Cattle Production From Native Pastures in the Semi-Humid Grasslands of Uganda

The cattle population of Uganda, estimated at 6 million, consists of more than 95% indigenous stock, raised on the semi-arid and semi-humid grasslands that make up 48% of the total land area and which supply over 85% of the marketed milk and meat. Native grassland pastures, which vary seasonal in quantity and quality due to rainfall and temperature variations, are the sole feed resource for cattle (Mbuza et al., 1992). This study examined the effects of seasonal herbage mass (HM), dietary crude protein (CPd), detergent lignin (ADLd) and digestibility (DiG) on body condition scores of milking cows grazed only on natural grassland pastures

Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study

Objective:We aimed to assess the nature and patterns of psychiatric disorders among adolescents who had been war-abducted in the war in northern Uganda, compared to non-abducted adolescents living in Gulu district, Uganda.Method: A cros sectional study that used an unmatched case-control design compared 82 abducted and 71 non-abducted adolescents for scores on measures of psychological distress and for selected psychiatric diagnoses using the Strength and Difficulties Questionnaire (SDQ) and the Mini International Neural-Psychiatric Interview for Children and Adolescents English version 2.0 (M.I.N.I-KID). Results: More than 90% of adolescents reported exposure to severe trauma, either through direct or indirect experiences. Significantly more war abducted adolescents reported PTSD (26.8%v.12.7%) (p=0.03) major depression (19.5%v.4.2%) (p=0.004), and generalised anxiety disorder (13.4v.4.2%) (p=0.049) than non abducted adolescents. By contrast, non-abducted adolescents reported more past suicidality (p=0.004, χ2=8.2) than adolescents who were abducted. However, despite high rates of psychiatric disorder, these adolescents had good psychosocial adjustment. Conclusion: Adolescents in war affected areas whether warabducted or not have varied and clinically significant emotional responses to different kinds of traumatic exposure. In a war-affected area, the development of a sustainable service for adolescents that tries to address the full range of mental health problems may be more appropriate than a psychological trauma service that focuses on one diagnosis.African Journal of Psychiatry Vol. 10 (4) 2007: pp. 225-23

The role of psycho-education in improving outcome at a general hospital psychiatry clinic in Uganda

Objective: While psychoeducation has been shown to positively affect outcomes in psychiatric disorders, its utility has been little studied in developing countries. The current study sought to examine the role of psychoeducation at a general psychiatric outpatient clinic in Kampala, Uganda in improving clinic attendance, treatment adherence, and clinical outcomes. Method: A prospective casecontrol study using a quasi-experimental design was conducted in 117 patients suffering various psychiatric disorders. Participants were recruited for two months and then followed for a further three months after recruitment ended. Participants in the intervention group received formalized psychoeducation sessions at each clinic visit in addition to the usual psychiatric evaluation and care. Participants in the control group received the usual clinical care. Measured outcomes were knowledge of mental illness, compliance with medications and follow-up, and Clinical Global Impression (CGI). Results: The groups did not differ with respect to sociodemographiccharacteristics or attendance at scheduled follow-up visits. Both groups significantly improved on the CGI, but with no significant difference between the groups. However, the intervention group was more likely to adhere to medication, and their knowledge of mental illness was significantly higher at follow-up. Conclusion: These data suggest that psychoeducation is a beneficial mental health intervention in a developing country that may increase compliance with medication and result in greater knowledge of mental illness. However, other factors such as distance from a centralized clinic or cost of treatment may impact outcomes, including attendance at scheduled follow-up visits.Keywords: Low and middle income countries; Outpatient treatment; Psychosocial interventions; Transcultural Psychiatry; Africa;  Psychoeducatio

Distribution of dissolved green-house gases (CO2, CH4, N2O) in Lakes Edward and George: Results from the first field cruise of the HIPE project

Inland waters (streams, rivers, lakes, reservoirs) are quantitatively important components of the global budgets of atmospheric emissions of long-lived greenhouse gases (GHGs) (CO2, CH4, N2O). Available data indicate that a very large fraction of CO2 and CH4 emissions from rivers and reservoirs occurs at tropical latitudes. Data on GHGs at tropical latitudes from lakes however are much more scarse, and the relative importance of emissions, in particular in Africa, remains to be determined. Large tropical lakes are net autotrophic (hence potentially sinks for atmospheric CO2) due generally low dissolved organic carbon concentrations, seasonally near constant light and temperature conditions, and generally deep water columns favourable for export of organic matter to depth. This sharply contrasts with their much better documented temperate and boreal counterparts, usually considered as CO2 sources to the atmosphere sustained by net heterotrophy. Here, we report a data-set of issolved CO2, CH4, N2O obtained in October 2016 in Lakes Edward and George and adjacent streams and cater lakes in he frame of Belgian Science Policy (BELSPO) HIPE (Human impacts on ecosystem health and resources of ake Edward, http://www.co2.ulg.ac.be/hipe/) project. Lake George and part of Lake Edward were sinks for tmospheric CO2 and N2O due to high primary production and denitrification in sediments, respectively, and modest ources of CH4 to the atmosphere. Sampled rivers and streams were oversaturated in CO2 and CH4 and close to tmospheric equilibrium with regards to N2O. Spatial variations within rivers and streams were related to elevation and vegetation characteristics on the catchments (savannah versus forest). Levels of CO2, CH4, and N2O were within the range of those we reported in other African rivers. Crater lakes acted as sinks for atmospheric CO2 and N2O but were extremely over-saturated in CH4, due to intense primary production sustained by cyanobacteria. These CH4 levels were much higher than what we have reported in other lakes and reservoirs elsewhere in Sub- Saharan Africa

Comparative durability of nevirapine versus efavirenz in first-line regimens during the first year of initiating antiretroviral therapy among Swaziland HIV-infected adults

Nevirapine (NVP) and Efavirenz (EFV) have generally comparable clinical and virologic efficacy. However, data comparing NVP durability to EFV are imprecise. We analyzed cohort data to compare durability of NVP to EFV among patients initiating ART in Mbabane, Swaziland. The primary outcome was poor regimen durability defined as any modification of NVP or EFV to the ART regimen. Multivariate Cox proportional hazards models were employed to estimate the risk of poor regimen durability (all-cause) for the two regimens and also separately to estimate risk of drug-related toxicity. We analyzed records for 769 patients initiating ART in Mbabane, Swaziland from March 2006 to December 2007. 30 patients (3.9%) changed their NVP or EFV-based regimen during follow up. Cumulative incidence for poor regimen durability was 5.3 % and 2.7 % for NVP and EFV, respectively. Cumulative incidence for drug-related toxicity was 1.9 % and 2.7 % for NVP and EFV, respectively. Burden of TB was high and 14 (46.7%) modifications were due to patients substituting NVP due to beginning TB treatment. Though the estimates were imprecise, use of NVP - based regimens seemed to be associated with higher risk of modifications compared to use of EFV - based regimens (HR 2.03 95%CI 0.58 - 7.05) and NVP - based regimens had a small advantage over EFV - based regimens with regard to toxicity - related modifications (HR 0.87 95%CI 0.26 - 2.90). Due to the high burden of TB and a significant proportion of patients changing their ART regimen after starting TB treatment, use of EFV as the preferred NNRTI over NVP in high TB endemic settings may result in improved first-line regimen tolerance. Further studies comparing the cost-effectiveness of delivering these two NNRTIs in light of their different limitations are required.Key words: Tolerability, Toxicity, Efavirenz, Nevirapine, Antiretroviral therapy, Resource limited setting, Swazilan

Strategic assessment of research priorities for sweetpotato.

The following report presents an ex‐ante evaluation of priority research options for sweetpotato carried out in the scope of the strategic assessment of research priorities for the CGIAR Research Program on Roots, Tubers, and Bananas (RTB). It contains the results from the economic surplus model used for the assessment, which are extended to include estimations of the number of beneficiaries and poverty reduction effects. The report identifies and describes the sweetpotato research options taken into consideration for and included into the assessment. The socioeconomic and technological parameters used as input data for the analysis are described and information on the elicitation process and data sources is provided. Results are presented so as to explain the outputs obtained and interpreted with respect to the relevant differences between research option

Learning Radiology in an Integrated Problem-Based Learning (PBL) Curriculum

Background: The Faculty of Medicine (FoM) has been training health professions in Uganda since 1924. Five years ago, it decided to change the undergraduate curriculum from traditional to Problem Based Learning (PBL) and adopted the SPICES model. Radiology was integrated into the different courses throughout the 5 year program. The objective was to improve the implementation of the integration of Radiology in the integrated PBL curriculum.Methods: This was a cross sectional descriptive study of radiologists and medical students using interviews and semi-structured questionnaires respectively.Results: Radiologists’ and students’ perceptions and opinions on Radiology training were gathered. A Radiology training rationale was developed. Learning outcomes for Radiology were defined and learning formats were chosen. Learning materials were identified and strategies to improve the implementation were formulated.Conclusions: This work has culminated into changes in Radiology integration in the curriculum and training at the FOM

"For how long are we going to take the tablets?" Kenyan stakeholders' views on priority investments to sustainably tackle soil-transmitted helminths.

Recent global commitments to shift responsibility for Neglected Tropical Disease (NTD) control to affected countries reflect a renewed emphasis on sustainability, away from aid-dependency. This calls for a better understanding of how domestic stakeholders perceive investments in different strategies for NTD control. Soil transmitted helminths (STH) are among the NTDs targeted for elimination as a public health problem by international agencies through mass drug administration, provided periodically to at-risk population groups, often using drugs donated by pharmaceutical companies. This study was conducted in Kenya at a time when responsibilities for long running STH programmes were transitioning from external to national and sub-national agencies. Following an initial assessment in which we identified key domestic stakeholders and reviewed relevant scientific and government documents, the perspectives of stakeholders working in health, education, community engagement and sanitation were investigated through semi-structured interviews with national level policymakers, county level policymakers, and frontline implementers in one high-STH burden county, Kwale. Our conceptual framework on sustainability traced a progression in thinking, from ensuring financial stability through the technical ability to adapt to changing circumstances, and ultimately to a situation where a programme is prioritised by domestic policymakers because empowered communities demand it. It was clear from our interviews that most Kenyan stakeholders sought to be at the final stage in this progression. Interviewees criticised long-term investment in mass drug administration, the approach favoured predominantly by external agencies, for failing to address underlying causes of STH. Instead they identified three synergistic priority areas for investment: changes in institutional structures and culture to reduce working in silos; building community demand and ownership; and increased policymaker engagement on underlying socioeconomic and environmental causes of STH. Although challenging to implement, the shift in responsibility from external agencies to domestic stakeholders may lead to emergence of new strategic directions

Understanding intra-community disparity in food and nutrition security in a generally food insecure part of eastern Africa

Food and nutrition insecurity continues to be one of the major development challenges in sub-Saharan Africa and other developing regions of the world. Karamoja sub-region, located in northern Uganda, is one of the poorest and most food insecure part of Eastern Africa. Previous studies have generalized the sub-region as food insecure. However, limited attention has been paid to locational differences in the food and nutrition security situation within this culturally and ecologically diverse part of the country. A crosssectional study design was used to examine at a community level, disparity in food and nutrition security situation among communities in Kotido and Moroto districts of the Karamoja sub-region. The study investigated the status of agricultural production, dietary habits and food security situation using individual household survey, focus group discussions, key informant interviews, household food insecurity access scale (HFIAS) and food insecurity coping strategy index (CSI). Data were analyzed using descriptive statistics, analysis of variance, and correlation and regression methods, at 5 % level of significance. The results showed that irrespective of ethnic differences, majority of households (78.8%) consumed less than 3 meals 24 hours preceding the interview. Generally, agricultural production was inadequate to support household food security and less than 30% of the households had adequate calorie intake. However, calorie intake adequacy was at least three (3) times higher in Kotido than in Moroto district. Plant foods were more frequently consumed than animal-source foods. At least 57% and 73% of households in Kotido and Moroto districts, respectively, never consumed fish. Food security was generally predicted by household size, ownership of food stores, occupation of household caregivers, number of livestock (especially goats) owned by households, time taken to fetch water (related to distance to water source) and sorghum production. Whereas it is generally known that Karamoja sub-region is highly food insecure, this study has demonstrated that communities in Moroto district are worse-off than those in Kotido district. Therefore, community-level characteristics ought to be an essential baseline consideration in designing food and nutrition interventions in Karamoja, and indeed in food insecure localities in general.Keywords: Karamoja, Eastern Africa, dietary practices, coping strategies, animal source food