Challenges in the management of a shared resource: the Nile Basin experience

River basinsWater resource management

Hazard analysis and critical control point plan for hazards in Ugandan amaranth vegetable value chain

Currently, there is a high demand for amaranth due to its ability to withstand harsh climatic conditions, making it an ideal crop in the changing climate. There is also increased awareness and education on its nutritional and overall health benefits, and the availability of improved recipes. However, the presence of hazards can hinder the commercialisation of amaranth, which is in most cases traded informally. Food safety issues along the amaranth value chain should, therefore, be addressed to cope with both production and safety demands. The objective of this study, therefore, was to develop a Hazard Analysis and Critical Control Point (HACCP) plan for hazards in the amaranth value chain in Uganda. The seven principles outlined by Codex Alimentarius were followed to develop the HACCP plan. A tree diagram was further used to identify each potential hazard at each processing stage and Critical Control Points (CCPs) along the chain. For the CCPs identified, reliable control mechanisms and corrective actions were established to fulfil the requirements set by the critical limits to guarantee the safety of the products. Verification and records systems were proposed to determine the effectiveness and traceability of the HACCP plan. For each of the identified CCPs, samples were collected purposively and analysed for chemical and microbial contaminants. From the analysis, fifteen processing stages, starting from the land section to cooking and serving, were identified. Out of these, eight stages were defined as CCPs. These were site selection, land and seedbed preparation, irrigation, market display/humidity control, washing before preparation, chopping, cooking, and holding time and serving. At CCP 1, soils were contaminated with lead and cadmium, mercury and aflatoxins but at considerably low levels. At CCP 2, organic fertilisers were only contaminated with E. coli. At CCP3, E. coli was present in irrigation water. Heavy metals were also present in the irrigation water but were below the critical limits. At CCP4, E. coli was absent in water and display surfaces. E. coli was, however, present on raw amaranth. S. aureus was detected on vendors’ hands. At CCP5, water was not contaminated with E. coli. At CCP6, only personnel hands were infected with S. aureus and Enterobacteriaceae. No contamination was detected in CCP7 and CCP8. Strict control of E. coli in manure and water and S. aureus and Enterobacteriaceae on personnel hands is required to ensure the amaranth value chain attains good food safety output.Keywords: Amaranth, food safety, prerequisite programs, HACCP plan, hazards, Ugand

Relative prevalence of methicilline resistant Staphylococcus aureus and its susceptibility pattern in Mulago Hospital, Kampala, Uganda

Methicilline resistant Staphylococcus aureus (MRSA) strains are becoming increasingly multiresistant, and have recently developed resistance to vancomycin, which has been used successfully to treat MRSA for many years. In-vitro determination of resistance patterns of S. aureus is critical in terms of administering suitable antimicrobial treatments. The objective of this study was to determine the relative prevalence of MRSA among S. aureus isolates from surgical site infections and their antibiotic susceptibility pattern in Mulago Hospital, Kampala, Uganda. One hundred eighty eight pus swabs were collected from patients with surgical site infections. Swabs were inoculated for culture at the Microbiology Laboratory of the Faculty of Medicine, Makerere University. S. aurues isolates were identifi ed using standard procedures and tested for oxacillin resistance according to methods of the National Committee for Clinical Laboratory Standards. Out of the 188 specimens, 54 (28.7%) grew S. aureus. Seventeen (31.5%) of the S. aureus isolates were confi rmed as MRSA by PCR. Resistance rates of MRSA were 88.2% for trimethoprim-sulfamethoxazole, 88.2% for erythromycin, 58.8% for gentamycin, 70.6% for ciprofl oxacin, and 88.2% for chloramphenicol. All isolates were found to be sensitive to vancomycin and clindamycin though the D-test was found to be positive in 82.4% of the isolates. In our region, although methicillin resistance increased in S. aureus strains, because of the unavailability and the high cost of alternative antibiotics, gentamycin is still suggested as an alternative for treatment of S. aureus infections. These results however indicate that vancomycin seemed to be the only antimicrobial agent effective against MRSA and it could be the drug of choice in treating multidrug resistant MRSA infection

Community perspectives on the extent to which transactional sex is viewed as sexual exploitation in Central Uganda.

BACKGROUND: Definitions of child sexual exploitation vary. Sexual exploitation violates children's rights and exposes them to mental and physical harm. There exist differences in views of behaviour that is considered exploitative, including transactional sex. This paper explores community perspectives on the extent to which transactional sex is considered exploitative. METHODS: In 2014, we conducted 19 focus group discussions and 44 in-depth interviews with young people and adults in two communities in Uganda. Participants were presented with vignettes describing sexual encounters between adolescent girls and young women and men to explore under what conditions participants considered the scenario to be exploitative and why. Interviews were conducted in Luganda using a semi-structured tool, audio recorded and transcribed verbatim. Analysis was thematic and complemented by constant comparison and deviant case analysis techniques. RESULTS: Definitions by multilateral, bilateral, and non-governmental organisations of the sexual exploitation of children shared similarities with community conceptualisations of wrong or unfair sex. Although in community conceptualisations there was no consensus on what constituted sexual exploitation, transactional sex was condemned to the extent to which it involved sex with a minor or misled a naïve or immature girl; involved lack of consent, particularly in relationships characterised by power differentials; or worsened the pre-existing status of the girl. Also relevant was the extent to which a man's intentions were considered inappropriate; the adolescent girl or young woman was considered vulnerable; and the adolescent girl or young woman was considered responsible for 'her situation'. CONCLUSIONS: Existing social norms that condemn sex with a minor or sex that involves deception, sexual coercion or misleading an immature girl, present opportunities to mobilise communities to protect adolescent girls and young women at risk. Any intervention must, however, be designed with full cognisance of the social and structural drivers that underlie transactional sex and limit adolescent girls' and young women's opportunities to provide for themselves without recourse to sexual relationships with men. Interventions must also be designed to recognise that girls in transactional sex relationships may not consider themselves as exploited, thus requiring engagement with them based on their own concerns, aspirations, and expectations

How did the Good School Toolkit reduce the risk of past week physical violence from teachers to students? Qualitative findings on pathways of change in schools in Luwero, Uganda.

Violence against children is a serious violation of children's rights with significant impacts on current and future health and well-being. The Good School Toolkit (GST) is designed to prevent violence against children in primary schools through changing schools' operational cultures. Conducted in the Luwero District in Uganda between 2012 and 2014, findings from previous research indicate that the Toolkit reduced the odds of past week physical violence from school staff (OR = 0.40, 95%CI 0.26-0.64, p < 0.001), corresponding to a 42% reduction in risk of past week physical violence. This nested qualitative study involved 133 interviews with students, teachers, school administration, and parents, and two focus group discussion with teachers. Interviews were conducted using semi-structured tools and analysed using thematic analysis complemented by constant comparison and deviant case analysis techniques. Within a context of normative acceptance of corporal punishment this qualitative paper reports suggestive pathways related to teacher-student relationships through which reductions in violence operated. First, improved student-teacher relationships resulted in improved student voice and less fear of teachers. Second, the intervention helped schools to clarify and encourage desired behaviour amongst students through rewards and praise. Third, many teachers valued positive discipline and alternative discipline methods, including peer-to-peer discipline, as important pathways to reduced use of violence. These shifts were reflected in changes in the views, use, and context of beating. Although the GST is effective for reducing physical violence from teachers to students, violence persisted, though at significantly reduced levels, in all schools with reductions varying across schools and individuals. Much of the success of the Toolkit derives from the support it provides for fostering better student-teacher relationships and alternative discipline options. Such innovation could usefully be incorporated in teacher training syllabi to equip teachers with knowledge and skills to maintain discipline without the use of fear or physical punishment

Socio-demographic profile and maternal-fetal prognosis of emergency caesarean section versus caesarean section programmed on scar uterus

Background: The objective of this study was to determine the maternal-fetal prognosis of emergency caesarean sections on the scar uterus to contribute to the reduction of maternal-fetal morbidity and mortality.Methods: An analytical cross-sectional study of pregnant women who were observed from admission to discharge including their newborns at Panzi Reference General Hospital in gynecology and obstetrics department. The sample was comprehensive for convenience consisting of 150 deliveries by caesarean section who had previously delivered at least once by caesarean section. (In 4 months, from 01st December 2018 to 31st March 2019). A pre-established survey sheet allowed us to collect the data. For data analysis, SPSS software and Microsoft excel were used. The chi-square test was used at the 0.05 level.Results: A total 95.2% of newborns were found to be of normal weight, their mothers were emergency cesarized but should be programmed and macrosomia was noted in 4.8%; (p >0.05). In addition, 57.1% of urgent caesarean sections scheduled to be performed were performed in female children (p 0.05). On the maternal side, morbidity was dominated by puerperal infections in 16.7% and uterine rupture in 2.4% in the emergency caesarean section, and no maternal deaths occurred in both groups during the study period.Conclusions: Maternal-fetal prognosis was characterized by asphyxia, neonatal infection and two cases of neonatal death. Study did not register a maternal death but we noticed puerperal infections

Building the capacity of small scale cocoa farmers to conduct on-farm fermentation

This policy brief highlights currently used cocoa fermentation methods along with policy recommendations for farm level fermentation. The project aims to aid fermentation through design of a single fermentation box which can handle 60 to 100kg of cocoa and has shown potential to reduce fermentation time from six to four days with 99% fermented beans. The majority of farmers have less than a hectare of land and produce approximately 70kg of cocoa bean pulp in two weeks. For small-scale farmers to benefit from the cocoa enterprise, there is need to add value to the beans through fermentation

Sexual vulnerability and HIV seroprevalence among the deaf and hearing impaired in Cameroon

<p>Abstract</p> <p>Background</p> <p>This quantitative cross-sectional study examines sexual behaviour of a target group of hearing-impaired persons in Yaounde, the capital city of the Republic of Cameroon. It measures their HIV prevalence to enable assessment of their sexual vulnerability and to help reduce the gap in existing HIV serology data among people with disabilities in general and the deaf in particular.</p> <p>Methods</p> <p>The snowball sampling procedure was adopted as an adequate approach to meet this hard-to-reach group. A total of 118 deaf participants were interviewed for the behavioural component, using sign language as a means of data collection, while 101 participants underwent HIV serology testing. Descriptive analyses were done for behavioural data with Epi info software, while sera were tested by health personnel, using rapid and confirmation test reagents.</p> <p>Results</p> <p>From the results, it was clear that the hearing impaired were highly involved in risky sexual practices, as observed through major sexual indicators, such as: age at first sexual intercourse; condom use; and knowledge of sexually transmitted infections and AIDS. Furthermore, it was noted that the HIV prevalence rate of the hearing impaired in the capital of Cameroon was 4%, close to the prevalence in the city's general population (4.7%).</p> <p>Conclusions</p> <p>Such results suggest that there is a need for in-depth behavioural research and serological studies in this domain to better understand the determinants of risky sexual behaviour among the hearing impaired, and to propose operational prevention approaches for this group.</p

Variants of IL6, IL10, FCN2, RNASE3, IL12B and IL17B loci are associated with Schistosoma mansoni worm burden in the Albert Nile region of Uganda

Background: Individuals genetically susceptible to high schistosomiasis worm burden may contribute disproportionately to transmission and could be prioritized for control. Identifying genes involved may guide development of therapy. // Methodology/Principal findings: A cohort of 606 children aged 10–15 years were recruited in the Albert Nile region of Uganda and assessed for Schistosoma mansoni worm burden using the Up-Converting Particle Lateral Flow (UCP-LF) test detecting circulating anodic antigen (CAA), point-of-care Circulating Cathodic Antigen (POC-CCA) and Kato-Katz tests. Whole genome genotyping was conducted on 326 children comprising the top and bottom 25% of worm burden. Linear models were fitted to identify variants associated with worm burden in preselected candidate genes. Expression quantitative trait locus (eQTL) analysis was conducted for candidate genes with UCP-LF worm burden included as a covariate. Single Nucleotide Polymorphism loci associated with UCP-LF CAA included IL6 rs2066992 (OR = 0.43, p = 0.0006) and rs7793163 (OR = 2.0, p = 0.0007); IL21 SNP kgp513476 (OR 1.79, p = 0.0025) and IL17B SNP kgp708159 (OR = 0.35, p = 0.0028). A haplotype in the IL10 locus was associated with lower worm burden (OR = 0.53, p = 0.015) and overlapped SNPs rs1800896, rs1800871 and rs1800872. Significant haplotypes (p<0.05, overlapping significant SNP) associated with worm burden were observed in IL6 and the Th17 pathway IL12B and IL17B genes. There were significant eQTL in the IL6, IL5, IL21, IL25 and IFNG regions. // Conclusions: Variants associated with S. mansoni worm burden were in IL6, FCN2, RNASE3, IL10, IL12B and IL17B gene loci. However only eQTL associations remained significant after Bonferroni correction. In summary, immune balance, pathogen recognition and Th17 pathways may play a role in modulating Schistosoma worm burden. Individuals carrying risk variants may be targeted first in allocation of control efforts to reduce the burden of schistosomiasis in the community

Transcriptomes of <i>Trypanosoma brucei</i> rhodesiense from sleeping sickness patients, rodents and culture:Effects of strain, growth conditions and RNA preparation methods

All of our current knowledge of African trypanosome metabolism is based on results from trypanosomes grown in culture or in rodents. Drugs against sleeping sickness must however treat trypanosomes in humans. We here compare the transcriptomes of Trypanosoma brucei rhodesiense from the blood and cerebrospinal fluid of human patients with those of trypanosomes from culture and rodents. The data were aligned and analysed using new user-friendly applications designed for Kinetoplastid RNA-Seq data. The transcriptomes of trypanosomes from human blood and cerebrospinal fluid did not predict major metabolic differences that might affect drug susceptibility. Usefully, there were relatively few differences between the transcriptomes of trypanosomes from patients and those of similar trypanosomes grown in rats. Transcriptomes of monomorphic laboratory-adapted parasites grown in in vitro culture closely resembled those of the human parasites, but some differences were seen. In poly(A)-selected mRNA transcriptomes, mRNAs encoding some protein kinases and RNA-binding proteins were under-represented relative to mRNA that had not been poly(A) selected; further investigation revealed that the selection tends to result in loss of longer mRNAs