Districts In Uganda Research Articles

Characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care in Kapelebyong district in Uganda: a mixed-methods study

BackgroundA rapid increase in community transmission of COVID-19 across the country overwhelmed Uganda’s health care system. In response, the Ministry of Health adopted the home-based care strategy for COVID-19 patients with mild-to-moderate disease. We determined the characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care during the second wave in Kapelebyong district, in eastern Uganda.MethodsWe conducted a sequential explanatory mixed-methods study. We first collected quantitative data using an interviewer-administered questionnaire to determine characteristics and treatment outcomes of COVID-19 patients under home-based care. Cured at home was coded as 1 (considered a good outcome) while being admitted to a health facility and/or dying were coded as 0 (considered poor outcomes). Thereafter, we conducted 11 in-depth interviews to explore the experiences of COVID-19 patients under home-based care. Multivariable logistic regression was used to assess factors associated with poor treatment outcomes using Stata v.15.0. Thematic content analysis was used to explore lived experiences of COVID-19 patients under home-based care using NVivo 12.0.0ResultsA total of 303 study participants were included. The mean age ± standard deviation of participants was 32.2 years ± 19.9. Majority of the participants [96.0% (289/303)] cured at home, 3.3% (10/303) were admitted to a health facility and 0.7% (2/303) died. Patients above 60 years of age had 17.4 times the odds of having poor treatment outcomes compared to those below 60 years of age (adjusted odds ratio (AOR): 17.4; 95% CI: 2.2–137.6). Patients who spent more than one month under home-based care had 15.3 times the odds of having poor treatment outcomes compared to those that spent less than one month (AOR: 15.3; 95% CI: 1.6–145.7). From the qualitative interviews, participants identified stigma, fear, anxiety, rejection, not being followed up by health workers and economic loss as negative experiences encountered during home-based care. Positive lived experiences included closeness to friends and family, more freedom, and easy access to food.ConclusionHome-based care of COVID-19 was operational in eastern Uganda. Older age (> 60 years) and prolonged illness (> 1 months) were associated with poor treatment outcomes. Social support was an impetus for home-based care.

Molecular and serological survey of paratuberculosis in cattle in selected districts of Western Uganda

Knowledge of Mycobacterium avium subsp. paratuberculosis (MAP) herd infection status is important to plan appropriate control and prevention strategies for Paratuberculosis (PTB); however, in Uganda MAP infection status of most herds is unknown. This study aimed at determining the MAP infection status of cattle herds and the associated risk factors for MAP infection in six western districts of Uganda. The survey covered a total of 93 herds where faecal and blood samples were collected from 1814 cattle. A Recombinase Polymerase Amplification (RPA) and an antibody-based (ELISA) assays were used to test for the presence of MAP DNA in faeces and MAP antibodies in serum, respectively. The apparent cow-level prevalence of MAP infection was 3.2 and 2.7% using ELISA and RPA respectively and the true cow-level prevalence using ELISA and RPA was 4.9 and 3% respectively. A herd-level prevalence of 43% (ELISA) and 40.8% (RPA) and a within-herd prevalence of 3.8 ± 2.1% based on ELISA were obtained. Among the risk factors investigated, long dry spells were significantly associated with high MAP infection (p < 0.05). These results indicate that MAP is actively present in most areas where surveillance was carried out. This poses a serious threat to the livestock industry and potentially to public health as MAP is highly suspected to play a role in the pathogenesis of several diseases in humans. Other areas of the country are to be surveyed as well in order to establish full data on MAP infection status to enable interventions for the control and prevention of the disease.

Determinants of uptake of biofortified crop varieties by smallholder farmers in Uganda

Hunger and malnutrition can be said to be one of the important global problems that have recently been exacerbated by climate change and environmental degradation. Meanwhile, an estimated two billion people suffer from micronutrient malnutrition, mostly due to low intake of vitamins and minerals such as iron and zinc. Biofortification, an agricultural technology that can increase the micronutrient content of staples, may confer large benefits to rural families and poor children with limited access to expensive high-quality foods. Possible pathways include own-consumption when directly consumed, the income pathway when they are sold and/or the food price pathway when they increase the availability of micronutrient-rich foods in the market place. This research aims to understand the factors associated with the uptake of biofortified crop varieties (BCV) among smallholder farmers in Uganda and derive policy information to support their accelerated uptake. The analysis used two waves of panel data consisting of 6,400 observations collected from 6 districts in Uganda as part of the Feed the Future (FtF) innovation laboratory for nutrition. Descriptive analysis was used to help discern the differences between adopters and non-adopters of BCV. Double hurdle regression analysis was used to understand the factors associated with adoption and the intensity of adoption of biofortified crop varieties. Descriptive results reveal significant differences between adopters and non-adopters of BCV. Double hurdle regression analysis results indicate that the primary determinants of uptake of biofortified crop varieties include geographical location, extension staff visits, household size, and mobile phone ownership. Other important factors associated with the adoption of BCV include the amount of land owned by the household. Results suggest that extension staff visits, and mobile phone ownership were important sources of information for rural households that appear to drive the decision to adopt biofortified crop varieties. Meanwhile, household size, regional location of the household and total land owned were important motivators in adopting BCV technology. From the present analysis, it was not possible to clearly discern the key drivers of the intensity of adoption of biofortified crop varieties among smallholder households in Uganda. Key words: Biofortification, smallholder farmers, quasi experimental design, double-hurdle regression, Uganda

Characterizing pyrethroid resistance and mechanisms in Anopheles gambiae (s.s.) and Anopheles arabiensis from 11 districts in Uganda

Insecticide resistance threatens recent progress on malaria control in Africa. To characterize pyrethroid resistance in Uganda, Anopheles gambiae (s.s.) and Anopheles arabiensis were analyzed from 11 sites with varied vector control strategies. Mosquito larvae were collected between May 2018 and December 2020. Sites were categorized as receiving no indoor-residual spraying (‘no IRS’, n ​= ​3); where IRS was delivered from 2009 to 2014 and in 2017 and then discontinued (‘IRS stopped’, n ​= ​4); and where IRS had been sustained since 2014 (‘IRS active’, n ​= ​4). IRS included bendiocarb, pirimiphos methyl and clothianidin. All sites received long-lasting insecticidal nets (LLINs) in 2017. Adult mosquitoes were exposed to pyrethroids; with or without piperonyl butoxide (PBO). Anopheles gambiae (s.s.) and An. arabiensis were identified using PCR. Anopheles gambiae (s.s.) were genotyped for Vgsc-995S/F, Cyp6aa1, Cyp6p4-I236M, ZZB-TE, Cyp4j5-L43F and Coeae1d, while An. arabiensis were examined for Vgsc-1014S/F. Overall, 2753 An. gambiae (s.l.), including 1105 An. gambiae (s.s.) and 1648 An. arabiensis were evaluated. Species composition varied by site; only nine An. gambiae (s.s.) were collected from ‘IRS active’ sites, precluding species-specific comparisons. Overall, mortality following exposure to permethrin and deltamethrin was 18.8% (148/788) in An. gambiae (s.s.) and 74.6% (912/1222) in An. arabiensis. Mortality was significantly lower in An. gambiae (s.s.) than in An. arabiensis in ‘no IRS’ sites (permethrin: 16.1 vs 67.7%, P ​< ​0.001; deltamethrin: 24.6 vs 83.7%, P ​< ​0.001) and in ‘IRS stopped’ sites (permethrin: 11.3 vs 63.6%, P ​< ​0.001; deltamethrin: 25.6 vs 88.9%, P ​< ​0.001). When PBO was added, mortality increased for An. gambiae (s.s.) and An. arabiensis. Most An. gambiae (s.s.) had the Vgsc-995S/F mutation (95% frequency) and the Cyp6p4-I236M resistance allele (87%), while the frequency of Cyp4j5 and Coeae1d were lower (52% and 55%, respectively). Resistance to pyrethroids was widespread and higher in An. gambiae (s.s.). Where IRS was active, An. arabiensis dominated. Addition of PBO to pyrethroids increased mortality, supporting deployment of PBO LLINs. Further surveillance of insecticide resistance and assessment of associations between genotypic markers and phenotypic outcomes are needed to better understand mechanisms of pyrethroid resistance and to guide vector control.

Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens

BackgroundPregnant women in sub-Saharan Africa (SSA) experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. While eight ANC contacts are now recommended, coverage of the previous minimum of four visits (ANC4+) remains low and inequitable in SSA.MethodsWe modelled ANC4+ coverage and likelihood of attaining district-level target coverage of 70% across three equity stratifiers (household wealth, maternal education, and travel time to the nearest health facility) based on data from malaria indicator surveys in Kenya (2020), Uganda (2018/19) and Tanzania (2017). Geostatistical models were fitted to predict ANC4+ coverage and compute exceedance probability for target coverage. The number of pregnant women without ANC4+ were computed. Prediction was at 3 km spatial resolution and aggregated at national and district -level for sub-national planning.ResultsAbout six in ten women reported ANC4+ visits, meaning that approximately 3 million women in the three countries had <ANC4+ visits. The majority of the 366 districts in the three countries had ANC4+ coverage of 50–70%. In Kenya, 13% of districts had < 70% coverage, compared to 10% and 27% of the districts in Uganda and mainland Tanzania, respectively. Only one district in Kenya and ten districts in mainland Tanzania were likely met the target coverage. Six percent, 38%, and 50% of the districts had at most 5000 women with <ANC4+ visits in Kenya, Uganda, and mainland Tanzania, respectively, while districts with > 20,000 women having <ANC4+ visits were 38%, 1% and 1%, respectively. In many districts, ANC4+ coverage and likelihood of attaining the target coverage was lower among the poor, uneducated and those geographically marginalized from healthcare.ConclusionsThese findings will be invaluable to policymakers for annual appropriations of resources as part of efforts to reduce maternal deaths and stillbirths.

A Long, Long Journey

Abstract This article considers the practical implications and effectiveness of a rights-based approach to delivering child protection programming in communities in which notions of children’s rights and child protection concerns may sit awkwardly with pre-existing cultural traditions. It reports on the findings of a qualitative study of child protection practitioners in two poor rural districts of Uganda and uses these to reflect on the key differences between international children’s rights norms as expressed in the United Nations Convention on the Rights of the Child and traditional African values as reflected in the African Charter for the Rights and Welfare of Children. It explores the perceived challenges posed by a children’s rights-based approach to parental authority and community practices in the context of the Ugandan legislation and the culture of the study communities and considers the key factors that appear to be influential in enabling changes in attitudes and behaviours towards children.

Perceived Support and Teacher Engagement in Secondary Schools in a Rural District in South-Western Uganda

Hard to reach schools in rural districts experience many challenges including harsh environmental conditions, financial difficulties, lack of school buildings and shortage of teachers due to their locality. Teachers who accept to join such schools tend to be disengaged because of poor working environments. This study sought to identify factors related to teacher engagement in secondary schools in rural hard-to-reach areas in Uganda. Generally, the study assessed the relationship between head teachers perceived support and teacher engagement in secondary schools in Buhweju district a hard-to-reach rural district in south-western Uganda. Specifically, the study tested whether perceived support in terms of training, pay and promotion related teacher engagement. This correlational study used a sample of 220 teachers. Data were collected using a self-administered questionnaire and were analysed using the quantitative approach. Data were analysed using Partial Least Square Structural Equation Modelling (PLS-SEM) using SmartPLS 4 testing the link between the study variables. The findings revealed that while pay and training had a positive and significant relationship with teacher engagement, promotion support had a positive but insignificant relationship with teacher engagement. The conclusions of the study were to the effect that while pay is essential for teacher engagement and training is imperative for teacher engagement in hard-to-reach secondary schools in rural districts, promotion is not a probable requirement for teacher engagement in the hard-to-reach secondary schools in rural districts. Therefore, it was recommended that head teachers of secondary schools should provide pay support to teachers, and prioritise providing training to teachers but promotion should not be overemphasised

Community prevalence of Helicobacter pylori and dyspepsia and efficacy of triple therapy in a rural district of eastern Uganda

BackgroundHelicobacter pylori (H. pylori) infection and chronic dyspepsia represent significant medical burdens in the developing world. An accurate assessment of the prevalence of chronic dyspepsia, as well as of the effectiveness of population-based screening and eradication of H. pylori are warranted. ObjectivesWe determined the prevalence of H. pylori and chronic dyspepsia within the general adult population in a region of eastern Uganda. Independent predictors of H. pylori infection were assessed. Finally, we evaluated the efficacy of standard triple therapy on H. pylori eradication. MethodsOf 400 randomly selected adult residents in eastern Uganda, 376 were administered a validated, chronic dyspepsia questionnaire and provided a stool sample for H. pylori testing. H. pylori-positive participants were given standard triple therapy and monitored for medication adherence. The efficacy of triple therapy on H. pylori eradication was determined by fecal antigen testing after treatment. Log-linear and logistic regression analyses identified predictors of H. pylori positivity and eradication failure. ResultsH. pylori prevalence within the study population was 48%. The prevalence of chronic dyspepsia was 87%. The presence or severity of dyspepsia did not predict H. pylori infection. However, a higher level of education was an independent predictor of H. pylori infection. Standard triple therapy resulted in ∼90% eradication. Missing at least four doses of any of the triple therapy medications over the 14-day course predicted eradication failure. ConclusionsIn our study population, chronic dyspepsia did not predict H. pylori infection, though clinical suspicion for this prevalent pathogen should nonetheless remain high. Population-based screening and adherence to triple therapy are effective at eradicating H. pylori within this region.

Physical Facilities as Predictors of the Quality of Girls’ Education at Primary School Level in Oyam District, Lango sub-region, Uganda

The significance of school environmental factors to girls’ education remains central because they have a tremendous impact on the quality of teaching and learning of pupils as well as the extent of attention they pay to lessons when in classrooms. This means that schools that fail to provide a conducive atmosphere for teaching and learning may hardly achieve quality in their pupils particularly the aspect of educational excellence. This situation continues to be among the reasons for wider disparities in the performance of girls and boys in a number of districts in Uganda. The main thrust of this research was to determine the effect of physical facilities on girls’ education in Oyam district. The study was guided by the cross-sectional survey using a mixed methods approach and structured questionnaires were administered to 139 respondents. Both Means and Standard Deviations were used to describe the variables while correlation analysis and regression analysis were used to determine the relationship and the effect respectively. The results reveal that physical facilities predict approximately 21% variation of all the possible factors that are likely to account for the quality of girls’ education in Oyam district (Adj. R2= 0.205). It is encouraged that a conducive school environment in terms of quality physical facilities becomes a central concern among key stakeholders if the quality of girls’ education is to be enhanced in Oyam district.

Level and comfort of caregiver–young adolescent communication on sexual and reproductive health: a cross-sectional survey in south-western Uganda

BackgroundCommunication on sexual and reproductive health (SRH) between caregivers and their young adolescent children plays a significant role in shaping attitudes and behaviours that are critical to laying the foundations for positive and safe SRH behaviours in later adolescence. Nevertheless, this communication is often limited, particularly in countries where adolescent sexuality is taboo. This study assessed the topics discussed (‘level’) and the comfort of caregivers with communicating with young adolescents on SRH, and their correlates. MethodsA cross-sectional survey was conducted among 218 caregivers of young adolescents (10–14 years) in Mbarara district of south-western Uganda in January and February 2020. Participants were selected through consecutive sampling. A structured, pre-tested questionnaire administered by interviewers was used for data collection. The surveys were computer-assisted using Kobo Collect software. Data was exported to STATA 14 for analysis. Level of SRH communication was measured based on 10 SRH communication topics, while comfort was based on 9 SRH discussion topics. Bivariate and multivariate linear regression analyses were conducted to determine correlates of level of, and comfort with, SRH communication P-value < 0.05 was considered for statistical significance.ResultsThe mean number of topics that caregivers discussed was 3.9 (SD = 2.7) out of the 10 SRH topics explored. None of the respondents discussed all the topics; 2% reported ever discussing nine topics with their young adolescent, while 3.5% reported never discussing any of the topics. General health and bodily hygiene (89.9%) and HIV/AIDS and other sexually transmitted infections (STIs) (77.5%) were the most commonly discussed, while night emissions in boys (4.3%) and condoms (8.3%) were least discussed. The majority of caregivers (62%) reported a high level of comfort with discussing SRH. The mean comfort score was 21.9 (SD = 3.8). In general, the level of SRH communication increased with an increase in comfort with SRH communication β = 0.22 (0.04); 95% CI = (0.15, 0.30). The level of comfort with SRH communication decreased with an increase in the number of YAs in a household β = -0.92 (0.38); 95%CI = (-1.66,-0.18).ConclusionOverall, the level of SRH communication is low and varies according to the number of SRH topics. Caregivers’ comfort with SRH communication with YAs was a significant correlate of SRH communication. This justifies the need for interventions that aim to improve caregivers’ comfort with communicating with young adolescents about SRH.

The Effects of Natural Disasters on Development: A Case of Uganda

Purpose: To examine the effects of natural disasters on development in Uganda.&#x0D; Methodology: The study adopted documentary review as a data collection technique in which data is gathered from reports from different sources, journals, magazines, newspapers, institutional archives, reports and articles which have data linked to the research being undertaken (Creswell, 2014). A documentary review checklist was employed to solicit data related to an examination of effects of natural disasters on development in Uganda from the Ministry of Disaster Preparedness and Refugees archives. This method was preferred by the researcher over other methods because was able to gain permission to access information from different department at the Ministry of Disaster and preparedness archives. In addition, using document analysis takes out the personal aspect of the effect a researcher might have on an individual during an interview.&#x0D; Findings: Epidemics have been the most important public health emergency in the districts of Uganda and neighboring countries. The situation has been worsened by the outbreak of COVID-19 being first reported in Wuhan, China in December 2019 (WHO, 2019). The most threatening epidemics in Uganda include Ebola, Marburg, Cholera HIV/AIDS and Malaria but the discussion on epidemics here will be limited to Ebola, Malaria and crop and animal diseases (Mullen et al, 2020). Floods and landslides are another type of natural disasters that affect development in Uganda leaving direct destruction or impacts on assets (Botzen et al, 2019). In addition, famine is the most dominant natural disasters Uganda faces from time to time despite having the necessary conditions for food security like fertile land and a favorable climate for agriculture as a large part of the population across the country fall victim to famine regularly (Government of Uganda, 2010). Disasters continue disrupting lives, livelihood and leaving adverse effects on individuals, communities, economies and even governments and ultimately affecting development.&#x0D; Unique Contribution to Theory, Practice and Policy: It’s therefore recommended that disaster management should focus on mitigation against identifiable Threats. The disaster management should also create more robust systems that can withstand a variety of known and unknown shocks. The disaster management theory may be used to anchor future studies in the disaster management sector&#x0D;

A qualitative study of the causes and circumstances of drowning in Uganda

BackgroundDrowning is a serious worldwide and preventable injury problem, especially in low- and middle-income countries (LMICs). The aim of this paper is to draw on the results of semi-structured interviews with witnesses, family members and friends of persons involved in fatal and nonfatal drowning incidents to describe the circumstances of drowning in both lakeside and non-lakeside districts and to identify potential contextually appropriate interventions for drowning prevention and surveillance in Uganda.MethodsThe findings presented in this study were based on data collected from study participants selected through purposive sampling comprising 324 individual face-to-face interviews with drowning witnesses, family members, friends of and survivors of drowning and ten (10) focus group discussions held with community members in 14 districts in Uganda. Data analysis was done using the Framework Analysis Approach with the aid of the Microsoft Atlas ti software (version 8) program.ResultsThe study results reveal a range of circumstances under which drowning occurs in Uganda, poor record keeping of drowning incidents, fear of reporting drowning incidences to the authorities, challenges in preventing drowning and proposed strategies for mitigating the problem.ConclusionsThis study found that there is no specialized record keeping system for drowning cases in Uganda and where such records are kept, the system is entirely manual (in hard copy form) with no electronic storage of data. Secondly, the drowning cases reported to police posts and stations in various parts of the country are not transmitted to the district headquarters and national database. These and other conclusions not only provide valuable insights into understanding of drowning circumstances but also the key policy and programme interventions for water-based economic activities such as fishing and public water transportation in Uganda and other LMICs.

Development of Antibody-Based Therapeutics Against West Nile Virus in Plants.

Since its discovery in 1937 in the West Nile district of Uganda, West Nile virus (WNV) has been one of the leading causes of mosquito-transmitted infectious diseases (Smithburn, Burke, Am J Trop Med 20:22, 1940). Subsequently, it spread to Europe, Asia, Australia, and finally North America in 1999 (Sejvar, Ochsner 5(3):6-10, 2003). Worldwide outbreaks have continued to increase since the 1990s (Chancey et al, Biomed Res Int 2015:376230, 2015). According to the Center for Disease Control and Prevention, more than 51,000 cases of WNV infection and nearly 2400 cases of WNV-related death were reported in the USA from 1999 to 2019. The estimated economic impact of WNV infections is close to 800 million dollars in the USA from 1999 to 2012 (Barrett, Am J Trop Med Hyg 90:389, 2014).

The Supervisory Function of School Principals in the Development of Basic Education in the Rural Districts of Uganda

The Supervisory Function of School Principals in the Development of Basic Education in the Rural Districts of Uganda

Implementation of UN Convention on the Rights of Persons with Disabilities in public and private schools in three districts of Uganda.

The study was grounded in the recent developments of implementing the United Nations Convention on the Right of Persons with Disabilities (UNCRPD) in schools in Uganda, leading to a renewed interest in the questionings about inclusive education. The inclusive approach was evaluated in terms of: (1) how public or private schools in Uganda understand inclusive education; (2) how schools implement inclusive education under the influence of the UN Convention; and (3) what determines the course of action and school routine of private and state schools. This exploratory qualitative research included interviews with six schools purposively selected in Mukono, Wakiso and Kampala districts of Central Uganda. The selected schools comprised three private and three state schools (i.e. representing primary and secondary schools and a vocational training institute). The research demonstrated that 'inclusive education practice' that was upheld by all the schools, was ironically stained with exclusion, for example, by non-admission of students with visual and hearing impairment, inaccessible physical environment, inadequate funding and separation of students according to abilities. However, whilst all schools followed the regular curriculum, some schools developed their own ways of teaching learners with diverse learning needs. Some schools in Uganda have developed meaningful approaches of including students with disabilities but there are still many challenges for many. Enforcing Uganda's disability policies adapted from the CRPDs could enable learners with disabilities to enjoy their legal rights. Since the intention of inclusion of students with disabilities stands in contrast to the reality of practice found in many schools, there seems to be a need to carry out regular assessments and measures of support for a sustainable inclusive school development.

Examining the Effects of Mobile Telephone Communication on the Utilization of Antenatal Care Services Among Expectant Mothers in Kyotera And Rakai Districts, Uganda

Uganda still grapples with a high maternal mortality rates of 336 deaths per 100,000. Expectant mothers across the country lack awareness about the availability of antenatal care services; yet attendance of antenatal care services during pregnancy is crucial in protecting the health of women and unborn children. This article describes a protocol for investigating the effectiveness of mobile telephone communication interventions on the utilization of antenatal care services among expectant mothers in the districts of Kyotera and Rakai Districts in Uganda. Under the protocol, 28 health facilities in the districts of Kyotera and Rakai will be selected using simple random sampling and allocated into the intervention and control arms at a ratio of 1:1. A total of 2224 expectant mothers receiving antenatal care from the sampled health facilities will be recruited using systematic sampling. Expectant mothers receiving antenatal care from facilities allocated into the intervention arm will receive mobile telephone voice and text messages reminders for scheduled ANC visits. The mobile telephone messages will further provide maternal health information and availability of ANC services on a fortnightly basis. On the other hand, expectant mothers receiving antenatal care from facilities allocated into the control group will not get any reminders for scheduled ANC visit and maternal health information through the mobile telephone communication platform. Expectant mothers in the control arm will receive standard maternal health care without reminders. Expectant mothers in both groups will provide baseline data, midterm data will be obtained from the ANC registers at 6 moths while end of term data will be collected after an intervention period of 12months. The data collected will include the number of antenatal care visits attended, antenatal care services obtained from the health facilities, sociodemographic factors and mobile telephone usage, ownership and knowledge. The anticipated outcomes are; increased awareness and utilization of ANC services.

The economic cost of bovine trypanosomosis in pastoral and ago pastoral communities surrounding Murchision Falls National park, Buliisa district, Uganda

Background:Animal diseases that are endemic like tsetse transmitted trypanosomosis cause the continuous expenditure of financial resources of livestock farmers and loss of productivity of livestock. Estimating the cost of controlling animal trypanosomosis can provide evidence for priority setting and targeting cost-effective control strategies.Methodology:A cross-sectional survey to estimate the economic cost of bovine trypanosomosis was conducted in cattle-keeping communities living around Murchision falls National Park, in Buliisa district Uganda. Data was collected on herd structure, the cost of treatment and control, prevalence of morbidity and mortality rates due to trypanosomosis, and salvage sales losses in cattle herds in the last year.Results:In this study, 55.4% (n = 87) of the households reported their cattle had been affected by trypanosomosis during the previous last year. There was a high economic cost of trypanosomosis (USD 653) per household in cattle-keeping communities in Buliisa district of which 83% and 9% were due to mortality and milk loss respectively/ High mortality loss was due to low investment in treatment. The study showed that prophylactic treatment 3 times a year of the whole herd of cattle using Samorin ® (Isometamidium chloride) at a cost of USD 110 could drastically reduce cattle mortality loss due to trypanosomosis due to trypanosomosis with a return on investment of USD 540 annually per herd. This could be coupled with strategic restricted insecticide spraying of cattle with deltamethrin products.Conclusion:The results show a high economic cost of trypanosomosis in cattle-keeping communities in Buliisa district, with cattle mortality contributing the largest proportion of the economic cost. The high mortality loss was due to low investment in treatment of sick cattle.

Breaking institutional barriers to enhance women's participation in and benefit from the Peste des Petits Ruminants and Newcastle Disease vaccine value chains for Sembabule district of Uganda.

This paper describes the institutional context that shapes the visibility and positioning of women along the Peste des Petits Ruminants (PPR) and Newcastle Disease (ND) vaccine value chains for Sembabule district of Uganda. It examines the institutional barriers and opportunities that affect women’s empowerment derived from inclusion of women in the decision-making processes along the livestock vaccine value chain (LVVC) and that can support viable women-centered and owned enterprises, at the vaccine development, delivery, distribution and use level. Qualitative data analysis tools such as focus group discussions, focus meals, jar voices and key informant interviews were used. Using outcome mapping, a stakeholder analysis of the critical partners in the PPR and ND value chain was done involving the regulators, vaccine manufacturers, importers, distributors, agrovets, public and private veterinary service deliverers, local leaders, women groups, and farmers. The study concluded that training related to gender equality and livestock vaccines, infrastructural and technical support to the poultry and goat women and men farmers and other chain actors are inadequate in themselves to increase vaccine adoption and improve livestock productivity in Sembabule district. Strategies that promote gender-transformative collaborative efforts among the LVVC actors and build viable gender-transformed women groups and networks are critical to increase women’s participation in and benefit from the livestock vaccine value chain.

The Impact of Work Environment, Occupational Health and Safety Practices on Performance of Health Workers in Kitagata Hospital and Two Health Centre IVS in Sheema District Uganda

The Impact of Work Environment, Occupational Health and Safety Practices on Performance of Health Workers in Kitagata Hospital and Two Health Centre IVS in Sheema District Uganda

An Evaluation of Antibiotic Prescription Rationality at Lower Primary Healthcare Facilities in Three Districts of South-Western Uganda.

PurposeAntimicrobial resistance is now one of the leading five causes of death globally. This study evaluated the rationality of antibiotic prescriptions at lower primary care levels in three districts of Southwestern Uganda.MethodsThis prospective cross-sectional study reviewed 9899 antibiotic prescriptions at 39 health centers following a drug delivery cycle by National Medical Stores in three phases (19 days each on average). Phase 1 started 3 days after delivery, mid-way (Phase 2) and towards the end (Phase 3). The proportion of rationally prescribed antibiotics was determined using a modified criterion by Badar and in reference to Uganda Clinical Guidelines (UCG). Using multivariate logistic regression, the factors associated with rational prescription were determined with 95% confidence intervals.ResultsSeven of every 10 antibiotic prescriptions were irrational. Half the prescriptions were made by unauthorized personnel (nurses) and many of the pediatric prescriptions (916, 46.5%) did not bear body weight measurements to guide appropriate dosing. Also, the proportion of rational prescriptions in reference to UCG, 2016 was very low (3387, 34.2%). However, a high proportion of antibiotic prescriptions were legibly written (9462, 95.7%), prescribed by generic names (9083, 91.8%) and had a diagnosis (9677, 97.8%) indicated. Multivariate logistic analysis showed that; availability of medicines (phase 1) (phase 2 AOR=1.14, 95% CI:1.02–1.28, phase 3, AOR=1.23, 95% CI:1.1–1.38), legibly written prescription (AOR=0.61, 95% CI: 0.47–0.78), indication of a date on the prescription (AOR=0.56, 95% CI0.38–0.81) and being a medical officer were factors associated with rational antibiotic prescription.ConclusionWe observed a high rate of irrational prescription in the study sites and the majority of these were by unauthorized personnel. A review of antibiotic use policies and focused interventions is crucial in these settings.