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Orobia, Laura, and Gerrit Rooks . "Risk Taking and Start-up Capital: Exploring Gender differences in Uganda, through an International Comparison." Journal of Economics and Behavioral Studies 3, no. 2 (August 15, 2011): 83–93. http://dx.doi.org/10.22610/jebs.v3i2.258.
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This study sought to explain the gender differences with respect to risk taking behaviour and startup capital in Uganda, comparing with other countries. The start-up capital of businesses run by females is ostensibly smaller than those run by males in Uganda and in any other country. A number of reasons have been forwarded to explain this variance. Some researchers have linked the size of start-up capital to the risk taking behaviour among other factors. However there is insufficient local or Ugandan empirical research into this difference, given that much of the empirical research are based on western data sets. Data for this study was from the Global Entrepreneurship Monitor (GEM) 2003. A causal research design was used to establish the relationship between risk taking attitude and start up capital. A comparative design was also employed to compare the findings of Uganda with other GEM countries, Chi-square tests, and a two way analysis of variances were used to analyse the data. There are gender differences with respect to risk taking behaviour across all countries under study. However, the gender gap is wider in other countries than Uganda. On the whole, Uganda women are less risk averse as compared to those in other countries. The start-up capital requirement of Ugandan men is more than their female counterparts. In addition, Ugandan men invested more personal start up capital when they are risk averse. Among other recommendations, policy makers should sensitise females about viability of business start ups and encourage women access to ownership of property.
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Kuhanen, Jan. "The Historiography of HIV and AIDS in Uganda." History in Africa 35 (January 2008): 301–25. http://dx.doi.org/10.1353/hia.0.0009.
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Uganda has been in the world headlines since the mid-1980s, first as a nation severely hit by HIV and AIDS, and later, from the late 1990s onwards, as the first country in sub-Saharan Africa that has managed to reverse a generalised HIV epidemic. Countless newspaper articles, television and radio documentaries and broadcasts, papers, books, and films have been produced about AIDS in Uganda, making the epidemic one of the most thoroughly researched and documented in the world. Medical doctors, virologists, epidemiologists and social and behavioral scientists, both Ugandan and expatriate, have produced massive amounts of scientific information about it since the early 1980s, in addition to which there have been policy papers, evaluation reports, and action plans produced by various government ministries, international donor agencies, and national and international NGOs and relief organizations which document the epidemic from administrative, developmental, and humanitarian perspectives.Uganda's AIDS epidemic has been publicized worldwide through the news media and various international agencies. It is being constantly monitored not only by national authorities and international health experts, but by myriads of Ugandan and international organizations, media, academics, and concerned members of the public using modern means of communication. Some of these national and international bodies not only monitor, report and educate, but demand their say in how the epidemic should be managed. Uganda has become a testing ground for medical and behavioral interventions, as exemplified by AIDS vaccination trials, the social marketing of condoms, antiretroviral treatment, and, recently, by the male circumcision trial. Positive results have then been marketed to other countries in sub-Saharan Africa as successful AIDS prevention strategies.
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Masaazi, Fred, Medadi Ssentanda, and Willy Ngaka. "On Uganda government’s commitment to the development and implementation of the mother tongue education policy in post-2015 era." Apples - Journal of Applied Language Studies 12, no. 2 (July 8, 2018): 1–17. http://dx.doi.org/10.17011/apples/urn.201809144126.
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The year 2015 was set as deadline to realise the Millennium Development Goals (MDGs) which were authored in 2000 by 189 states in the world. Language is at the heart of MDGs (Barron, 2012; Romaine, 2013). Some scholars look at language (development) as a measure and/or determinant of development (e.g. Romaine, 2013). This paper examines Uganda’s commitment to the development and employment of mother tongues in education as a way of realising the quality of education in Uganda. It is important to reflect on the trend and level of mother tongue development and employment in education in Uganda to chart the way forward for the post-2015 period. The paper draws from different studies and reports which have focussed on mother tongue education in Uganda. This study faults the government in many ways for failing to sustain the national initiatives of mother tongue education, particularly in terms of poor financing and failure to monitor the implementation of UPE and mother tongue education programmes. The paper proposes a way forward for the realisation of a meaningful Education for All (EFA) in form of Universal Primary Education (UPE) initiative and the mother tongue education policy introduced in Uganda in 1997 and 2006 respectively.
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Bosco Kakooza, John, Immaculate Tusiime, Hojops Odoch, and Vincent Bagire. "Management Practices and Performance of Public hospitals in Uganda." International Journal of Management Science and Business Administration 1, no. 7 (2015): 22–29. http://dx.doi.org/10.18775/ijmsba.1849-5664-5419.2014.17.1002.
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The Daily Monitor publications ran serialized articles showing the awful state of government hospitals across the country. While the Ministry of Health insists that the problem is not as bad as it is depicted, the level of service delivery in public hospitals has come under serious public scrutiny espousing the cause for concern about policy, practice and research. There should be glaring gaps in management practices as a possible explanation. In this study, we investigated impact of management decision making, structure, processes, communication and management style on hospital performance. The study has emphasized good management as the determinant of better performance of hospitals in the Ugandan context. Findings of this study challenges policy makers to strengthen management processes in addition to mobilizing financial, human and capital resources for hospitals. The study extends the debate on application of management theory with practice in the health sector in the Ugandan context.
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Serwadda, Isah. "Impact of Credit Risk Management Systems on the Financial Performance of Commercial Banks in Uganda." Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis 66, no. 6 (2018): 1627–35. http://dx.doi.org/10.11118/actaun201866061627.
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The paper is set to analyse the impact of credit risk management on the financial performance of commercial banks in Uganda for a period of 2006–2015 using panel data for a sample of 20 commercial banks. The study employs return on assets as a dependent variable and non‑performing loans, growth in interest earnings and loan loss provisions to total loans as credit risk measures. Secondary data is sourced from the Bank scope database, African development bank and the central bank of Uganda. The study employs descriptive statistics, regressions and correlation analysis. Regression models are to estimate the magnitude of significance of credit risk management on the performance of commercial banks in Uganda. The study revealed that credit risk management impacts on the performance of Ugandan commercial banks. The results portrayed that banks’ performance was inversely influenced by non‑performing loans which may expose them to large magnitudes of illiquidity and financial crisis. Thus given such results, the researcher recommends that banks need to enhance their credit risk management techniques not only to earn more profits but also to maintain a qualitative asset portfolio and attention be given to non‑performing loans, loan loss provision to total loans and growth in interest earnings that were found to be significant. Banks need to design appropriate credit policies that must handle all necessary conditions before advancing credit to their customers and also develop strong credit administration committees and teams that must conduct appropriate and sound loan appraisal evaluations and which must also monitor the loans throughout the required processes right from extending a loan to a customer up to the completion of loan repayments so as to mitigate credit risks.
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Obua, Celestino. "Multiple ART Programs Create a Dilemma for Providers to Monitor ARV Adherence in Uganda." Open AIDS Journal 5, no. 1 (March 18, 2011): 17–24. http://dx.doi.org/10.2174/1874613601105010017.
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S, Etajak. "Air Quality Monitoring using Beta Attenuation Monitor 1022 and E-Samplers in Kampala Uganda." Environmental Epidemiology 3 (October 2019): 114. http://dx.doi.org/10.1097/01.ee9.0000606972.97552.56.
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Ajanga, Max. "Allocative Inefficiency of General Hospitals in Poor Countries: A Case Study of Uganda." East African Journal of Interdisciplinary Studies 3, no. 1 (June 15, 2021): 128–43. http://dx.doi.org/10.37284/eajis.3.1.346.
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The increasing costs of healthcare arising largely from the growing population and emergence of non-communicable diseases have exerted pressure on healthcare budgets in poor countries. With a funding gap of 7% to realize WHO recommended target of 15 percent of GDP in Uganda, there is a need for hospitals to be efficient in allocation of financial resources in order to provide the required level of healthcare services. Most studies on Uganda have focused on the technical inefficiency of general hospitals and evidence on their allocative inefficiency is limited. Understanding the sources of inefficiency in the allocation of finances in general hospitals in Uganda is important to improve their performance. The purpose of this study was to determine the allocative inefficiency of the general hospitals in Uganda in order to provide a source of misuse of public allocations to a particular general hospital. Panel data from 22 general hospitals for the period 1997-2007 were used. Allocative inefficiency was estimated using Stochastic Frontier Analysis. The findings show that general hospitals are systematically allocatively inefficient in distributing the public funds given to them. The allocative inefficiencies value is high on payments of employee benefits (34.8 percent), followed by the purchase of drugs (29.2%) and lastly, costs on utilities like electricity and water (14.1%). To address the existing allocative inefficiencies, general hospitals in Uganda can improve the process of hiring of labour and management of staff payroll; monitor procurement of drugs, and reduce wastages in the use of utilities.
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Jacob, Aerin L., Tyler R. Bonnell, Nicholas Dowhaniuk, and Joel Hartter. "Topographic and spectral data resolve land cover misclassification to distinguish and monitor wetlands in western Uganda." ISPRS Journal of Photogrammetry and Remote Sensing 94 (August 2014): 114–26. http://dx.doi.org/10.1016/j.isprsjprs.2014.05.001.
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Workneh, Meklit, Mohammed Lamorde, Francis Kakooza, Olive Mbabazi, Rodney Mugasha, Richard Walwema, Yukari Manabe, and Patrick Musinguzi. "High-Level Neisseria gonorrhea Resistance Detected in a Newly Implemented Surveillance Program in Kampala, Uganda." Open Forum Infectious Diseases 4, suppl_1 (2017): S103. http://dx.doi.org/10.1093/ofid/ofx163.091.
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Abstract Background Neisseria gonorrhea resistance is a growing problem in Uganda with recent data showing increasing ciprofloxacin resistance up to 100% in this population. The WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) was initiated in Uganda in September 2016 to monitor resistance trends. Methods Urethral swabs were collected from men presenting with urethral discharge to the five sentinel clinic sites from September 2016 to March 2017. Samples were transported to a reference laboratory site. Presumptive identification of N. gonorrhea was based on growth of typical appearing colonies on Thayer–Martin in 5% CO2, a positive oxidase test, and observation of Gram-negative, oxidase-positive diplococci in stained smears. Results 116 samples were received to the reference laboratory site of which 70 (60.3%) had positive growth for Neisseria gonorrhea. Mean age was 28.5 (range 17–60). Fifty-one participants (44%) reported at least one prior episode of gonorrhea and 42 (36%) reported antibiotic use within the previous 60 days. Of those with completed Etest (bioMerieux, Marcy-lÕEtoile, France) resistance profiles, 66 (96%) were ciprofloxacin-resistant or intermediate. One isolate was ceftriaxone-resistant by E-test but susceptible by disk diffusion. Conclusion Early results from implementation of a gonorrhea surveillance program in Uganda suggest high levels of resistance to ciprofloxacin (90%) by Etest and penicillin (93%) and tetracyclines (100%) by disk diffusion. Prior studies of gonococcal resistance in Uganda have noted increasing levels of resistance, particularly to ciprofloxacin which until 2010 was the recommended first-line empiric therapy for gonococcal infection in Uganda. Of note, discrepancies were occasionally noted between disk diffusion and Etest results, which requires further investigation. Ongoing surveillance efforts will be crucial to shape clinical guidelines and national policy. Disclosures All authors: No reported disclosures.
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de la Cuesta, Brandon, Helen V. Milner, Daniel L. Nielson, and Stephen F. Knack. "Oil and aid revenue produce equal demands for accountability as taxes in Ghana and Uganda." Proceedings of the National Academy of Sciences 116, no. 36 (August 21, 2019): 17717–22. http://dx.doi.org/10.1073/pnas.1903134116.
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Received wisdom argues that citizens more readily demand accountability from government for taxes than for nontax revenue from oil or foreign aid, giving rise to an important mechanism underlying the “resource curse,” which posits that nontax revenue causes citizen quiescence and hampers government accountability. However, in developing countries, obfuscation through value-added taxes and strong popular feelings of ownership over all revenues may minimize differences across revenue sources. Identical experiments on representative samples of Ghanaians and Ugandans, and similar experiments on members of parliament, probe the effects of different sources and delivery channels of government revenues on citizens’ actions to monitor governments and members of parliament (MPs’) beliefs about accountability pressures. Roughly half of all citizens take action to monitor all 3 sources. However, neither Ghanaians nor Ugandans demand more accountability for taxes than oil or aid when the revenues go to the government. MPs likewise saw no difference. Citizens do differentiate between aid money given to nongovernmental organizations (NGOs) compared with revenues delivered to the government. Findings are robust to numerous alternatives and subgroups. Against strong expectations from prior research, little evidence exists showing that taxes strengthen citizens’ demands for accountability or that MPs perceive differences across revenue sources in these 2 representative African countries. However, aid channeled through NGOs motivates more accountability pressures.
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Thomson, Rebecca, Khalid B. Beshir, Jane Cunningham, Frank Baiden, Jameel Bharmal, Katia J. Bruxvoort, Catherine Maiteki-Sebuguzi, Seth Owusu-Agyei, Sarah G. Staedke, and Heidi Hopkins. "pfhrp2 and pfhrp3 Gene Deletions That Affect Malaria Rapid Diagnostic Tests for Plasmodium falciparum: Analysis of Archived Blood Samples From 3 African Countries." Journal of Infectious Diseases 220, no. 9 (June 28, 2019): 1444–52. http://dx.doi.org/10.1093/infdis/jiz335.
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Abstract Background Malaria rapid diagnostic tests (mRDTs) that target histidine-rich protein 2 (HRP2) are important tools for Plasmodium falciparum diagnosis. Parasites with pfhrp2/3 gene deletions threaten the use of these mRDTs and have been reported in Africa, Asia, and South America. We studied blood samples from 3 African countries to determine if these gene deletions were present. Methods We analyzed 911 dried blood spots from Ghana (n = 165), Tanzania (n = 176), and Uganda (n = 570). Plasmodium falciparum infection was confirmed by 18S rDNA polymerase chain reaction (PCR), and pfhrp2/3 genes were genotyped. True pfhrp2/3 gene deletions were confirmed if samples were (1) microscopy positive; (2) 18S rDNA PCR positive; (3) positive for merozoite surface protein genes by PCR or positive by loop-mediated isothermal amplification; or (4) quantitative PCR positive with >5 parasites/µL. Results No pfhrp2/3 deletions were detected in samples from Ghana, but deletions were identified in Tanzania (3 pfhrp2; 2 pfhrp3) and Uganda (7 pfhrp2; 2 pfhrp3). Of the 10 samples with pfhrp2 deletions, 9 tested negative by HRP2-based mRDT. Conclusions The presence of pfhrp2/3 deletions in Tanzania and Uganda, along with reports of pfhrp2/3-deleted parasites in neighboring countries, reinforces the need for systematic surveillance to monitor the reliability of mRDTs in malaria-endemic countries.
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Njuguna, Joseph, and Margaret Jjuuko. "A framing analysis of mainstream newspaper coverage of the 2013 ‘Coalition of the Willing’ initiative in East Africa." Journal of African Media Studies 12, no. 3 (September 1, 2020): 241–54. http://dx.doi.org/10.1386/jams_00022_1.
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The phrase, ‘Coalition of the Willing’, emerged in East Africa in 2013, when three East African Community (EAC) members (Kenya, Uganda and Rwanda) forged a Tripartite Initiative to fast-track the EAC regional integration, sidelining Tanzania and Burundi, for their apparent ‘aloofness’ to integration. This coalition created tensions among the five countries, exacerbating an already simmering conflict between Tanzania and Rwanda involving the expulsion of ‘illegal’ Rwandan migrants from Tanzania. Informed by contemporary political communication and media framing, this article examines how these events were framed in five leading newspapers in East Africa: the Daily Nation (Kenya), the Daily Monitor (Uganda), The Citizen (Tanzania), The New Times (Rwanda) and The East African (EAC region). Through a thematic frame analysis, we interrogate the prevalence and implications of five prominent themes found in most political conflicts (attributions of responsibility, conflict, human interest, economic consequences and morality) on the ‘Coalition of the Willing’ media debate. The analysis reveals conflicting frames with a potential to inflame antagonistic media debates to the integration efforts ‐ by the resultant blame-game and opening up of historical wounds and personal differences, among the key players.
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Hassenforder, Emeline, Raphaëlle Ducrot, Nils Ferrand, Olivier Barreteau, Katherine Anne Daniell, and Jamie Pittock. "Four challenges in selecting and implementing methods to monitor and evaluate participatory processes: Example from the Rwenzori region, Uganda." Journal of Environmental Management 180 (September 2016): 504–16. http://dx.doi.org/10.1016/j.jenvman.2016.05.019.
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Greco, Giulia, Louise Knight, Willington Ssekadde, Sophie Namy, Dipak Naker, and Karen Devries. "Economic evaluation of the Good School Toolkit: an intervention for reducing violence in primary schools in Uganda." BMJ Global Health 3, no. 2 (April 2018): e000526. http://dx.doi.org/10.1136/bmjgh-2017-000526.
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IntroductionThis paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda.MethodsThe effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider’s perspective to estimate total and unit costs.ResultsThe total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial.ConclusionsThe GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region.
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Tindimwebwa, Kenneth, Asmerom Kidane, and Silas Joel. "Efficiency Estimates of Public Health Center II Facilities in Southwestern Uganda." Journal of Economics and Behavioral Studies 10, no. 4(J) (September 14, 2018): 135–51. http://dx.doi.org/10.22610/jebs.v10i4(j).2414.
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The study estimates the efficiency of public health centre II (HCII) facilities in Southwestern Uganda. Specifically, it determines the level of technical efficiency (TE), scale efficiency (SE) and estimates the economic savings required to make inefficient public health facilities efficient. An output-oriented Data Envelopment Analysis (DEA) is employed in the estimation of TE and SE. It was found out that 73 % of the HCIIs were technically inefficient while 27% were technically efficient. Mean TE stood at 72.3% implying that an average HCII could potentially improve its efficiency by increasing its outputs by 27.7%. In addition, 77% of the facilities were SE implying that they obtained the most productive scale size given the input-output combination. 23% of the facilities were scaled inefficient implying that they have more input waste attributable to their size. There is great potential for economic savings shown by different magnitudes of input reductions and output augmentations required to make inefficient facilities efficient. The study has important policy implications. The health sector should embark on rigorous periodic research and development to enhance healthcare delivery efficiently. Since the health units are small, there is a need to augment their scale sizes and improve on their management practices so as to enhance their overall productivity and efficiency. Stakeholders should scale up efforts to attract, align skills with needs and improve retention and motivation of the health workforce. Holistic investment in resource inputs is essential. A comprehensive monitoring and evaluation plan with key verifiable indicators to monitor the overall health sector performance is required.
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Mujasi, Paschal N., and Zerish Z. Nkosi. "Factors Associated with Outsourcing Support Services by General Hospitals in Uganda." Open Public Health Journal 10, no. 1 (December 22, 2017): 283–93. http://dx.doi.org/10.2174/1874944501710010283.
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Background: The objective of this study was to identify factors associated with the decision, process and practices of outsourcing support services by general hospitals in Uganda. Methods: A cross sectional survey design was used; 32 hospitals were sampled using stratified random sampling. Trained research assistants distributed self-administered questionnaires to managers in the sampled hospitals. Wilcoxon-Mann-Whitney tests were performed on the collected data using SAS 9.3. Results: Majority (59%) of hospitals surveyed were rural; 41% were urban. More than half (n=23; 72%) reported to be outsourcing at least one support service. There was a significant difference in the proportion of rural and urban hospitals outsourcing and those not outsourcing (p=0.0033). While outsourcing, rural hospitals were more likely to report challenges with the availability of vendors (p= 0.0152); urban hospitals were more likely to report challenges with contractual issues (p=0.0056). Ministry of Health owned hospitals were more likely to report political interference in the outsourcing process (p= 0.0065). Rural hospitals were more likely to monitor the continued need for outsourcing compared to their urban counterparts (p=0.0358). We found no significant differences (p>0.05) in the hospital managers’ perceptions about the benefits of outsourcing, outsourcing risks, characteristics of services that need to be outsourced and outsourcing barriers among outsourcing and non-outsourcing hospitals. Conclusion: Hospital location and ownership have an influence on aspects of the outsourcing decision, process and practices by general hospitals in our study. However, the perceptions of the hospital managers regarding outsourcing have no influence on the hospital’s outsourcing decision and practices.
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Kabiri, Stella, Molly Allen, Juduth Toma Okuonzia, Beatrice Akello, Rebecca Ssabaganzi, and Drake Mubiru. "Detecting level of wetland encroachment for urban agriculture in Uganda using hyper-temporal remote sensing." AAS Open Research 3 (May 12, 2020): 18. http://dx.doi.org/10.12688/aasopenres.13040.1.
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Background: Urbanization is an important indicator of economic growth and social change but is associated with environmental degradation. In Uganda, wetlands cover an area of 11% of the country’s land area, of which half have been converted to industry and residential areas, and urban agriculture. Here, we investigate the extent of wetlands lost in two Ugandan cities, Wakiso and Kampala, in a period of 30 years. Secondly, we demonstrate a simple methodology to monitor agriculture on encroached wetlands. Methods: Using a field survey and free remote sensing data from Landsat TM 1986 and Landsat ETM 2016 we classified the rate of wetland loss and encroachment from 1986 to 2016. Using MODIS NDVI 16-day composites at 500-meter spatial resolution, we generated distinctive crops and crop mixtures in the encroached wetlands for urban agriculture using the ISODATA clustering algorithm. Results: Over 30 years, 72,828 ha (73%) of the Wakiso-Kampala wetlands have been lost. Agriculture areas have doubled, of which 16,488 ha (23%) were reclaimed from wetlands. All cultivated agriculture in Kampala was in the wetlands while in Wakiso, 73% of crop agriculture was in the wetlands. Major crops grown in these urban wetlands were banana (20%), sugarcane (22%), maize (17%), Eucalyptus trees (12%), sweet potatoes (10%). Conclusions: The Kampala-Wakiso wetlands have been disappearing at a rate of 2500 ha annually for the last 30 years. At this rate, there will be no wetlands left by 2029. Policy recommendations should promote wetland reclamation programs so as to restore and reconstruct lost and fragmented wetlands; should mandate food security and poverty eradication to convene with ministries regulating wetlands to merge conflicting policies; and should develop polices that are inclusive of challenges faced by the urban poor while at the same time minimize the pressures on urban environments.
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Haberer, Jessica E., Lindsey Garrison, John Bosco Tumuhairwe, Robert Baijuka, Edna Tindimwebwa, James Tinkamanyire, Bridget F. Burns, and Stephen Asiimwe. "Factors Affecting the Implementation of Electronic Antiretroviral Therapy Adherence Monitoring and Associated Interventions for Routine HIV Care in Uganda: Qualitative Study." Journal of Medical Internet Research 22, no. 9 (September 10, 2020): e18038. http://dx.doi.org/10.2196/18038.
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Background High, sustained adherence to HIV antiretroviral therapy (ART) is critical for achieving viral suppression, which in turn leads to important individual health benefits and reduced secondary viral transmission. Electronic adherence monitors record a date-and-time stamp with each opening as a proxy for pill-taking behavior. These monitors can be combined with interventions (eg, data-informed adherence counseling, SMS-based adherence support, and/or alarms) and have been shown to improve adherence in multiple settings. Their use, however, has largely been limited to the research context. Objective The goal of the research was to use the Consolidated Framework for Implementation Research (CFIR) to understand factors relevant for implementing a low-cost electronic adherence monitor and associated interventions for routine HIV clinical care in Uganda. Methods We conducted in-depth qualitative interviews with health care administrators, clinicians, and ART clients about likes and dislikes of the features and functions of electronic adherence monitors and associated interventions, their potential to influence HIV care, suggestions on how to measure their value, and recommendations for their use in routine care. We used an inductive, content analysis approach to understand participant perspectives, identifying aspects of CFIR most relevant to technology implementation in this setting. Results We interviewed 34 health care administrators/clinicians and 15 ART clients. Participants largely saw the monitors and associated interventions as favorable and beneficial for supporting adherence and improving clinical outcomes through efficient, differentiated care. Relevant outside factors included structural determinants of health, international norms around supporting adherence, and limited funding that necessitates careful assessment of costs and benefits. Within the clinic, the adherence data were felt likely to improve the quality of counseling and thereby morale, as well as increase the efficiency of care delivery. Existing infrastructure and care expenditures and the need for proper training were other noted considerations. At the individual level, the desire for good health and a welcomed pressure to adhere favored uptake of the monitors, although some participants were concerned with clients not using the monitors as planned and the influence of poverty, stigma, and need for privacy. Finally, participants felt that decisions around the implementation process would have to come from the Ministry of Health and other funders and would be influenced by sustainability of the technology and the target population for its use. Coordination across the health care system would be important for implementation. Conclusions Low-cost electronic adherence monitoring combined with data-informed counseling, SMS-based support, and/or alarms have potential for use in routine HIV care in Uganda. Key metrics of successful implementation will include their impact on efficiency of care delivery and clinical outcomes with careful attention paid to factors such as stigma and cost. Further theory-driven implementation science efforts will be needed to move promising technology from research into clinical care. Trial Registration ClinicalTrials.gov NCT03825952; https://clinicaltrials.gov/ct2/show/NCT03825952
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Hauser, Andrea, Kizito Mugenyi, Rose Kabasinguzi, Kerstin Bluethgen, Claudia Kuecherer, Gundel Harms, and Andrea Kunz. "Detection and Quantification of Minor Human Immunodeficiency Virus Type 1 Variants Harboring K103N and Y181C Resistance Mutations in Subtype A and D Isolates by Allele-Specific Real-Time PCR." Antimicrobial Agents and Chemotherapy 53, no. 7 (May 11, 2009): 2965–73. http://dx.doi.org/10.1128/aac.01672-08.
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ABSTRACTNevirapine (single dose), commonly used to prevent the mother-to-child transmission of human immunodeficiency virus (HIV) in developing countries, frequently induces viral resistance. Even mutations which occur only in a minor population of the HIV quasispecies (<20%) are associated with subsequent treatment failure but cannot be detected by population-based sequencing. We developed sensitive allele-specific real-time PCR (ASPCR) assays for two key resistance mutations of nevirapine. The assays were specifically designed to analyze HIV-1 subtype A and D isolates accounting for the majority of HIV infections in Uganda. Assays were evaluated using DNA standards and clinical samples of Ugandan women having preventively taken single-dose nevirapine. Lower detection limits of drug-resistant HIV type 1 (HIV-1) variants carrying reverse transcriptase mutations were 0.019% (K103N [AAC]), 0.013% (K103N [AAT]), and 0.29% (Y181C [TGT]), respectively. Accuracy and precision were high, with coefficients of variation (the standard ratio divided by the mean) of 0.02 to 0.15 for intra-assay variability and those of 0.07 to 0.15 (K103N) and 0.28 to 0.52 (Y181C) for inter-assay variability. ASPCR assays enabled the additional identification of 12 (20%) minor drug-resistant HIV variants in the 20 clinical Ugandan samples (3 mutation analyses per patient; 60 analyses in total) which were not detectable by population-based sequencing. The individual patient cutoff derived from the clinical baseline sample was more appropriate than the standard-based cutoff from cloned DNA. The latter is a suitable alternative since the presence/absence of drug-resistant HIV-1 strains was concordantly identified in 92% (55/60) of the analyses. These assays are useful to monitor the emergence and persistence of drug-resistant HIV-1 variants in subjects infected with HIV-1 subtypes A and D.
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Asiimwe, Caroline, Evan Lee, Lakshmi Sundaram, Yanis Ben Amor, Ebony Quinto, David Gelvin, David Bell, Matt Berg, and Charles Katureebe. "Use of an Innovative, Affordable, and Open-Source Short Message Service–Based Tool to Monitor Malaria in Remote Areas of Uganda." American Journal of Tropical Medicine and Hygiene 85, no. 1 (July 1, 2011): 26–33. http://dx.doi.org/10.4269/ajtmh.2011.10-0528.
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Wotton, S. R., M. A. Eaton, D. Sheehan, F. Barasa Munyekenye, I. J. Burfield, S. H. M. Butchart, K. Moleofi, et al. "Developing biodiversity indicators for African birds." Oryx 54, no. 1 (November 27, 2017): 62–73. http://dx.doi.org/10.1017/s0030605317001181.
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AbstractBiodiversity indicators are essential for monitoring the impacts of pressures on the state of nature, determining the effectiveness of policy responses, and tracking progress towards biodiversity targets and sustainable development goals. Indicators based on trends in the abundance of birds are widely used for these purposes in Europe and have been identified as priorities for development elsewhere. To facilitate this we established bird population monitoring schemes in three African countries, based on citizen science approaches used in Europe, aiming to monitor population trends in common and widespread species. We recorded > 500 bird species from c. 450 2-km transects in Botswana, > 750 species from c. 120 transects in Uganda, and > 630 species from c. 90 transects in Kenya. Provisional Wild Bird Indices indicate a strong increase in bird populations in Botswana and a small decrease in Uganda. We also provide comparisons between trends of habitat generalists and specialists, of birds within and outside protected areas, and between Afro-Palearctic migrants and resident birds. Challenges encountered included recruiting, training and retaining volunteer surveyors, and securing long-term funding. However, we show that with technical support and modest investment (c. USD 30,000 per scheme per year), meaningful biodiversity indicators can be generated and used in African countries. Sustained resourcing for the existing schemes, and replication elsewhere, would be a cost-effective way to improve our understanding of biodiversity trends globally, and measure progress towards environmental goals.
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Zheng, Dennis J., Patrick J. Sur, Mary Goretty Ariokot, Catherine Juillard, Mary Margaret Ajiko, and Rochelle A. Dicker. "Epidemiology of injured patients in rural Uganda: A prospective trauma registry’s first 1000 days." PLOS ONE 16, no. 1 (January 22, 2021): e0245779. http://dx.doi.org/10.1371/journal.pone.0245779.
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Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of injury in rural Uganda is limited. Hospital-based trauma registries are a critical tool in illustrating injury patterns and clinical outcomes. This study aims to characterize the traumatic injuries presenting to Soroti Regional Referral Hospital (SRRH) in order to identify opportunities for quality improvement and policy development. From October 2016 to July 2019, we prospectively captured data on injured patients using a locally designed, context-relevant trauma registry instrument. Information regarding patient demographics, injury characteristics, clinical information, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. A total of 4109 injured patients were treated during the study period. Median age was 26 years and 63% were male. Students (33%) and peasant farmers (31%) were the most affected occupations. Falls (36%) and road traffic injuries (RTIs, 35%) were the leading causes of injury. Nearly two-thirds of RTIs were motorcycle-related and only 16% involved a pedestrian. Over half (53%) of all patients had a fracture or a sprain. Suffering a burn or a head injury were significant predictors of mortality. The number of trauma patients enrolled in the study declined by five-fold when comparing the final six months and initial six months of the study. Implementation of a context-appropriate trauma registry in a resource-constrained setting is feasible. In rural Uganda, there is a significant need for injury prevention efforts to protect vulnerable populations such as children and women from trauma on roads and in the home. Orthopedic and neurosurgical care are important targets for the strengthening of health systems. The comprehensive data provided by a trauma registry will continue to inform such efforts and provide a way to monitor their progress moving forward.
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Workneh, Meklit, Matthew M. Hamill, Francis Kakooza, Emmanuel Mande, Jessica Wagner, Olive Mbabazi, Rodney Mugasha, et al. "Antimicrobial Resistance of Neisseria Gonorrhoeae in a Newly Implemented Surveillance Program in Uganda: Surveillance Report." JMIR Public Health and Surveillance 6, no. 2 (June 10, 2020): e17009. http://dx.doi.org/10.2196/17009.
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Background Neisseria gonorrhoeae (commonly known as gonorrhea) has developed resistance to all first-line therapy in Southeast Asia. East Africa has historically had absent or rudimentary gonorrhea surveillance programs and, while the existence of antimicrobial-resistant gonorrhea is recognized, the extent of its resistance is largely unknown. In 2016, the World Health Organization’s Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) was initiated in Uganda to monitor resistance trends. Objective This study characterizes gonorrhea and antibiotic resistance in a large surveillance program of men with urethral discharge syndrome from Kampala, Uganda. Methods Men attending sentinel clinics with urethritis provided demographic information, behavior data, and a urethral swab in line with the World Health Organization’s EGASP protocols for culture, identification, and antibiotic-sensitivity testing using 2 methods—disk diffusion (Kirby-Bauer test) and Etest (BioMérieux Inc). A subset of samples underwent detailed antimicrobial resistance testing. Results Of 639 samples collected from September 2016 to February 2018, 400 (62.6%) were culture-positive though 414 (64.8%) had microscopic evidence of gonorrhea. The mean age of the men from whom the samples were collected was 26.9 (SD 9.6) years and 7.2% (46/639) reported having HIV. There was high-level resistance to ciprofloxacin, tetracycline, and penicillin (greater than 90%) by Kirby-Bauer disk diffusion and 2.1% (4/188) had reduced azithromycin sensitivity by Etest. Of the early isolates that underwent detailed characterization, 60.3% (70/116) were culture-positive, 94% (66/69) isolates were either ciprofloxacin-resistant or ciprofloxacin-intermediate by Etest, 96% (65/68) were azithromycin-sensitive, and 96% (66/69) were gentamicin-sensitive. Resistance profiles were comparable between methods except for ceftriaxone (disk diffusion: 68/69, 99%; Etest: 67/69, 97%) and for gentamicin (disk diffusion: 2/8, 25%; Etest: 66/69, 96%) sensitivity. Conclusions This is the first report from a systematic gonorrhea surveillance program in Uganda. Findings demonstrated resistance or increased minimum inhibitory concentration to all key antigonococcal antibiotics. There was evidence of poor antibiotic stewardship, near-universal resistance to several antibiotics, and emerging resistance to others. Individuals in the population sampled were at exceptionally high risk of STI and HIV infection requiring intervention. Ongoing surveillance efforts to develop interventions to curtail antimicrobial-resistant gonorrhea are needed.
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Ssebugenyi, I., A. Kizza, B. Mpoza, G. Aluma, I. Boaz, K. Newell, O. Laeyendecker, J. P. Shott, D. Serwadda, and S. J. Reynolds. "Comparison of the Abbott m2000 HIV-1 Real-Time and Roche AMPLICOR Monitor v1.5 HIV-1 assays on plasma specimens from Rakai, Uganda." International Journal of STD & AIDS 22, no. 7 (July 2011): 373–75. http://dx.doi.org/10.1258/ijsa.2009.009526.
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Brachert, Thomas Christian, Gerhard B. Brügmann, Dieter F. Mertz, Ottmar Kullmer, Friedemann Schrenk, Dorrit E. Jacob, Immaculate Ssemmanda, and Heinrich Taubald. "Stable isotope variation in tooth enamel from Neogene hippopotamids: monitor of meso and global climate and rift dynamics on the Albertine Rift, Uganda." International Journal of Earth Sciences 99, no. 7 (February 4, 2010): 1663–75. http://dx.doi.org/10.1007/s00531-010-0518-1.
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Kizito, Mark, Rejani Lalitha, Henry Kajumbula, Ronald Ssenyonga, David Muyanja, and Pauline Byakika-Kibwika. "Antibiotic Prevalence Study and Factors Influencing Prescription of WHO Watch Category Antibiotic Ceftriaxone in a Tertiary Care Private Not for Profit Hospital in Uganda." Antibiotics 10, no. 10 (September 26, 2021): 1167. http://dx.doi.org/10.3390/antibiotics10101167.
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Background: Excessive use of ceftriaxone contributes to the emergence and spread of antimicrobial resistance (AMR). In low and middle-income countries, antibiotics are overused but data on consumption are scarcely available. We aimed to determine the prevalence and factors influencing ceftriaxone prescription in a tertiary care private not-for-profit hospital in Uganda. Methods: A cross-sectional study was carried out from October 2019 through May 2020 at Mengo Hospital in Uganda. Patients admitted to the medical ward and who had been prescribed antibiotics were enrolled. Sociodemographic and clinical data were recorded in a structured questionnaire. Bivariate and adjusted logistic regression analyses were performed to determine factors associated with ceftriaxone prescription. Results: Study participants were mostly female (54.7%). The mean age was 56.2 years (SD: 21.42). The majority (187, 73.3%) presented with fever. Out of the 255 participants included in this study, 129 (50.6%) participants were prescribed ceftriaxone. Sixty-five (25.5%) and forty-one (16.0%) participants had a prescription of levofloxacin and metronidazole, respectively. Seven participants (2.7%) had a prescription of meropenem. Out of 129 ceftriaxone prescriptions, 31 (24.0%) were in combination with other antibiotics. Overall, broad-spectrum antibiotic prescriptions accounted for 216 (84.7%) of all prescriptions. Ceftriaxone was commonly prescribed for pneumonia (40/129, 31%) and sepsis (38/129, 29.5%). Dysuria [OR = 0.233, 95% CI (0.07–0.77), p = 0.017] and prophylactic indication [OR = 7.171, 95% CI (1.36–37.83), p = 0.020] were significantly associated with ceftriaxone prescription. Conclusions: Overall, we observed a high prevalence of prescriptions of ceftriaxone at the medical ward of Mengo Hospital. We recommend an antibiotic stewardship program (ASP) to monitor antibiotic prescription and sensitivity patterns in a bid to curb AMR.
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STANDLEY, C. J., L. MUGISHA, M. ADRIKO, M. ARINAITWE, J. RUKUNDO, L. AJAROVA, S. MOPYA, M. BETSON, N. B. KABATEREINE, and J. R. STOTHARD. "Intestinal schistosomiasis in chimpanzees on Ngamba Island, Uganda: observations on liver fibrosis, schistosome genetic diversity and praziquantel treatment." Parasitology 140, no. 3 (October 25, 2012): 285–95. http://dx.doi.org/10.1017/s0031182012001576.
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SUMMARYDespite treatment with praziquantel (PZQ) at 40 mg/kg in food, several chimpanzees on Ngamba Island Chimpanzee Sanctuary (NICS) continue to excrete eggs of Schistosoma mansoni. To monitor disease, 8 animals were closely examined under anaesthesia in March 2011 with portable ultrasonography and by rectal snip biopsy. Schistosome genetic diversity had been previously assayed within 4 of these chimpanzees, finding extensive diversity with 27 DNA barcodes encountered, although none was common to all animals. Calcified schistosome eggs were found in the rectal snips from 5 chimpanzees and liver fibrosis was clearly documented, indicative of progressive disease in 6 animals, the latter being surprisingly advanced in a younger chimpanzee. All 8 animals were treated under anaesthesia by oral gavage with PZQ at 60 mg/kg dosing that was well tolerated. These animals were again re-examined in June 2012 using stool and urine sampling. Only 1 chimpanzee appeared to be free from infection and active egg excretion was confirmed in 6 animals. If intestinal schistosomiasis is to be controlled within this setting, a long-term disease management plan is required which should combine active case-detection with an insistent treatment regime with praziquantel for these chimpanzees, exploring perhaps the performance of even higher dosing.
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Waiswa, Charles, K. Picozzi, W. Olaho-Mukani, and E. Katunguka-Rwakishaya. "Monitor lizard (Varanus niloticus, Linnaeus, 1766) as a host for tsetse (Glossina fuscipes fuscipes, Newstead, 1910) in the sleeping sickness endemic foci of Uganda." African Journal of Ecology 41, no. 4 (December 2003): 349–51. http://dx.doi.org/10.1111/j.1365-2028.2003.00477.x.
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Mukooza, Edward Kibikyo. "Health Risk Associated with Near-Road Ambient Air Concentration of Particulate Matter in Mukono Municipal Council, Uganda." TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH 9, no. 1 (March 31, 2021): 127–37. http://dx.doi.org/10.21522/tijph.2013.09.01.art014.
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More than 98% of urban centres exceeding 100,000 people in Low and Middle-Income Countries (LMICs), do not meet the WHO air quality limits. Data on air pollution from LMICs is scarce. We measured the mean concentrations of near-road PM2.5 in the period of Aug.-Dec. 2020, described the Mukono Municipality’s near-road populations’ exposure to PM2.5, and assessed the associated health risk. PurpleAir PA-II laser particle counters, measured near-road ambient air PM2.5 concentration in Mukono Municipality during the period of 09/1/20 to 12/04/20. Excel Toolpak was used for data analysis and the health risk assessed with the WHO AirQ+ tool. The mean ambient near–road PM2.5 in Mukono Municipality were 30.97, 33.84 and 47.74 ug/m3for background, near-unpaved and near-paved roads, respectively. Mukono Municipality’s population was exposed to ambient PM2.5 concentrations higher than the WHO annual limit of 10 ug/m3. This level of air pollution is associated with preventable annual premature deaths of up to 133.11 per 100,000 population. Vehicles were assumed to be the predominant source of near-road ambient air PM2.5 pollution. The Municipality’s population was exposed to near-road ambient air PM2.5 exceeding the WHO annual limit by as much as *4.7 for the paved roads, *3.3 for the unpaved roads and *3 for the background. This leads to increased risk of preventable premature deaths in the Municipality.Mukono Municipality could monitor PM2.5; guide developers to placebuildings more than 100 meters away from roadsides and should promotepolicies for newer vehicles on Ugandan roads.
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Herzberg, Anne, and Gerald M. Steinberg. "IHL 2.0: Is There a Role for Social Media in Monitoring and Enforcement?" Israel Law Review 45, no. 3 (October 30, 2012): 493–536. http://dx.doi.org/10.1017/s0021223712000180.
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This article will examine the opportunities and limitations of using social media in the execution of legal duties relating to the monitoring and enforcement of IHL. The article will first provide an overview of social media. Next, it will briefly summarise the normative framework of IHL as well as the legal duties of the primary actors and promoters of IHL (for example, states, the UN, NGOs, the International Committee of the Red Cross and courts) to monitor and enforce these rules. The article will then address specific legal obligations relating to IHL monitoring and enforcement and the impact of social media on meeting these requirements.Throughout, the article will use case studies from several conflict zones, including Sudan, Uganda, Mexico, Somalia, Gaza and Libya. The article will conclude that social media can play a critical role in promoting IHL education, and monitoring for potential violations. The benefits of this technology, however, are less clear for carrying out legal obligations related to the enforcement of IHL, such as fact-finding, arrest and prosecution. It is essential, therefore, that clear guidelines for utilising this quickly evolving technology, particularly in official fact-finding and judicial frameworks, be established.
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Olodi, D., P. Asiimwe, and P. Ebusu. "Fostering a Multisectoral Approach in the Fight Against Cancer in Uganda: The Launch of the National Cancer Symposium." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 159s. http://dx.doi.org/10.1200/jgo.18.73300.
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Background and context: The 70th World Health Assembly Cancer Resolution was passed in May 2017. In Uganda, there is a clear need for social mobilization and to involve all stakeholders in the process of implementing the Cancer Resolution. The National Cancer Symposium (NCS) was launched on the 28th February 2018 to create an inclusive process where all sectors and stakeholders are engaged in the dialogue and processes leading to effective cancer control in Uganda. Aim: To build a systematic and impactful response to cancer epidemic in Uganda through a multisectoral approach. Strategy/Tactics: These included but not limited to; partnership through the TWG, media campaigns, lobbying, team meetings and panel/plenary discussions. Program/Policy process: NCS is an annual joint stakeholder event that will foster stakeholders' discussion and stock taking of progress made toward implementation of cancer control efforts. A Technical Working Group (TWG) comprised of representation from government, WHO, civil society, academia, professional bodies and international partners, has been constituted to lead the planning, coordination and execution. Outcomes: Increased collaboration and partnerships built among partners as demonstrated in commitment for joint cancer control efforts. A total of over 300 participants attended the event representing different agencies including religious groups, private sector, media, policy makers, government ministries and departments, civil society, development partners, cancer survivors and patients, and the general public. Wider publicity gained as over 3 national level newspapers ( New Vision, The Observer, and The Monitor publications) run the story about NCS. A total of 1028 people reacted to our posts on Facebook with 41 likes, 40 post clicks and 2 shares. The Prime Minister re-echoed the restoration of radiotherapy services and made commitment on the procurement of more radiotherapy equipment as the construction of the new bunker progresses. The panel discussion led to the recognition that cancer control requires a multisectoral approach if interventions are to become more effective. Deliberations at the panel discussions re-echoed the need for the population to be sensitive to the risk factors including tobacco usage, body activity, proper diet with emphasis on vegetables and fiber, among others. What was learned: We learned that through coalescing with stakeholders, we are able to come up with a much stronger voice. The working of the TWG of this symposium is a clear testimony to this. We also learned that the media is an important partner for greater visibility to be realized. There is great need for continuous engagement among stakeholders to influence policy decisions and general intervention in the fight against cancer.
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Carranza-Torres, Javier Andrés. "How can traditional statistical relationships be redefined through citizen to government partnerships?" Statistical Journal of the IAOS 37, no. 1 (March 22, 2021): 229–43. http://dx.doi.org/10.3233/sji-190578.
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The post-2015 Development Agenda proposes to produce much more statistics and data than currently available in the official arena through advanced methods and innovative partnerships. By associating governments and data producers of all kinds it aims to monitor the Sustainable Development Goals (SDGs). The objective of this paper is to explore and analyse one of the 2030 Agenda greatest challenges, i.e. to redefine traditional statistical relationships and processes to associate citizenry as an active stakeholder in the monitoring of SDGs. It proposes innovative ideas linking citizen-to-government and government-to-citizen data partnerships (C2G dp and G2C dp) to the SDG requirements. The paper portrays and analyses the benefits for parties of alternative projects from Uganda, Canada and Uruguay. The C2G dp Stats Up program is featured as an additional case study, describing its achievements and shortcomings. This contribution constitutes a valuable co-creation case to fill the gap of lack of partnering skills. In sum, the paper presents the added value of a constructive socio-technical approach to SDG 17. Final conclusions propose a roadmap to support the work of National Statistical Offices to address complex challenges to walk the talk of the 2030 Agenda harnessing the crucial role of civil society in their plans.
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D’Arcy, Nikki, Diane Ashiru-Oredope, Omotayo Olaoye, Daniel Afriyie, Zainab Akello, Daniel Ankrah, Derrick Mawuena Asima, et al. "Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented." Antibiotics 10, no. 9 (September 17, 2021): 1122. http://dx.doi.org/10.3390/antibiotics10091122.
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Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base.
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Mpango, Richard Stephen, Wilber Ssembajjwe, Sylvia Kiwuwa Muyingo, Kenneth D. Gadow, Vikram Patel, and Eugene Kinyanda. "Adaptation and validation of a brief DSM-5 based psychiatric rating scale for childhood and adolescent mental health in Uganda: the Child and Adolescent Symptom Inventory-Progress Monitor (CASI-PM)." Vulnerable Children and Youth Studies 15, no. 2 (November 7, 2019): 144–54. http://dx.doi.org/10.1080/17450128.2019.1686672.
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Thompson, Nicole A., Emily Otali, Zarin Machanda, Martin Muller, Richard Wrangham, and Melissa Emery-Thompson. "URINARY MARKERS OF OXIDATIVE STRESS CORRESPOND TO INFECTION AND AGING IN WILD CHIMPANZEES." Innovation in Aging 3, Supplement_1 (November 2019): S896. http://dx.doi.org/10.1093/geroni/igz038.3275.
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Abstract Oxidative stress (OS) plays a central role in aging and results from a variety of stressors, making it a powerful measure of health and a way to examine phylogenetic variation in life history. However, few urinary OS markers have been examined under field conditions, particularly in primates, and their utility to non-invasively monitor acute vs. chronic conditions is poorly understood. In this study, we examined variation in 5 urinary markers of oxidative damage and protection under 5 validation paradigms in 37 wild, adult chimpanzees living in the Kibale National Park, Uganda. We used 925 urine samples to conduct both cross-sectional and within-individual analyses of responses to acute infection and variation with age. Markers of damage (8-OHdG, F-isoprostanes, MDA-TBARS, and neopterin) and total antioxidant capacity were generally positively correlated with one another. Within individuals, all markers responded to at least one if not both types of acute infection. Markers of damage also varied with age, particularly in individuals near death. Unlike in human and rodent tissues, DNA damage in urine decreased with age, both across and within individuals near death, suggesting a potential decline in DNA repair and/or metabolic rate during senescence. Our results suggest that OS can be measured using field-collected urine and may be useful for both short- and long-term indicators of health. Our results further confirm that using multiple markers and longitudinal sampling within individuals is the most productive approach for studies that seek to determine the role of OS in health and lifespan in long-lived organisms.
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Etyang, Charles, Grace Nambozi, and Laura Brennaman. "A Nurse-Led Low-Cost Intervention Effectively Traces Prevalence of Catheter Associated Urinary Tract Infections at a Low-Resourced Regional Referral Hospital in Western Uganda: A Case for Policy Change." Policy, Politics, & Nursing Practice 21, no. 1 (November 11, 2019): 4–11. http://dx.doi.org/10.1177/1527154419886289.
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Catheter associated urinary tract infection (CAUTI) is the most common hospital-acquired infection worldwide. Low- and middle-income countries (LMICs) with limited resources for health care have not allocated resources to adequately monitor or prevent CAUTIs. The infection is associated with several adverse clinical outcomes, including antibiotic resistance, septicemia, and prolonged hospital stays, that burden the already resource-constrained health systems in LMICs with increased morbidity, health care costs, and deaths. Owing to the lack of resource allocation, little is known about the prevalence of CAUTI in the government-owned and operated hospitals in LIMCs. The purpose of this research was to test a method of CAUTI prevalence surveillance suitable to the resource-constrained health system in a LMIC and to determine the prevalence of CAUTI among hospitalized patients at the study site. In an intermittent 4-week data collection plan, the sample of 68 catheterized adult participants was evaluated for the presence of CAUTI using the three-pronged screening criteria of American Urological Society. CAUTI prevalence in the sample was 17.6%. The high prevalence of CAUTI in this sample represents a substantial risk of consequences to hospitalized patients and to the resource-constrained health system in this LMIC. This first report of CAUTI surveillance using readily available and affordable tools provides evidence to health ministry policymakers of the need for and value of monitoring and prevention programs for hospital-acquired infections in LMICs. We recommend LMIC health policymakers to establish infection prevention teams in hospitals and provide resources to continue surveillance and prevention of CAUTI and other hospital-acquired infections.
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Soi, Caroline, Jessica C. Shearer, Ashwin Budden, Emily Carnahan, Nicole Salisbury, Gilbert Asiimwe, Baltazar Chilundo, et al. "How to evaluate the implementation of complex health programmes in low-income settings: the approach of the Gavi Full Country Evaluations." Health Policy and Planning 35, Supplement_2 (November 1, 2020): ii35—ii46. http://dx.doi.org/10.1093/heapol/czaa127.
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Abstract Vaccination, like most other public health services, relies on a complex package of intervention components, functioning systems and committed actors to achieve universal coverage. Despite significant investment in immunization programmes, national coverage trends have slowed and equity gaps have grown. This paper describes the design and implementation of the Gavi Full Country Evaluations, a multi-country, prospective, mixed-methods approach whose goal was to monitor and evaluate processes, inputs, outputs and outcomes of immunization programmes in Bangladesh, Mozambique, Uganda and Zambia. We implemented the Full Country Evaluations from 2013 to 2018 with the goal of identifying the drivers of immunization programme improvement to support programme implementation and increase equitable immunization coverage. The framework supported methodological and paradigmatic flexibility to respond to a broad range of evaluation and implementation research questions at global, national and cross-country levels, but was primarily underpinned by a focus on evaluating processes and identifying the root causes of implementation breakdowns. Process evaluation was driven by theories of change for each Gavi funding stream (e.g. Health Systems Strengthening) or activity, ranging from global policy development to district-level programme implementation. Mixing of methods increased in relevance and rigour over time as we learned to build multiple methods into increasingly tailored evaluation questions. Evaluation teams in country-based research institutes increasingly strengthened their level of embeddedness with immunization programmes as the emphasis shifted over time to focus more heavily on the use of findings for programme learning and adaptation. Based on our experiences implementing this approach, we recommend it for the evaluation of other complex interventions, health programmes or development assistance.
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Diaz, Sophia, Tristan Ford, Monet Slinowsky, Kiley Gersch, Ebenezer Armah, Karina Frank, Zachary Buono, Margaret Glancey, Adam Goodwin, and Soumyadipta Acharya. "4524 Fighting Malaria, One Image at a Time: Using Computer Vision to Develop an Automated Vector Speciation Tool." Journal of Clinical and Translational Science 4, s1 (June 2020): 42. http://dx.doi.org/10.1017/cts.2020.159.
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OBJECTIVES/GOALS: Rapid and accurate identification of primary malaria vector species from collected specimens is the most critical aspect of effective vector surveillance and control. This interdisciplinary team of engineers aims to automate identification using a deep learning computer vision algorithm. METHODS/STUDY POPULATION: The team spent August of 2019 observing and participating in control and surveillance activities in Zambia and Uganda. They conducted >65 interviews with key stakeholders across 9 malaria control and surveillance sites, ranging from field and community health workers, to malaria researchers and Ministry of Health employees. Stakeholder feedback validated the need for a more accurate and efficient method of vector identification in order to more effectively deploy targeted malaria interventions. The team set forth in designing and prototyping a portable, automated field tool that could speciate mosquito vectors to the complex level using artificial intelligence. RESULTS/ANTICIPATED RESULTS: The team’s research demonstrated that accuracy, cost effectiveness, and ease of use would be critical to the successful adoption of the tool. Results of initial prototyping, usability studies, and stakeholder surveys were used to determine the tool’s minimal user specifications: 1) the ability to distinguish between Anopheles Gambiae and Anopheles Funestus, the two principal malaria vectors in the countries visited, 2) achieving an identification accuracy of ≥90% to the complex level, and 3) accessibility to the speciation data 3-7 days following vector collection. Next steps include optimizing the tool to deploy a minimal viable product for testing in Kenya by the summer of 2020. DISCUSSION/SIGNIFICANCE OF IMPACT: The accurate, high-quality surveillance enabled by this device would allow malaria control programs to scale surveillance to remote regions where an entomologist may not be available, allowing malaria programs to deploy effective interventions, monitor results, and prevent disease.
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Ntinginya, Nyanda E. "OC 8718 WHAT DID WE LEARN FROM PANACEA 1 CLINICAL TRIALS?" BMJ Global Health 4, Suppl 3 (April 2019): A17.2—A17. http://dx.doi.org/10.1136/bmjgh-2019-edc.42.
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BackgroundThe Pan African Consortium for the Evaluation of Anti-Tuberculosis Antibiotics (PanACEA) was designed to build clinical tuberculosis (TB) trial capacity whilst conducting clinical trials on novel and existing agents to shorten and simplify TB treatment. One of the objectives was to conduct, mentor and monitor observational and clinical studies at sites in 6 Sub-Saharan TB-endemic countries (Gabon, Kenya, South Africa, Tanzania, Uganda and Zambia)MethodsLearning through experience. All centres in the 6 countries self-assessed their requirements for capacity development in the following fields: a) clinical staff availability and experience; b) TB laboratory infrastructure and staff; c) safety laboratory infrastructure and staff; d) clinical site facilities and equipment; e) pharmacy facilities and staff; IT facilities; and f) overall training needs of site personnel.ResultsFrom March 2011 – June 2014, we conducted four epidemiological studies (characterising TB patient populations in preparation for future studies) and five phase II studies (GCP standard intervention trials).By working together in epidemiological and clinical trials, the sites identified their needs for resources and training as well as developing capabilities to perform independent large-scale TB clinical trials beyond PanACEA-initiated trials. Through the ReMoxTB study, for example, laboratories were brought to an international standard for safety and mycobacterial expertise. Furthermore, through developing skill-sets related to EBA studies, sites have since then attracted other sponsors for further studies.Sites could be mentored to perform GCP-compliant clinical TB trials that is built on sound physical infrastructure, training and strong on-site leadership.ConclusionThe learning-by-doing approach meant that staff could be trained whilst acquiring new core competencies and revealing operational gaps. Our experience of conducting TB trials within an environment of mentoring, networking and training has provided a platform for establishing future sustainable research centres that has capacities to conduct highly regulated studies.
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Oguttu, David, Christine Nahabwe, Thomas R. Unnasch, Edson Byamukama, Thomson Lakwo, Moses Katabarwa, Monica Ngabirano, et al. "Serosurveillance to Monitor Onchocerciasis Elimination: The Ugandan Experience." American Journal of Tropical Medicine and Hygiene 90, no. 2 (February 5, 2014): 339–45. http://dx.doi.org/10.4269/ajtmh.13-0546.
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Goy, Jennifer, Ruth Namazzi, Heather Ann Hume, Henry Ddungu, Musa K. Waiswa, Rohin Malhotra, Deborah J. Cook, and Mark A. Crowther. "Non-Invasive Hemoglobin Measurements In Anemic Patients." Blood 122, no. 21 (November 15, 2013): 2970. http://dx.doi.org/10.1182/blood.v122.21.2970.2970.
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Abstract Background Non-invasive Hemoglobin Measurement (NIHM) devices have recently become available in clinical practice. These point-of-care devices use spectrophotometry to measure hemoglobin (Hb), providing real-time results and do not require blood draws. However, the validity of this technology has not been examined in patients with moderate to severe anemia (Hb< 90g/L). The purpose of this study is to examine the validity and performance of non-invasive hemoglobin measurements (NIHM) among anemic patients in the real world setting. Methods Patients were recruited from two clinical settings that are highly applicable this technology. (i) The intensive care setting, where frequent blood draws contribute to anemia. Patients were recruited from three tertiary care critical care units (ii) A developing country setting. Patients were recruited from the Internal Medicine and Paediatrics wards at Mulago hospital in Kampala, Uganda. An additional cohort of patients was recruited from an outpatient Hematology clinic which served as a comparator group. All patients were enrolled in a consecutive manner. In the ICU population, patients were recruited through a consecutive, convenience sample in order to maximize patients with hemoglobin values < 90 g/L. The Pronto 7® NIHM device was compared to Coulter Counter Complete Blood Count (CBC) measurements. All CBC were processed at College of American Pathologist or Ontario Laboratory Accreditation approved labs; all CBC determinations were drawn within 4 hours of the Pronto determination in patients with stable hemoglobin values. Basic demographics along with suspected etiology of anemia were also collected. The consistency between CBC and NIHM was assessed by Pearson's Correlation, mean difference and linear regression. The study was reviewed by the Integrated REB at both St Joseph's Hospital, Hamilton and Mulago Hospital and Makerere University in Uganda. As a minimal risk study, the requirement for consent was waived at the Hamilton sites by the research ethics board. Consent was obtained from Ugandan participants. Results 188 patients were recruited. a. ICU population. Seventy four patients were recruited with mean age of 61 years (range 16-89). The patients were of a medical (n=44; 69%), surgical (n=17; 23%), trauma (n=7; 18%) mixed population (n=6; 13%). The mean Hb on CBC was 97 g/L. Forty patients (53%) had an Hb less than 90 g/L. The mean absolute difference between the CBC and NIHM was 14.85 (range 0-53g/L). The overall Pearson correlation coefficient was 0.62 and the R2 value was 0.37. b. Ugandan population. Eighty-three patients were recruited (31 pediatric and 52 adult) with a mean age of 27 (range 2-80). The mean Hb value on CBC was 80 g/L and 43% percent of patients had Hb values than 70 g/L. Seventeen percent of patients had sickle cell disease. NIHM were not obtainable in over half (n=55 (65%) of the study population) and in 30 of the 31 pediatric patients. In those who could be tested the mean absolute difference between the CBC and NIHM was 24 g/L (range 0-72) with Pearson coefficient of 0.84 and R2 value of 0.71. c. Outpatient population. Thirty one patients were recruited with mean age of 66. The mean Hb value was 119 g/L with mean absolute difference between the CBC and NIHM of 14.6 g/L (range 1-43 g/L) with Pearson correlation coefficient of 0.69 and R2 of 0.47. Figure 1 shows the scatter plot for the three patient groups. In all three groups, the majority of data points fall to the right of the line of equal value between NIHM and CBC measurements, indicating a tendency of the device towards overestimation of the hemoglobin. Discussion This is the first study of NIHM to target the patients with moderate to severe anemia and to include pediatric patients and those with hemoglobinopathy. There is only moderate degree of correlation between the NIHM and CBC measurements with the NIHM demonstrating a consistent positive bias. The positive bias was seen in all patient groups, and both the inpatient and outpatient setting. The device was unable to provide measurements in children though this may have been due the probe size available to the investigators. The discrepancy in values between NIHM and venipuncture CBC values suggests that the non-invasive hemoglobin monitor will be of limited utility in the patient groups evaluated in this study. Disclosures: Crowther: Asahi Kasai: Membership on an entity’s Board of Directors or advisory committees; Baxter: Membership on an entity’s Board of Directors or advisory committees, Speakers Bureau; Boehringer Ingelheim: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees; CSL Behring: Speakers Bureau; Leo Pharma: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding, Speakers Bureau; Merck: Consultancy; Octapharma: Consultancy, Membership on an entity’s Board of Directors or advisory committees; Pfizer: Consultancy, Honoraria, Research Funding; Sanofi-Aventis: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Viropharma: Membership on an entity’s Board of Directors or advisory committees.
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Krezanoski, Paul J., Data Santorino, Nuriat Nambogo, Jeffrey I. Campbell, and David R. Bangsberg. "Maternal Attitudes about Objectively Monitored Bednet Use in Rural Uganda." Malaria Research and Treatment 2016 (October 19, 2016): 1–8. http://dx.doi.org/10.1155/2016/8727131.
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Insecticide-treated bednets (ITNs) are a mainstay of malaria prevention, yet poor adherence poses a major barrier to effective prevention. Self-reports of bednet use suffer from recall and social desirability biases. We have designed a device that electronically records ITN usage longitudinally. SmartNet consists of circuits made from a conductive fabric interwoven into the sides and top of a rectangular ITN. Digital sampling of the state of these circuits allows for determining whether the SmartNet is deployed for use or folded up. We conducted a study among pregnant women and women with children <5 years in Uganda to determine attitudes about objective bednet monitoring and SmartNet. Fifty women were interviewed with an average age of 27 years and 2.3 children. Twenty-two percent were pregnant. Ninety-five percent had used a bednet and 90% reported having a bednet at home. After displaying a SmartNet, 92% thought it would be easy to use and 100% expressed interest in using SmartNet. Concerns about SmartNet included washing the net, worries about being monitored while asleep, and worries about users removing the device components. Objective monitoring of ITN use appears to be acceptable among women in rural Uganda, setting the stage for further SmartNet field testing.
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Gashakamba, Faustin. "Integrated Landscape Assessment and Monitoring (ILAM): A cost-effective approach towards informed decision-making for natural resources management." Biodiversity Information Science and Standards 2 (May 22, 2018): e26304. http://dx.doi.org/10.3897/biss.2.26304.
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As the world strives towards achieving Sustainable Development Goals, development planners both at national and local levels have now come to understand the importance of informed decision-making. Natural resources management is one of the areas where careful planning is required to ensure sustainable use of and maximum benefit from the services we get from ecosystems. In developing countries, the scarcity of resources (both in terms of funding and skills) constitutes the main hindrance to the generation of accurate and timely data and information that would guide planning and implementation of development strategies. As a result, decisions are taken on an ad-hoc basis and without possibility of appreciating the long-term effect of these decisions. In that regard, Albertine Rift Conservation Society (ARCOS) has developed a participatory and cost-effective framework to monitor the status and trends of biodiversity and ecosystem services at the landscape level and to assess the socio-economic conditions that affect them. The approach termed “Integrated Landscape Assessment and Monitoring – ILAM” uses the Driver-Pressure-State-Impact-Response model and applies a simple indicators framework that allows teams to collect needed data in a rapid and cost-effective way. Burkhard and Müller (2008) This approach is flexible enough to be adaptable to the available time and funding resources and is therefore very suitable to be applied in the context of the developing world including east-African countries. This flexibility ranges from the use GIS and remote sensing techniques combined with thorough biodiversity field surveys to simple rapid assessment of key indicators using smaller teams and for short periods of time in the field. Since 2013, ARCOS has been biennially conducting ILAM studies in its five focal landscapes in Rwanda, Uganda and Burundi and the results have influenced major decisions such as the designation of at least two wetlands as Ramsar sites and the upgrade of one forest as a national park. In addition to this, other planning processes have been informed by the results of these studies, such as the process to develop the new Rwandan National Strategy for Transformation for 2017–2024 and the development of the districts’ strategic plans for 2018–2024. Currently the biodiversity data generated through these studies is being published by Global Biodiversity Information Facility (GBIF) for wider access by researchers and educators in the region and a portal, the ARCOS Biodiversity Information Management System (ARBIMS), has been established to facilitate sharing of data and information to guide planning and decision-making in the region.
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Robie, David. "EDITORIAL: Mercenaries and the media." Pacific Journalism Review : Te Koakoa 4, no. 1 (November 1, 1997): 5–8. http://dx.doi.org/10.24135/pjr.v4i1.606.
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News breaks—or develops—on the Net these days with remarkable ease. News organisations are without the Internet at their peril. At the Commonwealth Journalists Association conference in Hong Kong during January, the Pacific delegation heard a Ugandan editor, Kevin Ogen, describe in details how his newspaper, The Monitor broke a major corruption story using the Net.
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Opuda-Asibo, J., L. Siefert, L. Omamure-Epaye, T. Ekopai, and H. Kyeyamwa. "Rinderpest vaccination responses among calves and adult cattle in Uganda monitored using ELISA assay." Comparative Immunology, Microbiology and Infectious Diseases 16, no. 4 (October 1993): 273–79. http://dx.doi.org/10.1016/0147-9571(93)90156-y.
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Oyana, Tonny, Ellen Kayendeke, and Samuel Adu-Prah. "Assessing Performance of Leaf Area Index in a Monitored Mountain Ecosystem on Mount Elgon-Uganda." International Journal of Applied Geospatial Research 8, no. 1 (January 2017): 64–80. http://dx.doi.org/10.4018/ijagr.2017010104.
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This study investigated the performance of leaf area index (LAI) and photosynthetically active radiation (PAR) in a mountain ecosystem. The authors hypothesized that significant spatial and temporal differences exist in LAI and PAR values in the Manafwa catchment on Mt. Elgon. This was accomplished through field measurements of actual LAI and PAR values of diverse vegetation types along a ~900m altitudinal gradient (1141–2029 masl) in the catchment. In-situ measurements were obtained from 841 micro-scale study plots in 28 sampling plots using high resolution LAI sensors. The findings showed a significant positive relationship exists between elevation and observed LAI (r = 0.45, p = 0.01). A regression model further shows that elevation and curvature of the landscape slope were highly significant (p < 0.00002) predictors of LAI. Finally, the authors detected significant spatial and temporal differences in LAI and PAR values in the study area. The study provides a critical basis for setting up long-term monitoring plans to understand mountain ecosystems and global climate change.
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Krezanoski, Paul J., Data Santorino, Alfred Agaba, Grant Dorsey, David R. Bangsberg, and Ryan W. Carroll. "How Are Insecticide-Treated Bednets Used in Ugandan Households? A Comprehensive Characterization of Bednet Adherence Using a Remote Monitor." American Journal of Tropical Medicine and Hygiene 101, no. 2 (August 7, 2019): 404–11. http://dx.doi.org/10.4269/ajtmh.19-0032.
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Kraef, Christian, Pamela A. Juma, Joseph Mucumbitsi, Kaushik Ramaiya, Francois Ndikumwenayo, Per Kallestrup, and Gerald Yonga. "Fighting non-communicable diseases in East Africa: assessing progress and identifying the next steps." BMJ Global Health 5, no. 11 (November 2020): e003325. http://dx.doi.org/10.1136/bmjgh-2020-003325.
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Sub-Saharan Africa has seen a rapid increase in non-communicable disease (NCD) burden over the last decades. The East African Community (EAC) comprises Burundi, Rwanda, Kenya, Tanzania, South Sudan and Uganda, with a population of 177 million. In those countries, 40% of deaths in 2015 were attributable to NCDs. We review the status of the NCD response in the countries of the EAC based on the available monitoring tools, the WHO NCD progress monitors in 2017 and 2020 and the East African NCD Alliance benchmark survey in 2017. In the EAC, modest progress in governance, prevention of risk factors, monitoring, surveillance and evaluation of health systems can be observed. Many policies exist on paper, implementation and healthcare are weak and there are large regional and subnational differences. Enhanced efforts by regional and national policy-makers, non-governmental organisations and other stakeholders are needed to ensure future NCD policies and implementation improvements.
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Cilliers, Jacobus, Ibrahim Kasirye, Clare Leaver, Pieter Serneels, and Andrew Zeitlin. "Pay for locally monitored performance? A welfare analysis for teacher attendance in Ugandan primary schools." Journal of Public Economics 167 (November 2018): 69–90. http://dx.doi.org/10.1016/j.jpubeco.2018.04.010.
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