Nutritional status of food consumption patterns of young children living in Western Uganda

Objectives: The aim of this pilot study was to compare the nutritional status and food consumption patterns of children under five years. Design: Quantitative, exploratory, cross sectional study. Setting: Kabarole district, western Uganda. Kabarole district is a rural district with subsistence farming as the main income. Subjects: Two hundred and five children between 12 and 72 months of age living in AIDS affected homes versus children living in non-AIDS affected homes were examined. Results: Fifty-five percent of all children were stunted and 20.5% were underweight. There was no difference in the prevalence of malnutrition between children living in AIDS affected homes versus non-AIDS affected homes. Only children between 12-35 months suffered from a daily deficit in caloric intake. The older children consumed the basic recommended daily intake (RDI) for protein, fat, iron and vitamin A. Due to frequent disease episodes and limitations in the estimations of individual total energy expenditure, the results are likely underestimations of the children's true nutritional requirements. The type of foods given to children in AIDS affected homes and controls were quite similar. Conclusion: Young children in Kabarole district suffer from severe chronic malnutrition rates, but rates and feeding patterns are not different in AIDS affected versus non AIDS affected homes. The East African Medical Journal Vol. 83 (11) 2006: pp. 619-62

Effect on weight gain of routinely giving albendazole to preschool children during child health days in Uganda: cluster randomised controlled trial

Objective: To estimate the effectiveness of delivering an anthelmintic through a community child health programme on the weight gain of preschool children in Uganda. Design: Cluster randomised controlled trial. Setting: Eastern Uganda. Participants: 48 parishes participating in a new programme for child health: 24 offered children an additional service of anthelmintic treatment. The outcome is based on measurements from 27 995 children. Intervention: Treatment of children aged between 1 and 7 years with 400 mg albendazole added to standard services offered during child health days over a three year period. Main outcome measure Weight gain. Results: The provision of periodic anthelmintic treatment as a part of child health services in Uganda resulted in an increase in weight gain of about 10% (166 g per child per year, 95% confidence interval 16 to 316) above expected weight gain when treatments were given twice a year, and an increase of 5% when the treatment was given annually. Conclusion: Deworming of preschool children in Uganda as part of regularly scheduled health services seems practical and associated with increased weight gain

Nature and dynamics of climate variability in the uganda cattle corridor

The study was conducted in the districts of Nakaseke and Nakasongola stratified into four farming systems of crop dominancy, pastoralists, mixed crop and livestock and fishing. The study was guided by two research questions: (1) how do community residents perceive climate change/variability? (2) What is the trend and nature of climate variability and how does it compare with people’s perceptions? Ninety eight percent (98%) of the respondents reported that the routine patterns of weather and climate had changed in the last 5 to 10 years and it has become less predictable with sunshine hours being extended and rainfall amounts being reduced. This compared well with the analyzed secondary data. Over 78% respondents perceived climate change and variability to be caused by tree cutting other than the known scientific reasons like increase in industrial fumes or increased fossil fuel use. Climate data showed that over the period 1961 to 2010 the number of dry spells within a rainfall season had increased with the most significant increase observed in the first rainfall season of March to May as compared to the season of September to November. The first dry season of June/July to August is short while the second dry season of December to February is long during the study period. The two rainfall seasons of March to May and September to November seem to be merging into one major season from May to November. Temperature data shows a significant increasing trend in mean annual temperatures with the most increase observed in the mean annual minimum temperatures than the maximum temperatures.Key words: Climate variability, community perceptions, Uganda cattle corridor, dry spells

HIV infection in rural households, Rakai district, Uganda

The Rakai Project conducted a population-based cohort study in rural Rakai District, Uganda, a region with high rates of HIV prevalence. The cohort population described here was followed between 1990 and 1992 and consisted of all residents aged 15 years or more living in 1945 households in 31 community clusters. A detailed census was conducted at baseline in every study household. Census data were updated annually, and all inter-survey deaths, births, and migrations were recorded. Immediately following each annual census, all consenting adults were administered a socio-demographic, behavioural and health survey, and provided a blood sample for HIV testing. HIV prevalence in the study population was high, with 19.1 per cent of adults aged 15 or more years being HIV-positive. By household, the burden of infection was even more pronounced: 31.3 per cent of households had at least one HIV-infected resident adult. Twenty seven per cent of heads of households were also HIV-positive. Overall, 3.6 per cent of study households experienced the death of an HIV-positive adult per year, and another two per cent lost an HIV-negative adult. HIV-related adult mortality had substantially more effect on subsequent household dependency ratio and on material possessions than the death of an HIV-uninfected adult, in part because the former deaths were concentrated in adults aged 15-49, the most economically active age group in this rural population. Just under 15 per cent of children aged 14 years or less had lost one or both parents, and approximately half of these parental losses are estimated to be associated with HIV infection. Nineteen per cent of study households reported at least one resident child who had lost one or both parents. Although there is evidence that loss of a parent is associated with lower school attendance, orphans overall continue to be absorbed by community households which are headed by adults. HIV infection is very prevalent among adults in Rakai and the associated mortality imposes a substantial social and economic burden on households in the district

The availability of six tracer medicines in private medicine outlets in Uganda​

OBJECTIVES: Many low income countries struggle to provide safe and effective medicines due to poor public health care infrastructure, budgetary constraints, and lack of human resource capacity. Private sector pharmacies and drug shops are used by a majority of the population as an alternative to public pharmacies. This study looks at the availability of six essential medicines in private drug outlets across Uganda. METHODS: A standardised medicines availability survey developed by the World Health Organization and Health Action International was adapted for use in this project to collect availability data for six tracer medicines in 126 private medicine outlets across four districts in Uganda from September 2011 to October 2012. RESULTS: Artemisinin-based combination treatments and metformin were the most commonly found medicines in the private medicine outlets surveyed. Ninty-nine percent of all outlets carried artemisinin-based combinations while 93% of pharmacies and 53% of drug shops stocked metformin. Oxytocin was found in one third of outlets surveyed. Fluoxetine was in 70% of pharmacies yet was not found in any drug shops. Rifampicin and lamivudine were found infrequently in outlets across all districts; 10% and 2%, respectively. Not all brands found in surveyed outlets were listed on the Ugandan National Drug Register. In particular, five unlisted brands of rifampicin were found in private medicine outlets. CONCLUSIONS: The regulatory process should be improved through the enforcement of outlet licensing and medicine registration. Additional studies to elucidate the reasons behind the use of private medicine outlets over the public sector would assist the government in implementing interventions to increase use of public sector medicine outlets

Effect of zinc on the treatment of Plasmodium falciparum malaria in children: A randomized controlled trial

Background: Zinc supplementation in young children has been associated with reductions in the incidence and severity of diarrheal diseases, acute respiratory infections, and malaria. Objective: The objective was to evaluate the potential role of zinc as an adjunct in the treatment of acute, uncomplicated falciparum malaria; a multicenter, double-blind, randomized placebo-controlled clinical trial was undertaken. Design: Children (n = 1087) aged 6 mo to 5 y were enrolled at sites in Ecuador, Ghana, Tanzania, Uganda, and Zambia. Children with fever and ≥ 2000 asexual forms of Plasmodium falciparum/μL in a thick blood smear received chloroquine and were randomly assigned to receive zinc (20 mg/d for infants, 40 mg/d for older children) or placebo for 4 d. Results: There was no effect of zinc on the median time to reduction of fever (zinc group: 24.2 h; placebo group: 24.0 h; P = 0.37), a ≥75% reduction in parasitemia from baseline in the first 72 h in 73.4% of the zinc group and in 77.6% of the placebo group (P = 0.11), and no significant change in hemoglobin concentration during the 3-d period of hospitalization and the 4 wk of follow-up. Mean plasma zinc concentrations were low in all children at baseline (zinc group: 8.54 ± 3.93 μmol/L; placebo group: 8.34 ± 3.25 μmol/L), but children who received zinc supplementation had higher plasma zinc concentrations at 72 h than did those who received placebo (10.95 ± 3.63 compared with 10.16 ± 3.25 μmol/L, P \u3c 0.001). Conclusion: Zinc does not appear to provide a beneficial effect in the treatment of acute, uncomplicated falciparum malaria in preschool children

Scaling Up Global Health Interventions: A Proposed Framework for Success

Drawing upon interviews with experts and a review of the literature, Gavin Yamey proposes a new framework for scaling up global health interventions