Records: First record of the Wattled Crane Grus carunculatus in Uganda

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Contractor selection, monitoring and performance of road infrastructure projects in Uganda synergies between policy and law

Abstract: The article highlights the powerful influence of contractor selection in improving road project performance in Uganda. It provides empirical evidence of the performance of road projects as a less studied phenomenon because in Uganda, most public works are delivered with longer delays, contracts are more often awarded to larger suppliers and a higher share of the payment is postponed after delivery. Use of poor-quality materials, poor scheduling, delayed procurement, and poor contractor selection causes cost and time overruns on roads. The study adopts a cross sectional design in terms of quantitative and qualitative approaches to collect data. A multivariate analysis and surveys were taken from 190 respondents. It was found that contractor monitoring has a significant positive effect on the completion of roads while contractor selection has a direct and indirect positive effect on performance of roads through the partial mediation of contractor selection. This suggests that contractor selection has an effect on the improvement of the level of road projects performance in Uganda. There is a need to improve the scrutiny of the contractor selection process in road agencies in Uganda. This will require a good review of the government policy on contractor selection aimed at making it more robust and efficient

Use of wind-up fetal Doppler versus Pinard for fetal heart rate intermittent monitoring in labour: a randomised clinical trial.

OBJECTIVES: In resource-poor settings, the standard of care to inform labour management is the partograph plus Pinard stethoscope for intermittent fetal heart rate (FHR) monitoring. We compared FHR monitoring in labour using a novel, robust wind-up handheld Doppler with the Pinard as a primary screening tool for abnormal FHR on perinatal outcomes. DESIGN: Prospective equally randomised clinical trial. SETTING: The labour and delivery unit of a teaching hospital in Kampala, Uganda. PARTICIPANTS: Of the 2042 eligible antenatal women, 1971 women in active term labour, following uncomplicated pregnancies, were randomised to either the standard of care or not. INTERVENTION: Intermittent FHR monitoring using Doppler. PRIMARY OUTCOME MEASURES: Incidence of FHR abnormality detection, intrapartum stillbirth and neonatal mortality prior to discharge. RESULTS: Age, parity, gestational age, mode of delivery and newborn weight were similar between study groups. In the Doppler group, there was a significantly higher rate of FHR abnormalities detected (incidence rate ratio (IRR)=1.61, 95% CI 1.13 to 2.30). However, in this group, there were also higher though not statistically significant rates of intrapartum stillbirths (IRR=3.94, 0.44 to 35.24) and neonatal deaths (IRR=1.38, 0.44 to 4.34). CONCLUSIONS: Routine monitoring with a handheld Doppler increased the identification of FHR abnormalities in labour; however, our trial did not find evidence that this leads to a decrease in the incidence of intrapartum stillbirth or neonatal death. TRIAL REGISTRATION NUMBER: Clinical Trails.gov (1000031587)

Composition and functional properties of yam bean (Pachyrhizus spp.) seed flour

Open Access JournalYam bean (Pachyrhizus spp.) is legume crop that not only produces edible roots but also has a high yield of unutilized seeds. Although the yam bean seeds are rich in protein, they are not used due to a high content of toxic rotenone. In this study, yam bean seeds were detoxified and the nutritional and functional properties of their protein determined to assess the proteins’ potential for applications. Seeds of 10 accessions (2 accessions of P. erosus, 4 accessions of P. ahipa and 4 accessions of P. tuberosus) were analyzed for proximate composition, pasting and functional properties (bulk density, least gelation concentration, water absorption capacity, oil absorption capacity, emulsifying capacity, emulsion stability, foaming capacity, foam stability and protein solubility). The results showed that yam bean seeds contained: 29.2 - 32.1 g/100g proteins, 31.3 - 33.0 g/100 g carbohydrates, 24.1 - 25.6 g/100g total fat, 7.5 - 8.1 g/100g crude fiber and 3.4 - 4.1 g/100g ash. The defatted P. erosus seed flour contained 45.6 - 48.8 g/100g protein, 32.6 - 36.5 g/100g total carbohydrate, 6.7 - 7.1 g/100g crude fiber, 6.0 - 6.4 g/100g ash and 5.2/100 g crude fat. The defatted yam bean seed flour exhibited relatively high protein solubility (68.0% - 70.4%), least gelation concentration (14%), water absorption capacity (2.8% - 2.9%) and oil absorption capacity (1.5%). The defatted flour exhibited emulsifying capacity of 35.7% - 36.0%, emulsion stability of 33.2% - 33.5%, foaming capacities of 42% and foam stability of 25.1% - 25.8%. With respect to pasting properties, the defatted yam bean seed flours exhibited pasting temperature of 80.0˚C - 81.3˚C, peak viscosity of 145.5 - 146.7 RVU, trough viscosity of 95.1 - 102.0 RVU, break down of 43.5 - 51.6 RVU, set back of 252.9 - 258.1 RVU and final viscosity of 348 - 360 RVU. The results show that yam bean seed has potential for use in both food and nonfood applications

Psychosocial Challenges and Strategies for Coping with HIV Among Adolescents in Uganda: A Qualitative Study

Although more than 90% of youth perinatally infected with HIV live in sub-Saharan Africa, little is known about the psychosocial factors that impact their wellbeing, or how these youth cope with these challenges. The purpose of this study was to identify the psychosocial challenges and coping strategies among perinatal HIV-infected adolescents in Uganda. In-depth interviews were conducted with a purposive sample of 38 HIV-infected adolescents aged 12?19 years at a large HIV treatment center in Kampala. Data were analyzed thematically to identify themes and domains related to stressors and specific coping strategies. Psychosocial challenges included stigma/discrimination, relationship challenges such as HIV status disclosure, and medication difficulties. Coping strategies included medication adherence, concealment or limited disclosure of HIV status, treatment optimism, social support, rationalizing, social comparison, spirituality/religiosity, avoidance, and distraction. Age and gender differences also emerged: younger participants generally lacked specific coping strategies; compared to females, male adolescents reported greater use of avoidance/distraction techniques. Findings underscore the need to address stigma within homes and schools, and to equip adolescents with the comprehensive knowledge and skills to address their varied challenges.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140199/1/apc.2014.0222.pd

Drug susceptibility of Plasmodium falciparum in eastern Uganda: a longitudinal phenotypic and genotypic study

Background: Treatment and control of malaria depends on artemisinin-based combination therapies (ACTs) and is challenged by drug resistance, but thus far resistance to artemisinins and partner drugs has primarily occurred in southeast Asia. The aim of this study was to characterise antimalarial drug susceptibility of Plasmodium falciparum isolates from Tororo and Busia districts in Uganda. Methods: In this prospective longitudinal study, P falciparum isolates were collected from patients aged 6 months or older presenting at the Tororo District Hospital (Tororo district, a site with relatively low malaria incidence) or Masafu General Hospital (Busia district, a high-incidence site) in eastern Uganda with clinical symptoms of malaria, a positive Giemsa-stained blood film for P falciparum, and no signs of severe disease. Ex-vivo susceptibilities to ten antimalarial drugs were measured using a 72-h microplate growth inhibition assay with SYBR Green detection. Relevant P falciparum genetic polymorphisms were characterised by molecular methods. We compared results with those from earlier studies in this region and searched for associations between drug susceptibility and parasite genotypes. Findings: From June 10, 2016, to July 29, 2019, 361 P falciparum isolates were collected in the Busia district and 79 in the Tororo district from 440 participants. Of 440 total isolates, 392 (89%) successfully grew in culture and showed excellent drug susceptibility for chloroquine (median half-maximal inhibitory concentration [IC50] 20·0 nM [IQR 12·0-26·0]), monodesethylamodiaquine (7·1 nM [4·3-8·9]), pyronaridine (1·1 nM [0·7-2·3]), piperaquine (5·6 nM [3·3-8·6]), ferroquine (1·8 nM [1·5-3·3]), AQ-13 (24·0 nM [17·0-32·0]), lumefantrine (5·1 nM [3·2-7·7]), mefloquine (9·5 nM [6·6-13·0]), dihydroartemisinin (1·5 nM [1·0-2·0]), and atovaquone (0·3 nM [0·2-0·4]). Compared with results from our study in 2010-13, significant improvements in susceptibility were seen for chloroquine (median IC50 288·0 nM [IQR 122·0-607·0]; p\u3c0·0001), monodesethylamodiaquine (76·0 nM [44·0-137]; p\u3c0·0001), and piperaquine (21·0 nM [7·6-43·0]; p\u3c0·0001), a small but significant decrease in susceptibility was seen for lumefantrine (3·0 nM [1·1-7·6]; p\u3c0·0001), and no change in susceptibility was seen with dihydroartemisinin (1·3 nM [0·8-2·5]; p=0·64). Chloroquine resistance (IC50\u3e100 nM) was more common in isolates from the Tororo district (11 [15%] of 71), compared with those from the Busia district (12 [4%] of 320; p=0·0017). We showed significant increases between 2010-12 and 2016-19 in the prevalences of wild-type P falciparum multidrug resistance protein 1 (PfMDR1) Asn86Tyr from 60% (391 of 653) to 99% (418 of 422; p\u3c0·0001), PfMDR1 Asp1246Tyr from 60% (390 of 650) to 90% (371 of 419; p\u3c0·0001), and P falciparum chloroquine resistance transporter (PfCRT) Lys76Thr from 7% (44 of 675) to 87% (364 of 417; p\u3c0·0001). Interpretation: Our results show marked changes in P falciparum drug susceptibility phenotypes and genotypes in Uganda during the past decade. These results suggest that additional changes will be seen over time and continued surveillance of susceptibility to key ACT components is warranted. Funding: National Institutes of Health and Medicines for Malaria Venture

Associations between Varied Susceptibilities to PfATP4 Inhibitors and Genotypes in Ugandan Plasmodium falciparum Isolates.

Among novel compounds under recent investigation as potential new antimalarial drugs are three independently developed inhibitors of the Plasmodium falciparum P-type ATPase (PfATP4): KAE609 (cipargamin), PA92, and SJ733. We assessed ex vivo susceptibilities to these compounds of 374 fresh P. falciparum isolates collected in Tororo and Busia districts, Uganda, from 2016 to 2019. Median IC50s were 65 nM for SJ733, 9.1 nM for PA92, and 0.5 nM for KAE609. Sequencing of pfatp4 for 218 of these isolates demonstrated many nonsynonymous single nucleotide polymorphisms; the most frequent mutations were G1128R (69% of isolates mixed or mutant), Q1081K/R (68%), G223S (25%), N1045K (16%), and D1116G/N/Y (16%). The G223S mutation was associated with decreased susceptibility to SJ733, PA92, and KAE609. The D1116G/N/Y mutations were associated with decreased susceptibility to SJ733, and the presence of mutations at both codons 223 and 1116 was associated with decreased susceptibility to PA92 and SJ733. In all of these cases, absolute differences in susceptibilities of wild-type (WT) and mutant parasites were modest. Analysis of clones separated from mixed field isolates consistently identified mutant clones as less susceptible than WT. Analysis of isolates from other sites demonstrated the presence of the G223S and D1116G/N/Y mutations across Uganda. Our results indicate that malaria parasites circulating in Uganda have a number of polymorphisms in PfATP4 and that modestly decreased susceptibility to PfATP4 inhibitors is associated with some mutations now present in Ugandan parasites

Point-of-admission hypothermia among high-risk Nigerian newborns

<p>Abstract</p> <p>Background</p> <p>Facilities which manage high-risk babies should frequently assess the burden of hypothermia and strive to reduce the incidence.</p> <p>Objective</p> <p>To determine the incidence and outcome of point-of-admission hypothermia among hospitalized babies.</p> <p>Methods</p> <p>The axillary temperatures of consecutive admissions into a Nigerian Newborn Unit were recorded. Temperature <36.5°C defined hypothermia. The biodata and outcome of these babies were studied.</p> <p>Results</p> <p>Of 150 babies aged 0 to 648 hours, 93 had hypothermia with an incidence of 62%. Mild and moderate hypothermia accounted for 47.3% and 52.7% respectively. The incidence of hypothermia was highest (72.4%) among babies aged less than 24 hours. It was also higher among out-born babies compared to in-born babies (64.4% <it>vs </it>58.3%). Preterm babies had significantly higher incidence of hypothermia (82.5%) compared with 54.5% of term babies (RR = 1.51; CI = 1.21 – 1.89). The incidence of hypothermia was also highest (93.3%) among very-low-birth-weight babies.</p> <p>The Case-Fatality-Rate was significantly higher among hypothermic babies (37.6% vs 16.7%; RR = 2.26, CI = 1.14 – 4.48) and among out-born hypothermic babies (50% vs 17.1%; RR = 0.34, CI = 0.16 – 0.74). CFR was highest among hypothermic babies with severe respiratory distress, sepsis, preterm birth and asphyxia.</p> <p>Conclusion</p> <p>The high incidence and poor outcome of hypothermia among high-risk babies is important. The use of the 'warm chain' and skin-to-skin contact between mother and her infant into routine delivery services in health facilities and at home may be useful.</p