Evaluation of tomato genotypes for tolerance to major diseases in Uganda

Tomato ( Solanum lycopersicum L.) is a priority vegetable in Uganda, but due to its limited genetic base, its cultivated types are prone to a variety of diseases. The objective of this study was to evaluate new tomato genotypes for resistance to major tomato diseases under hotspot conditions in Uganda. Fourty-five tomato genotypes were evaluated for reactions to tomato bacterial wilt, tomato bacterial speck, early blight and late blight. The study was conducted for two rainy seasons in 2019, at the National Crops Resources Research Institute, Namulonge in Uganda. Data for severity and incidence were collected at two-week intervals after transplanting. Twelve genotypes (Nouvella F1, Rambo F1, Commando F1, AVTO1315, AVTO922, AVTO1701, AVTO1219, AVTO1464, MT56, ADV1287A, Pruna and Vega) exhibited high levels of tolerance to bacterial wilt; while bacterial speck presented mild symptoms majorly seen on Vega, Zodiac and AVTO9802. Rhino, AVTO1418, AVTO1314, Eureka, Roma VFN, MT56, Pinktop, Assila F1, Money-maker, AVTO0922 and AVTO1464 were the least affected by early blight; while AVTO1219, AVTO1701, ADV12021, ADV12076 and ADV1287A expressed low AUDPC values for late blight. Overall, AVTO1315 was the best yielder (30.8 metric tonnes ha-1), followed by AVTO0301 (29.0 t ha-1) and Nouvella F1 (26.1 t ha-1). Among the tomato genotypes evaluated, we recommend AVTO1701, AVTO0922, AVTO1464, AVTO0301 AVTO1315, AVTO1219, Pruna, Vega, ADV1287A and MT56 for the national performance trials.La tomate ( Solanum lycopersicum L.) est un l\ue9gume prioritaire en Ouganda, mais en raison de sa base g\ue9n\ue9tique limit\ue9e, ses types cultiv\ue9s sont sujets \ue0 une vari\ue9t\ue9 de maladies. L\u2019objectif de cette \ue9tude \ue9tait d\u2019\ue9valuer des g\ue9notypes de tomates s\ue9lectionn\ue9s pour leur r\ue9sistance aux principales maladies de la tomate dans des conditions de hotspot en Ouganda. Quarante-cinq g\ue9notypes de tomates ont \ue9t\ue9 \ue9valu\ue9s pour leurs r\ue9actions au fl\ue9trissement bact\ue9rien de la tomate, \ue0 la tache bact\ue9rienne de la tomate, au mildiou et au mildiou. L\u2019\ue9tude a \ue9t\ue9 men\ue9e pendant deux saisons des pluies en 2019, au National Crops Resources Research Institute, \ue0 Namulonge en Ouganda. Les donn\ue9es de gravit\ue9 et d\u2019incidence ont \ue9t\ue9 recueillies \ue0 des intervalles de deux semaines apr\ue8s la transplantation. Douze g\ue9notypes (Nouvella F1, Rambo F1, Commando F1, AVTO1315, AVTO922, AVTO1701, AVTO1219, AVTO1464, MT56, ADV1287A, Pruna et Vega) pr\ue9sentaient des niveaux \ue9lev\ue9s de tol\ue9rance au fl\ue9trissement bact\ue9rien; tandis que la tache bact\ue9rienne pr\ue9sentait des sympt\uf4mes b\ue9nins principalement observ\ue9s sur Vega, Zodiac et AVTO9802. Rhino, AVTO1418, AVTO1314, Eureka, Roma VFN, MT56, Pinktop, Assila F1, Money-maker, AVTO0922 et AVTO1464 ont \ue9t\ue9 les moins touch\ue9s par le mildiou; tandis que AVTO1219, AVTO1701, ADV12021, ADV12076 et ADV1287A ont exprim\ue9 de faibles valeurs AUDPC pour le mildiou. Dans l\u2019ensemble, AVTO1315 a \ue9t\ue9 le meilleur producteur (30,8 tonnes m\ue9triques ha-1), suivi par AVTO0301 (29,0 t ha-1) et Nouvella F1 (26,1 t ha-1). Parmi les g\ue9notypes de tomates \ue9valu\ue9s, nous recommandons AVTO1701, AVTO0922, AVTO1464, AVTO0301 AVTO1315, AVTO1219, Pruna, Vega, ADV1287A et MT56 pour les essais de performance nationaux

Genetic diversity and population structure of Peronosclerospora sorghi isolates of Sorghum in Uganda

Sorghum is the third most important staple cereal crop in Uganda after maize and millet. Downy mildew disease is one of the most devastating fungal diseases which limits the production and productivity of the crop. The disease is caused by an obligate fungus, Peronosclerospora sorghi (Weston & Uppal) with varying symptoms. Information on the genetic diversity and population structure of P.sorghi in sorghum is imperative for the screening and selection for resistant genotypes and further monitoring possible mutant(s) of the pathogen. Isolates of P. sorghi infecting sorghum are difficult to discriminate when morphological descriptors are used. The use of molecular markers is efficient, and reliably precised for characterizing P. sorghi isolates. This study was undertaken to assess the level of genetic diversity and population structure that exist in P. sorghi isolates in Uganda. A total of 195 P. sorghi isolates, sampled from 13 different geographic populations from 10 different regions (agro-ecological zones) was used. Eleven (11) molecular markers, comprising of four Random amplified microsatellite (RAM) and seven (7) Inter-Simple Sequence Repeat (ISSR) markers were used in this study. The analysis of molecular variation (AMOVA) based on 11 microsatellite markers showed significant (P < 0.001) intra-population (88.9 %, PhiPT = 0.111) and inter-population (8.4 %, PhiPR = 0.083) genetic variation, while the genetic variation among regions (2.7 %, PhiRT = 0.022) was not significant. The highest genetic similarity value (0.987 = 98.7 %) was recorded between Pader and Lira populations and the lowest genetic similarity (0.913 = 91.3 %) was observed between Namutumba and Arua populations. The mean Nei's genetic diversity index (H) and Shannon Information Index (I) were 0.308 and 0.471 respectively. Seven distinct cluster groups were formed from the 195 P. sorghi isolates based on their genetic similarity. Mantel test revealed no association between genetic differentiation and geographical distance (R2 = 0.0026, p = 0.02) within the 13 geographic populations

On-site construction of a point-of-care low-field MRI system in Africa

PurposeTo describe the construction and testing of a portable point-of-care low-field MRI system on site in Africa. MethodsAll of the components to assemble a 50 mT Halbach magnet-based system, together with the necessary tools, were air-freighted from the Netherlands to Uganda. The construction steps included individual magnet sorting, filling of each ring of the magnet assembly, fine-tuning the inter-ring separations of the 23-ring magnet assembly, gradient coil construction, integration of gradient coils and magnet assembly, construction of the portable aluminum trolley and finally testing of the entire system with an open source MR spectrometer. ResultsWith four instructors and six untrained personnel, the complete project from delivery to first image took approximately 11 days. ConclusionsAn important step in translating scientific developments in the western world from high-income industrialized countries to low- and middle-income countries (LMICs) is to produce technology that can be assembled and ultimately constructed locally. Local assembly and construction are associated with skill development, low costs and jobs. Point-of-care systems have a large potential to increase the accessibility and sustainability of MRI in LMICs, and this work demonstrates that technology and knowledge transfer can be performed relatively seamlessly.Radiolog

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings

The cost‐effectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa

Introduction Many HIV‐positive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhanced‐prophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the cost‐effectiveness of this enhanced‐prophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count. Methods The REALITY trial enrolled from June 2013 to April 2015. A decision‐analytic model was developed to estimate the cost‐effectiveness of six management strategies in individuals initiating ART in the REALITY trial countries. Strategies included standard‐prophylaxis, enhanced‐prophylaxis, standard‐prophylaxis with fluconazole; and three CrAg testing strategies, the first stratifying individuals to enhanced‐prophylaxis (CrAg‐positive) or standard‐prophylaxis (CrAg‐negative), the second to enhanced‐prophylaxis (CrAg‐positive) or enhanced‐prophylaxis without fluconazole (CrAg‐negative) and the third to standard‐prophylaxis with fluconazole (CrAg‐positive) or without fluconazole (CrAg‐negative). The model estimated costs, life‐years and quality‐adjusted life‐years (QALY) over 48 weeks using three competing mortality risks: cryptococcal meningitis; tuberculosis, serious bacterial infection or other known cause; and unknown cause. Results Enhanced‐prophylaxis was cost‐effective at cost‐effectiveness thresholds of US$300 and US$500 per QALY with an incremental cost‐effectiveness ratio (ICER) of US$157 per QALY in the CD4 <200 cells/mm3 population providing enhanced‐prophylaxis components are sourced at lowest available prices. The ICER reduced in more severely immunosuppressed individuals (US$113 per QALY in the CD4 <100 cells/mm3 population) and increased in all individuals regardless of CD4 count (US$722 per QALY). Results were sensitive to prices of the enhanced‐prophylaxis components. Enhanced‐prophylaxis was more effective and less costly than all CrAg testing strategies as enhanced‐prophylaxis still conveyed health gains in CrAg‐negative patients and savings from targeting prophylaxis based on CrAg status did not compensate for costs of CrAg testing. CrAg testing strategies did not become cost‐effective unless the price of CrAg testing fell below US$2.30. Conclusions The REALITY enhanced‐prophylaxis package in individuals with advanced HIV starting ART reduces morbidity and mortality, is practical to administer and is cost‐effective. Efforts should continue to ensure that components are accessed at lowest available prices

Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial.

This article has been accepted for publication in Clinical Infectious Diseases Published by Oxford University PressBackground: Severely immunocompromised human immunodeficiency virus (HIV)-infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and "late presenter" phenotypes. Methods: The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts .1). Results: Among 1711 included participants, 203 (12%) died. Mortality was independently higher with older age; lower CD4 count, albumin, hemoglobin, and grip strength; presence of World Health Organization stage 3/4 weight loss, fever, or vomiting; and problems with mobility or self-care at baseline (all P < .04). Receiving enhanced antimicrobial prophylaxis independently reduced mortality (P = .02). Of five late-presenter phenotypes, Group 1 (n = 355) had highest mortality (25%; median CD4 count, 28 cells/µL), with high symptom burden, weight loss, poor mobility, and low albumin and hemoglobin. Group 2 (n = 394; 11% mortality; 43 cells/µL) also had weight loss, with high white cell, platelet, and neutrophil counts suggesting underlying inflammation/infection. Group 3 (n = 218; 10% mortality) had low CD4 counts (27 cells/µL), but low symptom burden and maintained fat mass. The remaining groups had 4%-6% mortality. Conclusions: Clinical and laboratory features identified groups with highest mortality following ART initiation. A screening tool could identify patients with low CD4 counts for prioritizing same-day ART initiation, enhanced prophylaxis, and intensive follow-up. Clinical Trials Registration: ISRCTN43622374.REALITY was funded by the Joint Global Health Trials Scheme (JGHTS) of the UK Department for International Development, the Wellcome Trust, and Medical Research Council (MRC) (grant number G1100693). Additional funding support was provided by the PENTA Foundation and core support to the MRC Clinical Trials Unit at University College London (grant numbers MC_UU_12023/23 and MC_UU_12023/26). Cipla Ltd, Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, and Merck Sharp & Dohme donated drugs for REALITY, and ready-to-use supplementary food was purchased from Valid International. A. J. P. is funded by the Wellcome Trust (grant number 108065/Z/15/Z). J. A. B. is funded by the JGHTS (grant number MR/M007367/1). The Malawi-Liverpool–Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine (grant number 101113/Z/13/Z) and the Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Kilifi (grant number 203077/Z/16/Z) are supported by strategic awards from the Wellcome Trust, United Kingdom. Permission to publish was granted by the Director of KEMRI. This supplement was supported by funds from the Bill & Melinda Gates Foundation

Involving men in cervical cancer prevention: a qualitative enquiry into male perspectives on screening and HPV vaccination in Mid-Western Uganda

IntroductionEvidence-based preventive strategies for cervical cancer in low-resource setting have been developed, but implementation is challenged, and uptake remains low. Women and girls experience social and economic barriers to attend screening and human papillomavirus (HPV) vaccination programs. Male support has been proven successful in uptake of other reproductive healthcare services. This qualitative study with focus groups aimed to understand the perspectives of males on cervical cancer screening and HPV vaccination in Western-Uganda This knowledge could be integrated into awareness activities to increase the attendance of cervical cancer screening and HPV vaccination programs.Materials and methods Focus group discussions were conducted with men aged 25 to 60 years, who were married and/or had daughters, in Kagadi district, Mid-Western Uganda. All interviews were transcribed verbatim and thematically analyzed using an inductive approach.Results Eleven focus group discussions were conducted with 67 men. Men were willing to support their wives for screening and their daughters for HPV vaccination. Misperceptions such as family planning and poor personal hygiene leading to cervical cancer, and misperception of the preventative aspect of screening and vaccination were common. Women with cervical cancer suffer from stigmatization and family problems due to loss of fertility, less marital sexual activity, domestic violence and decreased economic productivity.Conclusions Ugandan men were willing to support cervical cancer prevention for their wives and daughters after being informed about cervical cancer. Limited knowledge among men about the risk factors and causes of cervical cancer, and about the preventative aspect of HPV vaccination and screening and their respective target groups, can limit uptake of both services. Screening and vaccination programs should actively involve men in creating awareness to increase uptake and acceptance of prevention.Cervix cance