Faculty of Health Sciences

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Low Cost and Environmental Friendly Indoor Storage Methods of Guarding Food against Rodents in a Store
(Scholars World-International Refereed Journal of Arts, Science & Commerce, 2018) Nyamweha, Robin Bruce; Bwambale, Enos; Kakyo, Alexis Tracy
Rodents are serious pests in agriculture both in field and food stores putting food security and nutrition under big threat. This calls for effective control measures before they can cause economic damage. In this study, three indoor storage methods were evaluated in regard to their effectiveness in guarding food against rodents in a store; hanging baskets, metallic drum and cupboard storage methods. Hanging baskets was investigated by keeping 200 grams of maize seeds in form of small buckets hanged with a banana fibre string tied at the roof. While the use of metallic drums was investigated using sauce pan which were covered on top with another pan supported with a heavy load as metallic container, 200 grams of maize seeds were on plastic plates kept in three chambered wooden cupboard. In additional to the three methods, control treatment was in place for comparison purpose. Each method was replicated three times for the purpose of reliability. Daily monitoring was done to check for damaged seeds, contamination and weight losses. The software “R” was used to perform one-way ANOVA to find the significant differences in losses, rate of damage and contamination at 0.05 significant level. There are significant differences in loss, contamination and damages of maize seed among the different indoor storage methods (p <0.05). Highest losses incurred in cupboard and control methods of 156 grams and 144 grams respectively. While there were no losses registered for seeds stored in metallic containers and hanging baskets. Hanging baskets and metallic containers (drums) were confirmed as most effective indoor storage methods in guarding food against rodents.
Global cultural and public health challenges: the impact of conflict on health care in the Rhino camp refugee settlements in Uganda
(Sci Forschen, 2018-03-13) Kagabo, Robert; Frost, Caren J.; Case, Brynley; Porter, Meagan; Adaku, Alex; Alumai, Alfred
The African continent has experienced much political instability for the last few decades. The instabilities have led to unending wars. These wars cause huge numbers in a population to flee for their safety, thus creating an ever increasing number of displaced persons and refugees. This research was conducted in the refugee camps in the West Nile region of Uganda in the Rhino Camp Refugee Settlements. The objective was a pilot mixed methods assessment of the challenges that refugee and host communities face, and the challenges placed on the healthcare systems of the host country of Uganda. The findings reveal many factors that are interconnected at different levels to influence the health outcomes of the refugee population in refugee camps. These factors include individual refugee factors, environmental or communal factors. These factors interact across different levels of influence to impact both the general refugee health and the healthcare system of the host country of Uganda. Of particular concern are the healthcare providers who report a burning out. Interventions that include self-help guides, and professional development for providers to address their burnout issues may produce better outcomes for the entire healthcare system.
Utilization of solid waste as a substrate for production of oil from oleaginous microorganisms
(Hindawi, 2018-05-16) Laker, Fortunate; Agaba, Arnold; Akatukunda, Andrew; Gazet, Robert; Barasa, Joshua; Nanyonga, Sarah; Wendiro, Deborah; Wacoo, Alex Paul
The overwhelming demand of oil and fats to meet the ever increasing needs for biofuel, cosmetics production, and other industrial purposes has enhanced a number of innovations in this industry. One such innovation is the use of microorganisms as alternative sources of oil and fats. Organic solid waste that is causing a big challenge of disposal worldwide is biodegradable and can be utilized as substrate for alternative oil production.The study evaluated the potential of isolated yeast-like colonies to grow and accumulate oil by using organic solid waste as substrate. Of the 25 yeast-like colonies isolated fromthe soil samples collected fromthree different suburbs in Kampala district, Uganda, 20 were screened positive for accumulation of lipid but only 2 were oleaginous. The NHC isolate with the best oil accumulation potential of 48.8% was used in the central composite design (CCD) experiments. The CCD experimental results revealed a maximum oil yield of 61.5% from 1.25 g/L cell biomass at 10 g/L of solid waste and temperature of 25∘C. The study revealed that organic solid waste could be used as a substrate for microbial oil production.
Feasibility of a novel on-site detection method for aflatoxin in maize flour from markets and selected households in Kampala, Uganda
(MDPI AG, 2018-08-11) Wacoo, Alex Paul; Wendiro, Deborah; Nanyonga, Sarah; Hawumba, Joseph F.; Sybesma, Wilbert; Kort, Remco
In sub-Saharan Africa, there is a high demand for affordable and accessible methods for on-site detection of aflatoxins for appropriate food safety management. In this study, we validated an electrochemical immunosensor device by the on-site detection of 60 maize flour samples from six markets and 72 samples from households in Kampala. The immunosensor was successfully validated with a linear range from 0.7 ± 0.1 to 11 ± 0.3 µg/kg and limit of detection (LOD) of 0.7 µg/kg. The maize flour samples from the markets had a mean total aflatoxin concentration of 7.6 ± 2.3 µg/kg with approximately 20% of the samples higher than 10 µg/kg, which is the maximum acceptable level in East Africa. Further down the distribution chain, at the household level, approximately 45% of the total number contained total aflatoxin levels higher than the acceptable limit. The on-site detection method correlated well with the established laboratory-based HPLC and ELISA-detection methods for aflatoxin B1 with the correlation coefficients of 0.94 and 0.98, respectively. This study shows the feasibility of a novel on-site detection method and articulates the severity of aflatoxin contamination in Uganda.
Probiotic enrichment and reduction of aflatoxins in a traditional African maize-based fermented food
(Nutrients, 2019) Wacoo, Alex Paul; Mukisa, Ivan Muzira; Meeme, Rehema; Byakika, Stellah; Wendiro, Deborah; Sybesma, Wilbert; Kort, Remco
Fermentation of food products can be used for the delivery of probiotic bacteria and means of food detoxification, provided that probiotics are able to grow, and toxins are reduced in raw materials with minimal effects on consumer acceptability. This study evaluated probiotic enrichment and detoxification of kwete, a commonly consumed traditional fermented cereal beverage in Uganda, by the use of starter culture with the probiotic Lactobacillus rhamnosus yoba 2012 and Streptococcus thermophilus C106. Probiotic kwete was produced by fermenting a suspension of ground maize grain at 30 ◦C for a period of 24 h, leading to a decrease of the pH value to ≤ 4.0 and increase in titratable acidity of at least 0.2% (w/v). Probiotic kwete was acceptable to the consumers with a score of ≥6 on a 9-point hedonic scale. The products were stable over a month’s study period with a mean pH of 3.9, titratable acidity of 0.6% (w/v), and Lactobacillus rhamnosus counts >108 cfu g-1. HPLC analysis of aflatoxins of the water-soluble fraction of kwete indicated that fermentation led to an over 1000-fold reduction of aflatoxins B1, B2, G1, and G2 spiked in the raw ingredients. In vitro fluorescence spectroscopy confirmed binding of aflatoxin B1 to Lactobacillus rhamnosus with an efficiency of 83.5%. This study shows that fermentation is a means to enrich with probiotics and reduce widely occurring aflatoxin contamination of maize products that are consumed as staple foods in sub-Saharan Africa
Potential application of lactic acid starters in the reduction of aflatoxin contamination in fermented sorghum-millet beverages
(International Journal of Food Contamination, 2019) Byakika, Stellah; Mukisa, Ivan Muzira; Wacoo, Alex Paul; Kort, Remco; Byaruhanga, Yusuf Byenkya; Muyanja, Charles
Background: Aflatoxin contamination in traditionally fermented cereal-based beverages is a serious food safety challenge considering that commercialization of these products is rising. The challenge is aggravated by the fact that aflatoxin elimination from the food chain is almost impossible. This paper focuses on Obushera, a popular traditional spontaneously fermented sorghum – millet beverage from Uganda. Method: Mold and total aflatoxin levels in cereal flours and Obushera from different markets in Kampala were determined. Ability of lactic acid bacteria (LAB) starters from Obushera; Lb. plantarum MNC 21, W. confusa MNC 20 and L. lactis MNC 24 to bind aflatoxin B1 (AFB1) was evaluated against Lb. rhamnosus yoba 2012 as the reference strain. Results: Mold counts in sorghum, millet and Obushera ranged between 0.0–2.4 log cfu/g, 2.0–6.5 log cfu/g and 2.0–5.5 log cfu/g, respectively. None of the flours complied with food safety standards for molds (maximum = 4 log cfu/g) while 88.0% of Obushera did (standard = maximum 1.3 log cfu/g). Total aflatoxin levels in sorghum, millet and Obushera were 22.3 ± 21.2 ppb, 9.9 ± 10.0 ppb and 10.4 ± 6.1 ppb, respectively. LAB bound 19.3–69.4% of AFB1 in a 1000 ppb solution with binding efficiency in the order of Lb. rhamnosus yoba 2012 = Lb. plantarum MNC 21 > W. confusa MNC 20 = L. lactis MNC 24. The LAB-AFB1complex remained stable under a series of washes with physiological saline. Conclusion: This study indicates that LAB with aflatoxin binding properties can be exploited for controlled cereal fermentations to improve food safety.
Improving health and wealth by introduction of an affordable bacterial starter culture for probiotic yoghurt production in Uganda
(Challenges, 2019) Westerik, Nieke; Wacoo, Alex Paul; Anyimo, Esther; Matovu, William; Reid, Gregory; Kort, Remco; Sybesma, Wilbert
In rural Africa, income generating activities of many households heavily depend on agricultural activities. In this paper, we present the results of a multi-year intervention whereby dairy farmers and small-scale entrepreneurs were taught to convert their milk into a probiotic yoghurt using an innovative bacterial starter culture and basic equipment. This intervention creates additional sources of income and employment for people involved in the delivery of milk as well as production, distribution, and sales of yoghurt. Besides the economic benefits, the consumption of the probiotic yoghurt can contribute to reduction of the incidence and severity of diarrhea, respiratory tract infections, atopic diseases, alleviate the symptoms of stomach ulcers, and decrease the uptake of aflatoxins in the body. With minimal external financial support, 116 communities or small entrepreneurs have been able to start, expand, and maintain a business by production and sales of probiotic yoghurt. Applied business models and success rate in terms of revenues and profitability varied per region and depended on location, culture, ownership structure, wealth status, and gender.
Birth intervals and associated factors among women attending young child clinic in Yumbe hospital , Uganda.
(International Journal of Reproductive Medicine, 2020-01-04) Aleni, Mary; Mbalinda, S. N.; Muhindo, R.
Evidence suggests that both short and long birth intervals are associated with poor maternal and child health outcomes. However, current studies suggest that a number of births still occur at short intervals. The aim of this study was to document birth intervals and associated factors among women of reproductive age in rural Uganda. Materials and Methods. This was a cross-sectional study conducted among 296 women aged 15-49 years attending young child clinic at Yumbe Hospital who had at least two successive live births. Data was collected using interviewer-administered questionnaire. Birth interval was categorized according to the WHO-recommended birth interval of ≥24 months and <24 months. Results. Of the 296 participants, 86.6% desired a birth interval ≥ 24 months with a desired median birth interval of 36 months. The actual median birth interval was 22 months. Slightly more than half of the women (52.4%) had short birth intervals. Factors which were likely to be associated with short birth intervals included being younger (15-24 years) (AOR = 4:39, 95%CI = 1:49‐12:93, P = 0:007), not planning to have another pregnancy (AOR = 0:33, 95%CI = 0:18‐0:58, P = 0:001), not deciding together with husband when to have the next child (AOR = 3:10, 95%CI = 1:53‐6:28, P = 0:002), not always using contraceptives before the next pregnancy (AOR = 0:28, 95%CI = 0:12‐0:64, P = 0:003), and lack of influence of husband on when to have the next child (AOR = 2:59, 95% CI = 1:44 – 4:64, P = 0:001). Conclusion. Prevalence of short birth intervals is still high in rural Uganda (52.4%), although majority (86.6%) of the women desire optimal birth intervals. Factors which were likely to be associated with short birth intervals included young maternal age, not using contraceptives, and lack of male involvement in child spacing activities. Therefore, to optimize birth intervals, focused child spacing strategies targeting young women and men are needed
Nurse managers’ perspectives on care quality and safety in rural hospitals in Uganda.
(Unisa Press Journals, 2020-09-09) Kakyo, Tracy Alexis; Xiao, Lily Dongxia
Rural hospitals in sub-Saharan African countries play a key role in dealing with a high level of disease burden, but are usually poorly equipped with resources. Ward nurse managers in rural hospitals are in an ideal position to negotiate resources and bridge gaps in quality improvements. The aim of this study was to explore nurse managers’ perspectives on quality and safe care in rural hospitals in Uganda. This was a qualitative interpretive study in which 11 ward nurse managers with at least two years’ experience in the role were purposively selected to participate in the study. In-depth interviews using a semi-structured interview guide were applied for data collection. Thematic analysis was applied to analyse the data. Four themes were identified from the interviews. These themes explained how nurse managers engaged stakeholders in quality and safe care for patients; supported staff through supervision; improvised practices to cope with resource and equipment constraints; and being constrained by poor working conditions. Nurse managers in rural hospitals in sub-Saharan Africa face unique challenges in ensuring quality and safe care for patients due to a lack of basic human and material resources. The strategies they apply in quality improvements have implications for policy and resource development.
In-vivo efficacy profiles of plasmodium falciparum to Artemether- Lumefantrine, the recommended first-line treatment of uncomplicated Malaria in Kisii County Kenya
(South Asian Journal of Parasitology, 2021) Maniga, Josephat Nyabayo; Rael, Masai; Bwogo, Pacifica; Ntulume, Ibrahim; Tibyangye, Julius; Atiku, Saad Mahjub; Onchoke, Vera Bella; Mong’are, Samuel
Place and Duration of the Study: This study was carried out in Kisii County, Kenya in 2021, during the months of February to June. Methodology: Multi-stage random sampling was used. Participants suspected to be having malaria were recruited, confirmed for P. falciparum and treated with Arthemeter- Lumefantrine (AL). The participants were followed for 28 days. Efficacy of the AL treatment was assessed as per the WHO criteria (2007). Data was analyzed using the chi square (χ2), Fisher’s exact test and twosample t test. Results: Follow-up was completed for 84% (231.0± 0.23) participants. The study reported Earlier Treatment Failure (ETF) of 27 (11.7 %), Late Clinical Failure (LCF) of 20 (8.7 %), Late Parasitological Failure (LPF) of 11(3.9 %), and Adequate Clinical and Parasitological Failure (ACPR) of 173 (75.0 %). Fever was not detected among 1.45% (3.98 ± 0.25) during enrollment. The treatment outcome with AL was first noted at day 3 of the follow up with 15.2 ± 0.33 of the patients testing negative for P. falciparum. By day 28, 94% (217.14 ± 0.72) of the patients were cleared of parasitemia. Age and weight were statistically significant factors influencing the treatment outcomes at, Age, p=0.005 and Weight, p=0.001. Conclusions: Artemether-Lumefantrine (AL) remains efficacious in the study area, however more studies using molecular methods needs to be conducted.
Assessment of alternative approaches of primary cervical cancer screening among women in low-income environments
(Journal of Cancer Research and Experimental Oncology, 2021-01) Eilu, Emmanuel; Akinola, Saheed Adekunle; Tibyangye, Julius; Adeyemo, Rasheed Omotayo; Odoki, Martin; Adamu, Aliero Almustapha; Onkoba, Sarah Kemuma; Kemunto, Moindi Jeridah; Abyola, Ismail Adebayo; Kato, Charles Drago
Alternative techniques for detecting cancer of the cervix uteri alongside its early precancerous lesions still remain necessary for low income environments since morbidity and mortality due to cervical cancer continues to be on the rise. We recruited one thousand and seventy-seven women aged 15-55 years from selected study hospitals in Eastern Uganda and examined them using Papanicolaou (Pap) smear, direct visual inspection with 5% acetic acid solution (VIA), and human papillomavirus (HPV) DNA testing. Study participants detected with high-grade lesions (HSIL) or cancer cells on Pap smear test, positive VIA test (acetowhite lesions, cervical ulcer or growth), and positive high-risk HPV DNA (relative light units (RLU) were immediately scheduled for colposcopy and cervical biopsy. Of the forty percent of the women confirmed with pap smear positive, 43 of the 63 women had invasive carcinoma (68.3%), while 89 out of 137 women with confirmed biopsy were diagnosed with high grade CIN (CIN2,3) (65%). DVI identified 46 of 63 carcinomas (73%) as well as 47 of 74 high grades CIN (CIN 2, 3) (64%). There was a variation in HPV DNA results due to the cutoff value considered in defining the final result. HPV DNA of high-risk HPV types was detected 39 (61.9%) out the 63 women diagnosed invasive cervical cancer, while 66 (73.3%) or 46 (51%) was detected in the biopsy of women diagnosed with high grade CIN (CIN 2,3). Similarity in identification of high-grade cervical abnormalities was registered by the testing methods. Both VIA and HPV genetic testing methods diagnosed similar numbers of high grade CIN 2,3 and invasive cancer cases as Pap smears. Nevertheless, individual test methods categorized study participants with no cervical disease as being positive.
Clinical teaching of university-degree nursing students: are the nurses in practice in Uganda ready?
(BMC Nursing, 2021-01-04) Drasiku, Amos; Gross, Janet L.; Jones, Casey; Nyoni, Champion N.
Background: Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several lowresource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and may not have the necessary skills to facilitate clinical learning as expected at degree level. A university in Uganda established a bachelor’s degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of university-degree nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students. Methods: A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from Arua Regional Referral Hospital (ARRH) who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis. Results: The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; “Willingness to teach undergraduate students” “Perceived attributes of undergraduate students”, and “The clinical practice environment”. Conclusion: The nurses in practice need support in the execution of the clinical teaching role of university-degree nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.
Unsatisfactory COVID-19-related knowledge, attitudes and practices among undergraduate university students in Uganda: an online cross-sectional survey
(Scientific Research Publishing, 2021-06) Nyeko, Richard; Amanya, Sharon B.; Aleni, Mary; Akello, Franceska
This study examined the COVID-19-related knowledge, attitude and practices among undergraduate students in Uganda. An online cross-sectional survey was conducted from 12th-19th June 2020 among undergraduate students using a standard questionnaire designed using Google Forms sent via WhatsApp Messenger. The data were analyzed using SPSS. Pearson’s Chi-square test was used to test the differences and odds ratios with their 95% confidence intervals were used for quantifying the association between independent and dependent variables. p < 0.05 was considered significant. A cut-off score of ≥80% was used to denote sufficient knowledge, positive attitude, and good practices. Of the 161 respondents, 102 (63.4%) were males with a mean age of 24.2 (5.0) years. The majority 121 (75.2%) were pursuing health-related programs and overall, 110 (68.3%) had sufficient knowledge while 76 (47.2%) had a positive attitude and good practice each. Knowledge and attitude were significantly associated with health-related programs (AOR 4.78, 95% CI 2.06 - 11.07; p < 0.001) and (AOR 3.18, 95% CI 1.33 - 7.62; p = 0.010) respectively. The practice was associated with the male gender (AOR 2.37, 95% CI 1.19 - 4.73; p = 0.014). The most commonly cited sources of COVID-19 information were news media 147 (91.3%), Ministry of Health 134 (83.2%), and social media 125 (77.6%). The ministry of health was considered the most trustworthy source 139 (86.3%) and social media the least 21 (13.0%). COVID-19-related knowledge, attitude and practices among undergraduates in Uganda were low overall. Therefore, concerted efforts to provide tailored health education and behaviour change communication are needed.
The anti-mycobacterial activity and safety profile of selected Crinum species in north western Uganda.
(Global Scientific Journals, 2021-06) Candia, Milton; Katuura, Esther; Waako, Paul
Crinum species is a source of many bioactive molecules with both antimicrobial and anti-tumor properties. Chloroform, methanol and aqueous extracts of Crinum scabrum and Crinum macowanii bulbs and leaves were investigated for their anti-mycobacterial activity against Mycobacteria tuberculosis using agar well diffusion, and broth dilution methods. Rifampicinstreptomycin resistant (R.S), pan African sensitive (H37Rv) and wild type (Sou 14827) strains of the bacteria were used. The investigation aimed to determine the anti-mycobacterial activity and safety profile of the crude extracts of Crinum scabrum and Crinum macowanii. The extracts had antimycobacterial activity that ranged between 1-5μg/ml. Their patterns of inhibition varied with the plant extract, solvent used for extraction and the organisms tested. Different concentrations of methanol extract were compared with similar concentrations of chloroform and aqueous extracts for their maximum zones of inhibition. All the extracts of Crinum macowanii were found inactive against Mycobacteria tuberculosis. Methanol leaf extract of Crinum scabrum was the most active, with minimum inhibitory concentration (MIC) less than1μg/ml and minimum bactericidal concentration (MBC) of 1μg/ml. acute toxicity test in mice for Crinum scabrum leaf was found to have LD50 greater than 2000mg/kg. In conclusion, the leaf of Crinum scabrum is a natural source of new anti-mycobacterial compound that is tolerable and effective in treatment of tuberculosis. The study recommends herbalists to use the leaves instead of bulb of C. scabrum Alani Davis for treating TB patients. In future, a comparative study should be done on activity of crude methanol leaf extract of C. scabrum and combination of the drugs used to treat multidrug resistant MTB. The active principles in the leaves of C. scabrum Alani Davis should also be isolated, identified and tested on strains of Mycobacteria tuberculosis resistant to at least two or three drugs.
Status of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara University Teaching Hospital in Southwestern Uganda
(SAGE Publications, 2021-08-31) Njovu, Israel Kiiza; Musinguzi, Benson; Mwesigye, James; Kassaza, Kennedy; Turigurwa, Joseph; Nuwagira, Edwin; Bazira, Joel; Kabanda, Taseera; Mpeirwe, Moses; Ampaire, Lucas; Mutekanga, Andrew; Kiguli, James; Achan, Beatrice; Itabangi, Herbert
Pulmonary mycoses are important diseases of the respiratory tract caused by pulmonary fungal pathogens. These pathogens are responsible for significant morbidity and mortality rates worldwide; however, less attention has been paid to them. In this study we determined the prevalence of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara Regional Referral Hospital. This was a hospital based cross sectional survey. Sputum samples were collected from each study participant. For each sample, the following tests were performed: Sabouraud dextrose agar for fungal culture, GeneXpert for Mycobacteria tuberculosis (MTB) and potassium hydroxide for fungal screening. Filamentous fungal growth and yeasts were further examined with lactophenol cotton blue staining and germ tube respectively. Out of 113 study participants, 80 (70.7%) had pulmonary fungal pathogens whilst those with pulmonary tuberculosis numbered five (4.4%). Candida albicans [21 (22.58%)] and Aspergillus species [16 (17.20%)] were the pathogens most identified among others. Two (1.7%) TB GeneXpert positive participants had fungal pathogens isolated from their sputum samples. We established a prevalence of 57 (71.3%) for pulmonary fungal pathogen (PFP) isolates, three (60.0%) for MTB in HIV positive patients and 18 (22.5%) for PFP, and zero (0.0%) for MTB in HIV negative patients. On the other hand, two (100%) HIV positive patients had both PFP isolates and MTB.Our findings highlight the diversity of neglected pulmonary fungal pathogens whose known medical importance in causing pulmonary mycoses cannot be overemphasised. Therefore this presents a need for routine diagnosis for pulmonary mycoses among TB suspects and set-up of antimicrobial profile for pulmonary fungal isolates to support clinical management of these cases.
Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda
(Springer Nature, 2021-11-04) Zamarano, Henry; Musinguzi, Benson; Kabajulizi, Immaculate; Manirakiza, Godfrey; Guti, Walker; Muhwezi, Ivan; Ayan, Ahmed Hussein; Baweera, Agnes; Kabahinda, Boaz; Itabangi, Herbert; Bazira, Joel; Kabanda, Taseera
Neonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths.The objective of the study was to determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital. We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P < 0.05. Stata (version 14) used for statistical analysis. Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation.
Ethnicity, gender, and migration status:
(Wolters Kluwer Health, 2022-07-29) Mangwi, Richard Ayiasi; Mangwi, Alice Jean Ochola; Young, Ruth; Orach, Christopher Garimoi; Morgan, Rosemary
Globally, 298,000 women die due to pregnancy related causes and half of this occurs in Africa. In Uganda, maternal mortality has marginally reduced from 526 to 336 per 100,000 live births between 2001 and 2016. Health facility delivery is an important factor in improving maternal and neonatal outcomes. However, the concept of using a skilled birth attendant is not popular in Uganda. An earlier intervention to mobilize communities in the Masindi region for maternal and newborn health services discovered that immigrant populations used maternal health services less compared to the indigenous populations. The aim of this qualitative study was therefore to better understand why immigrant populations were using maternal health services less and what the barriers were in order to suggest interventions that can foster equitable access to maternal health services. Five focus group discussions (FGDs) (three among women; 2 with men), 8 in-depth interviews with women, and 7 key informant interviews with health workers were used to better understand the experiences of immigrants with maternal and newborn services. Interviews and FGDs were conducted from July to September 2016. Data were analyzed using content analysis and intersectionality. Results were based on the following thematic areas: perceived discrimination based on ethnicity as a barrier to access, income, education and gender. Immigrant populations perceived they were discriminated against because they could not communicate in the local dialect, they were poor casual laborers, and/or were not well schooled. Matters of pregnancy and childbearing were considered to be matters for women only, while financial and other decisions at the households are a monopoly of men. The silent endurance of labor pains was considered a heroic action. In contrast, care-seeking early during the onset of labor pains attracted ridicule and was considered frivolous. In this context, perceived discrimination, conflicting gender roles, and societal rewards for silent endurance of labor pains intersect to create a unique state of vulnerability, causing a barrier to access to maternal and newborn care among immigrant women. We recommend platforms to demystify harmful cultural norms and training of health workers on respectful treatment based on the 12 steps to safe and respectful mother baby-family care. Abbreviations: FGDs = Focus group discussions, IDI = In-depth interviews, MNCH = maternal newborn child health, USD = United States dollars.
Laboratory diagnosis of candidiasis
(IntechOpen, 2022-08-04) Musinguzi, Benson; Sande, Obondo J.; Mboowa, Gerald; Baguma, Andrew; Itabangi, Herbert; Achan, Beatrice
The burden of Candidiasis continues to increase and so does the Candida species. Although Candida species are closely similar phenotypically, they differ from each other in terms of epidemiology, genetic characteristics, antifungal susceptibility and virulence profile. Therefore, reliable and accurate laboratory methods for identification of Candida species can determine the Candidiasis burden and enable the administration of the most appropriate antifungal drug therapy to reduce fungal mortality rates. Conventional and biochemical methods are often used in identification of Candida species. However, these techniques are specific and sensitive enough in detecting the non albicans candida (NAC) species. Molecular techniques have improved the laboratory diagnosis and management of Candidiasis due to improved sensitivity and specificity threshold. This chapter provides an overview of different laboratory methods for diagnosis of Candidiasis.
Assessment of biosafety and biorisk management practices among medical laboratory students in two institutions in Uganda
(Elsevier, 2022-09-07) Padde, John Roberts; Akiteng, Winnie; Edema, William; Atiku, Saad Mahjub; Tibyangye, Julius; Tekakwo, Job; Andruga, Cosmas; Hope, Derick; Musinguzi, Benson; Gesa, Jean Brenda; Amadile, Lawrence; Agondua, Robert
Medical laboratory workers handle clinical specimens, which are a threat of exposure to infectious agents. Notably, medical laboratory science students report for internships with only theoretical knowledge of biosafety and biorisk management practices, predisposing them to a higher risk of laboratory hazards. In this study, we assessed the influence of entry-level students' adherence to practices and attitudes towards biosafety and biorisk management during the Internship. An online survey tool was used to explore the practices and attitudes towards laboratory biosafety and risk management. Of the 96 students, 60 (62.5%) anonymous responses were received, and of these, 60.3% were direct entrants, and 32.8% were diploma entrants. Most (91.7%) of the students attended hospital internships, with 60.2% in Biosafety Level (BSL)-2 laboratories and 70.2% rotating in all the core areas of laboratory medicine. The 8.3% who did not attend any internship were under the direct entry category. Exposure to biohazards was not significantly associated with laboratory safety level and student entry category (P> 0.05). Recommended laboratory biosafety practices were not significantly associated with the safety level of the laboratory and student entry category (P> 0.05). Poor attitudes towards certain laboratory biosafety practices were not significantly associated with the biosafety level of the training laboratory (P> 0.05), whereas training (P = 0.021) and clean-up procedures (P = 0.048) were associated with laboratory safety levels, respectively. The direct entrants had no access to BSL-3 laboratories, and this category of students had a negative attitude towards internship attendance. Therefore, there is a need to create a multi-channel full range laboratory biosafety and biorisk management teaching reforms based on practical application, real case studies, and laboratory simulation to be incorporated into the curriculum to benefit the direct entrant.
Mutactimycin AP, a new mutactimycin isolated from an actinobacteria from the Atacama Desert
(MDPI, 2022-10-24) Astakala, Rishi Vachaspathy; Preet, Gagan; Milne, Bruce F.; Tibyangye, Julius; Razmilic, Valeria; Castro, Jean Franco; Asenjo, Juan A.; Andrews, Barbara; Ebel, Rainer; Jaspars, Marcel
Bacteria belonging to the phylum Actinobacteria are a very good source of antibiotics, and indeed dominate the current clinical antibiotic space. This paper reports Mutactimycin AP, a new compound belonging to an anthracycline-type family of antibiotics, isolated from a Saccharothrix sp. This actinobacterial strain was isolated from the rhizosphere of lupine plants growing in the extreme hyper-arid Atacama Desert. Structural characterization was carried out using electrospray ionization-mass spectrometry (ESI-MS) and NMR spectroscopy in combination with molecular modelling. The compound was tested against the ESKAPE pathogens, where it showed activity against MRSA and five strains associated with bovine mastitis, where it showed activity against Enterococcus pseudoavium and Staphylycoccus Aureus subsp. Aureus.

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