The effect of prenatal counselling on postpartum family planning use among early postpartum women in Masindi and Kiryandongo districts, Uganda

Introduction: Globally, most postpartum pregnancies are unplanned, mainly as a result of low level of knowledge and fear of contraceptive use especially in low-income settings. The aim of this study was to evaluate the effect of prenatal contraceptive counselling on postpartum contraceptive use and pregnancy outcomes after one year. Methods: Sixteen health centres were equally and randomly allocated to control and intervention arms. Mothers were consecutively recruited during their first antenatal clinic consultations. In the intervention arm Village Health Team members made home visits and provided prenatal contraceptive advice and made telephone consultations with health workers for advice while in the control arm mothers received routine antenatal care offered in the health centres. Data were collected in 2014 in the two districts of Kiryandongo and Masindi. This data was collected 12-14 months postpartum. Mothers were asked about their family planning intentions, contraceptive use and screened for pregnancy using human Chorionic Gonadotropin (hCG) levels. Socio-demographic and obstetric indices were recorded. Our primary outcomes of interests were current use of modern contraceptive, decision to use a modern contraceptive method and pregnancy status. Multilevel analysis using the xtmelogit stata command was used to determine differences between intervention and control groups. Results: A total of 1,385 women, 748 (control) and 627 (intervention) were recruited. About 80% initiated breastfeeding within six hours of delivery 78.4% (control) and 80.4% (intervention). About half of the mothers in each arm had considered to delay the next pregnancy 47.1% (control) and 49% (intervention). Of these 71.4% in the control and 87% in the intervention had considered to use a modern contraceptive method, only 28.2% of the control and 31.6% in the intervention were current modern contraceptive users signifying unmet contraceptive needs among immediate postpartum mothers. Regarding pregnancy, 3.3% and 5.7% of the women were found to be pregnant in the control and intervention arms respectively. There were no statistical differences between the control and intervention arms for all primary outcomes of interests. Conclusion: Prenatal contraceptive counseling did not affect postpartum contraceptive use among immediate postpartum mothers in Masindi and Kiryandongo districts. Interventions aiming at improving postpartum contraceptive use should focus on addressing unmet contraceptive needs

Village Baseline Study: Site Analysis Report for Albertine Rift – Hoima, Uganda

The village baseline study of Kibaire village in the CCAFS benchmark site Hoima in Uganda took place from 13 to 16 July 2011. Forests are exploited at unsustainable levels in Kibaire but deforestation does not appear to be a serious threat because the tree population is still relatively high. Most of the forests have been leased to private individuals as part of the privatisation policy being implemented in Uganda. Wetlands are also increasingly subjected to overexploitation and pollution from brewing and other activities. Farming at both subsistence and commercial level is increasing at the expense of forests. Community access to forest resources is restricted. Participants identified 29 organisations working in the community, two-third of them operating from outside the locality. Participants said that they did have plenty of food in the village, and women expressed that they had never had a food crisis. Nonetheless, half of the organisations men and women identified were involved in some form of food security related activity, and notably food availability. Less than one-third of the organisations addressed natural resources management, and most of them were from outside the community. Organisations are the most significant source of information on agriculture. Farmers also get information through the many radio stations in the area that air many programs in local languages

Assessment of Striga hermonthica infestation and effectiveness of current management strategies in maize-based cropping systems in eastern Uganda

Striga is a major constraint to cereal production in the tropics, particularly on soils of low fertility. Striga causes 30 to 80% cereal crop losses in sub-Saharan Africa. The objective of this study was to assess farmers’ perception of level of infestation and efficacy of current management options of Striga (Striga hermonthica (Delile) Benth) in maize-based cropping systems in eastern Uganda. A survey was conducted in Iganga district in eastern Uganda, involving 360 households. On the basis of the survey outputs, on-farm trials were conducted to assess the efficacy of a herbicide seed-coating technology, imazapyr herbicide resistant maize (IR-maize) variety, either as a sole crop or intercropped with soybean (Glycine max) or common beans (Phaseolus vulgaris L). The study revealed that S. hermonthica caused more than 50% maize (Zea mays) yield loss and farmers were dissatisfied with the existing control practices. Farmers’ knowledge about Striga was mainly sourced from agricultural extension service providers. The on-farm trials revealed that IR-maize provided effective protection against S. hermonthica infestation. Also, intercropping Longe 6H maize variety with either soybean or common beans significantly reduced Striga infestation in farmers’ fields. Longe 6H-soybean intercropping reduced Striga infestation by 32%; while Longe 6H-common bean intercropping reduced Striga infestation by 14%. Intercropping either IR-maize or Longe 6H hybrid (farmer-preferred) with the aforementioned legumes, reduced S. hermonthica infestation (30–50%) and improved maize yield parameters (20-30%). For effective management of S. hermonthica in the maize-based cropping systems in eastern Uganda, farmers should be encouraged to adopt the improved IR-maize and intercrop farmer-preferred maize varieties with legumes in order to improve maize yields

ASSESSMENT OF COMMON BEAN CULTIVAR DIVERSITY IN SELECTED COMMUNITIES OFCENTRAL UGANDA

Common bean ( Phaseolus vulgaris ) L. diversity has been nurtured by Uganda\u2019s farming communities and in return it has sustained their livelihoods for over 40 decades. Despite the farmers\u2019 invaluable effort in perpetuating this diversity, there is limited overall understanding of its status and dynamics on-farm. This study assessed the amount and status of the cultivar diversity in selected rural and peri-urban communities of central Uganda. Data were purposefully collected from 120 households through household surveys, focus group discussions and direct field observations. Diversity measures, status of the cultivars and morphological distinctiveness were estimated by Simpson\u2019s index of diversity (1-D), four cell analysis and cluster analysis, respectively. A total of 24 cultivars were observed in the whole study, and both communities had equal cultivar richness.There were no significant differences in the number of cultivars maintained by the farmers in the rural and those in the peri-urban communities. Both communities had substantial cultivar evenness (0.81 and 0.82 in rural and peri-urban, respectively), although only 19% of cultivars were grown on relatively larger areas and by many households. Impressively, at least 30% of the households in each community nurtured different sets of cultivars. We thus recommend the need to put in place incentive mechanisms that can encourage a section of the community to continue conserving P. vulgaris diversity on-farm to ensure its continued evolution and adaptation to changing biotic and abiotic factors.La diversit\ue9 du haricot commun ( Phaseolus vulgaris ) L. a \ue9t\ue9 d\ue9velopp\ue9 par des communaut\ue9s de fermiers en Ouganda et, en retour, la culture a durablement contribu\ue9 au bien \ueatre familial pendant plus de quarante ans. Malgr\ue9 des efforts consid\ue9rables des fermiers dans la perp\ue9tuation de cette diversit\ue9, la compr\ue9hension de sa situation et dynamique en champ reste limit\ue9e. Cette \ue9tude a \ue9valu\ue9 le nombre et la situation de la diversit\ue9 des cultivars dans des communaut\ue9s s\ue9lectionn\ue9es en milieux rural et p\ue9ri-urbain de l\u2019Ouganda central. Les donn\ue9es d\u2019\ue9taient collect\ue9es de fa\ue7on raisonn\ue9e dans 120 m\ue9nages \ue0 travers une enqu\ueate de m\ue9nage, les groupes de discussions et des observations directes sur terrain. Des mesures de diversit\ue9, la situation des cultivars et la diff\ue9renciation morphologique \ue9taient estim\ue9es par l\u2019index de diversit\ue9 de Simpson (1-D), quatre analyses de cellules et l\u2019analyse de groupes, respectivement. Un total de 24 cultivars \ue9tait observ\ue9 dans toute l\u2019\ue9tude, et toutes les deux communaut\ue9s avaient une richesse \ue9gale de cultivars. Aucune diff\ue9rence significative n\u2019\ue9tait trouv\ue9e dans le nombre de cultivars maintenu par les fermiers ruraux et p\ue9ri-urbains. Les deux communaut\ue9s avaient un nombre substantiellement invariant de cultivars (0.81 et 0.82 en milieu rural et p\ue9ri-urbain, respectivement), malgr\ue9 que 19% seulement des cultivars \ue9taient cultiv\ue9s relativement sur des vastes \ue9tendues et par plusieurs m\ue9nages. De fa\ue7on impressionnante, au moins 30% des m\ue9nages dans chaque communaut\ue9 avaient d\ue9velopp\ue9 diff\ue9rents types de cultivars. Ceci d\ue9montre le besoin de mettre en place des m\ue9canismes d\u2019encouragement des communaut\ue9s afin de continuer la conservation en milieux paysan de la diversit\ue9 du P. vulgaris pour assurer son \ue9volution continue et l\u2019adaptation au changement des facteurs biotiques et abiotiques

Shigella spp. Antimicrobial Drug Resistance, Papua New Guinea, 2000–2009

Approximately half the Shigella spp. infections in developing countries are caused by endemic shigellae (1), which in these countries are responsible for ¡Ö10% of all episodes of diarrhea among childre

Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of recurrent diagnosis despite treatment.

OBJECTIVES: Bacterial vaginosis (BV) is associated with increased risk for sexually transmitted infections (STIs) and HIV acquisition. This study describes the epidemiology of BV in a cohort of women at high risk for STI/HIV in Uganda over 2 years of follow-up between 2008-2011. METHODS: 1027 sex workers or bar workers were enrolled and asked to attend 3-monthly follow-up visits. Factors associated with prevalent BV were analysed using multivariate random-effects logistic regression. The effect of treatment on subsequent episodes of BV was evaluated with survival analysis. RESULTS: Prevalences of BV and HIV at enrolment were 56% (573/1027) and 37% (382/1027), respectively. Overall, 905 (88%) women tested positive for BV at least once in the study, over a median of four visits. Younger age, a higher number of previous sexual partners and current alcohol use were independently associated with prevalent BV. BV was associated with STIs, including HIV. Hormonal contraception and condom use were protective against BV. Among 853 treated BV cases, 72% tested positive again within 3 months. There was no difference in time to subsequent BV diagnosis between treated and untreated women. CONCLUSIONS: BV was highly prevalent and persistent in this cohort despite treatment. More effective treatment strategies are urgently needed

'It is like a tomato stall where someone can pick what he likes': structure and practices of female sex work in Kampala, Uganda.

BACKGROUND: Effective interventions among female sex workers require a thorough knowledge of the context of local sex industries. We explore the organisation of female sex work in a low socio-economic setting in Kampala, Uganda. METHODS: We conducted a qualitative study with 101 participants selected from an epidemiological cohort of 1027 women at high risk of HIV in Kampala. Repeat in-depth life history and work practice interviews were conducted from March 2010 to June 2011. Context specific factors of female sex workers' day-to-day lives were captured. Reported themes were identified and categorised inductively. RESULTS: Of the 101 women, 58 were active self-identified sex workers operating in different locations within the area of study and nine had quit sex work. This paper focuses on these 67 women who gave information about their involvement in sex work. The majority had not gone beyond primary level of education and all had at least one child. Thirty one voluntarily disclosed that they were HIV-positive. Common sex work locations were streets/roadsides, bars and night clubs. Typically sex occurred in lodges near bars/night clubs, dark alleyways or car parking lots. Overall, women experienced sex work-related challenges at their work locations but these were more apparent in outdoor settings. These settings exposed women to violence, visibility to police, a stigmatising public as well as competition for clients, while bars provided some protection from these challenges. Older sex workers tended to prefer bars while the younger ones were mostly based on the streets. Alcohol consumption was a feature in all locations and women said it gave them courage and helped them to withstand the night chill. Condom use was determined by clients' willingness, a woman's level of sobriety or price offered. CONCLUSIONS: Sex work operates across a variety of locations in the study area in Kampala, with each presenting different strategies and challenges for those operating there. Risky practices are present in all locations although they are higher on the streets compared to other locations. Location specific interventions are required to address the complex challenges in sex work environments

Evaluating the impact of neurosurgical rotation experience in Africa on the interest and perception of medical students towards a career in neurosurgery : a protocol for a continental, cross-sectional study

Introduction Africa has the second highest neurosurgical workforce deficit globally. Despite the many recent advancements in increasing neurosurgical access in Africa, published reports have shown that the vast majority of undergraduate students have little or no exposure to neurosurgery. The lack of exposure may pose a challenge in reducing the neurosurgical workforce deficit, which is one of the long-term strategies of tackling the unmet burden of disease. Students may also miss the opportunity to appreciate the specialty and its demands as well as nurture their interest in the field. This study aims to assess the impact of a neurosurgical rotation during medical school in shaping the perception and interest of students towards a career in neurosurgery. Methods The cross-sectional study will be conducted through the dissemination of a self-administered e-survey hosted on Google Forms from 21st February 2021 to 20th March 2021. The survey will contain five-point Likert scale, multiple-choice and free-text questions. The structured questionnaire will have four sections with 27 items: (i) socio-demographic background, (ii) neurosurgical experience, (iii) perception towards a neurosurgical career and (iv) interest in a neurosurgical career. All consenting medical students in African medical schools who are in their clinical years (defined as fourth to sixth years or higher years of study) will be eligible. Odds ratios and their 95% confidence intervals, Wilcoxon rank-sum test, Welch t-test and adjusted logistic regression models will be used to test for associations between independent and dependent variables. Statistical significance will be accepted at P < 0.05