Masaka District Local Government: ASF biosecurity, centralized slaughter efforts and other interventions

Irish Ai

Enhancing biosecurity along Uganda’s pig value chains to control and prevent African swine fever

Irish AidInternational Fund for Agricultural Developmen

Impact of participatory training on biosecurity protocols on the knowledge, attitudes and practices of smallholder pig farmers in Uganda

Irish Ai

Estimating the burden of selected non-communicable diseases in Africa: a systematic review of the evidence

Background The burden of non-communicable diseases (NCDs) is rapidly increasing globally, and particularly in Africa, where the health focus, until recently, has been on infectious diseases. The response to this growing burden of NCDs in Africa has been affected owing to a poor understanding of the burden of NCDs, and the relative lack of data and low level of research on NCDs in the continent. Recent estimates on the burden of NCDs in Africa have been mostly derived from modelling based on data from other countries imputed into African countries, and not usually based on data originating from Africa itself. In instances where few data were available, estimates have been characterized by extrapolation and over-modelling of the scarce data. It is therefore believed that underestimation of NCDs burden in many parts of Africa cannot be unexpected. With a gradual increase in average life expectancy across Africa, the region now experiencing the fastest rate of urbanization globally, and an increase adoption of unhealthy lifestyles, the burden of NCDs is expected to rise. This thesis will, therefore, be focussing on understanding the prevalence, and/or where there are available data, the incidence, of four major NCDs in Africa, which have contributed highly to the burden of NCDs, not only in Africa, but also globally. Methods I conducted a systematic search of the literature on three main databases (Medline, EMBASE and Global Health) for epidemiological studies on NCDs conducted in Africa. I retained and extracted data from original population-based (cohort or cross sectional), and/or health service records (hospital or registry-based studies) on prevalence and/or incidence rates of four major NCDs in Africa. These include: cardiovascular diseases (hypertension and stroke), diabetes, major cancer types (cervical, breast, prostate, ovary, oesophagus, bladder, Kaposi, liver, stomach, colorectal, lung and non-Hodgkin lymphoma), and chronic respiratory diseases (chronic obstructive pulmonary disease (COPD) and asthma). From extracted crude prevalence and incidence rates, a random effect meta-analysis was conducted and reported for each NCD. An epidemiological model was applied on all extracted data points. The fitted curve explaining the largest proportion of variance (best fit) from the model was further applied. The equation generated from the fitted curve was used to determine the prevalence and cases of the specific NCD in Africa at midpoints of the United Nations (UN) population 5-year age-group population estimates for Africa. Results From the literature search, studies on hypertension had the highest publication output at 7680, 92 of which were selected, spreading across 31 African countries. Cancer had 9762 publications and 39 were selected across 20 countries; diabetes had 3701 publications and 48 were selected across 28 countries; stroke had 1227 publications and 19 were selected across 10 countries; asthma had 790 publications and 45 were selected across 24 countries; and COPD had the lowest output with 243 publications and 13 were selected across 8 countries. From studies reporting prevalence rates, hypertension, with a total sample size of 197734, accounted for 130.2 million cases and a prevalence of 25.9% (23.5, 34.0) in Africa in 2010. This is followed by asthma, with a sample size of 187904, accounting for 58.2 million cases and a prevalence of 6.6% (2.4, 7.9); COPD, with a sample size of 24747, accounting for 26.3 million cases and a prevalence of 13.4% (9.4, 22.1); diabetes, with a sample size of 102517, accounting for 24.5 million cases and a prevalence of 4.0% (2.7, 6.4); and stroke, with a sample size of about 6.3 million, accounting for 1.94 million cases and a prevalence of 317.3 per 100000 population (314.0, 748.2). From studies reporting incidence rates, stroke accounted for 496 thousand new cases in Africa in 2010, with a prevalence of 81.3 per 100000 person years (13.2, 94.9). For the 12 cancer types reviewed, a total of 775 thousand new cases were estimated in Africa in 2010 from registry-based data covering a total population of about 33 million. Among women, cervical cancer and breast cancer had 129 thousand and 81 thousand new cases, with incidence rates of 28.2 (22.1, 34.3) and 17.7 (13.0, 22.4) per 100000 person years, respectively. Among men, prostate cancer and Kaposi sarcoma closely follows with 75 thousand and 74 thousand new cases, with incidence rates of 14.5 (10.9, 18.0) and 14.3 (11.9, 16.7) per 100000 person years, respectively. Conclusion This study suggests the prevalence rates of the four major NCDs reviewed (cardiovascular diseases (hypertension and stroke), diabetes, major cancer types, and chronic respiratory diseases (COPD and asthma) in Africa are high relative to global estimates. Due to the lack of data on many NCDs across the continent, there are still doubts on the true prevalence of these diseases relative to the current African population. There is need for improvement in health information system and overall data management, especially at country level in Africa. Governments of African nations, international organizations, experts and other stakeholders need to invest more on NCDs research, particularly mortality, risk factors, and health determinants to have evidenced-based facts on the drivers of this epidemic in the continent, and prompt better, effective and overall public health response to NCDs in Africa

Perception and practices of farmers on the utilization of sweetpotato, and other root tubers, and banana for pig feeding in smallholder crop-livestock systems in Uganda

Limited access to quality feeds and reliable feed supply are amongst the priority constraints of smallholder pig production in Uganda. Among the feeds given to pigs, sweetpotato (SP), banana and other root tubers residues are common. However, information on farmers’ perceptions and practices on the proper use of these residues for pig feeding is limited. Therefore, this study aimed at assessing those aspects, as well as to identify opportunities for better use of these residues in the pig-SP systems. A qualitative survey was undertaken in Masaka and Kamuli, two districts of Uganda with high pig population and SP production. Focus Group Discussions (FGD) and Key Informant Interviews (KII) were undertaken with 80 small scale pig and SP producers and 24 key informants. Results from this study revealed that the majority of pig farmers in those districts use SP and other RTB crop residues as animal feed. During the rainy season, farmers scored high the utilization of SP crop residues, with the latter being the leading contributor to the pig diet especially in the rural area. SP crop residues are usually fed to pigs fresh without processing. Among the residues, fresh raw vines represent the largest part fed to pig (70%), as compared to roots and peels. The way these residues are offered vary, for example in peri-urban areas with easier access to commercial feeds, farmers feed the crop residues mixed with concentrates; whereas in rural areas with limited access to commercial feeds, crop residues tend to be given without supplementation. However, the full potential of SP and other RTB crop residues for pig feeding is not yet fully exploited as farmers accept that a large amount is wasted (37% in Masaka and 40% in Kamuli). In Masaka, the proportion of SP crop residues utilized at household level mostly for pig feeding was 40%, while in Kamuli was 52%. This study demonstrated that there is potential for better use of SP and other RTB crop residues as pig feed in the smallholder pig farming systems in Uganda, but the major constraint as pointed out by farmers is the poor access to technologies for preserving these resources. Therefore, there is a need for further exploration of strategies for conserving SP and other RTB crop residues during the harvesting period for use in pig feeding during times of feed scarcity