whose clavicles show only the inferior curvature, which is less pronounced than that which exists in monkeys. Curvatures in cranial view relate information regarding the parameters of arm elevation while those in dorsal view offer insights into the position of the scapula related to the thorax. The use of clavicular curvature analysis offers a new dimension in assessment of the functional morphology of the clavicle and its relationship to the shoulder complex. (c) 2006 Wiley-Liss, Inc.

Diversity and prevalence of gastrointestinal parasites in seven non-human primates of the Taï National Park, Côte d'Ivoire.

PubMed

Kouassi, Roland Yao Wa; McGraw, Scott William; Yao, Patrick Kouassi; Abou-Bacar, Ahmed; Brunet, Julie; Pesson, Bernard; Bonfoh, Bassirou; N'goran, Eliezer Kouakou; Candolfi, Ermanno

2015-01-01

Parasites and infectious diseases are well-known threats to primate populations. The main objective of this study was to provide baseline data on fecal parasites in the cercopithecid monkeys inhabiting Côte d'Ivoire's Taï National Park. Seven of eight cercopithecid species present in the park were sampled: Cercopithecus diana, Cercopithecus campbelli, Cercopithecus petaurista, Procolobus badius, Procolobus verus, Colobus polykomos, and Cercocebus atys. We collected 3142 monkey stool samples between November 2009 and December 2010. Stool samples were processed by direct wet mount examination, formalin-ethyl acetate concentration, and MIF (merthiolate, iodine, formalin) concentration methods. Slides were examined under microscope and parasite identification was based on the morphology of cysts, eggs, and adult worms. A total of 23 species of parasites was recovered including 9 protozoa (Entamoeba coli, Entamoeba histolytica/dispar, Entamoeba hartmanni, Endolimax nana, Iodamoeba butschlii, Chilomastix mesnili, Giardia sp., Balantidium coli, and Blastocystis sp.), 13 nematodes (Oesophagostomum sp., Ancylostoma sp., Anatrichosoma sp., Capillariidae Gen. sp. 1, Capillariidae Gen. sp. 2, Chitwoodspirura sp., Subulura sp., spirurids [cf Protospirura muricola], Ternidens sp., Strongyloides sp., Trichostrongylus sp., and Trichuris sp.), and 1 trematode (Dicrocoelium sp.). Diversity indices and parasite richness were high for all monkey taxa, but C. diana, C. petaurista, C. atys, and C. campbelli exhibited a greater diversity of parasite species and a more equitable distribution. The parasitological data reported are the first available for these cercopithecid species within Taï National Park. © R.W.Y. Kouassi et al., published by EDP Sciences, 2015.

Craniodental variation in Paranthropus boisei: a developmental and functional perspective.

PubMed

Wood, B; Lieberman, D E

2001-09-01

What levels and patterns of craniodental variation among a fossil hypodigm are necessary to reject the null hypothesis that only a single species is sampled? We suggest how developmental and functional criteria can be used to predict where in the skeleton of fossil hominins we should expect more, or less, within-species variation. We present and test three hypotheses about the factors contributing to craniodental variation in extant primate taxa, and then apply these results to the interpretation of the P. boisei hypodigm. Within the comparative samples of extant Homo, Pan, Gorilla, Pongo, and Colobus, variables from the cranial base, neurocranium, and face that are not subject to high magnitudes of strain have consistently lower levels of intraspecific variation than variables from regions of the face subject to high levels of strain. Dental size variables are intermediate in terms of their reliability. P. boisei is found to have a low degree of variability relative to extant primates for variables shown to be generally useful for testing taxonomic hypotheses. Contrary to the claims of Suwa et al. ([1997] Nature 389:489-492), the recently discovered material from Konso falls within the range of variation of the "pre-Konso" hypodigm of P. boisei for available conventional metrical variables. Those aspects of the Konso material that appear to extend the range of the P. boisei hypodigm involve regions of the skull predicted to be prone to high levels of within-species variation. The approach used in this study focuses on craniodental data, but it is applicable to other regions of the skeleton. Copyright 2001 Wiley-Liss, Inc.

Cash for carbon: A randomized trial of payments for ecosystem services to reduce deforestation.

PubMed

Jayachandran, Seema; de Laat, Joost; Lambin, Eric F; Stanton, Charlotte Y; Audy, Robin; Thomas, Nancy E

2017-07-21

We evaluated a program of payments for ecosystem services in Uganda that offered forest-owning households annual payments of 70,000 Ugandan shillings per hectare if they conserved their forest. The program was implemented as a randomized controlled trial in 121 villages, 60 of which received the program for 2 years. The primary outcome was the change in land area covered by trees, measured by classifying high-resolution satellite imagery. We found that tree cover declined by 4.2% during the study period in treatment villages, compared to 9.1% in control villages. We found no evidence that enrollees shifted their deforestation to nearby land. We valued the delayed carbon dioxide emissions and found that this program benefit is 2.4 times as large as the program costs. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Mentoring student nurses in Uganda: A phenomenological study of mentors' perceptions of their own knowledge and skills.

PubMed

Mubeezi, Mary P; Gidman, Janice

2017-09-01

This paper will report on the findings of a qualitative research study exploring mentorship in a rural hospital in Uganda. It explored how mentors perceived their roles and their own knowledge and skills in mentoring nurse students. Participants were confident in their ability to teach clinical skills, but they identified gaps in relation to the application of theory to these skills and they the need to update their own knowledge and to act more on their own initiative. The paper reports on the nature of the relationship between mentor and students, the teaching approaches used and the challenges of the role. Recommendations are proposed to develop a bespoke Ugandan curriculum to prepare mentors for their role, and to provide additional support, to enhance students' experiences of learning in this context. Copyright © 2017. Published by Elsevier Ltd.

"The Adopted Children of ART": expert clients and role tensions in ART provision in Uganda.

PubMed

Kyakuwa, Margaret; Hardon, Anita; Goldstein, Zoe

2012-01-01

The implementation of the greater involvement of people living with HIV (GIPA) principle in Ugandan AIDS care is described by focusing on the engagement of expert clients in two rural health centers during a time of antiretroviral therapy (ART) scale-up. We contrast how the expert clients help overburdened nurses to manage the well-attended ART programs in the public and in the nongovernmental organization clinic. They are unpaid, but acquire preferential status in the ART program because of their knowledge of AIDS medicines (and its adverse effects) and because of the compassionate care that they provide. Despite the assistance provided, nurses in the public facility felt threatened in their professional status by these expert clients, who were seen to overstep the boundaries of their role. We pay particular attention to the double burden for HIV-positive nurses, who fear stigma, and (unlike the expert patients) keep their HIV status secret.

Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers.

PubMed

Murray, S M; Familiar, I; Nakasujja, N; Winch, P J; Gallo, J J; Opoka, R; Caesar, J O; Boivin, M J; Bass, J K

2017-06-01

Prior studies indicate a substantial link between maternal depression and early child health but give limited consideration to the direction of this relationship or the context in which it occurs. We sought to create a contextually informed conceptual framework of this relationship through semi-structured interviews with women that had lived experience of caring for an HIV-infected child while coping with depression and anxiety symptoms. Caregivers explained their role in raising healthy children as complex and complicated by poverty, stigma, and isolation. Caregivers discussed the effects of their own mental health on child well-being as primarily emotional and behavioral, and explained how looking after a child could bring distress, particularly when unable to provide desired care for sick children. Our findings suggest the need for investigation of the reciprocal effects of child sickness on caregiver wellness and for integrated programs that holistically address the needs of HIV-affected families.

Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers

PubMed Central

Murray, S.M.; Familiar, I.; Nakasujja, N.; Winch, P.; Gallo, J.; Opoka, R.; Caesar, J.O.; Boivin, M.J.; Bass, J.K.

2017-01-01

Prior studies indicate a substantial link between maternal depression and early child health but give limited consideration to the direction of this relationship or the context in which it occurs. We sought to create a contextually informed conceptual framework of this relationship through semi-structured interviews with women that had lived experience of caring for an HIV-infected child while coping with depression and anxiety symptoms. Caregivers explained their role in raising healthy children as complex and complicated by poverty, stigma, and isolation. Caregivers discussed the effects of their own mental health on child well-being as primarily emotional and behavioral, and explained how looking after a child could bring distress, particularly when unable to provide desired care for sick children. Our findings suggest the need for investigation of the reciprocal effects of child sickness on caregiver wellness and for integrated programs that holistically address the needs of HIV-affected families. PMID:27951734

An escape from agony: a qualitative psychological autopsy study of women's suicide in a post-conflict northern Uganda.

PubMed

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

2012-09-05

We set out to investigate suicide among women in a post-conflict context in Northern Uganda using qualitative psychological autopsy interviews. Three to five relatives and friends for each of the three suicides recruited were interviewed (N=11). Through interpretative phenomenological analysis (IPA) we found that the women all had been through traumatic experiences attributable to the protracted war/conflict between the rebel groups and Ugandan Government armed forces. Nevertheless, the decision of self-inflicted death seemed to have been due to a combination of unpleasant experiences/events that prevailed within the last 3 months prior to the suicide. These experiences are summarized in two broad themes: No control in life and No care. Changes in the traditional gender roles, men's quest for their lost masculinity, and women's attempt to fight for their rights that was perceived as a cultural transgression contributed to the women's suicides.

An escape from agony: A qualitative psychological autopsy study of women's suicide in a post-conflict Northern Uganda

PubMed Central

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

2012-01-01

We set out to investigate suicide among women in a post-conflict context in Northern Uganda using qualitative psychological autopsy interviews. Three to five relatives and friends for each of the three suicides recruited were interviewed (N=11). Through interpretative phenomenological analysis (IPA) we found that the women all had been through traumatic experiences attributable to the protracted war/conflict between the rebel groups and Ugandan Government armed forces. Nevertheless, the decision of self-inflicted death seemed to have been due to a combination of unpleasant experiences/events that prevailed within the last 3 months prior to the suicide. These experiences are summarized in two broad themes: No control in life and No care. Changes in the traditional gender roles, men's quest for their lost masculinity, and women's attempt to fight for their rights that was perceived as a cultural transgression contributed to the women's suicides. PMID:22989691

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.

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.

Bribery in health care in Uganda.

PubMed

Hunt, Jennifer

2010-09-01

I examine the role of household permanent income in determining who bribes and how much they bribe in health care in Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household expenditure increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount is about 0.37. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector is able to price discriminate less effectively than public institutions with less competition from the private sector. Copyright 2010 Elsevier B.V. All rights reserved.

Shining a Light on Task-Shifting Policy: Exploring opportunities for adaptability in non-communicable disease management programmes in Uganda.

PubMed

Katende, Godfrey; Donnelly, Mary

2016-05-01

In terms of disease burden, many low- and middle-income countries are currently experiencing a transition from infectious to chronic diseases. In Uganda, non-communicable diseases (NCDs) have increased significantly in recent years; this challenge is compounded by the healthcare worker shortage and the underfunded health system administration. Addressing the growing prevalence of NCDs requires evidence-based policies and strategies to reduce morbidity and mortality rates; however, the integration and evaluation of new policies and processes pose many challenges. Task-shifting is the process whereby specific tasks are transferred to health workers with less training and fewer qualifications. Successful implementation of a task-shifting policy requires appropriate skill training, clearly defined roles, adequate evaluation, an enhanced training capacity and sufficient health worker incentives. This article focuses on task-shifting policy as a potentially effective strategy to address the growing burden of NCDs on the Ugandan healthcare system.

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

BETWEEN WOMEN’S RIGHTS AND MEN’S AUTHORITY: MASCULINITY AND SHIFTING DISCOURSES OF GENDER DIFFERENCE IN URBAN UGANDA

PubMed Central

Wyrod, Robert

2009-01-01

Across the African continent, women’s rights have become integral to international declarations, regional treaties, national legislation, and grassroots activism. Yet there is little research on how African men have understood these shifts, and how African masculinities are implicated in such changes. Drawing on a year of ethnographic research in the Ugandan capital Kampala, this article investigates how ordinary men and women in Uganda understand women’s rights, and how their attitudes are tied to local conceptions of masculinity. I argue that a new configuration of gender relations is evident in urban Uganda—one that accommodates some aspects of women’s rights while retaining previous notions of innate male authority. This article, therefore, illustrates the complex and often contradictory engagements with human rights that occur in local contexts, and how such engagements are shaped by gender relations, including conceptions of masculinity. PMID:19862350

Lymph node fibrosis: a structural barrier to unleashing effective vaccine immunity.

PubMed

Julg, Boris; Alter, Galit

2018-05-21

There is marked variability in vaccine efficacy among global populations. In particular, individuals in low- to middle-income countries have been shown to be less responsive to vaccines than those from developed nations. Several factors, including endemic infections, nutrition, genetics, and gut microbiome composition, have been proposed to underlie discrepancies in vaccine response. In this issue of the JCI, Kityo et al. evaluated response to yellow fever virus vaccine, inflammation, and lymphatic tissue architecture and fibrosis in three cohorts: two from the U.S. and one from Uganda. Compared with the U.S. subjects, the Ugandan cohort exhibited enhanced cytokine responses, increased lymph node fibrosis, reduced CD4+ T cell levels, and reduced vaccine response. Together, these results provide a link among chronic inflammation, damaged lymphoid architecture, and poor vaccine outcome, and set the stage for future studies to identify strategies to overcome these barriers.

Air medical evacuations from a developing world conflict zone.

PubMed

Low, Adam; Vadera, Bettina

2011-01-01

Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations-backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda-backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian populace, fighting with a lethal mixture of improvised explosive devices and suicide bombers. Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Experience of sexual coercion and risky sexual behavior among Ugandan university students

PubMed Central

2011-01-01

Background Growing worldwide evidence shows that the experience of sexual coercion is fairly prevalent among young people and is associated with risky sexual behavior thereafter. The causal mechanisms behind this are unclear but may be dependent on specific contextual determinants. Little is known about factors that could buffer the negative effects of coercion. The aim of this study was to assess the association between the experience of sexual coercion and risky sexual behavior among university students of both sexes in Uganda. Methods In 2005, 980 (80%) out of a total of 1,220 students enrolled in Mbarara University of Science and Technology in Uganda participated in a self-administered questionnaire covering socio-demographic and religious factors, social capital, mental health, alcohol use, and sexual behavior. A validated scale of six items was used to assess the experience of sexual coercion. Logistic regression analyses were applied to control for confounders. Potential buffering factors were analyzed by testing for effect modification. Results Fifty-nine percent of those who responded had previously had sexual intercourse. Among the male students 29.0%, and among the female students 33.1% reported having had some experience of sexual coercion. After controlling for age, gender, and educational level of household of origin, role of religion and trust in others sexual coercion was found to be statistically significantly associated with previously had sex (OR 1.6, 95% CI; 1.1-2.3), early sexual debut (OR 2.4, 95% CI; 1.5-3.7), as well as with having had a great number of sexual partners (OR 1.9, 95% CI; 1.2-3.0), but not with inconsistent condom use. Scoring low on an assessment of mental health problems, reporting high trust in others, or stating that religion played a major role in one's family of origin seemed to buffer the negative effect that the experience of sexual coercion had on the likelihood of having many sexual partners. Conclusion The findings of this study suggest that the experience of sexual coercion is common among youth/young adults in Uganda and is subsequently associated with risky sexual behavior in both sexes. The existence of individual and contextual factors that buffer the effects mentioned was also demonstrated. In the Ugandan context, this has implications for policy formulation and the implementation of preventive strategies for combating HIV/AIDS. PMID:21726433

Capacity-building and clinical competence in infectious disease in Uganda: a mixed-design study with pre/post and cluster-randomized trial components.

PubMed

Weaver, Marcia R; Crozier, Ian; Eleku, Simon; Makanga, Gyaviira; Mpanga Sebuyira, Lydia; Nyakake, Janepher; Thompson, MaryLou; Willis, Kelly

2012-01-01

Best practices for training mid-level practitioners (MLPs) to improve global health-services are not well-characterized. Two hypotheses were: 1) Integrated Management of Infectious Disease (IMID) training would improve clinical competence as tested with a single arm, pre-post design, and 2) on-site support (OSS) would yield additional improvements as tested with a cluster-randomized trial. Thirty-six Ugandan health facilities (randomized 1∶1 to parallel OSS and control arms) enrolled two MLPs each. All MLPs participated in IMID (3-week core course, two 1-week boost sessions, distance learning). After the 3-week course, OSS-arm trainees participated in monthly OSS. Twelve written case scenarios tested clinical competencies in HIV/AIDS, tuberculosis, malaria, and other infectious diseases. Each participant completed different randomly-assigned blocks of four scenarios before IMID (t0), after 3-week course (t1), and after second boost course (t2, 24 weeks after t1). Scoring guides were harmonized with IMID content and Ugandan national policy. Score analyses used a linear mixed-effects model. The primary outcome measure was longitudinal change in scenario scores. Scores were available for 856 scenarios. Mean correct scores at t0, t1, and t2 were 39.3%, 49.1%, and 49.6%, respectively. Mean score increases (95% CI, p-value) for t0-t1 (pre-post period) and t1-t2 (parallel-arm period) were 12.1 ((9.6, 14.6), p<0.001) and -0.6 ((-3.1, +1.9), p = 0.647) percent for OSS arm and 7.5 ((5.0, 10.0), p<0.001) and 1.6 ((-1.0, +4.1), p = 0.225) for control arm. The estimated mean difference in t1 to t2 score change, comparing arm A (participated in OSS) vs. arm B was -2.2 ((-5.8, +1.4), p = 0.237). From t0-t2, mean scores increased for all 12 scenarios. Clinical competence increased significantly after a 3-week core course; improvement persisted for 24 weeks. No additional impact of OSS was observed. Data on clinical practice, facility-level performance and health outcomes will complete assessment of overall impact of IMID and OSS. ClinicalTrials.gov NCT01190540.

The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism.

PubMed

Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James

2016-11-01

Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health's Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda's progress as 'stagnant'. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the '3-delays' model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or 'staff shortages' as a key component of this 'puzzle'. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) 'common sense' presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years' experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including professional voluntarism which relies on local 'co-presence' to be effective. Important steps forward could be achieved within the current resource framework, if the political will existed. International NGOs have exacerbated this problem encouraging forms of internal 'brain drain' particularly among doctors. Arguably the system as it is rewards doctors for non-compliance resulting in massive resource inefficiencies. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism

PubMed Central

Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James

2016-01-01

Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health’s Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda’s progress as ‘stagnant’. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the ‘3-delays’ model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or ‘staff shortages’ as a key component of this ‘puzzle’. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) ‘common sense’ presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years’ experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including professional voluntarism which relies on local ‘co-presence’ to be effective. Important steps forward could be achieved within the current resource framework, if the political will existed. International NGOs have exacerbated this problem encouraging forms of internal ‘brain drain’ particularly among doctors. Arguably the system as it is rewards doctors for non-compliance resulting in massive resource inefficiencies. PMID:27142803

Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey.

PubMed

Devries, Karen M; Knight, Louise; Child, Jennifer C; Kyegombe, Nambusi; Hossain, Mazeda; Lees, Shelley; Watts, Charlotte; Naker, Dipak

2017-02-28

Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home. A representative cross-sectional survey of primary schools. 3427 non-boarding primary school students, aged about 11-14 years. Luwero District, Uganda, 2012. Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV. 26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves. In this sample, witnessing IPV almost never occurred in isolation-almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in homes with no partner violence, highlighting the need for interventions to prevent child maltreatment more broadly. NCT01678846, results. 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/.

Experience of sexual coercion and risky sexual behavior among Ugandan university students.

PubMed

Agardh, Anette; Odberg-Pettersson, Karen; Ostergren, Per-Olof

2011-07-04

Growing worldwide evidence shows that the experience of sexual coercion is fairly prevalent among young people and is associated with risky sexual behavior thereafter. The causal mechanisms behind this are unclear but may be dependent on specific contextual determinants. Little is known about factors that could buffer the negative effects of coercion. The aim of this study was to assess the association between the experience of sexual coercion and risky sexual behavior among university students of both sexes in Uganda. In 2005, 980 (80%) out of a total of 1,220 students enrolled in Mbarara University of Science and Technology in Uganda participated in a self-administered questionnaire covering socio-demographic and religious factors, social capital, mental health, alcohol use, and sexual behavior. A validated scale of six items was used to assess the experience of sexual coercion. Logistic regression analyses were applied to control for confounders. Potential buffering factors were analyzed by testing for effect modification. Fifty-nine percent of those who responded had previously had sexual intercourse. Among the male students 29.0%, and among the female students 33.1% reported having had some experience of sexual coercion. After controlling for age, gender, and educational level of household of origin, role of religion and trust in others sexual coercion was found to be statistically significantly associated with previously had sex (OR 1.6, 95% CI; 1.1-2.3), early sexual debut (OR 2.4, 95% CI; 1.5-3.7), as well as with having had a great number of sexual partners (OR 1.9, 95% CI; 1.2-3.0), but not with inconsistent condom use.Scoring low on an assessment of mental health problems, reporting high trust in others, or stating that religion played a major role in one's family of origin seemed to buffer the negative effect that the experience of sexual coercion had on the likelihood of having many sexual partners. The findings of this study suggest that the experience of sexual coercion is common among youth/young adults in Uganda and is subsequently associated with risky sexual behavior in both sexes. The existence of individual and contextual factors that buffer the effects mentioned was also demonstrated. In the Ugandan context, this has implications for policy formulation and the implementation of preventive strategies for combating HIV/AIDS.

76 FR 16722 - Proposed Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

..., Overflow Creek Tributary, Red Cut Slough, Red Cut Slough Tributary, Red Cut Slough Tributary 2, and Red Cut... flooding sources: Gum Creek Flooding Effects, Little Red River, Overflow Creek Tributary, Red Cut Slough, Red Cut Slough Tributary, Red Cut Slough Tributary 2, and Red Cut Slough Tributary A. In this notice...

A Review of Prevention, Diagnosis and Treatment of Relative Energy Deficiency in Sport (RED-S) in Artistic (Synchronized) Swimming.

PubMed

Robertson, Sherry; Mountjoy, Margo

2018-05-03

The syndrome Relative Energy Deficiency in Sport (RED-S) is a clinical entity characterized by low energy availability (LEA), which can negatively affect the health and performance of both male and female athletes. The underlying mechanism of RED-S is an inadequacy of dietary energy to support optimal health and performance. This syndrome refers to impaired physiological function including metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health, with psychological consequences which can either precede (through restrictive dietary habits) or result from RED-S. The term RED-S extends beyond the condition termed the "Female Athlete Triad". Formerly known as synchronized swimming, artistic swimming is an Olympic sport requiring a high level of fitness as well as technical skill and artistry. The risk of RED-S is high in artistic swimming as it is an aesthetic, judged sport with an emphasis on a lean physique. RED-S is of significant concern in the sport of artistic swimming because of the potential negative effects on physical and mental health as well as consequences on athletic performance. This paper reviews health and performance consequences associated with LEA resulting in RED-S in artistic swimming. Medical and nutritional considerations specific to artistic swimming are reviewed and methods to help detect and manage RED-S are discussed. Prevention and management of RED-S in this athlete population should be a priority for coaches and the sport medicine professionals working with artistic swimming athletes should utilize the RED-S CAT, a Clinical Assessment Tool for screening and managing RED-S.

Spatial variation in mandibular bone elastic modulus and its effect on structural bending stiffness: A test case using the Taï Forest monkeys.

PubMed

Le, Kim N; Marsik, Matthew; Daegling, David J; Duque, Ana; McGraw, William Scott

2017-03-01

We investigated how heterogeneity in material stiffness affects structural stiffness in the cercopithecid mandibular cortical bone. We assessed (1) whether this effect changes the interpretation of interspecific structural stiffness variation across four primate species, (2) whether the heterogeneity is random, and (3) whether heterogeneity mitigates bending stress in the jaw associated with food processing. The sample consisted of Taï Forest, Cote d'Ivoire, monkeys: Cercocebus atys, Piliocolobus badius, Colobus polykomos, and Cercopithecus diana. Vickers indentation hardness samples estimated elastic moduli throughout the cortical bone area of each coronal section of postcanine corpus. For each section, we calculated maximum area moment of inertia, I max (structural mechanical property), under three models of material heterogeneity, as well as spatial autocorrelation statistics (Moran's I, I MORAN ). When the model considered material stiffness variation and spatial patterning, I max decreased and individual ranks based on structural stiffness changed. Rank changes were not significant across models. All specimens showed positive (nonrandom) spatial autocorrelation. Differences in I MORAN were not significant among species, and there were no discernable patterns of autocorrelation within species. Across species, significant local I MORAN was often attributed to proximity of low moduli in the alveolar process and high moduli in the basal process. While our sample did not demonstrate species differences in the degree of spatial autocorrelation of elastic moduli, there may be mechanical effects of heterogeneity (relative strength and rigidity) that do distinguish at the species or subfamilial level (i.e., colobines vs. cercopithecines). The potential connections of heterogeneity to diet and/or taxonomy remain to be discovered. © 2016 Wiley Periodicals, Inc.

DRD4 dopamine receptor allelic diversity in various primate species

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

Adamson, M.; Higley, D.; O`Brien, S.

The DRD4 dopamine receptor is uniquely characterized by a 48 bp repeating segment within the coding region, located in exon III. Different DRD4 alleles are produced by the presence of additional 48 bp repeats, each of which adds 16 amino acids to the length of the 3rd intracytoplasmic loop of the receptor. The DRD4 receptor is therefore an intriguing candidate gene for behaviors which are influenced by dopamine function. In several human populations, DRD4 alleles with 2-8 and 10 repeats have previously been identified, and the 4 and 7 repeat alleles are the most abundant. We have determined DRD4 genotypesmore » in the following nonhuman primate species: chimpanzee N=2, pygmy chimpanzee N=2, gorilla N=4, siamang N=2, Gelada baboon N=1, gibbon N=1, orangutan (Bornean and Sumatran) N=62, spider monkey N=4, owl monkey N=1, Colobus monkey N=1, Patas monkey N=1, ruffed lemur N=1, rhesus macaque N=8, and vervet monkey N=28. The degree of DRD4 polymorphism and which DRD4 alleles were present both showed considerable variation across primate species. In contrast to the human, rhesus macaque monkeys were monomorphic. The 4 and 7 repeat allels, highly abundant in the human, may not be present in certain other primates. For example, the four spider monkeys we studied showed the 7, 8 and 9 repeat length alleles and the only gibbon we analyzed was homozygous for the 9 repeat allele (thus far not observed in the human). Genotyping of other primate species and sequencing of the individual DRD4 repeat alleles in different species may help us determine the ancestral DRD4 repeat length and identify connections between DRD4 genotype and phenotype.« less

Modeling Conventional Land Combat in a Multi-Agent System Using Generalization of the Different Combat Entities and Combat Operations

DTIC Science & Technology

2001-09-01

Blue and Red Death Rates for Red Lethality = 1 ..........................66 xi Figure 23 Blue and Red Death Rates for Red Lethality = 2...67 Figure 24 Blue and Red Death Rates for Red Lethality = 3 ..........................67 Figure 25 Blue and Red Casualties...vs. Red Lethality....................................68 Figure 26 Blue and Red Death Rates for Blue Training = 100%...................69 Figure

Phosphatidylserine exposure on stored red blood cells as a parameter for donor-dependent variation in product quality.

PubMed

Dinkla, Sip; Peppelman, Malou; Van Der Raadt, Jori; Atsma, Femke; Novotný, Vera M J; Van Kraaij, Marian G J; Joosten, Irma; Bosman, Giel J C G M

2014-04-01

Exposure of phosphatidylserine on the outside of red blood cells contributes to recognition and removal of old and damaged cells. The fraction of phosphatidylserine-exposing red blood cells varies between donors, and increases in red blood cell concentrates during storage. The susceptibility of red blood cells to stress-induced phosphatidylserine exposure increases with storage. Phosphatidylserine exposure may, therefore, constitute a link between donor variation and the quality of red blood cell concentrates. In order to examine the relationship between storage parameters and donor characteristics, the percentage of phosphatidylserine-exposing red blood cells was measured in red blood cell concentrates during storage and in fresh red blood cells from blood bank donors. The percentage of phosphatidylserine-exposing red blood cells was compared with red blood cell susceptibility to osmotic stress-induced phosphatidylserine exposure in vitro, with the regular red blood cell concentrate quality parameters, and with the donor characteristics age, body mass index, haemoglobin level, gender and blood group. Phosphatidylserine exposure varies between donors, both on red blood cells freshly isolated from the blood, and on red blood cells in red blood cell concentrates. Phosphatidylserine exposure increases with storage time, and is correlated with stress-induced phosphatidylserine exposure. Increased phosphatidylserine exposure during storage was found to be associated with haemolysis and vesicle concentration in red blood cell concentrates. The percentage of phosphatidylserine-exposing red blood cells showed a positive correlation with the plasma haemoglobin concentration of the donor. The fraction of phosphatidylserine-exposing red blood cells is a parameter of red blood cell integrity in red blood cell concentrates and may be an indicator of red blood cell survival after transfusion. Measurement of phosphatidylserine exposure may be useful in the selection of donors and red blood cell concentrates for specific groups of patients.

Multi-level Correlates of Safer Conception Methods Awareness and Attitudes Among Ugandan HIV Clients with Fertility Intentions.

PubMed

Wagner, Glenn J; Woldetsadik, Mahlet A; Beyeza-Kashesya, Jolly; Goggin, Kathy; Mindry, Deborah; Finocchario-Kessler, Sarah; Khanakwa, Sarah; Wanyenze, Rhoda K

2016-03-01

Many people living with HIV desire childbearing, but low cost safer conception methods (SCM) such as timed unprotected intercourse (TUI) and manual self-insemination (MSI) are rarely used. We examined awareness and attitudes towards SCM, and the correlates of these constructs among 400 HIV clients with fertility intentions in Uganda. Measures included awareness, self-efficacy, and motivation regarding SCM, as well as demographics, health management, partner and provider characteristics. Just over half knew that MSI (53%) and TUI (51%) reduced transmission risk during conception, and 15% knew of sperm washing and pre-exposure prophylaxis. In separate regression models for SCM awareness, motivation, and self-efficacy, nearly all independent correlates were related to the partner, including perceived willingness to use SCM, knowledge of respondent's HIV status, HIV-seropositivity, marriage and equality in decision making within the relationship. These findings suggest the importance of partners in promoting SCM use and partner inclusion in safer conception counselling.

Assessment of Dithiocarbamate Residues on Tomatoes Conventionally Grown in Uganda and the Effect of Simple Washing to Reduce Exposure Risk to Consumers.

PubMed

Atuhaire, Aggrey; Kaye, Emmanuel; Mutambuze, Innocent Louis; Matthews, Graham; Friedrich, Theodor; Jørs, Erik

2017-01-01

Pesticide misuse by farmers poses health risks to consumers. This study assessed the level of dithiocarbamate residues in tomatoes acquired from 20 farmers and 25 market vendors in Wakiso District, how simple washing affects these residues, and the potential chronic health risk for Ugandans eating such tomatoes. Results revealed that mancozeb was the only reported dithiocarbamate, and 47.4% and 14% of farm and market samples, respectively, had dithiocarbamate residues exceeding the Codex alimentarius maximum residue limit of 2 mgCS 2 /kg. Mixing concentration had a positive significant effect on dithiocarbamate residue levels ( P = 0.004). Washing reduced dithiocarbamate residues by a factor of 0.3. Dietary risk assessment revealed no chronic health risk to both children and general population when a national daily per capita consumption of 1.0 g is considered. This study recommends comprehensive research into Uganda's food production and consumption patterns and establishment of a national pesticide residue surveillance program.

Poor Housing Construction Associated with Increased Malaria Incidence in a Cohort of Young Ugandan Children

PubMed Central

Snyman, Katherine; Mwangwa, Florence; Bigira, Victor; Kapisi, James; Clark, Tamara D.; Osterbauer, Beth; Greenhouse, Bryan; Sturrock, Hugh; Gosling, Roly; Liu, Jenny; Dorsey, Grant

2015-01-01

Despite the use of accepted interventions to combat malaria, such as insecticide-treated bed nets and artemisinin-based combination therapy, malaria remains a leading cause of morbidity and mortality in Uganda. We investigated associations between household factors and malaria incidence in a cohort of children living in a highly endemic region of Uganda. Living in a modern house, defined as the use of non-earth floors, non-thatched roofs, and non-mud walls, was associated with approximately half malaria incidence compared with living in a traditional home (incidence rate ratio [IRR] = 0.54, P = 0.001). Other factors found to be associated with a lower incidence of malaria included living in town versus rural setting; sleeping in a room with openings to the outside (windows, eaves, and airbricks); and having an older and more educated primary caregiver. This study adds to the growing body of evidence that improved house construction may be associated with a lower risk of malaria. PMID:25870429

TLR9 Polymorphisms Are Associated with Altered IFN-γ Levels in Children with Cerebral Malaria

PubMed Central

Sam-Agudu, Nadia A.; Greene, Jennifer A.; Opoka, Robert O.; Kazura, James W.; Boivin, Michael J.; Zimmerman, Peter A.; Riedesel, Melissa A.; Bergemann, Tracy L.; Schimmenti, Lisa A.; John, Chandy C.

2010-01-01

Toll-like receptor (TLR) polymorphisms have been associated with disease severity in malaria infection, but mechanisms for this association have not been characterized. The TLR2, 4, and 9 single nucleotide polymorphism (SNP) frequencies and serum interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) levels were assessed in Ugandan children with cerebral malaria (CM, N = 65) and uncomplicated malaria (UM, N = 52). The TLR9 C allele at −1237 and G allele at 1174 were strongly linked, and among children with CM, those with the C allele at −1237 or the G allele at 1174 had higher levels of IFN-γ than those without these alleles (P = 0.03 and 0.008, respectively). The TLR9 SNPs were not associated with altered IFN-γ levels in children with UM or altered TNF-α levels in either group. We present the first human data that TLR SNPs are associated with altered cytokine production in parasitic infection. PMID:20348497

Antibacterial activities of extracts from Ugandan medicinal plants used for oral care.

PubMed

Ocheng, Francis; Bwanga, Freddie; Joloba, Moses; Borg-Karlson, Ann-Karin; Gustafsson, Anders; Obua, Celestino

2014-08-08

Medicinal plants are widely used for treatment of oral/dental diseases in Uganda. To investigate antibacterial activities of 16 commonly used medicinal plants on microorganisms associated with periodontal diseases (PD) and dental caries (DC). Pulp juice and solvent extracts (hexane, methanol and water) from the plants were tested against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia associated with PD and Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilus associated with DC. Tests were done using agar well-diffusion (pulp juice) and agar-dilution (Solvent extracts) assays. Pulp juice from Zanthoxylum chalybeum and Euclea latidens showed activity against all the bacteria, Zanthoxylum chalybeum being most active. Hexane extract from aerial part of Helichrysum odoratissimum was most active (MIC: 0.125-0.5 mg/ml). Methanol extract from leaves of Lantana trifolia showed activity against all bacteria (MIC: 0.25-1 mg/ml). Several of the tested plants showed antibacterial activities against bacteria associated with PD and DC, meriting further investigations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Evaluating a scalable model for implementing electronic health records in resource-limited settings.

PubMed

Were, Martin C; Emenyonu, Nneka; Achieng, Marion; Shen, Changyu; Ssali, John; Masaba, John P M; Tierney, William M

2010-01-01

Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.

Caregivers’ depressive symptoms and parent-report of child executive function among young children in Uganda

PubMed Central

Familiar, Itziar; Nakasujja, Noeline; Bass, Judith; Sikorskii, Alla; Murray, Sarah; Ruisenor-Escudero, Horacio; Bangirana, Paul; Opoka, Robert; Boivin, Michael J.

2015-01-01

Maternal mental health (particularly depression) may influence how they report on their child’s behavior. Few research studies have focused on Sub-Saharan countries where pediatric HIV concentrates and impacts child neuropsychological development and caregiver mental health. We investigated the associations between caregivers’ depressive symptoms and neuropsychological outcomes in HIV-infected (n=118) and HIV-exposed (n=164) Ugandan children aged 2–5 years. We compared performance-based tests of development (Mullen Scales of Early Learning, Color Object Association Test), to a caregiver report of executive function (Behavior Rating Inventory of Executive Function, BRIEF). Caregivers were assessed with Hopkins Symptom Checklist-25 depression subscale. The associations between all BRIEF indices and caregiver’s depression symptoms were differential according to child’s HIV status. Caregivers with greater depressive symptoms reported their HIV-infected children as having more behavioral problems related to executive functioning. Assessment of behavior of HIV-infected children should incorporate a variety of sources of information and screening of caregiver mental health. PMID:27175052

Caregivers' depressive symptoms and parent-report of child executive function among young children in Uganda.

PubMed

Familiar, Itziar; Nakasujja, Noeline; Bass, Judith; Sikorskii, Alla; Murray, Sarah; Ruisenor-Escudero, Horacio; Bangirana, Paul; Opoka, Robert; Boivin, Michael J

2016-02-01

Maternal mental health (particularly depression) may influence how they report on their child's behavior. Few research studies have focused on Sub-Saharan countries where pediatric HIV concentrates and impacts child neuropsychological development and caregiver mental health. We investigated the associations between caregivers' depressive symptoms and neuropsychological outcomes in HIV-infected (n=118) and HIV-exposed (n=164) Ugandan children aged 2-5 years. We compared performance-based tests of development (Mullen Scales of Early Learning, Color Object Association Test), to a caregiver report of executive function (Behavior Rating Inventory of Executive Function, BRIEF). Caregivers were assessed with Hopkins Symptom Checklist-25 depression subscale. The associations between all BRIEF indices and caregiver's depression symptoms were differential according to child's HIV status. Caregivers with greater depressive symptoms reported their HIV-infected children as having more behavioral problems related to executive functioning. Assessment of behavior of HIV-infected children should incorporate a variety of sources of information and screening of caregiver mental health.

Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome

PubMed Central

Monaco, Cynthia L.; Gootenberg, David B.; Zhao, Guoyan; Handley, Scott A.; Ghebremichael, Musie S.; Lim, Efrem S.; Lankowski, Alex; Baldridge, Megan T.; Wilen, Craig B.; Flagg, Meaghan; Norman, Jason M.; Keller, Brian C.; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N.; Hunt, Peter W.; Bangsberg, David R.; Siedner, Mark J.; Kwon, Douglas S.; Virgin, Herbert W.

2016-01-01

SUMMARY Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression. PMID:26962942

Religiosity and adherence to antiretroviral therapy among patients attending a public hospital-based HIV/AIDS clinic in Uganda.

PubMed

Kisenyi, Rita N; Muliira, Joshua K; Ayebare, Elizabeth

2013-03-01

In Uganda, the prevalence of non-adherence to antiretroviral therapy (ART) by HIV/AIDS patients remains high and sometimes this is blamed on patients' religious behavior. A descriptive design was used to examine the relationship between religiosity and ART adherence in a sample of 220 patients attending a HIV/AIDS clinic in a Ugandan public hospital. Participants who self-identified as Pentecostal and Muslim had the highest percentage of members with high religiosity scores and ART adherence. Among Muslim participants (34), 82% reported high religiosity scores and high levels of ART adherence. Of the fifty Pentecostals participants, 96% reported high religiosity scores and 80% reported high levels of ART adherence. Correlation analysis showed a significant relationship between ART adherence and religiosity (r = 0.618, P ≤ 0.01). Therefore, collaboration between religious leaders and HIV/AIDS healthcare providers should be encouraged as one of the strategies for enhancing ART adherence.

How HIV diagnosis and disclosure affect sexual behavior and relationships in Ugandan fishing communities.

PubMed

McArthur, Moriah; Birdthistle, Isolde; Seeley, Janet; Mpendo, Juliet; Asiki, Gershim

2013-08-01

In this article we examine how members of fishing communities on the shores of Lake Victoria in Uganda respond to HIV diagnosis in terms of disclosure to sexual partners. We then explore the subsequent changes in sexual behavior and relationships. To access this information, we collected life history data from 78 HIV-positive individuals in five fishing communities. We found that the strength of the sexual relationships shaped how and why individuals disclosed to partners, and that these relationships tended to be stronger when partners shared familial responsibility. Those who perceived their current sexual partnership to be weak sought to conceal their status by maintaining prediagnosis patterns of sexual behavior. The majority of the study's participants rarely changed their sexual behavior following HIV diagnosis, regardless of their relationship's strength. These findings elucidate barriers to disclosure and behavior change, and suggest that a life-course approach might enhance individual-level counseling so that counselors can provide tailored support to individuals regarding disclosure decisions and outcomes.

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.

Evaluating microcystin exposure risk through fish consumption.

PubMed

Poste, Amanda E; Hecky, Robert E; Guildford, Stephanie J

2011-07-01

Microcystin is a cyanobacterial hepatotoxin that is found worldwide, and poses a serious threat to the ecological communities in which it is found as well as to those who rely on these waters for drinking, sanitation, or as a food source. Microcystin is known to accumulate in fish and other aquatic biota, however the prevalence of microcystin in fish tissue and the human health risks posed by microcystin exposure through fish consumption remain poorly resolved. Here we show that microcystin is pervasive in water and fish from several tropical (Ugandan) and temperate (North American) lakes, including lakes that support some of the largest freshwater fisheries in the world. We establish that fish consumption can be an important and sometimes dominant route of microcystin exposure for humans, and can cause consumers to exceed recommended total daily intake guidelines for microcystin. These results highlight the importance of monitoring microcystin concentrations in fish, and the need to consider potential exposure to microcystin through fish consumption in order to adequately assess human exposure risk.

Prevalence and Correlates of Use of Safer Conception Methods in a Prospective Cohort of Ugandan HIV-Affected Couples with Fertility Intentions.

PubMed

Wagner, Glenn J; Linnemayr, Sebastian; Goggin, Kathy; Mindry, Deborah; Beyeza-Kashesya, Jolly; Finocchario-Kessler, Sarah; Robinson, Eric; Birungi, Josephine; Wanyenze, Rhoda K

2017-08-01

We examined the prevalence and correlates of safer conception methods (SCM) use in HIV-affected couples with fertility intentions. A prospective cohort of 400 HIV clients in Uganda who had fertility intentions with their partner was surveyed every 6 months for 24 months. Logistic regression analysis was used to determine individual, relationship and provider level predictors of SCM use. Over one-third (35%) reported any use of timed unprotected intercourse (TUI) during the study; use of other SCM was rare. Baseline predictors of any TUI use included lower social support, greater perceived provider stigma of childbearing, greater SCM awareness, greater control over sexual decision making in the relationship, inconsistent condom use, and the belief that a desire for childbearing impedes condom use. These findings highlight the need for policy and provider training regarding integration of safer conception counselling into family planning and reproductive health services for people living with HIV.

Explaining Antiretroviral Therapy Adherence Success Among HIV-Infected Children in Rural Uganda: A Qualitative Study

PubMed Central

Olds, Peter K.; Kiwanuka, Julius P.; Ware, Norma C.; Tsai, Alexander C.

2014-01-01

High adherence is critical for achieving clinical benefits of HIV antiretroviral therapy (ART) and particularly challenging for children. We conducted 35 qualitative interviews with caregivers of HIV-infected Ugandan children who were followed in a longitudinal study of real-time ART adherence monitoring; 18 participants had undetectable HIV RNA, while 17 had detectable virus. Interviews blinded to viral suppression status elicited information on adherence experiences, barriers and facilitators to adherence, and social support. Using an inductive content analytic approach, we identified ‘lack of resources,’ ‘Lazarus effect,’ ‘caregiver's sense of obligation and commitment,’ and ‘child's personal responsibility’ as categories of influence on adherence, and defined types of caregiver social support. Among children with viral suppression, high hopes for the child's future and ready access to private instrumental support appeared particularly important. These findings suggest clinical counseling should explore caregivers' views of their children's futures and ability to access support in overcoming adherence barriers. PMID:25323679

Taking account of what young women want from school sex education: two groups from Scotland and Uganda.

PubMed

Cook, Sinead

2010-01-01

This study seeks to explore what young women want from their school-based sex education. Qualitative methods were used to explore the perspectives of two groups of young women from Uganda and Scotland. Of particular importance to all the young women were: a diverse sex education curriculum appropriate to the ages of the students, being taught by an outside female facilitator, single-sex classes and access to a female teacher. Furthermore, they proposed that discussion between small groups of friends is very useful. The Scottish group said that having a young teacher, teaching about emotions and relationships and being guided through their own decision making is also important. The Ugandan group emphasized the importance of being taught by female family members and having written materials provided on sex education. The study showed that young women from different backgrounds have strong opinions about sex education, and are an important resource for policy makers.

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.

Diet Diversity in Pastoral and Agro-pastoral Households in Ugandan Rangeland Ecosystems.

PubMed

Mayanja, Maureen; Rubaire-Akiiki, Chris; Morton, John; Young, Stephen; Greiner, Ted

2015-01-01

We explore how diet diversity differs with agricultural seasons and between households within pastoral and agro-pastoral livelihood systems, using variety of foods consumed as a less complex proxy indicator of food insecurity than benchmark indicators like anthropometry and serum nutrients. The study was in the central part of the rangelands in Uganda. Seventy nine households were monitored for three seasons, and eight food groups consumed during a 24 hour diet recall period used to create a household diet diversity score (HDDS). Mean HDDS was 3.2, varied significantly with gender, age, livelihood system and season (p<.001, F=15.04), but not with household size or household head's education level. Agro-pastoralists exhibited lower mean diet diversity than pastoralists (p<.01, F=7.84) and among agro-pastoralists, households headed by persons over 65 years were most vulnerable (mean HDDS 2.1). This exploratory study raises issues requiring further investigation to inform policies on nutrition security in the two communities.

Effect of Integrated Pest Management Training on Ugandan Small-Scale Farmers

PubMed Central

Clausen, Anna Sabine; Jørs, Erik; Atuhaire, Aggrey; Thomsen, Jane Frølund

2017-01-01

Small-scale farmers in developing countries use hazardous pesticides taking few or no safety measures. Farmer field schools (FFSs) teaching integrated pest management (IPM) have been shown to reduce pesticide use among trained farmers. This cross-sectional study compares pesticide-related knowledge, attitude, practice (KAP), potential exposure, and self-reported poisoning symptoms among 35 FFS farmers, 44 neighboring farmers, and 35 control farmers after an IPM intervention in Uganda (2011-2012). The FFS farmers were encouraged to teach their neighboring farmers. Data were based on standardized interviews and were analyzed using a linear trend test and logistic regression. The results showed that FFS and neighboring farmers used significantly fewer pesticide applications (P = .021) and used more safety measures. No differences were found on the hazardousness of pesticides used or self-reported symptoms. The study supports IPM as a method to reduce pesticide use and potential exposure and to improve pesticide-related KAP among small-scale farmers in developing countries. PMID:28469450

A Human-Centered Approach to CV Care: Infrastructure Development in Uganda.

PubMed

Longenecker, Christopher T; Kalra, Ankur; Okello, Emmy; Lwabi, Peter; Omagino, John O; Kityo, Cissy; Kamya, Moses R; Webel, Allison R; Simon, Daniel I; Salata, Robert A; Costa, Marco A

2018-04-20

In this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U.S. and Ugandan collaborators to improve cardiovascular capabilities. The collaboration has solicited innovative solutions from patients and providers focusing on education and advanced training, penicillin supply, diagnostic strategy (e.g., hand-held ultrasound), maternal health, and community awareness. Key outcomes of this approach have been the completion of formal training of the first interventional cardiologists and heart failure specialists in the country, establishment of 4 integrated regional centers of excellence in rheumatic heart disease care with a national rheumatic heart disease registry, a penicillin distribution and adherence support program focused on retention in care, access to imaging technology, and in-country capabilities to treat advanced rheumatic heart valve disease. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

e-Justice Implementation at a National Scale: The Ugandan Case

NASA Astrophysics Data System (ADS)

Kitoogo, Fredrick Edward; Bitwayiki, Constantine

The use of information and communications technologies has been identified as one of the means suitable for supplementing the various reforms in convalescing the performance of the justice sector. The Government of Uganda has made strides in the implementation of e-Government to effectively utilize information and communications technologies in governance. The justice players are manifested in a justice, law and order sector which is based on the the Sector Wide Approach whose basic principle is that communication, cooperation and coordination between institutions can greatly add value to service delivery within a sector. Although a subset of e-Government, e-Justice aims at improving service delivery and collaboration between all justice players through the use of ICTs and needs to be spear-headed at a sector level. This work proposes ways of harnessing the existing opportunities and methods to implement e-Justice in Uganda that will culminate into a generic framework that can be applied in similar countries.

Assessment of Dithiocarbamate Residues on Tomatoes Conventionally Grown in Uganda and the Effect of Simple Washing to Reduce Exposure Risk to Consumers

PubMed Central

Atuhaire, Aggrey; Kaye, Emmanuel; Mutambuze, Innocent Louis; Matthews, Graham; Friedrich, Theodor; Jørs, Erik

2017-01-01

Pesticide misuse by farmers poses health risks to consumers. This study assessed the level of dithiocarbamate residues in tomatoes acquired from 20 farmers and 25 market vendors in Wakiso District, how simple washing affects these residues, and the potential chronic health risk for Ugandans eating such tomatoes. Results revealed that mancozeb was the only reported dithiocarbamate, and 47.4% and 14% of farm and market samples, respectively, had dithiocarbamate residues exceeding the Codex alimentarius maximum residue limit of 2 mgCS2/kg. Mixing concentration had a positive significant effect on dithiocarbamate residue levels (P = 0.004). Washing reduced dithiocarbamate residues by a factor of 0.3. Dietary risk assessment revealed no chronic health risk to both children and general population when a national daily per capita consumption of 1.0 g is considered. This study recommends comprehensive research into Uganda’s food production and consumption patterns and establishment of a national pesticide residue surveillance program. PMID:28615952

Policing men: militarised masculinity, youth livelihoods, and security in conflict-affected northern Uganda.

PubMed

Tapscott, Rebecca

2018-01-01

Relations between militaries and masculinities-and hegemonic masculinity and the state-are well-established in the literature on gender and development. However, there is less research on how militarised masculinities relate to state governance strategies. This paper, based on qualitative research conducted in northern Uganda between 2014 and 2017, offers a gender analysis of youths participating in informal security arrangements. Civilian male youths accept poorly paid or unpaid work in the informal security sector in the hope of gaining access to livelihoods that will enable them to fulfil masculine ideal-types. However, this arrangement denies them the resources necessary to achieve the ideal-type of civilian masculinity, as well as the state's military masculinity, which produces young men as subjects of the ruling regime. To reconfigure this relationship between civilian and militarised masculinities, one should understand informal security organisations in the context of alternative livelihood arrangements and take a long-term approach to the demilitarisation of the Ugandan state. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Civil war and the spread of AIDS in Central Africa.

PubMed Central

Smallman-Raynor, M. R.; Cliff, A. D.

1991-01-01

Using ordinary least squares regression techniques this paper demonstrates, for the first time, that the classic association of war and disease substantially accounts for the presently observed geographical distribution of reported clinical AIDS cases in Uganda. Both the spread of HIV 1 infection in the 1980s, and the subsequent development of AIDS to its 1990 spatial pattern, are shown to be significantly and positively correlated with ethnic patterns of recruitment into the Ugandan National Liberation Army (UNLA) after the overthrow of Idi Amin some 10 years earlier in 1979. This correlation reflects the estimated mean incubation period of 8-10 years for HIV 1 and underlines the need for cognizance of historical factors which may have influenced current patterns of AIDS seen in Central Africa. The findings may have important implications for AIDS forecasting and control in African countries which have recently experienced war. The results are compared with parallel analyses of other HIV hypotheses advanced to account for the reported geographical distribution of AIDS in Uganda. PMID:1879492

Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome.

PubMed

Monaco, Cynthia L; Gootenberg, David B; Zhao, Guoyan; Handley, Scott A; Ghebremichael, Musie S; Lim, Efrem S; Lankowski, Alex; Baldridge, Megan T; Wilen, Craig B; Flagg, Meaghan; Norman, Jason M; Keller, Brian C; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N; Hunt, Peter W; Bangsberg, David R; Siedner, Mark J; Kwon, Douglas S; Virgin, Herbert W

2016-03-09

Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression. Copyright © 2016 Elsevier Inc. All rights reserved.

The guiltless guilty: trauma-related guilt and psychopathology in former Ugandan child soldiers.

PubMed

Klasen, Fionna; Reissmann, Sina; Voss, Catharina; Okello, James

2015-04-01

Child soldiers often experience complex trauma as victims and perpetrators, and feelings of guilt may affect their psychological health. The relationship between the children's traumatic experiences as victims or perpetrators, their perception of themselves as victim or perpetrator, guilt and psychopathology were investigated: of the 330 former child soldiers interviewed, 50.8 % perceived themselves as victims and 19.1 % as perpetrators. On psychopathology measures, scores within the clinical range were 33 % for posttraumatic stress disorder (PTSD), 36.4 % for major depressive disorder (MDD), and 26.1 % for externalizing problems. Low socio-economic status, traumatic experience as perpetrator, and guilt were significant predictors of PTSD. Significant predictors of MDD were low socio-economic status, traumatic experiences as victim, and guilt. A greater number of traumatic experiences as perpetrator and guilt were associated with externalizing problems. The current paper underscores the significance of guilt following traumatic experiences and has implications for the development of clinical interventions for war-affected children.

Behavioral Economics Matters for HIV Research: The Impact of Behavioral Biases on Adherence to Antiretrovirals (ARVs)

PubMed Central

Stecher, Chad

2016-01-01

Behavioral economics (BE) has been used to study a number of health behaviors such as smoking and drug use, but there is little knowledge of how these insights relate to HIV prevention and care. We present novel evidence on the prevalence of the common behavioral decision-making errors of present-bias, overoptimism, and information salience among 155 Ugandan HIV patients, and analyze their association with subsequent medication adherence. 36 % of study participants are classified as present-biased, 21 % as overoptimistic, and 34 % as having salient HIV information. Patients displaying present-bias were 13 % points (p = 0.006) less likely to have adherence rates above 90 %, overoptimistic clients were 9 % points (p = 0.04) less likely, and those not having salient HIV information were 17 % points (p < 0.001) less likely. These findings indicate that BE may be used to screen for future adherence problems and to better design and target interventions addressing these behavioral biases and the associated suboptimal adherence. PMID:25987190

Uganda's HIV Prevention Success: The Role of Sexual Behavior Change and the National Response

PubMed Central

Green, Edward C.; Nantulya, Vinand; Hogle, Janice A.

2006-01-01

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. PMID:16688475

Couple Relationship Functioning as a Source or Mitigator of HIV Risk: Associations Between Relationship Quality and Sexual Risk Behavior in Peri-urban Uganda.

PubMed

Ruark, Allison; Kajubi, Phoebe; Ruteikara, Sam; Green, Edward C; Hearst, Norman

2018-04-01

Despite evidence that a greater focus on couples could strengthen HIV prevention efforts, little health-related research has explored relationship functioning and relationship quality among couples in Africa. Using data from 162 couples (324 individuals) resident in a peri-urban Ugandan community, we assessed actor and partner effects of sexual risk behaviors on relationship quality, using psychometric measures of dyadic adjustment, sexual satisfaction, commitment, intimacy, and communication. For women and men, poor relationship quality was associated with having concurrent sexual partners and suspecting that one's partner had concurrent sexual partners (actor effects). Women's poor relationship quality was also associated with men's sexual risk behaviors (partner effects), although the inverse partner effect was not observed. These findings suggest that relationship quality is linked to HIV risk, particularly through the pathway of concurrent sexual partnerships, and that positive relationship attributes such as sexual satisfaction, intimacy, and constructive communication can help couples to avoid risk.

Regional variation in shea butter lipid and triterpene composition in four African countries.

PubMed

Di Vincenzo, Daria; Maranz, Steve; Serraiocco, Arnaldo; Vito, Raffaella; Wiesman, Zeev; Bianchi, Giorgio

2005-09-21

The triacylglycerol, fatty acid, and polycyclic triterpene compositions of shea butter were determined for 150 samples from the sub-Saharan countries of Mali, Burkina Faso, Nigeria, and Uganda. The compositional profiles showed high variability in all three classes of compounds. Shea butter is made up mainly of four triglycerides (TAG) differing in carbon number (CN) by two, starting from CN 50 to CN 56. The greatest source of variation was in the CN 54 TAG. Shea butter is characterized by 16 saturated and unsaturated fatty acids in greatly varying proportion, the major ones being the even homologues in the range of C(16)-C(20). Oleic acid is dominant in Ugandan provenances, whereas stearic acid is dominant in West African shea butter. Acetyl and cinnamyl polycyclic triterpene means for countries ranged from 3.69 to 12.57%, with the highest values found in Nigerian provenances. Statistical comparisons of fat composition show that the geographic distance between shea populations is reflected in the degree of separation of their chemical profiles.

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.

Nodding syndrome in Kitgum District, Uganda: association with conflict and internal displacement

PubMed Central

Landis, Jesa L; Palmer, Valerie S; Spencer, Peter S

2014-01-01

Objectives To test for any temporal association of Nodding syndrome with wartime conflict, casualties and household displacement in Kitgum District, northern Uganda. Methods Data were obtained from publicly available information reported by the Ugandan Ministry of Health (MOH), the Armed Conflict Location & Event Data (ACLED) Project of the University of Sussex in the UK, peer-reviewed publications in professional journals and other sources. Results Reports of Nodding syndrome began to appear in 1997, with the first recorded cases in Kitgum District in 1998. Cases rapidly increased annually beginning in 2001, with peaks in 2003–2005 and 2008, 5–6 years after peaks in the number of wartime conflicts and deaths. Additionally, peaks of Nodding syndrome cases followed peak influxes 5–7 years earlier of households into internal displacement camps. Conclusions Peaks of Nodding syndrome reported by the MOH are associated with, but temporally displaced from, peaks of wartime conflicts, deaths and household internment, where infectious disease was rampant and food insecurity rife. PMID:25371417

Evaluating microcystin exposure risk through fish consumption

PubMed Central

Poste, Amanda E.; Hecky, Robert E.; Guildford, Stephanie J.

2011-01-01

Microcystin is a cyanobacterial hepatotoxin that is found worldwide, and poses a serious threat to the ecological communities in which it is found as well as to those who rely on these waters for drinking, sanitation, or as a food source. Microcystin is known to accumulate in fish and other aquatic biota, however the prevalence of microcystin in fish tissue and the human health risks posed by microcystin exposure through fish consumption remain poorly resolved. Here we show that microcystin is pervasive in water and fish from several tropical (Ugandan) and temperate (North American) lakes, including lakes that support some of the largest freshwater fisheries in the world. We establish that fish consumption can be an important and sometimes dominant route of microcystin exposure for humans, and can cause consumers to exceed recommended total daily intake guidelines for microcystin. These results highlight the importance of monitoring microcystin concentrations in fish, and the need to consider potential exposure to microcystin through fish consumption in order to adequately assess human exposure risk. PMID:21671629

Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

PubMed Central

Kamali, Anatoli; Price, Matt A.; Lakhi, Shabir; Karita, Etienne; Inambao, Mubiana; Sanders, Eduard J.; Anzala, Omu; Latka, Mary H.; Bekker, Linda-Gail; Kaleebu, Pontiano; Asiki, Gershim; Ssetaala, Ali; Ruzagira, Eugene; Allen, Susan; Farmer, Paul; Hunter, Eric; Mutua, Gaudensia; Makkan, Heeran; Tichacek, Amanda; Brill, Ilene K.; Fast, Pat; Stevens, Gwynn; Chetty, Paramesh; Amornkul, Pauli N.; Gilmour, Jill

2015-01-01

HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. PMID:25602351

The Impact of Elections on Cooperation: Evidence from a Lab-in-the-Field Experiment in Uganda

PubMed Central

Grossman, Guy; Baldassarri, Delia

2013-01-01

Communities often rely on sanctioning to induce public goods contributions. Past studies focus on how external agencies or peer sanctioning induce cooperation. In this article, we focus instead on the role played by centralized authorities, internal to the community. Combining “lab-in-the-field” experiments with observational data on 1,541 Ugandan farmers from 50 communities, we demonstrate the positive effect of internal centralized sanctioning authorities on cooperative behavior. We also show that the size of this effect depends on the political process by which authority is granted: subjects electing leaders contribute more to public goods than subjects who were assigned leaders through a lottery. To test the ecological validity of our findings, we relate farmers’ behavior in the experiment to their level of cooperation in their community organization. We show that deference to authority in the controlled setting predicts cooperative behavior in the farmers’ natural environment, in which they face a similar social dilemma. PMID:23729913

Advice and Learning in Problem Solving

DTIC Science & Technology

2005-02-01

Person op Harry : Person op Ivy : Person op DarkRoom : Room op LightRoom : Room op RedRoom : Room op OrangeRoom : Room op...Time7) & % FreeRoom(DarkRoom, Time8) axiom RedRoom_Free_Time is FreeRoom( RedRoom , Time1) & FreeRoom( RedRoom , Time2) & FreeRoom... RedRoom , Time3) & FreeRoom( RedRoom , Time4) & % FreeRoom( RedRoom , Time5) & FreeRoom( RedRoom , Time6) & FreeRoom( RedRoom , Time7) & FreeRoom

Physical and Chemical Properties of Sintering Red Mud and Bayer Red Mud and the Implications for Beneficial Utilization

PubMed Central

Wang, Ping; Liu, Dong-Yan

2012-01-01

Performances of two common types of red mud, Bayer red mud and Sintering red mud, were investigated in this research. Their compositions, mechanical properties and microstructure characterization were measured through XRD, TG and SEM analysis. Their shear strength, particle size, density and hydraulic characteristics also had been performed. Huge differences between the basic mineral types of these two kinds of red mud also can be found. The comparison of compositions shows that CaCO3 content in Sintering red mud is higher, Bayer red mud has more hazardous elements such as As, Pb and Hg and both have a high concentration of radioactivity. The micro particle of Bayer red mud is finer and more disperse, but the Sintering red mud has higher shear strength. Combining the TG and hydraulic characteristics analysis, it can be shown that Bayer red mud has higher value of water content and Sintering red mud has higher hydraulic conductivity. The paper then illustrates that Sintering red mud can become the main filling material of supporting structure of red mud stocking yard. Bayer red mud has a high reuse value and also can be used as a mixing material of masonry mortar.

Longitudinal effect of CD4 by cotrimoxazole use on malaria incidence among HIV-infected Ugandan adults on antiretroviral therapy: a randomized controlled study.

PubMed

Kasirye, Ronnie; Grosskurth, Heiner; Munderi, Paula; Levin, Jonathan; Anywaine, Zacchaeus; Nunn, Andrew; Kamali, Anatoli; Baisley, Kathy

2016-07-15

The effect of CD4 count on malaria incidence in HIV infected adults on antiretroviral therapy (ART) was assessed in the context of a randomized controlled trial on the effect of stopping cotrimoxazole (CTX). This study presents a sub-analysis of the COSTOP trial (ISRCTN44723643) which was carried out among HIV-infected Ugandan adults stable on ART with CD4 counts ≥250 cells/µl. Participants were randomized (1:1) to continue CTX or stop CTX and receive matching placebo, and were followed up for a minimum of 1 year (median 2.5 years). CD4 counts were measured at baseline, 3 months and then every 6 months. Clinical malaria was defined as fever and a positive blood slide. First, the relationship between current CD4 count during follow-up and malaria among participants on placebo was examined; using random effects Poisson regression to account for repeated episodes. Second, the effect of CD4 count at enrolment, CD4 count at ART initiation, and CD4 count during follow-up on malaria, was assessed within each trial arm; to examine whether the effect of CD4 count differed by CTX use. 2180 participants were enrolled into the COSTOP trial. The incidence of clinical malaria was approximately four episodes/100 person years in the CTX arm and 14 episodes/100 person years in the placebo arm. There was no evidence of an association of current CD4 and clinical malaria incidence (P = 0.56), or parasitaemia levels (P = 0.24), in the placebo arm. Malaria incidence did not differ by CD4 count at ART initiation, enrolment or during follow up, irrespective of CTX use. When compared with participants in the lowest CD4 stratum, rate ratios within each trial arm were all close to 1, and P values were all above P = 0.30. The immune status of HIV infected participants who are stable on ART as measured by CD4 count was not associated with malaria incidence and did not modify the effect of stopping CTX on malaria. The decision of whether to stop or continue CTX prophylaxis for malaria in HIV infected individuals who are stable on ART should not be based on CD4 counts alone. COSTOP trial registration number ISRCTN44723643.

Estimated Costs for Delivery of HIV Antiretroviral Therapy to Individuals with CD4+ T-Cell Counts >350 cells/uL in Rural Uganda

PubMed Central

Jain, Vivek; Chang, Wei; Byonanebye, Dathan M.; Owaraganise, Asiphas; Twinomuhwezi, Ellon; Amanyire, Gideon; Black, Douglas; Marseille, Elliot; Kamya, Moses R.; Havlir, Diane V.; Kahn, James G.

2015-01-01

Background Evidence favoring earlier HIV ART initiation at high CD4+ T-cell counts (CD4>350/uL) has grown, and guidelines now recommend earlier HIV treatment. However, the cost of providing ART to individuals with CD4>350 in Sub-Saharan Africa has not been well estimated. This remains a major barrier to optimal global cost projections for accelerating the scale-up of ART. Our objective was to compute costs of ART delivery to high CD4+count individuals in a typical rural Ugandan health center-based HIV clinic, and use these data to construct scenarios of efficient ART scale-up. Methods Within a clinical study evaluating streamlined ART delivery to 197 individuals with CD4+ cell counts >350 cells/uL (EARLI Study: NCT01479634) in Mbarara, Uganda, we performed a micro-costing analysis of administrative records, ART prices, and time-and-motion analysis of staff work patterns. We computed observed per-person-per-year (ppy) costs, and constructed models estimating costs under several increasingly efficient ART scale-up scenarios using local salaries, lowest drug prices, optimized patient loads, and inclusion of viral load (VL) testing. Findings Among 197 individuals enrolled in the EARLI Study, median pre-ART CD4+ cell count was 569/uL (IQR 451–716). Observed ART delivery cost was $628 ppy at steady state. Models using local salaries and only core laboratory tests estimated costs of $529/$445 ppy (+/-VL testing, respectively). Models with lower salaries, lowest ART prices, and optimized healthcare worker schedules reduced costs by $100–200 ppy. Costs in a maximally efficient scale-up model were $320/$236 ppy (+/- VL testing). This included $39 for personnel, $106 for ART, $130/$46 for laboratory tests, and $46 for administrative/other costs. A key limitation of this study is its derivation and extrapolation of costs from one large rural treatment program of high CD4+ count individuals. Conclusions In a Ugandan HIV clinic, ART delivery costs—including VL testing—for individuals with CD4>350 were similar to estimates from high-efficiency programs. In higher efficiency scale-up models, costs were substantially lower. These favorable costs may be achieved because high CD4+ count patients are often asymptomatic, facilitating more efficient streamlined ART delivery. Our work provides a framework for calculating costs of efficient ART scale-up models using accessible data from specific programs and regions. PMID:26632823

Estimated Costs for Delivery of HIV Antiretroviral Therapy to Individuals with CD4+ T-Cell Counts >350 cells/uL in Rural Uganda.

PubMed

Jain, Vivek; Chang, Wei; Byonanebye, Dathan M; Owaraganise, Asiphas; Twinomuhwezi, Ellon; Amanyire, Gideon; Black, Douglas; Marseille, Elliot; Kamya, Moses R; Havlir, Diane V; Kahn, James G

2015-01-01

Evidence favoring earlier HIV ART initiation at high CD4+ T-cell counts (CD4>350/uL) has grown, and guidelines now recommend earlier HIV treatment. However, the cost of providing ART to individuals with CD4>350 in Sub-Saharan Africa has not been well estimated. This remains a major barrier to optimal global cost projections for accelerating the scale-up of ART. Our objective was to compute costs of ART delivery to high CD4+count individuals in a typical rural Ugandan health center-based HIV clinic, and use these data to construct scenarios of efficient ART scale-up. Within a clinical study evaluating streamlined ART delivery to 197 individuals with CD4+ cell counts >350 cells/uL (EARLI Study: NCT01479634) in Mbarara, Uganda, we performed a micro-costing analysis of administrative records, ART prices, and time-and-motion analysis of staff work patterns. We computed observed per-person-per-year (ppy) costs, and constructed models estimating costs under several increasingly efficient ART scale-up scenarios using local salaries, lowest drug prices, optimized patient loads, and inclusion of viral load (VL) testing. Among 197 individuals enrolled in the EARLI Study, median pre-ART CD4+ cell count was 569/uL (IQR 451-716). Observed ART delivery cost was $628 ppy at steady state. Models using local salaries and only core laboratory tests estimated costs of $529/$445 ppy (+/-VL testing, respectively). Models with lower salaries, lowest ART prices, and optimized healthcare worker schedules reduced costs by $100-200 ppy. Costs in a maximally efficient scale-up model were $320/$236 ppy (+/- VL testing). This included $39 for personnel, $106 for ART, $130/$46 for laboratory tests, and $46 for administrative/other costs. A key limitation of this study is its derivation and extrapolation of costs from one large rural treatment program of high CD4+ count individuals. In a Ugandan HIV clinic, ART delivery costs--including VL testing--for individuals with CD4>350 were similar to estimates from high-efficiency programs. In higher efficiency scale-up models, costs were substantially lower. These favorable costs may be achieved because high CD4+ count patients are often asymptomatic, facilitating more efficient streamlined ART delivery. Our work provides a framework for calculating costs of efficient ART scale-up models using accessible data from specific programs and regions.

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

PubMed Central

2013-01-01

Background Thousands of former child soldiers who were abducted during the prolonged conflict in northern Uganda have returned to their home communities. Programmes that facilitate their successful reintegration continue to face a number of challenges. Although there is increasing knowledge of the dynamics of HIV infection during conflict, far less is known about its prevalence and implications for population health in the post-conflict period. This study investigated the effects of abduction on the prevalence of HIV and HIV-risk behaviours among young people in Gulu District, northern Uganda. An understanding of abduction experiences and HIV-risk behaviours is vital to both the development of effective reintegration programming for former child soldiers and the design of appropriate HIV prevention interventions for all young people. Methods In 2010, we conducted a cross-sectional study of 2 sub-counties in Gulu District. A demographic and behavioural survey was interview-administered to a purposively selected sample of 384 transit camp residents aged 15–29. Biological specimens were collected for HIV rapid testing in the field and confirmatory laboratory testing. Descriptive statistics were used to describe characteristics of abduction. Additionally, a gender-stratified bivariate analysis compared abductees’ and non-abductees’ HIV risk profiles. Results Of the 384 participants, 107 (28%) were former child soldiers (61% were young men and 39% were young women). The median age of participants was 20 and median age at abduction was 13. HIV prevalence was similar among former abductees and non-abductees (12% vs. 13%; p = 0.824), with no differences observed by gender. With respect to differences in HIV vulnerability, our bivariate analysis identified greater risky sexual behaviours in the past year for former abductees than non-abductees, but there were no differences between the two groups’ survival/livelihood activities and food insufficiency experiences, both overall and by gender. The analysis further revealed that young northern Ugandans in general are in desperate need of education, skills development, and support for victims of sexual violence. Conclusions This study persuasively demonstrates that all young people in northern Ugandan have been similarly affected by HIV infection during war and displacement. Post-conflict programme planners must therefore abandon rudimentary targeting practices based on abductees as a high-profile category. Instead, they must develop evidence-based HIV interventions that are commensurate with young people’s specific needs. As such programmes will be less stigmatizing, more oriented to self-selection, and more inclusive, they will effectively reach the most vulnerable young people in northern Uganda. PMID:23919329

Efficacy of artesunate-amodiaquine for treating uncomplicated falciparum malaria in sub-Saharan Africa: a multi-centre analysis

PubMed Central

Zwang, Julien; Olliaro, Piero; Barennes, Hubert; Bonnet, Maryline; Brasseur, Philippe; Bukirwa, Hasifa; Cohuet, Sandra; D'Alessandro, Umberto; Djimdé, Abdulaye; Karema, Corine; Guthmann, Jean-Paul; Hamour, Sally; Ndiaye, Jean-Louis; Mårtensson, Andreas; Rwagacondo, Claude; Sagara, Issaka; Same-Ekobo, Albert; Sirima, Sodiomon B; van den Broek, Ingrid; Yeka, Adoke; Taylor, Walter RJ; Dorsey, Grant; Randrianarivelojosia, Milijaona

2009-01-01

Background Artesunate and amodiaquine (AS&AQ) is at present the world's second most widely used artemisinin-based combination therapy (ACT). It was necessary to evaluate the efficacy of ACT, recently adopted by the World Health Organization (WHO) and deployed over 80 countries, in order to make an evidence-based drug policy. Methods An individual patient data (IPD) analysis was conducted on efficacy outcomes in 26 clinical studies in sub-Saharan Africa using the WHO protocol with similar primary and secondary endpoints. Results A total of 11,700 patients (75% under 5 years old), from 33 different sites in 16 countries were followed for 28 days. Loss to follow-up was 4.9% (575/11,700). AS&AQ was given to 5,897 patients. Of these, 82% (4,826/5,897) were included in randomized comparative trials with polymerase chain reaction (PCR) genotyping results and compared to 5,413 patients (half receiving an ACT). AS&AQ and other ACT comparators resulted in rapid clearance of fever and parasitaemia, superior to non-ACT. Using survival analysis on a modified intent-to-treat population, the Day 28 PCR-adjusted efficacy of AS&AQ was greater than 90% (the WHO cut-off) in 11/16 countries. In randomized comparative trials (n = 22), the crude efficacy of AS&AQ was 75.9% (95% CI 74.6–77.1) and the PCR-adjusted efficacy was 93.9% (95% CI 93.2–94.5). The risk (weighted by site) of failure PCR-adjusted of AS&AQ was significantly inferior to non-ACT, superior to dihydroartemisinin-piperaquine (DP, in one Ugandan site), and not different from AS+SP or AL (artemether-lumefantrine). The risk of gametocyte appearance and the carriage rate of AS&AQ was only greater in one Ugandan site compared to AL and DP, and lower compared to non-ACT (p = 0.001, for all comparisons). Anaemia recovery was not different than comparator groups, except in one site in Rwanda where the patients in the DP group had a slower recovery. Conclusion AS&AQ compares well to other treatments and meets the WHO efficacy criteria for use against falciparum malaria in many, but not all, the sub-Saharan African countries where it was studied. Efficacy varies between and within countries. An IPD analysis can inform general and local treatment policies. Ongoing monitoring evaluation is required. PMID:19698172

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

PubMed

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

2013-08-07

Thousands of former child soldiers who were abducted during the prolonged conflict in northern Uganda have returned to their home communities. Programmes that facilitate their successful reintegration continue to face a number of challenges. Although there is increasing knowledge of the dynamics of HIV infection during conflict, far less is known about its prevalence and implications for population health in the post-conflict period. This study investigated the effects of abduction on the prevalence of HIV and HIV-risk behaviours among young people in Gulu District, northern Uganda. An understanding of abduction experiences and HIV-risk behaviours is vital to both the development of effective reintegration programming for former child soldiers and the design of appropriate HIV prevention interventions for all young people. In 2010, we conducted a cross-sectional study of 2 sub-counties in Gulu District. A demographic and behavioural survey was interview-administered to a purposively selected sample of 384 transit camp residents aged 15-29. Biological specimens were collected for HIV rapid testing in the field and confirmatory laboratory testing. Descriptive statistics were used to describe characteristics of abduction. Additionally, a gender-stratified bivariate analysis compared abductees' and non-abductees' HIV risk profiles. Of the 384 participants, 107 (28%) were former child soldiers (61% were young men and 39% were young women). The median age of participants was 20 and median age at abduction was 13. HIV prevalence was similar among former abductees and non-abductees (12% vs. 13%; p = 0.824), with no differences observed by gender. With respect to differences in HIV vulnerability, our bivariate analysis identified greater risky sexual behaviours in the past year for former abductees than non-abductees, but there were no differences between the two groups' survival/livelihood activities and food insufficiency experiences, both overall and by gender. The analysis further revealed that young northern Ugandans in general are in desperate need of education, skills development, and support for victims of sexual violence. This study persuasively demonstrates that all young people in northern Ugandan have been similarly affected by HIV infection during war and displacement. Post-conflict programme planners must therefore abandon rudimentary targeting practices based on abductees as a high-profile category. Instead, they must develop evidence-based HIV interventions that are commensurate with young people's specific needs. As such programmes will be less stigmatizing, more oriented to self-selection, and more inclusive, they will effectively reach the most vulnerable young people in northern Uganda.

Expressions of climate perturbations in western Ugandan crater lake sediment records during the last 1000 years

NASA Astrophysics Data System (ADS)

Mills, K.; Ryves, D. B.; Anderson, N. J.; Bryant, C. L.; Tyler, J. J.

2014-08-01

Equatorial East Africa has a complex regional patchwork of climate regimes, sensitive to climate fluctuations over a variety of temporal and spatial scales during the late Holocene. Understanding how these changes are recorded in and interpreted from biological and geochemical proxies in lake sedimentary records remains a key challenge to answering fundamental questions regarding the nature, spatial extent and synchroneity of climatic changes seen in East African palaeo-records. Using a paired lake approach, where neighbouring lakes share the same geology, climate and landscape, it might be expected that the systems will respond similarly to external climate forcing. Sediment cores from two crater lakes in western Uganda spanning the last ~1000 years were examined to assess diatom community responses to late Holocene climate and environmental changes, and to test responses to multiple drivers using redundancy analysis (RDA). These archives provide annual to sub-decadal records of environmental change. Lakes Nyamogusingiri and Kyasanduka appear to operate as independent systems in their recording of a similar hydrological response signal via distinct diatom records. However, whilst their fossil diatom records demonstrate an individualistic, indirect response to external (e.g. climatic) drivers, the inferred lake levels show similar overall trends and reflect the broader patterns observed in Uganda and across East Africa. The lakes appear to be sensitive to large-scale climatic perturbations, with evidence of a dry Medieval Climate Anomaly (MCA; ca. AD 1000-1200). The diatom record from Lake Nyamogusingiri suggests a drying climate during the main phase of the Little Ice Age (LIA) (ca. AD 1600-1800), whereas the diatom response from the shallower Lake Kyasanduka is more complex (with groundwater likely playing a key role), and may be driven more by changes in silica and other nutrients, rather than by lake level. The sensitivity of these two Ugandan lakes to regional climate drivers breaks down in ca. AD 1800, when major changes in the ecosystems appear to be a response to increasing cultural impacts within the lake catchments, although both proxy records appear to respond to the drought recorded across East Africa in the mid-20th century. The data highlight the complexity of diatom community responses to external drivers (climate or cultural), even in neighbouring, shallow freshwater lakes. This research also illustrates the importance of, and the need to move towards, a multi-lake, multi-proxy landscape approach to understanding regional hydrological change which will allow for rigorous testing of climate reconstructions, climate forcing and ecosystem response models.

Nevirapine/zidovudine/lamivudine has superior immunological and virological responses not reflected in clinical outcomes in a 48-week randomized comparison with abacavir/zidovudine/lamivudine in HIV-infected Ugandan adults with low CD4 cell counts.

PubMed

Munderi, P; Walker, A S; Kityo, C; Babiker, A G; Ssali, F; Reid, A; Darbyshire, J H; Grosskurth, H; Mugyenyi, P; Gibb, D M; Gilks, C F

2010-05-01

Triple nucleoside reverse transcriptase inhibitor regimens have advantages as first-line antiretroviral therapy (ART), avoiding hepatotoxicity and interactions with anti-tuberculosis therapy, and sparing two drug classes for second-line ART. Concerns exist about virological potency; efficacy has not been assessed in Africa. A safety trial comparing nevirapine with abacavir was conducted in two Ugandan Development of Antiretroviral Therapy in Africa (DART) centres: 600 symptomatic antiretroviral-naïve HIV-infected adults with CD4 counts <200 cells/microL were randomized to zidovudine/lamivudine plus abacavir or nevirapine (placebo-controlled to 24-week primary toxicity endpoint, and then open-label). Documented World Health Organization (WHO) stage 4 events were independently reviewed and plasma HIV-1 RNA assayed retrospectively. Exploratory efficacy analyses are intention-to-treat. The median pre-ART CD4 count was 99 cells/microL, and the median pre-ART viral load was 284 600 HIV-1 RNA copies/mL. A total of 563 participants (94%) completed 48 weeks of follow-up, 25 (4%) died and 12 (2%) were lost to follow-up. The randomized drug was substituted in 21 participants (7%) receiving abacavir vs. 34 (11%) receiving nevirapine (P=0.09). At 48 weeks, 62% of participants receiving abacavir vs. 77% of those receiving nevirapine had viral loads <50 copies/mL (P<0.001), and mean CD4 count increases from baseline were +147 vs. +173 cells/microL, respectively (P=0.006). Nine participants (3%) receiving abacavir vs. 16 (5%) receiving nevirapine died [hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.24-1.25; P=0.15]; 20 receiving abacavir vs. 32 receiving nevirapine developed new or recurrent WHO 4 events or died (HR=0.60; 95% CI 0.34-1.05; P=0.07) and 48 receiving abacavir vs. 68 receiving nevirapine developed new or recurrent WHO 3 or 4 events or died (HR=0.67; 95% CI 0.46-0.96; P=0.03). Seventy-one participants (24%) receiving abacavir experienced 91 grade 4 adverse events compared with 130 events in 109 participants (36%) on nevirapine (P<0.001). The clear virological/immunological superiority of nevirapine over abacavir was not reflected in clinical outcomes over 48 weeks. The inability of CD4 cell count/viral load to predict initial clinical treatment efficacy is unexplained and requires further evaluation.

Implementation and adaptation of the Re-Engineered Discharge (RED) in five California hospitals: a qualitative research study.

PubMed

Mitchell, S E; Weigel, G M; Laurens, V; Martin, J; Jack, B W

2017-04-19

Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and characterize contextual factors influencing how five California hospitals adapted and implemented RED and the subsequent impact on RED program sustainability. Participant observation and key informant and focus group interviews with 64 individuals at five California hospitals implementing RED in 2012 and 2013 were conducted. These involved hospital leadership, personnel responsible for Project RED implementation, hospital staff, and clinicians. Interview transcripts were coded and analyzed using a modified grounded theory approach and constant comparative analysis. Both internal and external contextual factors were identified that influenced hospitals' decisions on RED adaptation and implementation. These also impacted RED sustainability. External factors included: impending federal penalties for hospitals with high readmission rates targeting specific diagnoses, and access to external funding and technical support to help hospitals implement RED. Internal or organizational level contextual factors included: committed leadership prioritizing Project RED; RED adaptations; depth, accountability and influence of the implementation team; sustainability planning; and hospital culture. Only three of the five hospitals continued Project RED beyond the implementation period. The sustainability of RED in participating hospitals was only possible when hospitals approached RED implementation as a transformational process rather than a patient safety project, maintained a high level of fidelity to the RED protocol, and had leadership and an implementation team who embraced change and failure in the pursuit of better patient care and outcomes. Hospitals who were unsuccessful in implementing a sustainable RED process lacked all or most of these components in their approach.

Comparative Study of Betacyanin Profile and Antimicrobial Activity of Red Pitahaya (Hylocereus polyrhizus) and Red Spinach (Amaranthus dubius).

PubMed

Yong, Yi Yi; Dykes, Gary; Lee, Sui Mae; Choo, Wee Sim

2017-03-01

Betacyanins are reddish to violet pigments that can be found in red pitahaya (Hylocereus polyrhizus) and red spinach (Amaranthus dubius). This study investigated the impact of sub-fractionation (solvent partitioning) on betacyanin content in both plants. Characterization of betacyanins and evaluation of their antimicrobial activities were also carried out. Betanin was found in both plants. In addition, isobetanin, phyllocactin and hylocerenin were found in red pitahaya whereas amaranthine and decarboxy-amaranthine were found in red spinach. Sub-fractionated red pitahaya and red spinach had 23.5 and 121.5 % more betacyanin content, respectively, than those without sub-fractionation. Sub-fractionation increased the betanin and decarboxy-amaranthine content in red pitahaya and red spinach, respectively. The betacyanin fraction from red spinach (minimum inhibitory concentration [MIC] values: 0.78-3.13 mg/mL) demonstrated a better antimicrobial activity profile than that of red pitahaya (MIC values: 3.13-6.25 mg/mL) against nine Gram-positive bacterial strains. Similarly, the red spinach fraction (MIC values: 1.56-3.13 mg/mL) was more active than the red pitahaya fraction (MIC values: 3.13-6.25 mg/mL) against five Gram-negative bacterial strains. This could be because of a higher amount of betacyanin, particularly amaranthine in the red spinach.

Use of near infrared/red radiance ratios for estimating vegetation biomass and physiological status

NASA Technical Reports Server (NTRS)

Tucker, C. J.

1977-01-01

The application of photographic infrared/red (ir/red) reflectance or radiance ratios for the estimation of vegetation biomass and physiological status were investigated by analyzing in situ spectral reflectance data from experimental grass plots. Canopy biological samples were taken for total wet biomass, total dry biomass, leaf water content, dry green biomass, dry brown biomass, and total chlorophyll content at each sampling date. Integrated red and photographic infrared radiances were regressed against the various canopy or plot variables to determine the relative significance between the red, photographic infrared, and the ir/red ratio and the canopy variables. The ir/red ratio is sensitive to the photosynthetically active or green biomass, the rate of primary production, and actually measures the interaction between the green biomass and the rate of primary production within a given species type. The ir/red ratio resulted in improved regression significance over the red or the ir/radiances taken separately. Only slight differences were found between ir/red ratio, the ir-red difference, the vegetation index, and the transformed vegetation index. The asymptotic spectral radiance properties of the ir, red, ir/red ratio, and the various transformations were evaluated.

Red Misfits in the Sloan Digital Sky Survey: properties of star-forming red galaxies

NASA Astrophysics Data System (ADS)

Evans, Fraser A.; Parker, Laura C.; Roberts, Ian D.

2018-06-01

We study Red Misfits, a population of red, star-forming galaxies in the local Universe. We classify galaxies based on inclination-corrected optical colours and specific star formation rates derived from the Sloan Digital Sky Survey Data Release 7. Although the majority of blue galaxies are star-forming and most red galaxies exhibit little to no ongoing star formation, a small but significant population of galaxies (˜11 per cent at all stellar masses) are classified as red in colour yet actively star-forming. We explore a number of properties of these galaxies and demonstrate that Red Misfits are not simply dusty or highly inclined blue cloud galaxies or quiescent red galaxies with poorly constrained star formation. The proportion of Red Misfits is nearly independent of environment, and this population exhibits both intermediate morphologies and an enhanced likelihood of hosting an active galactic nucleus. We conclude that Red Misfits are a transition population, gradually quenching on their way to the red sequence and this quenching is dominated by internal processes rather than environmentally driven processes. We discuss the connection between Red Misfits and other transition galaxy populations, namely S0s, red spirals, and green valley galaxies.

Recycling red mud from the production of aluminium as a red cement-based mortar.

PubMed

Yang, Xiaojie; Zhao, Jianfeng; Li, Haoxin; Zhao, Piqi; Chen, Qin

2017-05-01

Current management for red mud is insufficient and a new method is needed. A series of experiments have been carried out to develop a new approach for effective management of red mud. Mortars without or with 3%, 6% and 9% red mud were prepared and their fresh and hardened properties were measured to access the possibility of recycling the red mud in the production of red cement-based mortar. The mechanisms corresponding to their mechanical performance variations were explored by X-ray powder diffraction and scanning electron microscopy. The results show that the fresh mortars with red mud present an increase of viscosity as compared with the control. However, little difference is found when the content of red mud is altered. It also can be seen that red mud increases flow time and reduces the slump flow of the mortar. Meanwhile, it is found that mortar with red mud is provided with higher air content. Red mud is eligible to adjust the decorative mortar colour. Compressive strength of mortar is improved when less than 6% red mud is added. However, overall it has a slightly negative effect on tensile bond strength. It decreases the Ca(OH) 2 content and densifies the microstructure of hardened paste. The heavy metal concentrations in leachates of mortars with red mud are much lower than the values required in the standard, and it will not do harm to people's health and the environment. These results are important to recycle and effectively manage red mud via the production of red cement-based mortar.

Stockpiling and Comprehensive Utilization of Red Mud Research Progress

PubMed Central

Liu, Dong-Yan; Wu, Chuan-Sheng

2012-01-01

With increasing production of red mud, the environmental problems caused by it are increasingly serious, and thus the integrated treatment of red mud is imminent. This article provides an overview of the composition and the basic characteristics of red mud. The research progress of safe stockpiling and comprehensive utilization of red mud is summarized. The safe stockpiling of red mud can be divided into two aspects: the design and safe operation of the stocking yard. The comprehensive utilization of red mud can be further divided into three aspects: the effective recycling of components, resource utilization and application in the field of environmental protection. This paper points out that the main focus of previous studies on red mud stockpiling is cost reproduction and land tenure. The recovery of resources from red mud has a high value-added, but low level industrialization. The use of red mud as a building material and filler material is the most effective way to reduce the stockpiling of red mud. Red mud used for environmental remediation materials is a new hotspot and worth promoting for its simple processing and low cost.

Rejuvenation of allogenic red cells: benefits and risks.

PubMed

Aujla, H; Woźniak, M; Kumar, T; Murphy, G J

2018-06-04

To review preclinical and clinical studies that have evaluated the effects of red cell rejuvenation in vivo and in vitro and to assess the potential risks and benefits from their clinical use. A systematic review and narrative synthesis of the intervention of red cell rejuvenation using a red cell processing solution containing inosine, pyruvate, phosphate and adenine. Outcomes of interest in vitro were changes in red cell characteristics including adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG), deformability and the accumulation of oxidized lipids and other reactive species in the red cell supernatant. Outcomes in vivo were 24-h post-transfusion survival and the effects on oxygen delivery, organ function and inflammation in transfused recipients. The literature search identified 49 studies evaluating rejuvenated red cells. In vitro rejuvenation restored cellular properties including 2,3-DPG and ATP to levels similar to freshly donated red cells. In experimental models, in vivo transfusion of rejuvenated red cells improved oxygen delivery and myocardial, renal and pulmonary function when compared to stored red cells. In humans, in vivo 24-h survival of rejuvenated red cells exceeded 75%. In clinical studies, rejuvenated red cells were found to be safe, with no reported adverse effects. In one adult cardiac surgery trial, transfusion of rejuvenated red cells resulted in improved myocardial performance. Transfusion of rejuvenated red cells reduces organ injury attributable to the red cell storage lesion without adverse effects in experimental studies in vivo. The clinical benefits of this intervention remain uncertain. © 2018 International Society of Blood Transfusion.

Phenol red-silk tyrosine cross-linked hydrogels.

PubMed

Sundarakrishnan, Aswin; Herrero Acero, Enrique; Coburn, Jeannine; Chwalek, Karolina; Partlow, Benjamin; Kaplan, David L

2016-09-15

Phenol red is a cytocompatible pH sensing dye that is commonly added to cell culture media, but removed from some media formulations due to its structural mimicry of estrogen. Phenol red free media is also used during live cell imaging, to avoid absorbance and fluorescence quenching of fluorophores. To overcome these complications, we developed cytocompatible and degradable phenol red-silk tyrosine cross-linked hydrogels using horseradish peroxidase (HRP) enzyme and hydrogen peroxide (H2O2). Phenol red added to silk during tyrosine crosslinking accelerated di-tyrosine formation in a concentration-dependent reaction. Phenol red diffusion studies and UV-Vis spectra of phenol red-silk tyrosine hydrogels at different pHs showed altered absorption bands, confirming entrapment of dye within the hydrogel network. LC-MS of HRP-reacted phenol red and N-acetyl-l-tyrosine reaction products confirmed covalent bonds between the phenolic hydroxyl group of phenol red and tyrosine on the silk. At lower phenol red concentrations, leak-proof hydrogels which did not release phenol red were fabricated and found to be cytocompatible based on live-dead staining and alamar blue assessments of encapsulated fibroblasts. Due to the spectral overlap between phenol red absorbance at 415nm and di-tyrosine fluorescence at 417nm, phenol red-silk hydrogels provide both absorbance and fluorescence-based pH sensing. With an average pKa of 6.8 and good cytocompatibiltiy, phenol red-silk hydrogels are useful for pH sensing in phenol red free systems, cellular microenvironments and bioreactors. Phenol red entrapped within hydrogels facilitates pH sensing in phenol red free environments. Leak-proof phenol red based pH sensors require covalent binding techniques, but are complicated due to the lack of amino or carboxyl groups on phenol red. Currently, there is no simple, reliable technique to covalently link phenol red to hydrogel matrices, for real-time pH sensing in cell culture environments. Herein, we take advantage of phenolic groups for covalent linkage of phenol red to silk tyrosine in the presence of HRP and H2O2. The novelty of the current system stems from its simplicity and the use of silk protein to create a cytocompatible, degradable sensor capable of real-time pH sensing in cell culture microenvironments. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Genetic Basis for Red Coloration in Birds.

PubMed

Lopes, Ricardo J; Johnson, James D; Toomey, Matthew B; Ferreira, Mafalda S; Araujo, Pedro M; Melo-Ferreira, José; Andersson, Leif; Hill, Geoffrey E; Corbo, Joseph C; Carneiro, Miguel

2016-06-06

The yellow and red feather pigmentation of many bird species [1] plays pivotal roles in social signaling and mate choice [2, 3]. To produce red pigments, birds ingest yellow carotenoids and endogenously convert them into red ketocarotenoids via an oxidation reaction catalyzed by a previously unknown ketolase [4-6]. We investigated the genetic basis for red coloration in birds using whole-genome sequencing of red siskins (Spinus cucullata), common canaries (Serinus canaria), and "red factor" canaries, which are the hybrid product of crossing red siskins with common canaries [7]. We identified two genomic regions introgressed from red siskins into red factor canaries that are required for red coloration. One of these regions contains a gene encoding a cytochrome P450 enzyme, CYP2J19. Transcriptome analysis demonstrates that CYP2J19 is significantly upregulated in the skin and liver of red factor canaries, strongly implicating CYP2J19 as the ketolase that mediates red coloration in birds. Interestingly, a second introgressed region required for red feathers resides within the epidermal differentiation complex, a cluster of genes involved in development of the integument. Lastly, we present evidence that CYP2J19 is involved in ketocarotenoid formation in the retina. The discovery of the carotenoid ketolase has important implications for understanding sensory function and signaling mediated by carotenoid pigmentation. Copyright © 2016 Elsevier Ltd. All rights reserved.

76 FR 22033 - Safety Zone; Red River Safety Zone, Red River, MN

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

...-AAOO Safety Zone; Red River Safety Zone, Red River, MN AGENCY: Coast Guard, DHS. ACTION: Temporary... a temporary safety zone on the Red River, MN. This safety zone is being established to ensure the... Red River in the State of Minnesota north of a line drawn across latitude 46[deg]20'00'' N, including...

“AmaRosa,” a red skinned, red fleshed fingerling with high phytonutrient value

USDA-ARS?s Scientific Manuscript database

AmaRosa is a mid season specialty potato with red skin and red flesh. This selection is unique among commercially available potato varieties in that plants set a large number of smooth, small, fingerling-shaped tubers with red skin and red flesh. AmaRosa tubers have higher total anthocyanin and hyd...

21 CFR 640.10 - Red Blood Cells.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.10 Red Blood Cells. The proper name of this product shall be Red Blood Cells. The product is defined as red blood cells remaining... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Red Blood Cells. 640.10 Section 640.10 Food and...

21 CFR 640.10 - Red Blood Cells.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.10 Red Blood Cells. The proper name of this product shall be Red Blood Cells. The product is defined as red blood cells remaining... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Red Blood Cells. 640.10 Section 640.10 Food and...

21 CFR 640.10 - Red Blood Cells.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.10 Red Blood Cells. The proper name of this product shall be Red Blood Cells. The product is defined as red blood cells remaining... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Red Blood Cells. 640.10 Section 640.10 Food and...

21 CFR 640.10 - Red Blood Cells.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.10 Red Blood Cells. The proper name of this product shall be Red Blood Cells. The product is defined as red blood cells remaining... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Red Blood Cells. 640.10 Section 640.10 Food and...

21 CFR 640.10 - Red Blood Cells.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Red Blood Cells. 640.10 Section 640.10 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.10 Red Blood Cells. The proper name of this product shall be Red Blood Cells. The product is defined as red blood cells remaining...

Red, Rank, and Romance in Women Viewing Men

ERIC Educational Resources Information Center

Elliot, Andrew J.; Niesta Kayser, Daniela; Greitemeyer, Tobias; Lichtenfeld, Stephanie; Gramzow, Richard H.; Maier, Markus A.; Liu, Huijun

2010-01-01

In many nonhuman species of vertebrates, females are attracted to red on male conspecifics. Red is also a signal of male status in many nonhuman vertebrate species, and females show a mating preference for high-status males. These red-attraction and red-status links have been found even when red is displayed on males artificially. In the present…

Red Wolf (Canis rufus) Recovery: A Review with Suggestions for Future Research

PubMed Central

Hinton, Joseph W.; Chamberlain, Michael J.; Rabon, David R.

2013-01-01

Simple Summary Once widespread in the Eastern United States, early 20th century predator-control programs reduced red wolves to a remnant population by the 1970s. The U.S. Fish and Wildlife Service, through the Red Wolf Recovery Program, restored red wolves to northeastern North Carolina in 1987. After 25 years of restoration efforts, issues of hybridization with coyotes, inbreeding, and human-caused mortality continue to hamper red wolf recovery. To understand how these issues influence recovery efforts, we examine the history of red wolf restoration and its challenges. We then formulate areas of research that are of direct relevance to the restoration of red wolves. Abstract By the 1970s, government-supported eradication campaigns reduced red wolves to a remnant population of less than 100 individuals on the southern border of Texas and Louisiana. Restoration efforts in the region were deemed unpromising because of predator-control programs and hybridization with coyotes. The U.S. Fish and Wildlife Service (USFWS) removed the last remaining red wolves from the wild and placed them in a captive-breeding program. In 1980, the USFWS declared red wolves extinct in the wild. During 1987, the USFWS, through the Red Wolf Recovery Program, reintroduced red wolves into northeastern North Carolina. Although restoration efforts have established a population of approximately 70–80 red wolves in the wild, issues of hybridization with coyotes, inbreeding, and human-caused mortality continue to hamper red wolf recovery. We explore these three challenges and, within each challenge, we illustrate how research can be used to resolve problems associated with red wolf-coyote interactions, effects of inbreeding, and demographic responses to human-caused mortality. We hope this illustrates the utility of research to advance restoration of red wolves. PMID:26479530

Growth and photomorphogenesis of pepper plants under red light-emitting diodes with supplemental blue or far-red lighting

NASA Technical Reports Server (NTRS)

Brown, C. S.; Schuerger, A. C.; Sager, J. C.

1995-01-01

Light-emitting diodes (LEDs) are a potential irradiation source for intensive plant culture systems and photobiological research. They have small size, low mass, a long functional life, and narrow spectral output. In this study, we measured the growth and dry matter partitioning of 'Hungarian Wax' pepper (Capsicum annuum L.) plants grown under red LEDs compared with similar plants grown under red LEDs with supplemental blue or far-red radiation or under broad spectrum metal halide (MH) lamps. Additionally, we describe the thermal and spectral characteristics of these sources. The LEDs used in this study had a narrow bandwidth at half peak height (25 nm) and a focused maximum spectral output at 660 nm for the red and 735 nm for the far-red. Near infrared radiation (800 to 3000 nm) was below detection and thermal infrared radiation (3000 to 50,000 nm) was lower in the LEDs compared to the MH source. Although the red to far-red ratio varied considerably, the calculated phytochrome photostationary state (phi) was only slightly different between the radiation sources. Plant biomass was reduced when peppers were grown under red LEDs in the absence of blue wavelengths compared to plants grown under supplemental blue fluorescent lamps or MH lamps. The addition of far-red radiation resulted in taller plants with greater stem mass than red LEDs alone. There were fewer leaves under red or red plus far-red radiation than with lamps producing blue wavelengths. These results indicate that red LEDs may be suitable, in proper combination with other wavelengths of light, for the culture of plants in tightly controlled environments such as space-based plant culture systems.

Neutral-red reaction is related to virulence and cell wall methyl-branched lipids in Mycobacterium tuberculosis.

PubMed

Cardona, P-J; Soto, C Y; Martín, C; Giquel, B; Agustí, G; Andreu, Núria; Guirado, E; Sirakova, T; Kolattukudy, P; Julián, E; Luquin, M

2006-01-01

Searching for virulence marking tests for Mycobacterium tuberculosis, Dubos and Middlebrook reported in 1948 that in an alkaline aqueous solution of neutral-red, the cells of the virulent H37Rv M. tuberculosis strain fixed the dye and became red in color, whereas the cells of the avirulent H37Ra M. tuberculosis strain remained unstained. In the 1950 and 1960s, fresh isolates of M. tuberculosis were tested for this neutral-red cytochemical reaction and it was reported that they were neutral-red positive, whereas other mycobacteria of diverse environmental origins that were non-pathogenic for guinea pigs were neutral-red negative. However, neutral-red has not really been proven to be a virulence marker. To test if virulence is in fact correlated to neutral-red, we studied a clinical isolate of M. tuberculosis that was originally neutral-red positive but, after more than 1 year passing through culture mediums, turned neutral-red negative. We found that, in comparison to the original neutral-red positive strain, this neutral-red negative variant was attenuated in two murine models of experimental tuberculosis. Lipid analysis showed that this neutral-red negative natural mutant lost the capacity to synthesize pthiocerol dimycocerosates, a cell wall methyl-branched lipid that has been related to virulence in M. tuberculosis. We also studied the neutral-red of different gene-targeted M. tuberculosis mutants unable to produce pthiocerol dimycocerosates or other cell wall methyl-branched lipids such as sulfolipids, and polyacyltrehaloses. We found a negative neutral-red reaction in mutants that were deficient in more than one type of methyl-branched lipids. We conclude that neutral-red is indeed a marker of virulence and it indicates important perturbations in the external surface of M. tuberculosis cells.

Detecting the red tide based on remote sensing data in optically complex East China Sea

NASA Astrophysics Data System (ADS)

Xu, Xiaohui; Pan, Delu; Mao, Zhihua; Tao, Bangyi; Liu, Qiong

2012-09-01

Red tide not only destroys marine fishery production, deteriorates the marine environment, affects coastal tourist industry, but also causes human poison, even death by eating toxic seafood contaminated by red tide organisms. Remote sensing technology has the characteristics of large-scale, synchronized, rapid monitoring, so it is one of the most important and most effective means of red tide monitoring. This paper selects the high frequency red tides areas of the East China Sea as study area, MODIS/Aqua L2 data as the data source, analysis and compares the spectral differences in the red tide water bodies and non-red tide water bodies of many historical events. Based on the spectral differences, this paper develops the algorithm of Rrs555/Rrs488> 1.5 to extract the red tide information. Apply the algorithm on red tide event happened in the East China Sea on May 28, 2009 to extract the information of red tide, and found that the method can determine effectively the location of the occurrence of red tide; there is a good corresponding relationship between red tide extraction result and chlorophyll a concentration extracted by remote sensing, shows that these algorithm can determine effectively the location and extract the red tide information.

Seeing red to being red: conserved genetic mechanism for red cone oil droplets and co-option for red coloration in birds and turtles.

PubMed

Twyman, Hanlu; Valenzuela, Nicole; Literman, Robert; Andersson, Staffan; Mundy, Nicholas I

2016-08-17

Avian ketocarotenoid pigments occur in both the red retinal oil droplets that contribute to colour vision and bright red coloration used in signalling. Turtles are the only other tetrapods with red retinal oil droplets, and some also display red carotenoid-based coloration. Recently, the CYP2J19 gene was strongly implicated in ketocarotenoid synthesis in birds. Here, we investigate CYP2J19 evolution in relation to colour vision and red coloration in reptiles using genomic and expression data. We show that turtles, but not crocodiles or lepidosaurs, possess a CYP2J19 orthologue, which arose via gene duplication before turtles and archosaurs split, and which is strongly and specifically expressed in the ketocarotenoid-containing retina and red integument. We infer that CYP2J19 initially functioned in colour vision in archelosaurs and conclude that red ketocarotenoid-based coloration evolved independently in birds and turtles via gene regulatory changes of CYP2J19 Our results suggest that red oil droplets contributed to colour vision in dinosaurs and pterosaurs. © 2016 The Author(s).

[Effects of water stress on red-edge parameters and yield in wheat cropping].

PubMed

He, Ke-Xun; Zaho, Shu-He; Lai, Jian-Bin; Luo, Yun-Xiao; Qin, Zhi-Hao

2013-08-01

The objective of the present paper is to study the influence of water stress on wheat spectrum red edge parameters by using field wheat spectrum data obtained from water stress experiment. Firstly, the authors analyzed the influence of water stress on wheat spectrum reflectance. Then the authors got the wheat red edge position and red edge peak through calculating wheat spectrum first-order differential and analyzed the influence of water stress on wheat red edge parameters. Finally the authors discussed the relationship between red peak and wheat yield. The results showed that the wheat red edge position shows "red shift" at the beginning of the wheat growth period and "blue shift" at the later period of the wheat growth period under the water stress experiment. Also, the red edge peak of the wheat showed that red edge peak increased with the water stress sharpening at the beginning of the wheat growth period, and then the red edge peak reduced with the water stress sharpening. The wheat red edge peak presented positive correlation with the wheat yield before the elongation period, and exhibited negative correlation after that period.

A novel type of light-harvesting antenna protein of red algal origin in algae with secondary plastids.

PubMed

Sturm, Sabine; Engelken, Johannes; Gruber, Ansgar; Vugrinec, Sascha; Kroth, Peter G; Adamska, Iwona; Lavaud, Johann

2013-07-30

Light, the driving force of photosynthesis, can be harmful when present in excess; therefore, any light harvesting system requires photoprotection. Members of the extended light-harvesting complex (LHC) protein superfamily are involved in light harvesting as well as in photoprotection and are found in the red and green plant lineages, with a complex distribution pattern of subfamilies in the different algal lineages. Here, we demonstrate that the recently discovered "red lineage chlorophyll a/b-binding-like proteins" (RedCAPs) form a monophyletic family within this protein superfamily. The occurrence of RedCAPs was found to be restricted to the red algal lineage, including red algae (with primary plastids) as well as cryptophytes, haptophytes and heterokontophytes (with secondary plastids of red algal origin). Expression of a full-length RedCAP:GFP fusion construct in the diatom Phaeodactylum tricornutum confirmed the predicted plastid localisation of RedCAPs. Furthermore, we observed that similarly to the fucoxanthin chlorophyll a/c-binding light-harvesting antenna proteins also RedCAP transcripts in diatoms were regulated in a diurnal way at standard light conditions and strongly repressed at high light intensities. The absence of RedCAPs from the green lineage implies that RedCAPs evolved in the red lineage after separation from the the green lineage. During the evolution of secondary plastids, RedCAP genes therefore must have been transferred from the nucleus of the endocytobiotic alga to the nucleus of the host cell, a process that involved complementation with pre-sequences allowing import of the gene product into the secondary plastid bound by four membranes. Based on light-dependent transcription and on localisation data, we propose that RedCAPs might participate in the light (intensity and quality)-dependent structural or functional reorganisation of the light-harvesting antennae of the photosystems upon dark to light shifts as regularly experienced by diatoms in nature. Remarkably, in plastids of the red lineage as well as in green lineage plastids, the phycobilisome based cyanobacterial light harvesting system has been replaced by light harvesting systems that are based on members of the extended LHC protein superfamily, either for one of the photosystems (PS I of red algae) or for both (diatoms). In their proposed function, the RedCAP protein family may thus have played a role in the evolutionary structural remodelling of light-harvesting antennae in the red lineage.

The Assessment of Red Beet as a Natural Colorant, and Evaluation of Quality Properties of Emulsified Pork Sausage Containing Red Beet Powder during Cold Storage

PubMed Central

Jin, Sang-Keun; Choi, Jung-Seok; Moon, Sung-Sil; Jeong, Jin-Yeon

2014-01-01

The purpose of this study was to assess red beet as a natural colorant in emulsified pork sausage and to investigate the effect of red beet on quality characteristics of emulsified pork sausage during 20 d of cold storage. Red beet was prepared as a powder and a substitute with sodium nitrite at 0.5% and 1.0% levels in emulsified pork sausage. Red beet significantly increased the moisture content and pH (p<0.0001) and affected color traits. Lightness of emulsified pork sausage decreased by the addition of red beet powder (p<0.01), whereas lightness with red beet treatments slightly increased during 20 d of cold storage at 4℃ (p<0.05). Redness dramatically increased with red beet powder (p<0.0001). Color by sensory evaluation also showed a significant effect from red beet addition (p<0.05), whereas the other sensory properties such as flavor, tenderness, juiciness, and overall acceptability were not affected by the addition of red beet powder (p>0.05). Texture and 2-thiobabituric acid reactive substance were also not affected by red beet addition (p>0.05). Therefore, red beet could be a good natural colorant in emulsified pork sausage but it needs additional processing, such as betalain concentration and extraction as a juice, to be used as an antioxidant in meat products. PMID:26761285

[Establishment and identification of mouse lymphoma cell line EL4 expressing red fluorescent protein].

PubMed

Li, Yan-Jie; Cao, Jiang; Chen, Chong; Wang, Dong-Yang; Zeng, Ling-Yu; Pan, Xiu-Ying; Xu, Kai-Lin

2010-02-01

This study was purposed to construct a lentiviral vector encoding red fluorescent protein (DsRed) and transfect DsRed into EL4 cells for establishing mouse leukemia/lymphoma model expressing DsRed. The bicistronic SIN lentiviral transfer plasmid containing the genes encoding neo and internal ribosomal entry site-red fluorescent protein (IRES-DsRed) was constructed. Human embryonic kidney 293FT cells were co-transfected with the three plasmids by liposome method. The viral particles were collected and used to transfect EL4 cells, then the cells were selected by G418. The results showed that the plasmid pXZ208-neo-IRES-DsRed was constructed successfully, and the viral titer reached to 10(6) U/ml. EL4 cells were transfected by the viral solution efficiently. The transfected EL4 cells expressing DsRed survived in the final concentration 600 microg/ml of G418. The expression of DsRed in the transfected EL4 cells was demonstrated by fluorescence microscopy and flow cytometry. In conclusion, the EL4/DsRed cell line was established successfully.

Red clothing increases perceived dominance, aggression and anger

PubMed Central

Wiedemann, Diana; Burt, D. Michael; Hill, Russell A.; Barton, Robert A.

2015-01-01

The presence and intensity of red coloration correlate with male dominance and testosterone in a variety of animal species, and even artificial red stimuli can influence dominance interactions. In humans, red stimuli are perceived as more threatening and dominant than other colours, and wearing red increases the probability of winning sporting contests. We investigated whether red clothing biases the perception of aggression and dominance outside of competitive settings, and whether red influences decoding of emotional expressions. Participants rated digitally manipulated images of men for aggression and dominance and categorized the emotional state of these stimuli. Men were rated as more aggressive and more dominant when presented in red than when presented in either blue or grey. The effect on perceived aggression was found for male and female raters, but only male raters were sensitive to red as a signal of dominance. In a categorization test, images were significantly more often categorized as ‘angry’ when presented in the red condition, demonstrating that colour stimuli affect perceptions of emotions. This suggests that the colour red may be a cue used to predict propensity for dominance and aggression in human males. PMID:25972401

Red Pine in the Northern Lake States

Treesearch

Thomas L. Schmidt

2003-01-01

Red pine is an important tree species for the Northern Lake States. About 4 percent of the total area of timberland is dominated by red pine but most other forest types also have red pine as a component. The red pine forest type in the region has dramatically increased in area since the 1930s. Stand-size class distribution of the red pine forest type has changed over...