A Cross-Sectional Study to Determine Urinary Tract Infections and Antibiotic Susceptibility Patterns among Pregnant Women attending Antenatal Clinic at Kawempe National Referral Hospital, Uganda.

Background: Urinary Tract Infection (UTI) is a disease of the urinary system. This type of infection involves urethritis, pyro nephritis, or cystitis. Symptoms can be pelvic pain, increased urge to urinate, pain on passing out urine, and blood in the urine (blander infections). A kidney UTI may cause back pain, nausea vomiting, and fever. Methods: This study was a cross-sectional-quantitative study carried out among 300 pregnant mothers attending ANC at Kawempe regional referral hospital in August 2021. Questionnaires were administered to get the biodata of Participants. Urine samples were collected using sterile containers. Urine culture was performed, urine chemistry using ten parameter strip then urine microscopy was done. Chemistry was done using ten parameter strips, urine microscopy and then later culture and sensitivity was done on urine samples with proteinuria. Results: Urine samples with proteinuria were 5.7 % (n=17), more than half of the Urine Samples 52%( n=156) had positive White blood cell cells and 48 %( n=144) had no abnormality detected. Culture on urine samples showed the following isolation, Escherichia.coli 24.3 %( n=9), Klebsiella pneumonia 21.6 %( n=8), Pseudomonas euroginosa 18.9 %( n=7) Staphylococcus aureus 16.22 %(n=6) Enterococcus spp 2.7%(n=1) and Candida albicans16.2 %( n=6). Conclusion: UTI is an infection of some part of your body’s urinary system which may include: kidneys, ureters, bladder, and urethra. Organisms causing UTIs in pregnancy are the same uropathogens that commonly cause UTI in non-pregnant patients with Escherichia coli being the most commonly isolated organism. Other bacteria include klebishella pneumoniae, staphulococuus, streptococcus,  enterococcus, and pseudomonas. Recommendations: Kawempe National Referral Hospital. Should improve the Laboratory to perform microbiology tests

Knowledge and perceptions of brucellosis in the pastoral communities adjacent to Lake Mburo National Park, Uganda

BACKGROUND: Brucellosis is one of the most common zoonotic infections globally. Lack of knowledge about brucellosis may affect the health-seeking behavior of patients, thus leading to sustained transmission in these communities. Our study assessed knowledge and perceptions of brucellosis among pastoral communities adjacent to Lake Mburo National Park (LMNP), Kiruhura District, Uganda. METHODS: A community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed between June and August 2012. Data collected included communities’ knowledge on causes, symptoms, transmission, treatment, prevention and risk factors of brucellosis. Multivariable logistic regression analysis was performed to explore strength of association between overall knowledge of brucellosis and various individual factors using odds ratios and 95% confidence intervals. RESULTS: Only 70 (19%) knew the symptoms of brucellosis in animals, and three quarters (279, 75.5%) mentioned joint and muscle pain as a common symptom in humans. Almost all participants (370, 99.3%) had ever heard about brucellosis, majority (311, 84.7%) believed it affects all sexes and two thirds (67.7%) of the respondents believed close proximity to wildlife contributes to the presence of the disease. Almost all (352, 95.4%) knew that brucellosis in humans could be treatable using modern drugs. The main routes of infection in humans such as consumption of unpasteurized dairy products were known by 97% (360/371); eating of half-cooked meat by 91.4% and eating contaminated pasture in animals by 97.4%. There was moderate overall knowledge of brucellosis 197 (53.1%). Factors associated with higher overall knowledge were being agro-pastoralists (aOR: 2.08, CI: 1.17-3.71) compared to pure pastoralists while those who reported that the disease was a health problem (aOR: 0.18, CI: 0.06-0.56) compared to those who said it was not were less likely to be knowledgeable. CONCLUSIONS: There was moderate overall knowledge of human and animal brucellosis among the participants. Majority of the participants believed that close proximity to wildlife contributes to the presence of the disease in the area. There is a need for collaboration between the public health, veterinary and wildlife sectors to provide health education on brucellosis for better management of the disease in the communities

Determinants of patients' choice of provider in accessing brucellosis care among pastoral communities adjacent to Lake Mburo National Park in Kiruhura district, Uganda

Brucellosis is the commonest zoonotic infection worldwide causing human suffering and economic losses through affected livestock. Symptoms are similar to other febrile syndromes such as malaria and typhoid fever and it is often easily misdiagnosed, resulting in underreporting and misdirected treatments. The study was conducted in pastoralist rangelands. Females and households with six to ten members were more likely to seek health care at government facilities, while those with tertiary education were less likely, after the first provider. Improved geographical access needs to be matched with good quality basic services, adequate medicines, qualified health personnel and regular supportive supervision

Facilitating multi-stakeholder dialogue to manage natural resource competition: A synthesis of lessons from Uganda, Zambia, and Cambodia

Rural development or natural resource management program planning and implementation frequently confront challenges of environmental resource competition and conflict, particularly where common pool resources are a major component of rural livelihoods. This paper reports on an approach to multistakeholder dialogue, supported by participatory action research, to address the roots of such competition and conflict. The approach, called “Collaborating for Resilience,” includes principles and guidance on building a shared understanding of risks and opportunities, weighing alternative actions, developing action plans, and evaluating and learning from the outcomes. Working in partnership with government, community and civil society actors, the approach was developed and refined through applications in large lake systems in Uganda, Zambia, and Cambodia. This paper presents a synthesis of lessons addressing practitioners in government, nongovernmental development organizations, and international development agencies. These lessons include guidance on the context of multistakeholder dialogue processes, addressing gender equity, building stakeholder relationships and accountability across scales, and encouraging learning and innovation over time

Predictors of loss to follow up among patients with type 2 diabetes mellitus attending a private not for profit urban diabetes clinic in Uganda : a descriptive retrospective study

BACKGROUND: Although the prevalence of type 2 diabetes mellitus is increasing in Uganda, data on loss to follow up (LTFU) of patients in care is scanty. We aimed to estimate proportions of patients LTFU and document associated factors among patients attending a private not for profit urban diabetes clinic in Uganda. METHODS: We conducted a descriptive retrospective study between March and May 2017. We reviewed 1818 out-patient medical records of adults diagnosed with type 2 diabetes mellitus registered between July 2003 and September 2016 at St. Francis Hospital - Nsambya Diabetes clinic in Uganda. Data was extracted on: patients' registration dates, demographics, socioeconomic status, smoking, glycaemic control, type of treatment, diabetes mellitus complications and last follow-up clinic visit. LTFU was defined as missing collecting medication for six months or more from the date of last clinic visit, excluding situations of death or referral to another clinic. We used Kaplan-Meier technique to estimate time to defaulting medical care after initial registration, log-rank test to test the significance of observed differences between groups. Cox proportional hazards regression model was used to determine predictors of patients' LTFU rates in hazard ratios (HRs). RESULTS: Between July 2003 and September 2016, one thousand eight hundred eighteen patients with type 2 diabetes mellitus were followed for 4847.1 person-years. Majority of patients were female 1066/1818 (59%) and 1317/1818 (72%) had poor glycaemic control. Over the 13 years, 1690/1818 (93%) patients were LTFU, giving a LTFU rate of 34.9 patients per 100 person-years (95%CI: 33.2-36.6). LTFU was significantly higher among males, younger patients (< 45 years), smokers, patients on dual therapy, lower socioeconomic status, and those with diabetes complications like neuropathy and nephropathy. CONCLUSION: We found high proportions of patients LTFU in this diabetes clinic which warrants intervention studies targeting the identified risk factors and strengthening follow up of patients

Global phylogeography and ancient evolution of the widespread human gut virus crAssphage

Microbiomes are vast communities of microorganisms and viruses that populate all natural ecosystems. Viruses have been considered to be the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared with that of other environments. Here, we investigate the origin, evolution and epidemiology of crAssphage, a widespread human gut virus. Through a global collaboration, we obtained DNA sequences of crAssphage from more than one-third of the world's countries and showed that the phylogeography of crAssphage is locally clustered within countries, cities and individuals. We also found fully colinear crAssphage-like genomes in both Old-World and New-World primates, suggesting that the association of crAssphage with primates may be millions of years old. Finally, by exploiting a large cohort of more than 1,000 individuals, we tested whether crAssphage is associated with bacterial taxonomic groups of the gut microbiome, diverse human health parameters and a wide range of dietary factors. We identified strong correlations with different clades of bacteria that are related to Bacteroidetes and weak associations with several diet categories, but no significant association with health or disease. We conclude that crAssphage is a benign cosmopolitan virus that may have coevolved with the human lineage and is an integral part of the normal human gut virome

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection