Cholera in endemic districts in Uganda during El Niño rains: 2002 – 2003

Background: El Niño phenomenon causing increased rainfall and flooding has been linked to flare ups and emergence of several disease outbreaks including cholera. The latter has been reported in many districts in Uganda in recent years. Therefore an understanding of factors influencing its pattern of occurrence is needed for effective control. Objectives: To determine cholera disease status during six months of El Niño rains and assess serotypes and antibiotic sensitivity of isolates. Methods: A prospective study was conducted in five cholera “endemic districts” in Uganda. Results: Cholera outbreaks occurred in all the study districts coincident with the onset of the El Niño rains. There were 924 cholera suspect cases reported with 95 fatalities (case fatality rate 10.3%). A total of 388 clinical specimens were analyzed by culture and of these, 168 were positive for V. cholerae. Biochemical and serological analysis identified the isolates as V. choleraem O1, biotype EL Tor serotype Ogawa. Antibiotic sensitivity revealed that isolates were 100% sensitive to ciprofloxacin, tetracycline and erythromycin, whereas sensitivity was variable for other tested antibiotics. Unlike Kampala, where the disease was contained within three months, persistence occurred in other districts only dying out with end of El Niño rains, suggesting differences in disease control. Conclusion: These results show that El Niño rains cause increase in the number of cholera cases in Uganda, calling for preparedness and a need to emulate Kampala response incase of outbreaks in other districts. African Health Sciences Vol. 6(2) 2006: 93-9

Microbiological Quality of Traditionally Smoked Fish from Lake Victoria Crescent, Uganda

Microbiological quality of traditionally smoked fish was assessed to ascertain the effectiveness of traditional smoking process and handling conditions for smoked fish shelf-life and safety. Fish smoking is a popular preservation method in Uganda. Although fish smoking is a widely used method of preservation, the presence of spoilage and pathogenic bacteria in smoked fish and food borne illnesses remain a threat in developing countries. However, little is known about microbial quality of fish smoked from Uganda. In light of this, the status of spoilage, hygiene and pathogenic indicator organisms in fish (Nile perch) was investigated. A total of 75 randomly selected fresh, freshly smoked, and on shelf smoked fish from landing sites and markets respectively, were obtained for microbial and moisture content analysis. Descriptive statistics was used to present the data, while ANOVA and Tukey tests were used to analyze the data. The study revealed that, the smoking process significantly (P<0.05) reduced microbial load in freshly fish to levels acceptable for consumption, despite the high levels of moisture content in the range of 59.2% to 66.5%. The mean microbial load (log of cfu/g) of indicator organisms for samples from different sites varied from; 9.97 to 10.18; 7.39 to 8.19 (aerobic mesophilic bacteria or TPC), 5.18 to 5.27; 0 to 4.28 (total coliforms), 2.73 to 5.55; 0 to 0.85 (E. coli), 4.97 to 7.32; 0 to 3.11 (S. aureus), and 2.21 to 4.56; 0 to 0.82 (Yeasts and molds), for fresh and smoked fish samples respectively. Additionally, mean microbial load for on shelf smoked fish from markets varied from; 8.2 to 10.57 (TPC), 2.8-6.63 (total coliforms), 0 to 6.11 (E. coli), 6.74 to 8.89 (S. aureus), and 0 to 5.51 (Yeasts and molds). Although findings showed that, traditional fish smoking was somewhat effective in reducing microbial load to acceptable levels, the microbial status of on shelf smoked fish indicated poor fish handling and storage. Therefore, proper fish handling during and post-smoking as well as cooking before consumption, are highly recommended for assured shelf-life and safety of smoked fish for consumption in Uganda. Keywords: Microbiological, quality, smoked fish, Uganda, indicator organisms DOI: 10.7176/FSQM/104-05 Publication date: January 31st 2021

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

Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda

Introduction: To meet key millennium development goals, the rural population needs to be reached for health assessment and service delivery. Gastroduodenal ulcer disease is a common ailment affecting the health of people in Uganda. A cross-sectional study was conducted at Bwera Hospital in Kasese district of western Uganda, to establish the prevalence and predisposing factors of Helicobacter pylori among gastroduodenal ulcer disease patients. Methods: A sample of 174 patients with symptoms of gastroduodenal ulcer disease was purposively obtained. Using two laboratory test methods, the prevalence of H. pylori among these patients was determined. A structured questionnaire was administered to participants to establish their demographic background and selected aspects of their lifestyle. Finally, the results obtained by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic rapid test (IRT) were compared. Results: We established the prevalence of H. pylori as 29.9% (52/174) by ELISA and 37.4% (65/174) by IRT. Cigarette smoking, poor sanitation, and lack of formal education were the significant predisposing factors with p-values <0.05. The two tests gave identical results in 87.9% of the patients. Discussion: The prevalence of H. pylori by IRT and ELISA test methods was similar to what has been reported elsewhere in developed countries; but was lower than previously reported in developing countries including Uganda. The previous studies in Uganda were carried out in the urban population and on young children; and some used antibody-detection methods only, therefore leading to different prevalence as a result of difference in study population and methods

Sociocultural factors associated with fish consumption in Lake Albert fishing community: Guidelines for lead and mercury

Fish consumption in subsistence fishing community is a life style associated with lead and mercury uptake for humans. Fish consumption is influenced by sociocultural factors, exposure and health risks. Unfortunately, no sociocultural study in the Lake Albert fishing community in light of lead and mercury exists. A cross-sectional sociocultural study was carried out between March and June 2015. A total of 270 household heads in four landing sites in Hoima district completed structured questionnaires and data analyzed using SPSS version 20. The majority of the households (74.8%) had primary education or below, 51.1% drank unboiled water, and 30% perceived lake water safe for drinking. Children under five ate soup (15%) and middle piece of the fish (29%). The Poisson general linear model predicting weekly fish consumption amounts against sociocultural factors showed that household size (p = 0.047), male child presence (p = 0.007), methods of preparation i.e. salting (p < 0.0001), fish parts consumed by adults (p < 0.0001), fish preference (p < 0.0001), awareness about the beach management unit (p < 0.0001), and income from charcoal selling (p < 0.0001) were positive predictors. The negative predictors of weekly fish consumption amounts were awareness about fish consumption benefits (p < 0.0001), eating young fish (p = 0.002), donor agency presence (p < 0.0001), and frying as the method of fish preparation (p = 0.002). In conclusion, knowledge of the sociocultural factors associated with fish consumption determines the amounts and frequency of the predominant fish eaten. Therefore, to establish and adopt fish consumption guidelines for lead and mercury in the Lake Albert, the sociocultural factors should be integrated in the message disseminated

Mercury concentration in muscle, bellyfat and liver from Oreochromis niloticus and Lates niloticus consumed in Lake Albert fishing communities in Uganda

Without surveillance studies on mercury (Hg) levels in predominant fish species and parts eaten in a fishing community, the FAO/WHO guidelines might be surpassed, hence health risk. A monitoring study in a developing country with 29 Oreochromis niloticus (Nile tilapia) and 34 Lates niloticus (Nile perch) from landing sites provided muscle, bellyfat and liver samples for Mercury detection using Inductive Couple Plasma-optical emission spectroscopy. The study shows that fish eaten in the fishing community are small with fewer risks from mercury. Tilapia accumulated more mercury in muscle and liver than Nile perch. Fish consumed has mercury levels higher than FAO/WHO guidelines, and the bellyfat of Nile perch bioaccumulated more mercury than Tilapia. Based on the above, it is clear that some fish species should not be eaten by the vulnerable groups due to levels of Hg found in the muscle and bellyfat. This research will serve as a base for future studies, sensitization campaigns and policy design on mercury uptake through fish in fishing communities of developing countries