Actor Diversity and Interactions in the Development of Banana Hybrid Varieties in Uganda: Implications for Technology Uptake

ERIC Educational Resources Information Center

Sanya, Losira Nasirumbi; Sseguya, Haroon; Kyazze, Florence Birungi; Baguma, Yona; Kibwika, Paul

2018-01-01

Purpose: We examine the nature of networks through which new hybrid banana varieties (HBVs) in Uganda are developed, and how different actors engage in the technology development process. Design/methodology/approach: We collected the data through 20 key informant interviews and 5 focus group discussions with actors involved in the process. We…

Water contamination with heavy metals and trace elements from Kilembe copper mine and tailing sites in Western Uganda; implications for domestic water quality.

PubMed

Abraham, Mwesigye R; Susan, Tumwebaze B

2017-02-01

The mining and processing of copper in Kilembe, Western Uganda, from 1956 to 1982 left over 15 Mt of cupriferous and cobaltiferous pyrite dumped within a mountain river valley, in addition to mine water which is pumped to the land surface. This study was conducted to assess the sources and concentrations of heavy metals and trace elements in Kilembe mine catchment water. Multi-element analysis of trace elements from point sources and sinks was conducted which included mine tailings, mine water, mine leachate, Nyamwamba River water, public water sources and domestic water samples using ICP-MS. The study found that mean concentrations (mg kg -1 ) of Co (112), Cu (3320), Ni (131), As (8.6) in mine tailings were significantly higher than world average crust and were being eroded and discharged into water bodies within the catchment. Underground mine water and leachate contained higher mean concentrations (μg L -1 ) of Cu (9470), Co (3430) and Ni (590) compared with background concentrations (μg L -1 ) in un contaminated water of 1.9, 0.21 and 0.67 for Cu, Co and Ni respectively. Over 25% of household water samples exceeded UK drinking water thresholds for Al of 200 μg L -1 , Co exceeded Winsconsin (USA drinking) water thresholds of 40 μg L -1 in 40% of samples while Fe in 42% of samples exceeded UK thresholds of 200 μg L -1 . The study however found that besides mining activities, natural processes of geological weathering also contributed to Al, Fe, and Mn water contamination in a number of public water sources. Copyright © 2016 Elsevier Ltd. All rights reserved.

Against a sea of troubles: AIDS control in Uganda.

PubMed

Magezi, M G

1991-01-01

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

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

NASA Astrophysics Data System (ADS)

Muhoro, Peter N.

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

Thermo-tectonic history reconstruction of the Rwenzori Mountains, D. R. Congo

NASA Astrophysics Data System (ADS)

Mansour, Sherif; Bauer, Friederike; Glasmacher, Ulrich; Grobe, René; Starz, Matthias

2015-04-01

The Albertine Rift forms the northern section of the western Rift of the East African Rift System (EARS) which was developed during the Neogene time. The Rwenzori Mtns evolved along the eastern rift shoulder of the Albertine Rift, rising up to form a striking feature within the rift valley. The scarcity of volcanic activity in the Western Rift has raised questions about the Rwenzori Mtns origin and evolution and how this fits into the general evolution of the Albertine Rift and the EARS. The Rwenzori Mtns represent the horst block in the Albertine Rift, with elevations reaching 5109 m a.s.l. (Margherita Peak). The main lithologies of the Rwenzori Mtns are gneiss, schist and amphibolite, subordinate intrusive rocks with various metamorphic overprint, and quartzite of Precambrian age (Tanner, 1971). All these units are intensively truncated by N-S, NW-SE, NE-SW and E-W trending normal faults, locally with a significant strike-slip component (Ring, 2008). The slope Rwenzori Mtns western flank is much steeper than the eastern one. This asymmetry is most striking in the central part where the western flank rises from about 1000 m a.s.l. to more than 5000 m a.s.l. in less than 15 km while, the eastern flank plunges to 1000 m a.s.l. again along a distance of more than 30 km (Bauer et al., 2013). Detailed thermochronologic study on the eastern (Uganda) side of central Rwenzori differentiated it into northern and southern blocks (Bauer et al., 2013). Samples from the northern block cooled faster, with three cooling/exhumation events; to ~120 °C in Carboniferous to Permian times, to ~70 °C in Mesozoic times, and to surface temperature in the Neogene. While, the southern block shows an earlier onset of cooling/exhumation events (>400 Ma). On the other hand, 33 samples from the western (Congo) side of central Rwenzori were studied using fission track and (U/Th)-He techniques. The apatite fission track data gives much younger cooling ages. Which, distinguished in three cooling age groups with; Eocene, Oligo-Miocene, and Middle Miocene ages. These results reveal the difference in thermo-tectonic history between the eastern and western flanks of Rwenzori Mtns and support the tilt uplift geometry hypotheses (e.g. Pickford et al., 1993). References Bauer, F.U., Glasmacher, U.A., Ring, U., Karl, M., Schumann, A., Nagudi, B. (2013). Tracing the exhumation history of the Rwenzori Mountains, Albertine Rift, Uganda, using low-temperature thermochronology, Tectonophysics, 599, 8-28. http://dx.doi.org/10.1016/j.tecto.2013.03.032. Pickford, M., Senut, B., Hadoto, D., 1993. Geology and Palaeobiology of the Albertine Rift Valley Uganda-Zaire, vol. 1. Geology. CIFEG Occas, Orleans. Publication, vol. 24, pp. 1-190. Ring, U., 2008. Extreme uplift of the Rwenzori Mountains in the East African Rift, Uganda: structural framework and possible role of glaciations. Tectonics 27 (TC4018). http://dx.doi.org/10.1029/2007TC002176. Tanner, P.W.G., 1971. The Stanley Volcanics formation of Ruwenzori, Uganda. Fifteenth Annual Report of the Research Institute of African Geology. University of Leeds.

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

PubMed

1996-12-01

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

Mosaic maternal ancestry in the Great Lakes region of East Africa.

PubMed

Gomes, Verónica; Pala, Maria; Salas, Antonio; Álvarez-Iglesias, Vanesa; Amorim, António; Gómez-Carballa, Alberto; Carracedo, Ángel; Clarke, Douglas J; Hill, Catherine; Mormina, Maru; Shaw, Marie-Anne; Dunne, David W; Pereira, Rui; Pereira, Vânia; Prata, Maria João; Sánchez-Diz, Paula; Rito, Teresa; Soares, Pedro; Gusmão, Leonor; Richards, Martin B

2015-09-01

The Great Lakes lie within a region of East Africa with very high human genetic diversity, home of many ethno-linguistic groups usually assumed to be the product of a small number of major dispersals. However, our knowledge of these dispersals relies primarily on the inferences of historical, linguistics and oral traditions, with attempts to match up the archaeological evidence where possible. This is an obvious area to which archaeogenetics can contribute, yet Uganda, at the heart of these developments, has not been studied for mitochondrial DNA (mtDNA) variation. Here, we compare mtDNA lineages at this putative genetic crossroads across 409 representatives of the major language groups: Bantu speakers and Eastern and Western Nilotic speakers. We show that Uganda harbours one of the highest mtDNA diversities within and between linguistic groups, with the various groups significantly differentiated from each other. Despite an inferred linguistic origin in South Sudan, the data from the two Nilotic-speaking groups point to a much more complex history, involving not only possible dispersals from Sudan and the Horn but also large-scale assimilation of autochthonous lineages within East Africa and even Uganda itself. The Eastern Nilotic group also carries signals characteristic of West-Central Africa, primarily due to Bantu influence, whereas a much stronger signal in the Western Nilotic group suggests direct West-Central African ancestry. Bantu speakers share lineages with both Nilotic groups, and also harbour East African lineages not found in Western Nilotic speakers, likely due to assimilating indigenous populations since arriving in the region ~3000 years ago.

Sexually transmitted diseases in the history of Uganda.

PubMed

Lyons, M

1994-04-01

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

Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda

PubMed Central

2013-01-01

Background Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda. Objective To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda. Methods Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3–19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents. Results The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14–19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR = 2.58, p < 0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education. Conclusion The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda. PMID:23841918

Unravelling the spirits’ message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda

PubMed Central

2014-01-01

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries. PMID:24940355

Unravelling the spirits' message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda.

PubMed

van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

2014-01-01

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries.

Identification of the causative dermatophyte of tinea capitis in children attending Mbarara Regional Referral Hospital in Uganda by PCR-ELISA and comparison with conventional mycological diagnostic methods.

PubMed

Wiegand, Cornelia; Mugisha, Peter; Mulyowa, Grace K; Elsner, Peter; Hipler, Uta-Christina; Gräser, Yvonne; Uhrlaß, Silke; Nenoff, Pietro

2017-08-01

Tinea capitis is a dermatophyte infection common among prepubertal children in sub-Saharan Africa and mainly caused by Trichophyton and Microsporum species. Accurate identification is challenging as conventional methods like culture and microscopy are slow and mostly based on morphological characteristics, which make them less sensitive and specific. Modern molecular methods, like polymerase chain reaction (PCR) assays, are gaining acceptance and are quick as well as accurate. The aim of this study was to investigate the clinical patterns of tinea capitis and to accurately identify the most common causative dermatophytes affecting the scalps of children aged 1 to 16 years attending the Skin Clinic at Mbarara University of Science and Technology (MUST), Mbarara, Uganda, East Africa, using both conventional mycological methods and PCR-ELISA for detection of dermatophyte DNA. One hundred fifteen clinical samples from children from Western Uganda attending the MUST Skin Clinic with a clinical diagnosis of tinea capitis were analyzed. T. violaceum was identified as the most common causative agent, followed by M. audouinii, T. soudanense, and T. rubrum. The early identification of the causative agent of tinea capitis is a prerequisite for the effective management of the disease, the identification of probable source and the prevention of spreading. Children with tinea capitis in Western Uganda should be treated by systemic therapy rather than topical preparations to ensure high cure rates as the most common causative dermatophytes T. violaceum exhibits an endothrix rather than ectothrix invasion of the hair follicle. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

The Prevalence of Brucellosis in Cattle, Goats and Humans in Rural Uganda: A Comparative Study.

PubMed

Miller, R; Nakavuma, J L; Ssajjakambwe, P; Vudriko, P; Musisi, N; Kaneene, J B

2016-12-01

A cross-sectional study was conducted to determine the presence of brucellosis in cattle, goats and humans in farms from south-western Uganda and identify risk factors associated with brucellosis in these three host groups. Data and serum samples were collected from 768 cattle, 315 goats and 236 humans, with 635 samples of bovine milk, from 70 farms in two different study areas in south-western Uganda. Sera from livestock were tested with the Rose Bengal Plate test, using B. abortus and B. melitensis antigens, and human sera were tested with a commercial IgG/IgM lateral flow assay. Milk samples were tested using the OIE-approved milk ring test. Screening tests for brucellosis were positive in 14% of cattle serum, 29% of bovine milk, 17% of goat serum and 11% of human serum samples. There were significant differences in the test prevalence of brucellosis by study site, with levels higher in the study area near Lake Mburo National Park than in the study area near Queen Elizabeth National Park. Multivariable regression models identified risk factors associated with increasing test positivity at the individual and farm levels for cattle, goats and humans. Positive associations were seen between increasing seropositivity of brucellosis in goats, cattle and humans. Results of multivariable analyses suggest that improvements in farm biosecurity and hygiene may reduce the risk of brucellosis on the farm and suggest a role for ticks in bovine brucellosis. Although cattle are the focus of brucellosis control in Uganda, the significant associations between seropositivity in humans and seropositivity in goats suggest that brucellosis in goats may be an important contributor to the epidemiology of the disease on the farm. © 2015 Blackwell Verlag GmbH.

[Trichophyton violaceum : Main cause of tinea capitis in children at Mbarara Regional Referral Hospital in Uganda].

PubMed

Wiegand, C; Mugisha, P; Mulyowa, G K; Elsner, P; Hipler, U C; Gräser, Y; Uhrlaß, S; Nenoff, P

2016-09-01

Tinea capitis is caused by anthropophilic, zoophilic or geophilic dermatophytes of the genera Microsporum or Trichophyton. The aim of this study was to analyze the clinical presentation of tinea capitis among children in western Uganda. From February to June 2012, skin and hair samples were obtained from 115 patients aged from 1 to 16 years presenting at Mbarara Regional Referral Hospital (MUSC) with clinically suspected tinea capitis. Conventional mycological diagnostics comprised Blancophor preparation and cultivation of fungi for species identification. Tinea capitis among the children included in the MUSC study was mainly noninflammatory showing mostly a seborrhoeic pattern or "black dot" and "gray patch" form and highly inflammatory kerion celsi. Blancophor preparation identified 82.6 % positive and 17.4 % negative samples. Cultural species differentiation showed Trichophyton (T.) violaceum as the causative agent for tinea capitis in 56.6 % of the patients. In 13 %, Microsporum (M.) audouinii was isolated followed by T. soudanense (2.6 %), and T. rubrum (1.7 %). In addition, moulds (contamination?) such as Scopulariopsis brevicaulis, Aspergillus niger, and Fusarium oxysporum were found as well as mixed infections. The anthropophilic dermatophyte T. violaceum represents the most frequent cause of tinea capitis in western Uganda. For successful management oral antifungal therapy is necessary together with supportive topical treatment.

Sexually transmitted diseases in the history of Uganda.

PubMed Central

Lyons, M

1994-01-01

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

Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study

PubMed Central

Mayora, Chrispus; Johansson, Emily White; Peterson, Stefan; Wamani, Henry; Bigdeli, Maryam; Shroff, Zubin Cyrus

2017-01-01

Background Intervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system. Methods A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention. Findings Stakeholders initially expressed caution and fears about the intervention’s implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops. Conclusion The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts. PMID:29259824

Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study.

PubMed

Kitutu, Freddy Eric; Mayora, Chrispus; Johansson, Emily White; Peterson, Stefan; Wamani, Henry; Bigdeli, Maryam; Shroff, Zubin Cyrus

2017-01-01

Intervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system. A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention. Stakeholders initially expressed caution and fears about the intervention's implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops. The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts.

Notes from the Field: Splenomegaly of Unknown Etiology in Congolese Refugees Applying for Resettlement to the United States - Uganda, 2015.

PubMed

Goers, Matthew; Ope, Maurice O; Samuels, Aaron; Gitu, Natalia; Akandwanaho, Saul; Nabwami, Gladys; Nyoka, Raymond; Cetron, Martin S; Dalal, Warren; Conroy, Andrea L; Cantey, Paul; John, Chandy; Naoum, Marwan; Weinberg, Michelle; Marano, Nina; Stauffer, William

2016-09-09

Approximately 70,000-90,000 refugees are resettled to the United States each year, and during the next 5 years, 50,000 Congolese refugees are expected to arrive in the United States. The International Organization for Migration (IOM) performs refugee medical examinations overseas for the U.S. Refugee Resettlement Program. In 2014, IOM reported that a large number of U.S.-bound Congolese refugees from Uganda had spleens that were enlarged on examination. During two evaluations of refugee populations in western Uganda in March and July 2015, refugees with splenomegaly on physical examination were offered additional assessment and treatment, including abdominal ultrasonography and laboratory testing. Among 987 persons screened, 145 (14.7%) had splenomegaly and received further testing. Among the 145 patients with splenomegaly, 63.4% were aged 5-17 years (median = 14.8 years). There was some evidence of family clustering, with 33 (22.7%) of the 145 cases occurring in families.

Examining land use change and cooking fuel-use in Uganda: implications and potential win-win scenarios for policy and carbon financing

NASA Astrophysics Data System (ADS)

Brunner, Nicole; Semmens, Darius; Hawbaker, Todd

2016-04-01

Uganda is one of the world's most biodiverse countries, yet also one of the poorest. Human dependence on natural resources, especially from forests, is most pronounced in developing countries such as Uganda, where many people live in poverty and rely on fuel wood for cooking. These demands often compete with conservation efforts aimed at protecting forests and biodiversity. An understanding of trends in forest condition and local community use of forests is necessary to explore the implications of changing environmental conditions on the sustainability of Uganda's forests and forest-related socioeconomic activities. A human-environment framework is applied to this research by comparing environmental layers derived from remotely sensed imagery with socioeconomic data acquired from household surveys. Statistical modeling was used to explain the relationship between household characteristics (e.g., fuel use) and environmental characteristics (e.g., land cover change) and to quantify the role of spatial arrangement or pattern in understanding human-environment relationships (e.g., access and distance). The findings show that distance from protected forests is related to changes in household fuel type. For example, increases in charcoal as the primary cooking fuel is observed in households a closer distance to protected forests. This change is likely due to access to forest resources. The results of this study could inform policies aimed at protecting forests as well as protecting the interests of people in proximity to protected forests.

Emergence of multi-acaricide resistant Rhipicephalus ticks and its implication on chemical tick control in Uganda.

PubMed

Vudriko, Patrick; Okwee-Acai, James; Tayebwa, Dickson Stuart; Byaruhanga, Joseph; Kakooza, Steven; Wampande, Edward; Omara, Robert; Muhindo, Jeanne Bukeka; Tweyongyere, Robert; Owiny, David Okello; Hatta, Takeshi; Tsuji, Naotoshi; Umemiya-Shirafuji, Rika; Xuan, Xuenan; Kanameda, Masaharu; Fujisaki, Kozo; Suzuki, Hiroshi

2016-01-04

Acaricide failure has been on the rise in the western and central cattle corridor of Uganda. In this study, we identified the tick species associated with acaricide failure and determined their susceptibility to various acaricide molecules used for tick control in Uganda. In this cross sectional study, tick samples were collected and identified to species level from 54 purposively selected farms (from 17 districts) that mostly had a history of acaricide failure. Larval packet test was used to screen 31 tick populations from 30 farms for susceptibility at discriminating dose (DD) and 2 × DD of five panels of commercial acaricide molecules belonging to the following classes; amidine, synthetic pyrethroid (SP), organophosphate (OP) and OP-SP co-formulations (COF). Resistance was assessed based on World Health Organization criteria for screening insecticide resistance. Of the 1357 ticks identified, Rhipicephalus (Rhipicephalus) appendiculatus and Rhipicephalus (Boophilus) decoloratus were the major (95.6%) tick species in farms sampled. Resistance against SP was detected in 90.0% (27/30) of the tick populations tested. Worryingly, 60.0% (18/30) and 63.0% (19/30) of the above ticks were super resistant (0% mortality) against 2 × DD cypermethrin and deltamethrin, respectively. Resistance was also detected against COF (43.3%), OP chlorfenvinphos (13.3%) and amitraz (12.9%). In two years, 74.1% (20/27) of the farms had used two to three acaricide molecules, and 55.6% (15/27) rotated the molecules wrongly. Multi-acaricide resistance (at least 2 molecules) was detected in 55.2% (16/29) of the resistant Rhipicephalus ticks and significantly associated with R. decoloratus (p = 0.0133), use of both SP and COF in the last 2 years (p < 0.001) and Kiruhura district (p = 0.0339). Despite emergence of amitraz resistance in the greater Bushenyi area, it was the most efficacious molecule against SP and COF resistant ticks. This study is the first to report emergence of super SP resistant and multi-acaricide resistant Rhipicephalus ticks in Uganda. Amitraz was the best acaricide against SP and COF resistant ticks. However, in the absence of technical interventions, farmer-led solutions aimed at troubleshooting for efficacy of multitude of acaricides at their disposal are expected to potentially cause negative collateral effects on future chemical tick control options, animal welfare and public health.

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

PubMed Central

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

2016-01-01

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

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

PubMed Central

Adams, Kamukama; Eliot, Twineomujuni; Gerald, Agaba

2015-01-01

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

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

PubMed

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

2015-11-14

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

Sleeping sickness in Uganda: revisiting current and historical distributions.

PubMed

Berrang-Ford, Lea; Odiit, Martin; Maiso, Faustin; Waltner-Toews, David; McDermott, John

2006-12-01

Sleeping sickness is a parasitic, vector-borne disease, carried by the tsetse fly and prevalent in sub-Saharan Africa. The disease continues to pose a public health burden in Uganda, which experienced a widespread outbreak in 1900-1920, and a more recent outbreak in 1976-1989. The disease continues to spread to uninfected districts. This paper compares the spatial distributions of sleeping in Uganda for the 1900-1920 outbreak period with current disease foci, and discusses information gaps and implications arising for future research, prevention and control. Population census records for 1911 and sleeping sickness records from Medical and Sanitary Reports of the Ugandan Protectorate for 1905-1936 were extracted from the Uganda Archives. Current sleeping sickness distribution data were provided by the Ministry of Health, Uganda. These were used to develop sleeping sickness distribution maps for comparison between the early 1900s and the early 2000s. The distribution of sleeping sickness from 1905-1920 shows notable differences compared to the current distribution of disease. In particular, archival cases were recorded in south-west and central Uganda, areas currently free of disease. The disease focus has moved from lakeshore Buganda (1905-1920) to the Busoga and south-east districts. Archival sleeping sickness distributions indicate the potential for a much wider area of disease risk than indicated by current disease foci. This is compounded by an absence of tsetse distribution data, continued political instability in north-central Uganda, continued spread of disease into new districts, and evidence of the role of livestock movements in spreading the parasite. These results support concerns as to the potential mergence of the two disease foci in the south-east and north-west of the country.

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

PubMed

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

2017-11-01

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

Epidemiological history and phylogeography of West Nile virus lineage 2.

PubMed

Ciccozzi, Massimo; Peletto, Simone; Cella, Eleonora; Giovanetti, Marta; Lai, Alessia; Gabanelli, Elena; Acutis, Pier Luigi; Modesto, Paola; Rezza, Giovanni; Platonov, Alexander E; Lo Presti, Alessandra; Zehender, Gianguglielmo

2013-07-01

West Nile virus (WNV) was first isolated in Uganda. In Europe WNV was sporadically detected until 1996, since then the virus has been regularly isolated from birds and mosquitoes and caused several outbreaks in horses and humans. Phylogenetic analysis showed two main different WNV lineages. The lineage 1 is widespread and segregates into different subclades (1a-c). WNV-1a includes numerous strains from Africa, America, and Eurasia. The spatio-temporal history of WNV-1a in Europe was recently described, identifying two main routes of dispersion, one in Eastern and the second in Western Europe. The West Nile lineage 2 (WNV-2) is mainly present in sub-Saharan Africa but has been recently emerged in Eastern and Western European countries. In this study we reconstruct the phylogeny of WNV-2 on a spatio-temporal scale in order to estimate the time of origin and patterns of geographical dispersal of the different isolates, particularly in Europe. Phylogeography findings obtained from E and NS5 gene analyses suggest that there were at least two separate introductions of WNV-2 from the African continent dated back approximately to the year 1999 (Central Europe) and 2000 (Russia), respectively. The epidemiological implications and clinical consequences of lineage 1 and 2 cocirculation deserve further investigations. Copyright © 2013 Elsevier B.V. All rights reserved.

Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda.

PubMed

Uchenna Tweteise, Patience; Natukunda, Bernard; Bazira, Joel

2016-01-01

Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2) are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2) antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA). Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2%) males and 139 (37.8%) females), only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out.

Detection and Genome Analysis of a Lineage III Peste Des Petits Ruminants Virus in Kenya in 2011.

PubMed

Dundon, W G; Kihu, S M; Gitao, G C; Bebora, L C; John, N M; Oyugi, J O; Loitsch, A; Diallo, A

2017-04-01

In May 2011 in Turkana County, north-western Kenya, tissue samples were collected from goats suspected of having died of peste des petits ruminant (PPR) disease, an acute viral disease of small ruminants. The samples were processed and tested by reverse transcriptase PCR for the presence of PPR viral RNA. The positive samples were sequenced and identified as belonging to peste des petits ruminants virus (PPRV) lineage III. Full-genome analysis of one of the positive samples revealed that the virus causing disease in Kenya in 2011 was 95.7% identical to the full genome of a virus isolated in Uganda in 2012 and that a segment of the viral fusion gene was 100% identical to that of a virus circulating in Tanzania in 2013. These data strongly indicate transboundary movement of lineage III viruses between Eastern Africa countries and have significant implications for surveillance and control of this important disease as it moves southwards in Africa. © 2015 Blackwell Verlag GmbH.

From Extraction to Knowledge Reproduction: The Impact of Australia's Development Awards on Uganda and Mozambique

ERIC Educational Resources Information Center

Amazan, Rose C.; Negin, Joel; Howie, Leanne; Wood, Julian

2016-01-01

With the renewed emphasis on higher education as an agent for development and economic growth, Australia has joined other Western countries in contributing to increasing the intellectual workforce of Africa[1]. While Australia has provided scholarships to Africans for more than three decades, since 2005, the Australian Government has dramatically…

Upper mantle structure beneath the northern part of the East African Plateau using data from the NE Uganda temporary seismic network

NASA Astrophysics Data System (ADS)

Bressers, C. A.; Nyblade, A.; Tugume, F.

2017-12-01

Data from a newly installed temporary seismic array in northeastern Uganda are incorporated into an existing body wave tomography model of eastern Africa to improve imaging of the upper mantle beneath the northern part of the East African Plateau. Nine temporary broadband stations were installed in January 2017 and will be operated through 2018 to obtain data for resolving structure under the northern part of the plateau as well as the East African rift in northern Kenya. Preliminary tomography models incorporate several months of data from stations in NE Uganda, plus many years of data from over 200 seismic stations throughout eastern Africa used in previously published body wave tomography models. The data come from teleseismic earthquakes with mb ≥ 5.5 at a distance from each station of 30° to 90°. P and S wave travel time residuals have been obtained using a multichannel cross correlation method and inverted using VanDecar's method to produce 3D tomographic images of the upper mantle. The preliminary results exhibit better resolved structure under the northern part of the East African Plateau than pervious models and suggest that the fast-wave speed anomaly in the upper mantle associated with the Tanzanian Craton—which is bounded by the Western and Eastern branches of the rift system—extends across most of northern Uganda.

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

PubMed Central

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

2013-01-01

Background Kenya and Uganda have reported different Human African Trypanosomiasis incidences in the past more than three decades, with the latter recording more cases. This cross-sectional study assessed the demographic characteristics, tsetse and trypanosomiasis control practices, socio-economic and cultural risk factors influencing Trypanosoma brucei rhodesiense (T.b.r.) infection in Teso and Busia Districts, Western Kenya and Tororo and Busia Districts, Southeast Uganda. A conceptual framework was postulated to explain interactions of various socio-economic, cultural and tsetse control factors that predispose individuals and populations to HAT. Methods A cross-sectional household survey was conducted between April and October 2008. Four administrative districts reporting T.b.r and lying adjacent to each other at the international boundary of Kenya and Uganda were purposely selected. Household data collection was carried out in two villages that had experienced HAT and one other village that had no reported HAT case from 1977 to 2008 in each district. A structured questionnaire was administered to 384 randomly selected household heads or their representatives in each country. The percent of respondents giving a specific answer was reported. Secondary data was also obtained on socio-economic and political issues in both countries. Results Inadequate knowledge on the disease cycle and intervention measures contributed considerable barriers to HAT, and more so in Uganda than in Kenya. Gender-associated socio-cultural practices greatly predisposed individuals to HAT. Pesticides-based crop husbandry in the 1970's reportedly reduced vector population while vegetation of coffee and banana's and livestock husbandry directly increased occurrence of HAT. Livestock husbandry practices in the villages were strong predictors of HAT incidence. The residents in Kenya (6.7%) applied chemoprophylaxis and chemotherapeutic controls against trypanosomiasis to a larger extent than Uganda (2.1%). Conclusion Knowledge on tsetse and its control methods, culture, farming practice, demographic and socio-economic variables explained occurrence of HAT better than landscape features. PMID:23638206

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Thermal and exhumation history of the central Rwenzori Mountains, Western Rift of the East African Rift System, Uganda

NASA Astrophysics Data System (ADS)

Bauer, F. U.; Glasmacher, U. A.; Ring, U.; Schumann, A.; Nagudi, B.

2010-10-01

The Rwenzori Mountains (Mtns) in west Uganda are the highest rift mountains on Earth and rise to more than 5,000 m. We apply low-temperature thermochronology (apatite fission-track (AFT) and apatite (U-Th-Sm)/He (AHe) analysis) for tracking the cooling history of the Rwenzori Mtns. Samples from the central and northern Rwenzoris reveal AFT ages between 195.0 (±8.4) Ma and 85.3 (±5.3) Ma, and AHe ages between 210.0 (±6.0) Ma to 24.9 (±0.5) Ma. Modelled time-temperature paths reflect a protracted cooling history with accelerated cooling in Permo-Triassic and Jurassic times, followed by a long period of constant and slow cooling, than succeeded by a renewed accelerated cooling in the Neogene. During the last 10 Ma, differentiated erosion and surface uplift affected the Rwenzori Mtns, with more pronounced uplift along the western flank. The final rock uplift of the Rwenzori Mtns that partly led to the formation of the recent topography must have been fast and in the near past (Pliocene to Pleistocene). Erosion could not compensate for the latest rock uplift, resulting in Oligocene to Miocene AHe ages.

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

Surgical volume and postoperative mortality rate at a referral hospital in Western Uganda: Measuring the Lancet Commission on Global Surgery indicators in low-resource settings.

PubMed

Anderson, Geoffrey A; Ilcisin, Lenka; Abesiga, Lenard; Mayanja, Ronald; Portal Benetiz, Noralis; Ngonzi, Joseph; Kayima, Peter; Shrime, Mark G

2017-06-01

The Lancet Commission on Global Surgery recommends that every country report its surgical volume and postoperative mortality rate. Little is known, however, about the numbers of operations performed and the associated postoperative mortality rate in low-income countries or how to best collect these data. For one month, every patient who underwent an operation at a referral hospital in western Uganda was observed. These patients and their outcomes were followed until discharge. Prospective data were compared with data obtained from logbooks and patient charts to determine the validity of using retrospective methods for collecting these metrics. Surgical volume at this regional hospital in Uganda is 8,515 operations/y, compared to 4,000 operations/y reported in the only other published data. The postoperative mortality rate at this hospital is 2.4%, similar to other hospitals in low-income countries. Finding patient files in the medical records department was time consuming and yielded only 62% of the files. Furthermore, a comparison of missing versus found charts revealed that the missing charts were significantly different from the found charts. Logbooks, on the other hand, captured 99% of the operations and 94% of the deaths. Our results describe a simple, reproducible, accurate, and inexpensive method for collection of the Lancet Commission on Global Surgery variables using logbooks that already exist in most hospitals in low-income countries. While some have suggested using risk-adjusted postoperative mortality rate as a more equitable variable, our data suggest that only a limited amount of risk adjustment is possible given the limited available data. Copyright © 2017 Elsevier Inc. All rights reserved.

The pathway of obstructed labour as perceived by communities in south-western Uganda: a grounded theory study

PubMed Central

Kabakyenga, Jerome K.; Östergren, Per-Olof; Emmelin, Maria; Kyomuhendo, Phionah; Odberg Pettersson, Karen

2011-01-01

Background Obstructed labour is still a major cause of maternal and perinatal morbidity and mortality in Uganda, where many women give birth at home alone or assisted by non-skilled birth attendants. Little is known of how the community view obstructed labour, and what actions they take in cases where this complication occurs. Objective The objective of the study was to explore community members’ understanding of and actions taken in cases of obstructed labour in south-western Uganda. Design Grounded theory (GT) was used to analyse data from 20 focus group discussions (FGDs), 10 with women and 10 with men, which were conducted in eight rural and two urban communities. Results A conceptual model based on the community members’ understanding of obstructed labour and actions taken in response is presented as a pathway initiated by women's desire to ‘protecting own integrity’ (core category). The pathway consisted of six other categories closely linked to the core category, namely: (1) ‘taking control of own birth process’; (2) ‘reaching the limit – failing to give birth’ (individual level); (3) ‘exhausting traditional options’; (4) ‘partner taking charge’; (5) ‘facing challenging referral conditions’ (community level); and finally (6) ‘enduring a non-responsive healthcare system’ (healthcare system level). Conclusions There is a need to understand and acknowledge women's reluctance to involve others during childbirth. However, the healthcare system should provide acceptable care and a functional referral system closer to the community, thus supporting the community's ability to seek timely care as a response to obstructed labour. Easy access to mobile phones may improve referral systems. Upgrading of infrastructure in the region requires a multi-sectoral approach. Testing of the conceptual model through a quantitative questionnaire is recommended. PMID:22216018

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

PubMed

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

2012-01-01

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

Post-Palaeozoic evolution of weathered landsurfaces in Uganda by tectonically controlled deep weathering and stripping

NASA Astrophysics Data System (ADS)

Taylor, R. G.; Howard, K. W. F.

1998-11-01

A model for the evolution of weathered landsurfaces in Uganda is developed using available geotectonic, climatic, sedimentological and chronological data. The model demonstrates the pivotal role of tectonic uplift in inducing cycles of stripping, and tectonic quiescence for cycles of deep weathering. It is able to account for the development of key landforms, such as inselbergs and duricrust-capped plateaux, which previous hypotheses of landscape evolution that are based on climatic or eustatic controls are unable to explain. Development of the Ugandan landscape is traced back to the Permian. Following late Palaeozoic glaciation, a trend towards warmer and more humid climates through the Mesozoic enabled deep weathering of the Jurassic/mid-Cretaceous surface in Uganda during a period of prolonged tectonic quiescence. Uplift associated with the opening South Atlantic Ocean terminated this cycle and instigated a cycle of stripping between the mid-Cretaceous and early Miocene. Deep weathering on the succeeding Miocene to recent (African) surface has occurred from Miocene to present but has been interrupted in the areas adjacent to the western rift where development of a new drainage base level has prompted cycles of stripping in the Miocene and Pleistocene.

Increasing incidence of pregnancy among women receiving HIV care and treatment at a large urban facility in western Uganda.

PubMed

Kabami, Jane; Turyakira, Eleanor; Biraro, Sam; Bajunirwe, Francis

2014-12-06

Antiretroviral treatment restores physical functioning and may have an impact on fertility desires. Counseling is given to HIV positive women to create awareness and to provide information on pregnancy and delivery. The purpose of this study was to determine the incidence of pregnancy and factors that predict pregnancy among women of reproductive age receiving HIV care and treatment at a large urban center in western Uganda. We conducted a retrospective cohort study using routinely collected data at the Immune Suppression (ISS) Clinic of Mbarara Regional Referral Hospital located in Mbarara District, western Uganda collected between January 2006 and June 2010. Women aged 15 to 50 years were eligible for analysis. The primary outcome was incidence of pregnancy calculated as number of pregnancies per 1000 person years (PY). Data was analyzed by calendar year and year of enrolment and used survival analysis to determine the predictors of pregnancy. A total of 3144 women were included with a median follow up of 12.5 months. The overall incidence rate was 90.7 pregnancies per 1000 person years. Incidence increased from 29.8 pregnancies per 1000 PY in 2006 to 122 pregnancies per 1000 PY in 2010 (p < 0.001). Significant predictors for pregnancy were younger age (HR 10.96 95% CI 3.22-37.2), married (HR 2.09 95% CI 1.69-2.64) and single (HR 1.95 95% CI 1.34-2.84) compared to widowed or separated, primary education (HR 1.65 95% CI 1.02-2.66), not knowing the HIV status of the spouse (HR 1.46, 95%CI 1.13-1.93) compared to knowing. The use of family planning (HR 0.23 95% CI 0.18- 0.30) and an increase in CD4 count between baseline and most recent count were protective against pregnancy. ART use was not a significant predictor. Incidence of pregnancy among women receiving routine HIV care and treatment has increased and is almost comparable to that in the general population. Thus routine HIV care should integrate reproductive health needs for these women.

Beliefs, stigma and discrimination associated with mental health problems in Uganda: implications for theory and practice.

PubMed

Quinn, Neil; Knifton, Lee

2014-09-01

There are major gaps in knowledge about beliefs, stigma and discrimination in Uganda, including the relationship between different cultural beliefs and stigmatising responses, how stigma and beliefs result in discrimination and the impact of social factors such as gender, poverty and ethnic conflict. This exploratory study aims to understand beliefs, stigma and discrimination associated with mental health in Uganda in more depth from the perspectives of different stakeholders. Focus groups and interviews were undertaken with mental health activists, policymakers, practitioners, non-governmental and human rights organisations, journalists and academics. Stigma was reported by individuals, families, communities and institutions, including health services. The study also found stigmatising beliefs linked to traditional, religious and medical explanatory frameworks, high levels of 'associated stigma', common mental health problems rarely medicalised and discrimination linked to poverty, gender and conflict. The findings suggest the need to address stigma in their cultural and social context, alongside other human rights initiatives. © The Author(s) 2013.

Health implications of war in Uganda and Sudan.

PubMed

Dodge, C P

1990-01-01

Civil war disrupted agriculture and trade in Uganda and Sudan. This reduced tax revenues and drained scarce resources away from health budgets to finance increased military expenditures. Hundreds and thousands of people were driven from their homes either as internally displaced people or as refugees. Normal health service delivery systems were broken down forcing doctors, nurses and other health professionals into towns, cities or neighbouring countries in search of peace and employment. Scores of hospitals, health centres and dispensaries were abandoned, destroyed or looted, rendering even the limited physical facilities useless. Preventive public health services such as immunization and provision of potable drinking water were discontinued leaving huge populations susceptible to controllable infectious diseases and epidemics.

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

PubMed

1992-01-01

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

Combining Theory-Driven Evaluation and Causal Loop Diagramming for Opening the 'Black Box' of an Intervention in the Health Sector: A Case of Performance-Based Financing in Western Uganda.

PubMed

Renmans, Dimitri; Holvoet, Nathalie; Criel, Bart

2017-09-03

Increased attention on "complexity" in health systems evaluation has resulted in many different methodological responses. Theory-driven evaluations and systems thinking are two such responses that aim for better understanding of the mechanisms underlying given outcomes. Here, we studied the implementation of a performance-based financing intervention by the Belgian Technical Cooperation in Western Uganda to illustrate a methodological strategy of combining these two approaches. We utilized a systems dynamics tool called causal loop diagramming (CLD) to generate hypotheses feeding into a theory-driven evaluation. Semi-structured interviews were conducted with 30 health workers from two districts (Kasese and Kyenjojo) and with 16 key informants. After CLD, we identified three relevant hypotheses: "success to the successful", "growth and underinvestment", and "supervision conundrum". The first hypothesis leads to increasing improvements in performance, as better performance leads to more incentives, which in turn leads to better performance. The latter two hypotheses point to potential bottlenecks. Thus, the proposed methodological strategy was a useful tool for identifying hypotheses that can inform a theory-driven evaluation. The hypotheses are represented in a comprehensible way while highlighting the underlying assumptions, and are more easily falsifiable than hypotheses identified without using CLD.

Ethnobotanical study of nutri-medicinal plants used for the management of HIV/AIDS opportunistic ailments among the local communities of western Uganda.

PubMed

Asiimwe, Savina; Kamatenesi-Mugisha, Maud; Namutebi, Agnes; Borg-Karlsson, Anna-Karin; Musiimenta, Peace

2013-11-25

Herbal remedies are a source of therapeutics for nearly 80% of the population in Uganda. Poor health facilities and limited access to antiretroviral drugs have perpetuated and increased the use of traditional medicine especially in rural areas for the treatment of opportunistic ailments of HIV/AIDS. To document the traditional uses of nutri-medicinal plants in the management of immunocompromised ailments associated with HIV/AIDS. To document the parts and growth forms of plants used, methods of preparation and administration of the herbal remedies. The study was conducted in Mbarara and Isingiro districts of western Uganda between December 2010 and May 2011. Ethnobotanical information was collected from 64 respondents who were sampled based on recommendations of local elders and administrators. Ethnobotanical data on the use of nutri-medicinal plants for traditional treatment of HIV/AIDS opportunistic ailments were collected by employing semi-structured interviews with selected respondents, house hold visits and field observations as described by (Martin, 1995a). The respondents were mainly traditional medical practitioners who treat patients who are already receiving antiretroviral drugs. Fidelity levels of plant species and informant consensus factor were determined to show the percentage of informants claiming the use of certain plant species for the same major purpose and to analyse people's knowledge of plant use. The study revealed 81 plant species most of which were herbs (49%). Leaves (71%) were the most frequently used parts in remedy preparations which were mainly administered orally (85%). The majority of plants (54%) were harvested from wild populations. Hibiscus sabdariffa L., Plumeria obtusa L., and Abutilon guineense (Shumach.) Baker. F and Exell were the nutri-medicinal plants that scored the highest Fidelity level values. The informant's consensus about usages of plants ranged from 0.75 to 0.80. Plants that are presumed to be effective in treating a certain disease have higher informant consensus factor (ICF) values. Family Asteraceae accounted for 18% of the total species recorded. Thirteen species (16%) of the plants are edible and provide nutritional support. The study recorded plant species with potential to treat ailments associated with immunocompromised people living with HIV/AIDS in western Uganda. Such studies can help stimulate confidence in traditional medicine and enhance appreciation of herbal medicine among the people and to appreciate the value of the plant resources and therefore enhance conservation efforts of the plant species. The high consensus means the majority of informants agree on the use of plant species and this reflects the intercultural relevance and the agreement in the use of the nutri-medicinal plants to the people. We recommend the documented plants for further Ethnopharmacological studies. © 2013 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2010-07-01

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

"...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.

Watershed Adaptation Measures to Climate Change Impacts: A case of Kiha Watershed in Albertine Graben

NASA Astrophysics Data System (ADS)

Zizinga, A.

2017-12-01

Watershed Adaptation Measures to Climate Change Impacts: A case of Kiha Watershed in Albertine GrabenAlex Zizinga1, Moses Tenywa2, Majaliwa Jackson Gilbert1, 1Makerere University, Department of Environmental Sciences, O Box 7062, Kampala, Uganda 1Makerere University, Department of Agricultural Production, P.O Box 7062, Kampala, Uganda Corresponding author: azizinga@caes.mak.ac.ug AbstractThe most pressing issues local communities in Uganda are facing result from land-use and land cover changes exacerbated by climate change impacts. A key issue is the documentation of land-cover changes visible with the ongoing clearance of remaining forests, bush-lands and wetlands for expanding farmland for sugarcane production, producing charcoal and collecting firewood for local distilleries using imported molasses. Decision-makers, resource managers, farmers and practitioners must build their capacity for adaptive measures. Here we present the potential impacts of climate change on watershed hydrological processes in the River Kiha Watershed, located in Western Uganda, Lake Albert Water Management Zone, by using social learning techniques incorporating water users, local stakeholders and researchers. The research team examined different farming and economic activities within the watershed to assess their impacts on catchment water resources, namely on water quality and discharge of river Kiha. We present the impacts of locally induced climate change, which are already manifested in increasing seasonal variability of rainfall. The study aims at answering questions posed by local communities and stakeholders about climate change and its effects on livelihood and key resources, specifically water and soils within the Kiha watershed. Key words: Climate change impacts, Social Learning and Watershed Management

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

NASA Astrophysics Data System (ADS)

Udongo, Betty Pacutho

This study analyzes the impact of armed conflicts on the development of education policy and particularly science education program in Uganda. Since independence from the British colonial rule, Uganda has experienced a series of armed conflicts, with the most devastating being the 21 years of conflict in Northern Uganda. The research study was guided by the following questions: (1) What is the level of government funding towards improving science education program in Uganda? (2) Have recent initiatives, such as free Primary and Secondary education, compulsory science, and 75% sponsorship for science-based courses, had a measurable impact on the proportion of students from the conflict-affected regions who enter tertiary institutions to pursue science and technology programs? (3) To what extent do the Ugandan Education Policy and, in particular, the Science Education Policy effectively address the educational needs of students affected by armed conflicts? The study employed a mixed method design where both quantitative and qualitative data were collected and analyzed. Quantitative data were obtained from a comprehensive search of policy documents and content analysis of literature on education policy, science education programs, and impact of conflicts on educational delivery. Qualitative data were obtained from surveys and interviews distributed to policy makers, central government and the local government officials, teachers, and students from the war-ravaged Northern Uganda. Analysis of policy documents and respondents' views revealed that Uganda does not have a science education policy, and the present education policy does not fully address the educational needs of students studying in conflict-affected regions. It was further observed that fewer students from the conflict-affected regions qualify for government scholarship to study science courses in higher institutions of learning. The study recommended the following policy interventions: (a) affirmative admission in higher institutions of learning, (b) curriculum reform, (c) professional development of teachers, (d) school security and safety, (e) science and technology education, and (f) increased funding for emergency education. The study proposes a model of "Schools as Islands of Peace and Hope" with science education as the tool for post-conflict economic recovery, as a blue print for emergency education policy framework.

Factors influencing the prevalence and infestation levels of Varroa destructor in honeybee colonies in two highland agro-ecological zones of Uganda.

PubMed

Chemurot, Moses; Akol, Anne M; Masembe, Charles; de Smet, Lina; Descamps, Tine; de Graaf, Dirk C

2016-04-01

Varroa mites are ecto-parasites of honeybees and are a threat to the beekeeping industry. We identified the haplotype of Varroa mites and evaluated potential factors that influence their prevalence and infestation levels in the eastern and western highland agro-ecological zones of Uganda. This was done by collecting samples of adult worker bees between December 2014 and September 2015 in two sampling moments. Samples of bees were screened for Varroa using the ethanol wash method and the mites were identified by molecular techniques. All DNA sequences obtained from sampled mite populations in the two zones were 100 % identical to the Korean Haplotype (AF106899). Mean mite prevalence in the apiaries was 40 and 53 % for the western and eastern zones, respectively, during the first sampling. Over the second sampling, mean mite prevalence increased considerably in the western (59 %) but not in the eastern (51 %) zone. Factors that were associated with Varroa mite infestation levels include altitude, nature of apiary slope and apiary management practices during the first sampling. Our results further showed that Varroa mites were spreading from lower to higher elevations. Feral colonies were also infested with Varroa mites at infestation levels not significantly different from those in managed colonies. Colony productivity and strength were not correlated to mite infestation levels. We recommend a long-term Varroa mite monitoring strategy in areas of varying landscape and land use factors for a clear understanding of possible changes in mite infestation levels among African honeybees for informed decision making.

Learning Profiles: The Learning Crisis Is Not (Mostly) about Enrollment

ERIC Educational Resources Information Center

Sandefur, Justin; Pritchett, Lant; Beatty, Amanda

2016-01-01

The differential patterns of grade progression have direct implications for the calculation of learning profiles. Researchers measure learning in primary school using survey data on reading and math skills of a nationally representative, population-based sample of children in India, Pakistan, Kenya, Tanzania, and Uganda. Research demonstrates that…

Private Secondary Education in Uganda: Implications for Planning

ERIC Educational Resources Information Center

Jacob, W. James; Holsinger, Donald B.; Mugimu, Christopher B.

2008-01-01

Purpose of Study: A fundamental question for educational planners and policy makers is which secondary school providers are most efficient in raising student learning for the most youth, given an available level of resources. Considerable attention has been devoted in recent years to the proposition that private providers offer efficient…

Enhanced passive screening and diagnosis for gambiense human African trypanosomiasis in north-western Uganda – Moving towards elimination

PubMed Central

Bessell, Paul Richard; Ndung’u, Joseph Mathu

2017-01-01

Introduction The incidence of gambiense human African trypanosomiasis (gHAT) in Uganda has been declining, from 198 cases in 2008, to only 20 in 2012. Interruption of transmission of the disease by early diagnosis and treatment is core to the control and eventual elimination of gHAT. Until recently, the format of available screening tests had restricted screening and diagnosis to central health facilities (passive screening). We describe a novel strategy that is contributing to elimination of gHAT in Uganda through expansion of passive screening to the entire population at risk. Methodology / Principal findings In this strategy, patients who are clinically suspected of having gHAT at primary health facilities are screened using a rapid diagnostic test (RDT), followed by parasitological confirmation at strategically located microscopy centres. For patients who are positive with the RDT and negative by microscopy, blood samples undergo further testing using loop-mediated isothermal amplification (LAMP), a molecular test that detects parasite DNA. LAMP positive patients are considered strong suspects, and are re-evaluated by microscopy. Location and upgrading of facilities to perform microscopy and LAMP was informed by results of georeferencing and characterization of all public healthcare facilities in the 7 gHAT endemic districts in Uganda. Three facilities were upgraded to perform RDTs, microscopy and LAMP, 9 to perform RDTs and microscopy, and 200 to screen patients with RDTs. This reduced the distance that a sick person must travel to be screened for gHAT to a median distance of 2.5km compared to 23km previously. In this strategy, 9 gHAT cases were diagnosed in 2014, and 4 in 2015. Conclusions This enhanced passive screening strategy for gHAT has enabled full coverage of the population at risk, and is being replicated in other gHAT endemic countries. The improvement in case detection is making elimination of the disease in Uganda an imminent possibility. PMID:29023573

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

PubMed

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

2018-02-01

The emergence of multi-acaricide resistant ticks has led to unprecedented level of acaricide failure in central and western Uganda. In the absence of a national acaricide resistance management strategy, the country's dairy sector is threatened by upsurge of ticks and tick-borne diseases. In this study, we developed a short-to-medium-term intervention approach called Evidence-Based Acaricide Tick Control (EBATIC): Identify, Test, Intervene and Eradicate (IT-IE). Furthermore, the perception of 199 farmers and extension workers, 12 key informants in four districts and 47 stakeholders in the animal industry in Uganda were assessed using semi-structured questionnaires. We report that the establishment of a specialized laboratory is pivotal in identifying and testing (IT) acaricide resistant ticks for prompt intervention and eradication (IE). The laboratory test results and the farm tick control gaps identified are very important in guiding acaricide resistance management strategies such as evidence-based acaricide rotation, development and dissemination of extension materials, training of farmers and extension workers, and stakeholders' engagement towards finding sustainable solutions. All the 47 stakeholders and 91.0% (181/199) of the farmers and extension workers reported that the EBATIC approach will help in solving the tick acaricide resistance crisis in Uganda. Similarly, all the 12 key informants and 92.5% (184/199) of the farmers and extension workers suggested that the EBATIC approach should be sustained and rolled out to other districts. The EBATIC stakeholders' dialogue generated both short-to-medium and long-term strategies for sustainable management of tick acaricide resistance in the country. Overall, the positive feedback from farmers, district veterinarians and stakeholders in the animal industry suggest that the EBATIC approach is a useful proof-of-concept on scalable intervention pathway against tick acaricide resistance in Uganda with possibility of adoption in other African countries. Copyright © 2017 Elsevier GmbH. All rights reserved.

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

PubMed

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

2017-07-01

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

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

PubMed Central

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

2015-01-01

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

Severe Flooding and Malaria Transmission in the Western Ugandan Highlands: Implications for Disease Control in an Era of Global Climate Change.

PubMed

Boyce, Ross; Reyes, Raquel; Matte, Michael; Ntaro, Moses; Mulogo, Edgar; Metlay, Joshua P; Band, Lawrence; Siedner, Mark J

2016-11-01

 There are several mechanisms by which global climate change may impact malaria transmission. We sought to assess how the increased frequency of extreme precipitation events associated with global climate change will influence malaria transmission in highland areas of East Africa.  We used a differences-in-differences, quasi-experimental design to examine spatial variability in the incidence rate of laboratory-confirmed malaria cases and malaria-related hospitalizations between villages (1) at high versus low elevations, (2) with versus without rivers, and (3) upstream versus downstream before and after severe flooding that occurred in Kasese District, Western Region, Uganda, in May 2013.  During the study period, 7596 diagnostic tests were performed, and 1285 patients were admitted with a diagnosis of malaria. We observed that extreme flooding resulted in an increase of approximately 30% in the risk of an individual having a positive result of a malaria diagnostic test in the postflood period in villages bordering a flood-affected river, compared with villages farther from a river, with a larger relative impact on upstream versus downstream villages (adjusted rate ratio, 1.91 vs 1.33).  Extreme precipitation such as the flooding described here may pose significant challenges to malaria control programs and will demand timely responses to mitigate deleterious impacts on human health. © 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.

Morphotectonic evolution of the central Kenya rift flanks: Implications for late Cenozoic environmental change in East Africa

NASA Astrophysics Data System (ADS)

Spiegel, Cornelia; Kohn, Barry P.; Belton, David X.; Gleadow, Andrew J. W.

2007-05-01

The Kenya rift valley is the classic example of an active continental rift zone. We report the rift flank cooling history based on a combination of previous apatite fission track (AFT) and new (U-Th)/He (AHe) data. Our results corroborate the Late Cretaceous rapid cooling episode of continent-wide significance revealed previously by AFT dating. Post-Cretaceous cooling of the eastern rift flank was slow with net cooling of <20 °C through much of the Cenozoic. We interpret this cooling style in terms of the absence of significant relief. Samples from the western rift flank and from low elevations of the eastern rift flank reveal a late Neogene cooling episode associated with net cooling of ˜38 °C, indicating that this flank was eroded to a deeper level than that to the east. The late Neogene cooling episode is interpreted as the time of uplift and shaping of the present-day relief of the graben shoulders, which attain elevations of >3400 m in central Kenya. This timing also largely coincides with the uplift of the Western Rift flanks in Uganda and Congo and with the change toward drier conditions and grassland-dominated vegetation in East Africa. We propose that the regional morphotectonic evolution of the Kenyan rift flanks contributed to late Cenozoic environmental change in East Africa, thus superimposing a pronounced local effect on global climate change at that time.

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

PubMed

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

2014-07-01

There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which the programmes have succeeded in reaching the target populations. This article estimates the coverage of facility deliveries by a maternal health voucher programme in South-western Uganda and examines whether such coverage is correlated with district-level characteristics such as poverty density and the number of contracted facilities. Analysis entails estimating the voucher coverage of health facility deliveries among the general population and poor population (PP) using programme data for 2010, which was the most complete calendar year of implementation of the Uganda safe motherhood (SM) voucher programme. The results show that: (1) the programme paid for 38% of estimated deliveries among the PP in the targeted districts, (2) there was a significant negative correlation between the poverty density in a district and proportions of births to poor women that were covered by the programme and (3) improving coverage of health facility deliveries for poor women is dependent upon increasing the sales and redemption rates. The findings suggest that to the extent that the programme stimulated demand for SM services by new users, it has the potential of increasing facility-based births among poor women in the region. In addition, the significant negative correlation between the poverty density and the proportions of facility-based births to poor women that are covered by the voucher programme suggests that there is need to increase both voucher sales and the rate of redemption to improve coverage in districts with high levels of poverty. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Genetic Patterns of Common-Bean Seed Acquisition and Early-Stage Adoption Among Farmer Groups in Western Uganda

PubMed Central

Wilkus, Erin L.; Berny Mier y Teran, Jorge C.; Mukankusi, Clare M.; Gepts, Paul

2018-01-01

Widespread adoption of new varieties can be valuable, especially where improved agricultural production technologies are hard to access. However, as farmers adopt new varieties, in situ population structure and genetic diversity of their seed holdings can change drastically. Consequences of adoption are still poorly understood due to a lack of crop genetic diversity assessments and detailed surveys of farmers' seed management practices. Common bean (Phaseolus vulgaris) is an excellent model for these types of studies, as it has a long history of cultivation among smallholder farmers, exhibits eco-geographic patterns of diversity (e.g., Andean vs. Mesoamerican gene-pools), and has been subjected to post-Columbian dispersal and recent introduction of improved cultivars. The Hoima district of western Uganda additionally provides an excellent social setting for evaluating consequences of adoption because access to improved varieties has varied across farmer groups in this production region. This study establishes a baseline understanding of the common bean diversity found among household producers in Uganda and compares the crop population structure, diversity and consequences of adoption of household producers with different adoption practices. Molecular diversity analysis, based on 4,955 single nucleotide polymorphism (SNP) markers, evaluated a total of 1,156 seed samples that included 196 household samples collected from household producers in the Hoima district, 19 breeder-selected varieties used in participatory breeding activities that had taken place prior to the study in the region, and a global bean germplasm collection. Households that had participated in regional participatory breeding efforts were more likely to adopt new varieties and, consequently, diversify their seed stocks than those that had not participated. Of the three farmer groups that participated in breeding efforts, households from the farmer group with the longest history of bean production were more likely to conserve “Seed Engufu”, a local “Calima”-type variety of the Andean bean gene pool, and, at the same time, introduce rare Mesoamerican gene pool varieties into household seed stocks. PMID:29868053

Genetic Patterns of Common-Bean Seed Acquisition and Early-Stage Adoption Among Farmer Groups in Western Uganda.

PubMed

Wilkus, Erin L; Berny Mier Y Teran, Jorge C; Mukankusi, Clare M; Gepts, Paul

2018-01-01

Widespread adoption of new varieties can be valuable, especially where improved agricultural production technologies are hard to access. However, as farmers adopt new varieties, in situ population structure and genetic diversity of their seed holdings can change drastically. Consequences of adoption are still poorly understood due to a lack of crop genetic diversity assessments and detailed surveys of farmers' seed management practices. Common bean ( Phaseolus vulgaris ) is an excellent model for these types of studies, as it has a long history of cultivation among smallholder farmers, exhibits eco-geographic patterns of diversity (e.g., Andean vs. Mesoamerican gene-pools), and has been subjected to post-Columbian dispersal and recent introduction of improved cultivars. The Hoima district of western Uganda additionally provides an excellent social setting for evaluating consequences of adoption because access to improved varieties has varied across farmer groups in this production region. This study establishes a baseline understanding of the common bean diversity found among household producers in Uganda and compares the crop population structure, diversity and consequences of adoption of household producers with different adoption practices. Molecular diversity analysis, based on 4,955 single nucleotide polymorphism (SNP) markers, evaluated a total of 1,156 seed samples that included 196 household samples collected from household producers in the Hoima district, 19 breeder-selected varieties used in participatory breeding activities that had taken place prior to the study in the region, and a global bean germplasm collection. Households that had participated in regional participatory breeding efforts were more likely to adopt new varieties and, consequently, diversify their seed stocks than those that had not participated. Of the three farmer groups that participated in breeding efforts, households from the farmer group with the longest history of bean production were more likely to conserve "Seed Engufu", a local "Calima"-type variety of the Andean bean gene pool, and, at the same time, introduce rare Mesoamerican gene pool varieties into household seed stocks.

The interruption of Onchocerca volvulus and Wuchereria bancrofti transmission by integrated chemotherapy in the Obongi focus, North Western Uganda

PubMed Central

Gabriel, Matwale; Tukahebwa, Edridah; Onapa, Ambrose Winston; Tinkitina, Benjamin; Tukesiga, Ephraim; Nyaraga, Michael; Auma, Anna Mary; Habomugisha, Peace; Byamukama, Edson; Oguttu, David; Katabarwa, Moses; Unnasch, Thomas Raymond

2017-01-01

Intervention Few studies have documented the interruption of onchocerciasis and Lymphatic Filariasis (LF) by integrated chemotherapy in Uganda. The study describes the interruption of transmission of the two diseases co-endemic in Obongi focus, north western Uganda. Base line data for Onchocerciasis and LF were collected in 1994 and 2006, respectively. Annual mass drug administration for onchocerciasis (Ivermectin) and Lymphatic Filariasis (Ivermectin + albendazole) was conducted for 20 and 6 years, respectively. Thereafter, assessments by skin snip, larval searches in rivers and human landing catches were performed. Children <10 years were screened for IgG4 antibodies using Ov16 ELISA technique in 2013. LF Pre-TAS and TAS1 were conducted in sentinel sites. ITN coverage and utilization for the implementation unit was also reported. Intervention coverage Onchocerciasis treatment coverage was <80% but improved with the introduction of CDTI in 1999. While for LF, effective coverage of >65% was achieved in the six treatment rounds. Household ownership of ITN’s and utilization was 96% and 72.4%., respectively. Impact Parasitological examinations conducted for onchocerciasis among 807 adults and children, revealed a reduction in mf prevalence from 58% in 1994 to 0% in 2012. Entomological monitoring conducted at the two sites had no single Simulium damnosum fly caught. Serological analysis using Ov16 ELISA for onchocerciasis revealed that out of the 3,308 children <10 years old screened in 2013, only 3/3308 (0.091%) positive cases were detected. All Ov16 positive children were negative when tested for patent infection by skin snip PCR. A reduction in LF microfilaria prevalence from 2.5% (n = 13/522) in 2006 to 0.0% (n = 602) in 2014 was observed. LF TAS1 conducted in 2015 among 1,532 children 6–7 years, all were negative for antigens of W. bancrofti. Conclusion The results concluded that interruption of onchocerciasis and LF has been achieved. PMID:29253862

Reconstructing the Thermo-tectonic history of the Rwenzori Mountains, D. R. Congo

NASA Astrophysics Data System (ADS)

Mansour, S.; Bauer, F.; Glasmacher, P. D. U. A. A.; Grobe, R. W.; Starz, M.

2014-12-01

The Albertine Rift forms the northern section of the western Rift of the East African Rift System (EARS). The Rwenzori Mtns evolved along the eastern rift shoulder of the Albertine Rift, rising up to form a striking feature within the rift valley with elevations reaching 5109 m a.s.l. While, the scarcity of volcanic activity in the Western Rift has raised questions about the Rwenzori Mtns origin and how this fits into the general evolution of the Albertine Rift and the EARS. Detailed thermochronologic study of Bauer et al., (2013) on the eastern side on Rwenzori Mtns, differentiated it into northern and southern blocks. The northern block cooled faster to ~120 °C in Carboniferous to Permian times. The second cooling event to ~70 °C occurred in Mesozoic time. The third cooling event to surface temperature occurred in the Neogene. While, the southern block shows an earlier onset of cooling at >400 Ma. Temperatures of about 70 °C were reached in Silurian to Devonian times. During this study, 33 samples were collected from the western side of central Rwenzori. Zircon and apatite fission track and (U/Th)-He techniques were applied on these samples. The apatite fission track data could be divided into three age groups; ~45±11, ~25±5, ~12±2 Ma. These results reveal the difference in thermo-tectonic history between the eastern and western flanks of Rwenzori Mtns and support the tilt uplift geometry hypotheses (e.g. Pickford et al., 1993). ReferencesBauer, F.U., Glasmacher, U.A., Ring, U., Karl, M., Schumann, A., Nagudi, B., 2013. Tracing the exhumation history of the Rwenzori Mountains, Albertine Rift, Uganda, using low-temperature thermochronology, Tectonophysics, 599, 8-28. http://dx.doi.org/10.1016/j.tecto.2013.03.032. Pickford, M., Senut, B., Hadoto, D., 1993. Geology and Palaeobiology of the Albertine Rift Valley Uganda-Zaire, vol. 1. Geology. CIFEG Occas, Orleans. Publication, vol. 24, pp. 1-190.

Food variety consumption and household food insecurity coping strategies after the 2010 landslide disaster - the case of Uganda.

PubMed

Rukundo, Peter M; Oshaug, Arne; Andreassen, Bård A; Kikafunda, Joyce; Rukooko, Byaruhanga; Iversen, Per O

2016-12-01

To evaluate the nutritional situation of the victims of the 2010 landslide disaster in Uganda, food varieties consumed and coping strategies were assessed. Cross-sectional. Food variety scores (FVS) were obtained as the total of food items eaten over the last week while an index was based on severity weighting of household food insecurity coping strategies. We included 545 affected and 533 control households. Victims in the affected Bududa district in Eastern Uganda and those victims resettled in the Kiryandongo district, Western Uganda. Adjusted for covariates, in Bududa significantly higher mean FVS were observed among: affected than controls; farmers than others; and relief food recipients. Control households scored higher means (se) on severity of coping: 28·6 (1·3) v. 19·2 (1·2; P<0·01). In Kiryandongo, significantly higher FVS were observed among: control households; household heads educated above primary school; those with assets that complement food source; and recipients of relief food. Severity of coping was significantly higher among affected households and non-recipients of relief food. Affected households had a higher likelihood to skip a day without eating a household meal in Bududa (OR=2·31; 95 % CI 1·62, 3·29; P<0·01) and Kiryandongo (OR=1·77; 95 % CI 1·23, 2·57; P<0·01). Whereas FVS and severity of coping showed opposite trends in the two districts, resettlement into Kiryandongo led to severe coping experiences. Administrative measures that provide a combination of relief food, social protection and resettlement integration may offset undesirable coping strategies affecting diet.

Combining Theory-Driven Evaluation and Causal Loop Diagramming for Opening the ‘Black Box’ of an Intervention in the Health Sector: A Case of Performance-Based Financing in Western Uganda

PubMed Central

Holvoet, Nathalie; Criel, Bart

2017-01-01

Increased attention on “complexity” in health systems evaluation has resulted in many different methodological responses. Theory-driven evaluations and systems thinking are two such responses that aim for better understanding of the mechanisms underlying given outcomes. Here, we studied the implementation of a performance-based financing intervention by the Belgian Technical Cooperation in Western Uganda to illustrate a methodological strategy of combining these two approaches. We utilized a systems dynamics tool called causal loop diagramming (CLD) to generate hypotheses feeding into a theory-driven evaluation. Semi-structured interviews were conducted with 30 health workers from two districts (Kasese and Kyenjojo) and with 16 key informants. After CLD, we identified three relevant hypotheses: “success to the successful”, “growth and underinvestment”, and “supervision conundrum”. The first hypothesis leads to increasing improvements in performance, as better performance leads to more incentives, which in turn leads to better performance. The latter two hypotheses point to potential bottlenecks. Thus, the proposed methodological strategy was a useful tool for identifying hypotheses that can inform a theory-driven evaluation. The hypotheses are represented in a comprehensible way while highlighting the underlying assumptions, and are more easily falsifiable than hypotheses identified without using CLD. PMID:28869518

Knowledge, Attitudes and Practices Regarding Risk to Human Infection due to Mycobacterium bovis among Cattle Farming Communities in Western Uganda.

PubMed

Kazoora, H B; Majalija, S; Kiwanuka, N; Kaneene, J B

2016-12-01

A cross-sectional study involving multistage cluster sampling was undertaken in Kashari county, Mbarara district, western Uganda, in which quantitative and qualitative approaches were utilized to determine the knowledge, attitudes and practices regarding risk of human infection with zoonotic tuberculosis due to Mycobacterium bovis among cattle farmers. Of 496 respondents, 50% were farm owners and 50% herdsmen. Males were 70.9% of all the study participants. Among these, 37.5% had good knowledge, 41.4% had positive attitudes and 75.2% good practices regarding zoonotic tuberculosis. In the multivariable model, good knowledge was associated with having ever received health education, spending more than 5 years keeping cattle, having heard of cattle condemned at the abattoir due to tuberculosis and marital status. Positive attitudes were associated with having ever received health education, having heard of cattle condemned at the abattoir due to tuberculosis and being a farm owner versus being a herdsman. Good practices were associated with health education and good knowledge of the disease. Overall, knowledge and attitudes towards zoonotic tuberculosis due to M. bovis in humans was found to be low. While the majority of the respondents reported good practices, there were some still consuming raw milk and its products, which may predispose them to infection and indicates the need for greater outreach for zoonotic tuberculosis education. © 2016 Blackwell Verlag GmbH.

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

Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda.

PubMed

Krause, Hannah G; Hall, Barbara A; Ng, Shu-Kay; Natukunda, Harriet; Singasi, Isaac; Goh, Judith T W

2017-06-01

High levels of mental health dysfunction have been identified in women with genital tract fistula. The aim of this study was to use the General Health Questionnaire-28 (GHQ-28) to screen women in western Uganda with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula for risk of mental health dysfunction. Women undergoing surgery for severe pelvic organ prolapse, chronic fourth-degree obstetric tear, and genital tract fistula were interviewed using the GHQ-28 to screen for the risk of mental health dysfunction. A total of 125 women completed the GHQ-28, including 22 with pelvic organ prolapse, 47 with fourth-degree obstetric tear, 21 with genital tract fistula, and 35 controls. Nearly all women with these serious gynaecological conditions were positive for the risk of mental health dysfunction. In the domain assessing symptoms of severe depression, women with fourth-degree obstetric tear and genital tract fistula scored higher than women with pelvic organ prolapse. A significant risk of mental health dysfunction was identified in women with severe pelvic organ prolapse and chronic fourth-degree obstetric tear. These rates are similar to the high rates of mental health dysfunction in women with genital tract fistula. Identification and management of mental health dysfunction in women with these conditions should be a priority.

Population Levels and Geographic Distribution of HIV RNA in Rural Ugandan and Kenyan Communities and Sero-Discordant Couples: a Cross-Sectional Analysis

PubMed Central

Jain, Vivek; Petersen, Maya L.; Liegler, Teri; Byonanebye, Dathan M.; Kwarisiima, Dalsone; Chamie, Gabriel; Sang, Norton; Black, Doug; Clark, Tamara D.; Ladai, Andras; Plenty, Albert; Kabami, Jane; Ssemmondo, Emmanuel; Bukusi, Elizabeth A.; Cohen, Craig R.; Charlebois, Edwin D.; Kamya, Moses R.; Havlir, Diane V.

2017-01-01

Background As Sub-Saharan Africa transitions to a new era of universal ART, up-to-date assessments of HIV RNA (viral load, VL) suppression at a population level are needed to understand demographic and geographic sources of ongoing viremia and to inform interventions to optimize ART delivery. We sought to measure population viral load (VL) metrics to assess current viral suppression levels and characterize demographic groups and geographic locations with high-level detectable viremia in East Africa. Methods In the SEARCH HIV test-and-treat study (NCT01864683), we conducted baseline HIV testing (89% uptake) and HIV RNA assessments in 32 rural communities in 2013–2014 in Uganda and Kenya (N=303,461). We measured VL in 8,828 HIV+ adults, and defined viral suppression as VL<500 copies/mL. To assess geographic sources of transmission risk, we determined the proportion of all adults (both HIV-positive and HIV-negative) with detectable VL (termed ‘local prevalence of viremia’). Transmission risk ‘hotspots’ were defined as geopolitical subunits within communities with >5.0% local prevalence of viremia. We also assessed sero-discordant couples, measuring the proportion in which the HIV+ partner had detectable viremia. Findings Viral suppression was 82% (3,427/4,202) among adults on ART, and 51% (4,490/8,828) among all HIV+ adults. Regional viral suppression among HIV+ adults was 48% (West Uganda), 45% (East Uganda) and 53% (Western Kenya). Transmission risk ‘hotspots’ included 1/21 W.Uganda, 0/18 E.Uganda, and 16/26 Kenya geopolitical subunits. In Uganda, sero-discordancy was 3.1% (492 discordant/16,023 total couples). In 58% of discordant couples, the HIV+ partner was viremic (14% had VL>100,000). In Kenya, sero-discordancy was 10.0% (859/8,616 total couples). In 53%, the HIV+ partner was viremic (15% with VL>100,000). Interpretation Prior to the 2013–2014 start of the SEARCH trial, 51% of East African HIV+ adults had viral suppression, reflecting ART scale-up efforts to date. However, geographic ‘hotspots’ of potential HIV transmission risk as well as detectable viremia among sero-discordant couples warrant intensified interventions. Funding US National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health. President’s Emergency Plan for AIDS Relief (PEPFAR). PMID:27989576

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.

Engendering Climate Information Networks in Africa: Case Studies of Digital and FM Radio for Disseminating Disaster Early Warnings to Women and Youth

NASA Astrophysics Data System (ADS)

Stewart, M. M.; Pratt, M.

2002-05-01

This paper examines the effectiveness of FM and digital radio in disseminating weather and climate information to remote rural populations in Niger and Uganda. In Niger, poor communications infrastructure necessitated the establishment of a basic radio system as a first step towards disseminating climate information. Dissemination via digital radio is limited, in this context, by lack of technical support and the difficulty of maintaining computer equipment in the hot and dusty climate. Community FM stations have supported a range of mitigation activities that reduced vulnerability in all sites studied. Digital radio proved a more effective tool for disseminating climate information in Uganda, where technical knowledge is more prevalent and infrastructure networks are stronger. The primary challenge in Uganda lies in maintaining equipment in remote locations and disseminating information to a wider audience by linking with FM radio. Climate and weather information is already demonstrating positive impacts on agricultural production in Uganda, health and civil society in Niger, and on vulnerability reduction in both countries. Radio,particularly FM, was an excellent medium for disseminating information to women, youth, and other hard to reach populations. Discussion will focus on recommendations for improving the effectiveness of both systems and for practically linking FM and digital dissemination systems for better communication of climate information. Implications of the case studies will also be discussed in the context of digital and FM radio as media for disseminating other types of scientific information.

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.

Forest Fragmentation as Cause of Bacterial Transmission among Nonhuman Primates, Humans, and Livestock, Uganda

PubMed Central

Gillespie, Thomas R.; Rwego, Innocent B.; Estoff, Elizabeth L.; Chapman, Colin A.

2008-01-01

We conducted a prospective study of bacterial transmission among humans, nonhuman primates (primates hereafter), and livestock in western Uganda. Humans living near forest fragments harbored Escherichia coli bacteria that were ≈75% more similar to bacteria from primates in those fragments than to bacteria from primates in nearby undisturbed forests. Genetic similarity between human/livestock and primate bacteria increased ≈3-fold as anthropogenic disturbance within forest fragments increased from moderate to high. Bacteria harbored by humans and livestock were approximately twice as similar to those of red-tailed guenons, which habitually enter human settlements to raid crops, than to bacteria of other primate species. Tending livestock, experiencing gastrointestinal symptoms, and residing near a disturbed forest fragment increased genetic similarity between a participant’s bacteria and those of nearby primates. Forest fragmentation, anthropogenic disturbance within fragments, primate ecology, and human behavior all influence bidirectional, interspecific bacterial transmission. Targeted interventions on any of these levels should reduce disease transmission and emergence. PMID:18760003

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.

Effect of Economic Assets on Sexual Risk-Taking Intentions Among Orphaned Adolescents in Uganda

PubMed Central

Han, Chang-Keun; Neilands, Torsten B.; Ismayilova, Leyla; Sperber, Elizabeth

2010-01-01

Objectives. We examined the effect of economic assets on sexual risk-taking intentions among school-going AIDS-orphaned adolescents in rural Uganda. Methods. AIDS-orphaned adolescents from 15 comparable schools were randomly assigned to control (n = 133) or treatment (n = 127) conditions. Treatment participants received child savings accounts, workshops, and mentorship. This economic intervention was in addition to the traditional care and support services for school-going orphaned adolescents (counseling and school supplies) provided to both treatment and control groups. Adolescents in the treatment condition were compared with adolescents in the control condition at baseline and at 10 months after the intervention. Results. After control for sociodemographic factors, child-caregiver/parental communication, and peer pressure, adolescents in the economic intervention group reported a significant reduction in sexual risk-taking intentions compared with adolescents in the control condition. Conclusions. The findings indicate that in Uganda, a country devastated by poverty and disease (including HIV/AIDS), having access to economic assets plays an important role in influencing adolescents' sexual risk-taking intentions. These findings have implications for the care and support of orphaned adolescents, especially in poor African countries devastated by poverty and sexually transmitted diseases. PMID:20075323

Study protocol for the SMART2D adaptive implementation trial: a cluster randomised trial comparing facility-only care with integrated facility and community care to improve type 2 diabetes outcomes in Uganda, South Africa and Sweden.

PubMed

Guwatudde, David; Absetz, Pilvikki; Delobelle, Peter; Östenson, Claes-Göran; Olmen Van, Josefien; Alvesson, Helle Molsted; Mayega, Roy William; Ekirapa Kiracho, Elizabeth; Kiguli, Juliet; Sundberg, Carl Johan; Sanders, David; Tomson, Göran; Puoane, Thandi; Peterson, Stefan; Daivadanam, Meena

2018-03-17

Type 2 diabetes (T2D) is increasingly contributing to the global burden of disease. Health systems in most parts of the world are struggling to diagnose and manage T2D, especially in low-income and middle-income countries, and among disadvantaged populations in high-income countries. The aim of this study is to determine the added benefit of community interventions onto health facility interventions, towards glycaemic control among persons with diabetes, and towards reduction in plasma glucose among persons with prediabetes. An adaptive implementation cluster randomised trial is being implemented in two rural districts in Uganda with three clusters per study arm, in an urban township in South Africa with one cluster per study arm, and in socially disadvantaged suburbs in Stockholm, Sweden with one cluster per study arm. Clusters are communities within the catchment areas of participating primary healthcare facilities. There are two study arms comprising a facility plus community interventions arm and a facility-only interventions arm. Uganda has a third arm comprising usual care. Intervention strategies focus on organisation of care, linkage between health facility and the community, and strengthening patient role in self-management, community mobilisation and a supportive environment. Among T2D participants, the primary outcome is controlled plasma glucose; whereas among prediabetes participants the primary outcome is reduction in plasma glucose. The study has received approval in Uganda from the Higher Degrees, Research and Ethics Committee of Makerere University School of Public Health and from the Uganda National Council for Science and Technology; in South Africa from the Biomedical Science Research Ethics Committee of the University of the Western Cape; and in Sweden from the Regional Ethical Board in Stockholm. Findings will be disseminated through peer-reviewed publications and scientific meetings. ISRCTN11913581; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed Central

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

2016-01-01

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

The Invisible Suffering: Sexual Coercion, Interpersonal Violence, and Mental Health - A Cross-Sectional Study among University Students in South-Western Uganda

PubMed Central

Agardh, Anette; Tumwine, Gilbert; Asamoah, Benedict O.; Cantor-Graae, Elizabeth

2012-01-01

Background Despite a history of conflicts and widespread human rights violation in sub-Saharan Africa, little is known about the prevalence of interpersonal violence among the population in this region. Evidence from high-income countries suggests that exposure to violence has mental health consequences and violence also has associations with experiences of sexual coercion. Aims This study sought to investigate the prevalence of physical and perceived threats of violence among university students in Uganda and to assess the possible relationship between such violence, sexual coercion, and symptoms of anxiety, depression, and psychoticism, respectively. Method In 2005, 980 Ugandan university students responded to a self-administered questionnaire (response rate 80%) that assessed socio-demographic factors, social capital, importance of religion, mental health, experience of violence and sexual coercion, and sexual behaviour factors. Logistic regression analysis was applied as the main analytical tool. Results Of those who responded, 28% reported perceived threats/threats of violence and 10% exposure to actual physical violence over the previous 12 months, with no significant gender differences in exposure history. Exposure to violence was significantly associated with the experience of sexual coercion among both males and females. Sexual coercion and threats/threats of violence were both significantly associated with poor mental health in males and females, but only males showed a strong association between exposure to physical violence and poor mental health. Conclusion The current study suggests that in terms of general exposure, both males and females in the study population are equally exposed to sexual coercion and interpersonal violence, and both male and female students show generally similar mental health effects of exposure to such violence. The prevalence of interpersonal violence found in our study population may have long-term negative health implications. Our findings may serve as a baseline for interventions and continuing research aimed at preventing interpersonal violence. PMID:23240021

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

PubMed

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

2016-01-01

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

Demography and health of “village dogs” in rural Western Uganda

PubMed Central

Hyeroba, David; Friant, Sagan; Acon, Johnson; Okwee-Acai, James; Goldberg, Tony L.

2017-01-01

“Village dogs” in developing economies are assumed to be heavily burdened by infectious disease. We followed a cohort of 61 village dogs in rural western Uganda prospectively for fifteen months to measure changes in health and demographic outcomes, and to examine risk factors for morbidity and mortality. The mean (± standard deviation) number of dogs per household was 2.4 (± 2.0), of which 56.0% were male and 44.0% female. For females, average age at first estrus was 1.7 (± 0.6) years with a mean litter size of 3.8 (± 1.5). In the first, second and third parities, average puppy mortality per litter was 3.2 (± 2.5), 2.4 (± 2.1) and 3.4 (± 2.9), respectively. The main causes of morbidity and mortality were infectious disease (46.1%), culling (euthanasia) by owners (30.8%), and attacks by baboons, Papio anubis (23.1%). Cox proportional hazard regression showed that a clinical diagnosis of anemia significantly predicted morbidity (HR = 4.3 (95% CI: 1.1–17.8); p < 0.05), and younger age significantly predicted mortality (HR = 3.6 (95% CI: 1.2–10.6); p < 0.05). Our results indicate that infectious disease is indeed important to the health and survival in village dogs in this setting, but that cultural practices related to ownership and interactions with wildlife also contribute substantially to morbidity and mortality. PMID:28107877

Farmers' awareness on landslide susceptibility on their plots: a first step towards household resilience in the Rwenzori region, Western Uganda

NASA Astrophysics Data System (ADS)

Mertens, Kewan; Jacobs, Lies; Maes, Jan; Kervyn, Matthieu; Vranken, Liesbet

2016-04-01

In the mountainous area of the Rwenzori region, western Uganda, landslides frequently destroy houses and plots of farmers living and cultivating on unstable slopes. The impact of these landslides on the local livelihoods depends on the exposure and the resilience of the households. Both the exposure and the resilience can be modified to a certain extent with specific measures, e.g. planting slope stabilizing trees of paying for (informal) insurance. The adoption of such measures and the willingness to accept measures imposed by local governments crucially depends on the local awareness of landslide risk. The aim of this research is to estimate awareness on landslide susceptibility, as a proxy for landslide risk, among household heads in a landslide prone area in the Rwenzori region, Western Uganda. The objective is to compare household and plot characteristics between aware and unaware households. This will allow us to identify those households which are less aware of landslide susceptibility and therefore most likely to be less resilient when exposed to landslide risk. We use data from a susceptibility map constructed in 2016 and a structured household survey conducted in the Rwenzori region in 2015. The susceptibility map is based on a SRTM 30m DEM and validated with field observations, while the household survey includes the answers of more than 450 households that have been asked to evaluate the landslide susceptibility on their plots. Simple probit models at plot level are used to compare the estimated landslide susceptibility with the modelled susceptibility. We use this comparison to identify the household characteristics of those households that do not correctly estimate the landslide susceptibility on their plots. We will exploit the fact that landslide susceptibility is very space specific and that households can therefore have plots in both susceptible and unsusceptible areas. The research is currently ongoing, but we hypothesize that younger farmers with a lower education level, lower trust, social capital and networks and with a recent migration history are less able to estimate landslide susceptibility on their plots. Literature on other disasters has demonstrated that human capital, social networks and past experience are crucial factors in determining risk perception. To our knowledge this is the first study to specifically investigate landslide risk awareness in a developing country, integrating both detailed socio-economic and geographical data. While estimating the awareness of landslide susceptibility is not sufficient to come to an estimation of a household's coping capacity, we consider it to be a first and necessary step towards a full estimation of household resilience.

Malaria diagnosis and mapping with m-Health and geographic information systems (GIS): evidence from Uganda.

PubMed

Larocca, Alberto; Moro Visconti, Roberto; Marconi, Michele

2016-10-24

Rural populations experience several barriers to accessing clinical facilities for malaria diagnosis. Increasing penetration of ICT and mobile-phones and subsequent m-Health applications can contribute overcoming such obstacles. GIS is used to evaluate the feasibility of m-Health technologies as part of anti-malaria strategies. This study investigates where in Uganda: (1) malaria affects the largest number of people; (2) the application of m-Health protocol based on the mobile network has the highest potential impact. About 75% of the population affected by Plasmodium falciparum malaria have scarce access to healthcare facilities. The introduction of m-Health technologies should be based on the 2G protocol, as 3G mobile network coverage is still limited. The western border and the central-Southeast are the regions where m-Health could reach the largest percentage of the remote population. Six districts (Arua, Apac, Lira, Kamuli, Iganga, and Mubende) could have the largest benefit because they account for about 28% of the remote population affected by falciparum malaria with access to the 2G mobile network. The application of m-Health technologies could improve access to medical services for distant populations. Affordable remote malaria diagnosis could help to decongest health facilities, reducing costs and contagion. The combination of m-Health and GIS could provide real-time and geo-localized data transmission, improving anti-malarial strategies in Uganda. Scalability to other countries and diseases looks promising.

"Girls Have More Challenges; They Need to Be Locked Up": A Qualitative Study of Gender Norms and the Sexuality of Young Adolescents in Uganda.

PubMed

Ninsiima, Anna B; Leye, Els; Michielsen, Kristien; Kemigisha, Elizabeth; Nyakato, Viola N; Coene, Gily

2018-01-24

Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives of young girls. This study explores the social construction of gender norms from early childhood, and how it influences adolescents' agency. Contrary to the mainstream theory of agency, which focuses on the ability to make informed choices, adolescents' agency appears constrained by context-specific obstacles. This study adopted qualitative research approaches involving 132 participants. Of these, 44 were in-depth interviews and 11 were focus group discussions, parcelled out into separate groups of adolescents (12-14 years), teachers, and parents ( n = 88), in Western Uganda. Data were analysed manually using open and axial codes, and conclusions were inductive. Results show that gender norms are established early in life, and have a very substantial impact on the agency of young adolescents. There were stereotypical gender norms depicting boys as sexually active and girls as restrained; girls' movements were restricted; their sexual agency constrained; and prevention of pregnancy was perceived as a girl's responsibility. Programs targeting behavioural change need to begin early in the lives of young children. They should target teachers and parents about the values of gender equality and strengthen the legal system to create an enabling environment to address the health and wellbeing of adolescents.

Soil Organic Matter Stability and Soil Carbon Storage with Changes in Land Use Intensity in Uganda

NASA Astrophysics Data System (ADS)

Tiemann, L. K.; Grandy, S.; Hartter, J.

2014-12-01

As the foundation of soil fertility, soil organic matter (SOM) formation and break-down is a critical factor of agroecosystem sustainability. In tropical systems where soils are quickly weathered, the link between SOM and soil fertility is particularly strong; however, the mechanisms controlling the stabilization and destabilization of SOM are not well characterized in tropical soils. In western Uganda, we collected soil samples under different levels of land use intensity including maize fields, banana plantations and inside an un-cultivated native tropical forest, Kibale National Park (KNP). To better understand the link between land use intensity and SOM stability we measured total soil C and N, and respiration rates during a 369 d soil incubation. In addition, we separated soils into particle size fractions, and mineral adsorbed SOM in the silt (2-50 μm ) and clay (< 2 μm) fractions was dissociated, purified and chemically characterized via pyrolysis-GC/MS. Cultivated soil C and N have declined by 22 and 48%, respectively, in comparison to uncultivated KNP soils. Incubation data indicate that over the last decade, relatively accessible and labile soil organic carbon (SOC) pools have been depleted by 55-59% in cultivated soils. As a result of this depletion, the chemical composition of SOM has been altered such that clay and silt associated SOM differed significantly between agricultural fields and KNP. In particular, nitrogen containing compounds were in lower abundance in agricultural compared to KNP soils. This suggests that N depletion due to agriculture has advanced to pools of mineral associated organic N that are typically protected from break-down. In areas where land use intensity is relatively greater, increases in polysaccharides and lipids in maize fields compared to KNP indicate increases in microbial residues and decomposition by-products as microbes mine SOM for organic N. Chemical characterization of post-incubation SOM will help us better understand how microbes preferentially break-down SOM. Agricultural intensification over the past decade in western Uganda has depleted SOC, on average, by 1427 g m-2. In addition, depletion of organic nitrogen reserves in stable SOM pools corresponds with reported declines in crop yields and productivity in this region.

Family caregivers in rural Uganda: the hidden reality.

PubMed

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

2007-01-01

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

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

PubMed Central

2012-01-01

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

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

Coerced First Sex among Adolescent Girls in Sub-Saharan Africa: Prevalence and Context

PubMed Central

Moore, Ann M.; Awusabo-Asare, Kofi; Madise, Nyovani; John-Langba, Johannes; Kumi-Kyereme, Akwasi

2008-01-01

Coercive experiences at sexual debut have been shown to be associated with other sexual risks throughout the life course. Using nationally representative surveys from 12–19 year old girls in Burkina Faso, Ghana, Malawi, and Uganda collected in 2004, we examine the prevalence of sexual coercion at sexual debut among unmarried girls and its correlates. In Malawi, 38 percent of girls said that they were “not willing at all” at their first sexual experience followed by Ghana at 30 percent, Uganda at 23 percent and Burkina Faso at 15 percent. In-depth interviews collected in 2003 with the same demographic shows that there are four primary types of sexual coercion: forced sex; pressure through money or gifts; flattery, pestering, and threatening to have sex with other girls; and passive acceptance. The article concludes with the research and policy implications of these findings. PMID:18458747

Asset Ownership and Health and Mental Health Functioning Among AIDS-Orphaned Adolescents: Findings From a Randomized Clinical Trial in Rural Uganda

PubMed Central

Han, Chang-Keun; Neilands, Torsten B

2010-01-01

This study evaluated an economic empowerment intervention designed to promote life options, health and mental health functioning among AIDS-orphaned adolescents in rural Uganda. The study used an experimental design in which adolescents (N=267) were randomly assigned to receive an economic empowerment intervention or usual care for orphaned children. The study measured mental health functioning using 20 items of the Tennessee Self-Concept Scale (TSCS: 2)—a standardized measure for self-esteem—and measured overall health using a self-rated health measure. Data obtained at 10-month follow-up revealed significant positive effects of the economic empowerment intervention on adolescents’ self-rated health and mental health functioning. Additionally, health and mental health functioning were found to be positively associated with each other. The findings have implications for public policy and health programming for AIDS-orphaned adolescents. PMID:19520472

Petrography and geochemistry of modern river sediments in an equatorial environment (Rwenzori Mountains and Albertine rift, Uganda) - Implications for weathering and provenance

NASA Astrophysics Data System (ADS)

Schneider, Sandra; Hornung, Jens; Hinderer, Matthias; Garzanti, Eduardo

2016-05-01

In hot-humid equatorial climate chemical weathering may be so strong that provenance signatures may be largely lost and even detritus derived from crystalline basement rocks reduced to quartzose sand. We tested this hypothesis in western Uganda, where stable plateau areas contrast with the active tectonic setting of the Albertine Rift (western branch of the East African Rift System, EARS), culminating in the strongly exhumed fault block of the > 5000 m high Rwenzori Mountains. In this setting, sediments derived from similar types of basement rocks including gneiss, schist, amphibolite, metasediments and granites can be traced from rapidly eroding high-altitude areas to low-altitude areas undergoing prolonged weathering. Sand and mud carried by 51 rivers overall in these two contrasting landscapes were sampled to study how and to what extent detrital modes are modified by the selective loss of unstable detrital minerals. Sediments generated in the high-relief Rwenzori Mountains show abundant feldspar (up to 32%) and rock fragments (up to 52%), which together with low SiO2/Al2O3 ratio and composition close to the Upper Continental Crust (UCC standard) reflect erosion in weathering-limited conditions. In the central Rwenzoris, low Th/Sc and Zr/Sc ratios, weak negative Eu anomaly, lower LaN/YbN values, and heavy-mineral assemblages with hornblende and epidote reflect the lithology of source rocks in the Buganda-Toro-Greenstone Belt. In contrast, sediments produced on the low-relief plateau have quartz content up to 98% and higher SiO2/Al2O3 ratio. Systematic loss of mobile elements is indicated by high chemical weathering indices CIA, PIA and WIP. However, provenance from metamorphic basement rocks is still indicated by heavy-mineral assemblages dominated by epidote and amphibole, whereas provenance from granitic rocks is revealed by high Th/Sc and Zr/Sc ratio, negative Eu anomaly and higher LaN/YbN values. We conclude that first-cycle sediments generated in high-relief areas preserve the original imprint of parent lithologies even in very humid equatorial climate. In low-relief areas, although weathering processes have proceeded over millions of years turning basement-derived detritus into an almost pure quartzose resistate, provenance signals are not erased entirely, and can be still retrieved from the residual heavy-mineral suite and relative abundance of high-field-strength trace elements.

Changing perceptions of protected area benefits and problems around Kibale National Park, Uganda.

PubMed

MacKenzie, Catrina A; Salerno, Jonathan; Hartter, Joel; Chapman, Colin A; Reyna, Rafael; Tumusiime, David Mwesigye; Drake, Michael

2017-09-15

Local residents' changing perceptions of benefits and problems from living next to a protected area in western Uganda are assessed by comparing household survey data from 2006, 2009, and 2012. Findings are contextualized and supported by long-term data sources for tourism, protected area-based employment, tourism revenue sharing, resource access agreements, and problem animal abundance. We found decreasing perceived benefit and increasing perceived problems associated with the protected area over time, with both trends dominated by increased human-wildlife conflict due to recovering elephant numbers. Proportions of households claiming benefit from specific conservation strategies were increasing, but not enough to offset crop raiding. Ecosystem services mitigated perceptions of problems. As human and animal populations rise, wildlife authorities in Sub-Saharan Africa will be challenged to balance perceptions and adapt policies to ensure the continued existence of protected areas. Understanding the dynamic nature of local people's perceptions provides a tool to adapt protected area management plans, prioritize conservation resources, and engage local communities to support protected areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sunguru virus: a novel virus in the family Rhabdoviridae isolated from a chicken in north-western Uganda.

PubMed

Ledermann, Jeremy P; Zeidner, Nord; Borland, Erin M; Mutebi, John-Paul; Lanciotti, Robert S; Miller, Barry R; Lutwama, Julius J; Tendo, Joseph M; Andama, Vincent; Powers, Ann M

2014-07-01

Sunguru virus (SUNV), a novel virus belonging to the highly diverse Rhabdoviridae family, was isolated from a domestic chicken in the district of Arua, Uganda, in 2011. This is the first documented isolation of a rhabdovirus from a chicken. SUNV is related to, but distinct from, Boteke virus and other members of the unclassified Sandjimba group. The genome is 11056 nt in length and contains the five core rhabdovirus genes plus an additional C gene (within the ORF of a phosphoprotein gene) and a small hydrophobic protein (between the matrix and glycoprotein genes). Inoculation of vertebrate cells with SUNV resulted in significant viral growth, with a peak titre of 7.8 log10 p.f.u. ml(-1) observed in baby hamster kidney (BHK) cells. Little to no growth was observed in invertebrate cells and in live mosquitoes, with Anopheles gambiae mosquitoes having a 47.4% infection rate in the body but no dissemination of the virus to the salivary glands; this suggests that this novel virus is not arthropod borne as some other members of the family Rhabdoviridae.

Sunguru virus: a novel virus in the family Rhabdoviridae isolated from a chicken in north-western Uganda

PubMed Central

Ledermann, Jeremy P.; Zeidner, Nord; Borland, Erin M.; Mutebi, John-Paul; Lanciotti, Robert S.; Miller, Barry R.; Lutwama, Julius J.; Tendo, Joseph M.; Andama, Vincent; Powers, Ann M.

2017-01-01

Sunguru virus (SUNV), a novel virus belonging to the highly diverse Rhabdoviridae family, was isolated from a domestic chicken in the district of Arua, Uganda, in 2011. This is the first documented isolation of a rhabdovirus from a chicken. SUNV is related to, but distinct from, Boteke virus and other members of the unclassified Sandjimba group. The genome is 11 056 nt in length and contains the five core rhabdovirus genes plus an additional C gene (within the ORF of a phosphoprotein gene) and a small hydrophobic protein (between the matrix and glycoprotein genes). Inoculation of vertebrate cells with SUNV resulted in significant viral growth, with a peak titre of 7.8 log10 p.f.u. ml−1 observed in baby hamster kidney (BHK) cells. Little to no growth was observed in invertebrate cells and in live mosquitoes, with Anopheles gambiae mosquitoes having a 47.4 % infection rate in the body but no dissemination of the virus to the salivary glands; this suggests that this novel virus is not arthropod borne as some other members of the family Rhabdoviridae. PMID:24718834

African Indigenous science in higher education in Uganda

NASA Astrophysics Data System (ADS)

Akena Adyanga, Francis

This study examines African Indigenous Science (AIS) in higher education in Uganda. To achieve this, I use anticolonial theory and Indigenous knowledge discursive frameworks to situate the subjugation of Indigenous science from the education system within a colonial historical context. These theories allow for a critical examination of the intersection of power relations rooted in the politics of knowledge production, validation, and dissemination, and how this process has become a systemic and complex method of subjugating one knowledge system over the other. I also employ qualitative and autoethnographic research methodologies. Using a qualitative research method, I interviewed 10 students and 10 professors from two universities in Uganda. My research was guided by the following key questions: What is African Indigenous Science? What methodology would help us to indigenize science education in Uganda? How can we work with Indigenous knowledge and anticolonial theoretical discursive frameworks to understand and challenge the dominance of Eurocentric knowledge in mainstream education? My research findings revealed that AIS can be defined in multiple ways, in other words, there is no universal definition of AIS. However, there were some common elements that my participants talked about such as: (a) knowledge by Indigenous communities developed over a long period of time through a trial and error approach to respond to the social, economic and political challenges of their society. The science practices are generational and synergistic with other disciplines such as history, spirituality, sociology, anthropology, geography, and trade among others, (b) a cumulative practice of the use, interactions with and of biotic and abiotic organism in everyday life for the continued existence of a community in its' totality. The research findings also indicate that Indigenous science is largely lacking from Uganda's education curriculum because of the influence of colonial and post-colonial education. Graduates of the colonial education system who are manning education in the country have themselves come to disdain Indigenous knowledge. The major findings from the study were: 1) participants' articulation of Indigenous science; 2) influence of organized religion on African Indigenous Science; 3) dominance of professors' foreign experiences in determining curriculum content; 4) protection of intellectual property rights for Indigenous science; and 5) collaborative research between Indigenous and Western scholars to enhance attitude change toward Indigenous science.

Mitochondrial Genome Analyses Suggest Multiple Trichuris Species in Humans, Baboons, and Pigs from Different Geographical Regions.

PubMed

Hawash, Mohamed B F; Andersen, Lee O; Gasser, Robin B; Stensvold, Christen Rune; Nejsum, Peter

2015-01-01

The whipworms Trichuris trichiura and Trichuris suis are two parasitic nematodes of humans and pigs, respectively. Although whipworms in human and non-human primates historically have been referred to as T. trichiura, recent reports suggest that several Trichuris spp. are found in primates. We sequenced and annotated complete mitochondrial genomes of Trichuris recovered from a human in Uganda, an olive baboon in the US, a hamadryas baboon in Denmark, and two pigs from Denmark and Uganda. Comparative analyses using other published mitochondrial genomes of Trichuris recovered from a human and a porcine host in China and from a françois' leaf-monkey (China) were performed, including phylogenetic analyses and pairwise genetic and amino acid distances. Genetic and protein distances between human Trichuris in Uganda and China were high (~19% and 15%, respectively) suggesting that they represented different species. Trichuris from the olive baboon in US was genetically related to human Trichuris in China, while the other from the hamadryas baboon in Denmark was nearly identical to human Trichuris from Uganda. Baboon-derived Trichuris was genetically distinct from Trichuris from françois' leaf monkey, suggesting multiple whipworm species circulating among non-human primates. The genetic and protein distances between pig Trichuris from Denmark and other regions were roughly 9% and 6%, respectively, while Chinese and Ugandan whipworms were more closely related. Our results indicate that Trichuris species infecting humans and pigs are phylogenetically distinct across geographical regions, which might have important implications for the implementation of suitable and effective control strategies in different regions. Moreover, we provide support for the hypothesis that Trichuris infecting primates represents a complex of cryptic species with some species being able to infect both humans and non-human primates.

Mitochondrial Genome Analyses Suggest Multiple Trichuris Species in Humans, Baboons, and Pigs from Different Geographical Regions

PubMed Central

Hawash, Mohamed B. F.; Andersen, Lee O.; Gasser, Robin B.; Stensvold, Christen Rune; Nejsum, Peter

2015-01-01

Background The whipworms Trichuris trichiura and Trichuris suis are two parasitic nematodes of humans and pigs, respectively. Although whipworms in human and non-human primates historically have been referred to as T. trichiura, recent reports suggest that several Trichuris spp. are found in primates. Methods and Findings We sequenced and annotated complete mitochondrial genomes of Trichuris recovered from a human in Uganda, an olive baboon in the US, a hamadryas baboon in Denmark, and two pigs from Denmark and Uganda. Comparative analyses using other published mitochondrial genomes of Trichuris recovered from a human and a porcine host in China and from a françois’ leaf-monkey (China) were performed, including phylogenetic analyses and pairwise genetic and amino acid distances. Genetic and protein distances between human Trichuris in Uganda and China were high (~19% and 15%, respectively) suggesting that they represented different species. Trichuris from the olive baboon in US was genetically related to human Trichuris in China, while the other from the hamadryas baboon in Denmark was nearly identical to human Trichuris from Uganda. Baboon-derived Trichuris was genetically distinct from Trichuris from françois’ leaf monkey, suggesting multiple whipworm species circulating among non-human primates. The genetic and protein distances between pig Trichuris from Denmark and other regions were roughly 9% and 6%, respectively, while Chinese and Ugandan whipworms were more closely related. Conclusion and Significance Our results indicate that Trichuris species infecting humans and pigs are phylogenetically distinct across geographical regions, which might have important implications for the implementation of suitable and effective control strategies in different regions. Moreover, we provide support for the hypothesis that Trichuris infecting primates represents a complex of cryptic species with some species being able to infect both humans and non-human primates. PMID:26367282

The cost of post-abortion care in developing countries: a comparative analysis of four studies

PubMed Central

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-01-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology—the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30–60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52–68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3–12% of the average cost of treating a PAC patient. PMID:27045001

Developing a Systemic Approach to Teacher Education in Sub-Saharan Africa: Emerging Lessons from Kenya, Tanzania and Uganda

ERIC Educational Resources Information Center

Hardman, Frank; Ackers, Jim; Abrishamian, Niki; O'Sullivan, Margo

2011-01-01

While many countries in Eastern and Southern Africa are on track for meeting the Education for All targets, there is a growing recognition of the need to improve the quality of basic education and that a focus on pedagogy and its training implications needs to be at the heart of this commitment. By drawing on three East African countries, Kenya,…

Treatment-seeking behaviour and social status of women with pelvic organ prolapse, 4th-degree obstetric tears, and obstetric fistula in western Uganda.

PubMed

Krause, Hannah G; Natukunda, Harriet; Singasi, Isaac; Hicks, Sylvia S W; Goh, Judith T W

2014-11-01

This study looks at a trilogy of women's health issues including severe pelvic organ prolapse, unrepaired 4th degree obstetric tears and obstetric fistula, all of which can cause significant suffering in the lives of women and their families. Women undergoing surgery for severe pelvic organ prolapse, unrepaired 4th degree obstetric tears and obstetric fistulae, were interviewed to assess their perceptions of what caused their condition, subsequent impact on their social situation and sexual activity, and whether they had sought treatment previously. One hundred fifty women participated in the survey, including 69 undergoing surgery for genito-urinary fistula, 25 with faecal incontinence only (including 24 women with unrepaired 4th degree obstetric tears and 1 woman with an isolated rectovaginal fistula), and 56 women with severe pelvic organ prolapse. All groups of women were exposed to abandonment by their families with 42 % of women with genito-urinary fistula, 21 % with unrepaired 4th degree obstetric tear, and 25 % of women with severe pelvic organ prolapse rejected by their husbands. Most of the women had actively sought treatment for their condition with no success due to unavailability of treatment or misinformation. This study confirms the social stigma associated with obstetric fistula, however also highlights the social stigma faced by women suffering with severe pelvic organ prolapse and unrepaired 4th degree obstetric tears in western Uganda. There is an urgent need for education and training in obstetric management and pelvic organ prolapse management in such areas of limited resources.

“Girls Have More Challenges; They Need to Be Locked Up”: A Qualitative Study of Gender Norms and the Sexuality of Young Adolescents in Uganda

PubMed Central

Ninsiima, Anna B.; Leye, Els; Michielsen, Kristien; Kemigisha, Elizabeth; Nyakato, Viola N.; Coene, Gily

2018-01-01

Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives of young girls. This study explores the social construction of gender norms from early childhood, and how it influences adolescents’ agency. Contrary to the mainstream theory of agency, which focuses on the ability to make informed choices, adolescents’ agency appears constrained by context-specific obstacles. This study adopted qualitative research approaches involving 132 participants. Of these, 44 were in-depth interviews and 11 were focus group discussions, parcelled out into separate groups of adolescents (12–14 years), teachers, and parents (n = 88), in Western Uganda. Data were analysed manually using open and axial codes, and conclusions were inductive. Results show that gender norms are established early in life, and have a very substantial impact on the agency of young adolescents. There were stereotypical gender norms depicting boys as sexually active and girls as restrained; girls’ movements were restricted; their sexual agency constrained; and prevention of pregnancy was perceived as a girl’s responsibility. Programs targeting behavioural change need to begin early in the lives of young children. They should target teachers and parents about the values of gender equality and strengthen the legal system to create an enabling environment to address the health and wellbeing of adolescents. PMID:29364192

Strengthening intrapartum and immediate newborn care to reduce morbidity and mortality of preterm infants born in health facilities in Migori County, Kenya and Busoga Region, Uganda: a study protocol for a randomized controlled trial.

PubMed

Otieno, Phelgona; Waiswa, Peter; Butrick, Elizabeth; Namazzi, Gertrude; Achola, Kevin; Santos, Nicole; Keating, Ryan; Lester, Felicia; Walker, Dilys

2018-06-05

Preterm birth (birth before 37 weeks of gestation) and its complications are the leading contributors to neonatal and under-5 mortality. The majority of neonatal deaths in Kenya and Uganda occur during the intrapartum and immediate postnatal period. This paper describes our study protocol for implementing and evaluating a package of facility-based interventions to improve care during this critical window. This is a pair-matched, cluster randomized controlled trial across 20 facilities in Eastern Uganda and Western Kenya. The intervention facilities receive four components: (1) strengthening of routine data collection and data use activities; (2) implementation of the WHO Safe Childbirth Checklist modified for preterm birth; (3) PRONTO simulation training and mentoring to strengthen intrapartum and immediate newborn care; and (4) support of quality improvement teams. The control facilities receive both data strengthening and introduction of the modified checklist. The primary outcome for this study is 28-day mortality rate among preterm infants. The denominator will include all live births and fresh stillbirths weighing greater than 1000 g and less than 2500 g; all live births and fresh stillbirths weighing between 2501 and 3000 g with a documented gestational age less than 37 weeks. The results of this study will inform interventions to improve personnel and facility capacity to respond to preterm labor and delivery, as well as care for the preterm infant. ClinicalTrials.gov, ID: NCT03112018 . Registered on 13 April 2017.

Rapid microsatellite marker development for African mahogany (Khaya senegalensis, Meliaceae) using next-generation sequencing and assessment of its intra-specific genetic diversity.

PubMed

Karan, M; Evans, D S; Reilly, D; Schulte, K; Wright, C; Innes, D; Holton, T A; Nikles, D G; Dickinson, G R

2012-03-01

Khaya senegalensis (African mahogany or dry-zone mahogany) is a high-value hardwood timber species with great potential for forest plantations in northern Australia. The species is distributed across the sub-Saharan belt from Senegal to Sudan and Uganda. Because of heavy exploitation and constraints on natural regeneration and sustainable planting, it is now classified as a vulnerable species. Here, we describe the development of microsatellite markers for K. senegalensis using next-generation sequencing to assess its intra-specific diversity across its natural range, which is a key for successful breeding programs and effective conservation management of the species. Next-generation sequencing yielded 93,943 sequences with an average read length of 234 bp. The assembled sequences contained 1030 simple sequence repeats, with primers designed for 522 microsatellite loci. Twenty-one microsatellite loci were tested with 11 showing reliable amplification and polymorphism in K. senegalensis. The 11 novel microsatellites, together with one previously published, were used to assess 73 accessions belonging to the Australian K. senegalensis domestication program, sampled from across the natural range of the species. STRUCTURE analysis shows two major clusters, one comprising mainly accessions from west Africa (Senegal to Benin) and the second based in the far eastern limits of the range in Sudan and Uganda. Higher levels of genetic diversity were found in material from western Africa. This suggests that new seed collections from this region may yield more diverse genotypes than those originating from Sudan and Uganda in eastern Africa. © 2011 Blackwell Publishing Ltd.

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

PubMed

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

2016-07-11

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

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

PubMed

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

2016-10-06

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

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

PubMed Central

2014-01-01

Background This paper establishes empirical evidence relating the agriculture and health sectors in Uganda. The analysis explores linkages between agricultural management, malaria and implications for improving community health outcomes in rural Uganda. The goal of this exploratory work is to expand the evidence-base for collaboration between the agricultural and health sectors in Uganda. Methods The paper presents an analysis of data from the 2006 Uganda National Household Survey using a parametric multivariate Two-Limit Tobit model to identify correlations between agro-ecological variables including geographically joined daily seasonal precipitation records and household level malaria risk. The analysis of agricultural and environmental factors as they affect household malaria rates, disaggregated by age-group, is inspired by a complimentary review of existing agricultural malaria literature indicating a gap in evidence with respect to agricultural management as a form of malaria vector management. Crop choices and agricultural management practices may contribute to vector control through the simultaneous effects of reducing malaria transmission, improving housing and nutrition through income gains, and reducing insecticide resistance in both malaria vectors and agricultural pests. Results The econometric results show the existence of statistically significant correlations between crops, such as sweet potatoes/yams, beans, millet and sorghum, with household malaria risk. Local environmental factors are also influential- daily maximum temperature is negatively correlated with malaria, while daily minimum temperature is positively correlated with malaria, confirming trends in the broader literature are applicable to the Ugandan context. Conclusions Although not necessarily causative, the findings provide sufficient evidence to warrant purposefully designed work to test for agriculture health causation in vector management. A key constraint to modeling the agricultural basis of malaria transmission is the lack of data integrating both the health and agricultural information necessary to satisfy the differing methodologies used by the two sectors. A national platform for collaboration between the agricultural and health sectors could help align programs to achieve better measurements of agricultural interactions with vector reproduction and evaluate the potential for agricultural policy and programs to support rural malaria control. PMID:24990158

The experiences of survivors and trauma counselling service providers in northern Uganda: Implications for mental health policy and legislation.

PubMed

Liebling, H; Davidson, L; Akello, G F; Ochola, G

Previous research in northern Uganda found high levels of trauma-related difficulties amongst the conflict-affected population. There is international evidence that psychological therapy can reduce depression, as one of the psychological effects of trauma, but very limited literature regarding the experiences of trauma counselling in Sub-Saharan Africa. The current British Academy and Leverhulme-funded research investigated the experiences of service users and providers of trauma services in Kitgum and Gulu, northern Uganda. It also examined their implications for mental health policy and legislation. A decision was made to utilise qualitative methodology to highlight the in-depth experiences of participants. The researcher's carried out interviews with 10 women and 10 men survivors attending trauma services in Kitgum and Gulu. The researchers also interviewed 15 key informants in Kitgum, Gulu and Kampala including trauma counselling service providers, ministers, cultural leaders and mental health professionals. The authors report the findings of the research based on thematic analysis of the interviews. Themes included the experiences of survivors, bearing witness and instilling hope, constraints to service provision, stigma and abuse, holistic approach, service providers doing their best, specialist populations, limited understanding, training and skills development, gaps in service provision and mental health policy and legislation. The interviews resulted in a clear indication that counselling and medication was valued by service users, and that service providers felt the treatments that were provided improved depression, and increased empowerment and engagement in social activities. However, the authors argue that there was a limit to the benefits that could be achieved without using the holistic approach that the survivors requested. Thus, in cases of trauma arising from conflict, there is a clear need for the state to ensure reparation and/or justice for the atrocities witnessed by and perpetrated against survivors. This might include the provision of compensation, which would help to meet social needs and reduce feelings of shame and anger. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Utilization of LANDSAT imagery for mapping vegetation on the millionth scale

NASA Technical Reports Server (NTRS)

Williams, D. L.; Coiner, J. C.

1975-01-01

A series of test sites were examined to determine if the information content of the LANDSAT imagery that may be obtained of these sites is sufficient to permit their mapping according to the vegetation classification system recently published by Unesco. These sites include examples from the humid tropics, arid and semi-arid subtropics and temperature zones: Western Highlands of Papua New Guinea, Mindoro Island in the Philippines, Great Smoky Mountains of the southeastern United States, East Tennessee Valley, interior of Western Australia, northeastern Uganda, and south-central Kansas. The results of the experiment were presented in the form of vegetation maps and annotated images which serve to illustrate the detectability of various formations. It was concluded that, for the test sites examined, the formations of the Unesco vegetation classification can be satisfactorily distinguished on LANDSAT MSS images, especially when used as color composites and judiciously chosen as to season.

EXTENT AND KINEMATICS OF ASWA SHEAR ZONE IN UGANDA AND SOUTH SUDAN USING AIRBORNE GEOPHYSICAL AND REMOTE SENSING DATA. A. Katumwehe. 1, E. A. Atekwana. 1, M.G. Abdelsalam.1 1Oklahoma State University, Boone Pickens School of Geology, Stillwater, USA

NASA Astrophysics Data System (ADS)

katumwehe, A. B.; Atekwana, E. A.; Abdel Salam, M. G.

2012-12-01

The Aswa Shear zone (ASZ) is a fundamental Precambrian lithospheric structure playing an important role in the evolution of the Mesozoic South Sudan rifts, the propagation of the Cenozoic East African Rift System (EARS), the eruption of EARS shield volcanoes (Mt Kilimanjaro and Mt Elgon), re-organization of drainage systems (the White Nile), and the distribution of recent seismicity in South Sudan. Traces of the shear zone have been mapped extending in central and east Africa in a NW-SE direction from South Sudan in the northwest through Uganda and Tanzania to the southeast and possibly into Madagascar. Gondwana reconstructions suggest that the ASZ continues further southeast into south India. Nonetheless, the kinematics and extent of the ASZ have not been fully understood because of limited exposure. In areas where it is exposed the shear zone is expressed by narrow dominantly NW-trending outcrops. We use recently acquired high resolution airborne magnetic and radiometric data over Uganda integrated with 90 m spatial resolution Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM) and 30 m spatial resolution Landsat Thematic Mapper (TM) spectral data to elucidate the kinematics and ascertain the significance of the ASZ in the development of the EARS and the tectonic architecture of east and central Africa. Vertical derivative, Euler deconvolution and analytical signal filters were applied to the total field magnetic data to image the shallow subsurface structures associated with the ASZ while upward continuation (5000 m) was applied to assess the ASZ depth continuity. We also used radiometric data to create ternary images while SRTM and Landsat TM data were used to map the surface expression of the shear zone. The geophysical data from Uganda suggest that the ASZ is characterised by a 50-60 km wide corridor of ductile deformation associated with NW-trending strike-slip shearing. It is dominated by three, equally-spaced and discrete sinistral strike-slip shear zones bounding wider belts dominated by splays of secondary shear zones and shear-related folds. These folds become tighter close to discrete shear zones and their axial traces become sub-parallel to the shear zones themselves. A similar pattern is observed on the surface in South Sudan in the SRTM DEM and the Landsat TM images. The evolution of these folds is explained in terms of secondary constructional strain developed in association and nearly perpendicular to the NW-trend of the sinistral strike-slip shearling. There is a remarkable resemblance between the magnetic fabric of the ASZ and that of the Najd fault system; a major sinistral strike-slip shear system in the Arabian-Nubian Shield suggesting that the shear zones may have evolved through similar Neopreterozoic Pan-African tectonic events, possibly associated with the collision between East and West Gondwana. The EARS bifurcates into the Eastern and Western branches -south of the ASZ while the Western branch terminates at the ASZ near the border between Uganda and South Sudan. This implies that the ASZ together with the Tanzanian craton played an important role in strain localization and prorogation during the evolution of the EARS.

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

PubMed

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

2015-10-01

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

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

Lethal Respiratory Disease Associated with Human Rhinovirus C in Wild Chimpanzees, Uganda, 2013.

PubMed

Scully, Erik J; Basnet, Sarmi; Wrangham, Richard W; Muller, Martin N; Otali, Emily; Hyeroba, David; Grindle, Kristine A; Pappas, Tressa E; Thompson, Melissa Emery; Machanda, Zarin; Watters, Kelly E; Palmenberg, Ann C; Gern, James E; Goldberg, Tony L

2018-02-01

We describe a lethal respiratory outbreak among wild chimpanzees in Uganda in 2013 for which molecular and epidemiologic analyses implicate human rhinovirus C as the cause. Postmortem samples from an infant chimpanzee yielded near-complete genome sequences throughout the respiratory tract; other pathogens were absent. Epidemiologic modeling estimated the basic reproductive number (R 0 ) for the epidemic as 1.83, consistent with the common cold in humans. Genotyping of 41 chimpanzees and examination of 24 published chimpanzee genomes from subspecies across Africa showed universal homozygosity for the cadherin-related family member 3 CDHR3-Y 529 allele, which increases risk for rhinovirus C infection and asthma in human children. These results indicate that chimpanzees exhibit a species-wide genetic susceptibility to rhinovirus C and that this virus, heretofore considered a uniquely human pathogen, can cross primate species barriers and threatens wild apes. We advocate engineering interventions and prevention strategies for rhinovirus infections for both humans and wild apes.

Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda.

PubMed

Bajunirwe, Francis; Bangsberg, David R; Sethi, Ajay K

2013-05-03

Antiretroviral treatment restores the physical and immunological function for patients with HIV/AIDS and the return of sexual desire. The frequency and correlates of sexual activity among patients receiving ART have not been widely studied. There is concern that widespread availability of ART may result in sexual disinhibition including practice of high-risk sexual behavior. We determined the correlates of sexual activity and high-risk sexual behavior in an ART-treated population in rural and urban Uganda. We conducted a cross-sectional study among 329 ART-treated adult patients at two hospitals, one located in rural and another in urban western Uganda. We collected data on sexual activity, frequency of condom use, pregnancy, viral load (VL) and CD4. Patients were considered sexually active if they had had sexual intercourse in the last 6 months. Any unprotected sex was considered high-risk sex. A two-stage logistic regression was performed to determine factors associated with sexual activity and high-risk sex among those sexually active. Overall, 222 (67%) patients were women, 138 (41.2%) had been on ART for at least one year, and 168 (51.4%) were sexually active of whom 127 (75.6%) used condoms at the last intercourse. Younger age (<=30 years) (Odds ratio; OR=2.3, 95% CI 1.2, 4.2), higher monthly income (OR=4.1, 95% CI 2.4, 7.4), and being married (OR=22.7, 95% CI 8.2, 62.9) were associated with being sexually active. Undetectable VL, CD4 count and treatment duration were not significantly associated with sexual activity. Among the sexually active, alcohol consumption (OR=3.3, 95% CI 1.2, 9.1) and unknown serostatus of partner (OR=5.8, 95% CI 1.5, 21.4) were significant predictors of high-risk sexual behavior. The frequency of unprotected sex at the last intercourse was 25.9% and 22.1% among the men and women respectively and was not significantly different (p value for chi square test =0.59). Younger persons receiving ART are more likely to be sexually active. ART clients are more likely to engage in unprotected sex when sero-status of partner is unknown or report use of alcohol. Counseling on alcohol use and disclosure of sero-status may be useful in reducing high risk sexual behavior.

Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study.

PubMed

Turiho, Andrew Kampikaho; Okello, Elialilia Sarikieli; Muhwezi, Wilson Winstons; Katahoire, Anne Ruhweza

2017-08-30

Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member's perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls' and parents' acceptance of HPV vaccination. Parents' increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. The perceived benefits and safety of HPV vaccination enhanced girls' and parents' acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.

"Helping my neighbour is like giving a loan…" -the role of social relations in chronic illness in rural Uganda.

PubMed

Amurwon, Jovita; Hajdu, Flora; Yiga, Dominic Bukenya; Seeley, Janet

2017-11-09

Understanding individuals' experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness. Rich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed. The data revealed that individuals and households depend heavily on their social relations in order to meet their needs during illness, including accessing the free healthcare and maintaining vital livelihood activities. The life stories illustrated ways in which households draw upon social relations to achieve the broader social protection necessary to prevent expenses becoming catastrophic, but also demonstrated the uncertainty in relying solely on informal relations. Improving access to healthcare in a rural context greatly depends on broader social protection. Thus, the informal social protection that already exists in the form of strong reciprocal social relations must be acknowledged, supported and included in health policy planning.

Gender and sexual vulnerability of young women in Africa: experiences of young girls in secondary schools in Uganda.

PubMed

Muhanguzi, Florence Kyoheirwe

2011-06-01

Sexuality is part and parcel of students' experiences of schooling manifested in personal friendships, relations and social interaction. These encounters constitute sites within which sexual identities are developed, practiced and actively produced through processes of negotiation. Drawing on qualitative research conducted in 14 selected secondary schools in Central and Western Uganda, the study illuminates gendered sexual vulnerability within patterns of social interaction and young girls gendered experiences and negotiation of their sexuality. The study reveals that through social and discursive practices, students construct complex gendered relations of domination and subordination that position boys and girls differently, often creating gender inequalities and sexual vulnerability for those gendered as girls. Girls' vulnerability is characterised by confusing and traumatic experiences fraught with double standards and silences. Typical of these experiences are complex tensions and contradictions surrounding constructions of sexuality that are predicated upon unequal power and gender relations characterised by homophobia, misogyny, control of female sexuality and sexual abuse and exploitation, all which work against girls' expression of sexuality. Gender sensitive sexuality education is identified as a valuable site of intervention to address such vulnerabilities and promote gender equality and equity in society.

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.

Comparison of HIV incidence estimated in clinical trial and observational cohort settings in a high risk fishing population in Uganda: Implications for sample size estimates.

PubMed

Abaasa, Andrew; Asiki, Gershim; Price, Matthew A; Ruzagira, Eugene; Kibengo, Freddie; Bahemuka, Ubaldo; Fast, Patricia E; Kamali, Anatoli

2016-04-04

Clinical trial participants may differ from the source population due to the demands of trial participation and self-selection, inadvertent selection of a lower-risk group, or both. We investigated the HIV risk status of volunteers in a Simulated Vaccine Efficacy Trial (SiVET) nested within a prospective observational cohort of fisher folks in South Western Uganda. Volunteers aged 18-49 years, at high risk for HIV from fishing communities in Masaka district were recruited into an observational cohort and followed quarterly. High risk was defined as a self-report, of at least one of the following in the past three months; sexually transmitted infections, unprotected sex with >1 partner or a new sexual partner, use of recreational drugs, weekly alcohol use, and/or frequent travel. Volunteers who had at least three months of follow-up in the observational cohort were consecutively enrolled in SiVET, administered Hepatitis B vaccine at months (0, 1, 6) and followed-up three days post vaccinations to mimic a vaccine trial schedule. HIV incidence over the next 12 months was compared between SiVET and the observational cohort studies. Between January 2012 and February 2013, 575 individuals were enrolled in the observational cohort, of whom 282 were enrolled in SiVET between July 2012 and February 2013. Despite similar pattern of reported risk behaviour in both studies, HIV incidence was higher in observational cohort, 11.4 cases/100 PYO [95% CI: 7.4-17.7] compared to 3.8 [95% CI: 2.0-7.0] in SiVET (p<0.01). SiVET volunteers tended to be men, having some education and longer-term residents, all factors that are also associated with lower HIV risk. We observed a lower HIV incidence in SiVET than in the observational cohort. The two populations differed significantly in demographics but not in reported risk. HIV incidence estimates from observational cohorts must be used with caution to estimate the trial study size. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Training Young Russian Physicians in Uganda: A Unique Program for Introducing Global Health Education in Russia.

PubMed

Ziganshin, Bulat A; Yausheva, Liliya M; Sadigh, Mitra; Ziganshina, Anna P; Pichugin, Arseniy A; Ziganshin, Ayrat U; Sadigh, Majid

2015-01-01

Global health is a new concept in Russia. There has been an ongoing academic collaboration between the Yale School of Medicine in the United States and Makerere University College of Health Sciences in Uganda since 2010, and the US Western Connecticut Health Network/University of Vermont College of Medicine since 2012, to introduce global health concepts to Kazan State Medical University (KSMU) in Russia. The purpose was to educate Russian physicians and medical trainees about the practice of clinical medicine and medical education, as well as the general practice of global health in culturally diverse, resource-limited settings. The aim of this study was to evaluate the initial outcomes of this multi-institutional partnership and to assess the impact of the global health elective on the participants and on KSMU. Participants were selected to attend a 6-week elective in global health at Mulago Hospital in Kampala, Uganda. The elective consisted of clinical experience, education about Uganda's common diseases, and region-specific sociocultural classes. It included a predeparture orientation and, upon return, completion of a standard questionnaire to assess the program's impact. Since 2010, there have been 20 KSMU members (4 medical students, 4 interns, 9 residents, 2 fellows, and 1 faculty member) who have participated in the program. As a result of the elective, the participants reported increased knowledge of tropical medicine (70%) and HIV/AIDS (75%), and 95% reported increased cultural sensitivity and desire to work with the underserved. The majority noted a very positive impact of their careers (90%) and personal life (80%). KSMU established the first successful collaborative program in global health education in Russia, leading to the integration of tropical medicine and global health courses in medical school curriculum. This elective has proven highly effective in introducing the concept of global health to faculty, fellows, residents, and medical students at KSMU. It trained these participants to address the challenges faced by physicians in culturally diverse and resource-limited countries. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Psychosocial Problems of War-Affected Youth in Northern Uganda: A Qualitative Study

PubMed Central

Speelman, Liesbeth; Onyango, Grace; Bolton, Paul

2008-01-01

Multiple studies have found that children from a variety of cultures who have been affected by war are at increased risk for a range of psychosocial problems. However, most studies are based on Western concepts and assume that these are locally applicable. Very few have investigated how psychosocial problems are perceived by the affected communities, families and the young people themselves. Understanding local perceptions is important to ensuring that local priorities are addressed, and addressed in ways that are likely to be acceptable and effective. In this study we used a previously developed rapid ethnographic assessment method to explore local perceptions of psychosocial problems among issues among children and adults from the Acholi ethnic group that have been displaced by the war in northern Uganda. We conducted 45 free list interviews (N= 30 10-17 year olds, N=15 adults) and 57 key informant interviews (N=32 10-17 year olds, N=25 adults) Our purpose was twofold: 1) To test whether this rapid ethnographic assessment approach previously used among adults would be suitable for use with children; and 2) To use this approach to understand the psychosocial problems affecting local children from their own viewpoint and that of their caretakers, in order to inform subsequent assessment and intervention efforts by organizations serving this population. The rapid assessment approach appears to have worked well for interviewing caretakers and children aged 10-17 years. Several locally defined syndromes were described: two tam/par/kumu (depression and dysthymia-like syndromes), ma lwor (an anxiety-like syndrome), and a category of conduct problems referred to as kwo maraco/gin lugero. The descriptions of these local syndromes are similar to Western mood, anxiety and conduct disorders, but contain some culture-specific elements. PMID:19541749

Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews

PubMed Central

Atwine, Fortunate; Hultsjö, Sally; Albin, Björn; Hjelm, Katarina

2015-01-01

Introduction Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Methods Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Results Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. Conclusion The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. PMID:26090034

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.

Prevention of mother-to-child transmission of HIV: Postpartum adherence to Option B+ until 18 months in Western Uganda.

PubMed

Decker, Sarah; Rempis, Eva; Schnack, Alexandra; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie

2017-01-01

Since 2012, the WHO recommends Option B+ for the prevention of mother-to-child transmission of HIV. This approach entails the initiation of lifelong antiretroviral therapy in all HIV-positive pregnant women, also implying protection during breastfeeding for 12 months or longer. Research on long-term adherence to Option B+ throughout breastfeeding is scarce to date. Therefore, we conducted a prospective observational cohort study in Fort Portal, Western Uganda, to assess adherence to Option B+ until 18 months postpartum. In 2013, we recruited 67 HIV-positive, Option B+ enrolled women six weeks after giving birth and scheduled them for follow-up study visits after six, twelve and 18 months. Two adherence measures, self-reported drug intake and amount of drug refill visits, were combined to define adherence, and were assessed together with feeding information at all study visits. At six months postpartum, 51% of the enrolled women were considered to be adherent. Until twelve and 18 months postpartum, adherence for the respective follow-up interval decreased to 19% and 20.5% respectively. No woman was completely adherent until 18 months. At the same time, 76.5% of the women breastfed for ≥12 months. Drug adherence was associated with younger age (p<0.01), lower travel costs (p = 0.02), and lower number of previous deliveries (p = 0.04). Long-term adherence to Option B+ seems to be challenging. Considering that in our cohort, prolonged breastfeeding until ≥12 months was widely applied while postpartum adherence until the end of breastfeeding was poor, a potential risk of postpartum vertical transmission needs to be taken seriously into account for Option B+ implementation.

Outcomes following surgical repair using layered closure of unrepaired 4th degree perineal tear in rural western Uganda.

PubMed

Goh, Judith T W; Tan, Stephanie B M; Natukunda, Harriet; Singasi, Isaac; Krause, Hannah G

2016-11-01

In many rural low-income countries, perineal tears at time of vaginal birth are not repaired at time of delivery. The aims of this study are to describe the surgical technique for management of the unrepaired 4th degree tear, performed without flaps, and short-term follow up on anal incontinence symptoms using a validated questionnaire. Women presenting to fistula camps in western Uganda with unrepaired 4th degree tears were interviewed using the Cleveland Clinic Continence Score. Interviews were undertaken pre-operatively, at 4-6 weeks post-operatively and 12 months following surgery. Repair of the 4th degree tear was performed in layers, with an overlapping anal sphincter repair and reconstruction of the perineal body, without flaps. All women were examined prior to discharge. 68 women completed pre-operative Cleveland Clinic Continence Scores. Prior to surgery, 59 % of women complained of daily incontinence to solid stools. Over 70 % of women complained of restriction to lifestyle due to the unrepaired 4th degree tear. About 50 % of the women are rejected by their husbands because of the condition. Only 1 woman had wound breakdown on Day 2. At 4 to 6 weeks follow-up, 61 women were contacted and all reported perfect continence. This study highlights the hidden problem of unrepaired 4th degree tears in rural areas of low-income countries where most deliveries are undertaken in the village without professional health care workers. These tears have significant impact on quality of life and anal incontinence. Short-term outcomes following surgical repair using a layered closure are promising.

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.

Prognosis and delay of diagnosis among Kaposi’s sarcoma patients in Uganda: a cross-sectional study

PubMed Central

2014-01-01

Background In low- and middle-income countries, the association between delay to treatment and prognosis for Kaposi’s sarcoma (KS) patients is yet to be studied. Methods This is a prospective study of HIV-infected adults with histologically-confirmed KS treated at the Uganda Cancer Institute (UCI). Standardized interviews were conducted in English or Luganda. Medical records were abstracted for KS stage at admission to UCI. Multivariable logistic regression assessed relationships between diagnostic delay and stage at diagnosis. Results Of 161 patients (90% response rate), 69% were men, and the mean age was 34.0 years (SD 7.7). 26% had been seen in an HIV clinic within 3 months, 72% were on antiretroviral therapy, and 26% had visited a traditional healer prior to diagnosis. 45% delayed seeking care at UCI for ≥3 months from symptom onset. Among those who delayed, 36% waited 6 months, and 25% waited 12 months. Common reasons for delay were lack of pain (48%), no money (32%), and distance to UCI (8%). In adjusted analysis patients who experienced diagnostic delay were more likely than those who did not delay to have poor-risk KS stage (OR 3.41, p = 0.002, 95% CI: 1.46-7.45). In adjusted analyses visiting a traditional healer was the only variable associated with greater likelihood of delay (OR 2.69, p = 0.020, 95% CI: 1.17-6.17). Conclusions Diagnostic delay was associated with poor-risk stage at diagnosis, and visiting a traditional healer was associated with higher odds of delay. The relationship between traditional and Western medicine presents a critical intervention point to improve KS-related outcomes in Uganda. PMID:24904686

To what extent does climate explain variations in reported malaria cases in early 20th century Uganda?

PubMed

Tompkins, Adrian M; Larsen, Laragh; McCreesh, Nicky; Taylor, David

2016-03-31

Malaria case statistics were analysed for the period 1926 to 1960 to identify inter-annual variations in malaria cases for the Uganda Protectorate. The analysis shows the mid-to-late 1930s to be a period of increased reported cases. After World War II, malaria cases trend down to a relative minimum in the early 1950s, before increasing rapidly after 1953 to the end of the decade. Data for the Western Province confirm these national trends, which at the time were attributed to a wide range of causes, including land development and management schemes, population mobility, interventions and misdiagnosis. Climate was occasionally proposed as a contributor to enhanced case numbers, and unusual precipitation patterns were held responsible; temperature was rarely, if ever, considered. In this study, a dynamical malaria model was driven with available precipitation and temperature data from the period for five stations located across a range of environments in Uganda. In line with the historical data, the simulations produced relatively enhanced transmission in the 1930s, although there is considerable variability between locations. In all locations, malaria transmission was low in the late 1940s and early 1950s, steeply increasing after 1954. Results indicate that past climate variability explains some of the variations in numbers of reported malaria cases. The impact of multiannual variability in temperature, while only on the order of 0.5°C, was sufficient to drive some of the trends observed in the statistics and thus the role of climate was likely underestimated in the contemporary reports. As the elimination campaigns of the 1960s followed this partly climate-driven increase in malaria, this emphasises the need to account for climate when planning and evaluating intervention strategies.

Food insecurity, social networks and symptoms of depression among men and women in rural Uganda: a cross-sectional, population-based study.

PubMed

Perkins, Jessica M; Nyakato, Viola N; Kakuhikire, Bernard; Tsai, Alexander C; Subramanian, S V; Bangsberg, David R; Christakis, Nicholas A

2018-04-01

To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics. A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators. In-home survey interviews in south-western Uganda. All adult residents across eight rural villages; 96 % response rate (n 1669). Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, P<0·001 for women; b=0·3, 95 % CI 0·2, 0·4, P<0·001 for men). There was no evidence of effect modification by social network factors for women. However, for men who are highly embedded within in their village social network, and (separately) for men who have few poor contacts in their personal network, the relationship between severe food insecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively. In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.

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

ERIC Educational Resources Information Center

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

2012-01-01

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

RTG resource book for western states and provinces: Final proceedings

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

NONE

The Western Interstate Energy Board held a workshop and liaison activities among western states, provinces, and utilities on the formation of Regional Transmission Groups (RTGs). Purpose of the activities was to examine the policy implications for western states and provinces in the formation of RTGs in the West, the implications for western ratepayers and utilities of the RTG formation and potential impacts of RTGs on the western electricity system. The workshop contributed to fulfilling the transmission access and competition objectives of Title VII of the Energy Policy Act of 1992.

The cost of post-abortion care in developing countries: a comparative analysis of four studies.

PubMed

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-10-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology-the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30-60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52-68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3-12% of the average cost of treating a PAC patient. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Study protocol: incentives for increased access to comprehensive family planning for urban youth using a benefits card in Uganda. A quasi-experimental study.

PubMed

Nuwasiima, Afra; Nuwamanya, Elly; Navvuga, Patricia; Babigumira, Janet U; Asiimwe, Francis T; Lubinga, Solomon J; Babigumira, Joseph B

2017-10-27

The use of contraception is one of the most cost-effective public health interventions and has the potential to prevent about 30% of maternal and 10% of child deaths in developing countries. Voucher-based initiatives for family planning are an effective and viable means of increasing contraceptive use. In this paper, we present a protocol for a pilot study of a novel incentive, a family planning benefits card (FPBC) program to increase uptake of family planning services among urban poor youth in Uganda while leveraging private sector funding. The study employs both impact and health economic evaluation methods to assess the effect of the FPBC program. We propose a quasi-experimental study design with two separate pre- and post-samples to measure program effectiveness. The main outcome of the impact evaluation is the percentage change in the prevalence of modern contraceptive use and unmet need for contraception. We will also conduct model-based incremental cost-effectiveness and budget impact analyses. The main outcomes of the economic evaluation are the cost per enrolled youth and cost per pregnancy averted, and cost per disability-adjusted life-year (DALY) averted. We will also pilot a corporate social responsibility model of sponsorship for the FPBC program in partnership with local corporations. Budget impact analysis will examine the potential affordability of scaling up the FPBC program and the fiscal implications of this scale up to the corporate social responsibility (CSR) budgets of partner corporations, the government, and the individual taxpayer. In this study, we propose an impact and economic evaluation to establish the proof concept of using a FPBC program to increase uptake of family planning services among urban poor youth in Uganda. The results of this study will present stakeholders in Uganda and internationally with a potentially viable option for corporate-sponsored access to family planning in urban poor communities. MUREC1/7 No. 10/05-17. Registered 19th July 2017.

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

PubMed

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

2012-07-01

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

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.

PubMed

Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M

2015-12-01

Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.

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

PubMed

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

2015-01-21

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

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

ERIC Educational Resources Information Center

World Bank, Washington, DC.

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

Phylogenetic Analysis of Rubella Viruses Identified in Uganda, 2003–2012

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-12-01

Molecular data on rubella viruses are limited in Uganda despite the importance of congenital rubella syndrome (CRS). Routine rubella vaccination, while not administered currently in Uganda, is expected to begin by 2015. The World Health Organization recommends that countries without rubella vaccination programs assess the burden of rubella and CRS before starting a routine vaccination program. Uganda is already involved in integrated case-based surveillance, including laboratory testing to confirm measles and rubella, but molecular epidemiologic aspects of rubella circulation have so far not been documented in Uganda. Twenty throat swab or oral fluid samples collected from 12 districts during routine rash and fever surveillance between 2003 and 2012 were identified as rubella virus RNA positive and PCR products encompassing the region used for genotyping were sequenced. Phylogenetic analysis of the 20 sequences identified 19 genotype 1G viruses and 1 genotype 1E virus. Genotype-specific trees showed that the Uganda viruses belonged to specific clusters for both genotypes 1G and 1E and grouped with similar sequences from neighboring countries. Genotype 1G was predominant in Uganda. More epidemiological and molecular epidemiological data are required to determine if genotype 1E is also endemic in Uganda. The information obtained in this study will assist the immunization program in monitoring changes in circulating genotypes. © 2014 Wiley Periodicals, Inc.

Marital instability in a rural population in south-west Uganda: implications for the spread of HIV-1 infection.

PubMed

Nabaitu, J; Bachengana, C; Seeley, J

1994-01-01

"The aim of this study was to examine people's beliefs about the causes of marital instability in a rural population cohort in south-west Uganda. Results from a baseline survey of HIV-1 infection in the cohort of over 4,000 adults (over 12 years old) showed a twofold increase in risk of infection in divorced or separated persons when compared with those who are married. A purposive sample of 134 respondents (seventy-two males, sixty-two females) selected to represent different ages, religions and marital status were asked in semi-structured interviews to comment on the reasons for continuing marital instability in their community. The most common reasons suggested for marital instability were sexual dissatisfaction, infertility, alcoholism and mobility....HIV infection was not mentioned as a direct cause of separation, but a small independent study revealed that seven out of ten couples separated on learning of a positive HIV test result of one or both partners. Marital instability is not uncommon in this population; there is evidence that HIV infection is making the situation worse." (SUMMARY IN FRE) excerpt

Variations in Reading Achievement Across 14 Southern African School Systems: Which Factors Matter?

NASA Astrophysics Data System (ADS)

Hungi, Njora; Thuku, Florence W.

2010-02-01

In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zanzibar). The data for this study were collected in 2002 as part of a major project known as the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) that sought to examine the quality of education offered in primary schools in these countries. The most important factors affecting variation in pupil achievement across most of these school systems were grade repetition, pupil socioeconomic background, speaking the language of instruction at home, and Pupil age. South Africa, Uganda and Namibia were among the school systems with the largest between-school variation while Seychelles and Mauritius had the largest within-school variation. Low social equity in reading achievement was evident in Mauritius, Seychelles and Tanzania. Policy implications of the findings are discussed.

Kanyawara Virus: A Novel Rhabdovirus Infecting Newly Discovered Nycteribiid Bat Flies Infesting Previously Unknown Pteropodid Bats in Uganda.

PubMed

Goldberg, Tony L; Bennett, Andrew J; Kityo, Robert; Kuhn, Jens H; Chapman, Colin A

2017-07-13

Bats are natural reservoir hosts of highly virulent pathogens such as Marburg virus, Nipah virus, and SARS coronavirus. However, little is known about the role of bat ectoparasites in transmitting and maintaining such viruses. The intricate relationship between bats and their ectoparasites suggests that ectoparasites might serve as viral vectors, but evidence to date is scant. Bat flies, in particular, are highly specialized obligate hematophagous ectoparasites that incidentally bite humans. Using next-generation sequencing, we discovered a novel ledantevirus (mononegaviral family Rhabdoviridae, genus Ledantevirus) in nycteribiid bat flies infesting pteropodid bats in western Uganda. Mitochondrial DNA analyses revealed that both the bat flies and their bat hosts belong to putative new species. The coding-complete genome of the new virus, named Kanyawara virus (KYAV), is only distantly related to that of its closest known relative, Mount Elgon bat virus, and was found at high titers in bat flies but not in blood or on mucosal surfaces of host bats. Viral genome analysis indicates unusually low CpG dinucleotide depletion in KYAV compared to other ledanteviruses and rhabdovirus groups, with KYAV displaying values similar to rhabdoviruses of arthropods. Our findings highlight the possibility of a yet-to-be-discovered diversity of potentially pathogenic viruses in bat ectoparasites.

Examination of facilitators and barriers to home-based supplemental feeding with ready-to-use food for underweight children in western Uganda

PubMed Central

Jilcott, Stephanie B.; Myhre, Jennifer A.; Adair, Linda S.; Thirumurthy, Harsha; Bentley, Margaret E.; Ammerman, Alice S.

2013-01-01

Poor complementary feeding practices and low quality complementary foods are significant causes of growth faltering and child mortality throughout the developing world. Ready-to-use foods (RUF) are energy dense, lipid-based products that do not require cooking or refrigeration, that have been used to prevent and treat malnutrition among vulnerable children. The effectiveness of these products in improving child nutritional status depends on household use by caregivers. To identify the key facilitators and barriers that influence appropriate in-home RUF consumption by supplemental feeding program beneficiaries, we conducted individual interviews among caregivers (n=80), RUF producers (n=8) and program staff (n=10) involved in the Byokulia Bisemeye mu Bantu (BBB) supplemental feeding program in Bundibugyo, Uganda. By documenting caregiver perceptions and feeding practices related to RUF, we developed a conceptual framework of factors that affect appropriate feeding with RUF. Findings suggest that locally produced RUF is well received by caregivers and children, and is perceived by caregivers and the community to be a healthy supplemental food for malnourished children. However, child feeding practices, including sharing of RUF within households, compromise the nutrient delivery to the intended child. Interventions and educational messages informed by this study can help to improve RUF delivery to targeted beneficiaries. PMID:22136223

Lessons about parks and poverty from a decade of forest loss and economic growth around Kibale National Park, Uganda.

PubMed

Naughton-Treves, Lisa; Alix-Garcia, Jennifer; Chapman, Colin A

2011-08-23

We use field data linked to satellite image analysis to examine the relationship between biodiversity loss, deforestation, and poverty around Kibale National Park (KNP) in western Uganda, 1996-2006. Over this decade, KNP generally maintained forest cover, tree species, and primate populations, whereas neighboring communal forest patches were reduced by half and showed substantial declines in tree species and primate populations. However, a bad decade for forest outside the park proved a prosperous one for most local residents. Panel data for 252 households show substantial improvement in welfare indicators (e.g., safer water, more durable roof material), with the greatest increases found among those with highest initial assets. A combination of regression analysis and matching estimators shows that although the poor tend to be located on the park perimeter, proximity to the park has no measureable effect on growth of productive assets. The risk for land loss among the poor was inversely correlated with proximity to the park, initial farm size, and decline in adjacent communal forests. We conclude the current disproportionate presence of poor households at the edge of the park does not signal that the park is a poverty trap. Rather, Kibale appears to provide protection against desperation sales and farm loss among those most vulnerable.

Lessons about parks and poverty from a decade of forest loss and economic growth around Kibale National Park, Uganda

PubMed Central

Naughton-Treves, Lisa; Alix-Garcia, Jennifer; Chapman, Colin A.

2011-01-01

We use field data linked to satellite image analysis to examine the relationship between biodiversity loss, deforestation, and poverty around Kibale National Park (KNP) in western Uganda, 1996–2006. Over this decade, KNP generally maintained forest cover, tree species, and primate populations, whereas neighboring communal forest patches were reduced by half and showed substantial declines in tree species and primate populations. However, a bad decade for forest outside the park proved a prosperous one for most local residents. Panel data for 252 households show substantial improvement in welfare indicators (e.g., safer water, more durable roof material), with the greatest increases found among those with highest initial assets. A combination of regression analysis and matching estimators shows that although the poor tend to be located on the park perimeter, proximity to the park has no measureable effect on growth of productive assets. The risk for land loss among the poor was inversely correlated with proximity to the park, initial farm size, and decline in adjacent communal forests. We conclude the current disproportionate presence of poor households at the edge of the park does not signal that the park is a poverty trap. Rather, Kibale appears to provide protection against desperation sales and farm loss among those most vulnerable. PMID:21873178

Living Under the Constant Threat of Ebola: A Phenomenological Study of Survivors and Family Caregivers During an Ebola Outbreak.

PubMed

Matua, Gerald Amandu; Wal, Dirk Mostert Van der

2015-09-01

Ebola is a highly infectious disease that is caused by viruses of the family Filoviridae and transmitted to humans by direct contact with animals infected from unknown natural reservoirs. Ebola virus infection induces acute fever and death within a few days in up to 90% of symptomatic individuals, causing widespread fear, panic, and antisocial behavior. Uganda is vulnerable to future Ebola outbreaks. Therefore, the survivors of Ebola and their family caregivers are likely to continue experiencing related antisocial overtones, leading to negative health outcomes. This study articulated the lived experiences of survivors and their family caregivers after an Ebola outbreak in Kibale District, Western Uganda. Eliciting a deeper understanding of these devastating lifetime experiences provides opportunities for developing and implementing more compassionate and competent nursing care for affected persons. Ebola survivors and their family caregivers were recruited using a purposive sampling method. Twelve (12) adult survivors and their family caregivers were recruited and were interviewed individually between May and July 2013 in Kibale, a rural district in Western Uganda close to the border of the Democratic Republic of the Congo, where Ebola virus was first discovered in 1976. Oral and written informed consent was obtained before all in-depth interviews, and the researchers adhered to principles of anonymity and confidentiality. The interviews were recorded digitally, and data analysis employed Wertz's Empirical Psychological Reflection method, which is grounded in descriptive phenomenology. Living under the constant threat of Ebola is experienced through two main categories: (a) defining features of the experience and (b) responding to the traumatizing experience. Five themes emerged in the first category: (a) fear, ostracism, and stigmatization; (b) annihilation of sufferer's actualities and possibilities; (c) the lingering nature of the traumatic experience; (d) psychosomatic manifestations; and (e) the inescapable nature of the experience. The second category was composed of two themes: (a) seeking self-preservation and protection and (b) transcending victimhood and becoming empowered. Living under the constant threat of Ebola is experienced as distressing in the physical, social, and psychological realms. In the future, prompt treatment and nursing care are recommended to minimize deaths and to reduce the widespread terror, anxiety, ostracism, and stigmatization that affected individuals and families face. Furthermore, it is recommended that the resilience of survivors and caregivers be increased to facilitate their better coping with the rampant antisocial overtones that they are likely to experience because of their association with Ebola.

Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda

PubMed Central

2013-01-01

Background Antiretroviral treatment restores the physical and immunological function for patients with HIV/AIDS and the return of sexual desire. The frequency and correlates of sexual activity among patients receiving ART have not been widely studied. There is concern that widespread availability of ART may result in sexual disinhibition including practice of high-risk sexual behavior. We determined the correlates of sexual activity and high-risk sexual behavior in an ART-treated population in rural and urban Uganda. Methods We conducted a cross-sectional study among 329 ART-treated adult patients at two hospitals, one located in rural and another in urban western Uganda. We collected data on sexual activity, frequency of condom use, pregnancy, viral load (VL) and CD4. Patients were considered sexually active if they had had sexual intercourse in the last 6 months. Any unprotected sex was considered high-risk sex. A two-stage logistic regression was performed to determine factors associated with sexual activity and high-risk sex among those sexually active. Results Overall, 222 (67%) patients were women, 138 (41.2%) had been on ART for at least one year, and 168 (51.4%) were sexually active of whom 127 (75.6%) used condoms at the last intercourse. Younger age (<=30 years) (Odds ratio; OR=2.3, 95% CI 1.2, 4.2), higher monthly income (OR=4.1, 95% CI 2.4, 7.4), and being married (OR=22.7, 95% CI 8.2, 62.9) were associated with being sexually active. Undetectable VL, CD4 count and treatment duration were not significantly associated with sexual activity. Among the sexually active, alcohol consumption (OR=3.3, 95% CI 1.2, 9.1) and unknown serostatus of partner (OR=5.8, 95% CI 1.5, 21.4) were significant predictors of high-risk sexual behavior. The frequency of unprotected sex at the last intercourse was 25.9% and 22.1% among the men and women respectively and was not significantly different (p value for chi square test =0.59). Conclusion Younger persons receiving ART are more likely to be sexually active. ART clients are more likely to engage in unprotected sex when sero-status of partner is unknown or report use of alcohol. Counseling on alcohol use and disclosure of sero-status may be useful in reducing high risk sexual behavior. PMID:23641795

Contribution à la systématique des laves alcalines, les laves du rift de l'Afrique Centrale (Zaïre-Uganda)

NASA Astrophysics Data System (ADS)

Pouclet, A.

1980-09-01

The lavas of the Central Africa rift (Western rift) are distributed in three groups with increasing alkalinity. The petrographical and chemical data give a classification of seven series: one series of alkaline-basalts in the first weakly alkaline group, two basanitic, sodic or potassic, series in the second fairly alkaline group, and four nephelinitic, melilitic, perpotassic or carbonatitic series in the third strongly alkaline group. The definitions of all these lavas are reviewed. We propose a simplified terminology with, in particular, a K-lavas’ nomenclature parallel to the Na-lavas’ one and a division using the DI of Thornton and Tuttle (1960).

Connections Between Soil Fertility Declines, Land Use, Ethnicity, Education, and Wealth In Uganda

NASA Astrophysics Data System (ADS)

Tiemann, L. K.; Hartter, J.; Grandy, S.

2016-12-01

Food security issues are particularly acute in Uganda, where the world's 8th highest population growth rate will lead to cultivation of all land available for agriculture by 2022. Agricultural intensification in Uganda, which includes continuous cropping, mono-cropping and expansion of agriculture into marginal areas, has put unprecedented pressure on soils. In western Uganda, we surveyed 474 households, collecting demographic data, information on land use practices and perceptions of risk to crop yields and food security. We also sampled soils from maize fields associated with each surveyed household and measured total organic C and nutrients such as nitrogen (N) and phosphorus (P). Using these data, we sought to determine how risk perceptions, ethnicity, household wealth and education combine to determine land use decisions and ultimately, declines in soil organic matter and soil nutrients. We conducted our study within 5 km of an un-cultivated native tropical forest reserve, Kibale National Park (KNP), which serves as a reference point for potential soil fertility. Of 470 respondents, only 29 answered `no' when asked if they noticed year to year declines in crop yields. Across all maize fields we found soil C has been reduced by 30% and soil N by 45% relative to KNP soils and declines were more pronounced when survey respondents were Bakiga rather than Batooro. Households that indicated they were "very much" dependent upon profits from maize had a 31% increase in soil C:N while those indicating no dependence on maize profits had a significantly lower increase in soil C:N of 21%. Ethnicity and education influenced land use decisions; the Batooro and people with a lower level of education were more likely to burn their fields or crop residues. Additionally, the Bakiga were more likely to use rock P in their fields and in consequence had 108% while Batooro soils had 65% of the P found in KNP soils. Across all respondents, the top two ranked risks to crop yields and food security were weather related, with soil fertility ranked third on average, regardless of ethnicity, education or wealth. While crop yields are being noticeably affected by declining soil organic matter and soil nutrients, in particular soil N, people in this region continue to be worried more about changing weather patterns than soil fertility.

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

PubMed Central

2017-01-01

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

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

NASA Astrophysics Data System (ADS)

Namulema, Mary Jude

2016-04-01

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

Eastern Thought and Movement Forms: Possible Implications for Western Sport.

ERIC Educational Resources Information Center

Case, Bob

1984-01-01

Eastern thought and movement forms can serve as a model for Western sports. Possible implications for physical education that stem from Eastern philosophic beliefs include practical and utilitarian concerns, hidden dimensions, metaphysical concerns, competition concerns, and pedagogical concerns. (DF)

Is health care financing in Uganda equitable?

PubMed

Zikusooka, C M; Kyomuhang, R; Orem, J N; Tumwine, M

2009-10-01

Health care financing provides the resources and economic incentives for operating health systems and is a key determinant of health system performance. Equitable financing is based on: financial protection, progressive financing and cross-subsidies. This paper describes Uganda's health care financing landscape and documents the key equity issues associated with the current financing mechanisms. We extensively reviewed government documents and relevant literature and conducted key informant interviews, with the aim of assessing whether Uganda's health care financing mechanisms exhibited the key principles of fair financing. Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of funding for Uganda's health sector. There is limited cross-subsidisation and high fragmentation within and between health financing mechanisms, mainly due to high reliance on out-of-pocket payments and limited prepayment mechanisms. Without compulsory health insurance and low coverage of private health insurance, Uganda has limited pooling of resources, and hence minimal cross-subsidisation. Although tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection and limited cross-subsidisation. Overall, Uganda's current health financing is inequitable and fragmented. The government should take explicit action to promote equitable health care financing by establishing pre-payment schemes, enhancing cross-subsidisation mechanisms and through appropriate integration of financing mechanisms.

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

PubMed

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

2015-10-01

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

Two Asian psychologies and their implications for Western psychotherapists.

PubMed

Walsh, R

1988-10-01

In the past, mainstream Western mental health professionals tended to ignore or dismiss Asian psychologies. However, in recent years they have attracted increasing attention and growing evidence suggests that we may have underestimated their potential contributions. This paper provides an introduction to two classical Asian psychologies and certain of their key concepts about human nature, pathology, and potential and psychotherapeutic techniques. Relevant Western research and theory are reviewed, and the implications of these Asian psychologies for, and areas of possible interface with, Western psychology, psychotherapy, and science are examined.

Gender and Age-Appropriate Enrolment in Uganda

ERIC Educational Resources Information Center

Wells, Ryan

2009-01-01

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

Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety.

PubMed

Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

2016-04-14

Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. A total of 241 private health facilities were surveyed; 70.5 % were registered drug shops, 24.5 % private clinics and 5.0 % pharmacies. Treatment of fever among pregnant women in accordance with the national treatment guidelines was poor: 40.7 % in private clinics, decreasing to 28.2 % in drug shops and 16.7 % at pharmacies. Anti-malarial monotherapies sulphadoxine-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were the factors that most influenced correct treatment of fever in pregnancy. Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector in Uganda.

Unrecognized circulation of SAT 1 foot-and-mouth disease virus in cattle herds around Queen Elizabeth National Park in Uganda.

PubMed

Dhikusooka, Moses Tefula; Ayebazibwe, Chrisostom; Namatovu, Alice; Belsham, Graham J; Siegismund, Hans Redlef; Wekesa, Sabenzia Nabalayo; Balinda, Sheila Nina; Muwanika, Vincent B; Tjørnehøj, Kirsten

2016-01-06

Foot-and-mouth disease (FMD) is endemic in Uganda in spite of the control measures used. Various aspects of the maintenance and circulation of FMD viruses (FMDV) in Uganda are not well understood; these include the role of the African buffalo (Syncerus caffer) as a reservoir for FMDV. To better understand the epidemiology of FMD at the livestock-wildlife-interface, samples were collected from young, unvaccinated cattle from 24 pastoral herds that closely interact with wildlife around Queen Elizabeth National Park in Uganda, and analysed for evidence of FMDV infection. In total, 37 (15%) of 247 serum samples had detectable antibodies against FMDV non-structural proteins (NSPs) using a pan-serotypic assay. Within these 37 sera, antibody titres ≥ 80 against the structural proteins of serotypes O, SAT 1, SAT 2 and SAT 3 were detected by ELISA in 5, 7, 4 and 3 samples, respectively, while neutralizing antibodies were only detected against serotype O in 3 samples. Two FMDV isolates, with identical VP1 coding sequences, were obtained from probang samples from clinically healthy calves from the same herd and are serotype SAT 1 (topotype IV (EA-I)). Based on the VP1 coding sequences, these viruses are distinct from previous cattle and buffalo SAT 1 FMDV isolates obtained from the same area (19-30% nucleotide difference) and from the vaccine strain (TAN/155/71) used within Uganda (26% nucleotide difference). Eight herds had only one or a few animals with antibodies against FMDV NSPs while six herds had more substantial evidence of prior infection with FMDV. There was no evidence for exposure to FMDV in the other ten herds. The two identical SAT 1 FMDV VP1 sequences are distinct from former buffalo and cattle isolates from the same area, thus, transmission between buffalo and cattle was not demonstrated. These new SAT 1 FMDV isolates differed significantly from the vaccine strain used to control Ugandan FMD outbreaks, indicating a need for vaccine matching studies. Only six herds had clear serological evidence for exposure to O and SAT 1 FMDV. Scattered presence of antibodies against FMDV in other herds may be due to the occasional introduction of animals to the area or maternal antibodies from past infection and/or vaccination. The evidence for asymptomatic FMDV infection has implications for disease control strategies in the area since this obstructs early disease detection that is based on clinical signs in FMDV infected animals.

Understanding and valuing the broader health system benefits of Uganda's national Human Resources for Health Information System investment.

PubMed

Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail

2015-08-31

To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in needed skills and deploy trained personnel to facilities where there is real demand. This cascade of benefits can extend the impact and rewards of working in the health sector, which elevates the health system as a whole.

Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2016-10-18

Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions between internal (program champion, staffing strength, M &E systems, goal clarity) and external drivers (donors, ARVs supply chain, patient demand). ART program sustainability contexts were distinguished by the size of health facility and ownership-type. The study's implications for health systems strengthening in resource-limited countries are discussed.

Phylogeny of Yellow Fever Virus, Uganda, 2016.

PubMed

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

2018-08-17

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

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

PubMed

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

2017-06-01

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

Dilemmas in Implementing Language Rights in Multilingual Uganda

ERIC Educational Resources Information Center

Namyalo, Saudah; Nakayiza, Judith

2015-01-01

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

Health Facility Utilisation Changes during the Introduction of Community Case Management of Malaria in South Western Uganda: An Interrupted Time Series Approach.

PubMed

Lal, Sham; Ndyomugenyi, Richard; Alexander, Neal D; Lagarde, Mylene; Paintain, Lucy; Magnussen, Pascal; Chandramohan, Daniel; Clarke, Siân E

2015-01-01

Malaria endemic countries have scaled-up community health worker (CHW) interventions, to diagnose and treat malaria in communities with limited access to public health systems. The evaluations of these programmes have centred on CHW's compliance to guidelines, but the broader changes at public health centres including utilisation and diagnoses made, has received limited attention. This analysis was conducted during a CHW-intervention for malaria in Rukungiri District, Western Uganda. Outpatient department (OPD) visit data were collected for children under-5 attending three health centres one year before the CHW-intervention started (pre-intervention period) and for 20 months during the intervention (intervention-period). An interrupted time series analysis with segmented regression models was used to compare the trends in malaria, non-malaria and overall OPD visits during the pre-intervention and intervention-period. The introduction of a CHW-intervention suggested the frequency of diagnoses of diarrhoeal diseases, pneumonia and helminths increased, whilst the frequency of malaria diagnoses declined at health centres. In May 2010 when the intervention began, overall health centre utilisation decreased by 63% compared to the pre-intervention period and the health centres saw 32 fewer overall visits per month compared to the pre-intervention period (p<0.001). Malaria visits also declined shortly after the intervention began and there were 27 fewer visits per month during the intervention-period compared with the pre-intervention period (p<0.05). The declines in overall and malaria visits were sustained for the entire intervention-period. In contrast, there were no observable changes in trends of non-malarial visits between the pre-intervention and intervention-period. This analysis suggests introducing a CHW-intervention can reduce the number of child malaria visits and change the profile of cases presenting at health centres. The reduction in workload of health workers may allow them to spend more time with patients or undertake additional curative or preventative roles.

Risk Factors for Podoconiosis: Kamwenge District, Western Uganda, September 2015.

PubMed

Kihembo, Christine; Masiira, Ben; Lali, William Z; Matwale, Gabriel K; Matovu, Joseph K B; Kaharuza, Frank; Ario, Alex R; Nabukenya, Immaculate; Makumbi, Issa; Musenero, Monica; Zhu, Bao-Ping; Nanyunja, Miriam

2017-06-01

AbstractPodoconiosis, a noninfectious elephantiasis, is a disabling neglected tropical disease. In August 2015, an elephantiasis case-cluster was reported in Kamwenge District, western Uganda. We investigated to identify the disease's nature and risk factors. We defined a suspected podoconiosis case as onset in a Kamwenge resident of bilateral asymmetrical lower limb swelling lasting ≥ 1 month, plus ≥ 1 of the following associated symptoms: skin itching, burning sensation, plantar edema, lymph ooze, prominent skin markings, rigid toes, or mossy papillomata. A probable case was a suspected case with negative microfilaria antigen immunochromatographic card test (ruling out filarial elephantiasis). We conducted active case-finding. In a case-control investigation, we tested the hypothesis that the disease was caused by prolonged foot skin exposure to irritant soils, using 40 probable case-persons and 80 asymptomatic village control-persons, individually matched by age and sex. We collected soil samples to characterize irritants. We identified 52 suspected (including 40 probable) cases with onset from 1980 to 2015. Prevalence rates increased with age; annual incidence (by reported onset of disease) was stable over time at 2.9/100,000. We found that 93% (37/40) of cases and 68% (54/80) of controls never wore shoes at work (Mantel-Haenszel odds ratio [OR MH ] = 7.7; 95% [confidence interval] CI = 2.0-30); 80% (32/40) of cases and 49% (39/80) of controls never wore shoes at home (OR MH = 5.2; 95% CI = 1.8-15); and 70% (27/39) of cases and 44% (35/79) of controls washed feet at day end (versus immediately after work) (OR = 11; 95% CI = 2.1-56). Soil samples were characterized as rich black-red volcanic clays. In conclusion, this reported elephantiasis is podoconiosis associated with prolonged foot exposure to volcanic soil. We recommended foot hygiene and universal use of protective shoes.

Contrasting long-term records of biomass burning in wet and dry savannas of equatorial East Africa.

PubMed

Colombaroli, Daniele; Ssemmanda, Immaculate; Gelorini, Vanessa; Verschuren, Dirk

2014-09-01

Rainfall controls fire in tropical savanna ecosystems through impacting both the amount and flammability of plant biomass, and consequently, predicted changes in tropical precipitation over the next century are likely to have contrasting effects on the fire regimes of wet and dry savannas. We reconstructed the long-term dynamics of biomass burning in equatorial East Africa, using fossil charcoal particles from two well-dated lake-sediment records in western Uganda and central Kenya. We compared these high-resolution (5 years/sample) time series of biomass burning, spanning the last 3800 and 1200 years, with independent data on past hydroclimatic variability and vegetation dynamics. In western Uganda, a rapid (<100 years) and permanent increase in burning occurred around 2170 years ago, when climatic drying replaced semideciduous forest by wooded grassland. At the century time scale, biomass burning was inversely related to moisture balance for much of the next two millennia until ca. 1750 ad, when burning increased strongly despite regional climate becoming wetter. A sustained decrease in burning since the mid20th century reflects the intensified modern-day landscape conversion into cropland and plantations. In contrast, in semiarid central Kenya, biomass burning peaked at intermediate moisture-balance levels, whereas it was lower both during the wettest and driest multidecadal periods of the last 1200 years. Here, burning steadily increased since the mid20th century, presumably due to more frequent deliberate ignitions for bush clearing and cattle ranching. Both the observed historical trends and regional contrasts in biomass burning are consistent with spatial variability in fire regimes across the African savanna biome today. They demonstrate the strong dependence of East African fire regimes on both climatic moisture balance and vegetation, and the extent to which this dependence is now being overridden by anthropogenic activity. © 2014 John Wiley & Sons Ltd.

Population exposure to trace elements in the Kilembe copper mine area, Western Uganda: A pilot study.

PubMed

Mwesigye, Abraham R; Young, Scott D; Bailey, Elizabeth H; Tumwebaze, Susan B

2016-12-15

The mining and processing of copper in Kilembe, Western Uganda, from 1956 to 1982 left over 15 Mt. of tailings containing cupriferous and cobaltiferous pyrite dumped within a mountain river valley. This pilot study was conducted to assess the nature and extent of risk to local populations from metal contamination arising from those mining activities. We determined trace element concentrations in mine tailings, soils, locally cultivated foods, house dust, drinking water and human biomarkers (toenails) using ICP-MS analysis of acid digested samples. The results showed that tailings, containing higher concentrations of Co, Cu, Ni and As compared with world average crust values had eroded and contaminated local soils. Pollution load indices revealed that 51% of agricultural soils sampled were contaminated with trace elements. Local water supplies were contaminated, with Co concentrations that exceeded Wisconsin (US) thresholds in 25% of domestic water supplies and 40% of Nyamwamba river water samples. Zinc exceeded WHO/FAO thresholds of 99.4mgkg -1 in 36% of Amaranthus vegetable samples, Cu exceeded EC thresholds of 20mgkg -1 in 19% of Amaranthus while Pb exceeded WHO thresholds of 0.3mgkg -1 in 47% of Amaranthus vegetables. In bananas, 20% of samples contained Pb concentrations that exceeded the WHO/FAO recommended threshold of 0.3mgkg -1 . However, risk assessment of local foods and water, based on hazard quotients (HQ values) revealed no potential health effects. The high external contamination of volunteers' toenails with some elements (even after a washing process) calls into question their use as a biomarker for metal exposure in human populations where feet are frequently exposed to soil dust. Any mitigation of Kilembe mine impacts should be aimed at remediation of agricultural soils, regulating the discharge of underground contaminated water but also containment of tailing erosion. Copyright © 2016 Elsevier B.V. All rights reserved.

Voluntary HIV counselling and testing among men in rural western Uganda: Implications for HIV prevention

PubMed Central

Bwambale, Francis M; Ssali, Sarah N; Byaruhanga, Simon; Kalyango, Joan N; Karamagi, Charles AS

2008-01-01

Background Voluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Uganda. However, the utilization of VCT services particularly among men is low in Kasese district. We therefore conducted a study to determine the prevalence and factors associated with VCT use among men in Bukonzo West health sub-district, Kasese district. Methods A population-based cross-sectional study employing both quantitative and qualitative techniques of data collection was conducted between January and April 2005. Using cluster sampling, 780 men aged 18 years and above, residing in Bukonzo West health sub-district, were sampled from 38 randomly selected clusters. Data was collected on VCT use and independent variables. Focus group discussions (4) and key informant interviews (10) were also conducted. Binary logistic regression was performed to determine the predictors of VCT use among men. Results Overall VCT use among men was 23.3% (95% CI 17.2–29.4). Forty six percent (95% CI 40.8–51.2) had pre-test counselling and 25.9% (95%CI 19.9–31.9) had HIV testing. Of those who tested, 96% returned for post-test counselling and received HIV results. VCT use was higher among men aged 35 years and below (OR = 2.69, 95%CI 1.77–4.07), the non-subsistence farmers (OR = 2.37, 95%CI 2.37), the couple testing (OR = 2.37, 95%CI 1.02–8.83) and men with intention to disclose HIV test results to sexual partners (OR = 1.64, 95%CI 1.04–2.60). The major barriers to VCT use among men were poor utilization of VCT services due to poor access, stigma and confidentiality of services. Conclusion VCT use among men in Bukonzo West, Kasese district was low. In order to increase VCT use among men, the VCT programme needs to address HIV stigma and improve access and confidentiality of VCT services. Among the more promising interventions are the use of routine counselling and testing for HIV of patients seeking health care in health units, home based VCT programmes, and mainstreaming of HIV counselling and testing services in community development programmes. PMID:18664301

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

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.

Access to Education for Orphans and Vulnerable Children in Uganda: A Multi-District, Cross-Sectional Study Using Lot Quality Assurance Sampling from 2011 to 2013.

PubMed

Olanrewaju, Ayobami D; Jeffery, Caroline; Crossland, Nadine; Valadez, Joseph J

2015-01-01

This study estimates the proportion of Orphans and Vulnerable Children (OVC) attending school in 89 districts of Uganda from 2011 - 2013 and investigates the factors influencing OVC access to education among this population. This study used secondary survey data from OVCs aged 5 - 17 years, collected using Lot Quality Assurance Sampling in 87 Ugandan districts over a 3-year period (2011 - 2013). Estimates of OVC school attendance were determined for the yearly time periods. Logistic regression was used to investigate the factors influencing OVC access to education. 19,354 children aged 5-17 were included in the analysis. We estimated that 79.1% (95% CI: 78.5% - 79.7%) of OVCs attended school during the 3-year period. Logistic regression revealed the odds of attending school were lower among OVCs from Western (OR 0.88; 95% CI: 0.79 - 0.99) and Northern (OR 0.64; 95% CI: 0.56 - 0.73) regions compared to the Central region. Female OVCs had a significantly higher odds of attending school (OR 1.09; 95% CI: 1.02 - 1.17) compared to their male counterparts. When adjusting for all variables simultaneously, we found the odds of school attendance reduced by 12% between 2011 and 2012 among all OVCs (OR 0.88; 95% CI: 0.81 - 0.97). Our findings reinforce the need to provide continuing support to OVC in Uganda, ensuring they have the opportunity to attain an education. The data indicate important regional and gender variation that needs to be considered for support strategies and in social policy. The results suggest the need for greater local empowerment to address the needs of OVCs. We recommend further research to understand why OVC access to education and attendance varies between regions and improvement of district level mapping of OVC access to education, and further study to understand the particular factors impacting the lower school attendance of male OVCs.

Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal.

PubMed

Dahl, V; Mellhammar, L; Bajunirwe, F; Björkman, P

2008-07-01

A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (<20 years: OR = 1.0; 20-24 years: OR = 1.81; 95%CI: 0.58-5.67; 25-29 years: OR = 2.15; 95%CI: 0.66-6.97; 30-34 years: OR = 3.88; 95%CI: 1.21-13.41), mistrust in reliability of the HIV test (OR = 20.60; 95%CI: 3.24-131.0) and not having been tested for HIV previously (OR = 2.15; 95%CI: 1.02-4.54) were associated with test refusal. Testing sites operating for longer durations had higher rates of acceptance. The most common reasons claimed for test refusal were: lack of access to antiretroviral therapy (ART) for HIV-infected women (88%; n=57), a need to discuss with partner before decision (82%; n=57) and fear of partner's reaction (54%; n=57). Comparison with previous periods showed that the acceptance rate increased with the duration of the program. Our study identified risk factors for HIV test refusal among pregnant women in Uganda and common reasons for not accepting testing. These findings may suggest modifications and improvements in the performance of HIV testing in this and similar populations.

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

Factors influencing adherence to exclusive breast feeding among HIV positive mothers in Kabarole district, Uganda.

PubMed

Matovu, A; Kirunda, B; Rugamba-Kabagambe, G; Tumwesigye, N M; Nuwaha, F

2008-04-01

To identify the factors influencing adherence to exclusive breast feeding (EBF) among HIV positive mothers in Kabarole district, Uganda. Cross-sectional study. Kabarore district, western Uganda. HIV infected women attending for psychosocial support that adhered or did not adhere to EBF. We compared personal factors, influence from other people, barriers and supports towards adherence to EBF among 139 HIV infected women who adhered and among 139 women who did not adhere to EBF using univariate and multivariate analyses. The independent predictors of adherence to EBF are: having formal education (Adjusted Odds Ratio [AOR] 2.21, 95% confidence interval [CI] 1.01-4.84), knowledge of EBF as a method of preventing mother to child transmission of HIV (AOR 2.53, CI 1.11-5.75), attending at least four antenatal infant feeding counselling sessions (AOR 3.86, CI 1.82-8.19), attending at least six postnatal counselling sessions (AOR 12.52, CI 3.89-40.30), health workers being consulted for breastfeeding problems (AOR 13.11, CI 3.75-45.81), mothers thinking that they are able to produce enough milk (AOR 3.92, CI 1.74-8.84), initiation of breastfeeding within one hour of birth (AOR 10.17, CI 4.52-22.88), getting support from the father to EBF (AOR 5.27, CI 1.87-14.81) and getting support from the family to EBF (AOR 4.54, CI 2.09-9.84). In order to improve adherence to EBF there is need to: involve the family especially fathers in infant feeding counselling and education, target less educated mothers for more intense infant feeding counselling using appropriate methods, intensify education on benefits of EBF and on how to produce enough milk and to encourage mothers to attend regularly for ante-natal and post-natal care.

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

Rapid assessment of the geographical distribution of lymphatic filariasis in Uganda, by screening of schoolchildren for circulating filarial antigens.

PubMed

Onapa, A W; Simonsen, P E; Baehr, I; Pedersen, E M

2005-03-01

To permit improvements in the targeting of control activities, the geographical distribution of lymphatic filariasis in Uganda was assessed by using a rapid immunochromatographic card test to check school-aged children for Wuchereria bancrofti-specific circulating filarial antigens (CFA). Survey sites were selected to represent the various ecological and topographical diversities in the country. Overall, 17,533 children from 76 sites were examined. CFA-positive cases were detected at 31 of the sites, with prevalences ranging from 0.4% to 30.7%. There appeared to be strikingly more lymphatic filariasis in the north of the country than in the south. The main focus was north of the Victoria Nile, where 27 (66%) of 41 sites had CFA-positive cases, often at high prevalences. Only four (11.4%) of the 35 sites south of the Victoria Nile had CFA-positive cases, and all four were along the western rift valley and had relatively low CFA prevalences. Geostatistical interpolation was used to create a map showing the geographical distribution of CFA prevalences in Uganda (by ordinary kriging), and to assess the population exposed to W. bancrofti transmission. Estimates based on population data from 2002 indicated that approximately 8.7 million people (35.3% of the national population) lived in areas where > 1% of the school-aged children were CFA-positive. CFA prevalences generally decreased with increasing altitude, and no CFA-positive cases were found at sites that were > 1300 m above sea level. Although it gives an under-estimate of the overall community prevalence (a fact that should be taken into account when interpreting the present results and comparing them with the results of other surveys), the screening of schoolchildren for CFA was found to be a simple and useful approach for mapping the geographical distribution of lymphatic filariasis.

Tracking the feeding patterns of tsetse flies (Glossina genus) by analysis of bloodmeals using mitochondrial cytochromes genes.

PubMed

Muturi, Catherine N; Ouma, Johnson O; Malele, Imna I; Ngure, Raphael M; Rutto, Jane J; Mithöfer, Klaus M; Enyaru, John; Masiga, Daniel K

2011-02-28

Tsetse flies are notoriously difficult to observe in nature, particularly when populations densities are low. It is therefore difficult to observe them on their hosts in nature; hence their vertebrate species can very often only be determined indirectly by analysis of their gut contents. This knowledge is a critical component of the information on which control tactics can be developed. The objective of this study was to determine the sources of tsetse bloodmeals, hence investigate their feeding preferences. We used mitochondrial cytochrome c oxidase 1 (COI) and cytochrome b (cytb) gene sequences for identification of tsetse fly blood meals, in order to provide a foundation for rational decisions to guide control of trypanosomiasis, and their vectors. Glossina swynnertoni were sampled from Serengeti (Tanzania) and G. pallidipes from Kenya (Nguruman and Busia), and Uganda. Sequences were used to query public databases, and the percentage identities obtained used to identify hosts. An initial assay showed that the feeds were from single sources. Hosts identified from blood fed flies collected in Serengeti ecosystem, included buffaloes (25/40), giraffes (8/40), warthogs (3/40), elephants (3/40) and one spotted hyena. In Nguruman, where G. pallidipes flies were analyzed, the feeds were from elephants (6/13) and warthogs (5/13), while buffaloes and baboons accounted for one bloodmeal each. Only cattle blood was detected in flies caught in Busia and Uganda. Out of four flies tested in Mbita Point, Suba District in western Kenya, one had fed on cattle, the other three on the Nile monitor lizard. These results demonstrate that cattle will form an integral part of a control strategy for trypanosomiasis in Busia and Uganda, while different approaches are required for Serengeti and Nguruman ecosystems, where wildlife abound and are the major component of the tsetse fly food source.

Significantly Reduced Genoprevalence of Vaccine-Type HPV-16/18 Infections among Vaccinated Compared to Non-Vaccinated Young Women 5.5 Years after a Bivalent HPV-16/18 Vaccine (Cervarix®) Pilot Project in Uganda

PubMed Central

Berggren, Vanja; Wabinga, Henry; Lillsunde-Larsson, Gabriella; Helenius, Gisela; Kaliff, Malin; Karlsson, Mats; Kirimunda, Samuel; Musubika, Caroline; Andersson, Sören

2016-01-01

The objective of this study was to determine the prevalence and some predictors for vaccine and non-vaccine types of HPV infections among bivalent HPV vaccinated and non-vaccinated young women in Uganda. This was a comparative cross sectional study 5.5 years after a bivalent HPV 16/18 vaccination (Cervarix®, GlaxoSmithKline, Belgium) pilot project in western Uganda. Cervical swabs were collected between July 2014-August 2014 and analyzed with a HPV genotyping test, CLART® HPV2 assay (Genomica, Madrid Spain) which is based on PCR followed by microarray for determination of genotype. Blood samples were also tested for HIV and syphilis infections as well as CD4 and CD8 lymphocyte levels. The age range of the participants was 15–24 years and mean age was 18.6(SD 1.4). Vaccine-type HPV-16/18 strains were significantly less prevalent among vaccinated women compared to non-vaccinated women (0.5% vs 5.6%, p 0.006, OR 95% CI 0.08(0.01–0.64). At type-specific level, significant difference was observed for HPV16 only. Other STIs (HIV/syphilis) were important risk factors for HPV infections including both vaccine types and non-vaccine types. In addition, for non-vaccine HPV types, living in an urban area, having a low BMI, low CD4 count and having had a high number of life time sexual partners were also significant risk factors. Our data concurs with the existing literature from other parts of the world regarding the effectiveness of bivalent HPV-16/18 vaccine in reducing the prevalence of HPV infections particularly vaccine HPV- 16/18 strains among vaccinated women. This study reinforces the recommendation to vaccinate young girls before sexual debut and integrate other STI particularly HIV and syphilis interventions into HPV vaccination packages. PMID:27482705

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

PubMed

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

2013-10-17

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

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

PubMed

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

2018-01-01

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

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

ERIC Educational Resources Information Center

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

2012-01-01

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

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

ERIC Educational Resources Information Center

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

2011-01-01

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

How Uganda Reversed Its HIV Epidemic

PubMed Central

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

2006-01-01

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

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

PubMed

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

2014-08-08

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

Youth, sexual risk-taking behavior, and mental health: a study of university students in Uganda.

PubMed

Agardh, Anette; Cantor-Graae, Elizabeth; Ostergren, Per-Olof

2012-06-01

Little focus has been paid to the role of mental health among young people with regard to risky sexual behavior and HIV prevention in sub-Saharan Africa. The aim of this study was to investigate the relationship between poor mental health and risky sexual behavior (HIV/AIDS) among a population of university students in Uganda. In 2005, 980 Ugandan university students completed a self-administered questionnaire (response rate 80%) assessing sociodemographic and religious background factors, mental health, alcohol use, and sexual behavior. Mental health was assessed using items from the Hopkins Symptoms Checklist-25 and the Symptom Checklist-90. High scores on depression and high numbers of sexual partners among both males (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.2-3.3) and females (OR 3.3, 95% CI 1.3-8.6) were significantly associated. Elevated anxiety scores among men were associated with high numbers of sexual partners (OR 1.9, 95% CI 1.1-3.3) and inconsistent condom use (OR 1.9, 95% CI 1.1-3.6). Psychoticism was also significantly associated with high numbers of sexual partners among men. The associations remained statistically significant after controlling for sociodemographic factors and level of alcohol consumption. These findings indicate that previous conclusions on the association between sexual behavior and mental health from high- and middle-income countries also are valid in a low-income setting, such as in Uganda. This knowledge has implications for policy formation and HIV/AIDS preventive strategies. Coordinated youth-friendly mental health and sexual and reproductive health services to meet the needs of young people would be desirable.

What influences availability of medicines for the community management of childhood illnesses in central Uganda? Implications for scaling up the integrated community case management programme.

PubMed

Bagonza, James; Rutebemberwa, Elizeus; Eckmanns, Tim; Ekirapa-Kiracho, Elizabeth

2015-11-25

The integrated Community Case Management (iCCM) of childhood illnesses strategy has been adopted world over to reduce child related ill health and mortality. Community Health workers (CHWs) who implement this strategy need a regular supply of drugs to effectively treat children under 5 years with malaria, pneumonia and diarrhea. In this paper, we report the prevalence and factors influencing availability of medicines for managing malaria, pneumonia and diarrhea in communities in central Uganda. A cross sectional study was conducted among 303 CHWs in Wakiso district in central Uganda. Eligible CHWs from two randomly selected Health Sub Districts (HSDs) were interviewed. Questionnaires, check lists, record reviews were used to collect information on CHW background characteristics, CHW's prescription behaviors, health system support factors and availability of iCCM drugs. Multivariable logistic regression analysis was done to assess factors associated with availability of iCCM drugs. Out of 300 CHWs, 239 (79.9%) were females and mean age was 42.1 (standard deviation =11.1 years). The prevalence of iCCM drug availability was 8.3% and 33 respondents (11%) had no drugs at all. Factors associated with iCCM drug availability were; being supervised within the last month (adjusted OR = 3.70, 95% CI 1.22-11.24), appropriate drug prescriptions (adjusted OR = 3.71, 95% CI 1.38-9.96), regular submission of drug reports (adjusted OR = 4.02, 95% CI 1.62-10.10) and having a respiratory timer as a diagnostic tool (adjusted OR =3.11, 95% CI 1.08-9.00). The low medicine stocks for the community management of childhood illnesses calls for strengthening of CHW supervision, medicine prescription and reporting, and increasing availability of functional diagnostic tools.

Taking stock of monitoring and evaluation systems in the health sector: findings from Rwanda and Uganda.

PubMed

Holvoet, Nathalie; Inberg, Liesbeth

2014-07-01

In the context of sector-wide approaches and the considerable funding being put into the health sectors of low-income countries, the need to invest in well-functioning national health sector monitoring and evaluation (M&E) systems is widely acknowledged. Regardless of the approach adopted, an important first step in any strategy for capacity development is to diagnose the quality of existing systems or arrangements, taking into account both the supply and demand sides of M&E. As no standardized M&E diagnostic instrument currently exists, we first invested in the development of an assessment tool for sector M&E systems. To counter the criticism that M&E is often narrowed down to a focus on technicalities, our diagnostic tool assesses the quality of M&E systems according to six dimensions: (i) policy; (ii) quality of indicators and data (collection) and methodology; (iii) organization (further divided into iiia: structure and iiib: linkages); (iv) capacity; (v) participation of non-government actors and (vi) M&E outputs: quality and use. We subsequently applied the assessment tool to the health sector M&E systems of Rwanda and Uganda, and this article provides a comparative overview of the main research findings. Our research may have important implications for policy, as both countries receive health sector (budget) support in relation to which M&E system diagnosis and improvement are expected to be high on the agenda. The findings of our assessments indicate that, thus far, the health sector M&E systems in Rwanda and Uganda can at best be diagnosed as 'fragmentary', with some stronger and weaker elements. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Taenia solium metacestode preparation in rural areas of sub-Saharan Africa: a source for diagnosis and research on cysticercosis.

PubMed

Schmidt, V; Sikasunge, C S; Odongo-Aginya, E; Simukoko, C; Mwanjali, G; Alarakol, S; Ovuga, E; Matuja, W; Kihamia, C; Löscher, T; Winkler, A S; Bretzel, G

2015-03-01

Taenia solium metacestodes/cysts obtained from pig carcasses constitute a primary source for diagnostic tools used for the detection of human cysticercosis. Data on T. solium cyst preparation in Africa is still scarce but required to establish independent reference laboratories. The aim of the present study is a) to present the likely yield of T. solium cyst material by the use of two different preparation methods in the field and b) to investigate its suitability for immunodiagnosis of human cysticercosis. In Zambia, Uganda and Tanzania 670 pigs were screened for T. solium infection. Cysts were prepared by 'shaking method' and 'washing method'. Generated crude antigens were applied in a standard western blot assay. 46 out of 670 pigs (6.9%) were found positive for T. solium (Zambia: 12/367, 3.3%; Uganda: 11/217, 5.1%; Tanzania 23/86, 26.7%). Mean values of 77.7 ml whole cysts, 61.8 ml scolices/membranes and 10.9 ml cyst fluid were obtained per pig. Suitability of collected material for the use as crude antigen and molecular diagnostic techniques was demonstrated. This study clearly shows that T. solium cyst preparation in African settings by simple field methods constitutes an effective way to obtain high quality material as source for diagnostic tools and research purposes.

We Remember… Elders' Memories and Perceptions of Sleeping Sickness Control Interventions in West Nile, Uganda.

PubMed

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

2016-06-01

The traditional role of African elders and their connection with the community make them important stakeholders in community-based disease control programmes. We explored elders' memories related to interventions against sleeping sickness to assess whether or not past interventions created any trauma which might hamper future control operations. Using a qualitative research framework, we conducted and analysed twenty-four in-depth interviews with Lugbara elders from north-western Uganda. Participants were selected from the villages inside and outside known historical sleeping sickness foci. Elders' memories ranged from examinations of lymph nodes conducted in colonial times to more recent active screening and treatment campaigns. Some negative memories dating from the 1990s were associated with diagnostic procedures, treatment duration and treatment side effects, and were combined with memories of negative impacts related to sleeping sickness epidemics particularly in HAT foci. More positive observations from the recent treatment campaigns were reported, especially improvements in treatment. Sleeping sickness interventions in our research area did not create any permanent traumatic memories, but memories remained flexible and open to change. This study however identified that details related to medical procedures can remain captured in a community's collective memory for decades. We recommend more emphasis on communication between disease control programme planners and communities using detailed and transparent information distribution, which is not one directional but rather a dialogue between both parties.

Assessing local instrument reliability and validity: a field-based example from northern Uganda.

PubMed

Betancourt, Theresa S; Bass, Judith; Borisova, Ivelina; Neugebauer, Richard; Speelman, Liesbeth; Onyango, Grace; Bolton, Paul

2009-08-01

This paper presents an approach for evaluating the reliability and validity of mental health measures in non-Western field settings. We describe this approach using the example of our development of the Acholi psychosocial assessment instrument (APAI), which is designed to assess depression-like (two tam, par and kumu), anxiety-like (ma lwor) and conduct problems (kwo maraco) among war-affected adolescents in northern Uganda. To examine the criterion validity of this measure in the absence of a traditional gold standard, we derived local syndrome terms from qualitative data and used self reports of these syndromes by indigenous people as a reference point for determining caseness. Reliability was examined using standard test-retest and inter-rater methods. Each of the subscale scores for the depression-like syndromes exhibited strong internal reliability ranging from alpha = 0.84-0.87. Internal reliability was good for anxiety (0.70), conduct problems (0.83), and the pro-social attitudes and behaviors (0.70) subscales. Combined inter-rater reliability and test-retest reliability were good for most subscales except for the conduct problem scale and prosocial scales. The pattern of significant mean differences in the corresponding APAI problem scale score between self-reported cases vs. noncases on local syndrome terms was confirmed in the data for all of the three depression-like syndromes, but not for the anxiety-like syndrome ma lwor or the conduct problem kwo maraco.

Use of eCompliance, an innovative biometric system for monitoring of tuberculosis treatment in rural Uganda.

PubMed

Snidal, Sarah Jane; Barnard, Genevieve; Atuhairwe, Emmanuel; Ben Amor, Yanis

2015-06-01

Directly observed therapy short-course (DOTS) requires direct observation of tuberculosis (TB) patients and manual recording of doses taken. Programmatically, manual tracking is both time-consuming and prone to human error. Our project in western Uganda assessed the impact on TB treatment outcomes of a comprehensive patient support program including eCompliance, a biometric medical record device, with the aim of increasing TB patient retention. Through an observational study of 142 patients, DOTS outcomes of patients in the intervention group were compared with two control groups. Descriptive statistical comparisons, case-cohort analysis, and difference in change over time were used to assess the impact. Intervention patients had a higher cure rate than all other patients (55.6% versus 28.3% [P < 0.01]) and the odds of having a "cured" outcome were 3.17 higher (P < 0.05). The intervention group had a statistically significantly lower odds of having a negative outcome (0% versus.17% [P < 0.01]) than patients from the control groups. Additionally, the intervention group had a lost to follow-up rate lower than all other groups (0% versus 7%) that was trending on significant. In resource-limited settings, implementing comprehensive DOTS including eCompliance may reduce the occurrence of negative DOTS outcomes for patients. © The American Society of Tropical Medicine and Hygiene.

Geophagy in Northern Uganda: Perspectives from Consumers and Clinicians

PubMed Central

Huebl, Lena; Leick, Stephan; Guettl, Lukas; Akello, Grace; Kutalek, Ruth

2016-01-01

The etiology and health consequences of geophagy are still poorly understood. The consumed soil, individual motives, consumption habits, and the clinical perspective of geophagy in northern Uganda were examined. A total of 50 semistructured interviews (17 pregnant, eight nonpregnant women, 10 men, and 15 health-care professionals) were conducted. Our results suggest that geophagy is not limited to pregnancy and can also be found among nonpregnant women and men. During gestation, excessive amounts of various soil types are consumed and can replace food at times. Nonpregnant women and men consume less soil and stick to one type. When pregnant, craving and alleviating gastrointestinal upset are the main motives. In men, the main reasons for geophagy were craving, hypersalivation, and natural stimulants. If soil is craved, it can show similarities to a dependency syndrome. When picked up in childhood, geophagy is more likely to be continued throughout life. The consumption habits differ and thereby vary in their possible implications on health. Our findings suggest that men should be included in further studies. Especially nurses from the antenatal care are exposed to geophagists; however, no national guidelines exist for geophagy. Further research is necessary to create guidelines to be included in medical training and practice. PMID:27698274

Preparing the Field for Feasibility Testing of a Parenting Intervention for War-Affected Mothers in Northern Uganda.

PubMed

Wieling, Elizabeth; Mehus, Christopher; Yumbul, Cigdem; Möllerherm, Julia; Ertl, Verena; Laura, Achan; Forgatch, Marion; Neuner, Frank; Catani, Claudia

2017-06-01

In this article, we discuss the successful implementation of an adapted evidence-based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long-term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance-use disorders. The processes described here cover a 4-year period culminating in the implementation of the nine-session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention. © 2015 Family Process Institute.

A Study of End-Users' Attitudes towards Digital Media Approach: The Experience of a Public University in Uganda

ERIC Educational Resources Information Center

Ndawula, Stephen; Ngobi, David Henry; Namugenyi, Deborah; Nakawuki, Rose Coaster

2012-01-01

University students in Uganda had been confined to use of traditional educational technologies such as chalkboards, papers and text books. Digital Media Approach recently found its way in the academia at public universities in Uganda. Information and communication technology (ICT) have become popular means of surfing, downloading and obtaining…

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

ERIC Educational Resources Information Center

Wamala, Robert; Seruwagi, Gerald

2013-01-01

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

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

ERIC Educational Resources Information Center

Akankunda, Denis B.

2014-01-01

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

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

ERIC Educational Resources Information Center

Grace, André P.

2016-01-01

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

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…

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

ERIC Educational Resources Information Center

Achen, Stella; Openjuru, George Ladaah

2012-01-01

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

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…

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

ERIC Educational Resources Information Center

Baine, Euzobia M. Mugisha

2010-01-01

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

The Medical Research Council (UK)/Uganda Virus Research Institute Uganda Research Unit on AIDS--'25 years of research through partnerships'.

PubMed

Kaleebu, P; Kamali, A; Seeley, J; Elliott, A M; Katongole-Mbidde, E

2015-02-01

For the past 25 years, the Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS has conducted research on HIV-1, coinfections and, more recently, on non-communicable diseases. Working with various partners, the research findings of the Unit have contributed to the understanding and control of the HIV epidemic both in Uganda and globally, and informed the future development of biomedical HIV interventions, health policy and practice. In this report, as we celebrate our silver jubilee, we describe some of these achievements and the Unit's multidisciplinary approach to research. We also discuss the future direction of the Unit; an exemplar of a partnership that has been largely funded from the north but led in the south. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

No impact of strongylid infections on the detection of Plasmodium spp. in faeces of western lowland gorillas and eastern chimpanzees.

PubMed

Mapua, Mwanahamisi I; Pafčo, Barbora; Burgunder, Jade; Profousová-Pšenková, Ilona; Todd, Angelique; Hashimoto, Chie; Qablan, Moneeb A; Modrý, David; Petrželková, Klára J

2017-04-26

Although a high genetic diversity of Plasmodium spp. circulating in great apes has been revealed recently due to non-invasive methods enabling detection in faecal samples, little is known about the actual mechanisms underlying the presence of Plasmodium DNA in faeces. Great apes are commonly infected by strongylid nematodes, including hookworms, which cause intestinal bleeding. The impact of strongylid infections on the detection of Plasmodium DNA in faeces was assessed in wild, western, lowland gorillas from Dzanga Sangha Protected Areas, Central African Republic and eastern chimpanzees from Kalinzu Forest Reserve, Uganda. Fifty-one faecal samples from 22 habituated gorillas and 74 samples from 15 habituated chimpanzees were analysed using Cytochrome-b PCR assay and coprological methods. Overall, 26.4% of the analysed samples were positive for both Plasmodium spp. and strongylids. However, the results showed no significant impact of intensity of infections of strongylids on detection of Plasmodium DNA in gorilla and chimpanzee faeces. Bleeding caused by strongylid nematode Necator spp. cannot explain the presence of Plasmodium DNA in ape faeces.

Soil erosion risk assessment using interviews, empirical soil erosion modeling (RUSLE) and fallout radionuclides in a volcanic crater lake watershed subjected to land use change, western Uganda

NASA Astrophysics Data System (ADS)

De Crop, Wannes; Ryken, Nick; Tomma Okuonzia, Judith; Van Ranst, Eric; Baert, Geert; Boeckx, Pascal; Verschuren, Dirk; Verdoodt, Ann

2017-04-01

Population pressure results in conversion of natural vegetation to cropland within the western Ugandan crater lake watersheds. These watersheds however are particularly prone to soil degradation and erosion because of the high rainfall intensity and steep topography. Increased soil erosion losses expose the aquatic ecosystems to excessive nutrient loading. In this study, the Katinda crater lake watershed, which is already heavily impacted by agricultural land use, was selected for an explorative study on its (top)soil characteristics - given the general lack of data on soils within these watersheds - as well as an assessment of soil erosion risks. Using group discussions and structured interviews, the local land users' perceptions on land use, soil quality, soil erosion and lake ecology were compiled. Datasets on rainfall, topsoil characteristics, slope gradient and length, and land use were collected. Subsequently a RUSLE erosion model was run. Results from this empirical erosion modeling approach were validated against soil erosion estimates based on 137Cs measurements.

Carbon dioxide emissions from peat soils under potato cultivation in Uganda

NASA Astrophysics Data System (ADS)

Farmer, Jenny; Langan, Charlie; Smith, Jo

2017-04-01

Organic wetland soils in south western Uganda are found in valley bottom wetlands, surrounded by steep, mineral soil hill slopes. Land use change in these papyrus dominated wetlands has taken place over the past forty years, seeing wetland areas cleared of papyrus, rudimentary drainage channel systems dug, and soil cultivated and planted with crops, predominantly potatoes. There has been little research into the cultivation of organic wetlands soils in Uganda, or the impacts on soil carbon dynamics and associated carbon dioxide (CO2) emissions. This study used two rounds of farmer interviews to capture the land management practices on these soils and how they vary over the period of a year. Three potato fields were also randomly selected and sampled for CO2 emissions at four points in time during the year; 1) just after the potato beds had been dug, 2) during the potato growing period, 3) after the potato harvest, and 4) at the end of the fallow season. Carbon dioxide emissions, soil and air temperatures, water table depth, vegetation cover and land use were all recorded in situ in each field on each sampling occasion, from both the raised potato beds and the trenches in between them. There appeared to be a delay in the disturbance effect of digging the peat, with heterotrophic CO2 emissions from the raised beds not immediately increasing after being exposed to the air. Excluding these results, there was a significant linear relationship between mean emissions and water table depth from the raised beds and trenches in each field over time (p<0.001, r2=0.85), as well as between emissions and soil moisture content (p<0.001, r2=0.85). Temporal variability was observed, with significant differences in the means of emissions measured at the different sampling times (p<0.001, one-way ANOVA); this was the case in both raised beds and trenches in all fields studied, except for the trenches in one field which showed no significant difference between sampling times (p=0.55). Mean emissions from the raised beds were highest during the potato growing season (1.74 ± 0.07 g m-2 hr-1 (± shows standard error)) and lowest at the time when the beds had been freshly dug (0.67 ± 0.17 g m-2 hr-1). Mean emissions from the trenches were highest at the end of the fallow period (0.37 ± 0.02 g m-2 hr-1) and lowest at the time when the beds had been freshly dug (0.20 ± 0.05 g m-2 hr-1). As the first of its kind on Uganda's peat soils, this study has provided some insight into the use of these soils and impacts on CO2 emissions which can be used to inform Uganda's national emissions scenarios, whilst highlighting some of the fundamental data gaps which need to be addressed with future studies.

Non-Formal Education and Livelihood Skills for Marginalised Street and Slum Youth in Uganda. Project Report

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization (UNESCO), 2006

2006-01-01

The Building Capacities for Non formal Education and Life Skills Programmes project in Uganda was implemented by Uganda Youth Development Link (UYDEL) with financial and technical support from UNESCO--Section for Literacy and non Formal Education in 2004-05; aiming at assisting vulnerable and marginalised youth affected by HIV/AIDS and other risk…

Factors Associated with Perceived Stigma among People Living with HIV/AIDS in Post-Conflict Northern Uganda

ERIC Educational Resources Information Center

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

2011-01-01

HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…

Budget Planning and the Quality of Educational Services in Uganda Public Universities: A Case Study of Kyambogo University

ERIC Educational Resources Information Center

Basheka, Benon C.; Nabwire, Addah

2013-01-01

This paper examines the relationship between budget planning and the quality of educational services at Kyambogo University in Uganda. We argue that the manner in which the university's budget planning activities are conducted determines in a significant way (by 76.8%) the quality of the services offered by public universities in Uganda. The…

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

ERIC Educational Resources Information Center

Lincove, Jane Arnold

2012-01-01

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

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

ERIC Educational Resources Information Center

Molyneaux, Kristen J.

2011-01-01

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

Benefit Incidence Analysis of Government Spending on Public-Private Partnership Schooling under Universal Secondary Education Policy in Uganda

ERIC Educational Resources Information Center

Wokadala, J.; Barungi, M.

2015-01-01

The study establishes whether government spending on private universal secondary education (USE) schools is equitable across quintiles disaggregated by gender and by region in Uganda. The study employs benefit incidence analysis tool on the Uganda National Panel Survey (UNPS 2009/10) data to establish the welfare impact of public subsidy on…

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

ERIC Educational Resources Information Center

Speizer, Ilene S.

2010-01-01

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

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

ERIC Educational Resources Information Center

Mugabi, H.

2012-01-01

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

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

ERIC Educational Resources Information Center

Mujuni, John Bosco

2015-01-01

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

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

ERIC Educational Resources Information Center

Witter, Sophie

2004-01-01

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

Oil industry in Uganda: The socio-economic effects on the people of Kabaale Village, Hoima, and Bunyoro region in Uganda

NASA Astrophysics Data System (ADS)

Kyomugasho, Miriam

This thesis examines the socio-economic effects of oil industry on the people of Kabaale Village, Hoima, and Bunyoro region in Uganda. The thesis analyses the current political economy of Uganda and how Uganda is prepared to utilize the proceeds from the oil industry for the development of the country and its people. In addition, the research examines the effects of industry on the people of Uganda by analyzing how the people of Kabaale in Bunyoro region were affected by the plans to construct oil refinery in their region. This field research was done using qualitative methods and the Historical Materialism theoretical framework guided the study. The major findings include; displacement of people from land especially women, lack of accountability from the leadership, and less citizen participation in the policy formulation and oil industry. Ugandans, East Africans and the wider Pan-African world need to re-organize their socio-economic structure to enable people own means of production; participate and form labor organizations. Additionally, there is a need for oil producing African countries to unite and setup and oil fund for resources and investment instead of relying on foreign multinationals or become rentier states.

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

ERIC Educational Resources Information Center

Payne, Deborah; Nakato, Margaret; Nabalango, Caroline

2008-01-01

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

Public Discourse on HIV and AIDS: An Archival Analysis of National Newspaper Reporting in Uganda, 1996-2011

ERIC Educational Resources Information Center

Lagone, Elizabeth; Mathur, Sanyukta; Nakyanjo, Neema; Nalugoda, Fred; Santelli, John

2014-01-01

Uganda is recognised as an early success story in the HIV epidemic at least in part due to an open and vigorous national dialogue about HIV prevention. This study examined the national discourse about HIV, AIDS, and young people in New Vision, Uganda's leading national newspaper between 1996 and 2011, building from a previous archival analysis of…

Along-axis segmentation and isostasy in the Western rift, East Africa

NASA Astrophysics Data System (ADS)

Upcott, N. M.; Mukasa, R. K.; Ebinger, C. J.; Karner, G. D.

1996-02-01

Structural variations along the southern sectors of the Western rift, East Africa, have previously been described, but subsurface structures in the northern sector (Uganda, Zaire) are virtually unknown. Our aims are to investigate the along-axis segmentation of the northern sector, thereby adding to the structural picture of the Western rift, and to study the isostatic compensation of the varying rift morphology along the sector's length. This study describes the first gravity survey to be carried out on the shallow Lake Albert, forward models of these and existing gravity data, and the results from inverse modeling of existing aeromagnetic data designed to delimit border and transfer fault systems. Our tectonic model shows that the northern rift sector is segmented along-axis into five 25 to 65-km-wide, 80 to 100-km-long rift segments, characterized by closed-contour Bouguer anomaly lows, and bounded by steep gravity, aeromagnetic, and topographic/bathymetric gradients. Werner and Euler deconvolution results and gravity anomaly data reveal that some faulted basins are separated by structural highs and cross-rift ramps or faults and suggest sedimentary basin depths of 4-6 km. Forward modeling of structural and free-air gravity profiles across individual basins and flanks using a model that assumes flexural compensation also suggests sediment thicknesses of up to 5.5 km, similar to the estimates from magnetic data. The basin and flank morphology can be explained by 6-9 km of extension of a lithosphere with an effective elastic thickness (Te) of 25 km (equivalent to a flexural rigidity of 1.4 × 1023 N m), similar to results in other Western rift basins. Potential field data and lithospheric strength estimates in the Western rift system show small along-axis variations in lithospheric structure, regardless of the presence or absence of Cenozoic magmatism.

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

PubMed Central

Vongsathorn, Kathleen

2014-01-01

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

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2010-10-06

African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. Uganda: Current Conditions...The United Nations, the African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. The...attacks took place at a rugby club and Ethiopian restaurant while people were watching the final match of the World Cup. The following day, an Al

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2011-04-29

United Nations, the African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. Uganda: Current...concerns. The African Union stated that the elections were peaceful and transparent, but called for a Review of the Electoral Law. Opposition groups...Nations, the African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. The attacks took place

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2010-12-09

Nations, the African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. Uganda: Current...An estimated 76 people, including one American, were killed and more than 80 injured. The United Nations, the African Union , and the United States...condemned the terrorist attacks. More than 20 suspects are currently in prison. The attacks took place at a rugby club and Ethiopian restaurant while

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

ERIC Educational Resources Information Center

Kasirye, Ibrahim; Hisali, Eria

2010-01-01

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

Exploring Differences in National and International Poverty Estimates: Is Uganda on Track to Halve Poverty by 2015?

ERIC Educational Resources Information Center

Levine, Sebastian

2012-01-01

This paper explores causes of differences in estimates of poverty incidence in Uganda since the early 1990s as measured by the Uganda Bureau of Statistics and the World Bank. While both sets of estimates from the two organisations show a declining trend in poverty incidence there are important differences in the levels of poverty, the speed of the…

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

ERIC Educational Resources Information Center

Mayengo, Nathaniel; Namusoke, Jane; Dennis, Barbara

2015-01-01

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

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.

Modifications to ART service delivery models by health facilities in Uganda in promotion of intervention sustainability: a mixed methods study.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2017-04-04

In November 2015, WHO released new treatment guidelines recommending that all diagnosed as HIV positive be enrolled on antiretroviral therapy (ART). Sustaining and expanding ART scale-up programs in resource-limited settings will require adaptations and modifications to traditional ART delivery models to meet the rapid increase in demand. We identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over a 10-year period (2004-2014). A mixed methods approach involving two study phases was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) in Uganda which were accredited to provide ART between 2004 and 2009 was conducted. The second phase involved semi-structured interviews (n = 18) with ART clinic managers of 6 of the 195 health facilities purposively selected from the first study phase. We adopted a thematic framework consisting of four categories of modifications (format, setting, personnel, and population). The majority of health facilities 185 (95%) reported making modifications to ART interventions between 2004 and 2014. Of the 195 health facilities, 157 (81%) rated the modifications made to ART as "major." Modifications to ART were reported under all the four themes. The quantitative and qualitative findings are integrated and presented under four themes. Format: Reducing the frequency of clinic appointments and pharmacy-only refill programs was identified as important strategies for decongesting ART clinics. Home-based care programs were introduced to reduce provider ART delivery costs. Personnel: Task shifting to non-physician cadre was reported in 181 (93%) of the health facilities. Visits to the ART clinic were rationalized in favor of the sub-population deemed to have more clinical need. Two health facilities focused on patients living nearer the health facilities to align with targets set by external donors. Over the study period, health facilities made several modifications ART interventions to improve fit with their resource-constrained settings thereby promoting long-term sustainability. Further research evaluating the effect of these modifications on patient outcomes and ART delivery costs is recommended. Our findings have implications for the sustainability of ART scale-up programs in Uganda and other resource-limited settings.

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

DTIC Science & Technology

2016-01-01

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

Uganda: Current Conditions and the Crisis in North Uganda

DTIC Science & Technology

2010-07-30

Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in prison. Uganda: Current Conditions and the...than 80 injured. The United Nations, the African Union , and the United States condemned the terrorist attacks. More than 20 suspects are currently in...prison. The attacks took place at a rugby club and Ethiopian restaurant while people were watching the final match of the World Cup. The following

Sedentary Lifestyle and Hypertension in a Periurban Area of Mbarara, South Western Uganda: A Population Based Cross Sectional Survey.

PubMed

Twinamasiko, Bruce; Lukenge, Edward; Nabawanga, Stella; Nansalire, Winnie; Kobusingye, Lois; Ruzaaza, Gad; Bajunirwe, Francis

2018-01-01

Globally, cardiovascular diseases (CVDs) and diabetes constitute over 50% of the noncommunicable disease (NCD) burden and projections indicate Sub-Saharan Africa will experience a larger burden. Urbanization on the continent is contributing to the change in lifestyle such as diet and physical activity, which may increase the risk for CVDs. There is lack of sufficient data from the African continent on hypertension and its association with sedentary lifestyle. We conducted a cross sectional study in periurban Uganda among adults aged at least 35 years. We administered questions on diet, physical activity, and smoking. We took anthropometric measurements, blood pressure, and fasting blood glucose. Hypertension was defined as systolic BP > = 140 and/or diastolic BP > = 90 and/or history of hypertension medications. Logistic regression was used to determine the crude and adjusted odds ratios for the factors associated with hypertension. We enrolled 310 participants and 50% were female. The prevalence of systolic hypertension was 24.5%, diastolic hypertension was 31%, obesity was 46%, and diabetes was 9%. Of those with hypertension ( n = 76), 53 participants (69.7%) were not aware they had high BP. Sedentary lifestyle was significantly associated with hypertension even after adjusting for age and obesity. There is a high prevalence of obesity, hypertension, and diabetes and majority of participants with hypertension are not aware. Participants with a sedentary work style should be targeted for prevention and screening.

Effect of HSV-2 on population-level trends in HIV incidence in Uganda between 1990 and 2007

PubMed Central

Biraro, Samuel; Kamali, Anatoli; White, Richard; Karabarinde, Alex; Nsiimire Ssendagala, Juliet; Grosskurth, Heiner; Weiss, Helen A

2013-01-01

Objective To assess the long-term effects of population-level HSV-2 infection on HIV incidence. Methods Data from a population-based cohort in south-western Uganda were used to estimate HIV incidence from 1990 to 2007. Stored blood samples were tested for HSV-2, and the impact of HSV-2 prevalence and incidence on HIV incidence was estimated by calculating population attributable fractions (PAFs). The association between population-level annual HIV incidence and annual HSV-2 incidence/prevalence was analysed using linear regression. Results HIV incidence declined over time among men, from 8.72/1000 person-years (pyr) in 1990 to 4.85/1000 pyr in 2007 (P-trend <0.001). In contrast, there was no decline in HIV incidence among women (4.86/1000 pyr in 1990 to 6.74/1000 pyr in 2007, P-trend = 0.18). PAFs of incident HIV attributable to HSV-2 were high (60% in males; 70% in females). There was no evidence of an association between long-term trends in HIV incidence and HSV-2 prevalence or incidence. Conclusion Assuming a causal relationship, a substantial proportion of new HIV infections in this population are attributable to HSV-2. The study did not find an effect of HSV-2 prevalence/incidence on trends in HIV incidence. HIV incidence did not vary much during the study period. This may partly explain the lack of association. PMID:24016032

Investigating “mass hysteria” in early postcolonial Uganda: Benjamin H. Kagwa, East African psychiatry, and the Gisu

PubMed Central

Pringle, Yolana

2016-01-01

In the early 1960s, medical officers and administrators began to receive reports of what was being described as “mass madness” and “mass hysteria” in Tanganyika (now Tanzania) and Uganda. Each epidemic reportedly affected between 300 and 600 people and, coming in the wake of independence from colonial rule, caused considerable concern. One of the practitioners sent to investigate was Benjamin H. Kagwa, a Ugandan-born psychiatrist whose report represents the first investigation by an African psychiatrist in East Africa. This article uses Kagwa’s investigation to explore some of the difficulties facing East Africa’s first generation of psychiatrists as they took over responsibility for psychiatry. During this period, psychiatrists worked in an intellectual climate that was both attempting to deal with the legacy of colonial racism, and which placed faith in African psychiatrists to reveal more culturally sensitive insights into African psychopathology. The epidemics were the first major challenge for psychiatrists such as Kagwa precisely because they appeared to confirm what colonial psychiatrists had been warning for years—that westernization would eventually result in mass mental instability. As this article argues, however, Kagwa was never fully able to free himself from the practices and assumptions that had pervaded his discipline under colonial rule. His analysis of the epidemics as a “mental conflict” fit into a much longer tradition of psychiatry in East Africa, and stood starkly against the explanations of the local community. PMID:24191308

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

PubMed

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

2010-12-13

Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities - Makerere and Mbarara - stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the development of STI in Uganda, demonstrated through personal initiatives of the President and the government's willingness to invest heavily for the long term in support of STI through the Millennium Science Initiative. Activities to support technology transfer and private-public collaboration have been put in motion; these need to be monitored, coordinated, and learned from. In the private sector, there are examples of incremental innovation to address neglected diseases driven by entrepreneurial individuals and South-South collaboration. Lessons can be learned from their experience that will help support Ugandan health innovation.

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

PubMed Central

2010-01-01

Background Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 30 people from across the science-based health innovation system, including government officials, researchers in research institutes and universities, entrepreneurs, international donors, and non-governmental organization representatives. Results Uganda has a range of institutions influencing science-based health innovation, with varying degrees of success. However, the country still lacks a coherent mechanism for effectively coordinating STI policy among all the stakeholders. Classified as a least developed country, Uganda has opted for exemptions from the TRIPS intellectual property protection regime that include permitting parallel importation and providing for compulsory licenses for pharmaceuticals. Uganda is unique in Africa in taking part in the Millennium Science Initiative (MSI), an ambitious though early-stage $30m project, funded jointly by the World Bank and Government of Uganda, to build science capacity and encourage entrepreneurship through funding industry-research collaboration. Two universities – Makerere and Mbarara – stand out in terms of health research, though as yet technology development and commercialization is weak. Uganda has several incubators which are producing low-tech products, and is beginning to move into higher-tech ones like diagnostics. Its pharmaceutical industry has started to create partnerships which encourage innovation. Conclusions Science-based health product innovation is in its early stages in Uganda, as are policies for guiding its development. Nevertheless, there is political will for the development of STI in Uganda, demonstrated through personal initiatives of the President and the government’s willingness to invest heavily for the long term in support of STI through the Millennium Science Initiative. Activities to support technology transfer and private-public collaboration have been put in motion; these need to be monitored, coordinated, and learned from. In the private sector, there are examples of incremental innovation to address neglected diseases driven by entrepreneurial individuals and South-South collaboration. Lessons can be learned from their experience that will help support Ugandan health innovation. PMID:21144076

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.

Processing gender: lived experiences of reproducing and transforming gender norms over the life course of young people in Northern Uganda.

PubMed

Lundgren, Rebecka; Burgess, Sarah; Chantelois, Heather; Oregede, Susan; Kerner, Brad; Kågesten, Anna E

2018-06-08

The years between 10-19 represent a critical stage of human development during which boys and girls learn and embody socially constructed gender norms, with long-term implications for their sexual and reproductive health. This ethnographic cohort study sought to understand how gendered norms and practices develop during the transition from child to young adult in post-conflict northern Uganda. A total of 60 girls and boys aged 10-19 were selected using purposive sampling for in-depth interviews over a three-year period; 47 individuals completed all four interviews. Drawing on feminist theory and an ecological perspective, findings were used to create a conceptual framework displaying the experiences of young people navigating patriarchal and alternative norms, emphasising their lived processes of performing and negotiating norms within six key domains (work, puberty, family planning, intimate partner relations, child discipline and alcohol). The framework identifies: (1) personal factors (knowledge, agency and aspirations); (2) social factors (socialisation processes, capital, costs and consequences); and (3) structural factors (health/educational systems, religious institutions, government policies) which may encourage young people towards one norm or another as they age. These findings can inform policies and programmes to transform gender norms and promote equitable, healthy relationships.

Seasonal Effects on Great Ape Health: A Case Study of Wild Chimpanzees and Western Gorillas

PubMed Central

Masi, Shelly; Chauffour, Sophie; Bain, Odile; Todd, Angelique; Guillot, Jacques; Krief, Sabrina

2012-01-01

Among factors affecting animal health, environmental influences may directly or indirectly impact host nutritional condition, fecundity, and their degree of parasitism. Our closest relatives, the great apes, are all endangered and particularly sensitive to infectious diseases. Both chimpanzees and western gorillas experience large seasonal variations in fruit availability but only western gorillas accordingly show large changes in their degree of frugivory. The aim of this study is to investigate and compare factors affecting health (through records of clinical signs, urine, and faecal samples) of habituated wild ape populations: a community (N = 46 individuals) of chimpanzees (Pan troglodytes) in Kanyawara, Kibale National Park (Uganda), and a western gorilla (G. gorilla) group (N = 13) in Bai Hokou in the Dzanga-Ndoki National Park (Central African Republic). Ape health monitoring was carried out in the wet and dry seasons (chimpanzees: July–December 2006; gorillas: April–July 2008 and December 2008–February 2009). Compared to chimpanzees, western gorillas were shown to have marginally greater parasite diversity, higher prevalence and intensity of both parasite and urine infections, and lower occurrence of diarrhea and wounds. Parasite infections (prevalence and load), but not abnormal urine parameters, were significantly higher during the dry season of the study period for western gorillas, who thus appeared more affected by the large temporal changes in the environment in comparison to chimpanzees. Infant gorillas were the most susceptible among all the age/sex classes (of both apes) having much more intense infections and urine blood concentrations, again during the dry season. Long term studies are needed to confirm the influence of seasonal factors on health and parasitism of these great apes. However, this study suggest climate change and forest fragmentation leading to potentially larger seasonal fluctuations of the environment may affect patterns of ape parasitism and further exacerbate health impacts on great ape populations that live in highly seasonal habitats. PMID:23227152

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

PubMed

Muriisa, Roberts Kabeba; Jamil, Ishtiaq

2011-01-01

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

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

Spread of English and Westernization in Saudi Arabia.

ERIC Educational Resources Information Center

Al-Abed, Fawwaz; And Others

1996-01-01

A questionnaire was distributed to Saudi Arabian undergraduates in order to investigate their attitudes toward Westernization, national identity, and religious commitment. Results revealed that learning English did not "Westernize" students nor weaken national identity. Implications and recommendations for establishing a rigid language…

Malaria in Uganda: challenges to control on the long road to elimination. I. Epidemiology and current control efforts

PubMed Central

Yeka, Adoke; Gasasira, Anne; Mpimbaza, Arthur; Achan, Jane; Nankabirwa, Joaniter; Nsobya, Sam; Staedke, Sarah G.; Donnelly, Martin J.; Wabwire-Mangen, Fred; Talisuna, Ambrose; Dorsey, Grant; Kamya, Moses R.; Rosenthal, Philip J.

2011-01-01

Malaria remains one of the leading health problems of the developing world, and Uganda bears a particularly large burden from the disease. Our understanding is limited by a lack of reliable data, but it is clear that the prevalence of malaria infection, incidence of disease, and mortality from severe malaria all remain very high. Uganda has made progress in implementing key malaria control measures, in particular distribution of insecticide impregnated bednets, indoor residual spraying of insecticides, utilization of artemisinin-based combination therapy to treat uncomplicated malaria, and provision of intermittent preventive therapy for pregnant women. However, despite enthusiasm regarding the potential for the elimination of malaria in other areas, there is no convincing evidence that the burden of malaria has decreased in Uganda in recent years. Major challenges to malaria control in Uganda include very high malaria transmission intensity, inadequate health care resources, a weak health system, inadequate understanding of malaria epidemiology and the impact of control interventions, increasing resistance of parasites to drugs and of mosquitoes to insecticides, inappropriate case management, inadequate utilization of drugs to prevent malaria, and inadequate epidemic preparedness and response. Despite these challenges, prospects for the control of malaria have improved, and with attention to underlying challenges, progress toward the control of malaria in Uganda can be expected. PMID:21420377

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

PubMed

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

2013-11-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2016-10-01

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

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

PubMed

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

2017-01-01

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

Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda.

PubMed

Rukundo, Peter M; Iversen, Per O; Andreassen, Bård A; Oshaug, Arne; Kikafunda, Joyce; Rukooko, Byaruhanga

2015-04-25

Despite the instruments on the right to adequate food adopted by the United Nations, there exists limited information on how this right is perceived. Following a major 2010 landslide disaster in the Bududa district of Eastern Uganda and the resettlement of some affected households into the Kiryandongo district in Western Uganda, we surveyed both districts to explore perceptions about the right to adequate food among households with different experiences; disaster-affected and controls. We deployed qualitative and quantitative techniques to a cross-sectional survey. The index respondent was the head of each randomly selected household from the landslide affected communities and controls from a bordering sub-county. Data was collected by interviews and focus group discussions (FGDs). Structured entries were tested statistically to report associations using Pearson's Chi-square at the 95% CI. Information from FGDs was transcribed, coded, sequenced and patterned. Findings from both techniques were triangulated to facilitate interpretations. Analysis included 1,078 interview entries and 12 FGDs. Significant differences between the affected and control households (P < 0.05) were observed with: age; education level; religious affiliation; existence of assets that complement food source; and having received relief food. Analysis between groups showed differences in responses on: whether everyone has a right to adequate food; who was supposed to supply relief food; whether relief food was adequate; and preferred choice on the means to ensure the right to adequate food. FGDs emphasized that access to land was the most important means to food and income. Affected households desired remedial interventions especially alternative land for livelihood. Despite the provision of adequate relief food being a state's obligation, there was no opportunity to exercise choice and preference. Comprehension and awareness of accountability and transparency issues was also low. Though a significant proportion of participants affirmed they have a right to adequate food, relief food was largely perceived as insufficient. Given the high regard for land as a preferred remedy, a resettlement policy is of the essence to streamline post-landslide displacement and resettlement. Information materials need to be assembled and disseminated to stimulate awareness and debate on the right to adequate food.

Access to Education for Orphans and Vulnerable Children in Uganda: A Multi-District, Cross-Sectional Study Using Lot Quality Assurance Sampling from 2011 to 2013

PubMed Central

Crossland, Nadine; Valadez, Joseph J.

2015-01-01

Objectives This study estimates the proportion of Orphans and Vulnerable Children (OVC) attending school in 89 districts of Uganda from 2011 – 2013 and investigates the factors influencing OVC access to education among this population. Methods This study used secondary survey data from OVCs aged 5 – 17 years, collected using Lot Quality Assurance Sampling in 87 Ugandan districts over a 3-year period (2011 – 2013). Estimates of OVC school attendance were determined for the yearly time periods. Logistic regression was used to investigate the factors influencing OVC access to education. Results 19,354 children aged 5-17 were included in the analysis. We estimated that 79.1% (95% CI: 78.5% – 79.7%) of OVCs attended school during the 3-year period. Logistic regression revealed the odds of attending school were lower among OVCs from Western (OR 0.88; 95% CI: 0.79 – 0.99) and Northern (OR 0.64; 95% CI: 0.56 – 0.73) regions compared to the Central region. Female OVCs had a significantly higher odds of attending school (OR 1.09; 95% CI: 1.02 – 1.17) compared to their male counterparts. When adjusting for all variables simultaneously, we found the odds of school attendance reduced by 12% between 2011 and 2012 among all OVCs (OR 0.88; 95% CI: 0.81 – 0.97). Conclusion Our findings reinforce the need to provide continuing support to OVC in Uganda, ensuring they have the opportunity to attain an education. The data indicate important regional and gender variation that needs to be considered for support strategies and in social policy. The results suggest the need for greater local empowerment to address the needs of OVCs. We recommend further research to understand why OVC access to education and attendance varies between regions and improvement of district level mapping of OVC access to education, and further study to understand the particular factors impacting the lower school attendance of male OVCs. PMID:26181056

Community Perceptions on Integrating Animal Vaccination and Health Education by Veterinary and Public Health Workers in the Prevention of Brucellosis among Pastoral Communities of South Western Uganda

PubMed Central

Kansiime, Catherine; Atuyambe, Lynn M.; Asiimwe, Benon B.; Mugisha, Anthony; Mugisha, Samuel; Guma, Victor; Rwego, Innocent B.; Rutebemberwa, Elizeus

2015-01-01

Background Brucellosis is a zoonotic disease of veterinary, public health, and economic significance in most developing countries, yet there are few studies that show integrated human and veterinary health care intervention focusing on integration at both activity and actors levels. The aim of our study, therefore, was to explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis in Uganda. Methods This study used a qualitative design where six Focus Group Discussions (FGDs) that were homogenous in nature were conducted, two from each sub-county, one with the local leaders, and another with pastoralists and farmers. Five Key Informant Interviews (KIIs) with two public health workers and three veterinary extension workers from three sub-counties in Kiruhura district, Uganda were conducted. All FGDs were conducted in the local language and tape recorded with consent from the participants. KIIs were in English and later transcribed and analyzed using latent content data analysis method. Results All the groups mentioned that they lacked awareness on brucellosis commonly known as Brucella and its vaccination in animals. Respondents perceived improvement in human resources in terms of training and recruiting more health personnel, facilitation of the necessary activities such as sensitization of the communities about brucellosis, and provision of vaccines and diagnostic tests as very important in the integration process in the communities. The FGD participants also believed that community participation was crucial for sustainability and ownership of the integration process. Conclusions The respondents reported limited knowledge of brucellosis and its vaccination in animals. The community members believed that mass animal vaccination in combination with health education about the disease is important and possible if it involves government and all other stakeholders such as wildlife authorities, community members, local to national political leaders, as well as the technical personnel from veterinary, medical and public health sectors since it affects both humans and animals. PMID:26218368

Cross-sectional comparative study of risky sexual behaviours among HIV-infected persons initiated and waiting to start antiretroviral therapy in rural Rakai, Uganda.

PubMed

Nakiganda, Lydia Jacenta; Nakigozi, Gertrude; Kagaayi, Joseph; Nalugoda, Fred; Serwadda, David; Sewankambo, Nelson; Gray, Ronald; Ndyanabo, Anthony; Muwanika, Richard; Asamoah, Benedict Oppong

2017-09-11

To compare risky sexual behaviours between HIV-positive persons initiated on antiretroviral therapy (ART) (ART-experienced) and persons waiting to start on ART (ART-naive) and assess predictors of risky sexual behaviours among HIV-infected patients in rural Rakai district, Uganda. This is a cross-sectional study that used data from the Rakai Community Cohort Study (RCCS) database between 2013 and 2014. A structured questionnaire was used for data collection. We used stepwise logistic regression as an index to estimate the adjusted ORs for the association between risky sexual behaviours and ART treatment status. This study was conducted in Rakai district, located in south-western Uganda. The data for this study were extracted from the RCCS. RCCS is an open prospective cohort of approximately 15 000 consenting participants aged 15-49 years. HIV-positive participants aged 18-49 years who had sex at least once a month with any partner prior to the start of the study. Inconsistent/no condom use in the last 12 months, alcohol use at last sexual encounter, and two or more sexual partners. ART-naive participants were more likely to report inconsistent condom use (OR=1.74, 95% CI 1.11 to 2.73) and more likely to drink alcohol at last sexual encounter (OR=1.65, 95% CI 1.11 to 2.46), compared with ART-experienced patients. ART treatment status (p<0.001) was a significant predictor of risky sexual behaviours. Both marital status (p=0.016) and occupation level (p=0.009) were positively associated with inconsistent condom use, while sex (p<0.001) correlated with alcohol use at last sexual encounter. ART-naive participants were more likely to exhibit risky sexual behaviours than the ART-experienced participants. The intensity of risk reduction counselling should be increased for HIV-positive persons waiting to start ART but already in HIV care. © 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.

Carriage prevalence and serotype distribution of Streptococcus pneumoniae prior to 10-valent pneumococcal vaccine introduction: A population-based cross-sectional study in South Western Uganda, 2014.

PubMed

Nackers, Fabienne; Cohuet, Sandra; le Polain de Waroux, Olivier; Langendorf, Céline; Nyehangane, Dan; Ndazima, Donny; Nanjebe, Deborah; Karani, Angela; Tumwesigye, Elioda; Mwanga-Amumpaire, Juliet; Scott, J Anthony G; Grais, Rebecca F

2017-09-18

Information on Streptococcus pneumoniae nasopharyngeal (NP) carriage before the pneumococcal conjugate vaccine (PCV) introduction is essential to monitor impact. The 10-valent PCV (PCV10) was officially introduced throughout Ugandan national childhood immunization programs in 2013 and rolled-out countrywide during 2014. We aimed to measure the age-specific Streptococcus pneumoniae carriage and serotype distribution across all population age groups in the pre-PCV10 era in South Western Uganda. We conducted a two-stage cluster, age-stratified, cross-sectional community-based study in Sheema North sub-district between January and March 2014. One NP swab was collected and analyzed for each participant in accordance with World Health Organization guidelines. NP carriage of any pneumococcal serotype was higher among children <2years old (77%; n=387) than among participants aged ≥15years (8.5%; n=325) (chi 2 p<0.001). Of the 623 positive cultures, we identified 49 serotypes among 610 (97.9%) isolates; thirteen (2.1%) isolates were non-typeable. Among <2years old, serotypes 6A, 6B, 14, 15B, 19F and 23F accounted for half of all carriers. Carriage prevalence with PCV10 serotypes was 29.4% among individuals aged <2years (n=387), 23.4% in children aged 2-4years (n=217), 11.4% in 5-14years (n=417), and 0.4% among individuals ≥15years of age (n=325). The proportion of carried pneumococci serotypes contained in PCV10 was 38.1% (n=291), 32.8% (n=154), 29.4% (n=156), and 4.4% (n=22) among carriers aged <2years, 2-4years, 5-14years and ≥15years, respectively. In Sheema district, the proportion of PCV10 serotypes was low (<40%), across all age groups, especially among individuals aged 15years or older (<5%). PCV10 introduction is likely to impact transmission among children and to older individuals, but less likely to substantially modify pneumococcal NP ecology among individuals aged 15years or older. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda

PubMed Central

Kabakyenga, Jerome K.; Östergren, Per-Olof; Turyakira, Eleanor; Pettersson, Karen Odberg

2012-01-01

Introduction Assistance by skilled birth attendants (SBAs) during childbirth is one of the strategies aimed at reducing maternal morbidity and mortality in low-income countries. However, the relationship between birth preparedness and decision-making on location of birth and assistance by skilled birth attendants in this context is not well studied. The aim of this study was to assess the influence of birth preparedness practices and decision-making and assistance by SBAs among women in south-western Uganda. Methods Community survey methods were used to identify 759 recently delivered women from 120 villages in rural Mbarara district. Interviewer-administered questionnaires were used to collect data. Logistic regression analyses were conducted to assess the relationship between birth preparedness, decision-making on location of birth and assistance by SBAs. Results 35% of the women had been prepared for childbirth and the prevalence of assistance by SBAs in the sample was 68%. The final decision regarding location of birth was made by the woman herself (36%), the woman with spouse (56%) and the woman with relative/friend (8%). The relationships between birth preparedness and women decision-making on location of birth in consultation with spouse/friends/relatives and choosing assistance by SBAs showed statistical significance which persisted after adjusting for possible confounders (OR 1.5, 95% CI: 1.0–2.4) and (OR 4.4, 95% CI: 3.0–6.7) respectively. Education, household assets and birth preparedness showed clear synergistic effect on the relationship between decision-maker on location of birth and assistance by SBAs. Other factors which showed statistical significant relationships with assistance by SBAs were ANC attendance, parity and residence. Conclusion Women’s decision-making on location of birth in consultation with spouse/friends/relatives and birth preparedness showed significant effect on choosing assistance by SBAs at birth. Education and household assets ownership showed a synergistic effect on the relationship between the decision-maker and assistance by SBAs. PMID:22558214

Option B+ for prevention of vertical HIV transmission has no influence on adverse birth outcomes in a cross-sectional cohort in Western Uganda.

PubMed

Rempis, Eva M; Schnack, Alexandra; Decker, Sarah; Braun, Vera; Rubaihayo, John; Tumwesigye, Nazarius Mbona; Busingye, Priscilla; Harms, Gundel; Theuring, Stefanie

2017-03-07

While most Sub-Saharan African countries are now implementing the WHO-recommended Option B+ protocol for prevention of vertical HIV transmission, there is a lack of knowledge regarding the influence of Option B+ exposure on adverse birth outcomes (ABOs). Against this background, we assessed ABOs among delivering women in Western Uganda. A cross-sectional, observational study was performed within a cohort of 412 mother-newborn-pairs in Virika Hospital, Fort Portal in 2013. The occurrence of stillbirth, pre-term delivery, and small size for gestational age (SGA) was analysed, looking for influencing factors related to HIV-status, antiretroviral drug exposure and duration, and other sociodemographic and clinical parameters. Among 302 HIV-negative and 110 HIV-positive women, ABOs occurred in 40.5%, with stillbirth in 6.3%, pre-term delivery in 28.6%, and SGA in 12.2% of deliveries. For Option B+ intake (n = 59), no significant association was found with stillbirth (OR 0.48, p = 0.55), pre-term delivery (OR 0.97, p = 0.92) and SGA (OR 1.5, p = 0.3) compared to seronegative women. Women enrolled on antiretroviral therapy (ART) before conception (n = 38) had no different risk for ABOs than women on Option B+ or HIV-negative women. Identified risk factors for stillbirth included lack of formal education, poor socio-economic status, long travel distance, hypertension and anaemia. Pre-term delivery risk was increased with poor socio-economic status, primiparity, Malaria and anaemia. The occurrence of SGA was influenced by older age and Malaria. In our study, women on Option B+ showed no difference in ABOs compared to HIV-negative women and to women on ART. We identified several non-HIV/ART-related influencing factors, suggesting an urgent need for improving early risk assessment mechanisms in antenatal care through better screening and triage systems. Our results are encouraging with regard to continued universal scale-up of Option B+ and ART programmes.

Seismic hazard assessment of the Kivu rift segment based on a new sismo-tectonic zonation model (Western Branch of the East African Rift system)

NASA Astrophysics Data System (ADS)

Havenith, Hans-Balder; Delvaux, Damien

2015-04-01

In the frame of the Belgian GeoRisCA multi-risk assessment project focused on the Kivu and Northern Tanganyika Region, a seismic hazard map has been produced for this area. It is based on a on a recently re-compiled catalogue using various local and global earthquake catalogues. The use of macroseismic epicenters determined from felt earthquakes allowed to extend the time-range back to the beginning of the 20th century, thus spanning about 100 years. The magnitudes have been homogenized to Mw and the coherence of the catalogue has been checked and validated. The seismo-tectonic zonation includes 10 seismic source areas that have been defined on the basis of the regional geological structure, neotectonic fault systems, basin architecture and distribution of earthquake epicenters. The seismic catalogue was filtered by removing obvious aftershocks and Gutenberg-Richter Laws were determined for each zone. On the basis of this seismo-tectonic information and existing attenuation laws that had been established by Twesigomwe (1997) and Mavonga et al. (2007) for this area, seismic hazard has been computed with the Crisis 2012 (Ordaz et al., 2012) software. The outputs of this assessment clearly show higher PGA values (for 475 years return period) along the Rift than the previous estimates by Twesigomwe (1997) and Mavonga (2007) while the same attenuation laws had been used. The main reason for these higher PGA values is likely to be related to the more detailed zonation of the Rift structure marked by a strong gradient of the seismicity from outside the rift zone to the inside. Mavonga, T. (2007). An estimate of the attenuation relationship for the strong ground motion in the Kivu Province, Western Rift Valley of Africa. Physics of the Earth and Planetary Interiors 62, 13-21. Ordaz M, Martinelli F, Aguilar A, Arboleda J, Meletti C, D'Amico V. (2012). CRISIS 2012, Program for computing seismic hazard. Instituto de Ingeniería, Universidad Nacional Autónoma de México. Twesigomwe, E. (1997). Probabilistic seismic hazard assessment of Uganda, Ph.D. Thesis, Dept. of Physics, Makare University, Uganda.

Factors contributing to measles transmission during an outbreak in Kamwenge District, Western Uganda, April to August 2015.

PubMed

Nsubuga, Fred; Bulage, Lilian; Ampeire, Immaculate; Matovu, Joseph K B; Kasasa, Simon; Tanifum, Patricia; Riolexus, Alex Ario; Zhu, Bao-Ping

2018-01-08

In April 2015, Kamwenge District, western Uganda reported a measles outbreak. We investigated the outbreak to identify potential exposures that facilitated measles transmission, assess vaccine effectiveness (VE) and vaccination coverage (VC), and recommend prevention and control measures. For this investigation, a probable case was defined as onset of fever and generalized maculopapular rash, plus ≥1 of the following symptoms: Coryza, conjunctivitis, or cough. A confirmed case was defined as a probable case plus identification of measles-specific IgM in serum. For case-finding, we reviewed patients' medical records and conducted in-home patient examination. In a case-control study, we compared exposures of case-patients and controls matched by age and village of residence. For children aged 9 m-5y, we estimated VC using the percent of children among the controls who had been vaccinated against measles, and calculated VE using the formula, VE = 1 - OR M-H , where OR M-H was the Mantel-Haenszel odds ratio associated with having a measles vaccination history. We identified 213 probable cases with onset between April and August, 2015. Of 23 blood specimens collected, 78% were positive for measles-specific IgM. Measles attack rate was highest in the youngest age-group, 0-5y (13/10,000), and decreased as age increased. The epidemic curve indicated sustained propagation in the community. Of the 50 case-patients and 200 controls, 42% of case-patients and 12% of controls visited health centers during their likely exposure period (OR M-H  = 6.1; 95% CI = 2.7-14). Among children aged 9 m-5y, VE was estimated at 70% (95% CI: 24-88%), and VC at 75% (95% CI: 67-83%). Excessive crowding was observed at all health centers; no patient triage-system existed. The spread of measles during this outbreak was facilitated by patient mixing at crowded health centers, suboptimal VE and inadequate VC. We recommended emergency immunization campaign targeting children <5y in the affected sub-counties, as well as triaging and isolation of febrile or rash patients visiting health centers.

Association between HRP-2/pLDH rapid diagnostic test band positivity and malaria-related anemia at a peripheral health facility in Western Uganda.

PubMed

Boyce, Ross; Reyes, Raquel; Ntaro, Moses; Mulogo, Edgar; Matte, Michael; Boum, Yap; Siedner, Mark J

2015-12-01

The detection of severe malaria in resource-constrained settings is often difficult because of requirements for laboratory infrastructure and/or clinical expertise. The aim of this study, therefore, was to explore the utility of a multiple antigen (HRP-2/pLDH) rapid diagnostic test (RDT) as a low-cost, surrogate marker of patients at high risk for complications of severe malaria. We reviewed programmatic data at a peripheral health center in Western Uganda. Available demographic and clinical data on all individuals presenting to the center who underwent an RDT for suspected malaria infection were reviewed. We fit logistic regression models to identify correlates of two outcomes of interest: 1) severe malaria-related anemia, defined here as hemoglobin ≤7g/dL and 2) receipt of parenteral quinine. 1509 patients underwent malaria testing with an SD FK60 RDT during the observation period. A total of 637 (42%) RDTs were positive for at least one species of malaria, of which 326 (51%) exhibited a single HRP-2 band and 307 (48%) exhibited both HRP-2 and pLDH bands, while 4 exhibited only a single pLDH band. There was a trend towards more severe anemia in patients with a HRP-2/pLDH positive RDT compared to a HRP-2 only RDT (β = -0.99 g/dl, 95% CI -1.99 to 0.02, P = 0.055). A HRP-2/pLDH positive RDT was associated with an increased risk of severe malaria-related anemia compared to a negative RDT (adjusted odds ratio (AOR) 18.8, 95% CI 4.32 to 82.0, P < 0.001) and to a HRP-2 only RDT (AOR 2.46, 95% CI 0.75 to 8.04, P = 0.14). There was no significant association between RDT result and the administration of parenteral quinine. These results offer preliminary evidence that specific patterns of antigen positivity on RDTs could be utilized to identify patients at an increased risk for complications of severe malaria.

Predictors and outcome of surgical repair of obstetric fistula at a regional referral hospital, Mbarara, western Uganda

PubMed Central

2011-01-01

Background Obstetric fistula although virtually eliminated in high income countries, still remains a prevalent and debilitating condition in many parts of the developing world. It occurs in areas where access to care at childbirth is limited, or of poor quality and where few hospitals offer the necessary corrective surgery. Methods This was a prospective observational study where all women who attended Mbarara Regional Referral Hospital in western Uganda with obstetric fistula during the study period were assessed pre-operatively for social demographics, fistula characteristics, classification and outcomes after surgery. Assessment for fistula closure and stress incontinence after surgery was done using a dye test before discharge Results Of the 77 women who were recruited in this study, 60 (77.9%) had successful closure of their fistulae. Unsuccessful fistula closure was significantly associated with large fistula size (Odds Ratio 6 95% Confidential interval 1.46-24.63), circumferential fistulae (Odds ratio 9.33 95% Confidential interval 2.23-39.12) and moderate to severe vaginal scarring (Odds ratio 12.24 95% Confidential interval 1.52-98.30). Vaginal scarring was the only factor independently associated with unsuccessful fistula repair (Odds ratio 10 95% confidential interval 1.12-100.57). Residual stress incontinence after successful fistula closure was associated with type IIb fistulae (Odds ratio 5.56 95% Confidential interval 1.34-23.02), circumferential fistulae (Odds ratio 10.5 95% Confidential interval 1.39-79.13) and previous unsuccessful fistula repair (Odds ratio 4.8 95% Confidential interval 1.27-18.11). Independent predictors for residual stress incontinence after successful fistula closure were urethral involvement (Odds Ratio 4.024 95% Confidential interval 2.77-5.83) and previous unsuccessful fistula repair (Odds ratio 38.69 95% Confidential interval 2.13-703.88). Conclusions This study demonstrated that large fistula size, circumferential fistulae and marked vaginal scarring are predictors for unsuccessful fistula repair while predictors for residual stress incontinence after successful fistula closure were urethral involvement, circumferential fistulae and previous unsuccessful fistula repair. PMID:22151960

Predictors and outcome of surgical repair of obstetric fistula at a regional referral hospital, Mbarara, western Uganda.

PubMed

Kayondo, Musa; Wasswa, Ssalongo; Kabakyenga, Jerome; Mukiibi, Nozmo; Senkungu, Jude; Stenson, Amy; Mukasa, Peter

2011-12-07

Obstetric fistula although virtually eliminated in high income countries, still remains a prevalent and debilitating condition in many parts of the developing world. It occurs in areas where access to care at childbirth is limited, or of poor quality and where few hospitals offer the necessary corrective surgery. This was a prospective observational study where all women who attended Mbarara Regional Referral Hospital in western Uganda with obstetric fistula during the study period were assessed pre-operatively for social demographics, fistula characteristics, classification and outcomes after surgery. Assessment for fistula closure and stress incontinence after surgery was done using a dye test before discharge Of the 77 women who were recruited in this study, 60 (77.9%) had successful closure of their fistulae. Unsuccessful fistula closure was significantly associated with large fistula size (Odds Ratio 6 95% Confidential interval 1.46-24.63), circumferential fistulae (Odds ratio 9.33 95% Confidential interval 2.23-39.12) and moderate to severe vaginal scarring (Odds ratio 12.24 95% Confidential interval 1.52-98.30). Vaginal scarring was the only factor independently associated with unsuccessful fistula repair (Odds ratio 10 95% confidential interval 1.12-100.57). Residual stress incontinence after successful fistula closure was associated with type IIb fistulae (Odds ratio 5.56 95% Confidential interval 1.34-23.02), circumferential fistulae (Odds ratio 10.5 95% Confidential interval 1.39-79.13) and previous unsuccessful fistula repair (Odds ratio 4.8 95% Confidential interval 1.27-18.11). Independent predictors for residual stress incontinence after successful fistula closure were urethral involvement (Odds Ratio 4.024 95% Confidential interval 2.77-5.83) and previous unsuccessful fistula repair (Odds ratio 38.69 95% Confidential interval 2.13-703.88). This study demonstrated that large fistula size, circumferential fistulae and marked vaginal scarring are predictors for unsuccessful fistula repair while predictors for residual stress incontinence after successful fistula closure were urethral involvement, circumferential fistulae and previous unsuccessful fistula repair.

Unintended pregnancy and abortion in Uganda.

PubMed

Hussain, Rubina

2013-01-01

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

West Nile Virus in the United States — A Historical Perspective

PubMed Central

Roehrig, John T.

2013-01-01

Prior to 1999, West Nile virus (WNV) was a bit player in the screenplay of global vector-borne viral diseases. First discovered in the West Nile District of Uganda in 1937, this Culex sp.-transmitted virus was known for causing small human febrile outbreaks in Africa and the Middle East. Prior to 1995, the last major human WNV outbreak was in the 1950s in Israel. The epidemiology and ecology of WNV began to change in the mid-1990s when an epidemic of human encephalitis occurred in Romania. The introduction of WNV into Eastern Europe was readily explained by bird migration between Africa and Europe. The movement of WNV from Africa to Europe could not, however, predict its surprising jump across the Atlantic Ocean to New York City and the surrounding areas of the United States (U.S.). This movement of WNV from the Eastern to Western Hemisphere in 1999, and its subsequent dissemination throughout two continents in less than ten years is widely recognized as one of the most significant events in arbovirology during the last two centuries. This paper documents the early events of the introduction into and the spread of WNV in the Western Hemisphere. PMID:24335779

West nile virus in the United States - a historical perspective.

PubMed

Roehrig, John T

2013-12-10

Prior to 1999, West Nile virus (WNV) was a bit player in the screenplay of global vector-borne viral diseases. First discovered in the West Nile District of Uganda in 1937, this Culex sp.-transmitted virus was known for causing small human febrile outbreaks in Africa and the Middle East. Prior to 1995, the last major human WNV outbreak was in the 1950s in Israel. The epidemiology and ecology of WNV began to change in the mid-1990s when an epidemic of human encephalitis occurred in Romania. The introduction of WNV into Eastern Europe was readily explained by bird migration between Africa and Europe. The movement of WNV from Africa to Europe could not, however, predict its surprising jump across the Atlantic Ocean to New York City and the surrounding areas of the United States (U.S.). This movement of WNV from the Eastern to Western Hemisphere in 1999, and its subsequent dissemination throughout two continents in less than ten years is widely recognized as one of the most significant events in arbovirology during the last two centuries. This paper documents the early events of the introduction into and the spread of WNV in the Western Hemisphere.

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

PubMed Central

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

2016-01-01

Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement of the Stroke Impact Scale. PMID:27746913

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

PubMed

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

2016-01-01

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

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.

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.

Contribution of plants and traditional medicines to the disparities and similarities in acute poisoning incidents in Botswana, South Africa and Uganda.

PubMed

Malangu, N

2014-01-01

Acute poisoning incidents are one of the leading causes of morbidity and hospitalization in several countries. The purpose of this analysis was to compare the patterns of acute poisoning in three countries namely, Botswana, South Africa and Uganda; and examine the similarities and disparities in the patterns of occurrence of acute poisoning based on the sociodemographic factors of the victims, the toxic agents involved, the circumstances surrounding the incidents and their outcomes. This paper is based on the re-analysis of data that were collected from January to June 2005 by some Master of Public Health students using a similar data collection tool. A single dataset made of the original individual datasheets was constituted and analysed. Overall, it was found that the mean age of victims of acute poisoning was 20.9 ± 14.5 years; the youngest victim was a 3 months old boy from South Africa; and the oldest was a 75 years old man from Uganda. In descending order, the most common toxic agents involved in poisoning incidents were household products (46.1%), agrochemicals (18.8%), pharmaceuticals (14.0%), animal and insect bites (13.0%), food poisoning (4.5%), as well as plants and traditional medicines (3.6%). Across the three countries, acute poisoning occurred mainly by accident, but the contextual factors of each country led to a pattern of acute poisoning that showed some similarities with regard to the distribution of deliberate self-poisoning among females, teenagers, and young adult victims. There were disparities related to the differential access to toxic agents, based on the age and gender of the victims. Of the 17 deaths reported, 2 (11.7%) were due to traditional medicines; household products were implicated in fatal outcomes in all three countries, though the extent of their involvement varied from country to country. Although plant and traditional medicines caused fewer cases of acute poisoning incidents, they contributed considerably to fatal outcomes.

Translating health research evidence into policy and practice in Uganda.

PubMed

Mbonye, Anthony K; Magnussen, Pascal

2013-08-05

Uganda experiences a high disease burden of malaria, infectious and non-communicable diseases. Recent data shows that malaria is the leading cause of morbidity and mortality among all age groups, while HIV prevalence is on the increase and there is re-emergence of viral haemorrhagic fevers and cholera epidemics. In order to respond to the above situation, a team of researchers, policy makers, civil society and the media was formed in order to build a collaboration that would help in discussing appropriate strategies to mitigate the high disease burden in Uganda. A preparatory secretariat composed of individuals from Ministry of Health, Malaria Research Centre and School of Public Health was formed. The secretariat identified researchers, key resource persons to guide the workshops and the format for presentation. The criteria for selection of the research topics were: National public health importance and had been published in peer-reviewed journals. The presentations were structured as follows: research questions, hypotheses, methodology, major findings and policy implications. The secretariat compiled all the proceedings of the workshops including attendance, address of participants including telephone and email contacts. During the last workshop, an evaluation was conducted to assess the impact of the workshops. Four workshops were held between 2006 and 2009. A total of 322 participants attended of whom mid-level policy makers, researchers and the media were consistently high. The workshops generated a lot of interest that lead to presentation and discussion of nationally relevant health research results. The workshops had an impact on the participants' skills in writing policy briefs, participating in the policy review process and entering into dialogue with policy makers. The following lessons have been learned: getting health research into policy is feasible but requires few self-motivated individuals to act as catalysts. Adequate funding and a stable internet are necessary to support the process. Mid-level policy makers and programme managers had interest in this initiative and are likely sustain it as they move to senior positions in policy making.

The feasibility of introducing rapid diagnostic tests for malaria in drug shops in Uganda.

PubMed

Mbonye, Anthony K; Ndyomugyenyi, Richard; Turinde, Asaph; Magnussen, Pascal; Clarke, Siân; Chandler, Clare

2010-12-21

National malaria control programmes and international agencies are keen to scale-up the use of effective rapid diagnostic tests (RDTs) for malaria. The high proportion of the Ugandan population seeking care at drug shops makes these outlets attractive as providers of malaria RDTs. However, there is no precedent for blood testing at drug shops and little is known about how such tests might be perceived and used. Understanding use of drug shops by communities in Uganda is essential to inform the design of interventions to introduce RDTs. We conducted a qualitative study, with 10 community focus group discussions, and 18 in-depth interviews with drug shop attendants, health workers and district health officials. The formative study was carried out in Mukono district, central Uganda an area of high malaria endemicity from May-July 2009. Drug shops were perceived by the community as important in treating malaria and there was awareness among most drug sellers and the community that not all febrile illnesses were malaria. The idea of introducing RDTs for malaria diagnosis in drug shops was attractive to most respondents. It was anticipated that RDTs would improve access to effective treatment of malaria, offset high costs associated with poor treatment, and avoid irrational drug use. However, communities did express fear that drug shops would overprice RDTs, raising the overall treatment cost for malaria. Other fears included poor adherence to the RDT result, reuse of RDTs leading to infections and fear that RDTs would be used to test for human immune deficiency virus (HIV). All drug shops visited had no record on patient data and referral of cases to health units was noted to be poor. These results not only provide useful lessons for implementing the intervention study but have wide implications for scaling up malaria treatment in drug shops.

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

PubMed Central

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

2012-01-01

Background Underachievement in schools is a global problem and is especially prevalent in developing countries. Indicators of educational performance show that Uganda has done remarkably well on education access-related targets since the introduction of universal primary education in 1997. However, educational outcomes remain disappointing. The absence of school feeding schemes, one of the leading causes of scholastic underachievement, has not been given attention by the Ugandan authorities. Instead, as a national policy, parents are expected to provide meals even though many, especially in the rural areas, cannot afford to provide even the minimal daily bowl of maize porridge. Objective To assess and demonstrate the effect of breakfast and midday meal consumption on academic achievement of schoolchildren. Design, Materials and Methods We assessed household characteristics, feeding patterns and academic achievement of 645 schoolchildren (aged 9–15 years) in Kumi district, eastern Uganda, in 2006–2007, using a modified cluster sampling design which involved only grade 1 schools (34 in total) and pupils of grade four. Household questionnaires and school records were used to collect information on socio-demographic factors, feeding patterns and school attendance. Academic achievement was assessed using unstandardized techniques, specifically designed for this study. Results Underachievement (the proportion below a score of 120.0 points) was high (68.4%); in addition, significantly higher achievement and better feeding patterns were observed among children from the less poor households (p<0.05). Achievement was significantly associated with consumption of breakfast and a midday meal, particularly for boys (p<0.05), and a greater likelihood of scoring well was observed for better nourished children (all OR values>1.0). Conclusion We observed that underachievement was relatively high; inadequate patterns of meal consumption, particularly for the most poor, significantly higher scores among children from ‘less poor’ households and a significant association between academic achievement and breakfast and midday meal consumption. PMID:22347147

Perinatal mental health care in a rural African district, Uganda: a qualitative study of barriers, facilitators and needs.

PubMed

Nakku, Juliet E M; Okello, Elialilia S; Kizza, Dorothy; Honikman, Simone; Ssebunnya, Joshua; Ndyanabangi, Sheila; Hanlon, Charlotte; Kigozi, Fred

2016-07-22

Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). This study aims to explore the barriers and facilitators, as well as perceptions about the feasibility and acceptability of plans to deliver perinatal mental health care in primary care settings in a low income, rural district in Uganda. Six focus group discussions comprising separate groups of pregnant and postpartum women and village health teams as well as eight key informant interviews were conducted in the local language using a topic guide. Transcribed data were translated into English, analyzed, and coded. Key themes were identified using a thematic analysis approach. Participants perceived that there was an important unmet need for perinatal mental health care in the district. There was evidence of significant gaps in knowledge about mental health problems as well as negative attitudes amongst mothers and health care providers towards sufferers. Poverty and inability to afford transport to services, poor partner support and stigma were thought to add to the difficulties of perinatal women accessing care. There was an awareness of the need for interventions to respond to this neglected public health problem and a willingness of both community- and facility-based health care providers to provide care for mothers with mental health problems if equipped to do so by adequate training. This study highlights the acceptability and relevance of perinatal mental health care in a rural, low-income country community. It also underscores some of the key barriers and potential facilitators to delivery of such care in primary care settings. The results of this study have implications for mental health service planning and development for perinatal populations in Uganda and will be useful in informing the development of integrated maternal mental health care in this rural district and in similar settings in other low and middle income countries.

Maternal experiences of caring for an infant with neurological impairment after neonatal encephalopathy in Uganda: a qualitative study

PubMed Central

Nakamanya, Sarah; Siu, Godfrey E.; Lassman, Rachel; Seeley, Janet; Tann, Cally J.

2015-01-01

Abstract Purpose: The study investigated maternal experiences of caring for a child affected by neurological impairment after neonatal encephalopathy (NE) (“birth asphyxia”) in Uganda. Methods: Between September 2011 and October 2012 small group and one-on-one in-depths interviews were conducted with mothers recruited to the ABAaNA study examining outcomes from NE in Mulago hospital, Kampala. Data were analysed thematically with the aid of Nvivo 8 software. Findings: Mothers reported caring for an infant with impairment was often complicated by substantial social, emotional and financial difficulties and stigma. High levels of emotional distress, feelings of social isolation and fearfulness about the future were described. Maternal health-seeking ability was exacerbated by high transport costs, lack of paternal support and poor availability of rehabilitation and counselling services. Meeting and sharing experiences with similarly affected mothers was associated with more positive maternal caring experiences. Conclusion: Mothering a child with neurological impairment after NE is emotionally, physically and financially challenging but this may be partly mitigated by good social support and opportunities to share caring experiences with similarly affected mothers. A facilitated, participatory, community-based approach to rehabilitation training may have important impacts on maximising participation and improving the quality of life of affected mothers and infants.Implications for RehabilitationCaring for an infant with neurological impairment after NE in Uganda has substantial emotional, social and financial impacts on families and is associated with high levels of emotional stress, feelings of isolation and stigma amongst mothers.Improved social support and the opportunity to share experiences with other similarly affected mothers are associated with a more positive maternal caring experience. High transport costs, lack of paternal support and poor availability of counselling and support services were barriers to maternal healthcare seeking.Studies examining the feasibility, acceptability and impact of early intervention programmes are warranted to maximise participation and improve the quality of life for affected mothers and their infants. PMID:25323396

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

PubMed Central

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

2016-01-01

Background Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15–49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program’s progress, and to refine the implementation approach. Methods and Findings The Decision Makers’ Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20–34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10–19 will offer the greatest impact over a 15-year period, while focusing on men ages 15–34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Conclusion Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda’s SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10–34 as a priority group for SMC in the 2014 application to the Global Fund’s new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence. PMID:27410234

Heterogeneity of the HIV epidemic: an observational epidemiologic study of agrarian, trading, and fishing communities in Rakai, Uganda

PubMed Central

Chang, Larry W; Grabowski, Mary K; Ssekubugu, Robert; Nalugoda, Fred; Kigozi, Godfrey; Nantume, Betty; Lessler, Justin; Moore, Sean M; Quinn, Thomas C; Reynolds, Steven J; Gray, Ronald H; Serwadda, David; Wawer, Maria J

2016-01-01

Summary Background Understanding the extent to which HIV burden differs across communities and the drivers of local disparities is critical for an effective and targeted HIV response. We assessed community-level variations in HIV prevalence, risk factors, and treatment and prevention service uptake in Rakai, Uganda. Methods The Rakai Community Cohort Study (RCCS) is an open, population-based cohort surveying persons aged 15–49 in 40 communities. Participants are HIV tested and interviewed to obtain sociodemographic, behavioral, and health information. RCCS data from August 2011 to May 2013 were used to classify communities as agrarian (n=27), trading (n=9), or lakeside fishing sites (n=4). HIV prevalence was mapped using Bayesian methods, and variability across and within community classifications was characterized. Differences in HIV risk factors and uptake of antiretroviral therapy and male circumcision between community types were assessed. Findings 17,119 individuals were included; 9215 (54%) were female. 9931 participants resided in agrarian, 3318 in trading, and 3870 in fishing communities. There was large variation in HIV prevalence, ranging from 9% to 43% across communities. Fishing communities had a higher median HIV prevalence (41%, range: 37–43%) compared to trading (17%, range: 11–22%) and agrarian communities (14%, range: 9–26%); ART and male circumcision coverage were significantly lower in fishing communities. Self-reported risk behaviors were significantly higher in men compared to women and in fishing communities compared to other community types. Interpretation There is substantial heterogeneity in HIV prevalence, risk factors, and service uptake across communities within one region of Uganda. These findings underscore the need for local surveillance and have important implications for the design of targeted HIV responses. In particular, the extremely high HIV burden and risk behaviors, and low use of combination HIV prevention in fishing communities make these areas a priority for intervention. PMID:27470029

Molecular characterisation of protist parasites in human-habituated mountain gorillas (Gorilla beringei beringei), humans and livestock, from Bwindi impenetrable National Park, Uganda.

PubMed

Nolan, Matthew J; Unger, Melisa; Yeap, Yuen-Ting; Rogers, Emma; Millet, Ilary; Harman, Kimberley; Fox, Mark; Kalema-Zikusoka, Gladys; Blake, Damer P

2017-07-18

Over 60 % of human emerging infectious diseases are zoonotic, and there is growing evidence of the zooanthroponotic transmission of diseases from humans to livestock and wildlife species, with major implications for public health, economics, and conservation. Zooanthroponoses are of relevance to critically endangered species; amongst these is the mountain gorilla (Gorilla beringei beringei) of Uganda. Here, we assess the occurrence of Cryptosporidium, Cyclospora, Giardia, and Entamoeba infecting mountain gorillas in the Bwindi Impenetrable National Park (BINP), Uganda, using molecular methods. We also assess the occurrence of these parasites in humans and livestock species living in overlapping/adjacent geographical regions. Diagnostic PCR detected Cryptosporidium parvum in one sample from a mountain gorilla (IIdA23G2) and one from a goat (based on SSU). Cryptosporidium was not detected in humans or cattle. Cyclospora was not detected in any of the samples analysed. Giardia was identified in three human and two cattle samples, which were linked to assemblage A, B and E of G. duodenalis. Sequences defined as belonging to the genus Entamoeba were identified in all host groups. Of the 86 sequence types characterised, one, seven and two have been recorded previously to represent genotypes of Cryptosporidium, Giardia, and Entamoeba, respectively, from humans, other mammals, and water sources globally. This study provides a snapshot of the occurrence and genetic make-up of selected protists in mammals in and around BINP. The genetic analyses indicated that 54.6% of the 203 samples analysed contained parasites that matched species, genotypes, or genetic assemblages found globally. Seventy-six new sequence records were identified here for the first time. As nothing is known about the zoonotic/zooanthroponotic potential of the corresponding parasites, future work should focus on wider epidemiological investigations together with continued surveillance of all parasites in humans, other mammals, the environment, and water in this highly impoverished area.

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

PubMed

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

2014-09-01

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

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

PubMed

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

2013-06-01

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

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

PubMed

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

2018-01-01

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

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

PubMed

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

2013-12-26

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

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

PubMed Central

2013-01-01

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

Crossing Borders and Blurring Boundaries: Early Childhood Practice in a Non-Western Setting

ERIC Educational Resources Information Center

Lewis, Trish; Macfarlane, Kym; Nobel, Karen; Stephenson, Amy

2006-01-01

This paper examines the educational and epistemological implications for early childhood practitioners who work in non-Western environments. Predominantly, early childhood knowledge is strongly driven by the metanarrative of child development, which can prove problematic for practitioners working in non-Western settings. Practitioners who draw…

Seismic anisotropy across the east African plateau from shear wave splitting analysis

NASA Astrophysics Data System (ADS)

Bagley, B. C.; Nyblade, A.; Mulibo, G.; Tugume, F.

2011-12-01

Previous studies of the east African plateau reveal complicated patterns of seismic anisotropy that are not easily explained by a single mechanism. The pattern is defined by rift-parallel fast directions for stations within or near Cenozoic rift valleys, and near-null results in Precambrian terrains away from the rift. Data from 65 temporary Africa Array stations deployed between 2007 and 2011 are being used to make new shear wave splitting measurements. The stations span the east African plateau and cover both the eastern and western branches of the east African rift system, as well as unrifted Proterozoic and Archean terrains in Uganda, Kenya, Tanzania, and Zambia. Through analysis of shear wave splitting we will better constrain the distribution of seismic anisotropy, and and from it gain new insight into the tectonic evolution of east Africa.

Uganda rainfall variability and prediction

NASA Astrophysics Data System (ADS)

Jury, Mark R.

2018-05-01

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

A climate trend analysis of Uganda

USGS Publications Warehouse

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

2012-01-01

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

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

PubMed

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

2017-09-05

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

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

PubMed

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

2017-03-01

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

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

PubMed Central

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

2017-01-01

Introduction: Uganda has reported eight outbreaks caused by filoviruses between 2000 to 2016, more than any other country in the world. We used species distribution modeling to predict where filovirus outbreaks are likely to occur in Uganda to help in epidemic preparedness and surveillance. Methods: The MaxEnt software, a machine learning modeling approach that uses presence-only data was used to establish filovirus – environmental relationships. Presence-only data for filovirus outbreaks were collected from the field and online sources. Environmental covariates from Africlim that have been downscaled to a nominal resolution of 1km x 1km were used. The final model gave the relative probability of the presence of filoviruses in the study area obtained from an average of 100 bootstrap runs. Model evaluation was carried out using Receiver Operating Characteristic (ROC) plots. Maps were created using ArcGIS 10.3 mapping software. Results: We showed that bats as potential reservoirs of filoviruses are distributed all over Uganda. Potential outbreak areas for Ebola and Marburg virus disease were predicted in West, Southwest and Central parts of Uganda, which corresponds to bat distribution and previous filovirus outbreaks areas. Additionally, the models predicted the Eastern Uganda region and other areas that have not reported outbreaks before to be potential outbreak hotspots. Rainfall variables were the most important in influencing model prediction compared to temperature variables. Conclusions: Despite the limitations in the prediction model due to lack of adequate sample records for outbreaks, especially for the Marburg cases, the models provided risk maps to the Uganda surveillance system on filovirus outbreaks. The risk maps will aid in identifying areas to focus the filovirus surveillance for early detection and responses hence curtailing a pandemic. The results from this study also confirm previous findings that suggest that filoviruses are mainly limited by the amount of rainfall received in an area. PMID:29034123

Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.

PubMed

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

2015-05-07

Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national capacity to undertake economic evaluations. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2017-01-01

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

The Burden of Cholera in Uganda

PubMed Central

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

2013-01-01

Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations prior to introducing the vaccine. PMID:24340106

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

PubMed Central

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

2017-01-01

Background The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities. Methodology/Principal findings We conducted a prospective study between 2011–15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5–10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5–9 years had increased risk. Cholera was endemic in some villages with well-defined “hotspots”. Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty. Conclusions/Significance Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities. PMID:28288154

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

PubMed

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

2017-01-01

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

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

PubMed

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

2015-01-01

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

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.

Governing chronic poverty under inclusive liberalism: the case of the Northern Uganda Social Action Fund.

PubMed

Golooba-Mutebi, Frederick; Hickey, Sam

2010-01-01

The paradigm of 'inclusive neoliberalism' that currently characterises international development places a particular emphasis on community-based responses to the often structural problems of poverty and exclusion. Such approaches have become increasingly controversial: celebrated by optimists as the most empowering way forward for marginal citizens on the one hand, and derided as an abrogation of responsibility by development trustees by sceptics on the other. Uganda provides a particularly interesting context to explore these debates, not least because it has become a standard bearer for inclusive neoliberalism at the same time that regional inequalities within it have become increasingly apparent. Our investigation of the flagship response to deep impoverishment in its northern region, the World Bank-funded Northern Uganda Social Action Fund, offers greater support to the sceptics, not least because of the ways in which the more pernicious tendencies within inclusive neoliberalism have converged with the contemporary politics of development in Uganda.

Eurocentrism and the Postcolonial Implications of Skin Color among Latinos

ERIC Educational Resources Information Center

Hall, Ronald E.

2011-01-01

Eurocentrism is a worldview of the academic mainstream. It is grounded in a European perspective that manifests as a tendency to interpret and prioritize the world in Western terms, Western values, and Western experiences. Eurocentric frames of reference are pathological as pertains to the psychological well-being of Latinos. Evidence of said…

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

PubMed

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

2013-08-01

To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Data were collected from a sample of facilities that participated in five demonstration projects for hpv vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services.

Past, Present, and Future of Neurosurgery in Uganda.

PubMed

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

2017-04-01

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

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

PubMed

Bbosa, Richard Serunkuma; Ehlers, Valerie Janet

2017-04-01

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

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

PubMed

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

2017-10-03

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

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

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.

Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia.

PubMed

Morgan, Camille; Bowling, Michael; Bartram, Jamie; Lyn Kayser, Georgia

2017-08-01

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization's recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities. Copyright © 2017 Elsevier GmbH. All rights reserved.

Family economic empowerment and mental health among AIDS-affected children living in AIDS-impacted communities: evidence from a randomised evaluation in southwestern Uganda.

PubMed

Han, Chang-Keun; Ssewamala, Fred M; Wang, Julia Shu-Huah

2013-03-01

The authors examine whether an innovative family economic empowerment intervention addresses mental health functioning of AIDS-affected children in communities heavily impacted by HIV/AIDS in Uganda. A cluster randomised controlled trial consisting of two study arms, a treatment condition (n=179) and a control condition (n=118), was used to examine the impact of the family economic empowerment intervention on children's levels of hopelessness and depression. The intervention comprised matched children savings accounts, financial management workshops and mentorship. Data were collected at baseline and 12 months post-intervention. Using multivariate analysis with several socioeconomic controls, the authors find that children in the treatment condition (receiving the intervention) report significant improvement in their mental health functioning. Specifically, the intervention reduces hopelessness and depression levels. On the other hand, children in the control condition (not receiving the intervention) report no changes on both measures. The findings indicate that children with poor mental health functioning living in communities affected by HIV/AIDS may benefit from innovative family economic empowerment interventions. As measures of mental health functioning, both hopelessness and depression have long-term negative psychosocial and developmental impacts on children. These findings have implications for public health programmes intended for long-term care and support of children living in resource poor AIDS-impacted communities.

Soil characteristics of landslides on Mount Elgon (Uganda): implications for estimating their age

NASA Astrophysics Data System (ADS)

Van Eynde, Elise; Dondeyne, Stefaan; Isabirye, Moses; Deckers, Jozef; Poesen, Jean

2017-04-01

The slopes of Mount Elgon, a complex volcano at the border between Uganda and Kenya, are frequently affected by landslides with disastrous effects on the livelihood of its population. Since local people greatly depend on the land for crop production, we examined if and how fast physico-chemical characteristics in landslide scars recover. A chronosequence of 18 landslides covering a period of 103 years was sampled in order to explore differences between topsoil within and outside landslide scars. For each landslide, two topsoil samples were taken within the landslide and two in nearby undisturbed soils to compare their physico-chemical characteristics. No differences were found for available P, Ca2+, Mg2+ content or for the fine earth texture. Recent landslides had however lower content of soil organic carbon (OC) and K+, and higher content of rock fragments and Na+ than the adjacent soils. Soil OC content increased significantly with age and reached levels of the corresponding undisturbed soils after ca. 60 years. Older landslides had even higher OC contents than soils adjacent to the landslide. Hence landslide scars act as local carbon sink. We suggest that the occurrence of rock fragments in the topsoil is a useful indicator for mapping past landslides. Moreover, the difference in soil OC content between landslide scars and adjacent soil could be used for estimating the age of landslides in data-poor regions.

How mothers mediate the social integration of their children conceived of forced marriage within the Lord's Resistance Army.

PubMed

Shanahan, Fiona; Veale, Angela

2016-01-01

This article aims to understand how formerly abducted young mothers mediate the social integration of their children conceived of forced marriage and sexual violence within the Lord's Resistance Army (LRA) in northern Uganda. Interviews and photographic methods were used in six Internally Displaced Persons Camps in northern Uganda. This article draws on data derived from ten mothers of thirteen children who were conceived in the LRA, five boys and eight girls. The analytic approach used was Interpretive Phenomenological Analysis (Smith & Osborn, 2008). The analysis identified turning points of sites of action where young formerly abducted mothers used diverse strategies to support the reintegration of their children born or conceived within the LRA. Six key turning points are identified, these are (a) participating in rituals and ceremonies, (b) naming, (c) adapting to changing family structures, (d) responding to discrimination against boys (e) managing disclosure and (f) sharing positive memories and identities. Formerly abducted young mothers mediate the social integration of their children by engaging in strategies to support and foster their wellbeing and social relationships. However, the contexts in which they are operating are highly constrained and the relational identities of children born in the LRA are fluid and potentially insecure within communities of return. Implications for policy and programming are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Family Economic Empowerment and Mental Health Among AIDS-Affected Children Living in AIDS-Impacted Communities: Evidence from a Randomized Evaluation in Southwestern Uganda

PubMed Central

Han, Chang-Keun; Ssewamala, Fred M.; Wang, Julia Shu-Huah

2012-01-01

OBJECTIVE We examine whether an innovative family economic empowerment intervention addresses mental health functioning of AIDS-affected children in communities heavily impacted by HIV/AIDS in Uganda. METHODS A cluster randomized controlled trial (RCT) consisting of two study arms: a treatment condition (n=179) and a control condition (n=118) was used to examine the impact of the family economic empowerment intervention on children’s levels of hopelessness and depression. The intervention comprised of matched children savings accounts, financial management workshops, and mentorship. Data were collected at baseline and 12 months post-intervention. RESULTS Using multivariate analysis with several socio-economic controls, we find that children in the treatment condition (receiving the intervention) report significant improvement in their mental health functioning. Specifically, the intervention reduces hopelessness and depression levels. On the other hand, children in the control condition (not receiving the intervention) report no changes on both measures. CONCLUSIONS The findings indicate that children with poor mental health functioning living in communities affected by HIV/AIDS may benefit from innovative family economic empowerment interventions. As measures of mental health functioning, both hopelessness and depression have long-term negative psychosocial and developmental impacts on children. These findings have implications for public health programs intended for long-term care and support of children living in resource poor, AIDS-impacted communities. PMID:23410851

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

PubMed

Lagone, Elizabeth; Mathur, Sanyukta; Nakyanjo, Neema; Nalugoda, Fred; Santelli, John

2014-01-01

Uganda is recognised as an early success story in the HIV epidemic at least in part due to an open and vigorous national dialogue about HIV prevention. This study examined the national discourse about HIV, AIDS, and young people in New Vision , Uganda's leading national newspaper between 1996 and 2011, building from a previous archival analysis of New Vision reporting by Kirby (1986-1995). We examined the continuing evolution in the public discourse in Uganda, focusing on reporting about young people. An increase in reporting on HIV and AIDS occurred after 2003, as antiretroviral treatment was becoming available. While the emphasis in newspaper reporting about adults and the population at large evolved to reflect the development of new HIV treatment and prevention methods, the majority of the articles focused on young people did not change. Articles about young people continued to emphasise HIV acquisition due to early and premarital sexual activity and the need for social support services for children affected by HIV and AIDS. Articles often did not report on the complex social conditions that shape HIV-related risk among young people, or address young people who are sexually active, married, and/or HIV infected. With HIV prevalence now increasing among young people and adults in Uganda, greater attention to HIV prevention is needed.

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

PubMed

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

2018-03-24

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

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

PubMed

Behrman, Julia Andrea

2015-02-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2018-01-01

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

Urban-rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study.

PubMed

Ajayi, IkeOluwapo O; Adebamowo, Clement; Adami, Hans-Olov; Dalal, Shona; Diamond, Megan B; Bajunirwe, Francis; Guwatudde, David; Njelekela, Marina; Nankya-Mutyoba, Joan; Chiwanga, Faraja S; Volmink, Jimmy; Kalyesubula, Robert; Laurence, Carien; Reid, Todd G; Dockery, Douglas; Hemenway, David; Spiegelman, Donna; Holmes, Michelle D

2016-10-28

Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Participants were nurses in two hospitals in Nigeria (200), school teachers in South Africa (489) and Tanzania (229), and village residents in one peri-urban (297) and one rural location in Uganda (200) who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component) was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. The prevalence of overweight and obese (combined) was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA), respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p < 0.001). Overall, prevalence of overweight was 374 (31 %) and obesity, 414 (34 %). Female sex was a predictor of overweight and obesity (combined) in peri-urban Uganda [AOR = 8.01; 95 % CI: 4.02, 15.96) and obesity in rural Uganda [AOR = 11.22; 95%CI: 2.27, 55.40), peri-urban Uganda [AOR = 27.80; 95 % CI: 7.13, 108.41) and SA [AOR = 2.17; 95 % CI: 1.19, 4.00). Increasing age was a predictor of BMI > =25 kg/m 2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m 2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m 2 compared with the rural and peri-urban sites. The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further highlights the need for urgent focused intervention to stem this trend, especially among women, professionals and urban dwellers.

The Consortium for Integrated Climate Research in Western Mountains (CIRMOUNT)

Treesearch

Constance I. Millar

2004-01-01

I represent a nascent effort in western North America that is committed to improving integration of climate-related research and its societal implications. We go under the name of CIRMOUNT, that is, Consortium for Integrated Climate-Related Research in Western North American Mountains. In a sense, CIRMOUNT is a North American answer (in the affirmative) to Thomas...

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

PubMed Central

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

2013-01-01

Abstract Objective To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Methods Data were collected from a sample of facilities that participated in five demonstration projects for HPV vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. Findings The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). Conclusion The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services. PMID:23940406

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

PubMed

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

2012-01-01

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

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

PubMed

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

2013-06-01

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

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

PubMed

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

2016-08-01

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

Serology and cytokine profiles in patients infected with the newly discovered Bundibugyo ebolavirus.

PubMed

Gupta, Manisha; MacNeil, Adam; Reed, Zachary D; Rollin, Pierre E; Spiropoulou, Christina F

2012-02-20

A new species of Ebolavirus, Bundibugyo ebolavirus, was discovered in an outbreak in western Uganda in November 2007. To study the correlation between fatal infection and immune response in Bundibugyo ebolavirus infection, viral antigen, antibodies, and 17 soluble factors important for innate immunity were examined in 44 patient samples. Using Luminex assays, we found that fatal infection was associated with high levels of viral antigen, low levels of pro-inflammatory cytokines, such as IL-1α, IL-1β, IL-6, TNF-α, and high levels of immunosuppressor cytokines like IL-10. Also, acute infected patients died in spite of generating high levels of antibodies against the virus. Thus, our results imply that disease severity in these patients is not due to the multi-organ failure and septic shock caused by a flood of inflammatory cytokines, as seen in infections with other Ebolavirus species. Published by Elsevier Inc.

Géologie du synclinal de l'Itombwe (Zaïre oriental) et le problème de l'existence d'un sillon plissé pan-africain

NASA Astrophysics Data System (ADS)

Villeneuve, Michel

From the N.S. linear structure of the Itombwe syncline arise some problems in central Africa. Some authors considered it as a Kibarian structure and others as an isolated fold belt of Pan-African orogeny. This ambiguity is the result, in its greatest part, of the scarceness of field work and the lack of dating on the rocks of this syncline. A study on the central area showed the existence of two lithostructural units. The western area is correlated with a Kibarian structure while the eastern area had some similarities with the tectonic Pan-African troughts from NE of Zaïre and west of Uganda. The existence of an area folded during the Pan-African orogeny and in the same environment as the great African lakes area must be considered.

Institutional Efficiency in Selected Universities in Uganda

ERIC Educational Resources Information Center

Amina, Nakimuli; Turyahebwa, Abanis

2015-01-01

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

A SINGLE GENOTYPE OF ENCEPHALITOZOON INTESTIINALIS INFECTS FREE-RANGING GORILLAS AND PEOPLE SHARING THEIR HABITATS, UGANDA

EPA Science Inventory

For conservation purposes and due to ecotourism free-ranging gorillas of Uganda have been habituated to humans, and molecular epidemiology evidence indicates that this habituation might have enhanced transmission of anthropozoonotic pathogens. Microsporidian spores have been det...

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

PubMed

Miito, Gilbert John; Banadda, Noble

2017-01-01

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

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.

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

PubMed Central

Miito, Gilbert John; Banadda, Noble

2017-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed Central

Menon, Manoj P.; Yoon, Steven S.

2015-01-01

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

Dismantling reified African culture through localised homosexualities in Uganda.

PubMed

Nyanzi, Stella

2013-01-01

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

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.

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

PubMed

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

2014-11-29

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

Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

PubMed Central

Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

2016-01-01

Introduction Cross-border cholera outbreaks are a major public health problem in Sub-Saharan Africa contributing to the high annual reported cholera cases and deaths. These outbreaks affect all categories of people and are challenging to prevent and control. This article describes lessons learnt during the cross-border cholera outbreak control in Eastern and Southern Africa sub-regions using the case of Uganda-DRC and Malawi-Mozambique borders and makes recommendations for future outbreak prevention and control. Materials and Methods We reviewed weekly surveillance data, outbreak response reports and documented experiences on the management of the most recent cross-border cholera outbreaks in Eastern and Southern Africa sub-regions, namely in Uganda and Malawi respectively. Uganda-Democratic Republic of Congo and Malawi-Mozambique borders were selected because the countries sharing these borders reported high cholera disease burden to WHO. Results A total of 603 cross-border cholera cases with 5 deaths were recorded in Malawi and Uganda in 2015. Uganda recorded 118 cases with 2 deaths and CFR of 1.7%. The under-fives and school going children were the most affected age groups contributing 24.2% and 36.4% of all patients seen along Malawi-Mozambique and Uganda-DRC borders, respectively. These outbreaks lasted for over 3 months and spread to new areas leading to 60 cases with 3 deaths, CRF of 5%, and 102 cases 0 deaths in Malawi and Uganda, respectively. Factors contributing to these outbreaks were: poor sanitation and hygiene, use of contaminated water, floods and rampant cross-border movements. The outbreak control efforts mainly involved unilateral measures implemented by only one of the affected countries. Conclusions Cross-border cholera outbreaks contribute to the high annual reported cholera burden in Sub-Saharan Africa yet they remain silent, marginalized and poorly identified by cholera actors (governments and international agencies). The under-fives and the school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

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

PubMed Central

Ahmed, Syed Masud; Zerihun, Abebual

2010-01-01

Background The use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy. Methodology/Principal Findings Information on possession of LLINs and relevant knowledge on its proper use and maintenance was collected from households either with an under-five child and/or a pregnant woman. The sample included three villages from each of the 10 branch offices where BRAC Uganda's community-based health programme was operating. Data were collected by trained enumerators through face-to-face interviews using a hand-held personal digital assistant (PDA). Findings reveal that the study population had superficial knowledge on malaria and its transmission, including the use and maintenance of LLINs. The households' rate of possession of bed nets (41–59%), and the proportion of under-five children (17–19%) and pregnant women (25–27%) who reported sleeping under an LLIN were not encouraging. Inequity was observed in the number of LLINs possessed by the households, in the knowledge on its use and maintenance, and between the two programme areas. Conclusions/Significance The BRAC Uganda's LLINs distribution at a subsidized price appeared to be inadequate and inequitable, and BRAC's knowledge dissemination is insufficient for initiating preventive actions such as proper use of LLINs to interrupt malaria transmission. Findings contribute to the on-going debate on LLINs distribution in Africa and make a strong case for its free distribution. PMID:20844749

History and structure of sub-Saharan populations of Drosophila melanogaster.

PubMed

Pool, John E; Aquadro, Charles F

2006-10-01

Drosophila melanogaster is an important model organism in evolutionary genetics, yet little is known about the population structure and the demographic history of this species within sub-Saharan Africa, which is thought to contain its ancestral range. We surveyed nucleotide variation at four 1-kb fragments in 240 individual lines representing 21 sub-Saharan and 4 Palearctic population samples of D. melanogaster. In agreement with recent studies, we find a small but significant level of genetic differentiation within sub-Saharan Africa. A clear geographic pattern is observed, with eastern and western African populations composing two genetically distinct groups. This pattern may have resulted from a relatively recent establishment of D. melanogaster in western Africa. Eastern populations show greater evidence for long-term stability, consistent with the hypothesis that eastern Africa contains the ancestral range of the species. Three sub-Saharan populations show evidence for cosmopolitan introgression. Apart from those cases, the closest relationships between Palearctic and sub-Saharan populations involve a sample from the rift zone (Uganda), suggesting that the progenitors of Palearctic D. melanogaster might have come from this region. Finally, we find a large excess of singleton polymorphisms in the full data set, which is best explained by a combination of population growth and purifying selection.

An Empirical Test of the Theory of Planned Behaviour Applied to Contraceptive Use in Rural Uganda

PubMed Central

Kiene, Susan M.; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K.

2013-01-01

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health behaviour change theories to contraceptive use amongst this population. The present study tested the Theory of Planned Behaviour’s ability to predict contraceptive use-related behaviours among postpartum women in rural Uganda. Results gave modest support to the theory’s application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. PMID:23928989

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

ERIC Educational Resources Information Center

Nyenje, Aida; James, Nkata L.

2016-01-01

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

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

USDA-ARS?s Scientific Manuscript database

Bovine tuberculosis is a ‘neglected zoonosis’ and its contribution to the proportion of Mycobacterium tuberculosis complex infections in humans is unknown. A retrospective study on archived Mycobacterium tuberculosis complex (MTC) isolates from a reference laboratory in Uganda was undertaken to iden...

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

PubMed

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

2016-04-14

Integrated vector management (IVM) is the recommended approach for controlling some vector-borne diseases (VBD). In the face of current challenges to disease vector control, IVM is vital to achieve national targets set for VBD control. Though global efforts, especially for combating malaria, now focus on elimination and eradication, IVM remains useful for Uganda which is principally still in the control phase of the malaria continuum. This paper outlines the processes undertaken to consolidate tactical planning and implementation frameworks for IVM in Uganda. The Uganda National Malaria Control Programme with its efforts to implement an IVM approach to vector control was the 'case' for this study. Integrated management of malaria vectors in Uganda remained an underdeveloped component of malaria control policy. In 2012, knowledge and perceptions of malaria vector control policy and IVM were assessed, and recommendations for a specific IVM policy were made. In 2014, a thorough vector control needs assessment (VCNA) was conducted according to WHO recommendations. The findings of the VCNA informed the development of the national IVM strategic guidelines. Information sources for this study included all available data and accessible archived documentary records on VBD control in Uganda. The literature was reviewed and adapted to the local context and translated into the consolidated tactical framework. WHO recommends implementation of IVM as the main strategy to vector control and has encouraged member states to adopt the approach. However, many VBD-endemic countries lack IVM policy frameworks to guide implementation of the approach. In Uganda most VBD coexists and could be managed more effectively if done in tandem. In order to successfully control malaria and other VBD and move towards their elimination, the country needs to scale up proven and effective vector control interventions and also learn from the experience of other countries. The IVM strategy is important in consolidating inter-sectoral collaboration and coordination and providing the tactical direction for effective deployment of vector control interventions along the five key elements of the approach and to align them with contemporary epidemiology of VBD in the country. Uganda has successfully established an evidence-based IVM approach and consolidated strategic planning and operational frameworks for VBD control. However, operating implementation arrangements as outlined in the national strategic guidelines for IVM and managing insecticide resistance, as well as improving vector surveillance, are imperative. In addition, strengthened information, education and communication/behaviour change and communication, collaboration and coordination will be crucial in scaling up and using vector control interventions.

Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross sectional study.

PubMed

Obai, Gerald; Odongo, Pancras; Wanyama, Ronald

2016-04-11

Anaemia is a public health problem affecting over 1.62 billion people globally. It affects all age groups of people and is particularly more prevalent in pregnant women. Africa carries a high burden of anaemia; in Uganda 24 % of women of child bearing age have anaemia. Pregnant women living in poverty are at greater risk of developing iron deficiency anaemia. The objective of this study was to determine the prevalence of anaemia and the associated risk factors in pregnant women attending antenatal care at Gulu and Hoima Regional Hospitals in Northern and Western Uganda respectively. We conducted a cross sectional study in Gulu and Hoima Regional Hospitals from July to October 2012. Our study participants were pregnant women attending antenatal care. Socio-demographic data were collected using structured questionnaires and blood samples were collected for haemoglobin estimation. Haemoglobin concentration was determined using an automated analyzer closed mode of blood sampling. Data were analysed using Stata version 12. Odds ratio was used as a measure of association, with 95% confidence interval; and independent risk factors for anaemia were investigated using logistic regression analyses. Ethical approval was obtained from Gulu University Research Ethics Committee and written informed consent was obtained from each study participant. The overall prevalence of anaemia was 22.1%; higher in Gulu (32.9%) than in Hoima (12.1%), p < 0.001. In Gulu, the prevalence of mild anaemia was 23%, moderate anaemia was 9%, and severe anaemia was 0.8%, while in Hoima, the prevalence of mild anaemia was 9%, moderate anaemia was 2.5%, and severe anaemia was 0.5%. Independent risk factors for anaemia were: being a housewife [Adjusted Odds Ratio (AOR) = 1.7, 95% CI: 1.05-2.68]; and being a resident in Gulu (AOR = 3.6, 95% CI: 2.41-5.58). The prevalence of anaemia in pregnant women in Gulu is higher than in Hoima. Amongst pregnancy women, being a housewife is an independent risk factor for anaemia. Greater efforts are required to encourage early antenatal attendance from women in these at risk groups. This would allow iron and folic acid supplementation during pregnancy, which would potentially reduce the prevalence of anaemia.

Household food insecurity and diet diversity after the major 2010 landslide disaster in Eastern Uganda: a cross-sectional survey.

PubMed

Rukundo, Peter M; Andreassen, Bård A; Kikafunda, Joyce; Rukooko, Byaruhanga; Oshaug, Arne; Iversen, Per Ole

2016-02-28

In 2010, a landslide in Bududa, Eastern Uganda, killed about 350 people and nearly 1000 affected households were resettled in Kiryandongo, Western Uganda. A cross-sectional survey assessed household food insecurity and diet diversity among 1078 affected and controls. In Bududa, the affected had a lower adjusted mean score of food insecurity than controls - 9·2 (se 0·4) v. 12·3 (se 0·4) (P<0·01)--but higher diet diversity score (DDS) - 7·1 (se 0·1) v. 5·9 (se 0·1) (P<0·01). On controlling for disaster and covariates, recipients of relief food had higher food insecurity - 12·0 (se 0·6) v. 10·4 (se 0·3) (P=0·02)--whereas farmers had higher DDS - 6·6 (se 0·2) v. 5·6 (se 0·3) (P<0·01). Household size increased the likelihood of food insecurity (OR 1·15; 95% CI 1·00, 1·32; P<0·05) but reduced DDS (OR 0·93; 95% CI 0·87, <1·00; P=0·04). Low DDS was more likely in disaster affected (OR 4·22; 95% CI 2·65, 6·72; P<0·01) and farmers (OR 2·52; 95% CI 1·37, 4·64; P<0·01). In Kiryandongo, affected households had higher food insecurity - 12·3 (se 0·8) v. 2·6 (se 0·8) (P<0·01)--but lower DDS - 5·8 (se 0·3) v. 7·0 (se 0·3) (P=0·02). The latter reduced with increased age (OR 0·99; 95% CI 0·97, 1·00; P<0·05), lowest education (OR 0·54; 95% CI 0·31, 0·93; P=0·03), farmers (OR 0·59; 95 % CI 0·35, 0·98; P=0·04) and asset ownership (OR 0·56; 95% CI 0·39, 0·81; P<0·01). Addressing social protection could mitigate food insecurity.

Remuneration discrepancies in the landlocked economies of Malaŵi and Uganda.

PubMed

Munthali, Alister; Matagi, Leon; Tumwebaze, Callist

2010-10-01

Although the original study of remuneration differences between local and expatriate development workers took place in the landlocked economy of Malaŵi, the study has never been replicated outside of one sector and organization (the National University), and took place prior to the 2000 Millennium Development Goals. Participating in the present studies were 458 aid and development professionals, working across a range of sectors in Malaŵi (n = 241, response rate = 50%) and Uganda (n = 217, response rate = 51%). The size of the gap between local and international workers, measured using the World Bank's purchasing power parity, was higher in Malaŵi (4.04:1) than in Uganda (1.97:1). The ratio was more clearly within tolerance levels in Uganda than in Malaŵi. Consistent with these differences, and controlling for organization, cultural, and demographic factors, locally remunerated workers reported more and expatriate workers less injustice and demotivation in Malaŵi than in Uganda. Although sample sizes for the internationally remunerated are small, the findings suggest that wider disparities may (1) hinder perspective-taking and (2) decrease motivation. In-country workshops with stakeholders and subject-matter experts considered the findings, and potential solutions offered through the survey form. They recommended the implementation of performance-based remuneration, including competency-based job analysis and evaluation. Competencies in such functions can be provided by humanitarian work psychology.

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

PubMed

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

2013-12-01

There is dearth of knowledge and research about the role of empowerment, partners' behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women's empowerment and partners' behaviours on IPPV among married women in Uganda. The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV. The prevalence of IPPV among women in union in Uganda is still high (41%). Women's occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV. In the Ugandan context, women's empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners' negative behaviours and history of witnessing parental violence.

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

PubMed Central

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

2013-01-01

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

Some Implications for Afro-American Culture: Rationalism and Western Music

ERIC Educational Resources Information Center

Walton, Ortiz M.

1973-01-01

Will the computer or instruments powered by electrical energy become the most efficient means by which to produce Western music, replacing the live performer? If so, what will be the effects of electronic, mechanical music on society? (Author/RJ)

Conservation and Education in Murchison Falls Conservation Area, Uganda

ERIC Educational Resources Information Center

Jordahl, Mark D.

2005-01-01

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

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

USDA-ARS?s Scientific Manuscript database

This paper describes the incidence and etiology of viral infection on passion fruit in Uganda. Viral disease symptoms, including those characteristic of Passion fruit woodiness disease (PWD), were observed in producing areas with an overall mean infection level of 27%. Electron microscopic observati...

A SINGLE GENOTYPE OF ENCEPHALITOZOON INTESTINALIS INFECTS FREE-RANGING GORILLAS AND PEOPLE SHARING THEIR HABITATS, UGANDA

EPA Science Inventory

Several microsporidia species are recognized etiologic agents of human diseases. Microsporidian spores have been detected by Chromotrope 2R and calcofluor stains in fecal samples of three fre-ranging human-habituated mountain gorillas of Uganda and two people who share gorilla h...

Affirmative Action, Gender Equity and University Admissions--Kenya, Uganda and Tanzania

ERIC Educational Resources Information Center

Onsongo, Jane

2009-01-01

The article examines the outcomes of affirmative action policies aimed at improving access for women students to university education in Kenya, Uganda and Tanzania. Different interpretations of affirmative action are found in the three countries. These include lower entry scores, remedial pre-university programmes and financial assistance. There…

Multilingual Cultural Resources in Child-Headed Families in Uganda

ERIC Educational Resources Information Center

Namazzi, Elizabeth; Kendrick, Maureen E.

2014-01-01

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

Situation Reports--Brasil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in six foreign countries are presented in these situation reports. Countries included are Brazil, Cambodia, Fiji, Malaysia (West), Thailand, and Uganda. Information is provided, where appropriate and available, under two topics, general background and family planning situation. General background…

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,…

Science, Technology and Innovation in Uganda

ERIC Educational Resources Information Center

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

2010-01-01

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

Delayed School Entry in Uganda

ERIC Educational Resources Information Center

Moyi, Peter

2011-01-01

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

Competence Challenges of Demand-Led Agricultural Research and Extension in Uganda

ERIC Educational Resources Information Center

Kibwika, P.; Wals, A. E. J.; Nassuna-Musoke, M. G.

2009-01-01

Governments and development agencies in Sub-Saharan Africa are experimenting alternative approaches within the innovation systems paradigm to enhance relevance of agricultural research and extension to the poverty eradication agenda. Uganda, for example, has recently shifted from the supply driven to demand-led agricultural research and extension.…

The negotiation of sexual relationships among school pupils in south-western Uganda.

PubMed

Nyanzi, S; Pool, R; Kinsman, J

2001-02-01

The objective of the study was to explore how school-going adolescents in south-western Uganda negotiate sexual relationships. Qualitative data were obtained from 15 boys and 15 girls (14-18 years old), during a series of role plays, focus group discussions and one-to-one interviews. A questionnaire was administered to 80 pupils (12-20 years old) from the same school. Most of the pupils were sexually active. Sexual relationships between boys and girls were mediated by peers. Boys initiated relationships. Exchange played an important role in the negotiation of sexual relationships. Money or gifts were given and received in exchange for sexual favours and to strengthen the relationship. To maximize gains, some adolescents had sexual relationships with adults. Sexual relationships were characterized by ambiguity. Love is intertwined with sexual desire, money and prestige. Girls have to be explicit enough to get a good deal; if they are too explicit they will be stigmatized as 'loose' but if they are not interested in money they may be suspected of wanting to spread HIV. Boys try to persuade girls that they have money, but do not want to emphasize this too much. In sexual negotiations a boy must persuade a girl that although he is modern and sophisticated (i.e. experienced) he does not chase after every girl; the girl does not want to come over as an unsophisticated virgin, but does not want to give the impression that she is loose either. There is a tension between the traditional ideal of female chastity and submissiveness and the modern image of sexual freedom. Multiple partnerships were highly valued as a sign of sophistication. Condoms were not considered important. Interventions aimed at reducing the spread of HIV do not seem to be having an effect on the behaviour of this group of adolescents. On the contrary, risky attitudes and behaviour are part of an adolescent ideal of modernity and sophistication. New approaches are needed to persuade this group of the need for change. Shifting the source of interventions from adults to the adolescents themselves, encouraging girls to try other means of earning money and debunking the idea that having many partners is sophisticated may be productive alternatives.

Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda.

PubMed

Altaras, Robin; Nuwa, Anthony; Agaba, Bosco; Streat, Elizabeth; Tibenderana, James K; Strachan, Clare E

2016-01-11

The large-scale introduction of malaria rapid diagnostic tests (RDTs) promises to improve management of fever patients and the rational use of valuable anti-malarials. However, evidence on the impact of RDT introduction on the overprescription of anti-malarials has been mixed. This study explored determinants of provider decision-making to prescribe anti-malarials following a negative RDT result. A qualitative study was conducted in a rural district in mid-western Uganda in 2011, ten months after RDT introduction. Prescriptions for all patients with negative RDT results were first audited from outpatient registers for a two month period at all facilities using RDTs (n = 30). Facilities were then ranked according to overall prescribing performance, defined as the proportion of patients with a negative RDT result prescribed any anti-malarial. Positive and negative deviant facilities were sampled for qualitative investigation; positive deviants (n = 5) were defined ex post facto as <0.75% and negative deviants (n = 7) as >5%. All prescribing clinicians were targeted for qualitative observation and in-depth interview; 55 fever cases were observed and 22 providers interviewed. Thematic analysis followed the 'framework' approach. 8344 RDT-negative patients were recorded at the 30 facilities (prescription audit); 339 (4.06%) were prescribed an anti-malarial. Of the 55 observed patients, 38 tested negative; one of these was prescribed an anti-malarial. Treatment decision-making was influenced by providers' clinical beliefs, capacity constraints, and perception of patient demands. Although providers generally trusted the accuracy of RDTs, anti-malarial prescription was driven by perceptions of treatment failure or undetectable malaria in patients who had already taken artemisinin-based combination therapy prior to facility arrival. Patient assessment and other diagnostic practices were minimal and providers demonstrated limited ability to identify alternative causes of fever. Provider perceptions of patient expectations sometimes appeared to influence treatment decisions. The study found high provider adherence to RDT results, but that providers believed in certain clinical exceptions and felt they lacked alternative options. Guidance on how the RDT works and testing following partial treatment, better methods for assisting providers in diagnostic decision-making, and a context-appropriate provider behaviour change intervention package are needed.

How Do Patients and Health Workers Interact around Malaria Rapid Diagnostic Testing, and How Are the Tests Experienced by Patients in Practice? A Qualitative Study in Western Uganda

PubMed Central

Altaras, Robin; Nuwa, Anthony; Agaba, Bosco; Streat, Elizabeth; Tibenderana, James K.; Martin, Sandrine; Strachan, Clare E.

2016-01-01

Background Successful scale-up in the use of malaria rapid diagnostic tests (RDTs) requires that patients accept testing and treatment based on RDT results and that healthcare providers treat according to test results. Patient-provider communication is a key component of quality care, and leads to improved patient satisfaction, higher adherence to treatment and better health outcomes. Voiced or perceived patient expectations are also known to influence treatment decision-making among healthcare providers. While there has been a growth in literature on provider practices around rapid testing for malaria, there has been little analysis of inter-personal communication around the testing process. We investigated how healthcare providers and patients interact and engage throughout the diagnostic and treatment process, and how the testing service is experienced by patients in practice. Methods This research was conducted alongside a larger study which explored determinants of provider treatment decision-making following negative RDT results in a rural district (Kibaale) in mid-western Uganda, ten months after RDT introduction. Fifty-five patients presenting with fever were observed during routine outpatient visits at 12 low-level public health facilities. Observation captured communication practices relating to test purpose, results, diagnosis and treatment. All observed patients or caregivers were immediately followed up with in-depth interview. Analysis followed the ‘framework’ approach. A summative approach was also used to analyse observation data. Results Providers failed to consistently communicate the reasons for carrying out the test, and particularly to RDT-negative patients, a diagnostic outcome or the meaning of test results, also leading to confusion over what the test can detect. Patients appeared to value testing, but were frustrated by the lack of communication on outcomes. RDT-negative patients were dissatisfied by the absence of information on an alternative diagnosis and expressed uncertainty around adequacy of proposed treatment. Conclusions Poor provider communication practices around the testing process, as well as limited inter-personal exchange between providers and patients, impacted on patients’ perceptions of their proposed treatment. Patients have a right to health information and may be more likely to accept and adhere to treatment when they understand their diagnosis and treatment rationale in relation to their perceived health needs and visit expectations. PMID:27494507

Internet Use among Ugandan Adolescents: Implications for HIV Intervention

PubMed Central

Ybarra, Michele L; Kiwanuka, Julius; Emenyonu, Nneka; Bangsberg, David R

2006-01-01

Background The Internet is fast gaining recognition as a powerful, low-cost method to deliver health intervention and prevention programs to large numbers of young people across diverse geographic regions. The feasibility and accessibility of Internet-based health interventions in resource-limited settings, where cost-effective interventions are most needed, is unknown. To determine the utility of developing technology-based interventions in resource-limited settings, availability and patterns of usage of the Internet first need to be assessed. Methods and Findings The Uganda Media and You Survey was a cross-sectional survey of Internet use among adolescents (ages 12–18 years) in Mbarara, Uganda, a municipality mainly serving a rural population in sub-Saharan Africa. Participants were randomly selected among eligible students attending one of five participating secondary day and boarding schools in Mbarara, Uganda. Of a total of 538 students selected, 93% (500) participated. Of the total respondents, 45% (223) reported ever having used the Internet, 78% (175) of whom reported going online in the previous week. As maternal education increased, so too did the odds of adolescent Internet use. Almost two in five respondents (38% [189]) reported already having used a computer or the Internet to search for health information. Over one-third (35% [173]) had used the computer or Internet to find information about HIV/AIDS, and 20% (102) had looked for sexual health information. Among Internet users, searching for HIV/AIDS information on a computer or online was significantly related to using the Internet weekly, emailing, visiting chat rooms, and playing online games. In contrast, going online at school was inversely related to looking for HIV/AIDS information via technology. If Internet access were free, 66% (330) reported that they would search for information about HIV/AIDS prevention online. Conclusions Both the desire to use, and the actual use of, the Internet to seek sexual health and HIV/AIDS information is high among secondary school students in Mbarara. The Internet may be a promising strategy to deliver low-cost HIV/AIDS risk reduction interventions in resource-limited settings with expanding Internet access. PMID:17090211

Assessing the reliability of FTIR spectroscopy measurements and validity of bioelectrical impedance analysis as a surrogate measure of body composition among children and adolescents aged 8-19 years attending schools in Kampala, Uganda.

PubMed

Ndagire, Catherine T; Muyonga, John H; Isabirye, Dan; Odur, Benard; Somda, Serge M A; Bukenya, Richard; Andrade, Juan E; Nakimbugwe, Dorothy

2018-06-04

Accurate measurement of body composition in children and adolescents is important as the quantities of fat and fat-free mass have implications for health risk. The objectives of the present study were: to determine the reliability of Fourier Transform Infrared spectroscopy (FTIR) measurements and; compare the Fat Mass (FM), Fat Free Mass (FFM) and body fat percentage (%BF) values determined by bioelectrical impedance analysis (BIA) to those determined by deuterium dilution method (DDM) to identify correlations and agreement between the two methods. A cross-sectional study was conducted among 203 children and adolescents aged 8-19 years attending schools in Kampala city, Uganda. Pearson product-moment correlation at 5% significance level was considered for assessing correlations. Bland Altman analysis was used to examine the agreement between of FTIR measurements and between estimates by DDM and BIA.. Reliability of measurements was determined by Cronbach's alpha. There was good agreement between the in vivo D 2 O saliva enrichment measurements at 3 and 4 h among the studied age groups based on Bland-Altman plots. Cronbach's alpha revealed that measurements of D 2 O saliva enrichment had very good reliability. For children and young adolescents, DDM and BIA gave similar estimates of FFM, FM, and %BF. Among older adolescents, BIA significantly over-estimated FFM and significantly under-estimated FM and %BF compared to estimates by DDM. The correlation between FFM, FM and %BF estimates by DDM and BIA was high and significant among young and older adolescents and for FFM among children. Reliability of the FTIR spectroscopy measurements was very good among the studied population. BIA is suitable for assessing body composition among children (8-9 years) and young adolescents (10-14 years) but not among older adolescents (15-19 years) in Uganda. The body composition measurements of older adolescents determined by DDM can be predicted using those provided by BIA using population-specific regression equations.

Internet use among Ugandan adolescents: implications for HIV intervention.

PubMed

Ybarra, Michele L; Kiwanuka, Julius; Emenyonu, Nneka; Bangsberg, David R

2006-11-01

The Internet is fast gaining recognition as a powerful, low-cost method to deliver health intervention and prevention programs to large numbers of young people across diverse geographic regions. The feasibility and accessibility of Internet-based health interventions in resource-limited settings, where cost-effective interventions are most needed, is unknown. To determine the utility of developing technology-based interventions in resource-limited settings, availability and patterns of usage of the Internet first need to be assessed. The Uganda Media and You Survey was a cross-sectional survey of Internet use among adolescents (ages 12-18 years) in Mbarara, Uganda, a municipality mainly serving a rural population in sub-Saharan Africa. Participants were randomly selected among eligible students attending one of five participating secondary day and boarding schools in Mbarara, Uganda. Of a total of 538 students selected, 93% (500) participated. Of the total respondents, 45% (223) reported ever having used the Internet, 78% (175) of whom reported going online in the previous week. As maternal education increased, so too did the odds of adolescent Internet use. Almost two in five respondents (38% [189]) reported already having used a computer or the Internet to search for health information. Over one-third (35% [173]) had used the computer or Internet to find information about HIV/AIDS, and 20% (102) had looked for sexual health information. Among Internet users, searching for HIV/AIDS information on a computer or online was significantly related to using the Internet weekly, emailing, visiting chat rooms, and playing online games. In contrast, going online at school was inversely related to looking for HIV/AIDS information via technology. If Internet access were free, 66% (330) reported that they would search for information about HIV/AIDS prevention online. Both the desire to use, and the actual use of, the Internet to seek sexual health and HIV/AIDS information is high among secondary school students in Mbarara. The Internet may be a promising strategy to deliver low-cost HIV/AIDS risk reduction interventions in resource-limited settings with expanding Internet access.

Genetic Variability and Evolutionary Implications of RNA Silencing Suppressor Genes in RNA1 of Sweet Potato Chlorotic Stunt Virus Isolates Infecting Sweetpotato and Related Wild Species

PubMed Central

Tugume, Arthur K.; Amayo, Robert; Weinheimer, Isabel; Mukasa, Settumba B.; Rubaihayo, Patrick R.; Valkonen, Jari P. T.

2013-01-01

Background The bipartite single-stranded RNA genome of Sweet potato chlorotic stunt virus (SPCSV, genus Crinivirus; Closteroviridae) encodes a Class 1 RNase III (RNase3), a putative hydrophobic protein (p7) and a 22-kDa protein (p22) from genes located in RNA1. RNase3 and p22 suppress RNA silencing, the basal antiviral defence mechanism in plants. RNase3 is sufficient to render sweetpotato (Ipomoea batatas) virus-susceptible and predisposes it to development of severe diseases following infection with unrelated virus. The incidence, strains and gene content of SPCSV infecting wild plant species have not been studied. Methodology/Principal Findings Thirty SPCSV isolates were characterized from 10 wild Ipomoea species, Hewittia sublobata or Lepistemon owariensis (family Convolvulaceae) in Uganda and compared with 34 local SPCSV isolates infecting sweetpotatoes. All isolates belonged to the East African (EA) strain of SPCSV and contained RNase3 and p7, but p22 was not detected in six isolates. The three genes showed only limited genetic variability and the proteins were under purifying selection. SPCSV isolates lacking p22 synergized with Sweet potato feathery mottle virus (SPFMV, genus potyvirus; Potyviridae) and caused severe symptoms in co-infected sweetpotato plants. One SPCSV isolate enhanced accumulation of SPFMV, but no severe symptoms developed. A new whitefly-transmitted virus (KML33b) encoding an RNase3 homolog (<56% identity to SPCSV RNase3) able to suppresses sense-mediated RNA silencing was detected in I. sinensis. Conclusions/Significance SPCSV isolates infecting wild species and sweetpotato in Uganda were genetically undifferentiated, suggesting inter-species transmission of SPCSV. Most isolates in Uganda contained p22, unlike SPCSV isolates characterized from other countries and continents. Enhanced accumulation of SPFMV and increased disease severity were found to be uncoupled phenotypic outcomes of RNase3-mediated viral synergism in sweetpotato. A second virus encoding an RNase3-like RNA silencing suppressor was detected. Overall, results provided many novel and important insights into evolutionary biology of SPCSV. PMID:24278443

Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach.

PubMed

Fadnes, Lars T; Engebretsen, Ingunn Marie S; Moland, Karen Marie; Nankunda, Jolly; Tumwine, James K; Tylleskär, Thorkild

2010-09-06

Health workers' counselling practices are essential to improve infant feeding practices. This paper will assess how infant feeding counselling was done and experienced by counsellors and mothers in Eastern Uganda in the context of previous guidelines. This has implications for implementation of the new infant feeding guidelines from 2009. This paper combines qualitative and quantitative data from Mbale District in Eastern Uganda. Data was collected from 2003 to 2005 in a mixed methods approach. This includes: key-informant interviews among eighteen health workers in the public hospital, health clinics and non-governmental organisations working with people living with HIV, fifteen focus group discussions in the general population and among clients from an HIV clinic, two cross-sectional surveys including 727 mothers from the general population and 235 HIV-positive mothers. The counselling sessions were often improvised. Health workers frequently had pragmatic approaches to infant feeding as many clients struggled with poverty, stigma and non-disclosure of HIV. The feasibility of the infant feeding recommendations was perceived as challenging among health workers, both for HIV-positive mothers and in the general population. Group counselling with large groups was common in the public health service. Some extra infant feeding teaching capacities were mobilised for care-takers of undernourished children. A tendency to simplify messages giving one-sided information was seen. Different health workers presented contradicting simplified perspectives in some cases. Outdated training was a common concern with many health workers not being given courses or seminars on infant feeding since professional graduation. Other problems were minimal staffing, lack of resources, and programs being started and subsequently stopped abruptly. Many of the HIV-counsellors in the non-governmental organisations got extended training in counselling which seemed to be beneficial. Health workers were faced with challenges related to workload, resources, scientific updating, and also a need to adjust to frequent changes in programs, recommendations and guidelines. The clients were faced with difficult choices, poverty, lack of education and stigma. Feasibility of the recommendations was a major concern. Systematic approaches to update health workers should be a priority.

Intersectionality of HIV stigma and masculinity in eastern Uganda: implications for involving men in HIV programmes.

PubMed

Mburu, Gitau; Ram, Mala; Siu, Godfrey; Bitira, David; Skovdal, Morten; Holland, Paula

2014-10-11

Stigma is a determinant of social and health inequalities. In addition, some notions of masculinity can disadvantage men in terms of health outcomes. However, few studies have explored the extent to which these two axes of social inequality intersect to influence men's health outcomes. This paper investigates the intersection of HIV stigma and masculinity, and its perceived impact on men's participation in and utilisation of HIV services in Uganda. Interviews and focus group discussions were conducted in Mbale and Jinja districts of Uganda between June and October 2010. Participants were men and women living with HIV (n = 40), their family members (n = 10) and health providers (n = 15). Inductive analysis was used to identify mechanisms through which stigma and masculinity were linked. Our findings showed that HIV stigma and masculinity did not exist as isolated variables, but as intersecting phenomena that influenced men's participation in HIV services. Specifically, HIV stigma threatened masculine notions of respectability, independence and emotional control, while it amplified men's risk-taking. As a result, the intersection of masculinity and HIV stigma prevented some men from i) seeking health care and accepting a 'sick role'; ii) fulfilling their economic family responsibilities; iii) safeguarding their reputation and respectability; iv) disclosing their HIV status; and v) participating in peer support groups. Participation in some peer support activities was considered a female trait and it also exacerbated HIV stigma as it implicitly singled out those with HIV. In contrast, inclusion of income-generating activities in peer support groups encouraged men's involvement as it enabled them to provide for their families, cushioned them from HIV stigma, and in the process, provided them with an opportunity to redeem their reputation and respectability. To improve men's involvement in HIV services, the intersection between HIV stigma and masculinity should be considered. In particular, better integration of and linkage between gender transformative interventions that support men to reconstruct their male identities and reject signifiers of masculinity that prevent their access to HIV services, and stigma-reduction interventions that target social and structural drivers of stigma is required within HIV programmes.

Separating Putative Pathogens from Background Contamination with Principal Orthogonal Decomposition: Evidence for Leptospira in the Ugandan Neonatal Septisome

PubMed Central

Schiff, Steven J.; Kiwanuka, Julius; Riggio, Gina; Nguyen, Lan; Mu, Kevin; Sproul, Emily; Bazira, Joel; Mwanga-Amumpaire, Juliet; Tumusiime, Dickson; Nyesigire, Eunice; Lwanga, Nkangi; Bogale, Kaleb T.; Kapur, Vivek; Broach, James R.; Morton, Sarah U.; Warf, Benjamin C.; Poss, Mary

2016-01-01

Neonatal sepsis (NS) is responsible for over 1 million yearly deaths worldwide. In the developing world, NS is often treated without an identified microbial pathogen. Amplicon sequencing of the bacterial 16S rRNA gene can be used to identify organisms that are difficult to detect by routine microbiological methods. However, contaminating bacteria are ubiquitous in both hospital settings and research reagents and must be accounted for to make effective use of these data. In this study, we sequenced the bacterial 16S rRNA gene obtained from blood and cerebrospinal fluid (CSF) of 80 neonates presenting with NS to the Mbarara Regional Hospital in Uganda. Assuming that patterns of background contamination would be independent of pathogenic microorganism DNA, we applied a novel quantitative approach using principal orthogonal decomposition to separate background contamination from potential pathogens in sequencing data. We designed our quantitative approach contrasting blood, CSF, and control specimens and employed a variety of statistical random matrix bootstrap hypotheses to estimate statistical significance. These analyses demonstrate that Leptospira appears present in some infants presenting within 48 h of birth, indicative of infection in utero, and up to 28 days of age, suggesting environmental exposure. This organism cannot be cultured in routine bacteriological settings and is enzootic in the cattle that often live in close proximity to the rural peoples of western Uganda. Our findings demonstrate that statistical approaches to remove background organisms common in 16S sequence data can reveal putative pathogens in small volume biological samples from newborns. This computational analysis thus reveals an important medical finding that has the potential to alter therapy and prevention efforts in a critically ill population. PMID:27379237

Hidden Population Structure and Cross-species Transmission of Whipworms (Trichuris sp.) in Humans and Non-human Primates in Uganda

PubMed Central

Ghai, Ria R.; Simons, Noah D.; Chapman, Colin A.; Omeja, Patrick A.; Davies, T. Jonathan; Ting, Nelson; Goldberg, Tony L.

2014-01-01

Background Whipworms (Trichuris sp.) are a globally distributed genus of parasitic helminths that infect a diversity of mammalian hosts. Molecular methods have successfully resolved porcine whipworm, Trichuris suis, from primate whipworm, T. trichiura. However, it remains unclear whether T. trichiura is a multi-host parasite capable of infecting a wide taxonomic breadth of primate hosts or a complex of host specific parasites that infect one or two closely related hosts. Methods and Findings We examined the phylogenetic structure of whipworms in a multi-species community of non-human primates and humans in Western Uganda, using both traditional microscopy and molecular methods. A newly developed nested polymerase chain reaction (PCR) method applied to non-invasively collected fecal samples detected Trichuris with 100% sensitivity and 97% specificity relative to microscopy. Infection rates varied significantly among host species, from 13.3% in chimpanzees (Pan troglodytes) to 88.9% in olive baboons (Papio anubis). Phylogenetic analyses based on nucleotide sequences of the Trichuris internal transcribed spacer regions 1 and 2 of ribosomal DNA revealed three co-circulating Trichuris groups. Notably, one group was detected only in humans, while another infected all screened host species, indicating that whipworms from this group are transmitted among wild primates and humans. Conclusions and Significance Our results suggest that the host range of Trichuris varies by taxonomic group, with some groups showing host specificity, and others showing host generality. In particular, one Trichuris taxon should be considered a multi-host pathogen that is capable of infecting wild primates and humans. This challenges past assumptions about the host specificity of this and similar helminth parasites and raises concerns about animal and human health. PMID:25340752

Hidden population structure and cross-species transmission of whipworms (Trichuris sp.) in humans and non-human primates in Uganda.

PubMed

Ghai, Ria R; Simons, Noah D; Chapman, Colin A; Omeja, Patrick A; Davies, T Jonathan; Ting, Nelson; Goldberg, Tony L

2014-10-01

Whipworms (Trichuris sp.) are a globally distributed genus of parasitic helminths that infect a diversity of mammalian hosts. Molecular methods have successfully resolved porcine whipworm, Trichuris suis, from primate whipworm, T. trichiura. However, it remains unclear whether T. trichiura is a multi-host parasite capable of infecting a wide taxonomic breadth of primate hosts or a complex of host specific parasites that infect one or two closely related hosts. We examined the phylogenetic structure of whipworms in a multi-species community of non-human primates and humans in Western Uganda, using both traditional microscopy and molecular methods. A newly developed nested polymerase chain reaction (PCR) method applied to non-invasively collected fecal samples detected Trichuris with 100% sensitivity and 97% specificity relative to microscopy. Infection rates varied significantly among host species, from 13.3% in chimpanzees (Pan troglodytes) to 88.9% in olive baboons (Papio anubis). Phylogenetic analyses based on nucleotide sequences of the Trichuris internal transcribed spacer regions 1 and 2 of ribosomal DNA revealed three co-circulating Trichuris groups. Notably, one group was detected only in humans, while another infected all screened host species, indicating that whipworms from this group are transmitted among wild primates and humans. Our results suggest that the host range of Trichuris varies by taxonomic group, with some groups showing host specificity, and others showing host generality. In particular, one Trichuris taxon should be considered a multi-host pathogen that is capable of infecting wild primates and humans. This challenges past assumptions about the host specificity of this and similar helminth parasites and raises concerns about animal and human health.

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

Adherence to feeding guidelines among HIV-infected and HIV uninfected mothers in a rural district in Uganda.

PubMed

Babirye, J N; Nuwaha, F; Grulich, A E

2009-07-01

To describe the infant feeding behaviour of HIV-infected and HIV-uninfected mothers, and identify factors influencing adherence to infant feeding guidelines. Analytical cross-sectional study. Bushenyi, rural district in South-western Uganda One hundred and ninety four mothers who had a child less than 12 months of age. About half, 94 (48.5%), of these were HIV-infected. Proportion of mothers who exclusively breastfed, complementary fed, replacement fed, and adhered to feeding guidelines. Most (84.5%, 164/194) of the mothers had ever breastfed their infants, the rest had exclusively replacement fed since birth. Among children less than six months who were breastfeeding, 31.5% (34/108) were exclusively breastfeeding and the rest were mixed feeding. HIV-infected mothers were more likely than HIV-uninfected mothers to exclusively breastfeed (Crude Odds Ratio [COR], 3.61, 95% Confidence Interval [CI] 1.42-9.21). For infants older than six months, complementary feeding was more common among HIV-uninfected (100%) than HIV-infected mothers (41.7%; P < 0.001). Among infants of all ages, none of the HIV-uninfected and 45% of HIV-infected mothers were replacement feeding (p < 0.001). More than a half (59.8%) of the mothers adhered to infant feeding guidelines. The only independent predictor of adherence after multivariate analysis was mother ever attending infant feeding counselling (AOR 9.03; 95% CI 4.03-20.25). Only 35% of mothers reported ever attending infant feeding counselling. Infant feeding counselling was associated with improved adherence to feeding guidelines. Since infant feeding counselling is low in this population there is need for scale-up of this essential service.

Prevention of Mother-to-Child Transmission of HIV in Option B+ Era: Uptake and Adherence During Pregnancy in Western Uganda.

PubMed

Schnack, Alexandra; Rempis, Eva; Decker, Sarah; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie

2016-03-01

Since 2012, lifelong antiretroviral therapy for all HIV-positive pregnant women ("Option B+") is recommended by WHO for the prevention of mother-to-child transmission of HIV (PMTCT). Many sub-Saharan African countries have since introduced this regimen, but to date, longer-term outcome evaluations are scarce. We conducted an observational study in Fort Portal Municipality, Uganda, to describe uptake and adherence of Option B+ during pregnancy. HIV-positive women approaching antenatal care (ANC) services in two hospitals were enrolled and followed-up at monthly routine ANC visits until delivery. At each visit, next to sociodemographic and clinical data, we assessed drug adherence through pill counts. In total, 124 HIV-positive pregnant women were enrolled in our study; from these, 80.8% had not been aware of their positive serostatus before. Forty-five PMTCT clients (36.3%) never returned to ANC after their first visit. Protective factors (p < 0.05) for immediate loss to care included previous HIV status knowledge, status disclosure before or at first ANC visit, and tertiary education. Among those clients starting Option B+, the median adherence during pregnancy was 95.7% pill intake. Rather low adherence (<80%) was observed in 21.1% of clients, while more than half achieved an adherence level of ≥95%, with 40.8% of all clients being 100% adherent. The cohort's median adherence remained stable throughout the course of pregnancy. Healthcare providers should place high emphasis on individual PMTCT counseling at first ANC encounter, and pay special attention to those women previously unaware of their HIV status. However, after initial uptake, high adherence seems to be feasible for Option B+.

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

PubMed

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

2015-03-01

Sporadic anthrax outbreaks have occurred in and around Uganda's Queen Elizabeth National Park (QENP) for years, affecting wildlife, domestic animals, and humans. Reported outbreaks (2004-2005 and 2010) in QENP collectively killed over 500 wild animals and over 400 domestic animals. A 2011 outbreak in Sheema district temporarily froze local markets while killing two humans and seven bovines. One Health is multidisciplinary at its core, yet studies sometimes focus on the effects of animals on human health to the detriment of investigating the surrounding ecological and cultural contexts. Participatory methods connect problems - such as disease - to their context. A multidisciplinary team used participatory epidemiology and conventional structured questionnaires to investigate the impacts of anthrax on human livelihoods and the related perceptions of conservation, public health, and veterinary health efforts in the QENP area. Proximities to previous anthrax outbreaks and to QENP were treated as risk factors in the collection and evaluation of data. Participants' feedback indicates that anthrax prevalence may be greater than officially reported. Community member perceptions about anthrax and other diseases appear to be more closely related to their proximity to QENP than their proximity to anthrax outbreaks. Neither risk factor had a strong effect on knowledge of disease, nor any effect on behaviors associated with disease response or control. Instead, participants reported that social pressures, the economics of poverty, and the lack of health and veterinary infrastructure highly influenced responses to disease. The complex connections between the social needs and the economic context of these communities seem to be undermining current anthrax control and education measures. This livelihood-based decision-making may be unlikely to respond to educational intervention alone. This study provides a strong base for further research and for improvements in effective disease control. Copyright © 2014 Elsevier Ltd. All rights reserved.

The history of syphilis in Uganda

PubMed Central

Davies, J. N. P.

1956-01-01

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

An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda.

PubMed

Kiene, Susan M; Hopwood, Sarah; Lule, Haruna; Wanyenze, Rhoda K

2014-12-01

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries. © The Author(s) 2013.

Doctoral Education and Institutional Research Capacity Strengthening: An Example at Makerere University in Uganda (2000-2013)

ERIC Educational Resources Information Center

Akuffo, Hannah; Freeman, Phyllis; Johansson, Eva; Obua, Celestino; Ogwal-Okeng, Jasper; Waako, Paul

2014-01-01

Bilateral research cooperation between Sweden (Sida/SAREC) and Uganda has supported major advances in institutional research capacity strengthening at Makerere University (2000-2013). This case study illustrates how a department within Makerere's Faculty of Medicine (Department of Pharmacy and Therapeutics) has contributed to transforming the…

Understanding Vulnerability: From Categories to Experiences of Young Congolese People in Uganda

ERIC Educational Resources Information Center

Clark, Christina R.

2007-01-01

This article problematises the "vulnerables" category that the United Nations High Commissioner for Refugees applies to groups of refugees. Drawing on 9 months' qualitative research with young Congolese refugees in Uganda, it presents research subjects' self-identification and lived realities that do not correspond to the homogenous,…

Psychological Capital, Career Identity and Graduate Employability in Uganda: The Mediating Role of Social Capital

ERIC Educational Resources Information Center

Ngoma, Muhammad; Dithan Ntale, Peter

2016-01-01

This paper seeks to evaluate the relationship between psychological capital, career identity, social capital and graduate employability. We also seek to evaluate the mediating role of social capital on the relationships between psychological capital, career identity and graduate employability in Uganda. A population of 480 unemployed young people…

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Construction of an Instrument to Measure Social Valuation in an Emerging Market Context

ERIC Educational Resources Information Center

Katono, Isaac Wasswa

2011-01-01

Purpose: This study aims to construct a parsimonious instrument to measure social valuation in a collective setting using Uganda as an example. Design/methodology/approach: A triangulation technique was used in this study. Conversations with students, parents, teaching and non-teaching staff at Uganda Christian University (UCU) main campus were…

Reemerging Sudan Ebola Virus Disease in Uganda, 2011

PubMed Central

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

2012-01-01

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

Higher Education Research in Uganda: Problems and Prospects

ERIC Educational Resources Information Center

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

2010-01-01

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

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

ERIC Educational Resources Information Center

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

2016-01-01

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

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

ERIC Educational Resources Information Center

Nyenje, Aida; Nkata, James

2016-01-01

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

Adolescents Caught between Fires: Cognitive Emotion Regulation in Response to War Experiences in Northern Uganda

ERIC Educational Resources Information Center

Amone-P'Olak, Kennedy; Garnefski, Nadia; Kraaij, Vivian

2007-01-01

This study aimed to assess the prevalence of war experiences and the use of specific cognitive emotion regulation strategies in response to these experiences among 294 formerly abducted adolescents at three rehabilitation centres in Uganda. Cognitive strategies were measured by Cognitive Emotion Regulation Questionnaire (CERQ). Symptoms of…

Implementing the Early Childhood Development Teacher Training Framework in Uganda: Gains and Challenges

ERIC Educational Resources Information Center

Ejuu, Godfrey

2012-01-01

Training of quality early childhood development (ECD) teachers is paramount in ensuring quality ECD service provision. This exploratory study focuses on the gains and challenges met in the implementation of the Uganda ECD teacher training framework. Data were obtained using questionnaires and interviews from principals and tutors of ECD teacher…

Application of Information and Communication Technology (ICT) in Health Information Access and Dissemination in Uganda

ERIC Educational Resources Information Center

Omona, Walter; Ikoja-Odongo, Robert

2006-01-01

This paper reports on a study which assessed the application of information and communication technologies (ICT) in health information access and dissemination in Uganda. The project focused not only on information obtainable through libraries for research, teaching, learning and practice, but also on ICT applications concerned with the…

Laramie in Uganda

ERIC Educational Resources Information Center

Kagan, Eve

2011-01-01

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

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

PubMed

Muula, Adamson S; Mpabulungi, Lillian

2007-03-01

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

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

PubMed

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

2017-03-01

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

How 'The Urge to Kill' Feels: Articulations of Emic 'Appetitive Aggression' Experiences Among Former Forcefully Recruited Children and Youth in the Acholi Region of Northern Uganda.

PubMed

Harnisch, Helle; Pfeiffer, Anett

2018-06-01

Based on 10 months of fieldwork in the Acholi region of northern Uganda among youth and adults who were forcefully recruited into the Lord's Resistance Army (LRA) during the war, this article provides qualitative details to research on 'appetitive aggression.' Through two case-stories the article unfolds first person articulations of how 'appetitive aggression' is experienced as 'the urge to kill' and how it relates to the emic Acholi spiritual concept of 'cen'; a local Luo expression used to describe places and human beings possessed by evil spirits. The analysis illuminates what the individual and social implications of 'the urge to kill' and 'cen' entail for two Acholi men; first in a militia and then in a civil post-war context. The analysis then relates these findings to soldier experiences across cultures and time periods. While our analysis supports the findings in 'appetitive aggression' studies that appetitive aggression serves as a resilient protective factor against developing post-traumatic stress disorder (PTSD), this study documents that once the former forcefully recruited return to civilian life, 'appetitive aggression' and 'the urge to kill' precipitate individual and at times lethal social and moral complications in a fragile post-war community. Thus, the article argues that appetitive aggression and the emic perceptions and experiences of it among the local population are essential to consider in studies, processes and programs targeting demobilization, rehabilitation, reconciliation and re-integration.

A global sensitivity analysis for African sleeping sickness.

PubMed

Davis, Stephen; Aksoy, Serap; Galvani, Alison

2011-04-01

African sleeping sickness is a parasitic disease transmitted through the bites of tsetse flies of the genus Glossina. We constructed mechanistic models for the basic reproduction number, R0, of Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, respectively the causative agents of West and East African human sleeping sickness. We present global sensitivity analyses of these models that rank the importance of the biological parameters that may explain variation in R0, using parameter ranges based on literature, field data and expertize out of Uganda. For West African sleeping sickness, our results indicate that the proportion of bloodmeals taken from humans by Glossina fuscipes fuscipes is the most important factor, suggesting that differences in the exposure of humans to tsetse are fundamental to the distribution of T. b. gambiense. The second ranked parameter for T. b. gambiense and the highest ranked for T. b. rhodesiense was the proportion of Glossina refractory to infection. This finding underlines the possible implications of recent work showing that nutritionally stressed tsetse are more susceptible to trypanosome infection, and provides broad support for control strategies in development that are aimed at increasing refractoriness in tsetse flies. We note though that for T. b. rhodesiense the population parameters for tsetse - species composition, survival and abundance - were ranked almost as highly as the proportion refractory, and that the model assumed regular treatment of livestock with trypanocides as an established practice in the areas of Uganda experiencing East African sleeping sickness.

Detection of Onchocerca volvulus in Skin Snips by Microscopy and Real-Time Polymerase Chain Reaction: Implications for Monitoring and Evaluation Activities.

PubMed

Thiele, Elizabeth A; Cama, Vitaliano A; Lakwo, Thomson; Mekasha, Sindeaw; Abanyie, Francisca; Sleshi, Markos; Kebede, Amha; Cantey, Paul T

2016-04-01

Microscopic evaluation of skin biopsies is the monitoring and evaluation (M and E) method currently used by multiple onchocerciasis elimination programs in Africa. However, as repeated mass drug administration suppresses microfilarial loads, the sensitivity and programmatic utility of skin snip microscopy is expected to decrease. Using a pan-filarial real-time polymerase chain reaction with melt curve analysis (qPCR-MCA), we evaluated 1) the use of a single-step molecular assay for detecting and identifying Onchocerca volvulus microfilariae in residual skin snips and 2) the sensitivity of skin snip microscopy relative to qPCR-MCA. Skin snips were collected and examined with routine microscopy in hyperendemic regions of Uganda and Ethiopia (N= 500 each) and "residual" skin snips (tissue remaining after induced microfilarial emergence) were tested with qPCR-MCA. qPCR-MCA detected Onchocerca DNA in 223 residual snips: 139 of 147 microscopy(+) and 84 among microscopy(-) snips, suggesting overall sensitivity of microscopy was 62.3% (139/223) relative to qPCR-MCA (75.6% in Uganda and 28.6% in Ethiopia). These findings demonstrate the insufficient sensitivity of skin snip microscopy for reliable programmatic monitoring. Molecular tools such as qPCR-MCA can augment sensitivity and provide diagnostic confirmation of skin biopsies and will be useful for evaluation or validation of new onchocerciasis M and E tools. © The American Society of Tropical Medicine and Hygiene.

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

PubMed

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

2016-05-04

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

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

PubMed

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

2018-06-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

2013-01-01

Background There is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda. Methods The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV. Results The prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV. Conclusion In the Ugandan context, women’s empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners’ negative behaviours and history of witnessing parental violence. PMID:24289495

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

PubMed

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

2008-04-01

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

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

PubMed

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

2015-12-01

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

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.

Power and process: The politics of electricity sector reform in Uganda

NASA Astrophysics Data System (ADS)

Gore, Christopher David

In 2007, Uganda had one of the lowest levels of access to electricity in the world. Given the influence of multilateral and bilateral agencies in Uganda; the strong international reputation and domestic influence of its President; the country's historic achievements in public sector and economic reform; and the intimate connection between economic performance, social well-being and access to electricity, the problems with Uganda's electricity sector have proven deeply frustrating and, indeed, puzzling. Following increased scholarly attention to the relationship between political change, policymaking, and public sector reform in sub-Saharan Africa and the developing world generally, this thesis examines the multilevel politics of Uganda's electricity sector reform process. This study contends that explanations for Uganda's electricity sector reform problems generally, and hydroelectric dam construction efforts specifically, must move beyond technical and financial factors. Problems in this sector have also been the result of a model of reform (promoted by the World Bank) that failed adequately to account for the character of political change. Indeed, the model of reform that was promoted and implemented was risky and it was deeply antagonistic to domestic and international civil society organizations. In addition, it was presented as a linear, technical, apolitical exercise. Finally the model was inconsistent with key principles the Bank itself, and public policy literature generally, suggest are needed for success. Based on this analysis, the thesis contends that policymaking and reform must be understood as deeply political processes, which not only define access to services, but also participation in, and exclusion from, national debates. Future approaches to reform and policymaking must anticipate the complex, multilevel, non-linear character of 'second-generation' policy issues like electricity, and the political and institutional capacity needed to increase the potential for success. At the heart of this approach is a need to carefully consider how the character of state-society relations in the country---"governance"---will influence reform processes and outcomes.

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

PubMed Central

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

2012-01-01

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

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

PubMed Central

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

2012-01-01

Background HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion The social-cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children. PMID:22713256

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

PubMed

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

2012-05-31

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

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

PubMed

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

2015-03-04

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

Timber product implications of a program of mechanical fuel treatments applied on public timberland in the Western United States

Treesearch

Barbour R. James.; Xiaoping Zhou; Jeffrey P. Prestemon

2008-01-01

This study reports the results from a 5 year simulation of forest thinning intended to reduce fire hazard on publicly managed lands in the western United States. A state simulation model of interrelated timber markets was used to evaluate the timber product outputs. Approximately 84 million acres (34 million hectares), or 66% of total timberland in the western United...

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

PubMed

Chi, Primus Che; Urdal, Henrik

2018-01-01

Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of 'birth companions'. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system.

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

PubMed Central

Urdal, Henrik

2018-01-01

Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. Conclusion: The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system. PMID:29375881

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

PubMed

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

2012-09-21

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

Gangnam-Style Plastic Surgery: The Science of Westernized Beauty in South Korea.

PubMed

Leem, So Yeon

2017-10-01

New beauty ideals and particular types of plastic surgery beauty have emerged in South Korea from the early twenty-first century. By defining Gangnam-style plastic surgery as a hybrid of old Westernized beauty ideals and a new science of beauty with variations and contradictions, I intend to twist the simplistic understanding of non-Western plastic surgery as an effort to resemble the white westerner's body. I also draw political implications from a case of monstrous Gangnam-style beauty made by excessive plastic surgery.

Attracting Youth to Agriculture: The Career Interests of Young Farmers Club Members in Uganda

ERIC Educational Resources Information Center

Mukembo, Stephen C.; Edwards, M. Craig; Ramsey, Jon W.; Henneberry, Shida R.

2014-01-01

This embedded, quantitative case study included 102 participants who were members of Young Farmers Clubs (YFCs) from two secondary schools in eastern Uganda. The study's multifold purpose was to describe YFC members' personal characteristics and their reasons for joining the clubs. In addition, the study sought to determine the career…

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

ERIC Educational Resources Information Center

Iannotti, Lora; Gillespie, Stuart

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

Adolescent Resilience in Northern Uganda: The Role of Social Support and Prosocial Behavior in Reducing Mental Health Problems

ERIC Educational Resources Information Center

Haroz, Emily E.; Murray, Laura K.; Bolton, Paul; Betancourt, Theresa; Bass, Judith K.

2013-01-01

We investigated relations between prosocial behavior, perceived social support, and improvement in depression and anxiety symptoms over 6 months among 102 Acholi adolescent (14-17 years, 58% female adolescents) survivors of war and displacement in Northern Uganda. Adolescents were assessed using a locally developed screener. Regression analyses…

Implementation of the World Starts with Me, a Comprehensive Rights-Based Sex Education Programme in Uganda

ERIC Educational Resources Information Center

Rijsdijk, Liesbeth E.; Bos, Arjan E. R.; Lie, Rico; Leerlooijer, Joanne N.; Eiling, Ellen; Atema, Vera; Gebhardt, Winifred A.; Ruiter, Robert A. C.

2014-01-01

This article presents a process evaluation of the implementation of the sex education programme the World Starts With Me (WSWM) for secondary school students in Uganda. The purpose of this mixed-methods study was to examine factors associated with dose delivered (number of lessons implemented) and fidelity of implementation (implementation…

Conducting a Large Public Health Data Collection Project in Uganda: Methods, Tools, and Lessons Learned

ERIC Educational Resources Information Center

Stover, Bert; Lubega, Flavia; Namubiru, Aidah; Bakengesa, Evelyn; Luboga, Samuel Abimerech; Makumbi, Frederick; Kiwanuka, Noah; Ndizihiwe, Assay; Mukooyo, Eddie; Hurley, Erin; Lim, Travis; Borse, Nagesh N.; Bernhardt, James; Wood, Angela; Sheppard, Lianne; Barnhart, Scott; Hagopian, Amy

2018-01-01

We report on the implementation experience of carrying out data collection and other activities for a public health evaluation study on whether U.S. President's Emergency Plan for AIDS Relief (PEPFAR) investment improved utilization of health services and health system strengthening in Uganda. The retrospective study period focused on the PEPFAR…

Laptops and Diesel Generators: Introducing PhET Simulations to Teachers in Uganda

ERIC Educational Resources Information Center

McKagan, Sam

2010-01-01

This article describes workshops for high school physics teachers in Uganda on inquiry-based teaching and PhET simulations. I hope it increases awareness of the conditions teachers face in developing countries and inspires others to give similar workshops. This work demonstrates what is possible with some concerted, but not extraordinary, effort.

Influence of Parental Education and Family Income on Children's Education in Rural Uganda

ERIC Educational Resources Information Center

Drajea, Alice J.; O'Sullivan, Carmel

2014-01-01

This article investigates the effect of parents' literacy levels and family income in Uganda on the quality and nature of parents' involvement in their children's primary education. A mixed-methods study with an ethnographic element was employed to explore the views and opinions of 21 participants through a qualitative approach. Methods for data…

A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda

ERIC Educational Resources Information Center

Falk, Diane S.; Pettet, Kristen; Mpagi, Charles

2016-01-01

In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…

Adaptation of the "Ten Questions" to Screen for Autism and other Neurodevelopmental Disorders in Uganda

ERIC Educational Resources Information Center

Kakooza-Mwesige, Angelina; Ssebyala, Keron; Karamagi, Charles; Kiguli, Sarah; Smith, Karen; Anderson, Meredith C.; Croen, Lisa A.; Trevathan, Edwin; Hansen, Robin; Smith, Daniel; Grether, Judith K.

2014-01-01

Neurodevelopmental disorders are recognized to be relatively common in developing countries but little data exist for planning effective prevention and intervention strategies. In particular, data on autism spectrum disorders are lacking. For application in Uganda, we developed a 23-question screener (23Q) that includes the Ten Questions screener…

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

ERIC Educational Resources Information Center

Nyenje, Aida

2016-01-01

This paper examines Uganda's recent undertaking to reform her Primary School education System with a focus on the effect of structural dynamics of education reforms and the quality of primary education. Structural dynamics in the context of this study is in reference to the organizational composition of the education system at the government,…

Does the Oganizational Structure Affect the Management of Universities in Uganda? An Empirical Analysis

ERIC Educational Resources Information Center

Zziwa, Gertrude

2014-01-01

The organisational structure of universities follows particular models that distinguish them from other learning institutions. This research investigated the effect of the organisational structure on the management of universities in Uganda using a sample of 361, 44% of whom were members of academic staff, and the rest contained university top…

Knowledge of Millennium Development Goals among University Faculty in Uganda and Kenya

ERIC Educational Resources Information Center

Wamala, Robert; Nabachwa, Mary Sonko; Chamberlain, Jean; Nakalembe, Eva

2012-01-01

This article examines the level of knowledge of the Millennium Development Goals (MDGs) among university faculty. The assessment is based on data from 197 academic unit or faculty heads randomly selected from universities in Uganda and Kenya. Frequency distributions and logistic regression were used for analysis. Slightly more than one in three…

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Improving Early-Grade Literacy in East Africa: Experimental Evidence from Kenya and Uganda

ERIC Educational Resources Information Center

Lucas, Adrienne M.; McEwan, Patrick J.; Ngware, Moses; Oketch, Moses

2014-01-01

Primary school enrollments have increased rapidly in sub-Saharan Africa, spurring concerns about low levels of learning. We analyze field experiments in Kenya and Uganda that assessed whether the Reading to Learn intervention, implemented by the Aga Khan Foundation in both countries, improved early-grade literacy as measured by common assessments.…

Effectiveness of Group Activity Play Therapy on Internalizing and Externalizing Behavior Problems of Preadolescent Orphans in Uganda

ERIC Educational Resources Information Center

Ojiambo, Deborah

2011-01-01

This pilot study investigated the impact of group activity play therapy (GAPT) on displaced orphans aged 10 to 12 years living in a large children's village in Uganda. Teachers and housemothers identified 60 preadolescents exhibiting clinical levels of internalizing and externalizing behavior problems. The participants' ethnicity was African and…

Non-Formal Vocational Education in Uganda: Practical Empowerment through a Workable Alternative

ERIC Educational Resources Information Center

Blaak, Marit; Openjuru, George L.; Zeelen, Jacques

2013-01-01

This article reflects on the potential of non-formal vocational education in Uganda to improve the quality of life of those excluded from formal education. Based on an exploration of humanizing development theorists Sen, Freire and Nyerere, together with two case studies, practical empowerment is described as a desirable outcome of education for…

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

ERIC Educational Resources Information Center

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

2006-01-01

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

University Leadership during Times of Significant Transformation: A Case of Kyambogo University in Uganda

ERIC Educational Resources Information Center

Namubiru, Gertrude; Onen, David; Oonyu, Joseph

2017-01-01

This study investigated how leadership was exercised at Kyambogo University [KyU] (in Uganda) during its formation that involved the merger of three tertiary institutions and the period immediately thereafter. This was regarded as a period of significant transformation at the institution. The study was prompted by the rampant strikes and protests…

Evaluation of the Effectiveness of AIDS Health Education Interventions in the Muslim Community in Uganda.

ERIC Educational Resources Information Center

Kagimu, Magid; Marum, Elizabeth; Wabwire-Mangen, Fred; Nakyanjo, Neema; Walakira, Yusuf; Hogle, Janice

1998-01-01

Describes an AIDS prevention project of the Islamic Medical Association of Uganda, discussing how it was influenced by information from a baseline survey and how it was implemented. A followup evaluation study that assessed the community-level impact indicated that the intense community education effort, which used religious leaders and lay…

Integration of Web-Based Learning into Higher Education Institutions in Uganda: Teachers' Perspectives

ERIC Educational Resources Information Center

Asuman, Baguma; Khan, Md. Shahadat Hossain; Clement, Che Kum

2018-01-01

This article reports on the barriers encountered by teachers and the possible solutions to the integration of web-based learning (WBL) into higher educational institutions in Uganda. A total of 50 teachers in the departments of ICT, management, and social sciences from five different universities were purposively selected. A self-designed…

Automatic Promotion and Student Dropout: Evidence from Uganda, Using Propensity Score in Difference in Differences Model

ERIC Educational Resources Information Center

Okurut, Jeje Moses

2018-01-01

The impact of automatic promotion practice on students dropping out of Uganda's primary education was assessed using propensity score in difference in differences analysis technique. The analysis strategy was instrumental in addressing the selection bias problem, as well as biases arising from common trends over time, and permanent latent…

"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…

Community Knowledge, Beliefs, Attitudes, and Practices towards Children with Spina Bifida and Hydrocephalus in Uganda

ERIC Educational Resources Information Center

Bannink, Femke; Stroeken, Koenraad; Idro, Richard; van Hove, Geert

2015-01-01

This article describes the findings of a qualitative study on knowledge, beliefs, attitudes, and practices towards children with spina bifida and hydrocephalus in four regions of Uganda. Focus group discussions and semi-structured interviews were held with parents of children with spina bifida and hydrocephalus, policy-makers, and service…

Geochemical Insights Into Lithospheric Melting and Instability in the Bufumbira Volcanic Field of the Western Rift, Uganda

NASA Astrophysics Data System (ADS)

Pitcavage, E.; Furman, T.; Nelson, W. R.

2016-12-01

The East African Rift System (EARS) is the earth's largest continental divergent boundary and is an unparalleled natural laboratory for understanding magmatic processes related to continental rifting. A fundamental unresolved question in EARS magmatism is the degree to which volcanism and rifting are influenced by Cenozoic plume-related melting rather than older, tectonically-driven metasomatism. In the latter scenario, metasomatism by carbonatite or silicate magmas and/or fluids that accompanies tectonic events such as the Proterozoic Pan-African Orogeny will create geochemical heterogeneities and rheological weaknesses in the sub-continental lithospheric mantle (SCLM). In the Western Rift, abundant alkaline mafic lavas record significant contributions from metasomatized SCLM. Modification, destabilization and foundering of metasomatized SCLM has an increasingly recognized role in continental magmatism worldwide. Lithospheric drip magmatism occurs when foundered lithosphere devolatilizes and melts on descent. Lithospheric thinning is one consequence of this process, and may play a role in physical aspects of rifting. Geochemical and geophysical evidence that drip magmatism has occurred in several areas of the EARS, including Turkana, Chyulu Hills, and Oligocene HT2 flood basalts in Afar, suggests that this process is fundamentally related to the onset of successful rifting. We use geochemical characteristics of primitive lavas from the Bufumbira volcanic field in the Western Rift's Virunga Province to demonstrate that ancient, tectonically-driven metasomatism modified the SCLM and contributes to recent volcanism. Further, we identify geochemical signatures which indicate that lithospheric drip melting is the primary petrogenetic process generating these lavas. Sr-Nd-Pb-Hf isotopic data show that the northern portion of the Western Rift, including Bufumbira, requires magma sources distinct from the rest of the EARS. Trace element data show that Bufumbira lavas are derived from depths within the garnet stability field and that source mineralogy includes phlogopite with potential amphibole and zircon; and that extent of melting increased with depth of melting, a signature of lithospheric drip.

Exploring climate niches of ponderosa pine (Pinus ponderosa Douglas ex Lawson) haplotypes in the western United States: implications for evolutionary history and conservation

Treesearch

Douglas J. Shinneman; Robert E. Means; Kevin M. Potter; Valerie D. Hipkins; Tzen-Yuh Chiang

2016-01-01

Ponderosa pine (Pinus ponderosa Douglas ex Lawson) occupies montane environments throughout western North America, where it is both an ecologically and economically important tree species. A recent study using mitochondrial DNA analysis demonstrated substantial genetic variation among ponderosa pine populations in the western U.S., identifying 10 haplotypes with unique...

Armenia, Azerbaijan, and Georgia: Political Developments and Implications for U.S. Interests

DTIC Science & Technology

2013-10-25

with Georgia have evolved from U.S. contacts with its pro -Western leadership. Successive Administrations have supported U.S. private investment in...Georgia after Eduard Shevardnadze (formerly a pro -Western Soviet foreign minister) assumed power there in early 1992. Faced with calls in Congress and...The Roles of Turkey, Iran, and Others The United States has generally viewed Turkey as able to foster pro -Western policies and discourage Iranian

Armenia, Azerbaijan, and Georgia: Political Developments and Implications for U.S. Interests

DTIC Science & Technology

2012-09-27

over its fate. Close ties with Georgia have evolved from U.S. contacts with its pro -Western leadership. Successive Administrations have supported U.S...ties with Georgia after Eduard Shevardnadze (formerly a pro -Western Soviet foreign minister) assumed power there in early 1992. Faced with calls in...generally viewed Turkey as able to foster pro -Western policies and discourage Iranian interference in the South Caucasus states, even though Turkey favors

Distribution of western juniper seeds across an ecotone and implications for seed dispersal processes

USDA-ARS?s Scientific Manuscript database

Western juniper forests have been the focus of extensive research and management due to range expansion and infilling that began over a century ago. Understanding juniper seed dispersal is vital to identifying processes behind increases in density and range. Dispersal of Juniperus seeds has generall...

Ecological consequences of mountain pine beetle outbreaks for wildlife in western North American forests

Treesearch

Victoria A. Saab; Quresh S. Latif; Mary M. Rowland; Tracey N. Johnson; Anna D. Chalfoun; Steven W. Buskirk; Joslin E. Heyward; Matthew A. Dresser

2014-01-01

Mountain pine beetle (Dendroctonus ponderosae) (MPB) outbreaks are increasingly prevalent in western North America, causing considerable ecological change in pine (Pinus spp.) forests with important implications for wildlife. We reviewed studies examining wildlife responses to MPB outbreaks and postoutbreak salvage logging to...

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

PubMed

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

2015-12-01

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

A Dialectical Paradigm for Psychological Research: Implications Drawn from the History of Psychology in the Soviet Union

ERIC Educational Resources Information Center

Wozniak, Robert H.

1975-01-01

The psycho-philosophical issues involved in the shift to a dialectical perspective in early Soviet psychology are reviewed in order to clarify the implications of the dialectical method for contemporary Western cognitive psychology. (JMB)

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…

Post-Primary Education and Capabilities: Insights from Young Women in Rural Uganda

ERIC Educational Resources Information Center

Jones, Shelley K.

2015-01-01

This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that…

Examining the Effect of Automatic Promotion on Students' Learning Achievements in Uganda's Primary Education

ERIC Educational Resources Information Center

Okurut, Jeje Moses

2015-01-01

This study employed a difference-in-differences analysis technique to estimate the average treatment effect of automatic promotion on students' cognitive learning outcomes in Uganda's primary education. Regression results indicate a positive policy effect on learning achievements in literacy and numeracy at primary three (P3) and primary six (P6).…

Acceptability and Trust of Community Health Workers Offering Maternal and Newborn Health Education in Rural Uganda

ERIC Educational Resources Information Center

Singh, Debra; Cumming, Robert; Negin, Joel

2015-01-01

When trusted, Community Health Workers (CHWs) can contribute to improving maternal and newborn health outcomes in low- and middle-income countries through education. Issues of acceptability of CHWs by communities were explored through experiences gained in a qualitative study that is part of a cluster randomized trial in East Uganda. Initially,…

Towards In-Service Training Needs of Secondary School Agriculture Teachers in a Paradigm Shift to Outcome-Based Education in Uganda

ERIC Educational Resources Information Center

Okiror, John James; Hayward, Geoff; Winterbottom, Mark

2017-01-01

Purpose: This paper examines the in-service teacher training needs of secondary school agriculture teachers in Uganda as the country moves towards an "outcome-based" education by removal of subjects and instead, uses learning areas, presenting a need for new pedagogical skills among teachers. Design/methodology/approach: A…

Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda(1).

PubMed

Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N; Mwanga-Amumpaire, Juliet; Parikh, Sunil; Boum, Yap

2016-08-01

A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non-P. falciparum malarial infections.

Drug Evaluation in the Plasmodium Falciparum-Aotus Model.

DTIC Science & Technology

1986-09-30

strains of Plasmodium falciparum, Uganda Palo Alto ( chloroquine sensi- tive) or Vietnam Smith (chioroquine resistant), in Aotus trivirgatus, were used...Plasmodium falciparum in the Panamanian owl monkey Aotus Two strains of falciparum malaria, Uganda Palo Alto (sensitive to chloroquine anfd quinine...resistant to pyrimetha- mine) and Vietnam Smith (resistant to chloroquine , quinine and pyrimethamine) were used. Previous evaluation of two stereoisomers of

Challenging the Status Quo: The Enabling Role of Gender Sensitive Fathers, Inspirational Mothers and Surrogate Parents in Uganda

ERIC Educational Resources Information Center

Warrington, Molly

2013-01-01

Within a context where relatively few girls complete secondary education, 18 women were interviewed in Uganda with the objective of ascertaining how they were able to overcome the challenges they encountered to become well-qualified and successful career-women. An important finding from this research was that although parental involvement in…

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…

Functional Adult Literacy: An Alternative Gateway to Grassroots Women's Improved Income Generation in Lango Subregion, Northern Uganda

ERIC Educational Resources Information Center

Akello, Judith Abal; Lutwama-Rukundo, Evelyn; Musiimenta, Peace

2017-01-01

This article presents findings of study on women's experiences of Functional Adult Literacy (FAL) as a gateway to their financial progress and welfare in Lango region, Northern Uganda. The qualitative study of 45 participants aimed at examining women's live changes resulting from using their acquired FAL knowledge and skills to participate in…

A Review of Community Extension Approaches to Innovation for Improved Livelihoods in Ghana, Uganda and Malawi

ERIC Educational Resources Information Center

Wellard, Kate; Rafanomezana, Jenny; Nyirenda, Mahara; Okotel, Misaki; Subbey, Vincent

2013-01-01

Purpose: Farmer-to-farmer extension offers a potentially low-cost and wide-reach alternative in supporting agricultural innovation. Various approaches are being promoted but information on their impact and sustainability is sparse. This study examines experiences of Self Help Africa and partners in Ghana, Uganda and Malawi. It asks: What is good…

Religious Views on Suicide among the Baganda, Uganda: A Qualitative Study

ERIC Educational Resources Information Center

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

2013-01-01

Relatively little research has been conducted on religion and suicide in Africa, yet religion has a lot of influence on people's way of life in Africa. To study religious views on suicide among the Baganda, Uganda, we used grounded theory and discourse analysis on a total of 28 focus groups and 30 key informant interviews. Suicide is largely seen…

The Place of Social Learning and Social Movement in Transformative Learning: A Case Study of Sustainability Schools in Uganda

ERIC Educational Resources Information Center

Westoby, Peter; Lyons, Kristen

2017-01-01

This article analyses the sustainability school (SS) program of the National Association of Professional Environmentalists (NAPE), Uganda. The focus is on how the social network, enabled by the SS program, fosters social and transformative learning. The significance of this approach to community-based education for social change, including in the…

Validity and Reliability of the 3-E Tool for Evaluating the Curriculum Support Intervention in Uganda

ERIC Educational Resources Information Center

Mutto, Milton; Mukasa, Immaculate; Avasi, Victor; Kilibo, Charles; Kamwesigye, Charles; Duku, Tom

2015-01-01

This study determined psychometric properties of 3-ET, an instrument specifically designed to track the effects of a curriculum support intervention created to enhance the delivery of the national curriculum in a war zone in Uganda. The instrument was developed through brain storm and expert review before being committed to structural and…

Scholarly Productivity in Developing Countries: An Analysis of Levels and Patterns among Doctoral Holders in Uganda

ERIC Educational Resources Information Center

Wamala, Robert; Ssembatya, Vincent A.

2013-01-01

Doctoral holders are considered to be key actors in the creation of innovation and knowledge. However, this generalization may not hold true for doctoral holders in all countries. This study sought to assess the scholarly productivity of these highly qualified individuals in Uganda. The investigation is based on data sourced from the 2012 Careers…

Just How Much Can School Pupils Learn from School Gardening? A Study of Two Supervised Agricultural Experience Approaches in Uganda

ERIC Educational Resources Information Center

Okiror, John James; Matsiko, Biryabaho Frank; Oonyu, Joseph

2011-01-01

School systems in Africa are short of skills that link well with rural communities, yet arguments to vocationalize curricula remain mixed and school agriculture lacks the supervised practical component. This study, conducted in eight primary (elementary) schools in Uganda, sought to compare the learning achievement of pupils taught using…

Generational, Cultural, and Linguistic Integration for Literacy Learning and Teaching in Uganda: Pedagogical Possibilities, Challenges, and Lessons from One NGO

ERIC Educational Resources Information Center

Ngaka, Willy; Graham, Ross; Masaazi, Fred Masagazi; Anyandru, Elly Moses

2016-01-01

This qualitative case study focuses on a volunteer-led local NGO in Uganda to examine how integrating generations, cultures, and languages is enhancing literacy learning to help ethnically and linguistically diverse rural communities survive in the prevailing globally competitive neoliberal environment. Immersing the study in the social practices…

Mediation Effect of Research Skills Proficiency on the Core Self-Evaluations--Research Engagement Relationship among Master of Education Students in Uganda

ERIC Educational Resources Information Center

Atibuni, Dennis Zami; Olema, David Kani; Ssenyonga, Joseph; Karl, Steffens; Kibanja, Grace Milly

2017-01-01

This study investigated the mediation effect of research skills proficiency on the relationship between core self-evaluations and research engagement among Master of Education students in Uganda. Questionnaire surveys including closed ended questions were administered to two cohorts of the students, 2011/2012 and 2012/2013, (N = 102). Results…

A SWOT Analysis of the Integration of E-Learning at a University in Uganda and a University in Tanzania

ERIC Educational Resources Information Center

Zhu, Chang; Justice Mugenyi, Kintu

2015-01-01

This research examines the strengths, weaknesses, opportunities and threats (SWOT) to integrating e-learning perceived by academic staff at a university in Uganda and a university in Tanzania. Mixed-methods research was used in which a main qualitative study was complemented by a quantitative method. The sample participants were academic staff…

Assessment of Leadership Training of Head Teachers and Secondary School Performance in Mubende District, Uganda

ERIC Educational Resources Information Center

Benson, Kayiwa

2011-01-01

The purpose of the study was to establish the relationship between leadership training of head teachers and school performance in secondary schools in Mubende district, Uganda. Descriptive-correlational research design was used. Six schools out of 32 were selected and the sample size of head teachers, teachers and students leaders was 287 out of…

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

ERIC Educational Resources Information Center

Kagoda, Alice Merab

2008-01-01

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

Establishing Junior-Level Colleges in Developing Nations: A Site Selection Process Using Data from Uganda

ERIC Educational Resources Information Center

Iaeger, Paula Irene

2012-01-01

This research synthesizes data and presents it using mapping software to help to identify potential site locations for community-centered higher education alternatives and more traditional junior-level colleges in Uganda. What factors can be used to quantify one site over another for the location of such an institution and if these factors can be…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Recalibrating Baseline Evidence in Burundi, Malawi, Senegal and Uganda: Exploring the Potential of Multi-Site, National-Level Stakeholder Engagement in Participatory Evaluation

ERIC Educational Resources Information Center

Edge, Karen; Marphatia, Akanksha A.

2015-01-01

This paper details our collaborative work on the Improving Learning Outcomes in Primary Schools (ILOPS) project in Burundi, Malawi, Uganda and Senegal. ILOPS set out to establish an innovative template for multi-stakeholder, multinational participatory evaluation (PE) and examine the fundamental roles, relationships and evidence that underpin the…

The Valorisation of African Languages and Policies in the African Education Systems: A Case of Uganda

ERIC Educational Resources Information Center

Muzoora, Michael; Terry, Daniel R.; Asiimwe, Agatha A.

2014-01-01

This paper highlights the challenges of current language policies in education in Africa, with reference to Uganda. Also examined are the likely challenges to language policy in education, while indicating how these challenges can be curtailed or overcome. The authors suggest a different view is required when approaching this topic with a paradigm…

Interview with Jacques Bwira Hope Primary School Kampala, Uganda

ERIC Educational Resources Information Center

Harvard Educational Review, 2009

2009-01-01

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

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 Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda.

PubMed

Kiene, Susan M; Bateganya, Moses H; Lule, Haruna; Wanyenze, Rhoda K

2016-09-01

Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda's standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5-2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection.

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

PubMed

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

2002-07-01

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

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

PubMed

Schlecht, Jennifer; Rowley, Elizabeth; Babirye, Juliet

2013-05-01

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

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.

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

PubMed

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

2011-10-01

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

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

PubMed

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

2018-04-01

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

Musculoskeletal trauma services in Uganda.

PubMed

Naddumba, E K

2008-10-01

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

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.

Sexual Risk Behavior, Sexual Violence, and HIV in Persons With Severe Mental Illness in Uganda: Hospital-Based Cross-Sectional Study and National Comparison Data.

PubMed

Lundberg, Patric; Nakasujja, Noeline; Musisi, Seggane; Thorson, Anna Ekéus; Cantor-Graae, Elizabeth; Allebeck, Peter

2015-06-01

We investigated prevalence of past-year sexual risk behavior and sexual violence exposure in persons with severe mental illness (SMI) in Uganda, and compared results to general population estimates. We also investigated whether persons with SMI reporting sexual risk behavior and sexual violence exposure were more likely to be HIV-infected. We included 602 persons consecutively discharged from Butabika Hospital, Kampala, Uganda, February to April 2010. We asked about past-year number of sexual partners and condom use. We assessed sexual violence with the World Health Organization Violence Against Women Instrument. We performed HIV testing. We used data from 2011 Uganda Demographic and Health Survey for comparison. Women with SMI had more sexual risk behavior and more sexual violence exposure than women in the general population. We found no difference in sexual risk behavior in men. Sexual risk behavior was associated with HIV infection in men, but not women. Sexual violence exposure was not associated with HIV infection in women. Findings suggest that SMI exacerbates Ugandan women's sexual vulnerability. Public health practitioners, policymakers, and legislators should act to protect health and rights of women with SMI in resource-poor settings.

Correlation dimensions of climate subsystems and their geographic variability

NASA Astrophysics Data System (ADS)

Gan, Thian Yew; Wang, Qiang; Seneka, Michael

2002-12-01

The correlation dimension D2 of precipitation (Canada and Africa), air temperature (Canada, New Zealand, and Southern Hemisphere), geo-potential height (Canada), and unregulated streamflow (Canada, USA, and Africa) were estimated using the Hill procedure of Mikosch and Wang [1995] and the bias correction of Wang and Gan [1998]. After bias correction, it seems that D2 is distinct between climate subsystems, such that for precipitation, it is between 8 and 9, for streamflow, it is between 7 and 9, for temperature, it is between 10 and 11, and for geo-potential heights, it is between 12 and 14. The results seem to suggest that climate might be viewed as a loosely coupled set of fairly high-dimensional subsystems and that different climate variables can yield different D2 values. Further, results also suggest that the D2 values of the climate subsystems studied, generally, have low geographic variability, as found between the precipitation data of Western Canada and Uganda, between the streamflow data of basins representing wide range climate and scales from Canada, USA, and Africa, and among the temperature data of Western Canada, New Zealand, and the southern hemisphere, and that the original D2 values analyzed from Canadian geo-potential heights are similar to that of Western Europe, eastern North America, and Germany. There is at most a weak relationship among basin physical characteristics, location, basin scale, and streamflow D2, while climatic influence is more obvious, as shown by drier basins having slightly higher D2 values than basins of wetter climate, basins from temperate climate having higher D2 values than those from cold or hot climates, and comparable D2 values between precipitation and streamflow data.

Origin of the HIV-1 group O epidemic in western lowland gorillas.

PubMed

D'arc, Mirela; Ayouba, Ahidjo; Esteban, Amandine; Learn, Gerald H; Boué, Vanina; Liegeois, Florian; Etienne, Lucie; Tagg, Nikki; Leendertz, Fabian H; Boesch, Christophe; Madinda, Nadège F; Robbins, Martha M; Gray, Maryke; Cournil, Amandine; Ooms, Marcel; Letko, Michael; Simon, Viviana A; Sharp, Paul M; Hahn, Beatrice H; Delaporte, Eric; Mpoudi Ngole, Eitel; Peeters, Martine

2015-03-17

HIV-1, the cause of AIDS, is composed of four phylogenetic lineages, groups M, N, O, and P, each of which resulted from an independent cross-species transmission event of simian immunodeficiency viruses (SIVs) infecting African apes. Although groups M and N have been traced to geographically distinct chimpanzee communities in southern Cameroon, the reservoirs of groups O and P remain unknown. Here, we screened fecal samples from western lowland (n = 2,611), eastern lowland (n = 103), and mountain (n = 218) gorillas for gorilla SIV (SIVgor) antibodies and nucleic acids. Despite testing wild troops throughout southern Cameroon (n = 14), northern Gabon (n = 16), the Democratic Republic of Congo (n = 2), and Uganda (n = 1), SIVgor was identified at only four sites in southern Cameroon, with prevalences ranging from 0.8-22%. Amplification of partial and full-length SIVgor sequences revealed extensive genetic diversity, but all SIVgor strains were derived from a single lineage within the chimpanzee SIV (SIVcpz) radiation. Two fully sequenced gorilla viruses from southwestern Cameroon were very closely related to, and likely represent the source population of, HIV-1 group P. Most of the genome of a third SIVgor strain, from central Cameroon, was very closely related to HIV-1 group O, again pointing to gorillas as the immediate source. Functional analyses identified the cytidine deaminase APOBEC3G as a barrier for chimpanzee-to-gorilla, but not gorilla-to-human, virus transmission. These data indicate that HIV-1 group O, which spreads epidemically in west central Africa and is estimated to have infected around 100,000 people, originated by cross-species transmission from western lowland gorillas.

Origin of the HIV-1 group O epidemic in western lowland gorillas

PubMed Central

D’arc, Mirela; Ayouba, Ahidjo; Esteban, Amandine; Learn, Gerald H.; Boué, Vanina; Liegeois, Florian; Etienne, Lucie; Tagg, Nikki; Leendertz, Fabian H.; Boesch, Christophe; Madinda, Nadège F.; Robbins, Martha M.; Gray, Maryke; Cournil, Amandine; Ooms, Marcel; Letko, Michael; Simon, Viviana A.; Sharp, Paul M.; Hahn, Beatrice H.; Delaporte, Eric; Mpoudi Ngole, Eitel; Peeters, Martine

2015-01-01

HIV-1, the cause of AIDS, is composed of four phylogenetic lineages, groups M, N, O, and P, each of which resulted from an independent cross-species transmission event of simian immunodeficiency viruses (SIVs) infecting African apes. Although groups M and N have been traced to geographically distinct chimpanzee communities in southern Cameroon, the reservoirs of groups O and P remain unknown. Here, we screened fecal samples from western lowland (n = 2,611), eastern lowland (n = 103), and mountain (n = 218) gorillas for gorilla SIV (SIVgor) antibodies and nucleic acids. Despite testing wild troops throughout southern Cameroon (n = 14), northern Gabon (n = 16), the Democratic Republic of Congo (n = 2), and Uganda (n = 1), SIVgor was identified at only four sites in southern Cameroon, with prevalences ranging from 0.8–22%. Amplification of partial and full-length SIVgor sequences revealed extensive genetic diversity, but all SIVgor strains were derived from a single lineage within the chimpanzee SIV (SIVcpz) radiation. Two fully sequenced gorilla viruses from southwestern Cameroon were very closely related to, and likely represent the source population of, HIV-1 group P. Most of the genome of a third SIVgor strain, from central Cameroon, was very closely related to HIV-1 group O, again pointing to gorillas as the immediate source. Functional analyses identified the cytidine deaminase APOBEC3G as a barrier for chimpanzee-to-gorilla, but not gorilla-to-human, virus transmission. These data indicate that HIV-1 group O, which spreads epidemically in west central Africa and is estimated to have infected around 100,000 people, originated by cross-species transmission from western lowland gorillas. PMID:25733890