Mbarara District Research Articles

Prevalence of Mycobacterium bovis skin positivity and associated risk factors in cattle from western Uganda.

A cross-sectional study was undertaken to determine the prevalence of Mycobacterium bovis skin positivity and associated risk factors in cattle in western Uganda. Herds were selected using multi-stage cluster sampling. The comparative cervical intradermal tuberculin test (CCT) was used to determine cattle tuberculosis status using US Department of Agriculture protocols. Risk factor data were collected from cattle owners through questionnaires collected by in-person interviews. Multivariable logistic regression models were used to measure the association between risk factors and herd CCT reactor prevalence. A total of 525 cattle from 63 herds were screened for M. bovis infection. Of the 525 cattle tested, 2.1 % were CCT reactors and 15.43 % were CCT suspects. Of herds tested, 14.28 % had at least 1 CCT reactor. Using a private water source for cattle and not introducing new cattle into the farm were associated with lower prevalence of M. bovis skin positivity. The herd-level prevalence of M. bovis reactors in Kashaari County of Mbarara District was 14.5 %, and the individual cattle prevalence was low (2.1 %). Using communal sources of drinking water for cattle and introducing new cattle on the farm were farm management practices associated with increased risk of M. bovis exposure in cattle. Despite the low prevalence of bovine tuberculosis (TB), there is a need to educate the populace on the possibility of human infection with zoonotic TB and for educating farmers on practices to reduce the risk of acquiring M. bovis in the Mbarara District.

Helicobacter pylori infection in pregnant women in four districts of Uganda: role of geographic location, education and water sources.

BackgroundThe prevalence of Helicobacter pylori infection varies in relation to geography, ethnicity and socioeconomic factors. Available data on the prevalence of Helicobacter pylori infection in Uganda are not representative of the general population. We sought to describe the epidemiology of this infection in pregnant women in Uganda to provide background data for a study into the effect of H. pylori infection during pregnancy on the hematological response to iron supplementation.MethodsUsing a cross-sectional design, H. pylori infection was assessed by the stool antigen test among 447 pregnant women attending antenatal care clinics in Apac, Mbale, Mbarara and Rakai Districts which are in different geographical regions in Uganda, and at Kawempe Health Center which serves a low-income densely populated area in Kampala City. Socio-demographic and household data were collected by face-to-face interviews using a questionnaire. Associations between H. pylori infection and socio-demographic and household characteristics were analyzed using logistic regression.ResultsThe overall prevalence of H. pylori infection was 45.2% but varied by geographical location from 18.2% in Apac District to 60.5% at Kawempe Health Centre. At 18.4%, the Langi ethnic group, who were enrolled exclusively in Apac District, had the lowest prevalence of H. pylori infection while the Gisu had the highest prevalence (58.4%). H. pylori was independently associated with enrollment at clinics not in Apac (adjusted OR = 5.68; 95% CI: 3.02-10.7) and with using water from public wells, boreholes or springs (AOR = 3.20; 95% CI: 1.19-8.61) and from rivers, lakes or streams (AOR = 5.20; 95% CI: 1.58-17.05). Urban residence (AOR = 1.71; 95% CI: 1.13-2.60) and no formal education (AOR = 1.95; 95% CI: 1.03-3.67) were also independently associated with H. pylori infection.ConclusionsThe unexpected variation in the prevalence of H. pylori infection in Uganda calls for population-based studies in the region and offers an opportunity to study the transmission dynamics of H. pylori infection. The association between H. pylori infection and surface water sources for household use suggests waterborne transmission of H. pylori infection highlighting the need for concerted efforts in environmental health in communities and at the household level.

Anthelmintic resistance in gastrointestinal nematodes in goats and evaluation of FAMACHA diagnostic marker in Uganda

Gastrointestinal nematodes (GIN) are a challenge to goat production globally causing reduced growth, morbidity and mortality. We report here results of the first nation-wide anthelmintic resistance (AR) study and validation of assessment of clinical anaemia with FAMACHA eye scores in goats in Uganda. From August to December 2012 the efficacy of albendazole (7.5mg/kg), levamisole (10.5mg/kg) and ivermectin (0.3mg/kg) against strongyle nematodes was tested on 33 goat farms in Soroti, Gulu, Mpigi, Mbarara and Ssembabule districts of Uganda. Altogether 497 goats were subjected to a total of 45 different faecal egg count reduction tests (FECRT), each involving 5–20 goats. On one farm all substances were tested. Faecal and blood samples were collected and FAMACHA eye scores evaluated on the day of treatment and 15 days later. A questionnaire survey was conducted on frequency, type and dose of anthelmintics used, farm size and grazing management system. Examination of infective third stage larvae (L3) from pooled faecal cultures demonstrated Haemonchus to be the predominant genus (>75%). Resistance to at least one anthelmintic group was detected on 61% of the 33 farms and in 49% of the 45 test groups. Prevalence of resistance to ivermectin, levamisole and albendazole was respectively 58%, 52% and 38%. Correlation between pre-treatment packed cell volume determinations and FAMACHA scores (r498=−0.89) was significant. Paddock grazing system (Odds ratio 4.9, 95% CI 1.4–17.3) and large farm size of >40 goats (odds ratio 4.4, 95% CI 1.2–16.1) were significant predictors of AR. In all districts, resistance to all three anthelmintics was higher on large-scale goat farms practising mostly paddock grazing. Interestingly, resistance to albendazole, the most commonly used anthelmintic in Uganda, was lower than that to ivermectin and levamisole. We recommend adaptation of FAMACHA to goats to help restrict anthelmintic treatment to heavily infected individuals. This will limit selection pressure and hence delay development of anthelmintic resistance.

Renegotiating customary tenure reform – Land governance reform and tenure security in Uganda

In academic and policy debates on how to effectively secure land tenure, an uncompromising belief in the need to formalize and title landownership has increasingly given way to an acknowledgement of the contributions non-state, ‘customary’ or otherwise local institutions may make in securing tenure. However, the question remains as to how different tenure systems may most effectively complement each other. This paper argues that the debate needs to give more attention to the local dynamics and politics of tenure reform, and how reforms are locally renegotiated as part of local institutional competition. It reflects on the case of Uganda, where legislation and policies over the last 15 years have promoted formalizing land titles and modernizing land law in combination with recognizing customary ownership and land governance. Fieldwork in Mbarara District in South-western Uganda shows that, although reforms delay, they increase institutional multiplicity and fuel contestation among local authorities and about the norms applied. Rather than strengthening local mechanisms to make small customary landowners more tenure secure, renegotiating of the reforms results in delegitimizing customary authorities and the reforms do not succeed in ‘modernizing’ the customary rules and conventions applied. Moreover, reforms fail to generate confidence in both statutory and customary land governing authorities as protectors of smallholders’ claims to land.

Bovine trypanosome species prevalence and farmers' trypanosomiasis control methods in south-western Uganda.

A cross-sectional study was conducted in Mbarara district, south-western Uganda in May 2012 to determine the burden of African animal trypanosomosis (AAT) in the semi-intensive dairy production systems where pyrethroid acaricides are frequently used in the control of tick-borne diseases (TBDs). A total of 295 cattle blood samples were taken and analysed using a single pair of primers previously designed to amplify internal transcribed spacer (ITS1) of trypanosome ribosomal deoxyribonucleic acid (rDNA). A structured questionnaire was administered to 55 participating livestock farmers to generate data on acaricide and trypanocidal drug usage. The overall prevalence of trypanosome species was 2.4% (95% CI; 1.0% - 4.8%); Trypanosoma vivax was the most predominant species (2.0%; 95% CI; 0.7% - 4.4%). A single mixed infection of T. vivax and Trypanosoma brucei s.l. was detected. All the participating farmers used acaricides for tsetse and TBD control; 89.1% of the acaricides used were pyrethroids. About half of the farmers used trypanocidal drugs, mainly diminazene formulations (Berenil®). Low prevalence of trypanosomes in examined samples is most likely related to the frequent use of pyrethroid insecticides, trypanocides and restricted grazing (paddocking and tethering). These rigorous management practices are geared towards optimising production of exotic dairy breeds kept in this region that are highly susceptible to TBDs and AAT.

Prevalence of Pulmonary Tuberculosis among Prison Inmates at Mbarara Central Prison, South Western Uganda

AimsThis study was conducted to determine the prevalence of tuberculosis among prison inmates at Mbarara Central prisonDesignA cross sectional study was carried out at Mbarara Central Prison in Mbarara district, Kiswahili cell in Mbarara municipality among female and male prison in mates between June 2012 to August 2012. A questionnaire was administered to each prison inmate who consented in writing and two sputum specimens were collected and examined by Ziehl-Neelsen technique.ResultsAt the time of the study, the prison had 900 inmates (both males and females). A total of 648 in mates were screened and 248 inmates enrolled in the study. Of the 248 inmates, 5 inmates were new cases of TB while 29 inmates were already on TB treatment. The median age of participants was 28 years (23.5-33 IQR) and 96.4% were males with majority (22.6%) coming from Mbarara as a home district. The participants had stayed in prison for a median duration of 2 years (1-3 IQR) and 23.7% had ever been in prison before. The median number of inmates per cell was 140 (138-149 IQR) and inmates (female and male) had a body mass index of 21.4 (19.9-22.6 IQR) and 20.2 (19.2-26.7 IQR) respectively. Of the inmates evaluated, 68.8% reported cough for 2 or more weeks. Other symptoms reported were weight loss (in 40.7%) and night sweats (in 35.8%). Of the 248 inmates evaluated, 95 inmates were tested for HIV and 4.1% were HIV serology positive.ConclusionThe prevalence of TB in Mbarara Central prison South Western Uganda is low but calls for continued surveillance through regular TB screening.

Associations between mass media exposure and birth preparedness among women in southwestern Uganda: a community-based survey

Background Exposure to mass media provides increased awareness and knowledge, as well as changes in attitudes, social norms and behaviors that may lead to positive public health outcomes. Birth preparedness (i.e. the preparations for childbirth made by pregnant women, their families, and communities) increases the use of skilled birth attendants (SBAs) and hence reduces maternal morbidity and mortality. Objective The aim of this study was to explore the association between media exposure and birth preparedness in rural Uganda. Method A total of 765 recently delivered women from 120 villages in the Mbarara District of southwest Uganda were selected for a community-based survey using two-stage cluster sampling. Univariate and multivariate logistic regression was performed with generalized linear mixed models using SPSS 21. Results We found that 88.6% of the women surveyed listened to the radio and 33.9% read newspapers. Birth preparedness actions included were money saved (87.8%), identified SBA (64.3%), identified transport (60.1%), and purchased childbirth materials (20.7%). Women who had taken three or more actions were coded as well birth prepared (53.9%). Women who read newspapers were more likely to be birth prepared (adjusted OR 2.2, 95% CI 1.5–3.2). High media exposure, i.e. regular exposure to radio, newspaper, or television, showed no significant association with birth preparedness (adjusted OR 1.3, 95% CI 0.9–2.0). Conclusion Our results indicate that increased reading of newspapers can enhance birth preparedness and skilled birth attendance. Apart from general literacy skills, this requires newspapers to be accessible in terms of language, dissemination, and cost.

Epidemiology and awareness of hypertension in a rural Ugandan community: a cross-sectional study.

BackgroundHypertension is one of the largest causes of preventable morbidity and mortality worldwide. There are few population-based studies on hypertension epidemiology to guide public health strategies in sub-Saharan Africa. Using a community-based strategy that integrated screening for HIV and non-communicable diseases, we determined the prevalence, awareness, treatment rates, and sociodemographic factors associated with hypertension in rural Uganda.MethodsA household census was performed to enumerate the population in Kakyerere parish in Mbarara district, Uganda. A multi-disease community-based screening campaign for hypertension, diabetes, and HIV was then conducted. During the campaign, all adults received a blood pressure (BP) measurement and completed a survey examining sociodemographic factors. Hypertension was defined as elevated BP (≥140/≥90 mmHg) on the lowest of three BP measurements or current use of antihypertensives. Prevalence was calculated and standardized to age distribution. Sociodemographic factors associated with hypertension were evaluated using a log-link Poisson regression model with robust standard errors.ResultsCommunity participation in the screening campaign was 65%, including 1245 women and 1007 men. The prevalence of hypertension was 14.6%; awareness of diagnosis (38.1%) and current receipt of treatment (20.6%) were both low. Age-standardized to the WHO world standard population, hypertension prevalence was 19.8%, which is comparable to 21.6% in the US and 18.4% in the UK. Sociodemographic factors associated with hypertension included increasing age, male gender, overweight, obesity, diabetes, alcohol consumption, and family history. Prevalence of modifiable factors was high: 28.3% women were overweight/obese and 24.1% men consumed ≥10 alcoholic drinks per month.ConclusionsWe found a substantial burden of hypertension in rural Uganda. Awareness and treatment of hypertension is low in this region. Enhanced community-based education and prevention efforts tailored to addressing modifiable factors are needed.

Survey of Brucellainfection and malaria among Abattoir workers in Kampala and Mbarara Districts, Uganda

BackgroundBrucellosis is among the most widespread zoonotic infections estimated at 14% in Uganda. A cross-sectional study was conducted to estimate the sero-prevalence, risk factors of Brucella infection and malaria among abattoir workers.MethodsA survey was conducted among 232 abattoir workers in main abattoirs of Kampala and Mbarara districts in February 2007. A pre-tested questionnaire captured socio-demographic and occupational data. Brachial vein blood was tested for Brucella using Microplate Agglutination Test (MAT) and Standard Tube Agglutination Test (STAT) with a cut off titre of 1:160, and giemsa stained blood slides for malaria. Data was analyzed in SPSS 17.0.ResultsSeven males (3%, n = 232) had malaria and dual brucella and Plasmodium falciparum malaria was found in one person. Brucella sero-positivity was 10% (95% CI 6 – 16; n = 232) with 12% (n = 161) in Kampala and 7% (n = 71) in Mbarara district. Non-use of protective gear Odds ratio (OR 3.3, 95% CI (1.25 – 50) and working in the abattoir beyond 5 years OR 2.4 95% CI (1.4 – 5.6) were associated with increased risk of Brucella infection. Age, sex, religion, keeping animals and consumption of raw milk or products were not significant.ConclusionsBrucella infection is a real risk among abattoir workers and use of full protective gear reduced risk significantly. Sensitization and public health care programs are needed to control this emerging problem.

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

Ethnopharmacological relevanceHerbal 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. Materials and methodsThe 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. ResultsThe 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. ConclusionThe 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.

Population structure and dynamics of Ankole cattle in Uganda: Implications for sustainable utilisation of the breed

This study aimed at determination of structure and dynamics of Ankole cattle herds in 248 farms in Kiboga, Mbarara, Mpigi and Sembabule districts of Uganda and was conducted using a pre-tested questionnaire, administered during one-to-one interviews. Farms were randomly sampled along transects originating from the headquarters of the 19 sub-counties studied. Results showed that Ankole cattle provide livelihood support to all households, with 60.9% relying solely on them. Most farms kept a mix of livestock species and breeds, though 44.5% of farms kept pure Ankole herds. Acquisition of cows across the year was mainly through birth (41.5%), gifts (38.7%) and purchase (33.8%), though the number of cattle removed from the herds exceeded the annual acquisitions. Avenues of cattle exit included sales (39.1%), donations (35.5%), death (31.1%), theft (30.5%) and slaughter for home use (30.2%). Conservation of the Ankole breed should involve empowering households who still maintain pure herds. Such households could be given elite bulls through a ‘cow for a bull’ exchange with the National Animal Genetic Resource Centre which currently operates a nucleus herd at Nshaara ranch. To sustain the relevance of various traits and the breed itself, controlled crossbreeding should be promoted in high milk and meat demand areas.

Cultural and socio-demographic predictors of car accident involvement in Norway, Ghana, Tanzania and Uganda

The prevalence of road traffic accidents is increasing towards endemic proportions in developing countries. The present study investigated cultural and demographic predictors of car accident involvement in a developed country in Europe and three developing countries in Sub-Saharan Africa. The comparison was carried out with questionnaires among a randomly obtained representative sample of the Norwegian population (n=247) as well as stratified samples in Accra and Cape-Coast in Ghana (n=299), Dar-es-Salaam and Arusha areas in Tanzania (n=599), and the central Kampala and the Mbarara district in Uganda (n=415). Measurement instruments of culture as symbol exchange and destiny orientation were used to predict self-reported road traffic accident involvement by car among the respondents. Demographic characteristics, such as gender, age and education, were also included as predictors of car accidents. The results showed that male gender was the only significant predictor of accident involvement in Norway. Introverted and extroverted culture, destiny orientation and written culture were associated with accident involvement in the African countries. Male gender also predicted accidents in these countries. Non-technical injury preventive countermeasures in developing countries could focus on cultural practice and fatalistic beliefs. Countermeasures in both developed and developing countries should target male drivers.

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

IntroductionAssistance 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.MethodsCommunity 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.Results35% 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.ConclusionWomen’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.

Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda

BackgroundImproving knowledge of obstetric danger signs and promoting birth preparedness practices are strategies aimed at enhancing utilization of skilled care in low-income countries. The aim of the study was to explore the association between knowledge of obstetric danger signs and birth preparedness among recently delivered women in south-western Uganda.MethodsThe study included 764 recently delivered women from 112 villages in Mbarara district. Community survey methods were used and 764 recently delivered women from 112 villages in Mbarara district were included in study. Interviewer administered questionnaire were used to collect data. Logistic regression analyses were conducted to explore the relationship between knowledge of key danger signs and birth preparedness.ResultsFifty two percent of women knew at least one key danger sign during pregnancy, 72% during delivery and 72% during postpartum. Only 19% had knowledge of 3 or more key danger signs during the three periods. Of the four birth preparedness practices; 91% had saved money, 71% had bought birth materials, 61% identified a health professional and 61% identified means of transport. Overall 35% of the respondents were birth prepared. The relationship between knowledge of at least one key danger sign during pregnancy or during postpartum and birth preparedness showed statistical significance which persisted after adjusting for probable confounders (OR 1.8, 95% CI: 1.2-2.6) and (OR 1.9, 95% CI: 1.2-3.0) respectively. Young age and high levels of education had synergistic effect on the relationship between knowledge and birth preparedness. The associations between knowledge of at least one key danger sign during childbirth or knowledge that prolonged labour was a key danger sign and birth preparedness were not statistically significant.ConclusionsThe prevalence of recently delivered women who had knowledge of key danger signs or those who were birth prepared was very low. Since the majority of women attend antenatal care sessions, the quality and methods of delivery of antenatal care education require review so as to improve its effectiveness. Universal primary and secondary education programmes ought to be promoted so as to enhance the impact of knowledge of key danger signs on birth preparedness practices.

Accuracy of pastoralists’ memory‐based kinship assignment of Ankole cattle: a microsatellite DNA analysis

This study aimed to estimate the level of relatedness within Ankole cattle herds using autosomal microsatellite markers and to assess the accuracy of relationship assignment based on farmers' memory. Eight cattle populations (four from each of two counties in Mbarara district in Uganda) were studied. Cattle in each population shared varying degrees of relatedness (first-, second- and third-degree relatives and unrelated individuals). Only memory-based kinship assignments which farmers knew with some confidence were tested in this experiment. DNA isolated from the blood of a subsample of 304 animals was analysed using 19 microsatellite markers. Average within population relatedness coefficients ranged from 0.010 ± 0.005 (Nshaara) to 0.067 ± 0.004 (Tayebwa). An exclusion probability of 99.9% was observed for both sire-offspring and dam-offspring relationships using the entire panel of 19 markers. Confidence from likelihood tests performed on 292 dyads showed that first-degree relatives were more easily correctly assigned by farmers than second-degree ones (p < 0.01), which were also easier to assign than third-degree relatives (p < 0.01). Accuracy of kinship assignment by the farmers was 91.9% ± 5.0 for dam-offspring dyads, 85.5% ± 3.4 for sire-offspring dyads, 75.6% ± 12.3 for half-sib and 60.0% ± 5.0 for grand dam-grand offspring dyads. Herd size, number of dyads assigned and length of time spent by the herder with their cattle population did not correlate with error in memorizing relationships. However, herd size strongly correlated with number of dyads assigned by the herder (r = 0.967, p < 0.001). Overall, we conclude that memorized records of pastoralists can be used to trace relationships and for pedigree reconstruction within Ankole cattle populations, but with the awareness that herd size constrains the number of kinship assignments remembered by the farmer.

Pastoralists' indigenous selection criteria and other breeding practices of the long-horned Ankole cattle in Uganda

The criteria for identification, selection and kinship assignment of Ankole cattle and their roles to pastoralists were studied on 248 farms in Kiboga, Mbarara, Mpigi and Sembabule districts of Uganda using a questionnaire, administered during one-to-one interviews. Farms were randomly sampled along transects originating from the headquarters of each of the 19 sub-counties studied. We found that male Ankole cattle are reared for income from sales, meat for home use and ceremonies, aesthetic value and to maintain cultural heritage. Female cattle are mainly kept for milk production, income from sales, heritage and aesthetics, and in few cases, for home use as meat. Other functions included savings, manure and butter production. All cattle are named at birth with coat colour or pattern being the main identification criterion; hence, it is also useful in assigning kinship. Selection criteria for males are more stringent than for females. On most farms, all females are kept for further breeding and are only culled in cases of poor reproductive health. Primary emphasis in selecting males is on the performance of ancestors in milk and reproductive traits, and then on the qualities of the bull itself. Bulls are selected mainly focusing on a big body frame and size, horns that are white, large and curved upward and a plain dark red "ruhogo" coat colour. The results of this study show that pastoralists have a rich body of indigenous knowledge on this breed, and this should effectively be incorporated into planned selective improvement schemes of the Ankole cattle breed.

Evaluation of environmental impact assessment (EIA) practice in Western Uganda

The paper presents the results of an evaluation of environmental impact assessment (EIA) practice in Western Uganda with specific reference to the extent of local community consultation. Drawing on experience from Mbarara and Kasese Districts in Western Uganda, a sample of 200 household representatives from the local communities and 20 key informants were interviewed with the help of a questionnaire and an interview guide. The major factors influencing EIA practice appear to be poor engagement with stakeholders, the negative perception of EIA held by developers, lack of capacity for follow-up and enforcement, weak institutional linkages and political interference. This study emphasizes the need for public involvement right from the project inception stage to the decision- making stage. It also highlights some positive interventions in achieving effective local community involvement in the EIA process.

CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors

Background: Given the importance of CD4-T-lymphocyte monitoring in HIV/ART management, we established CD4/CD8 reference ranges in Uganda and studied factors associated with CD4/CD8 in a normal population. Methods: Blood samples for 206 HIV seronegative healthy volunteers from the Mbarara and Kampala districts in Uganda were analyzed using the PanLeucogating protocol. Results: The reference ranges reported include data from 172 participants with no current or serious recent health problems. The 95% reference ranges for absolute CD4 (ACD4) count was 418-2105 cells/µL, 2561619 for absolute CD8 count, and 0.52-4.1 for CD4/CD8 cell ratio, which is wider than the reference ranges currently used in Uganda. Recent illnesses/medications and sociodemographic factors affected the CD4T-lymphocyte count. Conclusion: The CD4 reference ranges in Uganda were established using a cost-effective method, recommended and available in resource-limited settings. Effect of prevalent infections and socio-demographic differences on CD4-T-lymphocyte levels would need consideration in HIV/ART clinical management.

Opportunities and barriers for implementation of integrated TB and HIV care in lower level health units: experiences from a rural western Ugandan district.

As countries with a high burden of TB and HIV roll out integrated TB/HIV care, there is need to assess possibility of lower level health units treating TB to provide integrated TB/HIV care. To determine barriers and opportunities for provision of integrated TB/HIV care in lower level health units offering TB treatment in Mbarara district, Uganda. Conducted key informant interviews, interviewed health workers and observed services offered. 22 health units were assessed and 88 health workers were interviewed. Of the 18 health units mandated to offer laboratory services, 55.6% and 38.9% were able to offer rapid HIV-testing and ZN staining respectively. Understaffing, lack of capacity to diagnose HIV and TB, lack of guidelines to inform care options of TB/HIV co-infected patients and insufficient knowledge and skills among health workers towards provision of integrated TB/HIV care were mentioned as barriers to provision of integrated TB/HIV services. To offer integrated TB/HIV services at lower level health units currently offering TB stand alone services, there is need to address gaps in knowledge and skills among health workers, laboratory diagnostics, staffing levels, medical supplies and infrastructure.

Multiple Determinants of Milk Production in Africa: The Example of the Diversity of Dairy Farming Systems in the Mbarara Area (Uganda)

In developing countries, animal products supply presents a major challenge in meeting the demand for the two next decades. Many researchers point out the necessity for a ‘reasoned intensification’, especially in agricultural areas, by integrating agriculture and livestock activities. But intensification only occurs on specific farms. How can one explain the different dairy developments or technical options between farms? An analysis of the diversity of dairy farmingsystems in Mbarara district (Uganda) has been conducted from a monthly crosssectional survey of a sample of 22 farmers, identified from a large household survey (183 dairy producers). The multi-table factorial analysis allows a thorough review of the interactions and points out some causal relationships between the development of the dairy systems and the social and technical management of the whole farm. This analysis underlines the key factors of intensification suchas genetic improvement or market opportunities; but also the degree ofintensification which is well correlated to the stage of family development. If the livestock may reinforce different functions (security, consumption, cash flow) according to the farm type, the results show that all these functions exist for all the farm types, either in the pastoral or agricultural areas. So these results questionthe stereotypes built on the different livestock systems in Africa.