Assessing the external validity of a randomized controlled trial of anthelminthics in mothers and their children in Entebbe, Uganda.

BACKGROUND: The 'external validity' of randomized controlled trials is an important measure of quality, but is often not formally assessed. Trials concerning mass drug administration for helminth control are likely to guide public health policy and careful interpretation of their context is needed. We aimed to determine how representative participants in one such trial were of their community. We explore implications for trial interpretation and resulting public health recommendations. METHODS: The trial assessed was the Entebbe Mother and Baby Study (EMaBS), a trial of anthelminthic treatment during pregnancy and early childhood. In a novel approach for assessing external validity, we conducted a two-stage cluster sample community survey within the trial catchment area and compared characteristics of potentially-eligible community children with characteristics of children participating in the trial. RESULTS: A total of 173 children aged three to five-years-old were surveyed from 480 households. Of children surveyed, we estimated that mothers of 60% would have been eligible for recruitment, and of these, 31% had actually been enrolled. Children surveyed were compared to 199 trial children in the same age group reviewed at annual trial visits during the same time period. There were significant differences in ethnicity between the trial participants and the community children, and in socioeconomic status, with those in the trial having, on average, more educated parents and higher maternal employment. Trial children were less likely to have barefoot exposure and more likely to use insecticide-treated bed nets. There were no significant differences in numbers of reported illness events over the last year. CONCLUSIONS: The trial had not enrolled all eligible participants, and those enrolled were of higher socioeconomic status, and had lower risk of exposure to the parasitic infections targeted by the trial interventions. It is possible the trial may have underestimated the absolute effects of anthelminthic treatment during pregnancy and early childhood, although the fact that there were no differences in reported incidence of common infectious diseases (one of the primary outcomes of EMaBS) between the two groups provides reassurance. Concurrent community surveys may be an effective way to test the external validity of trials. EMABS TRIAL REGISTRATION: ISRCTN32849447, registered 22 July 2005

Ploidy level of the banana (Musa spp.) accessions at the germplasm collection centre for the East and Central Africa

Banana germplasm collections serves as a source of useful genes for banana breeding. However, insufficient and/or inaccurate information on the ploidy level of the germplasm renders its utilization in breeding difficult. The objective of this study was to determine and validate the ploidy level of 120 banana accessions in the ex situ germplasm collection centre for the East and Central Africa, located in Mbarara, Uganda. Flow cytometric analysis of the nuclear DNA content was used to determine the ploidy level of the accessions. Results indicate that accessions: Bura, Diana, Kambani-Rungwe, Paji and Pagatau, and Rungwe that were previously classified as diploids are actually triploids, whereas Selangor previously known to be a diploid is a tetraploid. Accessions such as Galeo, Mwitupemba and Ntindi 1 that were previously classified as triploids were found diploids. GT, FHIA 25 and Muzungu Mwekundu that were considered as tetraploids, were found triploids. The information generated will guide correct placement of these accessions in the regional germplasm collection centre for the East and Central Africa and their utilization in banana breeding

Selection of cooking banana genotypes for yield and black Sigatoka resistance in different locations in Uganda

It is imperative to systematically evaluate new banana genotypes in different locations before national release. This enables selection and recommendation of superior genotypes as new varieties for a wider range of environments. The objective of the present study was to select banana genotypes with stable and high performance for bunch yield and leaf black Sigatoka resistance. Eleven cooking banana genotypes developed by the Uganda National Agricultural Research Organization in collaboration with Bioversity International, and two check varieties were evaluated in multi-location preliminary yield trials in Uganda. Data collected were analyzed using Additive Main Effects and Multiplicative Interaction (AMMI) model, AMMI Stability Value, and Genotype Selection Index (GSI). Genotype × location interaction was significant for all the traits assessed. Most of the new genotypes had low interaction effects with locations for bunch yield (69.2%) and black Sigatoka (92.3%). The most stable genotypes for bunch yield were NABIO815, NABIO1117, NABIO216 and NABIO306 whereas for black Sigatoka resistance, were NABIO1011, NABIO815, NABIO1009 and NABIO216. Using the GSI that defines the most desirable genotypes as those that combine high agronomic performance and stability across environments, four genotypes (NABIO306, NABIO1011, NABIO808 and NABIO1009) were selected. These genotypes, in addition to their high performance for agronomic traits and stability, had soft and yellow fruit pulp on cooking, and will be advanced on farm for further evaluatio

Reaching rural communities through 'Healthy Entrepreneurs': a cross-sectional exploration of community health entrepreneurship's role in sexual and reproductive health

The purpose of the current study was to explore the association between community health entrepreneurship and the sexual and reproductive health status of rural households in West-Uganda. We collected data using digital surveys in a cluster-randomized cross-sectional cohort study. The sample entailed 1211 household members from 25 randomly selected villages within two subcounties, of a rural West-Ugandan district. The association between five validated sexual and reproductive health outcome indicators and exposure to community health entrepreneurship was assessed using wealth-adjusted mixed-effects logistic regression models. We observed that households living in an area where community health entrepreneurs were active reported more often to use at least one modern contraceptive method [odds ratios (OR): 2.01, 95% CI: 1.30-3.10] had more knowledge of modern contraceptive methods (OR: 7.75, 95% CI: 2.81-21.34), knew more sexually transmitted infections (OR: 1.86, 95% CI: 1.14-3.05), and mentioned more symptoms of sexually transmitted infections (OR: 1.83, 95% CI: 1.18-2.85). The association between exposure to community health entrepreneurship and communities' comprehensive knowledge of HIV/AIDS was more ambiguous (OR: 1.27, 95% CI: 0.97-1.67). To conclude, households living in areas where community health entrepreneurs were active had higher odds on using modern contraceptives and had more knowledge of modern contraceptive methods, sexually transmitted infections and symptoms of sexually transmitted infections. This study provides the first evidence supporting the role of community health entrepreneurship in providing rural communities with sexual and reproductive health care

East African pigs have a complex Indian, Far Eastern and Western ancestry

In this study, we have characterized the mitochondrial diversity of 81 swine from Uganda. Median-joining network analysis of D-loop sequences from these individuals and others characterized in previous studies allowed us to determine that Ugandan pigs cluster with populations from the West (Europe/North Africa), Far East and India. In addition, partial sequencing of the Y-chromosome UTY locus in 18 Ugandan domestic pigs revealed the segregation of a single HY1 lineage that has a cosmopolitan distribution. A Western and Far Eastern ancestry for East African pigs had been already reported, but this is the first study demonstrating an additional contribution from the Indian porcine gene pool. This result is consistent with the high frequency of zebuine alleles in cattle from East Africa. The geographic coordinates of East Africa, at the crossroads of many trading routes that, through the ages, linked Europe, Africa and Asia, might explain the rich and complex genetic heritage of livestock native to this area.We are greatly indebted to the Swedish International Development Agency (Sida) under the framework of Sida-Mak Bilateral Research Support Programme Phase 3 to the Post Doc program at the Directorate of Graduate and Research Training for the financial support (Grant No. 75007369, Swedish Research Links, contract number 348-2011-7380).Peer reviewe

MGIS: managing banana (Musa spp.) genetic resources information and high-throughput genotyping data

Unraveling the genetic diversity held in genebanks on a large scale is underway, due to advances in Next-generation sequence (NGS) based technologies that produce high-density genetic markers for a large number of samples at low cost. Genebank users should be in a position to identify and select germplasm from the global genepool based on a combination of passport, genotypic and phenotypic data. To facilitate this, a new generation of information systems is being designed to efficiently handle data and link it with other external resources such as genome or breeding databases. The Musa Germplasm Information System (MGIS), the database for global ex situ-held banana genetic resources, has been developed to address those needs in a user-friendly way. In developing MGIS, we selected a generic database schema (Chado), the robust content management system Drupal for the user interface, and Tripal, a set of Drupal modules which links the Chado schema to Drupal. MGIS allows germplasm collection examination, accession browsing, advanced search functions, and germplasm orders. Additionally, we developed unique graphical interfaces to compare accessions and to explore them based on their taxonomic information. Accession-based data has been enriched with publications, genotyping studies and associated genotyping datasets reporting on germplasm use. Finally, an interoperability layer has been implemented to facilitate the link with complementary databases like the Banana Genome Hub and the MusaBase breeding database. Database URL:https://www.crop-diversity.org/mgis