As one of the most youthful populations in the world, with close to 80% of its population under the age of 30, Uganda is grappling with initiatives for engaging youth in productive sectors of the economy. Agriculture is considered the most immediate means of catalyzing economic growth and employment for the youth. The Self-Help Groups (SHGs) Model is preferred by both government and non-government agencies to organize youth to engage in agriculture because it takes into account the critical socio-economic elements. The challenge is how to ensure the sustainability of the SHGs for the progressive transformation of the youth. This article assesses the likelihood forof the sustainability of youth groups engaged in agricultural enterprises, based on the parameters of group sustainability specified by the Producer Organization Sustainability Assessment Model. The study employed a quantitative design using a cross-sectional survey conducted between Government and Non-Governmeagency agenciesagencies supported Self Help Groups. In the study, Non-Government Supported groups were more likely to be sustainable than the Government supported groups. The main contributors to sustainability among the Non-Government supported groups were access to production resources, financial health, and member loyalty, while the main contributors for the Government supported groups were leadership, financial health, and member loyalty. © 2022 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
Background Globally, diarrheal and respiratory diseases are among the main causes of mortality and morbidity. In Uganda, cities are facing proliferation of trade in herbal medicines (HM), including those for diarrhea and/or cough. Information on the economic, and the ethnopharmacological aspects of these HM is scarce, deterring the sector from achieving optimal capacity to support national development. We profiled the anti-diarrhea and/or anti-cough HM, and the basic economic aspects of HM trade in Kampala city, to support ethnopharmacological knowledge conservation and strategic planning. Methods A cross-sectional survey was conducted on 65 herbalists using semi-structured questionnaires. This was supplemented by an observational survey using a high-resolution digital camera. Data were collected following the guidelines for research on HM, established by Uganda National Drug Authority, and World Health organization. Results Eighty-four plant species from 41 families were documented. Fabaceae and Myricaceae had the highest number of species (9, 10.7% each). Citrus limon (L.) Osbeck was the most commonly cited for cough, with a relative frequency of citation (RFC) of 1.00, and its relative medical importance was not significantly different from the other top 5 species except for Azadirachta indica A.Juss (RFC = 0.87). Entada abyssinica A. Rich (RFC = 0.97) was the most cited for diarrhea. Trees (34, 40.5%) were mostly used, and mainly harvested from wild habitats (55.2%) in 20 districts across Uganda. These HM were mainly sold as powders and concoctions, in markets, shops, pharmacies, and roadside or mobile stalls. The highest prices were Uganda Shillings (UGX) 48,000 ($13.15)/kg for Allium sativum L, and UGX 16,000 ($4.38)/kg for C. limon . All participants used HM trade as a sole source of basic needs; majority (60.0%) earned net monthly profit of UGX. 730,000 ($200) ≤ 1,460,000 ($400). The main hindrances to HM trade were the; disruptions caused by the COVID-19 pandemic ( n = 65, 100%), and the scarcity of medicinal plants (58, 89.2%). Conclusion There is a rich diversity of medicinal plant species traded in Kampala to treat diarrhea and cough. The HM trade significantly contributes to the livelihoods of the traders in Kampala, as well as the different actors along the HM value chain throughout the country.
Despite increasing evidence of the challenges affecting Community Health Workers (CHWs) such as those related to training, supportive supervision and remuneration, there is a need to explore concerns and challenges from the perspective of CHWs themselves. This commentary highlights some of the contested and unexplored notions of challenges affecting CHWs in low- and middle-income countries (LMICs) informed by the Silences Framework. This framework defines experiences that are under-explored, misunderstood or difficult to share because of the often invisible power relations within communities, but also in setting the research agenda. These challenges include the heavy workload imposed by several stakeholders, dealing with religious and cultural practices, and gendered barriers of care. The workload of CHWs is a major source of stress and anxiety as they have to balance both government and other stakeholders’ agendas to deliver interventions with their own need to provide for their families for those whose work is unpaid. The tensions of CHWs carrying out their work among members of the community whose religious or cultural beliefs are different from theirs also needs to be considered. Gender issues are an impediment to the work of CHWs, particularly with community members of the opposite sex around sensitive health issues. Lastly, CHWs have found themselves victims of domestic suspicion while fulfilling their duties in communities, such as when seen having conversations with spouses of other individuals in the community. Solutions to these challenges need to be co-produced with CHWs to both to strengthen their relationship with the communities they serve and shape more sustainable interventions for delivery of healthcare in LMICs.
Background The contemporary frameworks for clinical research require informed consent for research participation that includes disclosure of material information, comprehension of disclosed information and voluntary consent to research participation. There is thus an urgent need to test, and an ethical imperative, to test, modify or refine medications or healthcare plans that could reduce patient morbidity, lower healthcare costs or strengthen healthcare systems. Methods Conceptual review. Discussion Although some allocation principles seem better than others, no single moral principle allocates interventions justly, necessitating combining the moral principles into multiprinciple allocation systems. The urgency notwithstanding, navigating ethical challenges related to conducting corona virus disease (COVID-19) clinical trials is mandatory, in order to safeguard the safety and welfare of research participants, ensure autonomy of participants, reduce possibilities for exploitation and ensure opportunities for research participation. The ethical challenges to can be categorized as challenges in allocation of resources for research; challenges of clinical equipoise in relation to the research questions; challenges of understanding disclosed information in potential participants; and challenges in obtaining informed consent. Conclusion To navigate these challenges, stakeholders need a delicate balance of moral principles during allocation of resources for research. Investigators need to apply information processing theories to aid decision-making about research participation or employ acceptable modifications to improve the informed consent process. Research and ethics committees should strengthen research review and oversight to ensure rigor, responsiveness and transparency.
Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-based physicians, nurses and other healthcare professionals from 27 high-, middle- and low-income countries suggested 608 initial research questions, reduced after evidence review by 27 academic experts to 176 questions covering diagnosis, management, monitoring, self-management and prognosis of asthma, COPD and other respiratory conditions (including infections, lung cancer, tobacco control, sleep apnoea). Forty-nine questions reached 80% consensus for importance. Cross-cutting themes identified were: a need for more effective training of primary care clinicians; evidence and guidelines specifically relevant to primary care, adaption for local and low-resource settings; empowerment of patients to improve self-management; and the role of the multidisciplinary healthcare team.
Objective Currently, the only available staging criterion for T. b. rhodesiense requires a lumber puncture to collect and later examine cerebrospinal fluid (CSF). This study examined the potential of plasma Neuron-Specific Enolase (NSE) in discriminating between early and late-stage patients. Results When median NSE levels were compared between early and late-stage patients, results showed a significant (P < 0.02) upregulation among late-stage patients (599.8 ng/mL). No significant differences (P > 0.9) in NSE levels were observed between early-stage patients (300 ng/mL) and controls (454 ng/mL). We used Receiver Operator Characteristic (ROC) curves to explore the likelihood of using plasma NSE as a potential stage biomarker in discriminating between early and late-stage HAT patients. Our results showed that NSE demonstrated an area under the curve (AUC) of 0.702 (95% CI 0.583–0.830). A high staging accuracy for NSE was obtained by using a cutoff of > 346.5 ng/mL with a sensitivity of 68.6% (95% CI 55–79.7%) and a specificity of 93.3% (95% CI 70.2–99.7%). Although our results demonstrate that plasma NSE is upregulated in T. b. rhodesiense sleeping sickness patients, its value in discriminating between late and early-stage patients is limited. However, future studies could consider improving its specificity by combining it with other identified plasma biomarkers.
Background Communities of Practice (CoPs) offer an accessible strategy for healthcare workers to improve the quality of care through knowledge sharing. However, not enough is known about which components of CoPs are core to facilitating behavior change. Therefore, we carried out a qualitative study to address these important gaps in the literature on CoPs and inform planning for an interventional study of CoPs. Methods We organized community health workers (CHWs) from two tuberculosis (TB) clinics in Kampala, Uganda, into a CoP from February to June 2018. We conducted interviews with CoP members to understand their perceptions of how the CoP influenced delivery of TB contact investigation. Using an abductive approach, we first applied inductive codes characterizing CHWs’ perceptions of how the CoP activities affected their delivery of contact investigation. We then systematically mapped these codes into their functional categories using the Behavior Change Technique (BCT) Taxonomy and the Behavior Change Wheel framework. We triangulated all interview findings with detailed field notes. Results All eight members of the CoP agreed to participate in the interviews. CHWs identified five CoP activities as core to improving the quality of their work: (1) individual review of feedback reports, (2) collaborative improvement meetings, (3) real-time communications among members, (4) didactic education sessions, and (5) clinic-wide staff meetings. These activities incorporated nine different BCTs and five distinct intervention functions. CHWs reported that these activities provided a venue for them to share challenges, exchange knowledge, engage in group problem solving, and benefit from social support. CHWs also explained that they felt a shared sense of ownership of the CoP, which motivated them to propose and carry out innovations. CHWs described that the CoP strengthened their social and professional identities within and outside the group, and improved their self-efficacy. Conclusions We identified the core components and several mechanisms through which CoPs may improve CHW performance. Future studies should evaluate the importance of these mechanisms in mediating the effects of CoPs on program effectiveness.
The study assessed the economic impact of COVID-19 on cattle traders in the Karamoja and Teso pastoral and agro-pastoral areas in Uganda and their response after the COVID-19 lockdown in 2020. The results reveal that cattle traders were negatively affected by COVID-19 in many ways including reduction in cattle sales, erosion in operating capital, and failure to sell animals while others have diversified or moved to other businesses. Twenty-five per cent of the cattle traders did not sell any animal during the lockdown. A majority of these were from Karamoja (43%) compared to those in Teso sub-region. The decline in cattle sales was significantly higher in Karamoja than in Teso sub-region. However, their recovery was significantly higher in Karamoja than in Teso sub-region because traders in Teso greatly diversified to other economic activities compared to traders in Karamoja sub-region. The traders who lost capital were mainly in Teso sub-region (63%). As expected, there was a sharp decline in the number of cattle buyers from markets outside the study area, mainly from Juba, Kampala, Busia, and Kenya. Coping strategies by cattle traders included crop cultivation (80%), burning charcoal (15%), selling food items (8%), and boda-boda riding (12%), while others did not engage in any economic activity (25%). To mitigate against the pandemic, traders were observing some of the standard operating procedures (SOPs) such as wearing face masks (76.1%), handwashing (19.3%), sanitising (2.3%), and social distancing (2.3%). Traders from Karamoja performed poorly in both diversification and mitigation measures. Based on our findings, recommendations to mitigate the impact of COVID-19 on cattle traders include offering loans to cattle traders through their Village Savings and Loan Association (VSLA), reducing transaction costs, offering mobile phones especially for Karamoja traders, and promoting the adoption of enforcing SOPs to reduce the need for lockdowns and cattle market closures which are detrimental to pastoral livelihood.
Background Uganda remains one of the countries with the highest burden of TB/HIV. Drug-resistant TB remains a substantial challenge to TB control globally and requires new strategic effective control approaches. Drug resistance usually develops due to inadequate management of TB patients including improper treatment regimens and failure to complete the treatment course which may be due to an unstable supply or a lack of access to treatment, as well as patient noncompliance. Methods Two sputa samples were collected from Xpert MTB/RIF® assay-diagnosed multi-drug resistant tuberculosis (MDR-TB) patient at Lira regional referral hospital in northern Uganda between 2020 and 2021 for comprehensive routine mycobacterial species identification and drug susceptibility testing using culture-based methods. Detection of drug resistance-conferring genes was subsequently performed using whole-genome sequencing with Illumina MiSeq platform at the TB Supranational Reference Laboratory in Uganda. Results In both isolates, extensively drug-resistant TB (XDR-TB) was identified including resistance to Isoniazid ( katG p.Ser315Thr), Rifampicin ( rpoB p.Ser450Leu), Moxifloxacin ( gyrA p.Asp94Gly), Bedaquiline ( Rv0678 Glu49fs), Clofazimine ( Rv0678 Glu49fs), Linezolid ( rplC Cys154Arg), and Ethionamide ( ethA c.477del). Further analysis of these two high quality genomes revealed that this 32 years-old patient was infected with the Latin American Mediterranean TB strain (LAM). Conclusions This is the first identification of extensively drug-resistant Mycobacterium tuberculosis clinical isolates with bedaquiline, linezolid and clofazimine resistance from Uganda. These acquired resistances were because of non-adherence as seen in the patient’s clinical history. Our study also strongly highlights the importance of combating DR-TB in Africa through implementing next generation sequencing that can test resistance to all drugs while providing a faster turnaround time. This can facilitate timely clinical decisions in managing MDR-TB patients with non-adherence or lost to follow-up.
Understanding spatio-temporal land use land cover change is vital in responding to the dynamic and complex global environmental change that is having diverse effects on integrity of most landscapes. A study was conducted in the Budongo - Bugoma landscape to assess spatio-temporal patterns of land use land cover change using supervised image classification of Landsat imagery for 1990, 2000, 2010, 2020 and a prediction of LULC situation in 2040 done in Dinamica-EGO modelling platform. Between 1990–2020, there was a declining trend for grassland, bushland, and tropical high forest by −19.5%, −4.7%, and −2.7% respectively while subsistence farmland, commercial farmland, built-up areas experienced an overall rate of change of 19.0%, 5.0%, 3.5% respectively. This led to intensified landscape fragmentation and increased landscape homogeneity to mostly farmlands. The declining LULC classes were majorly converting to the increasing LULC classes with conversion hotspot areas detected in privately-owned lands occurring mainly in rural areas, sugarcane growing areas, refugee settlement areas, and oil/gas project sites. In 2040, it is predicted that approximately 50% of the landscape will be covered by human managed LULC classes including subsistence farmland, commercial farmland, and built-up area compared to approximately 40% in 2020. Agricultural activities and increased population density were the most significant drivers of the established land use land cover changes. This study has shown accelerated loss of key land cover biomes; grasslands, bushlands, and tropical high forests mediated by anthropogenic factors and leading to reduced landscape heterogeneity thus potential to significantly affect ecosystem services supply in this region. Promotion of agroecology, non-consumptive projects, and participatory land use planning are recommended to secure sustainable land use management. Establishment of the implication of LULCC on ecosystem services potential and ultimately human well-being is also recommended.
Background The global consumption of herbal medicine is increasing steadily, posing an extinction risk to medicinal plants. Uganda is among the top ten countries with a high threat of herbal medicine extinction, and Traditional Medicinal Knowledge (TMK) erosion. This might be attributed to the inadequate documentation, plus many more unclear hindrances. In this study, plant species used to treat human diseases in Butaleja district in Eastern Uganda and their associated TMK were documented. The conservation methods for medicinal plants were also evaluated. The rationale was to support the preservation of ethnopharmacological knowledge. Methods Data were collected from 80 herbalists using semi-structured questionnaires, from July 2020 to March 2021. Additionally, guided field walks and observations were conducted. Quantitative indices such as, use categories and informant consensus factor (ICF) were evaluated to elucidate the importance of the medicinal plants. Data were analyzed using STATA version-15.0 software. Results In total, 133 species, belonging to 34 families and 125 genera were identified. Fabaceae (65%), and Solanaceae (29%) were the dominant families. Leaves (80%), and roots (15%), were the commonest parts used in medicinal preparations; mostly administered orally as decoctions (34.6%) and infusions (16%). The commonest illnesses treated were cough (7.74%), gastric ulcers (7.42%), and malaria (4.52%). The informant consensus factor was high for all disease categories (≥ 0.8), indicating homogeneity of knowledge about remedies used. Only 73% of the respondents made efforts to conserve medicinal plants. The commonest conservation strategy was preservation of forests with spiritually valued species (100%), while compliance with government regulations was the rarest (4.5%). Overall, efforts to stop the extinction of medicinal plants and TMK were inadequate. Conclusion and recommendations There was enormous dependency on a rich diversity of medicinal plant species and TMK for healthcare and income generation. The potential for medicinal plant biodiversity loss was evident due to habitat destruction. Inclusion of traditional cultural norms in conservation strategies, and laboratory-based efficacy tests for the species identified are necessary, to promote the conservative and utilization of validated herbal medicines and TMK in rural settings.
Poor disposal and handling of asphalt material in construction activities has a great effect on the environment. Despite the use of asphalt material in other activities, a high percentage of it is poorly handled in Uganda. For this, the present study aimed to investigate the mechanical performance of reclaimed asphalt pavement (RAP) along with steel fibers in concrete and the variation of mechanical behavior concerning different curing times with the optimal RAP aggregate-substitute ratio. The result showed that the mechanical and physical properties of the fine and coarse aggregates used suited the replacement when compared with BS EN standard. Workability of fresh concrete is reduced as the percentage RAP increases in the mixture. This reduction was caused due to the asphalt mortar coating on the RAP aggregates, dirt particles and the irregular shape of aggregates. The compressive strength increases and decreases afterward with the increase of the percentage RAP replacement ratio. This occurred due to the presence of oils in the bitumen and weak bond between the asphalt binder coating around the RAP aggregates. When the steel fibers increase, the split strength increases along with curing time. A maximum savings of 6.13% of RAP was accomplished by incorporating 60% RAP replacement mix. For the Uganda scenario, this work serves as a guide for excess RAP application in construction activities. Using reclaimed asphalt materials provides a long-term solution for reducing the cost of materials and end-of-life materials disposal in the landfill.
Introduction The African Federation of Emergency Medicine (AFEM) recommends the use of emergency point-of-care ultrasound (ePOCUS) as a core skill for health care practitioners in Africa. The study explored the use of ePOCUS by health care practitioners among AFEM members who work across Africa. Methods An anonymous online survey was distributed to individual members of AFEM and affiliated organisations. The questionnaire was tested by the AFEM Scientific Committee for potential content modifications prior to distribution. Summary statistics are presented. Results Of the 220 participants that were analysed, 148 (67.3%) were using ePOCUS. The mean age was 36 years; 146 (66%) were male; and 198 (90%) obtained their primary medical qualification in Africa. In total, 168 (76%) were doctors, and most participants (n = 204, 93%) have worked in Africa during the last 5 years. Reasons for not using ePOCUS mainly related to lack of training and problems with ultrasound machines or consumables. Most ePOCUS users (116/148, 78%) attended courses with hands-on training, but only 65 (44%) participants were credentialed (by 18 different organizations). The median score for self-perceived level of ePOCUS skills was 75 in credentialed users versus 50 in those that were not credentialed. Ultrasound in trauma was the most frequently used module (n = 141, 99%), followed by focused cardiac assessment (n = 128, 90%) and thoracic (including lung) assessment (n = 128, 90.1%). The FASH-module (Focused Assessment with Sonography for HIV/TB) was the least used (n = 69, 49%). Conclusion Access barriers to ePOCUS training, mentorship, equipment and consumables are still relevant in Africa. The low credentialing rate and the potential discordance between local burden of disease and ePOCUS training requires further investigation.
Street artists around the world have been prominent in depicting issues concerning COVID-19, but the role of street art in public-making during the pandemic is unexplored. Despite burgeoning street art scenes in many African countries since the early 2000s, African street art is relatively neglected in critical street art scholarship. In response, this paper examines street art created during the pandemic in East African countries, principally Uganda, Kenya, Rwanda, and Tanzania, and explores the ways in which it is engaged in highly distinctive forms of public-making. Drawing primarily on qualitative online interviews with East African artists creating street art, and image analysis using online search tools, the paper argues that street art in urban areas is attempting to create knowledgeable publics through countering disinformation about the pandemic, to responsiblize publics through public health messaging and, through community activism, to build resilient publics. The paper concludes that street art is potentially an important tool in tackling the COVID-19 pandemic in East African countries due to the proximity, and mutual constitution of, creative practices and publics, which emerge from the embedding of street art within the social spaces of cities and everyday experiences of the pandemic.
Objective: We aimed to determine the prevalence of abnormal umbilical artery (UA), uterine artery (UtA), middle cerebral artery (MCA), and cerebroplacental ratio (CPR) Dopplers, and their relationship with adverse perinatal outcomes in women undergoing routine antenatal care in the third trimester. Design: Prospective cohort SETTING: Kagadi Hospital, Uganda POPULATION: Non-anomalous singleton pregnancies. Methods: Women underwent an early dating ultrasound and a third trimester Doppler scan between 32 and 40 weeks, from 2018 - 2020. We handled missing data using multiple imputation and analyzed the data using descriptive methods and binary logistic regression model. Main outcome measures: Composite adverse perinatal outcome (CAPO), perinatal death, and stillbirth. Results: We included 995 women. Mean gestational age at Doppler scan was 36.9 (SD, 1.02) and 88.9% of the women gave birth in a health facility. About 4.4% and 5.6% of the UA PI and UtA PI were > 95th percentile, while 16.4% and 10.4% of the MCA PI and CPR were < 5th percentile, respectively. Low CPR was strongly associated with stillbirth (OR= 4.82, 95% CI: 1.09 - 21.30). CPR and MCA PI <5th percentiles were independently associated with CAPO; the association with MCA PI was stronger in small for gestational age neonates, (OR= 3.75, 95% CI: 1.18- 11.88). Conclusion: In late gestation, abnormal UA PI was rare. Fetuses with cerebral blood flow redistribution were at increased risk of stillbirth and perinatal complications. Further studies examining its predictive accuracy and effectiveness in reducing the risk of perinatal deaths in LMICs are warranted.
Coffee-based farming systems (CBFS) support smallholder farmers through mainly coffee growing with integration of other food crops and livestock. Climate change is expected to ravage crop suitability in several agroecological zones, posing a threat to national earnings and livelihoods. However, previous studies have mainly considered crop-specific analyses rather than the major crops in a farming system. This study illustrates variations in climatic suitability of major crops grown in Uganda’s Arabica and Robusta CBFS at disaggregated altitudes. Climate data (1980–2009) was projected for 2010–2039 (near-term future) for five climate scenarios under Representative Concentration Pathways—RCP 8.5 and 4.5 using twenty-nine global climate models (GCMs) based on the delta method. Climatic suitability of coffee, banana, maize, and beans was assessed using EcoCrop model. Rainfall and temperature changes are expected during long rains and second-dry seasons, with higher rainfall increments during short rains. Minimum temperatures are likely to increase in low altitudes under ensemble-mean, hot-wet, and hot-dry scenarios. Crop suitability improvements (> 5% area) are expected in mid to high altitudes under cool-wet and hot-wet, mainly for RCP 4.5 while western Uganda Arabica CBFS are unlikely to experience crop suitability changes. Suitable area for East African banana and beans is likely to increase utmost 44.7%, and expected to decline to marginal utmost 64% (coffee and banana) and 21.2% (maize) in central Robusta and eastern Arabica CBFS under ensemble-mean, cool-dry, and hot-dry scenarios. Plantain and dessert banana are likely to become unsuitable within Robusta and high-altitude Arabica CBFS. This study recommends identification and use of system appropriate climate-smart adaptation strategies to mitigate future crop-climate vulnerabilities within CBFS.
Background Mycobacterium tuberculosis presents several lineages each with distinct characteristics of evolutionary status, transmissibility, drug resistance, host interaction, latency, and vaccine efficacy. Whole genome sequencing (WGS) has emerged as a new diagnostic tool to reliably inform the occurrence of phylogenetic lineages of Mycobacterium tuberculosis and examine their relationship with patient demographic characteristics and multidrug-resistance development. Methods 191 Mycobacterium tuberculosis isolates obtained from a 2017/2018 Tanzanian drug resistance survey were sequenced on the Illumina Miseq platform at Supranational Tuberculosis Reference Laboratory in Uganda. Obtained fast-q files were imported into tools for resistance profiling and lineage inference (Kvarq v0.12.2, Mykrobe v0.8.1 and TBprofiler v3.0.5). Additionally for phylogenetic tree construction, RaxML-NG v1.0.3(25) was used to generate a maximum likelihood phylogeny with 800 bootstrap replicates. The resulting trees were plotted, annotated and visualized using ggtree v2.0.4 Results Most [172(90.0%)] of the isolates were from newly treated Pulmonary TB patients. Coinfection with HIV was observed in 33(17.3%) TB patients. Of the 191 isolates, 22(11.5%) were resistant to one or more commonly used first line anti-TB drugs (FLD), 9(4.7%) isolates were MDR-TB while 3(1.6%) were resistant to all the drugs. Of the 24 isolates with any resistance conferring mutations, 13(54.2%) and 10(41.6%) had mutations in genes associated with resistance to INH and RIF respectively. The findings also show four major lineages i.e. Lineage 3[81 (42.4%)], followed by Lineage 4 [74 (38.7%)], the Lineage 1 [23 (12.0%)] and Lineages 2 [13 (6.8%)] circulaing in Tanzania. Conclusion The findings in this study show that Lineage 3 is the most prevalent lineage in Tanzania whereas drug resistant mutations were more frequent among isolates that belonged to Lineage 4.
Several studies evaluate active (i.e., seeding/planting) and passive (i.e., protecting forest regrowth) restoration, but few studies examine successional patterns for different plant sizes. By using biodiversity and structure, we examined whether restoration communities approach old‐growth forests over time, and whether restoration success varies for different tree sizes in both active and passive interventions. We examined how initial site conditions affect active restoration. Small (dbh ≥ 5 cm), medium (≥15 cm), and large trees (≥30 cm) were measured in 2003–2017 in permanent sample plots in restoration plantings (initially 3–8 years old) and in an old‐growth forest in Kibale National Park, Uganda. Trees were also measured in regrowth forests (initially 16 years old) in 2011–2017. We collated information about site conditions from restoration reports. Biodiversity and structure increased over time towards the old‐growth forest. Restoration plantings and regrowth forests recovered diversity and structure of small and medium trees except for large trees. Forest recovery increased with proportions of remnant banana plants and shrubs, while isolation from the old‐growth forest slowed recovery. Disaggregating vegetation inventory data by tree size may be useful in achieving a holistic measure of restoration. Restorationists could prioritize sites with remnant banana plants and shrubs, and sites closer to old‐growth forests in order to achieve better results. Our article examined whether restoration communities approach reference forests over time, assessed the influence of tree size on restoration success in restoration plantings and regrowth forests, and how landscape conditions affect active restoration. We show that restoration success is faster for smaller than larger trees. Forest recovery increases with the proportion of banana plants and remnant shrubs, while isolation from the old‐growth forest slows recovery.
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