Contribution of Wetland Resources to Household Incomes of Riparian Communities of Katonga Wetland in Mpigi District, Uganda

Katonga wetland which lies to the western part of Lake Victoria covers an area of 237.4 km2. Although the wetland is known to contain flora and fauna that support livelihoods, there has been lack of information on the economic value of these resources and their contribution to livelihoods particularly of the rural riparian communities. The objective of the study was to generate information on the vital wetland resources, the economic value and contribution of these resources to riparian community livelihoods. The study was carried out in Nkozi and Kituntu sub-counties in Mpigi District-Uganda; it covered six parishes through which the wetland runs and involved 120 respondents. The study established that resources in the wetland are collected for subsistence and direct commercial extraction. The most important resource derived from the wetland for subsistence use was water for rural domestic use with each household using an average of 188l per day (23l per person) and was estimated at an annual economic value of Uganda shillings (Ushs) 490,191 (U$233.4) per person per year. Fisheries were the most important commercial activities undertaken in these parts of the wetland involving 36$ 1,900.6) per person. These activities particularly collection of water and fuel wood are undertaken throughout the year, while harvesting of craft materials is mainly done during the dry season (January-March and June-August). Fishing is done mainly in the wet season (March-May and September-November).he wetland is a source of income for at least 74% of the respondents. The majority of respondents, 57.5%, were among low income groups earning up to Ushs 600,000 per respondent annually. Fishing provides the highest gross incomes per respondent Ushs 200,000 per month hence the high value of the wetland to its riparian communities. It was noted that 30% of respondents depend on both the wetland and other activities with the wetland providing a buffer income source. It is recommended that the wetland hydrology which is vital for the sustainability of these activities be maintained through catchment improvement while sustainable harvesting levels be established for fishing activities. Environment management structures should be strengthened to sustainably manage the wetland. Local communities should also be sensitized about the importance of this wetland so that they can appreciate its ecosystem services and participate in its sustainable management

Unravelling the spirits’ message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries

Concurrent evaluation of cytokines improves the accuracy of antibodies against Mycobacterium tuberculosis antigens in the diagnosis of active tuberculosis

Data availability statement: All the important data relevant to this study was reported in the manuscript. Any additional data will be made available upon request from the corresponding author.Copyright © 2022 The Authors. Background: Antibodies against mycobacterial proteins are highly specific, but lack sensitivity, whereas cytokines have been shown to be sensitive but not very specific in the diagnosis of tuberculosis (TB). We assessed combinations between antibodies and cytokines for diagnosing TB. Methods: Immuoglubulin (Ig) A and IgM antibody titres against selected mycobacterial antigens including Apa, NarL, Rv3019c, PstS1, LAM, “Kit 1” (MTP64 and Tpx)”, and “Kit 2” (MPT64, Tpx and 19 kDa) were evaluated by ELISA in plasma samples obtained from individuals under clinical suspicion for TB. Combinations between the antibody titres and previously published cytokine responses in the same participants were assessed for diagnosing active TB. Results: Antibody responses were more promising when used in combination (AUC of 0.80), when all seven antibodies were combined. When anti-“Kit 1”-IgA levels were combined with five host cytokine biomarkers, the AUC increased to 97% (92–100%) with a sensitivity of 95% (95% CI, 73–100%), and specificity of 88.5% (95% CI, 68.7–97%) achieved after leave-one-out cross validation. Conclusion: When used in combination, IgA titres measured with ELISA against multiple Mycobacterium tuberculosis antigens may be useful in the diagnosis of TB. However, diagnostic accuracy may be improved if the antibodies are used in combination with cytokines.This work was part of the EDCTP1 programme supported by the European Union (grant number IP_2009_32040, AE-TBC; awarded to GW). The project was also supported by the South African Government through the National Research Foundation (NRF, awarded to NC) and the South African Medical Research Council (SAMRC, postgraduate scholarship to RJ)

RISK6, a 6-gene transcriptomic signature of TB disease risk, diagnosis and treatment response

Improved tuberculosis diagnostics and tools for monitoring treatment response are urgently needed. We developed a robust and simple, PCR-based host-blood transcriptomic signature, RISK6, for multiple applications: identifying individuals at risk of incident disease, as a screening test for subclinical or clinical tuberculosis, and for monitoring tuberculosis treatment. RISK6 utility was validated by blind prediction using quantitative real-time (qRT) PCR in seven independent cohorts. Prognostic performance significantly exceeded that of previous signatures discovered in the same cohort. Performance for diagnosing subclinical and clinical disease in HIV-uninfected and HIV-infected persons, assessed by area under the receiver-operating characteristic curve, exceeded 85%. As a screening test for tuberculosis, the sensitivity at 90% specificity met or approached the benchmarks set out in World Health Organization target product profiles for non-sputum-based tests. RISK6 scores correlated with lung immunopathology activity, measured by positron emission tomography, and tracked treatment response, demonstrating utility as treatment response biomarker, while predicting treatment failure prior to treatment initiation. Performance of the test in capillary blood samples collected by finger-prick was noninferior to venous blood collected in PAXgene tubes. These results support incorporation of RISK6 into rapid, capillary blood-based point-of-care PCR devices for prospective assessment in field studies

Prevalence of common gastro-intestinal nematode infections in commercial goat farms in Central Uganda

Gastro-intestinal nematode (GIN) infections are the leading cause of production losses in commercial goat farms worldwide. This study determined the level of gastro-intestinal nematodes (GIN) infection and identified the common GIN parasites in commercial goat production in Central Uganda. Faecal egg counts and morphological larval identification in coprocultures were used to estimate the burden of common GIN of goats in Central Uganda. Egg shedding was detected in 43% of the goats. Worm burdens were highest (498 -713 epg) in goats 3-5 and 8-9 months old. Goats of 6-8 and older than 9 months showed relatively lower egg counts (254- 491epg). Haemonchus (56%), Oesophagostomum (33%) and strongyloides species (11%) were the only nematode species identified on coprocultures.Key words: Gastro-intestinal nematode, Haemonchus species, Oesophagostomum, worm

Student mental health service provision for suicide behaviour prevention on university campuses in Uganda

The prevalence of mental health problems among Uganda university students, unlike globally, has been poorly documented. The present paper posits that the provision of early mental health interventions could prevent or reduce both current and future mental health problems, including suicidal behaviours among Ugandan university students. Various studies in the field of university student health have found the mental health of university student populations do not have adequate psychotherapeutic services. Today, there is a growing recognition for the need to increase investment in the promotion, prevention, and treatment approaches to mental health and well-being as part of the Sustainable Development Goals (SDG) 3.4 developed by the United Nations in 2015. However, little research has been carried out concerning the provision of university mental healthcare services that address students at risk for mental ill-health including suicidal behaviours on Ugandan university campuses. An assessment of the university mental health service provision as a strategy to address student suicidal behaviours on campuses in Uganda would provide insights that underlie the focused services needed through which vulnerable university students can be addressed and helped. This calls for a strategic intervention model, locally contextualized, developed and informed by the Sustainable Development Goals to address the mental health and well-being of the students

Tuberculosis case finding in first-degree relative contacts not living with index tuberculosis cases in Kampala, Uganda

Phalkun Chheng,1,2 Mary Nsereko,2 LaShaunda L Malone,2 Brenda Okware,2 Sarah Zalwango,2 Moses Joloba,2,3 W Henry Boom,2 Ezekiel Mupere,1,2,4 Catherine M Stein1,2 On behalf of the Tuberculosis Research Unit 1Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA; 2Uganda-Case Western Reserve University Research Collaboration, 3Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda; 4Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda Purpose: To assess the prevalence of pulmonary tuberculosis among first-degree relative (FDR) contacts not living with tuberculosis (TB) cases. Methods: A cross-sectional analysis of household contacts living with an index TB case and FDR contacts living outside of households in Kampala, Uganda, is presented. Results: A total of 177 contacts (52 FDRs and 125 index household contacts) of 31 TB cases were examined. Compared with index household contacts, FDR contacts were older, more likely to be TB symptomatic (50% vs 33%), had a higher percentage of abnormal chest X-rays (19% vs 11%), sputum smear positive (15% vs 5%), and many similar epidemiologic risk factors, including HIV infection (13% vs 10%). Contact groups had similar pulmonary tuberculosis prevalence: 9.6% in FDR vs 10.4% in index household contacts and similar Mycobacterium tuberculosis infection: 62% in FDR vs 61% in index households. Conclusion: TB is common among FDR contacts. High TB prevalence justifies targeting FDRs during household contact investigations. Combining TB active-case finding among FDR contacts with household contact investigation in low-income setting is feasible. This should be part of national TB control program strategies for increasing TB case-detection rates and reducing community TB transmission and death. Keywords: prevalence of pulmonary tuberculosis, limited resource setting, contact tracin

Long-term dominance of Mycobacterium tuberculosis Uganda family in peri-urban Kampala-Uganda is not associated with cavitary disease

Previous studies have shown that Mycobacterium tuberculosis (MTB) Uganda family, a sub-lineage of the MTB Lineage 4, is the main cause of tuberculosis (TB) in Uganda. Using a well characterized patient population, this study sought to determine whether there are clinical and patient characteristics associated with the success of the MTB Uganda family in Kampala.; A total of 1,746 MTB clinical isolates collected from1992-2009 in a household contact study were genotyped. Genotyping was performed using Single Nucleotide Polymorphic (SNP) markers specific for the MTB Uganda family, other Lineage 4 strains, and Lineage 3, respectively. Out of 1,746 isolates, 1,213 were from patients with detailed clinical data. These data were used to seek associations between MTB lineage/sub-lineage and patient phenotypes.; Three MTB lineages were found to dominate the MTB population in Kampala during the last two decades. Overall, MTB Uganda accounted for 63% (1,092/1,746) of all cases, followed by other Lineage 4 strains accounting for 22% (394/1,746), and Lineage 3 for 11% (187/1,746) of cases, respectively. Seventy-three (4 %) strains remained unclassified. Our longitudinal data showed that MTB Uganda family occurred at the highest frequency during the whole study period, followed by other Lineage 4 strains and Lineage 3. To explore whether the long-term success of MTB Uganda family was due to increased virulence, we used cavitary disease as a proxy, as this form of TB is the most transmissible. Multivariate analysis revealed that even though cavitary disease was associated with known risk factors such as smoking (adjusted odds ratio (aOR) 4.8, 95% confidence interval (CI) 3.33-6.84) and low income (aOR 2.1, 95% CI 1.47-3.01), no association was found between MTB lineage and cavitary TB.; The MTB Uganda family has been dominating in Kampala for the last 18 years, but this long-term success is not due to increased virulence as defined by cavitary disease