Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of ca...Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.展开更多
BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by uni...BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by unique challenges in adolescent health care.Despite its importance,only a few studies have explored healthcare transition among adolescents in Uganda.AIM To identify factors associated with the transition to adult human immunodeficiency virus(HIV)-centered care among adolescents attending HIV/AIDS clinics in Uganda.METHODS A cross-sectional mixed-methods study was conducted among 265 adolescents,randomly selected from three antiretroviral therapy(ART)clinics,using a structured questionnaire.Focus group discussions and key informant interviews were conducted.Individuals aged 10-20 years who were actively enrolled in the ART program between January 4,2022 and January 30,2023 were recruited.The primary outcome of interest was the transition to adult care.Bivariate and multivariate analyses were performed for quantitative data,while content analysis was used to analyze qualitative data.RESULTS The prevalence of transition to adult care was 40.6%.Most participants were male(53.6%)and fell within the 13-15 age group(35.6%).Multivariate logistic regression analysis identified several factors significantly associated with transition to adult care:Age group 10-12 years[prevalence ratio(PR)=2.525,95%CI:2.121-2.944,P=0.002],Age group 13-15 years(PR=1.900,95%CI:1.196-3.416,P=0.001),successful viral load suppression(PR=1.534,95%CI:1.173-1.648,P=0.016),disclosure of HIV status to relatives(PR=5.001,95%CI:3.411-3.611,P=0.000),being prepared for transitioning(PR=5.417,95%CI:3.468-7.135,P=0.041)and having skilled pediatric caregivers(PR=3.724,95%CI:2.084-4.105,P=0.005).CONCLUSION Transition to adult care among adolescents was low.Improving transition outcomes may require strengthening individual support within the family context and integrating transition-focused care into existing specialized clinical settings to enhance the delivery of adolescent-friendly services.展开更多
If there’s one meat dish Ugandan people really enjoy,that’s goat meat.Across the country in restaurants,bars and clubs,the aroma of roasted goat meat wafts enticingly,attracting people at all hours of the day and ni...If there’s one meat dish Ugandan people really enjoy,that’s goat meat.Across the country in restaurants,bars and clubs,the aroma of roasted goat meat wafts enticingly,attracting people at all hours of the day and night.展开更多
Teso subregion in Eastern Uganda is a leading production hub for citrus in Uganda. However, information on fruit quality profile of the three major varieties (Hamlin, Valencia and Washington navel) grown in this regio...Teso subregion in Eastern Uganda is a leading production hub for citrus in Uganda. However, information on fruit quality profile of the three major varieties (Hamlin, Valencia and Washington navel) grown in this region was limited and/or unreported, partly resulting in their limited use for industrial processing. The current study sought to understand the seasonal quality profile of these varieties during the wet and dry seasons for the years 2019, 2022 and 2023. The study was conducted with farmers in the districts of Kumi, Ngora, Soroti and Kalaki. Mature green oranges were periodically harvested and analysed for physical and chemical properties. The results showed that the quality of oranges varied depending on the season at harvest and the variety with significant differences (p ≤ 0.05). Mean weight per fruit was highest in wet season Washington navel (277.5 g) and lowest in dry season Hamlin (149.3 g). Similarly, fruit size varied in the wet season where Washington navel (81.2 mm) had the biggest fruits while dry season Hamlin were smallest (66.6 mm). Dry season Washington navel had had the thickest peel (7.9 mm). Valencia from the wet season had the highest juice content (36.9%) compared to Washington navel (26.5%) from the dry season with the lowest. Titratable acidity was higher in the dry season Valencia (0.9%) compared to the wet season Washington navel and Hamlin (0.3%). Similarly, Total soluble solids (TSS) was higher in the dry season (Washington navel, 10.1 ˚Brix) in contrast to the wet season (Hamlin and Valencia, 7.7 ˚Brix). Valencia had the lowest pH (3.1) however, pH did not vary significantly between season for each variety except for Hamlin. Vitamin C content was higher during the dry season led by Valencia (57.6 mg/100g) and Hamlin (57.4 mg/100g). Sugar to acid ratio was highest during the wet season (Washington navel, 41.5) and lowest in the dry season (Valencia, 17.1). Overall, dry season fruits and more especially Valencia showed versatility in meeting most of the quality requirements for both industrial juice processing and the fresh market. However, there is need to improve the available orange varieties with regard to juice content and optimal sugar: acid ratio regardless of season.展开更多
Citrus is an important commercial crop in Uganda, especially the Eastern region. However, in spite of the increasing regional demand, citrus productivity is still low, attributed to pest and diseases, soil moisture st...Citrus is an important commercial crop in Uganda, especially the Eastern region. However, in spite of the increasing regional demand, citrus productivity is still low, attributed to pest and diseases, soil moisture stress, and low soil fertility, among others. Efforts to improve soil fertility are limited by inadequate supply of organic fertilizers due to competing demands. In addition, there is inadequate information on inorganic fertilizer requirements for citrus production in Uganda. The objective of this study was to develop optimum fertilizer recommendations for citrus production for Eastern Uganda. The study was conducted in Teso region, Eastern Uganda. Fertilizer (NPK, 17:17:17) was randomly applied to Hamlin, Valencia and Washington varieties with fertilizer and variety factorially arranged for each farm and citrus age range, replicated three times. Fertilizer rates were 0, 139, 278 and 556 kg NPK/ha for the 4 - 7-year old trees, and 0, 278, 556 and 1111 kg NPK/ha for the mature (8 years and above) trees. For a given variety, each fertilizer rate was applied onto three representative trees per farmer, six farmers per district. Results showed that yields and net profits were highest for variety Hamlin, and nearly the same for varieties Washington and Valencia. Fertilizer application increased fruit yield and profits for both the 4 to 7-year and 8 and above-year-old trees, with highest yield and profitability values observed at 556 kg NPK/ha. These results suggest applying 556 kg NPK/ha to citrus per year as an optimum fertilizer rate for citrus production in Teso region. The fertilizer should be applied in smaller splits of 800, 600, and 600 grams per tree, applied in April, June, and August.展开更多
Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests und...Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests under such management are better in tree diversity and conservation status and thus hold more carbon stocks. The study assessed the impact of CFM on carbon stocks, tree species diversity & tree species density in Mabira Central Forest Reserve. Data were collected from plots that were systematically laid in the different purposively selected forest areas. The study findings show that there is no difference in stem density and carbon stocks between CFM and non-CFM areas. CFM areas had lower species richness compared to non-CFM areas. CFM areas, however, exhibited more species diversity than non-CFM areas. Climax colonization may favor a few dominant species over others, hence lowering species diversity despite the number of species being many in the understory, hence at the same time increasing species richness. Likewise, disturbance in CFM area may affect natural colonization and favor the emergency of many species either naturally or through assisted regeneration by reforestation, hence increasing diversity, whereas artificial selection of preferred species through harvesting may lower species richness, as observed. Recommendations for improving collaborative forest management (CFM) areas include implementing targeted interventions to enhance carbon sequestration, such as promoting reforestation and afforestation with high-carbon-storing species and strengthening monitoring and evaluation frameworks to assess carbon stock changes over time. Additionally, efforts should focus on enhancing biodiversity conservation by implementing more stringent protection measures and reducing human disturbance while encouraging community participation in biodiversity monitoring and conservation education.展开更多
Wetlands play a number of vital roles in the ecosystem, such as serving as nutrient sinks, preventing floods, storing carbon, and filtering water. Encroachment on wetlands has led to substantial economic and environme...Wetlands play a number of vital roles in the ecosystem, such as serving as nutrient sinks, preventing floods, storing carbon, and filtering water. Encroachment on wetlands has led to substantial economic and environmental losses, including water quality degradation, loss of biodiversity and natural habitats, reduced climate mitigation as well as social and health risks. This study evaluated the effect of different land use types on nutrient stock distribution across varying soil depths in Busega wetland. The soil samples were collected in three different land uses (annually cultivated areas, perennially cultivated areas, and the undisturbed wetland area) at three different depths (0 - 10 cm, 10 - 20 cm, and 20 - 30 cm) in 2021. The soil samples were analyzed for physicochemical soil properties including soil texture and nitrogen, phosphorus, calcium, and potassium concentrations. The interaction between land use type and soil depth did not have a significant effect on nutrient distribution. However, our results showed that the main effects of land use type and soil depth influenced nutrient stock distribution across the wetland. Higher nutrient concentrations were observed under perennial cropping system than in both annual cropping system and the undisturbed wetland area. Soils under perennial cropping systems had the highest soil organic matter (1.45%), calcium (2.06 Cmol/Kg) and potassium (0.091 Cmol/Kg) levels. Higher soil organic matter (1.40%), nitrogen (0.22%), calcium (1.74 Cmol/Kg), and potassium (0.07 Cmol/Kg) were found at the mid-soil depth of 10 - 20 cm. Our results show substantial nutrient changes due to agricultural activities in the Busega wetland, suggesting further research is urgently needed to determine if these changes have adverse effects on biodiversity and water quality of the wetland and nearby water resources.展开更多
Osyris lanceolata is heavily and illegally exploited in East Africa for its essential oils, yet little is known about its population status and ecological requirements. This study examined its population structure and...Osyris lanceolata is heavily and illegally exploited in East Africa for its essential oils, yet little is known about its population status and ecological requirements. This study examined its population structure and environmental factors influencing its distribution in the semi-arid Karamoja sub-region, Uganda. We surveyed 388 plots (5 m radius) at different altitudes, recording life stages, stem diameters, and regeneration patterns, and analyzed soil samples. Multivariate analyses, including Canonical Correspondence Analysis (CCA), Detrended Correspondence Analysis (DCA), Non-metric Multidimensional Scaling (NMDS), and Multiple Regression Modeling (MRM), identified key environmental factors affecting its distribution. Findings show that O. lanceolata populations in Moroto, Nakapiripirit, and Amudat districts are severely degraded due to overexploitation. The species is primarily regenerating through coppicing rather than seedlings, with an exploitation intensity of 56.6%. Population densities are low, distribution is irregular, and sustainable harvesting is not viable. Soil properties, particularly Ca2+, N, P, K+, Na+, and organic matter, significantly influence its abundance. Conservation efforts should focus on identifying suitable provenances for genetic preservation and plantation establishment. Areas with at least 9 trees per hectare in Moroto, Nakapiripirit, and Amudat could serve as potential sites for ex-situ plantations. Further research should explore how biotic interactions, genetic diversity, and morphology affect oil yield and quality to support restoration, breeding, and domestication initiatives.展开更多
The increasing cost of infrastructure development risks stifling national investment plans.Many projects in Uganda have suffered because of the frequency and magnitude of claims made by parties involved especially the...The increasing cost of infrastructure development risks stifling national investment plans.Many projects in Uganda have suffered because of the frequency and magnitude of claims made by parties involved especially the contractors.As a result,the construction industry is plagued with claims which quite often lead to adversarial relationships.The major grounds for claims were identified through studying the contract documents where claims had been made.Increase in scope;change orders;errors in contract documents;inclement weather;inflation;delay in possessing the site;and change in the tax policy were the most prevalent grounds for making claims.Problems identified in claiming process include delays in getting approval;information on claims not reliable;hostility from the parties involved;pricing of claims;delays in effecting payment when approved;and overzealous contract interpretation leading to misunderstanding and delays Using a survey on project managers for 64 contractors and their corresponding clients or their representatives,the major ways in which it can be reduced were identified as being thoroughness during the design phase;providing for inflation;proper planning of works;using prequalified contractors;and proper documentation of records.Clients have a big role to play in reducing claims.展开更多
Deforestation remains one of the most imminent threats to biodiversity in the tropics.As such,its causes and dynamics need to be studied and understood to put a halt to further forest loss and degradation.In tropical ...Deforestation remains one of the most imminent threats to biodiversity in the tropics.As such,its causes and dynamics need to be studied and understood to put a halt to further forest loss and degradation.In tropical countries such as Uganda,agricultural expansion and wood fuel demand are its leading drivers.While the establishment of protected areas is a key tool in conserving remaining forest biodiversity,results indicate that current management does not sufficiently provide alternatives to forest resources utilised by households and income provided from timber and non-timber forest products.Beyond safeguarding ecosystems,protected areas need to ensure the sustainable socioeconomic development of adjacent communities for effective biodiversity conservation–however,both management and research often neglect to consider all dimensions.In this study,we analysed five decades of forest cover change in the Mount Elgon region,Uganda,by conducting a remote sensing analysis of its protected areas using Landsat MSS and TM data from 1973-2023 in combination with literature and subsequent interview analysis to consider both the ecological and socioeconomic dimension.We applied a random forest approach to differentiate forest and non-forest areas and carried out a pixel-based change detection analysis to differentiate temporal and spatial changes.Throughout the study period of 50 years,forest cover has evolved dynamically within the boundaries of the protected areas of Mount Elgon.A significant decline was observed in both Mount Elgon National Park with a loss of-5.98%(-46.83km²)and Mount Elgon Biosphere Reserve with a loss of-14.96%(-134.33km²).Our results showcase a cycle of deforestation and afforestation that could be tied to a series of development initiatives,re-demarcation of boundaries,changes in management and recurring evictions.Overall,the results lead to the conclusion that the lack of sustainable and efficient management and funding has fostered the rate of deforestation and accelerated ecological degradation in the region,but that existing problems are also rooted in the land tenure history of the region.We recommend the proper implementation of participatory and long-term management approaches on the ground and to address the land rights issue to contribute to both socioeconomic wellbeing and sustainable conservation outcomes.展开更多
Analysis of catchment Land use/Land cover (LULC) change is a vital tool in ensuring sustainable catchment management. The study analyzed land use/land cover changes in the Rwizi catchment, south western Uganda from 19...Analysis of catchment Land use/Land cover (LULC) change is a vital tool in ensuring sustainable catchment management. The study analyzed land use/land cover changes in the Rwizi catchment, south western Uganda from 1989-2019 and projected the trend by 2040. Landsat images, field observations, key informant interviews and focus group discussions were used to collect data. Changes in cropland, forestland, built up area, grazing land, wetland and open water bodies were analyzed in ArcGIS version 10.2.2 and ERDAS IMAGINE 14 software and a Markov chain model. All the LULC classes increased in area except grazing land. Forest land and builtup area between 2009-2019 increased by 370.03% and 229.53% respectively. Projections revealed an increase in forest land and builtup area by 2030 and only built up area by 2040. LULCC in the catchment results from population pressure, reduced soil fertility and high value of agricultural products.展开更多
Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer del...Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.展开更多
Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Nor...Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.展开更多
The resurgence of locally acquired malaria cases in the USA and the persistent global challenge of malaria transmission highlight the urgent need for research to prevent this disease. Despite significant eradication e...The resurgence of locally acquired malaria cases in the USA and the persistent global challenge of malaria transmission highlight the urgent need for research to prevent this disease. Despite significant eradication efforts, malaria remains a serious threat, particularly in regions like Africa. This study explores how integrating Gregor’s Type IV theory with Geographic Information Systems (GIS) improves our understanding of disease dynamics, especially Malaria transmission patterns in Uganda. By combining data-driven algorithms, artificial intelligence, and geospatial analysis, the research aims to determine the most reliable predictors of Malaria incident rates and assess the impact of different factors on transmission. Using diverse predictive modeling techniques including Linear Regression, K-Nearest Neighbor, Neural Network, and Random Forest, the study found that;Random Forest model outperformed the others, demonstrating superior predictive accuracy with an R<sup>2</sup> of approximately 0.88 and a Mean Squared Error (MSE) of 0.0534, Antimalarial treatment was identified as the most influential factor, with mosquito net access associated with a significant reduction in incident rates, while higher temperatures correlated with increased rates. Our study concluded that the Random Forest model was effective in predicting malaria incident rates in Uganda and highlighted the significance of climate factors and preventive measures such as mosquito nets and antimalarial drugs. We recommended that districts with malaria hotspots lacking Indoor Residual Spraying (IRS) coverage prioritize its implementation to mitigate incident rates, while those with high malaria rates in 2020 require immediate attention. By advocating for the use of appropriate predictive models, our research emphasized the importance of evidence-based decision-making in malaria control strategies, aiming to reduce transmission rates and save lives.展开更多
Introduction: Resistance to antituberculosis drugs and adverse drug reactions remain the leading causes of tuberculosis therapeutic failure globally. Despite the increasing acceptance of medicinal plant use in combina...Introduction: Resistance to antituberculosis drugs and adverse drug reactions remain the leading causes of tuberculosis therapeutic failure globally. Despite the increasing acceptance of medicinal plant use in combination with conventional antituberculosis drugs in treatment of tuberculosis (TB) in Uganda, there is paucity of knowledge on their combination effect. Aim: This research aimed to determine combination activity of standard antituberculosis drugs with extracts of Zanthoxylum leprieurii Guill. & Perr. and Rubia cordifolia L., the two common antituberculosis medicinal plants in Uganda, against pansensitive (H37Rv) and multi-drug resistant (MDR) Mycobacterium tuberculosis strains. Materials and Methods: Two reference MTB strains (H37Rv and MDR strain) were inoculated on Middlebrook 7H11 medium containing a combination of standard antituberculosis drugs and methanol extracts of Z. leprieurii and R. cordifolia at varying concentrations. The number of colonies on the plates was observed and counted weekly for up to 8 weeks. In vitro combination activity was determined using proportion method. Mean percentage inhibition was calculated for the reduction of number of colonies on drug-extract combination medium in relation to drug-extract-free control medium. Results: Drug-extract combinations showed good combination activity against Mycobacterium tuberculosis strains when compared with individual standard anti-TB drugs. This was more exhibited against MDR strain. There was however a reduction in percentage inhibition when extracts were combined with ethambutol and streptomycin against H37Rv strain. Conclusions: Zanthoxylum leprieurii and Rubia cordifolia in combination with standard anti-TB drugs exhibited increased in vitro activity against Mycobacterium tuberculosis, especially MDR-TB strain. This justifies the local use of these plants in traditional treatment of tuberculosis especially in resistant cases in Uganda.展开更多
Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendati...Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.展开更多
Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors d...Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors due to their curriculum that requires a lot of near work affecting their performance and quality of life unknowingly. Genetic and environmental factors are thought to play a role in the development of refractive errors. This study addresses the paucity of knowledge about refractive errors among university students in East Africa, providing a foundation for further research. Objectives: To determine the prevalence and factors associated with refractive errors among students in the Faculty of Medicine at Mbarara University of Science and Technology. Methodology: This was a cross-sectional descriptive and analytical study in which 368 undergraduate students selected using random sampling were assessed for refractive errors from March 2021-July 2021. Eligible participants were recruited and their VA assessment done after answering a questionnaire. Students whose VA improved on pin hole had subjective retinoscopy and results were compiled and imported to STATA 14 for analysis. Results: The prevalence of refractive errors was 26.36% with (95% CI) among university students especially myopia. Myopia is most predominant at 60%, followed by 37% Astigmatism and hyperopia of 3% among medical students. Astigmatism consisted of largely myopic astigmatism 72% (26) and 28% (10) compound/mixed astigmatism only. Student positive family history of refractive error was found to have a statistically significant relationship with refractive errors with AOR 1.68 (1.04 - 2.72) (95% CI) and P (0.032). Conclusion: The prevalence of refractive errors among university students, especially myopia, was found to be high and family history was associated with students having refractive errors.展开更多
文摘Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.
文摘BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by unique challenges in adolescent health care.Despite its importance,only a few studies have explored healthcare transition among adolescents in Uganda.AIM To identify factors associated with the transition to adult human immunodeficiency virus(HIV)-centered care among adolescents attending HIV/AIDS clinics in Uganda.METHODS A cross-sectional mixed-methods study was conducted among 265 adolescents,randomly selected from three antiretroviral therapy(ART)clinics,using a structured questionnaire.Focus group discussions and key informant interviews were conducted.Individuals aged 10-20 years who were actively enrolled in the ART program between January 4,2022 and January 30,2023 were recruited.The primary outcome of interest was the transition to adult care.Bivariate and multivariate analyses were performed for quantitative data,while content analysis was used to analyze qualitative data.RESULTS The prevalence of transition to adult care was 40.6%.Most participants were male(53.6%)and fell within the 13-15 age group(35.6%).Multivariate logistic regression analysis identified several factors significantly associated with transition to adult care:Age group 10-12 years[prevalence ratio(PR)=2.525,95%CI:2.121-2.944,P=0.002],Age group 13-15 years(PR=1.900,95%CI:1.196-3.416,P=0.001),successful viral load suppression(PR=1.534,95%CI:1.173-1.648,P=0.016),disclosure of HIV status to relatives(PR=5.001,95%CI:3.411-3.611,P=0.000),being prepared for transitioning(PR=5.417,95%CI:3.468-7.135,P=0.041)and having skilled pediatric caregivers(PR=3.724,95%CI:2.084-4.105,P=0.005).CONCLUSION Transition to adult care among adolescents was low.Improving transition outcomes may require strengthening individual support within the family context and integrating transition-focused care into existing specialized clinical settings to enhance the delivery of adolescent-friendly services.
文摘If there’s one meat dish Ugandan people really enjoy,that’s goat meat.Across the country in restaurants,bars and clubs,the aroma of roasted goat meat wafts enticingly,attracting people at all hours of the day and night.
文摘Teso subregion in Eastern Uganda is a leading production hub for citrus in Uganda. However, information on fruit quality profile of the three major varieties (Hamlin, Valencia and Washington navel) grown in this region was limited and/or unreported, partly resulting in their limited use for industrial processing. The current study sought to understand the seasonal quality profile of these varieties during the wet and dry seasons for the years 2019, 2022 and 2023. The study was conducted with farmers in the districts of Kumi, Ngora, Soroti and Kalaki. Mature green oranges were periodically harvested and analysed for physical and chemical properties. The results showed that the quality of oranges varied depending on the season at harvest and the variety with significant differences (p ≤ 0.05). Mean weight per fruit was highest in wet season Washington navel (277.5 g) and lowest in dry season Hamlin (149.3 g). Similarly, fruit size varied in the wet season where Washington navel (81.2 mm) had the biggest fruits while dry season Hamlin were smallest (66.6 mm). Dry season Washington navel had had the thickest peel (7.9 mm). Valencia from the wet season had the highest juice content (36.9%) compared to Washington navel (26.5%) from the dry season with the lowest. Titratable acidity was higher in the dry season Valencia (0.9%) compared to the wet season Washington navel and Hamlin (0.3%). Similarly, Total soluble solids (TSS) was higher in the dry season (Washington navel, 10.1 ˚Brix) in contrast to the wet season (Hamlin and Valencia, 7.7 ˚Brix). Valencia had the lowest pH (3.1) however, pH did not vary significantly between season for each variety except for Hamlin. Vitamin C content was higher during the dry season led by Valencia (57.6 mg/100g) and Hamlin (57.4 mg/100g). Sugar to acid ratio was highest during the wet season (Washington navel, 41.5) and lowest in the dry season (Valencia, 17.1). Overall, dry season fruits and more especially Valencia showed versatility in meeting most of the quality requirements for both industrial juice processing and the fresh market. However, there is need to improve the available orange varieties with regard to juice content and optimal sugar: acid ratio regardless of season.
文摘Citrus is an important commercial crop in Uganda, especially the Eastern region. However, in spite of the increasing regional demand, citrus productivity is still low, attributed to pest and diseases, soil moisture stress, and low soil fertility, among others. Efforts to improve soil fertility are limited by inadequate supply of organic fertilizers due to competing demands. In addition, there is inadequate information on inorganic fertilizer requirements for citrus production in Uganda. The objective of this study was to develop optimum fertilizer recommendations for citrus production for Eastern Uganda. The study was conducted in Teso region, Eastern Uganda. Fertilizer (NPK, 17:17:17) was randomly applied to Hamlin, Valencia and Washington varieties with fertilizer and variety factorially arranged for each farm and citrus age range, replicated three times. Fertilizer rates were 0, 139, 278 and 556 kg NPK/ha for the 4 - 7-year old trees, and 0, 278, 556 and 1111 kg NPK/ha for the mature (8 years and above) trees. For a given variety, each fertilizer rate was applied onto three representative trees per farmer, six farmers per district. Results showed that yields and net profits were highest for variety Hamlin, and nearly the same for varieties Washington and Valencia. Fertilizer application increased fruit yield and profits for both the 4 to 7-year and 8 and above-year-old trees, with highest yield and profitability values observed at 556 kg NPK/ha. These results suggest applying 556 kg NPK/ha to citrus per year as an optimum fertilizer rate for citrus production in Teso region. The fertilizer should be applied in smaller splits of 800, 600, and 600 grams per tree, applied in April, June, and August.
文摘Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests under such management are better in tree diversity and conservation status and thus hold more carbon stocks. The study assessed the impact of CFM on carbon stocks, tree species diversity & tree species density in Mabira Central Forest Reserve. Data were collected from plots that were systematically laid in the different purposively selected forest areas. The study findings show that there is no difference in stem density and carbon stocks between CFM and non-CFM areas. CFM areas had lower species richness compared to non-CFM areas. CFM areas, however, exhibited more species diversity than non-CFM areas. Climax colonization may favor a few dominant species over others, hence lowering species diversity despite the number of species being many in the understory, hence at the same time increasing species richness. Likewise, disturbance in CFM area may affect natural colonization and favor the emergency of many species either naturally or through assisted regeneration by reforestation, hence increasing diversity, whereas artificial selection of preferred species through harvesting may lower species richness, as observed. Recommendations for improving collaborative forest management (CFM) areas include implementing targeted interventions to enhance carbon sequestration, such as promoting reforestation and afforestation with high-carbon-storing species and strengthening monitoring and evaluation frameworks to assess carbon stock changes over time. Additionally, efforts should focus on enhancing biodiversity conservation by implementing more stringent protection measures and reducing human disturbance while encouraging community participation in biodiversity monitoring and conservation education.
文摘Wetlands play a number of vital roles in the ecosystem, such as serving as nutrient sinks, preventing floods, storing carbon, and filtering water. Encroachment on wetlands has led to substantial economic and environmental losses, including water quality degradation, loss of biodiversity and natural habitats, reduced climate mitigation as well as social and health risks. This study evaluated the effect of different land use types on nutrient stock distribution across varying soil depths in Busega wetland. The soil samples were collected in three different land uses (annually cultivated areas, perennially cultivated areas, and the undisturbed wetland area) at three different depths (0 - 10 cm, 10 - 20 cm, and 20 - 30 cm) in 2021. The soil samples were analyzed for physicochemical soil properties including soil texture and nitrogen, phosphorus, calcium, and potassium concentrations. The interaction between land use type and soil depth did not have a significant effect on nutrient distribution. However, our results showed that the main effects of land use type and soil depth influenced nutrient stock distribution across the wetland. Higher nutrient concentrations were observed under perennial cropping system than in both annual cropping system and the undisturbed wetland area. Soils under perennial cropping systems had the highest soil organic matter (1.45%), calcium (2.06 Cmol/Kg) and potassium (0.091 Cmol/Kg) levels. Higher soil organic matter (1.40%), nitrogen (0.22%), calcium (1.74 Cmol/Kg), and potassium (0.07 Cmol/Kg) were found at the mid-soil depth of 10 - 20 cm. Our results show substantial nutrient changes due to agricultural activities in the Busega wetland, suggesting further research is urgently needed to determine if these changes have adverse effects on biodiversity and water quality of the wetland and nearby water resources.
文摘Osyris lanceolata is heavily and illegally exploited in East Africa for its essential oils, yet little is known about its population status and ecological requirements. This study examined its population structure and environmental factors influencing its distribution in the semi-arid Karamoja sub-region, Uganda. We surveyed 388 plots (5 m radius) at different altitudes, recording life stages, stem diameters, and regeneration patterns, and analyzed soil samples. Multivariate analyses, including Canonical Correspondence Analysis (CCA), Detrended Correspondence Analysis (DCA), Non-metric Multidimensional Scaling (NMDS), and Multiple Regression Modeling (MRM), identified key environmental factors affecting its distribution. Findings show that O. lanceolata populations in Moroto, Nakapiripirit, and Amudat districts are severely degraded due to overexploitation. The species is primarily regenerating through coppicing rather than seedlings, with an exploitation intensity of 56.6%. Population densities are low, distribution is irregular, and sustainable harvesting is not viable. Soil properties, particularly Ca2+, N, P, K+, Na+, and organic matter, significantly influence its abundance. Conservation efforts should focus on identifying suitable provenances for genetic preservation and plantation establishment. Areas with at least 9 trees per hectare in Moroto, Nakapiripirit, and Amudat could serve as potential sites for ex-situ plantations. Further research should explore how biotic interactions, genetic diversity, and morphology affect oil yield and quality to support restoration, breeding, and domestication initiatives.
文摘The increasing cost of infrastructure development risks stifling national investment plans.Many projects in Uganda have suffered because of the frequency and magnitude of claims made by parties involved especially the contractors.As a result,the construction industry is plagued with claims which quite often lead to adversarial relationships.The major grounds for claims were identified through studying the contract documents where claims had been made.Increase in scope;change orders;errors in contract documents;inclement weather;inflation;delay in possessing the site;and change in the tax policy were the most prevalent grounds for making claims.Problems identified in claiming process include delays in getting approval;information on claims not reliable;hostility from the parties involved;pricing of claims;delays in effecting payment when approved;and overzealous contract interpretation leading to misunderstanding and delays Using a survey on project managers for 64 contractors and their corresponding clients or their representatives,the major ways in which it can be reduced were identified as being thoroughness during the design phase;providing for inflation;proper planning of works;using prequalified contractors;and proper documentation of records.Clients have a big role to play in reducing claims.
基金The financial support by the Deutsche Bundesstiftung Umwelt (DBU)
文摘Deforestation remains one of the most imminent threats to biodiversity in the tropics.As such,its causes and dynamics need to be studied and understood to put a halt to further forest loss and degradation.In tropical countries such as Uganda,agricultural expansion and wood fuel demand are its leading drivers.While the establishment of protected areas is a key tool in conserving remaining forest biodiversity,results indicate that current management does not sufficiently provide alternatives to forest resources utilised by households and income provided from timber and non-timber forest products.Beyond safeguarding ecosystems,protected areas need to ensure the sustainable socioeconomic development of adjacent communities for effective biodiversity conservation–however,both management and research often neglect to consider all dimensions.In this study,we analysed five decades of forest cover change in the Mount Elgon region,Uganda,by conducting a remote sensing analysis of its protected areas using Landsat MSS and TM data from 1973-2023 in combination with literature and subsequent interview analysis to consider both the ecological and socioeconomic dimension.We applied a random forest approach to differentiate forest and non-forest areas and carried out a pixel-based change detection analysis to differentiate temporal and spatial changes.Throughout the study period of 50 years,forest cover has evolved dynamically within the boundaries of the protected areas of Mount Elgon.A significant decline was observed in both Mount Elgon National Park with a loss of-5.98%(-46.83km²)and Mount Elgon Biosphere Reserve with a loss of-14.96%(-134.33km²).Our results showcase a cycle of deforestation and afforestation that could be tied to a series of development initiatives,re-demarcation of boundaries,changes in management and recurring evictions.Overall,the results lead to the conclusion that the lack of sustainable and efficient management and funding has fostered the rate of deforestation and accelerated ecological degradation in the region,but that existing problems are also rooted in the land tenure history of the region.We recommend the proper implementation of participatory and long-term management approaches on the ground and to address the land rights issue to contribute to both socioeconomic wellbeing and sustainable conservation outcomes.
文摘Analysis of catchment Land use/Land cover (LULC) change is a vital tool in ensuring sustainable catchment management. The study analyzed land use/land cover changes in the Rwizi catchment, south western Uganda from 1989-2019 and projected the trend by 2040. Landsat images, field observations, key informant interviews and focus group discussions were used to collect data. Changes in cropland, forestland, built up area, grazing land, wetland and open water bodies were analyzed in ArcGIS version 10.2.2 and ERDAS IMAGINE 14 software and a Markov chain model. All the LULC classes increased in area except grazing land. Forest land and builtup area between 2009-2019 increased by 370.03% and 229.53% respectively. Projections revealed an increase in forest land and builtup area by 2030 and only built up area by 2040. LULCC in the catchment results from population pressure, reduced soil fertility and high value of agricultural products.
文摘Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.
文摘Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.
文摘The resurgence of locally acquired malaria cases in the USA and the persistent global challenge of malaria transmission highlight the urgent need for research to prevent this disease. Despite significant eradication efforts, malaria remains a serious threat, particularly in regions like Africa. This study explores how integrating Gregor’s Type IV theory with Geographic Information Systems (GIS) improves our understanding of disease dynamics, especially Malaria transmission patterns in Uganda. By combining data-driven algorithms, artificial intelligence, and geospatial analysis, the research aims to determine the most reliable predictors of Malaria incident rates and assess the impact of different factors on transmission. Using diverse predictive modeling techniques including Linear Regression, K-Nearest Neighbor, Neural Network, and Random Forest, the study found that;Random Forest model outperformed the others, demonstrating superior predictive accuracy with an R<sup>2</sup> of approximately 0.88 and a Mean Squared Error (MSE) of 0.0534, Antimalarial treatment was identified as the most influential factor, with mosquito net access associated with a significant reduction in incident rates, while higher temperatures correlated with increased rates. Our study concluded that the Random Forest model was effective in predicting malaria incident rates in Uganda and highlighted the significance of climate factors and preventive measures such as mosquito nets and antimalarial drugs. We recommended that districts with malaria hotspots lacking Indoor Residual Spraying (IRS) coverage prioritize its implementation to mitigate incident rates, while those with high malaria rates in 2020 require immediate attention. By advocating for the use of appropriate predictive models, our research emphasized the importance of evidence-based decision-making in malaria control strategies, aiming to reduce transmission rates and save lives.
文摘Introduction: Resistance to antituberculosis drugs and adverse drug reactions remain the leading causes of tuberculosis therapeutic failure globally. Despite the increasing acceptance of medicinal plant use in combination with conventional antituberculosis drugs in treatment of tuberculosis (TB) in Uganda, there is paucity of knowledge on their combination effect. Aim: This research aimed to determine combination activity of standard antituberculosis drugs with extracts of Zanthoxylum leprieurii Guill. & Perr. and Rubia cordifolia L., the two common antituberculosis medicinal plants in Uganda, against pansensitive (H37Rv) and multi-drug resistant (MDR) Mycobacterium tuberculosis strains. Materials and Methods: Two reference MTB strains (H37Rv and MDR strain) were inoculated on Middlebrook 7H11 medium containing a combination of standard antituberculosis drugs and methanol extracts of Z. leprieurii and R. cordifolia at varying concentrations. The number of colonies on the plates was observed and counted weekly for up to 8 weeks. In vitro combination activity was determined using proportion method. Mean percentage inhibition was calculated for the reduction of number of colonies on drug-extract combination medium in relation to drug-extract-free control medium. Results: Drug-extract combinations showed good combination activity against Mycobacterium tuberculosis strains when compared with individual standard anti-TB drugs. This was more exhibited against MDR strain. There was however a reduction in percentage inhibition when extracts were combined with ethambutol and streptomycin against H37Rv strain. Conclusions: Zanthoxylum leprieurii and Rubia cordifolia in combination with standard anti-TB drugs exhibited increased in vitro activity against Mycobacterium tuberculosis, especially MDR-TB strain. This justifies the local use of these plants in traditional treatment of tuberculosis especially in resistant cases in Uganda.
文摘Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.
文摘Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors due to their curriculum that requires a lot of near work affecting their performance and quality of life unknowingly. Genetic and environmental factors are thought to play a role in the development of refractive errors. This study addresses the paucity of knowledge about refractive errors among university students in East Africa, providing a foundation for further research. Objectives: To determine the prevalence and factors associated with refractive errors among students in the Faculty of Medicine at Mbarara University of Science and Technology. Methodology: This was a cross-sectional descriptive and analytical study in which 368 undergraduate students selected using random sampling were assessed for refractive errors from March 2021-July 2021. Eligible participants were recruited and their VA assessment done after answering a questionnaire. Students whose VA improved on pin hole had subjective retinoscopy and results were compiled and imported to STATA 14 for analysis. Results: The prevalence of refractive errors was 26.36% with (95% CI) among university students especially myopia. Myopia is most predominant at 60%, followed by 37% Astigmatism and hyperopia of 3% among medical students. Astigmatism consisted of largely myopic astigmatism 72% (26) and 28% (10) compound/mixed astigmatism only. Student positive family history of refractive error was found to have a statistically significant relationship with refractive errors with AOR 1.68 (1.04 - 2.72) (95% CI) and P (0.032). Conclusion: The prevalence of refractive errors among university students, especially myopia, was found to be high and family history was associated with students having refractive errors.
