The impact of urbanisation on the health, of black pre-school children in the Umtata district, Transkei, 1990

The impact of rapid urbanisation on some aspects of child health in Transkei was assessed. The study area comprised clusters from urban, peri-urban and rural areas, giving a sample size of 1 080 children. Information collected included anthropometric measurements (weight and height), immunisation status, family socio-economic status, and practices regarding preventive health. The child's place of birth, maternal education and paternal support were also assessed. In the sample, 20,6% of child~en were born at home. Diarrhoea prevalence ranged from 18,3% in urban to 24,9% in peri-urban areas; 70,2% of mothersI carers knew about oral rehydration therapy and 56,3% had used it to treat diarrhoea, only 2,5% knew how to prepare the solution properly. Breastfeeding was practised early in life but by 1 year 74,6% of mothers had stopped; 54,9% started supplementary feeds by 1 month of age and by 4 months 89,6% of all children were on supplementary feeds. Of the children, 9,5% were underweight, 25,5% were stunted and 3,8% had acute protein energy malnutrition (wasting). Monthly per capita food expenditure was used to assess socio-economic status and 50% of all children came from homes spending R21,00 per person on food per month. Reasons for poor child health were examined and recommendations are made for promoting child health in the face of rapid urbanisation

Challenges faced by the university to provide integral human development for 'exposed' Kenyan students.

The 7th annual Ethics ConferenceUniversities originally came into being from the love of knowledge and from the curiosity of knowing. However, of late, with increased access and advanced technological facilities and an influx of both necessary and unnecessary information, universities are facing cultural challenges which have gone so far as to challenge an integral human development. This challenge is especially true for our Kenyan universities, which for the first time are able to expose their students to the whole world as has never before been possible. Care needs to be taken because, man can and has been sacrificed to the success and influence of science and technology. The time has come to ask ourselves whether these facilities are being used to contribute to an authentic human development of students.Universities originally came into being from the love of knowledge and from the curiosity of knowing. However, of late, with increased access and advanced technological facilities and an influx of both necessary and unnecessary information, universities are facing cultural challenges which have gone so far as to challenge an integral human development. This challenge is especially true for our Kenyan universities, which for the first time are able to expose their students to the whole world as has never before been possible. Care needs to be taken because, man can and has been sacrificed to the success and influence of science and technology. The time has come to ask ourselves whether these facilities are being used to contribute to an authentic human development of students

Reflections on trauma and violence-related deaths in Soweto, July 1990 - June 1991

This is a retrospective analysis of 5 600 deaths registered in Soweto from July 1990 to June 1991. The impact of trauma and violence on the overall mortality pattern was assessed. The majority of deaths occurred in people under the age of 50 years and more men died than women. In 40% of male deaths, the cause was stated as 'ill-defined' or 'unknown'; this was the case in an even higher percentage of female deaths (50,5%). Trauma or violence accounted for 28,5% of all deaths. The gender difference was particularly visible in the trauma category, viz. 89,5% and 10,5% in men and women respectively. Young men (20 - 29 years) were particularly affected by trauma and violence-related deaths (38,5%). The major types of injuries inflicted were gunshot wounds (33%), unspecified multiple injuries (32%) and stab wounds (27%). Motor vehicle accidents accounted for only 8% of deaths. The urgent need for intervention programmes to prevent unnecessary loss of life, targeted especially at young adults and children, is highlighted

Detection and Quantification of Oestrogenic Endocrine Disruptors in Water in Mwanza Gulf in the Lake Victoria Basin, Tanzania

The aim of this study was to detect the presence and quantify the total oestrogens (estriol (E1), estradiol (E2), and estrone (E3)) in Lake Victoria water with a view of assessing their contribution to the health status of fish. A total of 27 water samples; three from each of the nine sampling sites were collected in Mwanza gulf in the city in May 2012. Solvent extraction procedures were used to obtain extracts of pollutants that were further analysed using the competitive Enzyme- Linked Immunosorbent Assay (ELISA) technique to detect and quantify the total oestrogens. Overall, the concentration of total oestrogens was low and ranged from 10 – 200 pg/L. Concentrations of these chemicals decreased along the gradient, being highest (107±81.4 pg/L) in rivers before entering into the lake and lowest (19±5.4 pg/L) in water samples collected in the lake at about 100 meters from inshore (intermediate sampling points). Levels of total oestrogens were significantly different between categories of water sources (P = 0.009). Two most polluted rivers were Butimba and Nyakurunduma with concentrations at 150 pg/L and 200 pg/L respectively. Dumping of wastes in rivers without treatment was the most likely source of the pollutants. Findings from this study have revealed the existence of oestrogens with endocrine disrupting properties at different concentrations, and that rivers are the main sources of oestrogenic endocrine disruptors in Lake Victoria water near Mwanza City.Keywords: ELISA, endocrine disruptors, oestrogens, pollutio

Genotypic characterisation of Avian paramyxovirus type-1 viruses isolated from aquatic birds in Uganda

Avian paramyxovirus type-1 (APMV-1) viruses of the lentogenic pathotypes are often isolated from wild aquatic birds and may mutate to high pathogenicity when they cross into poultry and cause debilitating Newcastle disease. This study characterised AMPV-1 isolated from fresh faecal droppings from wild aquatic birds roosting sites in Uganda. Fresh faecal samples from wild aquatic birds at several waterbodies in Uganda were collected and inoculated into 9–10-day-old embryonated chicken eggs. After isolation, the viruses were confirmed as APMV-1 by APMV-1-specific polymerase chain reaction (PCR). The cleavage site of the fusion protein gene for 24 representative isolates was sequenced and phylogenetically analysed and compared with representative isolates of the different APMV-1 genotypes in the GenBank database. In total, 711 samples were collected from different regions in the country from which 72 isolates were recovered, giving a prevalence of 10.1%. Sequence analysis of 24 isolates revealed that the isolates were all lentogenic, with the typical 111GGRQGR’L117 avirulent motif. Twenty-two isolates had similar amino acid sequences at the cleavage site, which were different from the LaSota vaccine strain by a silent nucleotide substitution T357C. Two isolates, NDV/waterfowl/Uganda/MU150/2011 and NDV/waterfowl/Uganda/MU186/2011, were different from the rest of the isolates in a single amino acid, with aspartate and alanine at positions 124 and 129, respectively. The results of this study revealed that Ugandan aquatic birds indeed harbour APMV-1 that clustered with class II genotype II strains and had limited genetic diversity

Human immunodeficiency virus infection and cerebral malaria in children in Uganda: a case-control study

<p>Abstract</p> <p>Background</p> <p>Human immunodeficiency virus (HIV)-1 infection increases the burden of malaria by increasing susceptibility to infection and decreasing the response to malarial treatment. HIV-1 has also been found to suppress the immune system and predispose to severe forms of malaria in adults. There is still a paucity of data on the association between HIV-1 infection and cerebral malaria in children. The aim of this study was to determine whether HIV-1 infection is a risk factor for cerebral malaria in children.</p> <p>Method</p> <p>We conducted an unmatched case-control study, in which 100 children with cerebral malaria were compared with 132 with uncomplicated malaria and 120 with no malaria. In stratified analyses we estimated odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age.</p> <p>Results</p> <p>HIV-1 infection was present in 9% of children with cerebral malaria compared to 2.3% in uncomplicated malaria (age-adjusted odds ratio (aOR) 5.94 (95% confidence interval (CI) 1.36-25.94, p = 0.012); and 2.5% in children with no malaria (aOR 3.85 (95% CI0.99-14.93, p = 0.037). The age-adjusted odds of being HIV-positive among children with cerebral malaria compared to the control groups (children with uncomplicated malaria and no malaria) was 4.98 (95% CI 1.54-16.07), p-value = 0.003.</p> <p>Conclusions</p> <p>HIV-1 infection is associated with clinical presentation of cerebral malaria in children. Clinicians should ensure that children diagnosed with HIV infection are initiated on cotrimoxazole prophylaxis as soon as the diagnosis is made and caretakers counselled on the importance of adherence to the cotrimoxazole towards reducing the risk of acquiring <it>P.falciparum </it>malaria and associated complications such as cerebral malaria. Other malaria preventive measures such as use of insecticide-treated mosquito nets should also be emphasized during counselling sessions.</p

Low Resistance to First and Second Line Anti-Tuberculosis Drugs among Treatment Naive Pulmonary Tuberculosis Patients in Southwestern Uganda

Background: There are limited data on region-specific drug susceptibility of tuberculosis (TB) in Uganda. We performed resistance testing on specimens collected from treatment-naive patients with pulmonary TB in Southwestern Uganda for first and second line anti-TB drugs. We sought to provide data to guide regional recommendations for empiric TB therapy. Methods: Archived isolates, obtained from patients at Mbarara Regional Referral Hospital from February 2009 to February 2013, were tested for resistance to isoniazid and rifampicin using the MTBDRplus and Xpert MTB/RIF assays. A subset of randomly selected isolates was tested for second line agents, including fluoroquinolones (FQs), aminoglycosides, cyclic peptides, and ethambutol using the MTBDRsl assay. We performed confirmatory testing for FQ resistance using repeated MTBDRsl, the Mycobacteria growth indicator tube (MGIT) assay, and sequencing of the gyrA and gyrB genes. Results: We tested isolates from 190 patients. The cohort had a median age of 33 years (IQR 26-43), 69% (131/190) were male, and the HIV prevalence was 42% (80/190). No isolates (0/190) were rifampicin-resistant and only 1/190 (0.5%) was isoniazid-resistant. Among 92 isolates tested for second-line drug resistance, 71 (77%) had interpretable results, of which none were resistant to aminoglycosides, cyclic peptides or ethambutol. Although 7 (10%) initially tested as resistant to FQs by the MTBDRsl assay, they were confirmed as susceptible by repeat MTBDRsl testing as well as by MGIT and gyrase gene sequencing Conclusion: We found no MDR-TB and no resistance to ethambutol, FQs, or injectable anti-TB drugs in treatment naïve patients with pulmonary TB in Southwestern Uganda. Standard treatment guidelines for susceptible TB should be adequate for most patients with TB in this population. Where possible, molecular susceptibility testing methods should be routinely validated by culture methods