Adoption and preferences for coffee drought index-based insurance in Uganda

Micro-insurance can be an effective approach to smoothening income in adverse times and potentially a way to contribute to the financial inclusion of vulnerable populations. However, direct sales to individual smallholders remains a challenging task without an easily scalable solution. The current research seeks to find the determinants of adoption of a stand-alone coffee index-based insurance product in Uganda marketed by a farmer cooperative, and elicited preferences for improving the design and delivery model. A stratified household survey was conducted among 614 farmers, of which 40% adopted insurance and 62% were member of a farmer cooperative. In odds ratio terms, adopters perceived themselves to be 3.09 times more likely to receive a pay-out than non-adopters (P<0.01), and those having better access to extension services were 2.47 times more likely to adopt a policy (P<0.01). Yet farmers perceiving the design as complex were approximately half as likely to adopt (P<0.05). Farmers preferred the option of premium payments proceeds on delivery, mobile premium payments and deliver-ing insurance through cooperatives/associations. Deepening insurance uptake among coffee farmers will therefore require a strong focus on communication and information sharing facilitated by cooperatives/associations (e.g. farmer cooperates, village and saving associations, or women’s associations).</p

Prevalence of brucellosis among patients attending Wau Hospital, South Sudan

<div><p>Brucellosis is a zoonotic disease of public health importance; its prevalence varies globally. In low-income countries, brucellosis is an endemic and neglected disease affecting both animals and humans. This study was intended to establish brucellosis sero-prevalence among patients attending Wau hospital, South Sudan. Across sectional study, was done among randomly selected patients attending Wau hospital. Data was collected using questionnaires and laboratory investigations. Rose Bengal plate Test (RBPT), Serum agglutination test (SAT) and Competitive Enzyme Linked Immuno Sorbent Assay (c-ELISA) was used in the analysis of blood samples serially starting with RBPT which is more sensitive and least specific then SAT. c-ELISA test which is most specific and less sensitive compared to RBPT and SAT was then used to confirm presence of Brucella antibodies in the samples. A total of 416 participants out of 1664 were enrolled to this study. The majority of participants were between 7-to-76 years of age with mean age of 30.72 (SD+/- 12.83). The sero-positivity of patient’s blood samples for brucellosis using c-ELISA was 23.3% (97/416) among patients presenting to Wau hospital. Socio-demographic characteristics, occupation, clinical signs of disease and types of animals reared by animal owners showed no significant correlation with occurrence of sero-positivity among patient’s blood samples for brucellosis. While ethnicity (Nilotic), knowledge of zoonotic disease, and consumption of animal urine were statistically significant (p<0.05). The study found a high prevalence of brucellosis among febrile patients attending Wau hospital general outpatient clinic. There is need for co-ordination and collaboration between veterinary and health sectors of government to help prevent and control brucellosis in the region.</p></div

Developing digital contact tracing tailored to haulage in East Africa to support COVID-19 surveillance: a protocol

International audienceIntroduction At the peak of Uganda’s first wave of SARS-CoV-2 in May 2020, one in three COVID-19 cases was linked to the haulage sector. This triggered a mandatory requirement for a negative PCR test result at all ports of entry and exit, resulting in significant delays as haulage drivers had to wait for 24–48 hours for results, which severely crippled the regional supply chain. To support public health and economic recovery, we aim to develop and test a mobile phone-based digital contact tracing (DCT) tool that both augments conventional contact tracing and also increases its speed and efficiency. Methods and analysis To test the DCT tool, we will use a stratified sample of haulage driver journeys, stratified by route type (regional and local journeys). We will include at least 65% of the haulage driver journeys ~83 200 on the network through Uganda. This allows us to capture variations in user demographics and socioeconomic characteristics that could influence the use and adoption of the DCT tool. The developed DCT tool will include a mobile application and web interface to collate and intelligently process data, whose output will support decision-making, resource allocation and feed mathematical models that predict epidemic waves. The main expected result will be an open source-tested DCT tool tailored to haulage use in developing countries. This study will inform the safe deployment of DCT technologies needed for combatting pandemics in low-income countries. Ethics and dissemination This work has received ethics approval from the School of Public Health Higher Degrees, Research and Ethics Committee at Makerere University and The Uganda National Council for Science and Technology. This work will be disseminated through peer-reviewed publications, our websites https://project-thea.org/ and Github for the open source code https://github.com/project-thea/

Sputum microbiota profiles of treatment-naïve TB patients in Uganda before and during first-line therapy

Information on microbiota dynamics in pulmonary tuberculosis (TB) in Africa is scarce. Here, we sequenced sputa from 120 treatment-naïve TB patients in Uganda, and investigated changes in microbiota of 30 patients with treatment-response follow-up samples. Overall, HIV-status and anti-TB treatment were associated with microbial structural and abundance changes. The predominant phyla were Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria and Actinobacteria, accounting for nearly 95% of the sputum microbiota composition; the predominant genera across time were Prevotella, Streptococcus, Veillonella, Haemophilus, Neisseria, Alloprevotella, Porphyromonas, Fusobacterium, Gemella, and Rothia. Treatment-response follow-up at month 2 was characterized by a reduction in abundance of Mycobacterium and Fretibacterium, and an increase in Ruminococcus and Peptococcus; month 5 was characterized by a reduction in Tannerella and Fusobacterium, and an increase in members of the family Neisseriaceae. The microbiota core comprised of 44 genera that were stable during treatment. Hierarchical clustering of this core’s abundance distinctly separated baseline (month 0) samples from treatment follow-up samples (months 2/5). We also observed a reduction in microbial diversity with 9.1% (CI 6–14%) of the structural variation attributed to HIV-status and anti-TB treatment. Our findings show discernible microbiota signals associated with treatment with potential to inform anti-TB treatment response monitoring

Patient satisfaction with TB care clinical consultations in Kampala: a cross sectional study.

Background: Patient satisfaction towards care during encounter with clinicians is key for better treatment outcomes. We assessed patient satisfaction with TB clinical care consultations in Kampala, Uganda. Methods: This was a facility-based cross sectional study done between September 2012 and February 2013 using qualitative method of data collection. Participants consecutively completed a pre-tested structured satisfaction questionnaire. A criteria of the rating as good; &gt;75% was considered acceptable, (50-75%) as more effort is needed and &lt;50 as unacceptable and require immediate action was used to categorize data for analysis using Epi-info 7.1.4.0. Results: Of the 260 registered TB patients, 178(68.5%) completed the questionnaire. Overall, 162 (91.0%) were satisfied with the clinical consultation. Factors that contributed to high patient satisfaction, were: time spent with clinician (85.4%), explanation of what was done (87.6%), technical skills (91.6%), personal manner of the clinician seen (91.6%). Factors for low satisfaction were; waiting time before getting an appointment (61.8%), convenience of location of consultation office (53.4%), getting through to the office by phone (21.3%) and length of time waiting at the office (61.2%). Conclusion: Tuberculosis patients in Kampala are satisfied with TB clinical care consultations. Addressing factors with low patient satisfaction may significantly impact on treatment outcome

Tracking haulage in East Africa to support COVID-19 surveillance: THEA-C19 Sociology Report

The study objectives included; • Develop a mobile application for COVID-19 digital contact-tracing tool tailored to the haulage sector. The novelty here is in its enhanced privacy, using a unique universal identifier (UUID), digital -tracking boundary defined by the road infrastructure and simplicity based on conventional time-stamped GPS. • Conduct stakeholder consultative meetings to inform the mobile application development and deployment, through capturing user knowledge, attitudes and practices associated to COVID19, and dialogue on the study output, especially the impact of the technology on disease control and preparedness. • Examine the ethical, legal and social context of developing and deploying such technology in contact tracing. • Test the utility of mobile application technology among haulage truck drivers in Uganda, to determine its uptake, speed and efficiency in tracing of cases (drivers) and contacts, to reduce the spread into communities in the region, as well as improve flow of the regional supply chain. • Use the data generated to develop models that robustly map transmission risk, estimate the contribution of the haulage sector to the national disease epidemiology, and most importantly, inform resource allocation

Patient satisfaction with TB care clinical consultations in Kampala: a cross sectional study

Item does not contain fulltex

Sero-prevalence of brucellosis among slaughterhouse workers in Bahr el Ghazal region, South Sudan

Background - Brucellosis is an infectious zoonotic disease and is common especially among pastoral communities in most low and middle-income countries. The aim of this study was to determine sero-prevalence, and risk factors of Brucella infection among Slaughterhouse workers, in Bahr el Ghazal region, South Sudan. Methods - A cross sectional study was conducted among Slaughterhouse workers in Bahr el Ghazal region, South Sudan from December 2015 to May 2016. A pre-tested questionnaire was used in data collection. Each randomly selected participant was interviewed and a venous blood sample collected. The blood samples were screened for Brucellosis infection using Rose Bengal Plate Test (RBPT) and confirmed using Competitive Enzyme link Immuno Sorbet Assay (c-ELISA). Data was analyzed using Stata version 13 at 95% level of confidence. Results - A total of 234 Slaughterhouse workers were screen for Brucella infection. Overall, a third, 32.1% (75/234) of the participants were sero-positive for brucellosis. The prevalence of brucellosis was higher, 17.1% (40/234) in Wau state compared to other states. There was high prevalence among males, 28.6% (67/234) compared to females 3.4% (8/234). The mean age of study participants was 34.4 ± 9.6 years. A high proportion, 12.8% (30/234) of participants with confirmed brucellosis infection were 31–40 years of age. Brucellosis prevalence was high among butchers, 14.5% (34/234), and meat handlers, 9.0% (21/234). Conclusions - Brucellosis is common among animal slaughterhouse workers in Bahr el Ghazal region, South Sudan. There is need for public awareness campaigns and educational programs to help sensitize communities on Brucella infection