Busia District Research Articles

Evaluating the Relationship between Teacher Pupil Ratio on Academic Performance of Pupils in Selected Primary Schools in Busia District, Uganda

This article evaluates the relationship between teacher-pupil ratios on the academic performance of pupils in selected primary schools in t h e Busia district of Uganda. the article revealed that planning an interactive and demonstration lesson becomes so challenging in large classes. This forces teachers to resort to using the lecture method because it is the only convenient one for large classes. However, with a lower student-teacher ratio, teachers have the capacity to address this situation, offering the students extra materials and helping them succeed to the best of their abilities. The teacher will also have a higher bandwidth to go above and beyond in communicating this area of strength with the student's parents and considering the next best steps. In the end, the article calls for the government of Uganda to thoroughly plan a path to universal primary education so that the necessary infrastructure is provided alongside the acceptance of more pupils instead of overwhelming an unprepared system with thousands of pupils. More so, as the Ministry of Education and sports reviews its policies annually,the input of teachers, students, parents, and administrators should be considered. Similarly, to encourage students and families to value education and have a stake in each student's education, the government should not advertise universal secondary education as entirely free and consequently require input from families. Furthermore, UPE should drastically reduce its recommended class size so that teachers can reasonably know each student and give him or her the necessary attention he or she deserves. Keywords: Academic performance, Education, Government, Parents, Teacher-pupil ration

Sickness Presenteeism Correlates to Teaching-Learning Activities: Implication Focus on Public Secondary Schools in Busia District, Uganda

To evaluate the implications of sickness presenteeism on the teaching-learning services in public secondary schools in Busia district, Eastern Uganda. The study adopted a cross-sectional design and gathered responses both qualitatively and quantitatively using structured interviews and questionnaires from secondary school teachers and Headteachers in government secondary schools in Busia District. The study used a stratified sampling technique with a sample size of 215 respondents. The study reveals that teachers’ on-time work plans, focus on their duties, and understanding of students’ needs and learning styles are crucial for effective teaching and learning. Teachers must prioritize and meet deadlines to maintain classroom cleanliness and discipline. The study recommended that the Ugandan government, through the Ministry of Education and Sports, should provide continuous professional development opportunities for teachers, enabling them to update their skills and knowledge. Additionally, the government should put in place mechanisms to encourage the use of technology in classrooms to foster interactive and engaging learning environments. Implication of the study, the government through the Ministry of Education and Sports should advocate for the introduction of insurance for teachers to further support and incentivize their commitment to their profession. This insurance could provide financial protection for teachers in the event of illness, injury, or any unforeseen circumstances that may prevent them from working. By offering this benefit, schools can demonstrate their commitment to the well-being of their teachers and their dedication to ensuring their job security.

Pyrethroid resistance and gene expression profile of a new resistant An. gambiae colony from Uganda reveals multiple resistance mechanisms and overexpression of Glutathione-S-Transferases linked to survival of PBO-pyrethroid combination.

The effectiveness of long-lasting insecticidal nets (LLINs) are being threatened by growing resistance to pyrethroids. To restore their efficacy, a synergist, piperonyl butoxide (PBO) which inhibits cytochrome P450s has been incorporated into pyrethroid treated nets. A trial of PBO-LLINs was conducted in Uganda from 2017 and we attempted to characterize mechanisms of resistance that could impact intervention efficacy. We established an Anopheles gambiae s.s colony in 2018 using female mosquitoes collected from Busia district in eastern Uganda. We first assessed the phenotypic resistance profile of this colony using WHO tube and net assays using a deltamethrin dose-response approach. The Busia colony was screened for known resistance markers and RT-qPCR targeting 15 genes previously associated with insecticide resistance was performed. The Busia colony had very high resistance to deltamethrin, permethrin and DDT. In addition, the colony had moderate resistance to alpha-cypermethrin and lambda-cyhalothrin but were fully susceptible to bendiocarb and fenitrothion. Exposure to PBO in combination with permethrin and deltamethrin resulted in higher mortality rates in both net and tube assays, with a higher mortality observed in net assays than tube assays. The kdr marker, Vgsc-995S was at very high frequency (91.7-98.9%) whilst the metabolic markers Coeae1d and Cyp4j5-L43F were at very low (1.3% - 11.5%) and moderate (39.5% - 44.7%) frequencies respectively. Our analysis showed that gene expression pattern in mosquitoes exposed to deltamethrin, permethrin or DDT only were similar in comparison to the susceptible strain and there was significant overexpression of cytochrome P450s, glutathione-s-transferases (GSTs) and carboxyl esterases (COEs). However, mosquitoes exposed to both PBO and pyrethroid strikingly and significantly only overexpressed closely related GSTs compared to unexposed mosquitoes while major cytochrome P450s were underexpressed. The high levels of pyrethroid resistance observed in Busia appears associated with a wide range of metabolic gene families.

The Influence of School Board of Governors’ Roles and Instructional Resource Availability on Teachers' Performance in Secondary Schools in Busia District, Uganda

The Influence of School Board of Governors’ Roles and Instructional Resource Availability on Teachers' Performance in Secondary Schools in Busia District, Uganda

Boosting Learner Independence: Adaptive Technology for Students with Cerebral Palsy in Primary Schools Across Busia District, Uganda

This study aims to identify the factors influencing the utilization of adaptive technology (AT) to promote independence among learners with cerebral palsy in primary schools within Busia District, Uganda. The specific objectives include assessing attitudes, determining training levels, evaluating proficiency in AT use, and scrutinizing environmental adaptations. Using a descriptive survey design, data was collected from a sample of 297 participants, including parents, children with cerebral palsy, teachers, and rehabilitation officers. The findings highlight positive attitudes toward AT, inadequate training levels, varying proficiency in AT use, and the need for environmental adaptations. Recommendations include comprehensive caregiver training, targeted interventions for specific challenges, and collaboration between stakeholders to create supportive environments for learners with cerebral palsy using AT. This study contributes to bridging gaps in existing research, aligning with Uganda's commitment to inclusive education and lifelong learning.

Pyrethroid resistance and gene expression profile of a new resistant An. gambiae colony from Uganda reveals multiple resistance mechanisms and overexpression of Glutathione-S-Transferases linked to survival of PBO-pyrethroid combination

Background: The effectiveness of long-lasting insecticidal nets (LLINs) are being threatened by growing resistance to pyrethroids. To restore their efficacy, a synergist, piperonyl butoxide (PBO) which inhibits cytochrome P450s has been incorporated into pyrethroid treated nets. A trial of PBO-LLINs was conducted in Uganda from 2017 and we attempted to characterize mechanisms of resistance that could impact intervention efficacy. Methods: We established an Anopheles gambiae s.s colony in 2018 using female mosquitoes collected from Busia district in eastern Uganda. We first assessed the phenotypic resistance profile of this colony using WHO tube and net assays using a deltamethrin dose-response approach. The Busia colony was screened for known resistance markers and RT-qPCR targeting 15 genes previously associated with insecticide resistance was performed. Results: The Busia colony had very high resistance to deltamethrin, permethrin and DDT. In addition, the colony had moderate resistance to alpha-cypermethrin and lambda-cyhalothrin but were fully susceptible to bendiocarb and fenitrothion. Exposure to PBO in combination with permethrin and deltamethrin resulted in higher mortality rates in both net and tube assays, with a higher mortality observed in net assays than tube assays. The kdr marker, Vgsc-995S was at very high frequency (91.7-98.9%) whilst the metabolic markers Coeae1d and Cyp4j5-L43F were at very low (1.3% - 11.5%) and moderate (39.5% - 44.7%) frequencies respectively. Our analysis showed that gene expression pattern in mosquitoes exposed to deltamethrin, permethrin or DDT only were similar in comparison to the susceptible strain and there was significant overexpression of cytochrome P450s, glutathione-s-transferases (GSTs) and carboxyl esterases (COEs). However, mosquitoes exposed to both PBO and pyrethroid strikingly and significantly only overexpressed closely related GSTs compared to unexposed mosquitoes while major cytochrome P450s were underexpressed. Conclusions: The high levels of pyrethroid resistance observed in Busia appears associated with a wide range of metabolic gene families.

Sexual gender-based violence among adolescent girls and young women during COVID-19 pandemic, Mid-Eastern Uganda.

global studies indicate that sexual gender-based violence (SGBV) may increase during pandemics including COVID-19. The Mid-Eastern region in Uganda was of concern due to the high prevalence of intimate partner sexual violence among adolescent girls and young women (AGYW). Due to limited data, we investigated factors associated with SGBV among AGYW during the COVID-19 pandemic in Eastern Uganda, in April 2022. we listed all AGYW 10-24 years who obtained SGBV services at 10 high-volume health facilities from March 2020 to December 2021, the main COVID-19 period in Uganda. We conducted a case-control study among these AGYW. A case was ≥1 SGBV episode experienced by an AGYW aged 10-24 years residing in the Tororo and Busia districts. For every randomly selected case from the health facility line list, we identified two neighbourhood-matched AGYW controls who reported no SGBV. We interviewed 108 and 216 controls on socio-demographics, socio-economics, and SGBV experiences during COVID-19. We conducted logistic regression to identify associated factors. among 389 SGBV cases, the mean age was 16.4 (SD± 1.6: range 10-24) years, and 350 (90%) were aged 15-19 years. Among 108 cases interviewed, 79 (73%) reported forced sex. Most (n=73; 68%) knew the perpetrator. In multivariate analysis, self-reported SGBV before the COVID-19 period [aOR=5.8, 95%CI: 2.8-12] and having older siblings [aOR=1.9, 95%: CI 1.1-3.4] were associated with SGBV during the period. Living with a family that provided all the basic needs was protective [aOR=0.42, 95%: CI 0.23-0.78]. previous SGBV experiences and family dynamics, such as having older siblings, increased the odds of SGBV during the COVID-19 pandemic in Uganda. Conversely, a supportive family environment was protective. Identifying, supporting, and enacting protective interventions for SGBV victims and socioeconomically vulnerable AGYW could reduce the burden of SGBV during similar events.

Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda.

Tororo District, Uganda experienced a dramatic decrease in malaria burden from 2015-19 during 5 years of indoor residual spraying (IRS) with carbamate (Bendiocarb) and then organophosphate (Actellic) insecticides. However, a marked resurgence occurred in 2020, which coincided with a change to a clothianidin-based IRS formulations (Fludora Fusion/SumiShield). To quantify the magnitude of the resurgence, investigate causes, and evaluate the impact of a shift back to IRS with Actellic in 2023, we assessed changes in malaria metrics in regions within and near Tororo District. Malaria surveillance data from Nagongera Health Center, Tororo District was included from 2011-2023. In addition, a cohort of 667 residents from 84 houses was followed from August 2020 through September 2023 from an area bordering Tororo and neighboring Busia District, where IRS has never been implemented. Cohort participants underwent passive surveillance for clinical malaria and active surveillance for parasitemia every 28 days. Mosquitoes were collected in cohort households every 2 weeks using CDC light traps. Female Anopheles were speciated and tested for sporozoites and phenotypic insecticide resistance. Temporal comparisons of malaria metrics were stratified by geographic regions. At Nagongera Health Center average monthly malaria cases varied from 419 prior to implementation of IRS; to 56 after 5 years of IRS with Bendiocarb and Actellic; to 1591 after the change in IRS to Fludora Fusion/SumiShield; to 155 after a change back to Actellic. Among cohort participants living away from the border in Tororo, malaria incidence increased over 8-fold (0.36 vs. 2.97 episodes per person year, p<0.0001) and parasite prevalence increased over 4-fold (17% vs. 70%, p<0.0001) from 2021 to 2022 when Fludora Fusion/SumiShield was used. Incidence decreased almost 5-fold (2.97 vs. 0.70, p<0.0001) and prevalence decreased by 39% (70% vs. 43%, p<0.0001) after shifting back to Actellic. There was a similar pattern among those living near the border in Tororo, with increased incidence between 2021 and 2022 (0.93 vs. 2.40, p<0.0001) followed by a decrease after the change to Actellic (2.40 vs. 1.33, p<0.001). Among residents of Busia, malaria incidence did not change significantly over the 3 years of observation. Malaria resurgence in Tororo was temporally correlated with the replacement of An. gambiae s.s. by An. funestus as the primary vector, with a marked decrease in the density of An. funestus following the shift back to IRS with Actellic. In Busia, An. gambiae s.s. remained the primary vector throughout the observation period. Sporozoite rates were approximately 50% higher among An. funestus compared to the other common malaria vectors. Insecticide resistance phenotyping of An. funestus revealed high tolerance to clothianidin, but full susceptibility to Actellic. A dramatic resurgence of malaria in Tororo was temporally associated with a change to clothianidin-based IRS formulations and emergence of An. funestus as the predominant vector. Malaria decreased after a shift back to IRS with Actellic. This study highlights the ability of malaria vectors to rapidly circumvent control efforts and the importance of high-quality surveillance systems to assess the impact of malaria control interventions and generate timely, actionable data.

Bio-Efficacy of Insecticides Used for Vector Control in Busia and Tororo Districts, Eastern Uganda

Reductions in malaria burden worldwide coincides with the massive scale-up of malaria treatment and prevention measures, of which vector control is the major component, particularly in SSA. The key vector control interventions in Africa including Uganda, rely heavily on utilisation of long-lasting insecticidal nets (LLINs) and insecticide-based indoor residual spraying (IRS). This study assessed the bio-efficacy of insecticides used for vector control in LLINs and IRS in Busia and Tororo. Samples of Anopheles mosquito larvae were collected from various breeding grounds before rearing them in an insectary. Emerged adults were observed under a dissecting microscope and identified using standardized morphological keys after respective bioassays on used nets and sprayed walls. Independent two sample T-test was used to test for significant differences in the mean malaria vectors diversity, mean variations, mortalities by net and wall type. Results showed that mean mortalities of Anopheles mosquitoes to used brands of nets from Busia (9.86±11.35) and Tororo (9.64 ±11.12) varied insignificantly (t=0.119, p=0.906). A disaggregated analysis for each net used revealed that, the DAWA plus 2.0 registered a highest mean mortality of mosquitos, followed by PermaNet 3.0+PBO, Olyset and PermaNet 2.0 respectively. Fludora fusion revealed highest mortalities on plastered painted wall, followed by Brick plain then mud/wattle walls at all times. The trend is similar for Actellic, but unlike Fludora fusion, Actellic exhibited mortalities lower than the 80% threshold for all the wall types and T-test (T-test P values&lt;0.001) indicated Actellic efficacy to be significantly lower than that of Fludora fusion on all the three wall substrates. This study has shown that vector behaviour, biology and physiology need consistent monitoring and surveillance for further entomological characterisation.

Bio-Efficacy of Insecticides Used for Vector Control in Busia and Tororo Districts, Eastern Uganda

Reductions in malaria burden worldwide coincides with the massive scale-up of malaria treatment and prevention measures, of which vector control is the major component, particularly in SSA. The key vector control interventions in Africa including Uganda, rely heavily on utilisation of long-lasting insecticidal nets (LLINs) and insecticide-based indoor residual spraying (IRS). This study assessed the bio-efficacy of insecticides used for vector control in LLINs and IRS in Busia and Tororo. Samples of Anopheles mosquito larvae were collected from various breeding grounds before rearing them in an insectary. Emerged adults were observed under a dissecting microscope and identified using standardized morphological keys after respective bioassays on used nets and sprayed walls. Independent two sample T-test was used to test for significant differences in the mean malaria vectors diversity, mean variations, mortalities by net and wall type. Results showed that mean mortalities of Anopheles mosquitoes to used brands of nets from Busia (9.86±11.35) and Tororo (9.64 ±11.12) varied insignificantly (t=0.119, p=0.906). A disaggregated analysis for each net used revealed that, the DAWA plus 2.0 registered a highest mean mortality of mosquitos, followed by PermaNet 3.0+PBO, Olyset and PermaNet 2.0 respectively. Fludora fusion revealed highest mortalities on plastered painted wall, followed by Brick plain then mud/wattle walls at all times. The trend is similar for Actellic, but unlike Fludora fusion, Actellic exhibited mortalities lower than the 80% threshold for all the wall types and T-test (T-test P values&lt;0.001) indicated Actellic efficacy to be significantly lower than that of Fludora fusion on all the three wall substrates. This study has shown that vector behaviour, biology and physiology need consistent monitoring and surveillance for further entomological characterisation.

Seroprevalence of Antibodies to SARS-CoV-2 in Rural Households in Eastern Uganda, 2020-2022

Estimating the true burden of SARS-CoV-2 infection has been difficult in sub-Saharan Africa owing to asymptomatic infections and inadequate testing capacity. Antibody responses from serologic surveys can provide an estimate of SARS-CoV-2 exposure at the population level. To estimate SARS-CoV-2 seroprevalence, attack rates, and reinfection in eastern Uganda using serologic surveillance from 2020 to early 2022. This cohort study was conducted in the Tororo and Busia districts of eastern Uganda. Plasma samples from participants in the Program for Resistance, Immunology, Surveillance, and Modeling of Malaria in Uganda Border Cohort were obtained at 4 sampling intervals: October to November 2020, March to April 2021, August to September 2021, and February to March 2022. Each participant contributed up to 4 time points for SARS-CoV-2 serology, with almost half of all participants contributing at all 4 time points, and almost 90% contributing at 3 or 4 time points. Information on SARS-CoV-2 vaccination status was collected from participants, with the earliest reported vaccinations in the cohort occurring in May 2021. The main outcomes of this study were antibody responses to the SARS-CoV-2 spike protein as measured with a bead-based serologic assay. Individual-level outcomes were aggregated to population-level SARS-CoV-2 seroprevalence, attack rates, and boosting rates. Estimates were weighted by the local age distribution according to census data. A total of 1483 samples from 441 participants living in 76 households were tested. Of the 441 participants, 245 (55.6%) were female, and their mean (SD) age was 16.04 (16.04) years. By the end of the Delta wave and before widespread vaccination, adjusted SARS-CoV-2 seroprevalence was 67.7% (95% credible interval [CrI], 62.5%-72.6%) in the study population. During the subsequent Omicron wave, 84.8% (95% CrI, 67.9%-93.7%) of unvaccinated, previously seronegative individuals were infected for the first time, and 50.8% (95% CrI, 40.6%-59.7%) of unvaccinated, already seropositive individuals were likely reinfected, leading to an overall seropositivity of 96.0% (95% CrI, 93.4%-97.9%) in this population. These results suggest a lower probability of reinfection in individuals with higher preexisting antibody levels. There was evidence of household clustering of SARS-CoV-2 seroconversion. No significant associations were found between SARS-CoV-2 seroconversion and gender, household size, or recent Plasmodium falciparum malaria exposure. In this cohort study in a rural population in eastern Uganda, there was evidence of very high SARS-CoV-2 infection rates throughout the pandemic inconsistent with national level case data and high reinfection rates during the Omicron wave.

Measures of malaria transmission, infection, and disease in an area bordering two districts with and without sustained indoor residual spraying of insecticide in Uganda.

Tororo District, in Eastern Uganda, experienced a dramatic decline in malaria burden starting in 2014 following the implementation of indoor residual spraying of insecticide (IRS) in the setting of repeated long-lasting insecticide treated nets (LLINs) distribution campaigns. However, in 2020 malaria began to resurge in Tororo following a change in the active ingredient used for IRS. In this study, epidemiological measures of malaria were compared shortly after the resurgence between two parishes in Tororo District (Kayoro and Osukuru) and one contiguous parish in Busia District (Buteba), where IRS has never been implemented. A cohort of 483 residents from 80 randomly selected households were followed from August 2020 to January 2021. Mosquitoes were collected every 2 weeks using CDC light traps in rooms where participants slept; parasitemia and gametoctyemia measured every 4 weeks by microscopy and PCR; and symptomatic malaria measured by passive surveillance. The annual entomological inoculation rate was significantly higher in Buteba (108.2 infective bites/person/year), compared to Osukuru (59.0, p = 0.001) and Kayoro (27.4, p<0.001). Overall, parasite prevalence was 19.5% by microscopy and 50.7% by PCR, with no significant differences between the three parishes. Among infected individuals, gametocyte prevalence by PCR was 45.5% and similar between sites. The incidence of malaria was significantly higher in Osukuru (2.46 episodes PPY) compared to Buteba (1.47, p = 0.005) and Kayoro (1.09, p<0.001). For participants over 15 years of age, the risk of symptomatic malaria if microscopic parasitemia was present was higher in Osukuru (relative risk [RR] = 2.99, p = 0.03) compared to Buteba. These findings highlight the complex relationships between measures of malaria transmission, infection, and disease, and the potential for excess disease burden, possibly due to waning immunity, in areas where vector control interventions begin to fail after a sustained period of highly effective control.

Impact of different mosquito collection methods on indicators of Anopheles malaria vectors in Uganda

BackgroundMethods used to sample mosquitoes are important to consider when estimating entomologic metrics. Human landing catches (HLCs) are considered the gold standard for collecting malaria vectors. However, HLCs are labour intensive, can expose collectors to transmission risk, and are difficult to implement at scale. This study compared alternative methods to HLCs for collecting Anopheles mosquitoes in eastern Uganda.MethodsBetween June and November 2021, mosquitoes were collected from randomly selected households in three parishes in Tororo and Busia districts. Mosquitoes were collected indoors and outdoors using HLCs in 16 households every 4 weeks. Additional collections were done indoors with prokopack aspirators, and outdoors with pit traps, in these 16 households every 2 weeks. CDC light trap collections were done indoors in 80 households every 4 weeks. Female Anopheles mosquitoes were identified morphologically and Anopheles gambiae sensu lato were speciated using PCR. Plasmodium falciparum sporozoite testing was done with ELISA.ResultsOverall, 4,891 female Anopheles were collected, including 3,318 indoors and 1,573 outdoors. Compared to indoor HLCs, vector density (mosquitoes per unit collection) was lower using CDC light traps (4.24 vs 2.96, density ratio [DR] 0.70, 95% CIs 0.63–0.77, p < 0.001) and prokopacks (4.24 vs 1.82, DR 0.43, 95% CIs 0.37–0.49, p < 0.001). Sporozoite rates were similar between indoor methods, although precision was limited. Compared to outdoor HLCs, vector density was higher using pit trap collections (3.53 vs 6.43, DR 1.82, 95% CIs 1.61–2.05, p < 0.001), while the sporozoite rate was lower (0.018 vs 0.004, rate ratio [RR] 0.23, 95% CIs 0.07–0.75, p = 0.008). Prokopacks collected a higher proportion of Anopheles funestus (75.0%) than indoor HLCs (25.8%), while pit traps collected a higher proportion of Anopheles arabiensis (84.3%) than outdoor HLCs (36.9%).ConclusionIn this setting, the density and species of mosquitoes collected with alternative methods varied, reflecting the feeding and resting characteristics of the common vectors and the different collection approaches. These differences could impact on the accuracy of entomological indicators and estimates of malaria transmission, when using the alternative methods for sampling mosquitos, as compared to HLCs.

Does Learners’ School Security and Safety Measures Impact on Learners Academic Performance? Tales with focus on Selected Primary Schools in Majanji Sub-County, Busia District

The study was intended to establish the effect of school security and safety on learners’ academic performance in selected primary schools in Majanji Sub County, Busia District. With intent to find out the factors influencing learners’ academic performance as well as identifying the strategies in place to cater for school security and also determine the effect of school security strategies on learners’ academic performance. Findings showed cases of early pregnancies or early marriages, failure to consider children’s rights and presence of learners with emotional problems. Conclusively, an unsafe school is more likely to result in students who have emotional problems, particularly direct victims of violence or bullying. Consider setting up a hotline to allow victims and witnesses to report occurrences in confidence. Some public schools are increasingly enforcing uniforms for all pupils, just like private institutions. Thus, the study recommends that schools work with the parents together with development partners and government to put up security systems in schools for learners’ safety.

Child Abuse in Busia Uganda: Causes, Magnitude and Consquences

Purpose: The purpose of the study research was to describe the causes, magnitude and consequences of child abuse in Busia Uganda. Methodology: The researcher used a cross- sectional research design which mainly involved qualitative in-depth interviews, FGDs and questionnaires as well as a descriptive and analytical study. Qualitative and descriptive methods were used to obtain exhaustive information on causes, magnitude, consequences and possible suggestions to curb child abuse in Busia district. The study involved a sample size of 110 people selected in Busia municipality and the sub counties of Buteba, Busitema and Sikuda. The data collected was sorted and edited for completeness, inconsistence and correctness of information given by the respondents. Qualitative data was grouped into themes and sub themes of the study to determine emerging patterns and generate interpretations and notes from respondents analyzed from large volume to meaningful components to respond to research objectives/questions into small units. Findings: the study found out that Poverty, poor parenting and attitude towards child protection, poor enforcement of laws, domestic violence, alcohol and drug abuse and urbanization as some respondents claimed that ignorance of the law was the cause of child abuse in Busia district. Conclusion: The study concluded that child abuse remains prevalent in the district despite various legislations and mechanisms locally and globally to combat the same. The vice continues to deprive many children in the world of their rights and freedoms and compromises their well-being and development due to the various physical, psychological, emotional and health impacts associated to it. Recommendation: The study recommended that government should adopt a multi-faceted approach to child abuse incorporating a combination of educational, behavioral, psychosocial, legal and economic interventions to holistically address the problem.

Farmer-led protected zero-grazed dairy cattle initiative in tsetse-infested areas of Southeast Uganda

A farmer-led protected zero-grazed dairy cattle initiative, involving pyrethroid treated netting around zero-grazing cowsheds, was implemented over a four-year period in tsetse-infested areas of Southeast Uganda. The pyrethroid treated netting was intended to prevent dairy cattle against tsetse bites and consequently transmission of trypanosomosis, while boosting milk production as an economic venture. A longitudinal study was conducted in six districts, including Budaka, Busia, Iganga, Manafwa, Mayuge and Tororo, during which a total of 184 protected zero-grazing units holding 289 dairy cattle were visited five times. The prevalence of trypanosomosis, mortality, mean packed cell volume (PCV), status of netting, spraying practices, and pasture and legume feed status, cowshed hygiene status, and milk yield were monitored. The findings revealed low prevalence of trypanosomosis among dairy cattle (1.0-5.5%), due to Trypanosoma brucei (0.0-0.4%), Trypanosoma congolense (0.0-0.7%) and Trypanosoma vivax (0.4-3.4%) infections. Only 25 adult cattle and 40 calves were reported dead. Dairy cattle had good health, given high mean PCV values (27.7 - 30.6). 99.2% and 100.0% of the zero-grazing units had lost netting by visit IV and V, respectively. By the second to the fourth year, prevention of dairy cattle from tsetse or tick bites hugely relied on spraying because all zero-grazing units had lost netting. Dual tsetse and tick control was practised by 66.9% of the 184 zero-grazing units, while only 33.1% of the units applied tick-selective control. Correct spraying intervals were observed by 57.8% of the zero-grazing units. Most zero-grazing units (range 67.9-97.5%) had sufficient pasture, while few units (range 17.9-34.8%) had sufficient legumes. Poorest cowshed hygiene was observed in zero-grazing units in Budaka district (93.1%), followed by Busia district (33.3%), Iganga district (31.1%), Mayuge district (12.1%), Tororo district (10.0%) and Manafwa district (6.3%).The best average milk yield per cow per day was registered in Iganga district (6.2 L-8.7 L), followed by Mayuge district (4.5 L- 8.2 L), Manafwa district (4.5 L-6.2 L), Busia district (4.0 L-6.3 L), Tororo district (3.3 L-6.7 L), and Budaka district (3.7 L-6.0 L). Overall average milk yield per cow per day of 5.0 L to 6.4 L across visits with a minimum of 0.5 L and maximum of 19.0 L per cow per day were achieved. In conclusion, pyrethroid treated netting around zero-grazing units supplemented with spraying of cattle effectively protected dairy cattle against trypanosomosis and maintained their good health. However, farmers’ observation indicated that as netting became older, it became more fragile. Larger nets of 1.5 m high had a longer duration of 6 to 8 months than smaller nets of 1.0 m high (shorter duration of 3 to 4 months). Replacement of netting for all zero-grazing units was desirable after the first year of installation, however, farmers could not afford the cost of 100,000 Uganda shillings (approx. USD 30) per zero-grazing unit.

Environmental Literacy and Practice of Environmental Sustainability among Secondary School Students in Busia District, Eastern Uganda

Environmental education is vital to promote knowledge, skills, attitudes, and practices to solve environmental problems, in the long run building a sustainable environment for current and future generations. This study aimed at determining the influence of Environmental Literacy (EL) on the practice of Environmental Sustainability (ES) among secondary school students in Busia District in Eastern Uganda. Using parallel convergent mixed methods and cross-sectional survey designs, 466 participants including 409 randomly selected students in 12 secondary schools filled the Environmental Literacy Survey (ELS) tool and questionnaire on the practice of ES. Forty-eight students from 6 randomly selected schools in 6 groups participated in focus group discussion (FGD), and 9 teachers of Geography, Agriculture, and Biology from 3 schools participated in an FGD. The results indicate that the students had a functional level of EL (M = 115.72, SD = 18.27), and a moderate level of practice of ES (M = 38.83, SD = 8.39). There was a significant relationship between EL and ES (r = .446, p &lt; .01) which suggested that the secondary school curriculum yielded a functional EL. The level of EL was higher than the level of practice of ES. We recommend that the teaching profession should address the gap in attitude and practice by balancing the learning experiences in the school curriculum on the environmental knowledge, attitudes towards the environment as well as behaviour and practice of environmental sustainability.

Decreased Susceptibility to Dihydrofolate Reductase Inhibitors Associated With Genetic Polymorphisms in Ugandan Plasmodium falciparum Isolates.

The Plasmodium falciparum dihydrofolate reductase (PfDHFR) inhibitors pyrimethamine and cycloguanil (the active metabolite of proguanil) have important roles in malaria chemoprevention, but drug resistance challenges their efficacies. A new compound, P218, was designed to overcome resistance, but drug-susceptibility data for P falciparum field isolates are limited. We studied ex vivo PfDHFR inhibitor susceptibilities of 559 isolates from Tororo and Busia districts, Uganda, from 2016 to 2020, sequenced 383 isolates, and assessed associations between genotypes and drug-susceptibility phenotypes. Median half-maximal inhibitory concentrations (IC50s) were 42 100 nM for pyrimethamine, 1200 nM for cycloguanil, 13000 nM for proguanil, and 0.6 nM for P218. Among sequenced isolates, 3 PfDHFR mutations, 51I (100%), 59R (93.7%), and 108N (100%), were very common, as previously seen in Uganda, and another mutation, 164L (12.8%), had moderate prevalence. Increasing numbers of mutations were associated with decreasing susceptibility to pyrimethamine, cycloguanil, and P218, but not proguanil, which does not act directly against PfDHFR. Differences in P218 susceptibilities were modest, with median IC50s of 1.4 nM for parasites with mixed genotype at position 164 and 5.7 nM for pure quadruple mutant (51I/59R/108N/164L) parasites. Resistance-mediating PfDHFR mutations were common in Ugandan isolates, but P218 retained excellent activity against mutant parasites.

Associations between Varied Susceptibilities to PfATP4 Inhibitors and Genotypes in Ugandan Plasmodium falciparum Isolates.

Among novel compounds under recent investigation as potential new antimalarial drugs are three independently developed inhibitors of the Plasmodium falciparum P-type ATPase (PfATP4): KAE609 (cipargamin), PA92, and SJ733. We assessed ex vivo susceptibilities to these compounds of 374 fresh P. falciparum isolates collected in Tororo and Busia districts, Uganda, from 2016 to 2019. Median IC50s were 65 nM for SJ733, 9.1 nM for PA92, and 0.5 nM for KAE609. Sequencing of pfatp4 for 218 of these isolates demonstrated many nonsynonymous single nucleotide polymorphisms; the most frequent mutations were G1128R (69% of isolates mixed or mutant), Q1081K/R (68%), G223S (25%), N1045K (16%), and D1116G/N/Y (16%). The G223S mutation was associated with decreased susceptibility to SJ733, PA92, and KAE609. The D1116G/N/Y mutations were associated with decreased susceptibility to SJ733, and the presence of mutations at both codons 223 and 1116 was associated with decreased susceptibility to PA92 and SJ733. In all of these cases, absolute differences in susceptibilities of wild-type (WT) and mutant parasites were modest. Analysis of clones separated from mixed field isolates consistently identified mutant clones as less susceptible than WT. Analysis of isolates from other sites demonstrated the presence of the G223S and D1116G/N/Y mutations across Uganda. Our results indicate that malaria parasites circulating in Uganda have a number of polymorphisms in PfATP4 and that modestly decreased susceptibility to PfATP4 inhibitors is associated with some mutations now present in Ugandan parasites.

Drug susceptibility of Plasmodium falciparum in eastern Uganda: a longitudinal phenotypic and genotypic study

SummaryBackgroundTreatment and control of malaria depends on artemisinin-based combination therapies (ACTs) and is challenged by drug resistance, but thus far resistance to artemisinins and partner drugs has primarily occurred in southeast Asia. The aim of this study was to characterise antimalarial drug susceptibility of Plasmodium falciparum isolates from Tororo and Busia districts in Uganda.MethodsIn this prospective longitudinal study, P falciparum isolates were collected from patients aged 6 months or older presenting at the Tororo District Hospital (Tororo district, a site with relatively low malaria incidence) or Masafu General Hospital (Busia district, a high-incidence site) in eastern Uganda with clinical symptoms of malaria, a positive Giemsa-stained blood film for P falciparum, and no signs of severe disease. Ex-vivo susceptibilities to ten antimalarial drugs were measured using a 72-h microplate growth inhibition assay with SYBR Green detection. Relevant P falciparum genetic polymorphisms were characterised by molecular methods. We compared results with those from earlier studies in this region and searched for associations between drug susceptibility and parasite genotypes.FindingsFrom June 10, 2016, to July 29, 2019, 361 P falciparum isolates were collected in the Busia district and 79 in the Tororo district from 440 participants. Of 440 total isolates, 392 (89%) successfully grew in culture and showed excellent drug susceptibility for chloroquine (median half-maximal inhibitory concentration [IC50] 20·0 nM [IQR 12·0–26·0]), monodesethylamodiaquine (7·1 nM [4·3–8·9]), pyronaridine (1·1 nM [0·7–2·3]), piperaquine (5·6 nM [3·3–8·6]), ferroquine (1·8 nM [1·5–3·3]), AQ-13 (24·0 nM [17·0–32·0]), lumefantrine (5·1 nM [3·2–7·7]), mefloquine (9·5 nM [6·6–13·0]), dihydroartemisinin (1·5 nM [1·0–2·0]), and atovaquone (0·3 nM [0·2–0·4]). Compared with results from our study in 2010–13, significant improvements in susceptibility were seen for chloroquine (median IC50 288·0 nM [IQR 122·0–607·0]; p<0·0001), monodesethylamodiaquine (76·0 nM [44·0–137]; p<0·0001), and piperaquine (21·0 nM [7·6–43·0]; p<0·0001), a small but significant decrease in susceptibility was seen for lumefantrine (3·0 nM [1·1–7·6]; p<0·0001), and no change in susceptibility was seen with dihydroartemisinin (1·3 nM [0·8–2·5]; p=0·64). Chloroquine resistance (IC50>100 nM) was more common in isolates from the Tororo district (11 [15%] of 71), compared with those from the Busia district (12 [4%] of 320; p=0·0017). We showed significant increases between 2010–12 and 2016–19 in the prevalences of wild-type P falciparum multidrug resistance protein 1 (PfMDR1) Asn86Tyr from 60% (391 of 653) to 99% (418 of 422; p<0·0001), PfMDR1 Asp1246Tyr from 60% (390 of 650) to 90% (371 of 419; p<0·0001), and P falciparum chloroquine resistance transporter (PfCRT) Lys76Thr from 7% (44 of 675) to 87% (364 of 417; p<0·0001).InterpretationOur results show marked changes in P falciparum drug susceptibility phenotypes and genotypes in Uganda during the past decade. These results suggest that additional changes will be seen over time and continued surveillance of susceptibility to key ACT components is warranted.FundingNational Institutes of Health and Medicines for Malaria Venture.