Abstract Background Climate change poses severe threats to smallholder farmers' agricultural livelihoods and food security in Sub Saharan Africa. Understanding long-term rainfall trends of variability and extremes at local scales and perceptions regarding long-term changes in climate variables is important in planning appropriate adaptation measures to climate change. This paper examines the perception of farmers in Apac district regarding long-term changes in climate variables and analyzes the trend of occurrence in seasonal and annual rainfall in Apac district, northern Uganda. A cross-sectional survey design was employed to collect data on farmers' perceptions regarding long-term changes in climate from 260 randomly selected smallholder farmers’ households across two sub-counties in Apac district by administering semi-structured questionnaires in February 2018. Monthly rainfall data sets from the Uganda Meteorological Authority (UMA) for the period 1980 to 2019 for Apac district were also used to analyze trends of occurrences in seasonal and annual rainfall in the study area. The non-parametric Sequential Mann–Kendall (SMK) tests were employed at a 5% significance level to detect mean seasonal rainfall trends and abrupt change points. Results The majority of the respondents (87%) perceived a decrease in precipitation over the past 39 years. The plot of forward regression u(t i ) values and backward regression u’(t i ) values showed interactions indicating rainfall trends, rainfall lower and upper limits and abrupt change points in the different cropping seasons. Analysis of historical series of mean monthly and annual rainfall showed an abrupt change in rainfall in March, April, May (MAM) season in 1982. Although the September, October and November (SON) season did not show a significant abrupt change, there was a significant (p
Adoption and usage of mobile phones enable information and knowledge flows among value chain players, including farmers, and therefore contribute to improved efficiency. To ensure the successful implementation of MPTs in agriculture, farmers should embrace them. We present a systematic review of determinants, constraints, methods, indicators, and measures of MPT adoption among farmers and a methodological quality assessment of the included studies. Findings from 53 studies showed significant heterogeneity in research. Most studies targeted developing regions in Africa and Asia and only a few in developed countries. Although studies mainly focused on MPT adoption, they varied significantly in the outcome indicators assessed and their measurement. This heterogeneity in the conceptualization and measurement of adoption indicators underscores the need for standardized approaches in future studies. There is also sub-optimal use of established psychological-behavioral theories to underpin MPT adoption. Cross-sectional designs and quantitative approaches dominate the research landscape. Concerning farmers' MPT adoption, key drivers were education, age, gender, perceived ease of use, perceived usefulness, perceived cost, performance and effort expectancy, attitude, skills, and knowledge. Factors such as mobile phone cost, inadequate infrastructure, and language barrier constitute major hurdles constraining farmers' adoption of MPT in developing countries. The generally low quality of the reviewed studies suggests that future studies should invest in transparently providing their study objectives, methods, and interpretation of the findings. This systematic review contributes to a better understanding of farmers' MPT adoption drivers and suggests areas for future research. It provides relevant information to policy-makers, public and private sector agencies, mobile phone companies and app developers, researchers, agricultural extension workers, academicians, and other stakeholders when designing and implementing policies for MPT adoption in agriculture.
This study set out to investigate the effects of adhesive type, rice husk and sawdust proportions on the properties of composite particleboards. Specimens of 200 × 200 × 24 mm were made by blending 500 g of rice husks with each adhesive type at a mass ratio of 1:1. The rest of the specimens of similar dimensions were prepared with addition of sawdust in the range of 10–40 wt%, while maintaining the ratio of biomass particles to adhesive at 1:1. Three commercial synthetic adhesives Fevicol (FV), Ponal (PA) and woodfix (WF) were used. The particle-adhesive mixtures were molded into a mat which was subsequently cold pressed at 10 MPa and left to dry in air. Density, water absorption (WA), linear expansion (LE), thickness swelling (TS), modulus of elasticity (MOE), modulus of rupture (MOR) and screw holding capacity of the specimens were evaluated. Adhesives were found to have over 42% solid content, with similar liquid constituents but in varying proportions. FTIR library search for the spectra of FV, PA and WF revealed correlations of 82.5%, 78.6% and 50.2%, respectively with polyvinyl-acetate. The developed boards had density 510–610 kg/m³, MOE 13–26 MPa, TS 9–31%, LE 3–7%. These properties suit them for furniture boards and sound proofing. The properties improved with increasing proportion of sawdust. FV and PA-bonded particleboards exhibited higher stability and strengths than WF-bonded particleboards due to higher concentrations of polyvinyl-acetate in the latter. Blending 40 wt% sawdust, 10 wt% rice husk with 50 wt% of either FV or PA showed better prospects.
Background The ongoing COVID-19 pandemic has significantly impacted the physical and mental health of the general population worldwide, with healthcare workers at particular risk. The pandemic's effect on healthcare workers' mental well-being has been characterized by depression, anxiety, work-related stress, sleep disturbances, and post-traumatic stress disorder. Hence, protecting the mental well-being of healthcare workers (HCWs) is a considerable priority. This review aimed to determine risk factors for adverse mental health outcomes and protective or coping measures to mitigate the harmful effects of the COVID-19 crisis among HCWs in sub-Saharan Africa. Methods We performed a literature search using PubMed, Google Scholar, Cochrane Library, and Embase for relevant materials. We obtained all articles published between March 2020 and April 2022 relevant to the subject of review and met pre-defined eligibility criteria. We selected 23 articles for initial screening and included 12 in the final review. Result A total of 5,323 participants in twelve studies, predominantly from Ethiopia (eight studies), one from Uganda, Cameroon, Mali, and Togo, fulfilled the eligibility criteria. Investigators found 16.3–71.9% of HCWs with depressive symptoms, 21.9–73.5% with anxiety symptoms, 15.5–63.7% experienced work-related stress symptoms, 12.4–77% experienced sleep disturbances, and 51.6–56.8% reported PTSD symptoms. Healthcare workers, working in emergency, intensive care units, pharmacies, and laboratories were at higher risk of adverse mental health impacts. HCWs had deep fear, anxious and stressed with the high transmission rate of the virus, high death rates, and lived in fear of infecting themselves and families. Other sources of fear and work-related stress were the lack of PPEs, availability of treatment and vaccines to protect themselves against the virus. HCWs faced stigma, abuse, financial problems, and lack of support from employers and communities. Conclusion The prevalence of depression, anxiety, insomnia, and PTSD in HCWs in sub-Saharan Africa during the COVID-19 pandemic has been high. Several organizational, community, and work-related challenges and interventions were identified, including improvement of workplace infrastructures, adoption of correct and shared infection control measures, provision of PPEs, social support, and implementation of resilience training programs. Setting up permanent multidisciplinary mental health teams at regional and national levels to deal with mental health and providing psychological support to HCWs, supported with long-term surveillance, are recommended.
Background Antimicrobial resistance (AMR) is an important global health concern, projected to contribute to significant mortality, particularly in developing countries. This study aimed to determine the knowledge, perceptions of clinical health professions students towards antimicrobial resistance and rational use of medicine and confidence level to prescribe antimicrobials. Methods An online descriptive cross-sectional survey was conducted among clinical health professions students across 9 medical schools in Uganda. A semi-structured questionnaire using Kobo Toolbox form was shared among participants via WhatsApp Messenger (Meta, California, USA). Knowledge was categorized using modified Bloom’s cut-off. One-way ANOVA, Chi-square or Fisher’s exact test, and logistic regression were used to assess the association between dependent and independent variables. A p < 0.05 was considered statistically significant. Results We surveyed 681 participants, most were pursuing a Bachelor of Medicine and Surgery degree ( n = 433, 63.6%), with a mean age of 24 (standard deviation: 3.6) years. Most participants ( n = 596, 87.5%) had sufficient knowledge about antimicrobial resistance with a mean score of 85 ± 14.2%. There was a significant difference in mean knowledge scores of year 4 (86.6%) compared to year 3 (82.4%) ( p = 0.002) and year 5 (88.0%) compared to year 3 (82.4%) ( p < 0.001). Most participants ( n = 456, 66.9%), were confident on making an accurate diagnosis of infection, and choosing the correct antimicrobial agent to use ( n = 484, 71.1%). Conclusion Health profession students exhibited good knowledge on antimicrobial resistance and high self-perceived confidence that should be leveraged to foster better future antimicrobial prescription practices. However, they still agreed that a separated course unit on AMR is necessary which responsible authorities should consider to consolidate the efforts.
Post-harvest losses (PHL) reported in maize production put Sub-Saharan African countries at higher risks of food insecurity. Recent studies reported that higher percentage of PHLs occur during the production stage when farmers are in full control of the crop, suggesting that farmers are not equipped with PHL management skills. This study therefore aimed at assessing the determinants of access to trainings on PHL management among maize farmers in Uganda. Primary data were drawn from 246 randomly sampled farmers in Alebtong District followed by Binary logit analysis. The results depicted that majority of the farmers (58%) did not have access to PHL management trainings. However, those who had access sourced it from extension workers (40.65%), farmers’ groups (22.76%) and farmer-to-farmer trainings (12.20%). The main barriers limiting access to the trainings were unawareness of the PHL trainings and inaccessibility of the training centers. Farm size, group membership, maize output and marital status had positive effect on farmers’ access to PHL management trainings while farm location, and distance to the training centers had a negative effect on access to PHL management trainings. Based on the findings, there is need for public sensitization on the benefits of the PHL trainings, farmers should also be motivated to join farmer-based groups and association where they would learn more about the PHL trainings. In addition, the government should open more training centers and employ more training agents so that many farmers can be reached and trained on how to handle and mitigate PHLs in maize.
Background Women of Afro-Caribbean and Asian origin are more at risk of stillbirths. However, there are limited tools built for risk-prediction models for stillbirth within sub-Saharan Africa. Therefore, we examined the predictors for stillbirth in low resource setting in Northern Uganda. Methods Prospective cohort study at St. Mary’s hospital Lacor in Northern Uganda. Using Yamane’s 1967 formula for calculating sample size for cohort studies using finite population size, the required sample size was 379 mothers. We doubled the number (to > 758) to cater for loss to follow up, miscarriages, and clients opting out of the study during the follow-up period. Recruited 1,285 pregnant mothers at 16–24 weeks, excluded those with lethal congenital anomalies diagnosed on ultrasound. Their history, physical findings, blood tests and uterine artery Doppler indices were taken, and the mothers were encouraged to continue with routine prenatal care until the time for delivery. While in the delivery ward, they were followed up in labour until delivery by the research team. The primary outcome was stillbirth 24 + weeks with no signs of life. Built models in RStudio. Since the data was imbalanced with low stillbirth rate, used ROSE package to over-sample stillbirths and under-sample live-births to balance the data. We cross-validated the models with the ROSE-derived data using K (10)-fold cross-validation and obtained the area under curve (AUC) with accuracy, sensitivity and specificity. Results The incidence of stillbirth was 2.5%. Predictors of stillbirth were history of abortion (aOR = 3.07, 95% CI 1.11—8.05, p = 0.0243), bilateral end-diastolic notch (aOR = 3.51, 95% CI 1.13—9.92, p = 0.0209), personal history of preeclampsia (aOR = 5.18, 95% CI 0.60—30.66, p = 0.0916), and haemoglobin 9.5 – 12.1 g/dL (aOR = 0.33, 95% CI 0.11—0.93, p = 0.0375). The models’ AUC was 75.0% with 68.1% accuracy, 69.1% sensitivity and 67.1% specificity. Conclusion Risk factors for stillbirth include history of abortion and bilateral end-diastolic notch, while haemoglobin of 9.5—12.1 g/dL is protective.
Background Assessing factors associated with mortality among COVID-19 patients could guide in developing context relevant interventions to mitigate the risk. The study aimed to describe mortality and associated factors among COVID-19 patients admitted at six health facilities in Uganda. Methods We reviewed medical records of patients admitted with COVID-19 between January 1st 2021 and December 31st 2021 in six hospitals in Uganda. Using Stata version 17.0, Kaplan Meier and Cox regression analyses were performed to describe the time to death and estimate associations between various exposures and time to death. Finally, accelerated failure time (AFT) models with a lognormal distribution were used to estimate corresponding survival time ratios. Results Out of the 1040 study participants, 234 (22.5%: 95%CI 12.9 to 36.2%) died. The mortality rate was 30.7 deaths per 1000 person days, 95% CI (26.9 to 35.0). The median survival time was 33 days, IQR (9–82). Factors associated with time to COVID-19 death included; age ≥ 60 years [adjusted hazard ratio (aHR) = 2.4, 95% CI: [1.7, 3.4]], having malaria test at admission [aHR = 2.0, 95% CI:[1.0, 3.9]], a COVID-19 severity score of severe/critical [aHR = 6.7, 95% CI:[1.5, 29.1]] and admission to a public hospital [aHR = 0.4, 95% CI:[0.3, 0.6]]. The survival time of patients aged 60 years or more is estimated to be 63% shorter than that of patients aged less than 60 years [adjusted time ratio (aTR) 0.37, 95% CI 0.24, 0.56]. The survival time of patients admitted in public hospitals was 2.5 times that of patients admitted in private hospitals [aTR 2.5 to 95%CI 1.6, 3.9]. Finally, patients with a severe or critical COVID-19 severity score had 87% shorter survival time than those with a mild score [aTR 0.13, 95% CI 0.03, 0.56]. Conclusion In-hospital mortality among COVID-19 patients was high. Factors associated with shorter survival; age ≥ 60 years, a COVID-19 severity score of severe or critical, and having malaria at admission. We therefore recommend close monitoring of COVID-19 patients that are elderly and also screening for malaria in COVID-19 admitted patients.
Background Food safety is a major public health issue, particularly in developing countries. Ready-to-eat street-vended foods contribute to daily dietary life, but with elevated food safety burden. Here, hygiene and food safety practices as well as the microbial contamination in Uganda's edible grasshopper value chain was evaluated. Methods This was a cross-sectional mixed methods study with both qualitative and quantitative approaches. A face-to-face administered questionnaire and observational checklists were used to collect data. A total of 29 households (Kampala; 12 and Masaka; 17) participated, and grasshopper samples collected along the value chain. Indicator pathogens were analysed using standard microbiological methods. Results Sociodemographic characteristics reveal that two-thirds of households in Kampala and 53% in Masaka were female headed. In Kampala and Masaka, respectively, 50% and 12% of households had earth or sand floors. All households in Kampala were one or two-roomed dwellings with no separate room as a kitchen, and shared a toilet compared to 43%, 65% and 53%, respectively, in Masaka. 83% households in Kampala and 56% in Masaka obtained drinking water from public taps. Handwashing was inadequate and none of the actors was observed to wash their hands after taking a break or handling waste. Only 8.3% respondents had raised racks for drying utensils. For vendors, wearing protective clothing was not common, with only 28.5% in Kampala and 30.8% in Masaka wearing an apron. Containers for vending grasshoppers were largely uncovered and the utensils (spoon or cup) for measuring the grasshoppers were left mainly uncovered during the observation period. Indicator organisms, E. coli and Salmonella typhimurium, were detected. E. coli was the most common contaminant, but with lower levels in Masaka compared to Kampala. Salmonella typhimurium was mainly a burden in Kampala. Conclusions Our findings demonstrate that there are enormous contributors to poor hygiene and sanitation along the value chain. The existence of pathogenic bacteria such as E. coli in ready-to-eat foods imply that their consumption pose a health risk. There is an urgent need to create awareness among the actors,through regular trainings on food safety and personal hygiene practices in food handling and inspection to prevent foodborne disease outbreaks.
Background Health care workers (HCWs) are at increased risk of acquiring coronavirus disease 2019 (COVID-19). This study aimed to determine and compare the morbidity and mortality rates due to COVID-19 among the HCWs and the general population (non-HCWs). Methods We conducted a retrospective chart review. We accessed electronic database of participants admitted at Mulago National Referral Hospital COVID-19 Treatment Unit (CTU) between March 2020 and September 2021. Participants with missing occupations were excluded. Results Of 594 eligible participants, 6.4% ( n = 38) were HCWs. Compared with non-HCWs, HCWs were much younger (48 versus 55 years, p = 0.020). The proportion of participants with severe disease (73.7% versus 77.6%, p = 0.442), who had not received COVID-19 vaccine (91.2% versus 94.7%, p = 0.423), mortality rate (44.7% versus 54.8%, p = 0.243) and the median length of hospitalization (6 versus 7 days, p = 0.913) were similar among HCWs and non-HCWs, respectively. A higher proportion of HCWs required oxygen therapy (24.3% versus 9.7%, p < 0.01). At admission, the presence of cough ( p = 0.723), breathlessness ( p = 0.722), fever ( p = 0.19), sore throat ( p = 0.133), comorbidities ( p = 0.403) and headache ( p = 0.162) were similar across groups. Rhinorrhoea was more common among HCWs (34.4% versus 16.6%, p = 0.017). Among HCWs, nurses had the highest morbidity (52.6%) and mortality (58.8%). Conclusion The morbidity and mortality among HCWs in Uganda were substantial, with a low COVID-19 vaccination rate and a higher requirement for oxygen therapy despite a younger age.
Background Post-traumatic stress disorder (PTSD) has considerable and persistent effects on survivors of war, particularly in postconflict areas. Yet, evidence on what keeps survivors on the path of PTSD remains scarce. Aims The current study aimed to assess the prevalence and correlates of PTSD symptoms among the war-affected population in northern Uganda. Methods Data from 476 war-affected youths (aged 20–27 years) who had participated in a longitudinal cohort study were analysed to describe the enduring associations of background and postwar environmental risk factors with PTSD symptoms. The Impact of Event Scale-Revised was used to evaluate symptoms of PTSD. Descriptive statistics were used to compute background and postwar environmental correlates. Binary logistic regression analyses were fitted to assess the magnitude of the effects of the correlates on PTSD symptoms. Results Background and postwar environmental factors (eg, sexual abuse and injury in captivity) were significantly associated with PTSD symptoms. Postwar environmental factors associated with PTSD symptoms included postwar hardships, stigma/discrimination, chronic illness, community relations, family acceptance and general functioning, among others. The odds ratios (ORs) for post-war hardships were 2.41 (95% confidence interval (CI): 1.63 to 3.56) and 2.90 (95% CI: 2.03 to 4.14) for high and severe PTSD, respectively. For stigma/discrimination, compared with higher scores, the ORs were 3.38 (95% CI: 2.22 to 5.17) and 4.12 (95% CI: 2.69 to 6.30) for high and severe PTSD symptoms, respectively. Conclusions Background and postwar environmental stressors exacerbate the severity of PTSD symptoms in survivors of war and should form the basis for interventions to alleviate the toxic effects of war on survivors.
ABSTRACT Objective Contemporary data on the attainment of optimal diabetes treatment goals and the burden of diabetes complications in adult populations with type 2 diabetes in Africa are lacking. We aimed to document the current status of attainment of three key indicators of optimal diabetes care and the prevalence of five diabetes complications in adult African populations with type 2 diabetes. Methods We systematically searched Embase, PubMed and the Cochrane library for published studies from January 2000 to December 2020. Included studies reported any information on the proportion of attainment of optimal glycated haemoglobin (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) goals and/or prevalence of five diabetes complications (diabetic peripheral neuropathy, retinopathy, nephropathy, foot ulcers and peripheral arterial disease). Random effect model meta-analysis was performed to determine the pooled proportion of attainment of the three treatment goals and the prevalence of five diabetes complications. Results In total, 109 studies with a total of 63 890 participants (53.3% being females) were included in the meta-analysis. Most of the studies were conducted in Eastern African countries (n=44, 40.4%). The pooled proportion of attainment of an optimal HbA1c, BP and LDLC goal was 27% (95% CI 24 to 30, I2=94.7%), 38% (95% CI 30 to 46, I2=98.7%) and 42% (95% CI 32 to 52, I2=97.4%), respectively. The pooled prevalence of diabetic peripheral neuropathy, retinopathy, diabetic nephropathy, peripheral arterial disease and foot ulcers was 38% (95% CI 31 to 45, I2=98.2%), 32% (95% CI 28 to 36, I2=98%), 31% (95% CI 22 to 41, I2=99.3%), 19% (95% CI 12 to 25, I2=98.1%) and 11% (95% CI 9 to 14, I2=97.4%), respectively. Conclusion Attainment of optimal diabetes treatment goals, especially HbA1c, in adult patients with type 2 diabetes in Africa remains a challenge. Diabetes complications, especially diabetic peripheral neuropathyand retinopathy, are highly prevalent in adult populations with type 2 diabetes in Africa.
The history of the heavy presence of South Sudanese refugees in Northern Uganda dates way back to 1955 when the first group of refugees came to Uganda. The purpose of this study was to investigate the functionality of humanitarian aid principles in addressing the refugee question in the settlements. We adopted a cross-sectional study design and used a mix of quantitative and qualitative approaches. Data were collected using structured questionnaires with 203 household heads and an interview guide with 7 officials from humanitarian aid agencies and Adjumani District Local Government. Results show moderate to low adherence to humanitarian aid principles as observed by principles of humanity (mean = 3.3, SD = 0.67), impartiality (mean = 3.0, SD = 0.52), independence (mean = 2.2, SD = 0.53), and neutrality (mean = 1.6, SD = 0.58). Correlation analysis shows a significant positive relationship between the principles of humanity; impartiality; and neutrality with the conditions for refugee settlement (r = 0.262, p < 0.01; r = 0.452, p < 0.01; r = 0.268, p < 0.01) respectively, but the principle of independence has no statistically significant relationship with the conditions for refugee settlement, the relationship measured at 95% level of confidence. The multivariable test for association shows a significant positive effect between adherence to the principles of impartiality (β = 0.272, p < 0.01), neutrality (β = 0.168, p < 0.01), and level of education with positive perception in the conditions for refugee settlement. While the number of years spent in the refugee settlement has a negative effect on the perceived condition in refugee settlement (β = − 0.061, p < 0.05). Refugees need to have a positive attitude towards the services delivered by the humanitarian aid agencies. Refugees through their leadership should be supported to advocate and demand inclusion in the decision-making process for projects that affect them and to hold the aid agencies accountable in the implementation of the projects in the settlements.
Background: Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. Methodology: We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sites were in Uganda, Malawi and in Tanzania (Dar es Salaam and Haydom). The study in Uganda and Malawi were community-based, the two studies in Tanzania were hospital-based. The same questionnaire was used for assessment of clinical characteristics of patients with epilepsy. Computed tomography (CT) scans and serological testing were performed in order to diagnose NCC. Results: Overall, 1,179 people with epilepsy were included in our analysis. Of those, 941 PWE underwent CT scanning and were pooled for NCC analysis. Seventy patients were diagnosed with NCC, but NCC prevalence differed considerably between sites ranging from 2.0% (95%CI 0.4% to 3.6%) in Dar es Salaam to 17.5% (95%CI 12.4% to 22.6%) in Haydom. NCC prevalence did not show any association with sex but increased with age and was higher in rural than urban settings. In addition, being a farmer, non-Muslim, eating pork and living with pigs close by was associated with a higher NCC prevalence. PWE with NCC experienced their first epileptic seizure around 3 years later in life compared to PWE without NCC and their epileptic seizures seemed to be better controlled (p<0.001). There was no difference between focal onset seizures and focal signs on neurological examination in both groups (p = 0.49 and p = 0.92, respectively). The rT24H-EITB had a sensitivity for the detection of NCC of 70% (95% confidence interval [CI] 51 to 84%), the LLGP of 76% (95%CI 58 to 89%) and the antigen ELISA of 36% (95% CI 20 to 55%). Conclusions: NCC is prevalent among PWE in eastern Africa, although it may not be as common as previously stated. Demographic characteristics of PWE with NCC differed from those without NCC, but semiological characteristics and results on neurological examination did not differ compared to PWE without NCC. Interestingly, seizures seemed to be less frequent in PWE with NCC. Being aware of those differences and similarities may help triaging PWE for neuroimaging in order to establish a diagnosis of NCC.
Background Deteriorating soil fertility is a major constraint to agricultural production and food security among smallholder farmers in Uganda and throughout sub-Saharan Africa, where the majority of the population relies on subsistence farming for its livelihoods. Unfortunately, inorganic fertiliser used as a significant soil nutrient replenishment is unsustainable, causing adverse environmental effects, including soil acidification and pollution of water bodies. Therefore, finding alternative, more sustainable, low-cost nutrient management systems is vital. This study assessed the decomposition and nutrient release patterns of municipal solid waste compost (MSWC) in a 36 weeks litter bag experiment under field conditions in two agro-ecological zones (AEZs) of Uganda. Results We found a higher rate of decomposition in the South-western Grass Farmlands (SGF) agro-ecological zone (0.041 week⁻¹, with 20% of initial compost mass remaining after 36 weeks of decay) compared to Southern and Eastern Lake Kyoga Basin (SEKB) (0.043 week⁻¹, 32% of initial litter mass remaining). The half-life values were 16 and 17 weeks for SGF and SEKB AEZs, respectively. The nutrient release rates differed between the two study sites. The macronutrient release pattern in both sites followed the order K > P > N. The secondary macronutrients release followed the order Ca > Mg in the SGF, while in SEKB, the order was reversed. The micronutrients followed the order Cu > Mn > Fe > Zn and Cu > Mn > Zn > Fe in SGF and SEKB AEZs, respectively. The MSWC mass loss during decomposition was negatively correlated with rainfall in both AEZs and with temperature in SGF AEZ, while it was positively correlated with temperature in SEKB AEZ. However, the relationship with nutrient release rates was inconsistent in both AEZs. Conclusions Our results showed consistent release of nutrients in all AEZs throughout the study period, which coincides with the two cropping seasons in Uganda, suggesting that smallholder farmers can use MSWC as a soil amendment to address soil fertility decline and improve crop productivity. However, because most nutrients were released almost right away in both AEZs, planting should be done at the beginning of high rainfall months when soil moisture is high to synchronise nutrient release from MSWC with crop demand and maximise nutrient uptake by crops while minimising losses to the environment. Furthermore, the inconsistent relationships between the climatic variables and nutrient release suggest that other factors, such as site-specific microbial composition, influenced MSWC nutrient release. Therefore, long-term research is needed to examine other factors affecting nutrient release in these AEZs.
Background Tuberculosis (TB) and its risk factors are independently associated with cardiovascular disease (CVD). We determined the prevalence and associations of CVD risk factors among people with drug-resistant tuberculosis (DRTB) in Uganda. Methods In this cross-sectional study, we enrolled people with microbiologically confirmed DRTB at four treatment sites in Uganda between July to December 2021. The studied CVD risk factors were any history of cigarette smoking, diabetes mellitus (DM) hypertension, high body mass index (BMI), central obesity and dyslipidaemia. We used modified Poisson regression models with robust standard errors to determine factors independently associated with each of dyslipidaemia, hypertension, and central obesity. Results Among 212 participants, 118 (55.7%) had HIV. Overall, 196 (92.5%, 95% confidence interval (CI) 88.0-95.3) had ≥ 1 CVD risk factor. The prevalence; 95% CI of individual CVD risk factors was: dyslipidaemia (62.5%; 55.4–69.1), hypertension (40.6%; 33.8–47.9), central obesity (39.3%; 32.9–46.1), smoking (36.3%; 30.1–43.1), high BMI (8.0%; 5.0–12.8) and DM (6.5%; 3.7–11.1). Dyslipidaemia was associated with an increase in glycated haemoglobin (adjusted prevalence ratio (aPR) 1.14, 95%CI 1.06–1.22). Hypertension was associated with rural residence (aPR 1.89, 95% CI 1.14–3.14) and previous history of smoking (aPR 0.46, 95% CI 0.21–0.98). Central obesity was associated with increasing age (aPR 1.02, 95%CI 1.00–1.03), and elevated diastolic blood pressure (aPR 1.03 95%CI 1.00–1.06). Conclusion There is a high prevalence of CVD risk factors among people with DRTB in Uganda, of which dyslipidaemia is the commonest. We recommend integrated services for identification and management of CVD risk factors in DRTB.
Thanks to the ongoing expansion of internet access and, most recently, the movement restrictions that were put in place globally to stop COVID-19 spread, many small and medium enterprises (SMEs) are prepared to use social media platforms to market their products as a way to improve their business performance in emerging economies. Businesses at all levels that use social media marketing (SMM) see a considerable increase in their output. This study’s objective is to identify the factors that significantly help Ugandan SMEs implement SMM techniques to enhance their commercial performance. Here, statistical models are utilized to analyze how the age and gender of SMEs owners as moderating variables affect the adoption and performance of SMEs in Uganda. A theoretical model that is based on the Technology Acceptance Model (TAM) and Innovation Diffusion Theory (IDT) theories has been put out as part of a specific conceptual framework. The following indicators are used to evaluate the performance of SMEs: sales, customer engagement, awareness of customers’ needs, low operation costs, and brand modification by staff. Empirical model validation has been performed using 152 business units (observation units) corresponding to the number of respondents (units of analysis), and the ensuing analyses have been done using structural equation modelling (SEM). The results indicate that compatibility and perceived ease of use have a positive impact on SMEs to adopt SMM, while perceived usefulness has a negative impact on SMEs to adopt SMM. Age and gender as moderating variables all have a positive moderating effect. With limited studies available on the subject, this research contributes to already existing literature by combining two components of the TAM model and one component of the IDT to explain the impact of SMM on SMEs when moderated by both age and gender in a developing economy.
Woody plants support livelihoods and the well-being of billions of people worldwide. However, the establishment, management, and use of essential woody species can vary across regions. We sought to describe the diversity and uses of woody species and explore the values for which people maintain and protect these plants. We conducted research in the Awach Sub-county of Uganda, using household interviews with randomly selected informants and applied exploratory quantitative ethnobotany analysis to analyze the survey results. The results revealed 64 multipurpose tree species valued for their material contributions to the households. We outline the key challenges, such as pests, diseases, and lack of infrastructure that hamper the establishment and growth of woody species in the region. Our findings offer insights into potential policy mechanisms targeting the establishment of trees in the region and other parts of Uganda and sub-Saharan Africa.
Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using polymerase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 ± 0.00 to 8.23 ± 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p < 0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33–90%, 40–67%, and 17–88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE, and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.
Objective The prevalence of childhood hearing loss (HL) is high in low and middle income countries (LMICs), with many of the affected children facing communication delays and poor opportunities for education. Despite the increased advocacy for childhood hearing screening globally, Uganda has no established childhood hearing screening programs. This study set out to introduce hearing screening services by non-specialist health workers at routine immunization clinics among children aged 0–59 months and describe the prevalence and factors associated with failed hearing screening (HS) in these children. Methods A cross-sectional multi-center study was conducted at immunization clinics at three regional referral hospitals (RRHs). A semi structured questionnaire was used to capture data on socio-demographic, clinical factors and the two stage Transient Evoked Oto-acoustic emissions (TEOAEs) screening performed on children aged 0–59 months. A child that failed two stage screening was considered to have failed HS. Logistic regression was used to calculate odds ratios (OR) for factors associated with failed HS. Results 1217 children were recruited at three RRHs, with a median age of 2 months (range: 0 to 59), half were male 52% (n = 633). Overall 45 children failed two staged TEOAE screening giving a prevalence of failed HS of 3.7%, of these 27 (2.2%) and 18 (1.5%) failed unilaterally and bilaterally respectively. Children of rural residence (aOR = 2.18, p = 0.027), of low birth weight (aOR = 0.42, p = 0.045), with relatives having hearing loss (aOR = 4.64, p= <0.001), who were admitted in hospital after birth (aOR = 3.72, p = 0.012) and a history of a childhood suppurative otitis media (aOR = 9.53, p = 0.015) all had increased odds of failed HS. Conclusions The prevalence of failed screening is high. Implementation of childhood hearing screening by non-specialist health workers at immunization clinics using TEOAEs is possible and may be a necessary initial step in starting countrywide hearing screening in Uganda.
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