Comparison of immune responses induced by Bacillus calmette-Guerin when given at birth or at 6 weeks of age in Ugandan Infants

Includes bibliographical references.In Uganda, infants delivered at a health care facility receive the tuberculosis vaccine Bacillus Calmette-Guerin (BCG) on the first day of life. Infants delivered at home receive BCG at their first health care facility visit at 6 weeks of age. Our aim was to determine the effect of this delay in BCG administration on the induced immune response. Our hypothesis was that infants who received BCG at 6 weeks of age would show an enhanced BCG-induced T cell immunity compared to infants vaccinated at birth. We optimised several polychromatic flow cytometry reagent panels to compare BCG-specific immunity in 9 months-old infants who had received the vaccine either at birth or at 6 weeks of age. We used a 12-hour whole blood intracellular cytokine/cytotoxic marker assay to measure T cell-associated cytokine expression and memory phenotypes. We also compared the capacity of BCGspecific T cells to proliferate and produce cytokines upon antigenic stimulation with a 6-day proliferation assay. Finally, we measured plasma soluble cytokines levels in the two groups of infant using multiplex assay. We enrolled 92 infants: 50 had received BCG at birth and 42 at 6 weeks of age. BCG induced predominantly CD4⁺ T cell responses, and lesser CD8⁺ T cell responses, in both groups. Birth vaccination was associated with greater induction of CD4⁺ and CD8⁺ T cells expressing either IFN-γ alone, or IFN-γ together with perforin, compared with delayed vaccination. Further, birth vaccination induced proliferating cells that had greater capacity to produce IFN-γ, TNF-α and IL-2 together, compared with delayed vaccination. In conclusion, distinct patterns of T cell induction occurred when BCG was given at birth and at 6 weeks of age. We propose that this diversity might impact protection against tuberculosis. Our results differ from those of delayed BCG vaccination studies in South Africa and the Gambia, suggesting geographical and population heterogeneity may affect BCG-induced T cell response

Women Beneficiaries of Functional Adult Literacy Speak Out: Opportunities and Challenges for Socio-Economic Development in Apac District, Northern Uganda

Women’s literacy is critical to addressing gender inequality, though, globally, only 88 adult women are considered literate for every 100 adult men. This article is an analysis of challenges faced by Ugandan women based in the Northern part of the country who attempt to acquire and use skills attained from training in Functional Adult Literacy (FAL) to improve their socio-economic conditions. Qualitative data was collected from 45 participants (literate and non-literate) selected purposively. The study was informed by Freire’s literacy and agency theories which argues on the element of awareness by making marginalised non-literates see the reality of the world by using their agency to recognise their impediment to development. Findings indicate that women FAL graduates faced challenges ranging from lack of acknowledgement, belittlement to negative perceptions. It would be helpful for Government, International development partners, NGO’s and civil society to ensure strong support and inclusive planning with FAL trainees to enable them not only to benefit from their training but also to contribute to achievement of sustainable development. Keywords: Practical Learning, Challenge, Socio-economic progres

The performance of health workers in decentralised services in Uganda

This study investigated the performance of health workers in the decentralised services in Uganda in order to develop a management framework that may be used to improve performance. The study followed a mixed research methodology and was descriptive. The survey design was used to collect quantitative data by means of a structured questionnaire. Qualitative data was collected using a semi-structured interview guide. The study population for the quantitative strand comprised 276 health workers including doctors, clinical officers, and professional nurses working in four districts: Kumi, Mbale, Sironko and Tororo. The health workers were selected using stratified random sampling. The population for qualitative strand was health services managers (N=21) from the same districts. The managers were selected purposively. Quantitative data was analysed using SPSS version 18.0, while qualitative data was coded and analysed manually. The findings revealed that the performance of health workers is generally affected by health systems and work environment related factors. The findings indicated that health workers are skilled, competent, and generally have positive attitudes and behaviours towards their clients. The study uncovered loop holes in performance management in the district health sectors. In most cases there is no target setting, no performance management planning, performance indicators are not clearly defined, and the schedules for performance measurement are not always followed. There is limited career progression and lack of functional performance feedback and rewarding mechanisms. Although health workers are committed, there is widespread political interference and nepotism in the district health sector management. Overall, the researcher is optimistic that if the proposed performance management framework is implemented, the performance of health workers might improve.Health StudiesD. Litt. et Phil. (Health Studies

Training Report: Training of trainers and farmers’ training on validated sweetpotato silage making and use in Masaka and Kamuli districts.

European UnionInternational Fund for Agricultural Developmen

A mixed methods approach to prioritizing components of Uganda’s eHealth environment

Introduction: Globally the use of information and communication technologies (ICTs) in healthcare,  eHealth, is on the increase. This increased use is accompanied with several challenges requiring uniformly understood and accepted regulations. Developing such regulations requires the engagement of all stakeholders. In this manuscript we explored the priorities of various eHealth stakeholders in Uganda to inform the eHealth policy review process.Methods: We used a Delphi approach during the initial programmed plenary of a consultative workshop in which participants were asked to identify and post their topmost priority related to eHealth under one of the seven components of the eHealth environment as described in the WHO national eHealth toolkit. We used an additional qualitative analytical method to further group the participant sorted priorities into sub clusters to support additional interpretation using the toolkit.Results: The components of the eHealth environment ranked as follows with respect to descending number of postings: information services and applications (36 postings), information and technology standard (31 postings), leadership and governance (22 postings), strategic planning (21 postings), infrastructure(14 postings), financial management (2 postings) and others (6 postings).Conclusion: Uganda's eHealth environment is in the developing and building up stage (II). In this environment the policy and implementation strategy should strengthen linkages in core systems, create a foundation for investment, ensure  legal certainty and create a strong eHealth enabling environment.Key words: Information and communications technologies, policy, eHealt

Participatory survey of risk factors and pathways for Rift Valley fever in pastoral and agropastoral communities of Uganda

To assess pastoralists’ and agropastoralists’ knowledge on Rift Valley fever (RVF), participatory epidemiological studies were conducted with 215 livestock keepers and 27 key informants in Napak, Butebo, Isingiro and Lyantonde districts, Uganda, between January and February 2022. Livestock keepers in all four districts had knowledge of RVF and even had local names or descriptions for it. Pastoralists and agropastoralists possessed valuable knowledge of RVF clinical descriptions and epidemiological risk factors such as the presence of infected mosquitoes, living in flood-prone areas, and excessive rainfall. RVF was ranked among the top ten most important cattle diseases. Pastoralists called RVF Lonyang, symbolizing a disease associated with jaundice, high fever, abortions in pregnant cows, and sudden death in calves. Key informants identified infected domestic animals, the presence of infected mosquitoes, livestock movement and trade, and infected wild animals as risk pathways for the introduction of RVF into an area. Drinking raw blood and milk was perceived as the most likely pathway for human exposure to RVF virus; while the highest consequence was high treatment costs. The results indicate that pastoralists provided key epidemiological information that could be essential for designing an effective national RVF surveillance and early warning system

An update on the mosquito species composition and diversity in western and North Western Uganda

Although the west and north western parts of Uganda are historically known homes to a number of mosquito species and arboviruses associated with morbidity and mortality, early studies were highly focal and limited to specific collection methods. We aimed to update mosquito species composition in areas where a febrile illness study had shown evidence of arboviruses circulating. Adult mosquito sampling was done outside and inside houses using light traps baited with solid carbon dioxide and pyrethrum spray respectively. All collected mosquitoes were identified using appropriate morphological identification keys. A total of 22,455 mosquitoes from 89 species, 22 sub species and 11 genera were collected from Arua and Kasese districts. Overall abundance was found to be higher in Kasese (n=13446, 59.9%) than Arua district (n = 9009, 40.1%), though no significant differences were observed across villages in Arua and Kasese districts (Kruskal Wallis, X2 = 2, df = 3, p>0.05). Collection numbers were highest for genus Coquillettidia (n = 7942, 35.4%), followed by Culex (n = 7642, 34.03%), Mansonia (n = 3414, 15.2%), Anopheles (n = 1970, 8.8%) and Aedes (n = 1349, 6.01%). Other species were across 6 genera Eretmopodites (n = 59, 0.26%), Uranoteania (n = 36, 0.16%), Lutzia (n = 26, 0.12%), Mimomyia (n = 13, 0.06%), Aediomyia (n = 3, 0.01%) and Toxorhynchites (n = 1, 0.004%) appeared low in both districts. Species richness was comparatively higher in Kasese than Arua district, however across villages, it was evenly distributed with no significant differences observed, and species diversity was significantly higher in Arua than Kasese (Mann Whitney U test, p<0.05). A number of species identified here have been implied in arbovirus transmission. Moreover, we show the first description of Culex (Culex) litwakae Harbach mosquito in Uganda, a species previously described in the coastal regions of Kenya. The existence of a mosquito species previously not documented in Uganda suggests a likelihood of many invasive species whose potential to transmit viruses to humans and animals remains largely unknown

Development and assessment of a geographic knowledge-based model for mapping suitable areas for Rift Valley fever transmission in Eastern Africa

Rift Valley fever (RVF), a mosquito-borne disease affecting ruminants and humans, is one of the most important viral zoonoses in Africa. The objective of the present study was to develop a geographic knowledge-based method to map the areas suitable for RVF amplification and RVF spread in four East African countries, namely, Kenya, Tanzania, Uganda and Ethiopia, and to assess the predictive accuracy of the model using livestock outbreak data from Kenya and Tanzania. Risk factors and their relative importance regarding RVF amplification and spread were identified from a literature review. A numerical weight was calculated for each risk factor using an analytical hierarchy process. The corresponding geographic data were collected, standardized and combined based on a weighted linear combination to produce maps of the suitability for RVF transmission. The accuracy of the resulting maps was assessed using RVF outbreak locations in livestock reported in Kenya and Tanzania between 1998 and 2012 and the ROC curve analysis. Our results confirmed the capacity of the geographic information system-based multi-criteria evaluation method to synthesize available scientific knowledge and to accurately map (AUC = 0.786; 95% CI [0.730–0.842]) the spatial heterogeneity of RVF suitability in East Africa. This approach provides users with a straightforward and easy update of the maps according to data availability or the further development of scientific knowledge. (Résumé d'auteur

Identification and molecular characterization of highly divergent RNA viruses in cattle, Uganda

The risk for the emergence of novel viral zoonotic diseases in animals and humans in Uganda is high given its geographical location with high biodiversity. We aimed to identify and characterize viruses in 175 blood samples from cattle selected in Uganda using molecular approaches. We identified 8 viral species belonging to 4 families (Flaviviridae, Peribunyaviridae, Reoviridae and Rhabdoviridae) and 6 genera (Hepacivirus, Pestivirus, Orthobunya-virus, Coltivirus, Dinovernavirus and Ephemerovirus). Four viruses were highly divergent and tetantively named Zikole virus (Family: Flaviviridae), Zeboroti virus (Family: Reoviridae), Zebtine virus (Family: Rhabdoviridae) and Kokolu virus (Family: Rhabdoviridae). In addition, Bovine Hepacivirus, Obodhiang virus, Aedes pseudoscutellaris reovirus and Schmallenberg virus were identified for the first time in Ugandan cattle. We report 8 viral species belonging to 4 viral families including divergent ones in the blood of cattle in Uganda. Hence, cattle may be reservoir hosts for likely emergence of novel viruses with pathogenic potential to cause zoonotic diseases in different species with serious public health implications