Prevalence of Extended-Spectrum Beta-Lactamases-Producing Microorganisms in Patients Admitted at KRRH, Southwestern Uganda

The emergence of extended-spectrum beta-lactamase- (ESBL-) producing pathogenic bacteria at Kabale Regional Referral Hospital (KRRH), located in southwestern Uganda, is of great concern: a phenomenon that worries clinicians and other healthcare workers due to the serious threat they pose to patients. This current study aimed at determining the phenotypic detection of ESBL-producing strains of E. coli, Klebsiella sp., and Proteus sp. isolated from clinical specimens and their prevalence in patients admitted at KRRH. We used combined disc diffusion technique to detect and establish the presence of ESBLs-producing bacteria. Of the 100 tested bacterial isolates, 89 (89%) were identified as ESBL-producing bacteria. Klebsiella sp. predominated in the samples (46 (52%)), presenting the highest frequency of ESBLs producing followed by E. coli (39 (44%)) and Proteus mirabilis (4 (4.5%)) from the combined disk diffusion

A Collaborative Curriculum Review: Applicability to Higher Education Institutions

Curriculum review is mandatory for all higher education institutions (HEIs). The process brings together different stakeholders’ expertise to evaluate and revise an existing curriculum, positioning the field of study within the current market and industry trends. Although this process is repetitive, it still remains complex, majorly due to divergent stakeholders’ interests, varying levels of expertise, uncertain activity paths and multiple desired outcomes. The paper thus presents a Collaborative Curriculum Review Process (ColCuRP) to support the review of varying curricula in HEIs. We followed a mixed research approach (design science and action research) to design and evaluate the ColCuRP. It underwent four iterations during its evaluation and proved to be successful regards reduction in time for the review process, and supporting the different teams of departmental faculty to review Bachelors, Post Graduate Diploma, Masters and PhD curricula, at four HEIs in Uganda. Moreover, the ColCuRP can be used by inexperienced facilitators

Laboratory Diagnosis of Candidiasis

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

Adverse Childhood Experiences and Adult Cardiometabolic Risk Factors and Disease Outcomes: Cross-Sectional, Populationbased Study of Adults in Rural Uganda

Background: Cardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda. Methods Data come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-International Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and cardiometabolic risk factors and health outcomes. Results Data were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD. Conclusions: Adverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes

Gain and performance in yield and micronutrient concentration in common bean improvement

Common bean (Phaseolus vulgaris L.) is a staple and nutritious leguminous food crop for all income categories in Africa. Efforts to improve its yield performance and nutritional components, especially Iron and zinc have resulted in the release of several varieties in the sub-Saharan African region. The objective of this study was to assess genetic progress in varieties released in 12 African countries through the Pan African Bean Research Alliance (PABRA) from 1973 to 2017, to inform current breeding decisions. A total of 214 released varieties, land races and breeding lines, of bush and climbing beans were evaluated for yield, micronutrient (Fe and Zn) concentration, and phenology in three locations (Kawanda and Kachwekano in Uganda, and Kitengule in Tanzania) in 2017–2018. There were significant differences (P 0.01) among genotypes for all traits except days to maturity (DPM). Genotype x environment interaction was also significant (P<0.05) for all assessed traits, except for iron in climbing beans. Across environments, repeatability (H2) was greater than 0.50 for all traits, except for DPM in climbing beans. Annual rates of genetic yield gains were 4.41 and 4.57 kg ha-1 for large and small seed bush beans, and -2.74 and 21.6 kg ha-1 for large and small seeded climbers. Similarly, gains in seed iron (FESEED) were 0.40 and 0.17 ppm for bush and climbing beans, respectively. These represented an annual relative gain over the oldest varieties of 0.6 and 0.7% kg ha-1 for yield of large and small seeded bush beans, -0.3 and 1.6% kg ha-1 for yield of large and small seeded climbers, 0.6 and 0.2% ppm for FESEED of bush and climbers. Overall, genetic progress was slow for both yield and FESEED

Adverse childhood experiences and adult cardiometabolic risk factors and disease outcomes: Cross-sectional, population-based study of adults in rural Uganda.

Background: Cardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda. Methods: Data come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-International Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and cardiometabolic risk factors and health outcomes. Results: Data were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD. Conclusions: Adverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes

Heavy Metal Contamination of Sediments from an Exoreic African Great Lakes’ Shores (Port Bell, Lake Victoria), Uganda

Lake Victoria (L. Victoria) is the largest African tropical and freshwater lake, with one of the highest pollution levels, globally. It is shared among Uganda, Kenya and Tanzania, but it is drained only by the river Nile, the longest river in Africa. Though environmental studies have been conducted in the lake, investigations of the heavy metals (HMs) contamination of sediments from fish landing sites and ports on the Ugandan portion of L. Victoria are limited. In this study, sediments of an urban, industrial and fish landing site (Port Bell) on L. Victoria, Uganda was investigated to establish its HMs pollution levels and potential health risks to humans and ecosystems. Sediment samples were collected in triplicate (n = 9) from three different points of Port Bell, digested and analyzed using atomic absorption spectrometry for the presence of these HMs: copper (Cu), lead (Pb), cadmium (Cd) and chromium (Cr). The average daily dose through dermal contact and hazard quotient (HQ) were calculated to assess the health risk that is associated with dredging works (lake sand mining). Four geochemical enrichment indices: contamination factor (CF), geo-accumulation index (Igeo), pollution load index (PLI) and potential ecological risk (PERI) were used to quantify the contamination of the HMs in the sediments. The results showed that the mean HM content of the samples ranged from: 6.111 ± 0.01 to 7.111 ± 0.002 mg/kg for Cu; from 40.222 ± 0.003 to 44.212 ± 0.002 mg/kg for Pb; from 0.352 ± 0.007 to 0.522 ± 0.010 mg/kg for Cr; from 3.002 ± 0.002 to 3.453 ± 0.003 mg/kg for Cd. Health risk assessments indicated that there are no discernible non-carcinogenic health risks that could arise from the dredging works that are conducted in the study area as the indices were all below one. The contamination factors that were obtained suggest that Cd has reached a state of severe enrichment in the sediments (CF > 6). An assessment using Igeo established that the sediments were not contaminated with regards to Cu and Cr, but they exhibited low-to-median and median contamination with respect to Pb and Cd, respectively. Though the pollution load indices show that the contamination levels raise no serious concerns, the potential ecological risk indices show that there is considerable pollution of the Port Bell sediments, particularly with regard to Cd. Upon examination using multivariate statistical analyses, Cd and Cr showed a strong correlation which alluded to their introduction from anthropogenic sources. Based on the sedimentary HMs concentrations and the environmental indices that are employed in this study, it is recommended that the spatial variations in the concentrations of the HMs in water, sediments and biota should be monitored

Climatic, Socio-Economic, and Health Factors Affecting Human Vulnerability to Cholera in the Lake Victoria Basin, East Africa

Cholera epidemics have a recorded history in the eastern Africa region dating to 1836. Cholera is now endemic in the Lake Victoria basin, a region with one of the poorest and fastest growing populations in the world. Analyses of precipitation, temperatures, and hydrological characteristics of selected stations in the Lake Victoria basin show that cholera epidemics are closely associated with El Niño years. Similarly, sustained temperatures high above normal (Tmax) in two consecutive seasons, followed by a slight cooling in the second season, trigger an outbreak of a cholera epidemic. The health and socioeconomic systems that the lake basin communities rely upon are not robust enough to cope with cholera outbreaks, thus rendering them vulnerable to the impact of climate variability and change. Collectively, this report argues that communities living around the Lake Victoria basin are vulnerable to climate-induced cholera that is aggravated by the low socioeconomic status and lack of an adequate health care system. In assessing the communities\u27 adaptive capacity, the report concludes that persistent levels of poverty have made these communities vulnerable to cholera epidemics. © Royal Swedish Academy of Sciences 2007

Vulnerability to Climate-Induced Highland Malaria in East Africa

Malaria is a mosquito-borne (Anopheles gambiae species) viral illness, which causes the greatest morbidity and mortality in tropical and subtropical countries, with an especially high prevalence in Africa. Approximately 90 per cent of the 1 million global annual deaths due to malaria occur in Africa and nearly three-quarters of these are children under the age of five (WHO, 1996; McMichael et al, 1996;). It is also associated with several complications such as severe anaemia (especially in children and pregnant women) and cerebral malaria. Low birth weight caused by malaria is responsible for about 6 per cent of the infant mortality

Climate, Malaria and Cholera in the Lake Victoria Region: Adapting to Changing Risks

In the East African countries, malaria is ranked as the primary cause of morbidity and mortality in both children and adults. It causes about 40,000 infant deaths in Kenya each year; in Uganda annual cases of malaria range between 6 to 7 million, with 6500 to 8500 fatalities, and in Tanzania the annual death toll is between 70,000 and 125,000 and accounts for 19 per cent of health expenditure (De Savigny et al, 2004a and b). In the case of cholera, the first epidemic in Africa was reported as far back as 1836 (Rees, 2000). Major outbreaks were next reported in 1970 and affected West Africa (Guinea), the horn of Africa (Ethiopia, Somalia and Sudan) and Kenya (Waiyaki, 1996). The most severe cholera outbreak on the African continent was in 1998, accounting for more than 72 per cent of the global total number of cholera cases and acutely affecting the Democratic Republic of Congo, Kenya, Mozambique, Uganda and the United Republic of Tanzania. Cholera outbreaks in East Africa have been reported to the World Health Organization (WHO) since 1972. In the Lake Victoria region of East Africa both malaria and cholera are common, with malaria endemic in the lowlands and epidemic in the highland areas and cholera endemic in the basin since the early 1970s (Rees, 2000)