QUALITATIVE EVALUATION OF AFLATOXINS IN SELECTED CURRY POWDERS ON UGANDAN MARKET IN NAKIWOGO - ENTEBBE, WAKISO DISTRICT. A CROSS-SECTIONAL STUDY.

Background. Mycotoxins are biologically active secondary metabolites produced by fungal species in the genera Aspergillus, Penicillium, and Fusarium and grow in a variety of foods including cereals, grains, nuts, oil seeds, fruits, vegetables, cocoa and coffee beans, wine, herbs, and spices. Several mycotoxin classes exist but aflatoxins are of great medical importance. Aflatoxins are produced by the fungi Aspergillus flavus, Aspergillus parasiticus, and Aspergillus nomius. Aflatoxins exhibit teratogenic, mutagenic, carcinogenic, immunosuppression and growth retardation properties in humans and animals. Although aflatoxins occur in various groups, aflatoxin B, is acutely poisonous. Aflatoxin occurrence in various food matrices has been reported across the globe with tropical countries bearing the most burden. In our setting, there is paucity information on aflatoxin status of food spices. In this study, 36 samples of curry powders from 16 brands in sacks and packed forms were prepared and screened for aflatoxins. Methods. The aflatoxins were extracted using 70% methanol and Chloroform for concentration. Aflatoxins were screened using thin layer chromatography and examined under Ultraviolet (UV) light at a wavelength of 366nm. Results. Results of this study indicated that 34 samples were contaminated with aflatoxin G (94.4%), followed by 6 aflatoxin B samples (16.7%). Additionally, 5 samples had both types of aflatoxins studied (13.9%). Conclusion. This study reports aflatoxin contamination in the commonly sold curry powders that are used in our homes in Uganda. Recommendations: The Uganda National Bureau of Standards needs to start periodic aflatoxin screening and quantification in the curry powders and other spices used in the production of curry powders to establish if the contamination is above the acceptable quantities

Muddling through : a critical review of Ugandan language policy in education

This article discusses the contradictions and paradoxes embedded in the implementation of the contemporary language policy in education in Uganda. The paper argues that language choice in education has depended largely on political interplay, balance of power and finances and less on pedagogical considerations influenced by underpinning forces that are antithetical to such down-up policies. The paper highlights that there is need to revisit the policy to achieve the intended goals by recognising the role of democracy, equity and equality aspects of language in education to break through the distribution of power relations to foster linguistic justice, emancipatory pedagogies, linguistic and cultural diversity and sustainability. Consideration of historical, social contextual and pedagogical issues based on scientific data are paramount rather than holding on to colonial policies, less relevant in today’s contemporary Uganda. The article concludes that success of ‘mother tongue’ medium in school is preconditioned by the collapse of the status quo through democratisation and empowerment of local communities. They are to take ownership and target local needs rather than continued with current wasteful measures propagated by subtractive bilingual imperatives, which are counterproductive yet still compelled by neo-colonial and colonial leaders. A number of bilingual and total-endoglossic models are highlighted which may be further examined through contextual research. This may foster a more effective implementation of language use in education that could lead to the realisation of increased literacy levels, national unity, language and cultural sustainability as well as overall development of Uganda

Distinct immunologic and radiographic patterns in etanercept-induced lung injury

Nonspecific clinical presentation of non-infectious, immune-mediated pulmonary complications of etanercept therapy makes the diagnosis difficult. While bronchoalveolar lavage fluid (BALF) cell analysis is frequently used in diagnosing drug-induced lung disease, BALF patterns in etanercept-induced lung injury (EILI) are not well established. Furthermore, previous reports of EILI diagnosis relied on transbronchial or surgical lung biopsies. Here, we report two patients who developed pulmonary toxicity after etanercept treatment. Both patients were diagnosed with EILI. While one patient presented with CD4(+)-predominant lymphocytic alveolitis (consistent with a sarcoid-like pattern), the other patient exhibited a CD8(+)-predominant pattern (consistent with hypersensitivity pneumonitis-like reaction). The different BAL patterns were accompanied by distinct radiographic findings. Both patients significantly improved after etanercept discontinuation and corticosteroid initiation. We propose that EILI can present with distinct immunologic and radiographic phenotypes. In addition, early BALF analysis with lymphocyte immunophenotyping can further define the underlying immunologic abnormalities, and thereby, avoid more invasive procedures

Sawdust as a filtering media in sludge drying beds

Conventional wastewater treatment is a common method of domestic wastewater treatment in Sub Saharan Africa. Lubigi wastewater treatment plant (LSTP) in Kampala – Uganda is a unique wastewater treatment system combining treatment of on-site faecal sludge and domestic wastewater. High solids content of on-site faecal sludge mean large volumes of the same, thus limited sludge drying space. This means need to optimize sludge drying bed use (improving the sludge drying efficiency) by reducing their drying times. This study investigated use of wood sawdust as a filtering layer in the faecal sludge drying process. Comparison of performance between sand, fine and coarse sawdust as a filtering media was conducted at LSTP. Sludge shrinkage depth (cm) and moisture content (%) were key parameters used to analyze and determine the most ideal media for sludge dewatering. The study was conducted during both wet and dry seasons to determine the impact of seasonal changes. Dry season results showed a drastic decrease in the sludge depth (shrinkage) for all the three media types after a period of 8 days followed by a gradual decrease in sludge depth up to 28 days. This implies that effective dewatering happens for the first 8 days, which goes on for the rest of the remaining days. Overall, the best performing media was fine sawdust, coarse sawdust and lastly sand. Independent two sample t-tests assuming equal variances show that there is a significant difference between the mean sludge depth of sand and fine sawdust t(df) = 56, P<0.05). There was no significant difference in the mean sludge shrinkage depth of fine sawdust and coarse sawdust. Similar results were obtained during the wet season. Comparisons of similar media types during the dry and wet seasons shows that the mean sludge shrinkage for the dry season were significantly lower than that of the wet season (P<0.05). This implies that seasonal changes significantly affect the sludge dewatering. In terms of moisture content (MC), the results for dry season showed that fresh fine and fresh coarse wood sawdust achieved MC of 28% and 31% respectively after 28 days. Sand produced faecal sludge with a higher MC of 49% after 28 days. Similar results of the performance of the three types of media was observed during the wet season. In conclusion, fine sawdust performs better than coarse sawdust and sand media in faecal sludge dewatering. Sludge dewatering is affected by seasonal changes

Upper gastrointestinal diseases in patients for endoscopy in South-Western Uganda

Background: There is a paucity of published data regarding upper gastrointestinal diseases in Ugandans with upper gastrointestinal symptoms referred for endoscopy.Objectives: To study the presenting complaints, pathology and Helicobacter pylori prevalence among patients with upper gastrointestinal symptoms in South-Western Uganda.Methods: Patients presenting with upper gastrointestinal symptoms underwent upper endoscopy and a urease test for Helicobacter Pylori, all suspicious lesions were biopsied for histopathology review as appropriate.Results: The most common presenting complaints were epigastric pain (51.6%), dysphagia (13.6%) and odynophagia (7.1%). The most common endoscopy finding was gastritis (40.2%), followed by normal examination (15.2%), oesophageal cancer (13.6%), gastric ulcer (7.6%) and gastric cancer (7.1%). Patients older than 40 years (n=110) had significant findings including gastritis (50.9%), oesophageal cancer (22.7%) and gastric cancer (11.8%). However in younger patients, with the age range of 18-40 years (n=74), most examinations were normal (92.9%). Of the 176 patients able to undergo Helicobacter pylori testing 75.6% were positive. Helicobacter pylori infection was associated with statistically significant increase in gastritis, oesophageal cancer, gastric ulcer, gastric cancer, and duodenal ulcers (p-values< 0.05).Conclusion: Gastritis, ulcerative disease, and upper gastrointestinal malignancies are common in South-Western Ugandansand are associated with a high prevalence of Helicobacter pylori. Keywords: Upper gastrointestinal symptoms, Pathology, Urease test, Helicobacter pylori, Endoscopy, Uganda

Perceived barriers and facilitators to antiretroviral therapy adherence among youth aged 15-24 years at a regional HIV clinic in South-Western Uganda: a qualitative study

Introduction: South-Western region has the second highest HIV prevalence in Uganda. Youth aged 15-24 have shown poor adherence to antiretroviral therapy compared to the older cohorts. Previous studies from other regions have shown various barriers and facilitators. Our study was designed to describe specific barriers and facilitators to treatment adherence among youths in a large regional HIV clinic in southwestern Uganda. Methods: We used a phenomenological qualitative study design conducted amongst 30 purposively selected HIV positive youth aged 15-24 years enrolled at Mbarara Regional Referral Hospital HIV clinic on ART for a period of at least one year and 6 key informants using in-depth interviews. The data was collected in an inductive manner during the period between 21st July and 17th August 2020. The recordings were backed up, transcribed verbatim and then analyzed manually using thematic content analysis. Results: The barriers to ART adherence were described in three descending categories as perceived treatment burden, perceived resultant stigma and discrimination, whereas the main facilitators were; perceived usefulness of HIV medications, availability of free services and Social support. Conclusion: Youths aged 15-24 have challenges with ART associated treatment burden and fear to disclose their HIV status because of the resultant stigma from their communities. Many have however accepted the fact that HIV medications are lifesaving and are strongly motivated to adhere to their medications despite the circumstances. Keywords: Barriers; Facilitators; Adherence; HIV/AIDS; Young Adults

Disinhibition in Risky Sexual Behavior in Men, but Not Women, during Four Years of Antiretroviral Therapy in Rural, Southwestern Uganda

Background: In resource-rich areas, risky sexual behavior (RSB) largely diminishes after initiation of anti-retroviral therapy, with notable exceptions among some populations who perceive a protected benefit from anti-retroviral therapy (ART). Yet, there is limited data about long-term trends in risky sexual behavior among HIV-infected people in sub-Saharan Africa after initiation of anti-retroviral therapy. Methods: We administered questionnaires every three months to collect sexual behavior data among patients taking ART in southwestern Uganda over four years of follow-up time. We defined RSB as having unprotected sex with an HIV-negative or unknown status partner, or unprotected sex with a casual partner. We fit logistic regression models to estimate changes in RSB by time on ART, with and without adjustment for calendar year and CD4 count. Results: 506 participants were enrolled between 2005 and 2011 and contributed a median of 13 visits and 3.5 years of observation time. The majority were female (70%) and median age was 34 years (interquartile range 29–39). There was a decrease in the proportion of men reporting RSB from the pre-ART visit to the first post-ART visit (16.2 to 4.3%, p<0.01) but not women (14.1 to 13.3%, p = 0.80). With each year of ART, women reported decreasing RSB (OR 0.85 per year, 95%CI 0.74–0.98, p = 0.03). In contrast, men had increasing odds of reporting RSB with each year of ART to near pre-treatment rates (OR 1.41, 95%CI 1.14–1.74, p = 0.001), which was partially confounded by changes in calendar time and CD4 count (AOR = 1.24, 95%CI 0.92–1.67, p = 0.16). Conclusions: Men in southwestern Uganda reported increasing RSB over four years on ART, to levels approaching pre-treatment rates. Strategies to promote long-term safe sex practices targeted to HIV-infected men on ART might have a significant impact on preventing HIV transmission in this setting

Validation of Farmer Perceived Soil Fertility Improving Tree Species in Agropastoral Communities of Bushenyi District

In sub-Saharan Africa, including Uganda, there is declining soil fertility and limited on-farm use of inorganic fertilizers due to poverty and limited subsidies for inorganic fertilizer use. Thus, integration of soil fertility improving tree species (SFITs) in farming systems remains a plausible option to sustaining soil productivity. However, knowledge of the effects of many of the locally growing farmer perceived soil fertility enhancing tree species on to soil chemical and nutrient contents are thus still lacking, and this has constrained decisions on their adoption and scaling up. The objectives of this paper were to identify farmers' preferred soil fertility improving tree species in agropastoral communities of Kyeizooba subcounty Bushenyi district, and characterize their litter content and assess their effect on selected soil chemical properties. Semistructured questionnaires were administered to 333 randomly selected agropastoral farmers. Litter and soils under canopy soils were sampled from three different environments: Under canopy radius (A), canopy edge (B), open pasture land up to thrice the canopy radius (C). Results revealed Eucalyptus as the most common tree species on livestock farms, followed by Erythrina abyssinica. The highest litter content was recorded for Markhamia lutea (240 g/cm2 under its canopy) followed by Croton macrostachyus (90 g/cm2), and 19 g/cm2 Erythrina abyssinica. Nitrogen was higher (P=.02) in Erythrina abyssinica litter, K and carbon in Croton macrostachyus litter (P=.03). These results give evidence that of soil improvers Erythrina abyssinica, Croton macrostachyus, and Markhamia lutea may positively affect soil fertility. Farmers' indigenous knowledge and or valuation of important tree species can be relied on, and thus, their indigenous knowledge need to be incorporated during identification of tree species for promotion in farming systems

Incidence and Predictors of Pregnancy among a Cohort of HIV-Positive Women Initiating Antiretroviral Therapy in Mbarara, Uganda

Objective: Many people living with HIV in sub-Saharan Africa desire biological children. Implementation of HIV preventionstrategies that support the reproductive goals of people living with HIV while minimizing HIV transmission risk to sexualpartners and future children requires a comprehensive understanding of pregnancy in this population. We analyzedprospective cohort data to determine pregnancy incidence and predictors among HIV-positive women initiatingantiretroviral therapy (ART) in a setting with high HIV prevalence and fertility.Methods:Participants were enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort of HIV-positiveindividuals initiating ART in Mbarara. Bloodwork (including CD4 cells/mm3, HIV viral load) and questionnaires (includingsocio-demographics, health status, sexual behavior, partner dynamics, HIV history, and self-reported pregnancy) werecompleted at baseline and quarterly. Our analysis includes 351 HIV-positive women (18–49 years) who enrolled between2005–2011. We measured pregnancy incidence by proximal and distal time relative to ART initiation and used multivariableCox proportional hazards regression analysis (with repeated events) to identify baseline and time-dependent predictors ofpregnancy post-ART initiation.Results:At baseline (pre-ART initiation), median age was 33 years [IQR: 27–37] and median prior livebirths was four [IQR: 2–6]. 38% were married with 61% reporting HIV-positive spouses. 73% of women had disclosed HIV status to a primary sexualpartner. Median baseline CD4 was 137 cells/mm3[IQR: 81–207]. At enrolment, 9.1% (31/342) reported current pregnancy.After ART initiation, 84 women experienced 105 pregnancies over 3.8 median years of follow-up, yielding a pregnancyincidence of 9.40 per 100 WYs. Three years post-ART initiation, cumulative probability of at least one pregnancy was 28%and independently associated with younger age (Adjusted Hazard Ratio (AHR): 0.89/year increase; 95%CI: 0.86–0.92) and HIVserostatus disclosure to primary sexual partner (AHR: 2.45; 95%CI: 1.29–4.63).Conclusions:Nearly one-third of women became pregnant within three years of initiating ART, highlighting the need forintegrated services to prevent unintended pregnancies and reduce periconception-related risks for HIV-infected womenchoosing to conceive. Association with younger age and disclosure suggests a role for early and couples-based safer conception counselling