Intestinal intussusception in an adult caused by helminthic parasitosis

Intestinal intussusception is an uncommon acute condition in adults and is most commonly caused by an intestinal tumor mass. Helminthic parasitosis is a widespread infection in Africa, and the load of worms is often high in individuals living in areas with inadequate sanitation. We report a case of intestinal obstruction caused by Ascaris lumbricoides infection, which was complicated by ileo-caecal intussusception and required surgical treatment in a 40-year-old Ugandan woman. This case reinforces the importance of anthelminthic prophylaxis in African rural areas

Student self-assessment after Essential Surgical Skills training for final-year medical students at Gulu University, northern Uganda

Background: Medical practice depends on a set of essential clinical and surgical skills, yet inadequate attention is given to training these skills in medical school. This study aimed to evaluate the effect of Essential Surgical Skills® (ESS) training on self-report comfort levels in performing surgical skills among final-year medical students at Gulu University in Gulu, Uganda. Methods: This study analysed 5 years’ worth of pre- and post-course ESS self-evaluation questionnaires completed by final-year medical students attending Gulu University between 2013 and 2017. Pre- and post-course results were compared using Student’s t-test. ESS elements covered over the 5-day course were: surgery fundamentals; respiratory and anaesthesia skills; and skills related to gastrointestinal, obstetric, and orthopaedic surgery. Results: There was a significant improvement in the students’ level of comfort related to all ESS components when pre- and post-course questionnaire responses were compared (P < 0.001). Conclusions: Medical schools should emphasize training of essential clinical and surgical skills because these give medical students the confidence and proficiency needed in clinical practice. Keywords: surgical skills; education; training; medical school; Uganda; Somalia

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security