Evaluation of PCR for direct detection of mycobacterium tuberculosis complex in sputum samples in Kampala, Uganda

Objective: The aim of this study was to evaluate an in-house PCR for direct detection of Mycobacterium tuberculosis complex (MTC) in sputum samples.Design: Across sectional study was conducted on samples isolates from suspected TB patients. Settings: Patients presenting to Mulago hospital Ward 5 TB Clinics for management and care from June 2014 to April 2015. Subjects: Three sputum samples per patient were obtained from 30 patients with negative (N= 90) and 30 patients with positive (N= 90) ZN smear results for a total of 180 sputum samples was studied. The samples were processed using N-acetyl-L-cycteine and 4% NaOH. Genomic DNA was extracted from the sputum samples and used as template for IS6110-PCR. The prevalence of MTC bacilli in the sputum samples was determined. Results: IS6l110-PCR detected MTC bacilli in 81% (73/90) sputum samples from patients with ZN-positive smears while it detected 51% (46/ 90) sputum samples from patients with ZN-negative. There were statistically significant associations between frequency in performing PCR on three sputum samples per patient and increased proportion of samples positive for MTC, p<0.05). All the 30 patients with ZN positive smears were positive on IS6110-PCR, while 80% (24/30) patients with ZN-negative smears were positive on IS6110-PCR. Chi square test revealed a statistically significant positive association between ZN positive and ZN-negative smears p<0.05. Conclusion: In low income setting burden with high TB incidence and mortality, inhouse IS6110-PCR efficiently detects MTC bacilli in sputum samples and can be introduced for routine detection of these bacilli in isolates form pulmonary TB suspects

Effect Of Seasonal Rainfall And Other Environmental Changes, On Snail Density And Infection Rates With Schistosoma mansoni Fifteen Years After The Last Snails\' Study In Kigungu, Entebbe, Uganda

Background: The last study on snail population density in relation to rainfall pattern in Kigungu canoe landing and recreational sites on Lake Victoria shore was earlier carried out about fifteen years ago. This study also reviewed the influence of other environmental factors on the snails\' infection rate. Objective: To reassess the density dynamic of Biomphalaria (B) choanomphala and Biomphalaria (B) pfeifferi, which act as the intermediate host for S. mansoni and Bulinus (B) globosus, and Bulinus (B) tropicus, which act as intermediate host for S. haematobium. Design: Retrospective study. Setting: Busy canoe landing sites along Lake Victoria in Kigungu fishing village were selected for the snail sampling. Results: Nine thousand one hundred and ninety four B. choanomphala were collected over the study period. The numbers of B. choanomphala collected in each year was 4742 (51.6%) and 4452 (48.4%) in 2004 and 2005 respectively. Of the 4742 B.Choanomphala collected in 2004, 82 (1.7%) shed human cercariae and 329 (6.7%) shed non-human cercariae. Whereas in 2005, out of 4452 B. choanomphala collected 302 (6.85%) shed non-human cercariae and 82 (1.8%) shed human cercariae. Similarly, 4173 B. pfeifferi were also collected in the same period. Out of which 2224 (53.3%) were collected in 2004 and 1949 (46.7%) in 2005. For B. pfeifferi, 42 (1.9%) out of 2224 snails collected in 2004 shed human cercariae and 246 (11.1%) shed non-human cercariae. While in 2005, 33 out of 1949 snails (1.7%) shed human cercariae and 159 (8.2%) shed non-human cercariae. Other snails of medical importance collected included 292 B. globosus and 3094 B. tropicus. None of the Bulinus spp. collected shed any human cercariae but 37 (2.1%) and 30 (2.3%) B. tropicus shed non-human cercariae in 2004 and 2005 respectively. In 2004 and 2005, the area received, 1729mm and 1959mm of rainfall respectively. The mean rainfall during the year was 144.05 mm and 163.3 mm in 2004 and 2005 respectively. There was a negative correlation between rainfalls and snail density dynamic. Conclusion: We have found in this study that in spite of the bush clearing of the papyrus swamps which originally was the major habitats for B. choanomphala, B. pfeifferi and the Bulinus spp the intermediate host for schistosome at all canoe landing sites at Kigungu, these snails are still present. Moreover, that their population density dynamic and infection rate are inversely proportional to the rainfall pattern. East African Medical Journal Vol. 85 (11) 2008: pp. 556-56

Evidence for conservation in antigen gene sequences combined with extensive polymorphism at VNTR loci

Theileria parva is a tick‐transmitted apicomplexan protozoan parasite that infects lymphocytes of cattle and African Cape buffalo (Syncerus caffer), causing a frequently fatal disease of cattle in eastern, central and southern Africa. A live vaccination procedure, known as infection and treatment method (ITM), the most frequently used version of which comprises the Muguga, Serengeti‐transformed and Kiambu 5 stocks of T. parva, delivered as a trivalent cocktail, is generally effective. However, it does not always induce 100% protection against heterologous parasite challenge. Knowledge of the genetic diversity of T. parva in target cattle populations is therefore important prior to extensive vaccine deployment. This study investigated the extent of genetic diversity within T. parva field isolates derived from Ankole (Bos taurus) cattle in south‐western Uganda using 14 variable number tandem repeat (VNTR) satellite loci and the sequences of two antigen‐encoding genes that are targets of CD8+T‐cell responses induced by ITM, designated Tp1 and Tp2. The findings revealed a T. parva prevalence of 51% confirming endemicity of the parasite in south‐western Uganda. Cattle‐derived T. parva VNTR genotypes revealed a high degree of polymorphism. However, all of the T. parva Tp1 and Tp2 alleles identified in this study have been reported previously, indicating that they are widespread geographically in East Africa and highly conserved

FIGO postpartum intrauterine device initiative: Complication rates across six countries.

OBJECTIVE: To record and analyze complication rates following postpartum intrauterine device (PPIUD) insertion in 48 hospitals in six countries: Sri Lanka, India, Nepal, Bangladesh, Tanzania, and Kenya. METHODS: Healthcare providers were trained in counselling and insertion of PPIUD via a training-the-trainer model. Data were collected on methodology, timing, cadre of staff providing care, and number of insertions. Data on complications were collected at 6-week follow-up. Statistical analysis was performed to elucidate factors associated with increased expulsion and absence of threads. RESULTS: From May 2014 to September 2017, 36 766 PPIUDs were inserted: 53% vaginal and 47% at cesarean delivery; 74% were inserted by doctors. Follow-up was attended by 52%. Expulsion and removal rates were 2.5% and 3.6%, respectively. Threads were not visible in 29%. Expulsion was less likely after cesarean insertion (aOR 0.33; 95% CI, 0.26-0.41), following vaginal insertion at between 10 minutes and 48 hours (aOR 0.59; 95% CI, 0.42-0.83), and when insertion was performed by a nurse (aOR 0.33; 95% CI, 0.22-0.50). CONCLUSION: PPIUD has low complication rates and can be safely inserted by a variety of trained health staff. Given the immediate benefit of the one-stop approach, governments should urgently consider adopting this model

Knowledge, attitudes and practices of prevention of mother to child transmision of HIV among women in Laroo Division Gulu Municipality, Uganda

This study is exploring the knowledge, attitudes and practices of Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) among child bearing women aged between 15- 45 years old in Laroo division in Gulu municipality. The goal of the study was to determine the level of attitude as well as of knowledge and belief about PMTCT and proportion of women practicing it among the child bearing women of Laroo Division. The Cross-sectional and Descriptive study design was applied in multistage sampling method with random selection of a parish followed by random selection of a village within the parish from which a sample of homesteads was randomly selected. From each homesteads, a single respondent was randomly selected and registered in the study. Questionnaires were given to respondents that had consented to take part in the study. A total of 208 respondents were registered and interviewed in a period of February to march 2011. There were 165 (79.3%) of the mothers who had knowledge about various PMTCT methods. Of these 86(52%) heard about PMTCT first from hospital. 50 (30%) knew about exclusive breast feeding, while another 50(30%) use of ART, 45(27%) knew about replacement feedings and only 21(13%) knew of elective caesarean section as method of PMTCT. However the majority of the mothers 159(96.5%) thought that PMTCT was beneficial. Nevertheless some mothers thought that PMTCT causes various counter indications including infertility 17 (10.5%) and abnormalities in children at birth 27 (16.7). Their HIV serostatus also varied. Of the 135(81.7%) screened for HIV 42(31.2%) tested HIV positive and only 27 (64.2%) used contraceptives to prevent pregnancy while they were HIV positive. However of the correspondents who tested positive in their last HIV tests, the majority (83%) had had at least a pregnancy after testing HIV positive of which 6.8% did not practice PMTCT. Our study suggests evidence that Knowledge, attitude and practice of PMTCT among women of reproductive age in Laroo Division in Gulu municipality in Northern Uganda is adequate.Nevertheless with the infection rate of 31.2% among them points out that there is a substantial burden of HIV in the women community

Management of windbreaks in the Sahel: the strategic implications of tree water use

At sites in the Sahel where windbreaks are used to control wind erosion, management strategies are required to minimise competition for water between trees and crops. Uptake of water by windbreak trees was therefore studied in experiments designed to compare water use among tree species, assess which variables exert most control over transpiration and determine the source of water transpired by windbreak trees. Transpiration and soil-water extraction by Acacia nilotica, Acacia holosericea and Azadirachta indica trees in windbreaks were measured at the ICRISAT Sahelian Centre, Niger. Coupling of windbreaks to the atmosphere was evaluated and a stable isotope technique was used to compare utilisation of groundwater by windbreaks and crops at two sites in Niger with different water table levels. Azadirachta indica used least water, probably as a result of lower stomatal conductances, since windbreaks exhibited good physiological control over transpiration. The potential for competition for water was most severe with Acacia nilotica and Acacia holosericea, as they extracted large quantities of water through lateral roots, and at the location where trees could not access groundwater. At such sites, the effects of competition on crop productivity should be minimised by planting tree species with low water requirements and by using pruning to limit tree transpiratio

Induction of humoral immune response to multiple recombinant Rhipicephalus appendiculatus antigens and their effect on tick feeding success and pathogen transmission

BACKGROUND: Rhipicephalus appendiculatus is the primary vector of Theileria parva, the etiological agent of East Coast fever (ECF), a devastating disease of cattle in sub-Saharan Africa. We hypothesized that a vaccine targeting tick proteins that are involved in attachment and feeding might affect feeding success and possibly reduce tick-borne transmission of T. parva. Here we report the evaluation of a multivalent vaccine cocktail of tick antigens for their ability to reduce R. appendiculatus feeding success and possibly reduce tick-transmission of T. parva in a natural host-tick-parasite challenge model. METHODS: Cattle were inoculated with a multivalent antigen cocktail containing recombinant tick protective antigen subolesin as well as two additional R. appendiculatus saliva antigens: the cement protein TRP64, and three different histamine binding proteins. The cocktail also contained the T. parva sporozoite antigen p67C. The effect of vaccination on the feeding success of nymphal and adult R. appendiculatus ticks was evaluated together with the effect on transmission of T. parva using a tick challenge model. RESULTS: To our knowledge, this is the first evaluation of the anti-tick effects of these antigens in the natural host-tick-parasite combination. In spite of evidence of strong immune responses to all of the antigens in the cocktail, vaccination with this combination of tick and parasite antigens did not appear to effect tick feeding success or reduce transmission of T. parva. CONCLUSION: The results of this study highlight the importance of early evaluation of anti-tick vaccine candidates in biologically relevant challenge systems using the natural tick-host-parasite combination

Leishmania major infections in Phlebotomus duboscqi fed on murine models immunized with L. major subcellular antigens and sandfly gut antigens

The ability of antibodies in bloodmeals of mice and hamsters immunized with Leishmania major subcellular fractions and sandfly (Phlebotomus duboscqi) gut antigens to inhibit development of L. major in its vector P. duboscqi was examined. Antibodies from animals immunized with either L. major subcellular fractions alone or sandfly gut antigen alone were not very effective in inhibiting development of L. major in the sandfly. When P. duboscqi were fed on blood from animals immunized with both parasite flagella and sandfly gut antigen, development of L. major was significantly inhibited ( P<0.05). Control sandflies fed on naive animals displayed a normal pattern of parasite development to the metacyclic stage. Electron microscopy studies showed that one of the mechanisms through which antisandfly gut antibody can cause inhibition of parasite development is by lysing sandfly gut epithelium. This study has demonstrated that it is possible to reduce transmission of leishmaniosis through immunization against both the parasite and its sandfly vector.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.UNDP/WORLD BANK/WHO, Special Programme for Research and Training in Tropical Diseases. Kenya Medical Research Institute (KEMRI).mn201