“How Are My Age and Cows Related?” Cognitive Interviewing as a Tool to Pretest Survey Questions in Two Limited Resource Settings

Antimicrobial resistance is a complex topic requiring interdisciplinary solutions embedded in One Health thinking. Currently, many surveys are underway in low- and middle-income countries to study how antimicrobial use in the livestock sector is driving resistance. In a survey, the respondents must understand and answer the questions correctly to produce accurate and valuable results. Pretesting survey questions is therefore important but sometimes not performed due to limited time and resources. Cognitive interviewing is a pretesting method to give insights into the respondent's way of interpreting and mentally processing the survey questions to identify problems and finding ways to improve the questions. It has previously been suggested that cognitive interviews may be difficult to use in some cultural settings. This study aimed to use cognitive interviews in a respondent-adjusted way to study how survey questions related to antimicrobial use are understood and answered by 12 small-scale farmers in Kenya and Uganda. The results show that even a small number of interviews and using interviewers with limited knowledge of cognitive interviewing can identify many problems in survey questions and the survey tool. Cognitive interviews may provide a feasible and affordable way of pretesting questionnaires in situations where time and resources are limited, for example, during a disease outbreak

"How Are My Age and Cows Related?" Cognitive Interviewing as a Tool to Pretest Survey Questions in Two Limited Resource Settings.

Antimicrobial resistance is a complex topic requiring interdisciplinary solutions embedded in One Health thinking. Currently, many surveys are underway in low- and middle-income countries to study how antimicrobial use in the livestock sector is driving resistance. In a survey, the respondents must understand and answer the questions correctly to produce accurate and valuable results. Pretesting survey questions is therefore important but sometimes not performed due to limited time and resources. Cognitive interviewing is a pretesting method to give insights into the respondent's way of interpreting and mentally processing the survey questions to identify problems and finding ways to improve the questions. It has previously been suggested that cognitive interviews may be difficult to use in some cultural settings. This study aimed to use cognitive interviews in a respondent-adjusted way to study how survey questions related to antimicrobial use are understood and answered by 12 small-scale farmers in Kenya and Uganda. The results show that even a small number of interviews and using interviewers with limited knowledge of cognitive interviewing can identify many problems in survey questions and the survey tool. Cognitive interviews may provide a feasible and affordable way of pretesting questionnaires in situations where time and resources are limited, for example, during a disease outbreak

Investigation of Ebolavirus exposure in pigs presented for slaughter in Uganda

In 2008, an outbreak ofReston ebolavirus(RESTV) in pigs in the Philippines expanded our understanding of the host range of ebolaviruses. Subsequent experimental infections with the human-pathogenic speciesZaire ebolavirus(EBOV) confirmed that pigs are susceptible to African species of ebolaviruses. Pig keeping has become an increasingly important livelihood strategy throughout parts of sub-Saharan Africa, driven by increasing demand for pork. The growth in pig keeping is particularly rapid in Uganda, which has the highest per capita pork consumption in East Africa and a history of sporadic human outbreaks of Ebola virus disease (EVD). Using a systematic sampling protocol, we collected sera from 658 pigs presented for slaughter in Uganda between December 2015 and October 2016. Forty-six pigs (7%) were seropositive based on ELISA tests at two different institutions. Seropositive pigs had antibodies that bound to Sudan NP (n = 27), Zaire NP (Kikwit;n = 8) or both NPs (n = 11). Sera from 4 of the ELISA-positive pigs reacted in Western blot (EBOV NP = 1; RESTV NP = 2; both NPs = 2), and one sample had full neutralizing antibody againstSudan ebolavirus(SUDV) in virus neutralization tests. Pigs sampled in June 2016 were significantly more likely to be seropositive than pigs sampled in October 2016 (p = .03). Seropositive pigs were sourced from all regions except Western region. These observed temporal and spatial variations are suggestive of multiple introductions of ebolaviruses into the pig population in Uganda. This is the first report of exposure of pigs in Uganda to ebolaviruses and the first to employ systematic abattoir sampling for ebolavirus surveillance during a non-outbreak period. Future studies will be necessary to further define the role pigs play (if any) in ebolavirus maintenance and transmission so that potential risks can be mitigated

Comparison of rose bengal plate test, serum agglutination test, and indirect enzyme-linked immunosorbent assay in brucellosis detection for human and goat samples

Background: In Uganda, detection of brucellosis in goats and humans is more frequently done using rose bengal plate test (RBPT) in comparison to other serological tests such as serum agglutination test (SAT) and indirect enzyme-linked immunosorbent assay (i-ELISA). Aim: This study aimed at estimating the degree of agreement, specificity and sensitivity of RBPT, SAT, and ELISA in brucellosis detection in human and goat samples. Materials and Methods: An analytical study was conducted involving parallel testing of 425 goat samples and 177 human samples to compare RBPT, SAT, and i-ELISA tests of brucellosis detection. Results: A seroprevalence of 14.82% in animals and 11.86% in humans was detected using RBPT, 7.06% in goats and 5.09% in humans using SAT, and 6.35% in humans and 4.52% in animals using i-ELISA. The degree of agreement between the three tests in humans and animals was compared using Fleiss' kappa statistics where a moderate agreement (MA) was obtained for both with kappa value 0.57 in animals and 0.51 in humans and p<0.001. Kappa values in animals were 0.52 (MA) for RBPT and i-ELISA, 0.61 (MA) for RBPT and SAT, and 0.82 substantial agreement (SA) for SAT and i-ELISA. The kappa values in humans were 0.52 (MA) for RBPT and i-ELISA, 0.57 (MA) for RBPT and SAT, and 0.82 (SA) for SAT and i-ELISA, respectively. The study revealed a significant agreement in the tests for all the three tests, but there was SA between SAT and i-ELISA in both animal and human samples. Sensitivity and specificity of RBT and SAT were estimated using i-ELISA as a gold standard as follows, in goats RBPT: 100 and 91% and SAT: 100 and 99%, respectively, and in humans RBPT: 100 and 92% and SAT: 88 and 99%, respectively. Conclusion: It appears that RBPT is good as a screening test, whereas SAT and i-ELISA are good for diagnosis purposes or confirmatory test

A retrospective analysis of antimicrobial resistance in pathogenic Escherichia coli and Salmonella spp. isolates from poultry in Uganda

There are increasing reports of antimicrobial treatment failures for bacterial diseases of poultry in Uganda. The paucity of data on antimicrobial resistance (AMR) of pathogenic bacteria in Uganda is a major setback to AMR control. This study investigated the occurrence of fowl typhoid, colibacillosis, and AMR in associated pathogens from 2012 to 2018. Laboratory records from the Central Diagnostic Laboratory (CDL), a National Veterinary Diagnostic Facility located at Makerere University, were reviewed. Archived isolates of the causative bacteria for the two diseases were also evaluated for AMR. The frequencies of the two disease conditions, their clinical and necropsy presentations and the demographic data of the diagnostic samples were summarized from the records. Archived bacterial isolates were revived before antimicrobial susceptibility testing. This was done on Mueller Hinton agar using the disk diffusion method, against 16 antimicrobials of medical and veterinary importance according to the Clinical Laboratory Standards Institute guidelines. A total of 697 poultry cases were presented for bacteriological investigations in the review period. Colibacillosis and salmonellosis had prevalence rates of 39.7% (277/697) and 16.2% (113/697), respectively. A total of 63 and 92 isolates of Escherichia coli and Salmonella spp., respectively, were archived but 43 (68.3%) E. coli and 47 (51.1%) Salmonella spp. isolates were recovered and evaluated for AMR. Multidrug resistance was more frequent in E. coli (38; 88.4%) than salmonellae (25; 53.2%), (p < 0.001). The high prevalence of colibacillosis, salmonellosis and the AMR of associated pathogens warrants immediate institution of appropriate disease control measures

Antimicrobial use and antimicrobial resistance in broiler farms in peri-urban Wakiso, Uganda

Objective: A cross sectional study was carried out to 1) describe the antimicrobial use patterns among poultry farmers in Wakiso 2) establish resistant profiles of Salmonella, E. coli and Enterococci among poultry farms in Wakiso. Methods: A cross sectional study in Wakiso district was carried out in October and November 2021 for a period of 6 weeks. A semi structured questionnaire was used to collect data on antimicrobial use on the farms. Boot sock sampling was used to collect samples from the whole poultry house. A composite sample of faecal material was also collected from the poultry house. The information on antimicrobial use is being analyzed for descriptive statistics. The faecal samples were cultured in the laboratory for Isolation of Salmonella, E. coli and Enterococci. The Isolates will further be tested to establish their resistant profiles. The composite sample was used to quantify resistant coliforms against cefotaxime and colistin Results: A total of 200 poultry farms in Wakiso were visited, 211 boot sock samples and 211 composite samples were collected. 29.85% of the respondents were male while 70.15% were female.37.38% had attained secondary level of education. There was observed widespread use of antimicrobials on the farms for treatment of different conditions as well as prevention of disease. The most used groups of antibiotics were, Penicillins, Tetracyclines and Aminoglycosides while Sulphonamides were the least used. From the laboratory analysis, out of the 211 samples collected, Salmonella was isolated at a rate of 8.5%, E. coli at 77.3% and Enterococcus at 62.6%. Resistant coliforms to cefotaxime (5I.7%) and colistin (45.5%) were also identified. Conclusion: There are indications of resistant coliforms among poultry farms in Wakiso. This is attributed to the observed continuous use of antibiotics on the poultry farms. There is need to improve antimicrobial use among farmers. Proper diagnosis of conditions is one possible way that will reduce the use of different antibiotics at farm level