Mathematical model for the impact of awareness on the dynamics of infectious diseases

This paper analyses an SIRS-type model for infectious diseases with account for behavioural changes associated with the simultaneous spread of awareness in the population. Two types of awareness are included into the model: private awareness associated with direct contacts between unaware and aware populations, and public information campaign. Stability analysis of different steady states in the model provides information about potential spread of disease in a population, and well as about how the disease dynamics is affected by the two types of awareness. Numerical simulations are performed to illustrate the behaviour of the system in different dynamical regimes

Dynamics of vaccination in a time-delayed epidemic model with awareness

This paper investigates the effects of vaccination on the dynamics of infectious disease, which is spreading in a population concurrently with awareness. The model considers contributions to the overall awareness from a global information campaign, direct contacts between unaware and aware individuals, and reported cases of infection. It is assumed that there is some time delay between individuals becoming aware and modifying their behaviour. Vaccination is administered to newborns, as well as to aware individuals, and it is further assumed that vaccine-induced immunity may wane with time. Feasibility and stability of the disease-free and endemic equilibria are studied analytically, and conditions for the Hopf bifurcation of the endemic steady state are found in terms of system parameters and the time delay. Analytical results are supported by numerical continuation of the Hopf bifurcation and numerical simulations of the model to illustrate different types of dynamical behaviour

Participatory definition of trait preferences for designing village breeding schemes for goats in harsh environments of Ethiopia

There is critical need to improve productivity of indigenous goat breeds in order to sustain supply of food and income to communities living in harsher areas that are coming to relay more and more on the drought tolerant commodity; goats, due to changing climate. To this end, a community-based goat breeding project is being implemented in 5 zones of Ethiopia by ILRI and its partners. Designing of the breeding programs proceeded phenotypic and molecular characterization of the indigenous Ethiopian goat breeds. The characterization studies revealed that ample genetic diversity exists between and within the indigenous goat breeds pointing hug potential to tap for improving productivity amid a changing climate. Participatory definition of trait preferences was undertaken to pave the way for deriving economic weights of traits to develop selection indices

Registration and local production of essential medicines in Uganda

Universal access to high quality essential medicines is critical to sustainable development (SDG 3.8). However low- and middle-income countries struggle to ensure access to all medicines on their national essential medicines lists (EML). Market registration is the first step in determining both access and availability yet the extent to which essential medicines are registered for use at country level is not known. Companies apply for a marketing authorisation, however low price or lack of a market is a disincentive. Local production has been promoted to ensure availability of essential medicines but research in this area is also limited.; The study took place between 2011 and 2015. We systematically examined the registration status of medicines and vaccines listed in the Ugandan 2012 EML and conducted 20 interviews with regulators, ministry of health representatives, donors, and pharmaceutical producers and analysed quality assurance issues affecting registration, procurement, and local production of medicines in Uganda. In 2017 we conducted a further three interviews to clarify issues around non-registration of essential medicines highlighted by our analysis.; Of the 566 essential medicines and vaccines nearly half (49%; 275/566) had no registered product in 2012. Of the 3130 registered products, just over a quarter (28%; 880/3130) were listed on the EML. Six local producers had registered 138 products of which 40 corresponded to 32 unique essential medicines. Interviews highlighted alternative routes to availability other than registration. Local producers faced considerable barriers to achieving international quality standards required for international procurement of medicines for the domestic market.; Monitoring and audit of the registration of essential and non-essential medicines should be a priority nationally and, regionally through harmonisation of registration requirements in the East African Community. National and regional manufacturing plans should consider local production of unregistered essential medicines

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in Uganda: a double-blind randomized non-inferiority trial

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal death in sub-Saharan Africa. Although the World Health Organization recommends use of oxytocin for prevention of PPH, misoprostol use is increasingly common owing to advantages in shelf life and potential for sublingual administration. There is a lack of data about the comparative efficacy of oxytocin and sublingual misoprostol, particularly at the recommended dose of 600 mu g, for prevention of PPH during active management of labor. Methods and Findings: We performed a double-blind, double-dummy randomized controlled non-inferiority trial between 23 September 2012 and 9 September 2013 at Mbarara Regional Referral Hospital in Uganda. We randomized 1,140 women to receive 600 mu g of misoprostol sublingually or 10 IU of oxytocin intramuscularly, along with matching placebos for the treatment they did not receive. Our primary outcome of interest was PPH, defined as measured blood loss >= 500 ml within 24 h of delivery. Secondary outcomes included measured blood loss >= 1,000 ml; mean measured blood loss at 1, 2, and 24 h after delivery; death; requirement for blood transfusion; hemoglobin changes; and use of additional uterotonics. At 24 h postpartum, primary PPH occurred in 163 (28.6%) participants in the misoprostol group and 99 (17.4%) participants in the oxytocin group (relative risk [RR] 1.64, 95% CI 1.32 to 2.05, p<0.001; absolute risk difference 11.2%, 95% CI 6.44 to 16.1). Severe PPH occurred in 20 (3.6%) and 15 (2.7%) participants in the misoprostol and oxytocin groups, respectively (RR 1.33, 95% CI 0.69 to 2.58, p = 0.391; absolute risk difference 0.9%, 95% CI -1.12 to 2.88). Mean measured blood loss was 341.5 ml (standard deviation [SD] 206.2) and 304.2 ml (SD 190.8, p = 0.002) at 2 h and 484.7 ml (SD 213.3) and 432.8 ml (SD 203.5, p<0.001) at 24 h in the misoprostol and oxytocin groups, respectively. There were no significant differences between the two groups in any other secondary outcomes. Women in the misoprostol group more commonly experienced shivering (RR 1.91, 95% CI 1.65 to 2.21, p<0.001) and fevers (RR 5.20, 95% CI 3.15 to 7.21, p = 0.005). This study was conducted at a regional referral hospital with capacity for emergency surgery and blood transfusion. High-risk women were excluded from participation. Conclusions: Misoprostol 600 mu g is inferior to oxytocin 10 IU for prevention of primary PPH in active management of labor. These data support use of oxytocin in settings where it is available. While not powered to do so, the study found no significant differences in rate of severe PPH, need for blood transfusion, postpartum hemoglobin, change in hemoglobin, or use of additional uterotonics between study groups. Further research should focus on clarifying whether and in which sub-populations use of oxytocin would be preferred over sublingual misoprostol

Farmers’ knowledge on forage production in smallholder dairy systems of Uganda

The aim of the study was to assess dairy farmers’ knowledge on forage production and utilization in the Lake Victoria crescent and Eastern Highlands Agro Ecological Zones (AEZs) of Uganda. Semi-structured questionnaires were administered to a total of 208 small holder dairy farmers in Masaka (100) and Mbale (108) districts. Data was analyzed using Statistical Package for Social Scientists. While the main source of forage is on farm (67.2%), forage growing is not taken as a tradition among small holder dairy farmers. The most prominent forage species used for feeding livestock are Pennisetum purpureum, Calliandra calothyrsus, Musa paradisiacal (peelings and stems), and Leucaena leucocephala. Milk production increases during months of forage abundance (March to May and September to November) and the observed trends are generally comparable to the seasonal rainfall patterns in Uganda. Forage production among dairy farmers is significantly (P < 0.05) influenced by location, household size, land ownership, forage source and livestock feeding system. Apart from chopping before feeding the animals, minimal processing is done to forage. The study provides a basis for designing interventions for improving fodder production and utilization among Uganda’s smallholder dairy farmers.Buyinza Joel, Sekatuba Jude, Ongodia Gerald, Eryau Kenneth, Nansereko Susan, Opolot Ibwala Vincent, Kwaga Phiona, Akellem Richard, Mudondo Scovia and Agaba Hillar

Transcriptional profiling of cattle infected with Trypanosoma congolense highlights gene expression signatures underlying trypanotolerance and trypanosusceptibility

<p>Abstract</p> <p>Background</p> <p>African animal trypanosomiasis (AAT) caused by tsetse fly-transmitted protozoa of the genus <it>Trypanosoma </it>is a major constraint on livestock and agricultural production in Africa and is among the top ten global cattle diseases impacting on the poor. Here we show that a functional genomics approach can be used to identify temporal changes in host peripheral blood mononuclear cell (PBMC) gene expression due to disease progression. We also show that major gene expression differences exist between cattle from trypanotolerant and trypanosusceptible breeds. Using bovine long oligonucleotide microarrays and real time quantitative reverse transcription PCR (qRT-PCR) validation we analysed PBMC gene expression in naïve trypanotolerant and trypanosusceptible cattle experimentally challenged with <it>Trypanosoma congolense </it>across a 34-day infection time course.</p> <p>Results</p> <p>Trypanotolerant N'Dama cattle displayed a rapid and distinct transcriptional response to infection, with a ten-fold higher number of genes differentially expressed at day 14 post-infection compared to trypanosusceptible Boran cattle. These analyses identified coordinated temporal gene expression changes for both breeds in response to trypanosome infection. In addition, a panel of genes were identified that showed pronounced differences in gene expression between the two breeds, which may underlie the phenomena of trypanotolerance and trypanosusceptibility. Gene ontology (GO) analysis demonstrate that the products of these genes may contribute to increased mitochondrial mRNA translational efficiency, a more pronounced B cell response, an elevated activation status and a heightened response to stress in trypanotolerant cattle.</p> <p>Conclusion</p> <p>This study has revealed an extensive and diverse range of cellular processes that are altered temporally in response to trypanosome infection in African cattle. Results indicate that the trypanotolerant N'Dama cattle respond more rapidly and with a greater magnitude to infection compared to the trypanosusceptible Boran cattle. Specifically, a subset of the genes analyzed by real time qRT-PCR, which display significant breed differences, could collectively contribute to the trypanotolerance trait in N'Dama.</p

Prevalence of irritable bowel syndrome: A community survey in an African population

Background : Irritable bowel syndrome (IBS) has been reported to be common in the West. Community surveys are lacking in the African setting. We determined the prevalence of IBS in a rural community setting in Nigeria. Method : Questionnaires were administered to consenting individuals. Subjects satisfying the Rome II criteria for IBS were invited for physical examination at a health center to identify the presence of "alarm factors." Results : One hundred forty (31.6%) of the 443 evaluated individuals fulfilled the Rome II criteria for IBS, with a male-to-female ratio of 1.37:1 (P= .11). The prevalence of IBS was highest (39.3%) in the third decade, followed by 25% in the fourth decade (P= .009). Ninety-six (67%) IBS individuals had the alternating pattern of diarrhea and constipation, whereas 28 (20%) and 19 (13%) had constipation and diarrhea subtypes, respectively. Conclusion : IBS as diagnosed by the Rome II criteria has a high prevalence in the African rural population, as obtained elsewhere.Contexte: Irritable Syndrome (IBS) a \ue9t\ue9 signal\ue9 \ue0 \ueatre commune \ue0 l\u2019Ouest. Enqu\ueates communautaires font d\ue9faut dans le contexte africain. Nous avons d\ue9termin\ue9 la pr\ue9valence de IBS dans un milieu rural. communaut\ue9 d\ue9fi nition dans le Nig\ue9ria. M\ue9thode: Questionnaires ont \ue9t\ue9 administr\ue9 aux personnes consentantes. Sujets de satisfaction de la Rome II crit\ue8res d\u2019IBS ont \ue9t\ue9 invit\ue9s pour l\u2019examen physique dans un centre de sant\ue9 \ue0 identifi er la pr\ue9sence de \u201c alarme les facteurs \u201d. R\ue9sultats: Un cent et quarante (31,6 %) des individus \ue9valu\ue9es 443 rempli le Rome Crit\ue8res II IBS avec un m\ue2le \ue0 ratio f\ue9minin de 1.37:1 (p = 0,11) .la pr\ue9valence IBS \ue9tait plus \ue9lev\ue9 dans la troisi\ue8me d\ue9cennie (39.3 %), suivie de 25 % dans le quatri\ue8me dix ans (p = 0.009). Quatre-vingt-seize (67 %) IBS personnes avaient le mod\ue8le d\u2019alternance de la diarrh\ue9e et constipation, alors que 28 (20 %) et 19 (13 %) avaient constipation et la diarrh\ue9e subtypes respectivement. Conclusion: IBS comme un diagnostic par les crit\ue8res de Rome II a une haute pr\ue9valence dans la population rurale africaine comme obtenu ailleurs

Characterizing microscopic and submicroscopic malaria parasitaemia at three sites with varied transmission intensity in Uganda.

BACKGROUND: Parasite prevalence is a key metric used to quantify the burden of malaria and assess the impact of control strategies. Most published estimates of parasite prevalence are based on microscopy and likely underestimate true prevalence. METHODS: Thick smear microscopy was performed in cohorts of children (aged 6 month to 10 years) and adults every 90 days over 2 years, at three sites of varying transmission intensity in Uganda. Microscopy-negative samples were tested for sub-microscopic parasitaemia using loop-mediated isothermal amplification (LAMP). Generalized estimating equation models were used to evaluate associations between age and parasitaemia, factors associated with sub-microscopic infection and associations between parasitaemia and haemoglobin. RESULTS: A total of 9260 samples were collected from 1245 participants. Parasite prevalence among children across the three sites was 7.4, 9.4 and 28.8 % by microscopy and 21.3, 31.8 and 69.0 % by microscopy plus LAMP. Parasite prevalence among adults across the three sites was 3.1, 3.0 and 5.2 % by microscopy and 18.8, 24.2 and 53.5 % by microscopy plus LAMP. Among those with parasitaemia, adults and persons recently treated with anti-malarial therapy had the highest prevalence of sub-microscopic infection. Children with sub-microscopic or microscopic parasitaemia had lower mean haemoglobin levels compared to children with no detectable parasites. CONCLUSIONS: Across a range of transmission intensities in Uganda, microscopy vastly underestimated parasite prevalence, especially among adults

The epidemiology of conjunctival squamous cell carcinoma in Uganda

As part of a larger investigation of cancer in Uganda, we conducted a case–control study of conjunctival squamous cell carcinoma in adults presenting at hospitals in Kampala. Participants were interviewed about social and lifestyle factors and had blood tested for antibodies to HIV, KSHV and HPV-16, -18 and -45. The odds of each factor among 60 people with conjunctival cancer was compared to that among 1214 controls with other cancer sites or types, using odds ratios, estimated with unconditional logistic regression. Conjunctival cancer was associated with HIV infection (OR 10.1, 95% confidence intervals [CI] 5.2–19.4; P<0.001), and was less common in those with a higher personal income (OR 0.4, 95% CI 0.3–1.2; P<0.001). The risk of conjunctival cancer increased with increasing time spent in cultivation and therefore in direct sunlight (χ2 trend=3.9, P=0.05), but decreased with decreasing age at leaving home (χ2 trend=3.9, P=0.05), perhaps reflecting less exposure to sunlight consequent to working in towns, although both results were of borderline statistical significance. To reduce confounding, sexual and reproductive variables were examined among HIV seropositive individuals only. Cases were more likely than controls to report that they had given or received gifts for sex (OR 3.5, 95% CI 1.2–10.4; P=0.03), but this may have been a chance finding as no other sexual or reproductive variable was associated with conjunctival cancer, including the number of self-reported lifetime sexual partners (P=0.4). The seroprevalence of antibodies against HPV-18 and -45 was too low to make reliable conclusions. The presence of anti-HPV-16 antibodies was not significantly associated with squamous cell carcinoma of the conjunctiva (OR 1.5, 95% CI 0.5–4.3; P=0.5) and nor were anti-KSHV antibodies (OR 0.9, 95% CI 0.4–2.1; P=0.8). The 10-fold increased risk of conjunctival cancer in HIV infected individuals is similar to results from other studies. The role of other oncogenic viral infections is unclear