Nasopharyngeal carriage rate of Streptococcus pneumoniae in Ugandan children with sickle cell disease

<p>Abstract</p> <p>Background</p> <p>Nasopharyngeal carriage of <it>Streptococcus pneumoniae </it>is a determinant for invasive pneumococcal disease, which often complicates homozygous sickle cell disease. Here, we determined the nasopharyngeal carriage rate of <it>S. pneumoniae </it>in Ugandan children with homozygous sickle cell disease, who attended the outpatient Sickle Cell Clinic at Mulago National Referral hospital in Kampala, Uganda.</p> <p>Results</p> <p><it>S. pneumoniae </it>occurred in 27 of the 81 children with homozygous sickle cell disease (giving a carriage rate of 33%, 27/81). Twenty three children were previously hospitalized of whom <it>S. pneumoniae </it>occurred in only two (9%, 2/23), while among the 58 who were not previously hospitalized it occurred in 25 (43%, 25/58, χ²= 8.8, <it>p </it>= 0.003), meaning there is an association between high carriage rate and no hospitalization. Two children previously immunized with the pneumococcal conjugate vaccine did not carry the organism. Prior antimicrobial usage was reported in 53 children (65%, 53/81). There was high resistance of pneumococci to penicillin (100%, 27/27) and trimethoprime-sulfamethoxazole (97%, 26/27), but low resistance to other antimicrobials. Of the 70 children without sickle cell disease, <it>S. pneumoniae </it>occurred in 38 (54%, 38/70) of whom 43 were males and 27 females (53% males, 23/43, and 56% females, 15/27).</p> <p>Conclusion</p> <p>Nasopharyngeal carriage of penicillin resistant pneumococci in Ugandan children with homozygous sickle cell disease is high. While nasopharyngeal carriage of <it>S. pneumoniae </it>is a determinant for invasive pneumococcal disease, pneumococcal bacteremia is reportedly low in Ugandan children with sickle cell disease. Studies on the contribution of high carriage rates to invasive pneumococcal disease in these children will be helpful. This is the first report on pneumococcal carriage rate in Ugandan children with sickle cell disease.</p

Retrospective multi-locus sequence analysis of African swine fever viruses by “PACT” confirms co-circulation of multiple outbreak strains in Uganda

This article belongs to the Special Issue titled 'African Swine Fever Virus Transmission and Control: The Role of Wild and Domestic Suids'.SUPPORTING INFORMATION: FILE S1: Supplementary Materials: The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/ani14010071/s1, Figures S1–S4: Figure S1: Agarose gel electrophoresis of p72-PCR products amplified with P1 and P2 OIE p72 screening primers (Lane m: 100 bp ladder; lane N: Negative control; lane P: Positive control; lanes 10, 36, 46, 48, 52, 58 and 59; Positive amplicons (n = 7)); Figure S2: Agarose gel electrophoresis of p54 [A], CVR-ORF [C], p72 [P] and Tk [T] gene cycle sequenced products using modified reaction conditions and demonstrating improved TK gene amplification (Lanes L = 100 bp ladder; N = Negative control; A1, P1, P6, T1, T2, T3, T4, T6 and T7 are positive amplicons from purified DNA products. The figure showed that agarose gel bands for positive cycle sequenced products are evident in lanes in A1, P1, P6, T1, T2, T3, T4, T6 and T7. Figure 3 shows the second PCR results in lanes A2, A6, A7, C1, C2, C5, C6, C7, P1, P2, P5, P6, P7, T2, T5, T6 and T7); Figure S3: Agarose gel electrophoresis of p54 [A], CVR-ORF [C], p72 [P] and Tk [T] gene products (Lanes L = 100 bp ladder; N = Negative control; A2, A6, A7, C1, C2, C5, C6, C7, P1, P2, P5, P6, P7, T2,T5, T6 and T7 are positive amplicons from purified DNA products); Figure S4: Agarose gel electrophoresis of TK gene-PCR products amplified with TK-1 + TK-Rev primers (Lane L = 100 bp ladder; N = Negative control; P1= Positive control; 2, 15 and 17 are new Tk gene positive amplicons).DATA AVAILABILITY STATEMENT : All supporting data used in this research are freely available as Supplementary Materials or at the UPeTD (https://repository.up.ac.za/handle/2263/31741, accessed on 15 December 2023). All sequence data are available in the manuscript with their Accession numbers.African swine fever (ASF) is a haemorrhagic fever of swine that severely constrains pig production, globally. In Uganda, at least 388 outbreaks of ASF were documented from 2001 to 2012. We undertook a retrospective serological and molecular survey of ASF virus (ASFV) using banked samples collected from seven districts (Pallisa, Lira, Abim, Nebbi, Kabarole, Kibaale, and Mukono) of Uganda. Six assays (ELISA for antibody detection, diagnostic p72 gene PCR and genomic amplification, and sequencing of four gene regions (p72 [P], p54 [A], CVR of the 9RL-ORF [C], and TK [T]), hereinafter referred to as P-A-C-T (PACT)) were evaluated. Antibodies to ASFV were detected in the Abim district (6/25; 24.0%), and the remainder of the serum samples were negative (187/193; 96.9%). For the tissue samples, ASFV detection by assay was 8.47% for P, 6.78% for A, 8.47% for C, and 16.95% for T. The diagnostic PCR (p72 gene) detected seven positive animals from four districts, whereas the TK assay detected ten positives from all seven districts. In addition to the superior detection capability of TK, two virus variants were discernible, whereas CVR recovered three variants, and p72 and p54 sequencing each identified a single variant belonging to genotype IX. Our results indicate that dependence on serology alone underestimates ASF positivity in any infected region, that multi-locus sequence analysis provides better estimates of outbreak strain diversity, and that the TK assay is superior to the WOAH-prescribed conventional p72 diagnostic PCR, and warrants further investigation.The National Agricultural Research Organization, Uganda, through Government of Uganda; The World Bank-ATAAS scholarship; The University of Pretoria Postgraduate scholarship; NRF incentive funding; the National Research Foundation (NRF)https://www.mdpi.com/journal/animalsProduction Animal StudiesVeterinary Tropical DiseasesZoology and EntomologySDG-03:Good heatlh and well-bein

Evaluation framework of community-based livestock breeding programs

The objective of this paper is to present an evaluation framework to provide guidance for an assessment of the performance, outputs and associated impacts of community-based livestock breeding programs (CBBPs), responding to the need of formalizing the evaluation procedures as it was stressed by FAO. The purpose of such evaluation is to monitor and evaluate on-going activities in CBBPs, to identify challenges and mistakes in the execution of the program, so that appropriate actions can be taken. This evaluation also serves as a guide for funding bodies to measure socio-economic impact on the livelihoods of livestock farmers in order to decide if the program’s goals have been met. The evaluation framework is divided into three domains: evaluation of CBBP implementation based on organizational and technical criteria; monitoring of implementation outputs to evaluate genetic improvement at herd/flock level and the consequential changes at the household level and the community at large; and evaluation of impacts to assess improvement in livelihoods of livestock farmers and eventual effects on the environment. For each evaluation criteria, several indicators are provided.EEA BarilocheFil: Lamuno, Doreen. National Animal Genetic Resources Centre and Databank; UgandaFil: Sölkner, Johann. National Animal Genetic Resources Centre and Databank; UgandaFil: Mészáros, Gabor. National Animal Genetic Resources Centre and Databank; UgandaFil: Nakimbugwe, Helen. National Animal Genetic Resources Centre and Databank; UgandaFil: Mulindwa, Henry. National Agricultural Research Organization, UgandaFil: Nandolo, Wilson. Lilongwe University of Agriculture and Natural Resources, MalawiFil: Gondwe, Timothy. United States Department of Agriculture; Estados UnidosFil: van Tassel, Curt. United States Department of Agriculture; Estados UnidosFil: Mueller, Joaquín Pablo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche; ArgentinaFil: Wursinger, Maria. University of Natural Resources and Life Sciences; AustriaFil: Gutierrez, Gustavo. Universidad Nacional Agraria La Molina; Per

Epidemiology of the Rhinovirus (RV) in African and Southeast Asian Children: A Case-Control Pneumonia Etiology Study.

Rhinovirus (RV) is commonly detected in asymptomatic children; hence, its pathogenicity during childhood pneumonia remains controversial. We evaluated RV epidemiology in HIV-uninfected children hospitalized with clinical pneumonia and among community controls. PERCH was a case-control study that enrolled children (1-59 months) hospitalized with severe and very severe pneumonia per World Health Organization clinical criteria and age-frequency-matched community controls in seven countries. Nasopharyngeal/oropharyngeal swabs were collected for all participants, combined, and tested for RV and 18 other respiratory viruses using the Fast Track multiplex real-time PCR assay. RV detection was more common among cases (24%) than controls (21%) (aOR = 1.5, 95%CI:1.3-1.6). This association was driven by the children aged 12-59 months, where 28% of cases vs. 18% of controls were RV-positive (aOR = 2.1, 95%CI:1.8-2.5). Wheezing was 1.8-fold (aOR 95%CI:1.4-2.2) more prevalent among pneumonia cases who were RV-positive vs. RV-negative. Of the RV-positive cases, 13% had a higher probability (>75%) that RV was the cause of their pneumonia based on the PERCH integrated etiology analysis; 99% of these cases occurred in children over 12 months in Bangladesh. RV was commonly identified in both cases and controls and was significantly associated with severe pneumonia status among children over 12 months of age, particularly those in Bangladesh. RV-positive pneumonia was associated with wheezing

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir

Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children.

BACKGROUND: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low-income and middle-income countries is unknown. We sought to address these knowledge gaps. METHODS: We enrolled 1 to 59monthold children hospitalized with pneumonia at eight African and Asian Pneumonia Etiology Research for Child Health sites in six countries, recorded digital stethoscope lung sounds, obtained chest radiographs, and collected clinical outcomes. Recordings were processed and classified into binary categories positive or negative for adventitial lung sounds. Listening and reading panels classified recordings and radiographs. Recording classification associations with chest radiographs with World Health Organization (WHO)-defined primary endpoint pneumonia (radiographic pneumonia) or mortality were evaluated. We also examined case fatality among risk strata. RESULTS: Among children without WHO danger signs, wheezing (without crackles) had a lower adjusted odds ratio (aOR) for radiographic pneumonia (0.35, 95% confidence interval (CI): 0.15, 0.82), compared to children with normal recordings. Neither crackle only (no wheeze) (aOR: 2.13, 95% CI: 0.91, 4.96) or any wheeze (with or without crackle) (aOR: 0.63, 95% CI: 0.34, 1.15) were associated with radiographic pneumonia. Among children with WHO danger signs no lung recording classification was independently associated with radiographic pneumonia, although trends toward greater odds of radiographic pneumonia were observed among children classified with crackle only (no wheeze) or any wheeze (with or without crackle). Among children without WHO danger signs, those with recorded wheezing had a lower case fatality than those without wheezing (3.8% vs. 9.1%, p = .03). CONCLUSIONS: Among lower risk children without WHO danger signs digitally recorded wheezing is associated with a lower odds for radiographic pneumonia and with lower mortality. Although further research is needed, these data indicate that with further development digital auscultation may eventually contribute to child pneumonia care

Katekismu Enfunze eya Ekelezia Katolika

Although English is the official language in Uganda, most Ugandans do not speak English simply because they are either illiterate or semi literate. Secondly most of the Church business in Uganda is carried out in the vernacular. You hardly find catechesis or liturgy carried out in English. For any evangelizer to be effective in Uganda, she/he must be able to use the vernacular. In the same way, for any church document to be accessible to the majority of Christians it must be in the local languages of the different peoples. There are over 800 catechists in the diocese of Masaka and only about one third of them can read and understand English. They all speak and read Luganda, the local language and the language of this translation. According to Catholic Hierarchy website, 51% of Uganda's Catholics speak Luganda as their first language. This shows that Luganda is the most widely spoken and used local language among Ugandan Catholics. These people need to have the Compendium translated into their local language so that they can read it and study it for them selves. Pastoral agents can easily use it in the catechesis of adults but more especially in Catholic Religious Formation classes for Elementary schools. The purpose of this translation is to make the Compendium of the Catechism available in the Luganda language such that pastoral agents in the parishes and teachers of children in the Catholic Religious Formation classes may have an authentic handbook for Catholic faith and morality

The Digitization of School Rests on Scientific Grounds Alongside Prepared Teachers and Proper Tools : A Literature Study About Teachers´ TPACK and ICT in Schools

IKT har varit en del av skolans undervisning under årtionde och tar med tiden allt mer plats i undervisningen.  Det är mer regel än undantag att eleverna har egna elevdatorer men har lärare den kunskap som krävs för att undervisa med digitala hjälpmedel? Detta arbete är en forskningsöversikt som använder sig av analytisk induktion för att svara på om IKT i skolan stöttar  elevers kunskapsutveckling i matematik samt om lärare har den kunskap om IKT och sådan uppfattning om sin kunskap, att de effektivt kan förmedla nya kunskaper till eleverna med hjälp av IKT? Arbetet visar att det finns en utbredd uppfattning om att IKT kan bidra till att stärka elevers matematiska förmågor men att det samtidigt är vanligt att lärare upplever sig sakna den kompetens som behövs för att använda IKT i sin undervisning.ICT has been a part of school education for decades and as time passes it's becoming a bigger part of the education. Students usually have their own computers but do the teachers have the necessary knowledge to teach with ICT. This study is a research overview which uses an analytical induction to answer the following two questions:  Does ICT In schools support students´ growth of knowledge in mathematics? Have teachers got such knowledge about ICT and such belief about their knowledge, that they are able to educate students in an effective way, using ICT? This study shows that there is a broad perception that ICT has the ability to strengthen students´ mathematical achievements but at the same teachers usually believe that they don’t have the necessary competence that is needed to use ICT In their teaching

The Digitization of School Rests on Scientific Grounds Alongside Prepared Teachers and Proper Tools : A Literature Study About Teachers´ TPACK and ICT in Schools

IKT har varit en del av skolans undervisning under årtionde och tar med tiden allt mer plats i undervisningen.  Det är mer regel än undantag att eleverna har egna elevdatorer men har lärare den kunskap som krävs för att undervisa med digitala hjälpmedel? Detta arbete är en forskningsöversikt som använder sig av analytisk induktion för att svara på om IKT i skolan stöttar  elevers kunskapsutveckling i matematik samt om lärare har den kunskap om IKT och sådan uppfattning om sin kunskap, att de effektivt kan förmedla nya kunskaper till eleverna med hjälp av IKT? Arbetet visar att det finns en utbredd uppfattning om att IKT kan bidra till att stärka elevers matematiska förmågor men att det samtidigt är vanligt att lärare upplever sig sakna den kompetens som behövs för att använda IKT i sin undervisning.ICT has been a part of school education for decades and as time passes it's becoming a bigger part of the education. Students usually have their own computers but do the teachers have the necessary knowledge to teach with ICT. This study is a research overview which uses an analytical induction to answer the following two questions:  Does ICT In schools support students´ growth of knowledge in mathematics? Have teachers got such knowledge about ICT and such belief about their knowledge, that they are able to educate students in an effective way, using ICT? This study shows that there is a broad perception that ICT has the ability to strengthen students´ mathematical achievements but at the same teachers usually believe that they don’t have the necessary competence that is needed to use ICT In their teaching