Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda

Background International and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits of geo-targeted control, we assessed the extent to which HIV hotspots along Lake Victoria sustain transmission in neighbouring populations in south-central Uganda. Methods We did a population-based survey in Rakai, Uganda, using data from the Rakai Community Cohort Study. The study surveyed all individuals aged 15–49 years in four high-prevalence Lake Victoria fishing communities and 36 neighbouring inland communities. Viral RNA was deep sequenced from participants infected with HIV who were antiretroviral therapy-naive during the observation period. Phylogenetic analysis was used to infer partial HIV transmission networks, including direction of transmission. Reconstructed networks were interpreted through data for current residence and migration history. HIV transmission flows within and between high-prevalence and low-prevalence areas were quantified adjusting for incomplete sampling of the population. Findings Between Aug 10, 2011, and Jan 30, 2015, data were collected for the Rakai Community Cohort Study. 25 882 individuals participated, including an estimated 75·7% of the lakeside population and 16·2% of the inland population in the Rakai region of Uganda. 5142 participants were HIV-positive (2703 [13·7%] in inland and 2439 [40·1%] in fishing communities). 3878 (75·4%) people who were HIV-positive did not report antiretroviral therapy use, of whom 2652 (68·4%) had virus deep-sequenced at sufficient quality for phylogenetic analysis. 446 transmission networks were reconstructed, including 293 linked pairs with inferred direction of transmission. Adjusting for incomplete sampling, an estimated 5·7% (95% credibility interval 4·4–7·3) of transmissions occurred within lakeside areas, 89·2% (86·0–91·8) within inland areas, 1·3% (0·6–2·6) from lakeside to inland areas, and 3·7% (2·3–5·8) from inland to lakeside areas. Interpretation Cross-community HIV transmissions between Lake Victoria hotspots and surrounding inland populations are infrequent and when they occur, virus more commonly flows into rather than out of hotspots. This result suggests that targeted interventions to these hotspots will not alone control the epidemic in inland populations, where most transmissions occur. Thus, geographical targeting of high prevalence areas might not be effective for broader epidemic control depending on underlying epidemic dynamics. Funding The Bill & Melinda Gates Foundation, the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, the National Institute of Child Health and Development, the Division of Intramural Research of the National Institute for Allergy and Infectious Diseases, the World Bank, the Doris Duke Charitable Foundation, the Johns Hopkins University Center for AIDS Research, and the President's Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention

Inferring HIV-1 transmission networks and sources of epidemic spread in Africa with deep-sequence phylogenetic analysis

To prevent new infections with human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa, UNAIDS recommends targeting interventions to populations that are at high risk of acquiring and passing on the virus. Yet it is often unclear who and where these ‘source’ populations are. Here we demonstrate how viral deep-sequencing can be used to reconstruct HIV-1 transmission networks and to infer the direction of transmission in these networks. We are able to deep-sequence virus from a large population-based sample of infected individuals in Rakai District, Uganda, reconstruct partial transmission networks, and infer the direction of transmission within them at an estimated error rate of 16.3% [8.8–28.3%]. With this error rate, deep-sequence phylogenetics cannot be used against individuals in legal contexts, but is sufficiently low for population-level inferences into the sources of epidemic spread. The technique presents new opportunities for characterizing source populations and for targeting of HIV-1 prevention interventions in Africa

Kairomone trapping system for delivery of Beauveria bassiana to control the banana weevil

No Abstract

Farmer evaluation of dried banana based products

A farmer participatory evaluation of dried banana based products was conducted in various districts of Uganda. Bananas were dried using a tunnel solar dryer developed by Post Harvest Handling and Storage project (PHHS) of Kawanda Post-harvest Programme and improved by the National Banana Research Programme. The dried banana was milled into flour using a high speed rotary mill. Porridge and thick-porridge (ugali) were prepared using 100% banana flour, a mixture of banana-millet flour in the ratios of 8:2 and 9:1, and banana-millet-soybean in the ratio 7:2:1, banana-millet-soybean- maize in the ratio of 7:1:1:1 and banana-millet-cassava in the ratio of 7:2:1. Acceptability of the products was tested by farmers and scored on a hedonic scale. Statistical analysis showed the mixture of banana-millet-soy in ratio of 7:2:1 and that of banana-millet in a ratio of 8:2 were best for porridge and thick porridge (ugali), respectively.Une évaluation participative des fermiers des produits secs dérivés de la banane était conduite dans plusieurs districts de l'Ouganda. Les banana étaient séchées en utilisant un séchoir solaire en forme de tunnel développé par le projet Post Harvest Handling and Storage (PHHS) de Kawanda Post-Harvest Programme et amélioré par le National Banana Programme. Les bananes séchées étaient transformées en poudre en utilisant un moulin du type rotary à grande vitesse. La bouillie et le foufou étaient préparés sur base de la banane (100%), du mélange banane et millet a un taux de 8:2 et 9:1, et banane-millet-soya à un taux de 7:2:1, banane-millet-soya-maïs a un taux de 7:2:1. L'acceptabilité des produits était testée par les fermiers et marquée sur une échelle hédonique. L'analyse statistique montre que le mélange banane-millet-soya au taux de 7:2:1 et celui de la banane-millet au taux de 8:2 étaient les meilleurs pour la bouillie et l'ugali, respectivement

Farmer evaluation of dried banana based products

A farmer participatory evaluation of dried banana based products was conducted in various districts of Uganda. Bananas were dried using a tunnel solar dryer developed by Post Harvest Handling and Storage project (PHHS) of Kawanda Post-harvest Programme and improved by the National Banana Research Programme. The dried banana was milled into flour using a high speed rotary mill. Porridge and thick-porridge (ugali) were prepared using 100% banana flour, a mixture of banana-millet flour in the ratios of 8:2 and 9:1, and banana-millet-soybean in the ratio 7:2:1, banana-millet-soybean- maize in the ratio of 7:1:1:1 and banana-millet-cassava in the ratio of 7:2:1. Acceptability of the products was tested by farmers and scored on a hedonic scale. Statistical analysis showed the mixture of banana-millet-soy in ratio of 7:2:1 and that of banana-millet in a ratio of 8:2 were best for porridge and thick porridge (ugali), respectively. Key Words: Acceptability, farmer participatory, hedonic scale, Musa spp. RESUME Une évaluation participative des fermiers des produits secs dérivés de la banane était conduite dans plusieurs districts de l'Ouganda. Les banana étaient séchées en utilisant un séchoir solaire en forme de tunnel développé par le projet Post Harvest Handling and Storage (PHHS) de Kawanda Post-Harvest Programme et amélioré par le National Banana Programme. Les bananes séchées étaient transformées en poudre en utilisant un moulin du type rotary à grande vitesse. La bouillie et le foufou étaient préparés sur base de la banane (100%), du mélange banane et millet a un taux de 8:2 et 9:1, et banane-millet-soya à un taux de 7:2:1, banane-millet-soya-maïs a un taux de 7:2:1. L'acceptabilité des produits était testée par les fermiers et marquée sur une échelle hédonique. L'analyse statistique montre que le mélange banane-millet-soya au taux de 7:2:1 et celui de la banane-millet au taux de 8:2 étaient les meilleurs pour la bouillie et l'ugali, respectivement. Mots Clés: Acceptabilité, participation des fermiers, echelle hédonique, Musa spp. African Crop Science Journal Vol.12(1) 2004: 27-3

Impact of Awareness Campaigns for Banana Bacterial Wilt Control in Uganda

A study was conducted in central Uganda to determine the impact of awareness campaigns raised through participatory development communication (PDC). Results showed that the majority of farmers were aware of key BBW symptoms, the modes of disease spread and the recommended control measures. The high level of awareness was attributed to the communication approach (PDC) employed. The control measures most commonly employed were removal of the male buds and cutting down affected plants. Most removed male buds using a forked stick though quite many were using knives as opposed to the recommended practice of using a forked stick. Farmers who practiced full packages of control measures reported lasting prevention or complete eradication of the disease from their farms

Impact of awareness campaigns for banana bacterial wilt in Uganda

No Abstract. African Crop Science Jouranl Vol. 14 (2) 2006: pp. 175-18

Economic importance of the banana bacterial wilt in Uganda

No Abstract. African Crop Science Jouranl Vol. 14 (2) 2006: pp. 93-10