Factors that affect quality of life among people living with HIV attending an urban clinic in Uganda: A cohort study

© 2015 Mutabazi-Mwesigire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction: With the availability of antiretroviral therapy (ART) and primary general care for people living with HIV (PLHIV) in resource limited settings, PLHIV are living longer, and HIV has been transformed into a chronic illness. People are diagnosed and started on treatment when they are relatively well. Although ART results in clinical improvement, the ultimate goal of treatment is full physical functioning and general well-being, with a focus on quality of life rather than clinical outcomes. However, there has been little research on the relationship of specific factors to quality of life in PLHIV. The objective of this study was to investigate factors associated with quality of life among PLHIV in Uganda receiving basic care and those on ART. Methods: We enrolled 1274 patients attending an HIV outpatient clinic into a prospective cohort study. Of these, 640 received ART. All were followed up at 3 and 6 months. Health related quality of life was assessed with the MOS-HIV Health Survey and the Global Person Generated Index (GPGI). Multivariate linear regression and logistic regression with generalized estimating equations were used to examine the relationship of social behavioral and disease factors with Physical Health Summary (PHS) score, Mental Health Summary (MHS) score, and GPGI. Results: Among PLHIV receiving basic care, PHS was associated with: sex (p=0.045) - females had lower PHS; age in years at enrollment (p=0.0001) - older patients had lower PHS; and depression (

Trace metal distribution in the bed, bank and suspended sediment of the Ravensbourne River and its implication for sediment monitoring in an urban river

Purpose This study aims to identify a suitable sediment compartment for sediment quality monitoring by: (a) studying the concentration of trace metals (Cd, Cu, Ni, Pb and Zn) in the bed, bank and suspended sediment compartments of the Ravensbourne River to establish any differences in trace metal concentrations with compartment; (b) determining the influence of sediment particle size fractions ( 0.05) in the concentrations of metals between the suspended sediment and the < 63 μm bed sediment fraction, but there was a significant difference (p < 0.05) between the suspended sediment and the < 63 μm bank sediment fraction. There were also significant differences between the concentrations of metals in the < 63 μm and the 63 μm–2 mm fractions. Generally, the Ravensbourne River did not comply with the draft UK sediment quality guidelines for the metals analysed. Conclusions This study shows the importance of identifying a suitable sediment compartment to sample for compliance with sediment quality standards. The bed and suspended sediments are the most widely used sediment compartments for sediment monitoring, but collecting sufficient mass of the < 63 μm sediment fraction for monitoring presents a challenge for urban gravel bed rivers like the Ravensbourne River. It seems appropriate to establish individual monitoring regimes for different rivers

Assessment of heavy metal pollution in the urban stream sediments and its tributaries

Globally, aquatic ecosystems are highly polluted with heavy metals arising from anthropogenic and terrigenous sources. The objective of this study was to investigate the pollution of stream sediments and possible sources of pollutants in Nakivubo Channel Kampala, Uganda. Stream sediments were collected and analysed for heavy metal concentration using flame atomic absorption spectrophotometer. The degree of pollution in Nakivubo channelized stream sediments for lead, cadmium, copper, zinc, manganese and iron was assessed using enrichment factor, geoaccumulation index and pollution load index. The results indicated that (1) the sediments have been polluted with lead, cadmium and zinc and have high anthropogenic influences; (2) the calculation of geo-accumulation index suggest that Nakivubo stream sediments have background concentration for copper, manganese and Fe (Igeo ≤ 0); (3) factor analysis results reveal three sources of pollutants as explained by three factors (75.0 %); (i) mixed origin or retention phenomena of industrial and vehicular emissions; (ii) terrigenous and (iii) dual origin of zinc (vehicular and industrial). In conclusion, the co-precipitation (inclusion, occlusion and adsorption) of lead, cadmium and zinc with manganese and iron hydroxides, scavenging ability of other metals, very low dissolved oxygen and slightly acidic to slightly alkaline pH in stream water could account for the active accumulation of heavy metals in Nakivubo stream sediments. These phenomena may pose a risk of secondary water pollution under sediment disturbance and/or changes in the geo-chemistry of sediments

Application of algae in biomonitoring and phytoextraction of heavy metals contamination in urban stream water

Biological technologies for wastewater remediation techniques employed to remove contaminants in urban stream water are increasingly receiving attention worldwide. The purpose of this study was therefore to determine the concentrations of lead, cadmium, copper, zinc, manganese and iron in algal biomass and establish the feasibility of using algae in phytoextraction and bio-monitoring of environmental quality. Analysis of algal biomass samples in the Nakivubo urban stream ecosystem, Kampala, Uganda, showed that there was contamination by lead, cadmium, copper and zinc as indicated by enrichment factor and pollution load index values. It is suspected that industrial and vehicular emissions are the major sources of these pollutants. Calculated bio-concentration factor was = 1000 but with low concentration thresholds in each element, suggesting that algal biomass was a very good heavy metal accumulator. The bio-concentration values in algal biomass were found to be in the order of copper > zinc > lead > cadmium in the Nakivubo Channelized stream. In conclusion, algae can be a promising aquatic bio-filter plant for phytoextraction and bio-monitoring of polluted urban stream ecosystems and wastewater

Heavy metal assessment and water quality values in urban stream and rain water

Water quality monitoring in developing countries is inadequate, especially in stream water affected by urban effluents and runoff. The purpose of this study was to investigate heavy metal contaminants in the Nakivubo Stream water in Kampala, Uganda. Water samples Nakivubo Channelized Stream, tributaries and industrial effluents that drain into the stream were collected and analysed for the total elemental concentration using flame atomic absorption spectrophotometer. The results showed that: 1) the wastewater was highly enriched with lead and manganese above the maximum permissible limit; 2) the levels of dissolved oxygen were below the maximum permissible limit, while the biological oxygen demand was above the maximum permissible limit. All industrial effluents/wastewater were classified as strong (> 220 mg/L). Factor analysis results reveal two sources of pollutants; 1) mixed origin or chemical phenomena of industrial and vehicular emissions and 2) multiple origin of lead (vehicular, commercial establishment and industrial). In conclusion, Nakivubo Channelized Stream water is not enriched with heavy metals. These heavy metals (lead, cadmium and zinc) were rapidly removed by co-precipitation with manganese and iron hydroxides and total dissolved solids into stream sediments. This phenomena is controlled by pH in water