Community chloroquine distribution for malaria control in Bushenyi district of Uganda.

OBJECTIVE: To document successful community chloroquine distribution for malaria control in Bushenyi district, southwestern Uganda. DESIGN: A cross sectional survey immediately after a four-month community chloroquine distribution exercise. One hundred sixty seven distributors in 140 out of 166 parishes in Bushenyi district did the chloroquine distribution during the 2001 malaria epidemic. PARTICIPANTS: A cluster random sample of 215 heads of households or their spouses were interviewed using a pre-tested questionnaire. MAIN OUTCOME MEASURES: Socio-demographic characteristics, malaria/fever morbidity, health seeking behaviour in the previous four months, knowledge about chloroquine distribution, opinions about the chloroquine distribution exercise and whether the household had used the service of the chloroquine distributors. RESULTS: Thirty per cent of the people surveyed had suffered from malaria in the previous four months. Seventy per cent of the households were aware of the chloroquine distribution and 56% of the patients who had malaria in the previous four months accessed the services of chloroquine distributors. People who were aware of chloroquine distributors were less likely to use services where a fee is levied. The total cost of chloroquine distribution was about 20,000 United States dollars. CONCLUSIONS: Community chloroquine distribution can increase access to treatment and can be done in a short time at an affordable cost

False teeth "ebiino" and millet disease "oburo" in Bushenyi district of Uganda

Background:\"False teeth\" (Ebiino) and \"Millet disease\" (Oburo, Tea-tea) have been reported in Uganda and other countries in Sub-Saharan Africa. These two perceived diseases are commonly reported in children under-five years of age. Anecdotal and published evidence suggests that these conditions are associated with moderate to severe childhood diseases such as malaria, pneumonia and diarrhoea and that most health seeking behaviour for the conditions is from traditional healers. Objectives:To estimate how common the 2 perceived diseases (false teeth and millet disease) are and describe health seeking behaviour for the two diseases. Methods:We did a cross-sectional survey using an interviewer administered questionnaire with closed and open questions in Bushenyi district, Uganda. The participants included 215 heads of households or their spouses obtained by cluster random sampling of 30 villages. Participants answered questions regarding occurrence of false teeth and millet disease disease in the household, treatment sought for false teeth and millet disease, perceived causes of false teeth and millet disease and about social economic situation of the household. Results: More than one in two of the households had a child less than five years who suffered from false teeth or millet disease in the last five years. More than 80% of the respondents used traditional medicine alone or in combination with modern medicine to treat false teeth and or millet disease. Occurrence of false teeth and millet disease disease were favoured by low education status and not living in a house with cemented floor or having a brick wall. Use of traditional medicine was not associated with social economic conditions. Conclusions:The frequency of the perceived diseases false teeth and millet disease disease is high and may be attributed to low access to preventive and curative health services. Keywords: Malaria; Pneumonia; Diarrhoea; health seeking behaviour; access to health facilities; traditional medicine; health beliefs. African Health Sciences Vol. 7(1) 2007: pp. 25-3

Ebola Hemorrhagic Fever Associated with Novel Virus Strain, Uganda, 2007–2008

Case-fatality rate is lower for this strain than for the other 3 Ebola species known to be pathogenic to humans

Managing Ebola from rural to urban slum settings: experiences from Uganda.

Managing Ebola in Uganda.Five outbreaks of ebola occurred in Uganda between 2000-2012. The outbreaks were quickly contained in rural areas. However, the Gulu outbreak in 2000 was the largest and complex due to insurgency. It invaded Gulu municipality and the slum- like camps of the internally displaced persons (IDPs). The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas

The Impact of Socio-Demographic and Religious Factors upon Sexual Behavior among Ugandan University Students

INTRODUCTION: More knowledge is needed about structural factors in society that affect risky sexual behaviors. Educational institutions such as universities provide an opportune arena for interventions among young people. The aim of this study was to investigate the relationship between sociodemographic and religious factors and their impact on sexual behavior among university students in Uganda. METHODS: In 2005, 980 university students (response rate 80%) were assessed by a self-administered questionnaire. Validated instruments were used to assess socio-demographic and religious factors and sexual behavior. Logistic regression analyses were applied. RESULTS: Our findings indicated that 37% of the male and 49% of the female students had not previously had sex. Of those with sexual experience, 46% of the males and 23% of the females had had three or more sexual partners, and 32% of the males and 38% of the females did not consistently use condoms. For those who rated religion as less important in their family, the probability of early sexual activity and having had a high number of lifetime partners increased by a statistically significant amount (OR = 1.7; 95% CI: 1.2-2.4 and OR = 1.6; 95% CI: 1.1-2.3, respectively). However, the role of religion seemed to have no impact on condom use. Being of Protestant faith interacted with gender: among those who had debuted sexually, Protestant female students were more likely to have had three or more lifetime partners; the opposite was true for Protestant male students. CONCLUSION: Religion emerged as an important determinant of sexual behavior among Ugandan university students. Our findings correlate with the increasing number of conservative religious injunctions against premarital sex directed at young people in many countries with a high burden. of HIV/AIDS. Such influence of religion must be taken into account in order to gain a deeper understanding of the forces that shape sexual behavior in Uganda

Schistosomiasis among Recreational Users of Upper Nile River, Uganda, 2007

After recreational exposure to river water in Uganda, 12 (17%) of 69 persons had evidence of schistosome infection. Eighteen percent self-medicated with praziquantel prophylaxis immediately after exposure, which was not appropriate. Travelers to schistosomiasis-endemic areas should consult a travel medicine physician

Hepatitis E Epidemic, Uganda

In October 2007, an epidemic of hepatitis E was suspected in Kitgum District of northern Uganda where no previous epidemics had been documented. This outbreak has progressed to become one of the largest hepatitis E outbreaks in the world. By June 2009, the epidemic had caused illness in >10,196 persons and 160 deaths

Uganda's HIV Prevention Success: The Role of Sexual Behavior Change and the National Response

There has been considerable interest in understanding what may have led to Uganda's dramatic decline in HIV prevalence, one of the world's earliest and most compelling AIDS prevention successes. Survey and other data suggest that a decline in multi-partner sexual behavior is the behavioral change most likely associated with HIV decline. It appears that behavior change programs, particularly involving extensive promotion of “zero grazing” (faithfulness and partner reduction), largely developed by the Ugandan government and local NGOs including faith-based, women’s, people-living-with-AIDS and other community-based groups, contributed to the early declines in casual/multiple sexual partnerships and HIV incidence and, along with other factors including condom use, to the subsequent sharp decline in HIV prevalence. Yet the debate over “what happened in Uganda” continues, often involving divisive abstinence-versus-condoms rhetoric, which appears more related to the culture wars in the USA than to African social reality

Relatively Low HIV Infection Rates in Rural Uganda, but with High Potential for a Rise: A Cohort Study in Kayunga District, Uganda

BACKGROUND: Few studies have been conducted in Uganda to identify and quantify the determinants of HIV-1 infection. We report results from a community-based cohort study, whose primary objectives were to determine HIV-1 prevalence, incidence, and determinants of these infections, among other objectives. METHODOLOGY: Consenting volunteers from the rural district of Kayunga in Uganda aged 15-49 years were enrolled between March and July 2006. Participants were evaluated every six months. A questionnaire that collected information on behavioral and other HIV-1 risk factors was administered, and a blood sample obtained for laboratory analysis at each study visit. PRINCIPAL FINDINGS: HIV-1 prevalence among the 2025 participants was 9.9% (95% CI = 8.6%-11.2%). By the end of 12 months of follow-up, 1689.7 person-years had been accumulated, with a median follow-up time of 11.97 months. Thirteen HIV-1 incident cases were detected giving an annual HIV-1 incidence of 0.77% (95% CI = 0.35-1.19). Prevalence of HSV-2 infection was 57% and was strongly associated with prevalent HIV-1 infection (adjusted Odds Ratio = 3.9, 95% CI = 2.50-6.17); as well as incident HIV-1 infection (adjusted Rate Ratio (RR) = 8.7, 95% CI = 1.11-67.2). The single most important behavioral characteristic associated with incident HIV infection was the number of times in the past 6 months, a participant had sex with person(s) they suspected/knew were having sex with others; attaining statistical significance at 10 times and higher (adjusted RR = 6.3, 95% CI = 1.73-23.1). By the end of 12 months of follow-up, 259 participants (13%) were lost to follow-up, 13 (0.6%) had died, and 2 (0.1%) had withdrawn consent. CONCLUSIONS: Despite relatively low HIV-1 incidence observed in this community, prevalence remains relatively high. In the presence of high prevalence of HSV-2 infection and the behavioral characteristic of having sex with more than one partner, there is potential for increase in HIV-1 incidence