Knowledge, Attitude and Practices towards Management of Diarrhea among Care takers of Children below 5 years attending Katoogo Health Centre III, Mukono District. A Cross-sectional Study.

Background:  The purpose of the study was to assess the knowledge, attitude, and practices towards the management of diarrhea among caretakers of children below five years attending Katoogo Health Centre III, Mukono district. The specific objectives of the study were to assess the; knowledge towards management of diarrhea among caretakers of children below five years, attitudes towards management of diarrhea among caretakers of children below five years, and practices towards management of diarrhea among caretakers of children below five years. Methodology:  The study employed a descriptive cross-sectional design with a simple random sampling technique as a sampling technique. Data were extracted from a sample of 50 respondents using semi-structured questionnaires written in the English language and analyzed manually by use of tally sheets, entered in the excel computer program to generate tables, graphs, and pie charts. Results: Overall results on practices towards management of diarrhea showed that; (60%) of respondents' children were not exclusively breastfed, (54%) of their children’s immunization cards were not up to date as per EPI guidelines, (and 58%) administered ORS to their children during an episode of diarrhea, (94%) keep solid wastes at home in open heap garbage places, (50%) sometimes they practice personal hygiene and (56%) visit the doctors when the child’s health does not improve. Conclusion: The researcher generally concluded that caretakers exhibited fairly pleasant knowledge and attitude towards management of diarrhea but poor practices were noticed which exposes their children to persistent diarrhea illness.  Recommendation: The researcher, therefore, strongly recommended that Katoogo Health Centre III should intensively promote health education on diarrhea not only on what is all about but majorly preventive practices on the occurrence since prevention is better than cure.

Teachers’ Pedagogical Intricacies in Handling Large Science Classes in Eastern Uganda

The introduction of Universal Primary Education (UPE) in Uganda in 1997 increased the number of students who join secondary education. The beginning of Universal Secondary Education (USE) in 2007 salvaged many learners who could not afford secondary education. This resulted in congested classrooms especially in government-aided schools. The study was prompted by the continued decline in student performance in sciences ever since USE was introduced in Uganda (UNEB, 2008 – 2016) and so the need to establish what really the problem was. A quantitative cross-sectional survey administered questionnaires to head-teachers, science teachers and students in 32 secondary schools in Eastern Uganda was done. The study investigated science teachers’ pedagogical innovative strategies used in teaching science in large classes. It also assessed how students cope with learning science concepts in congested classes. The results show that a majority of science teachers (84.8%) handle large classes in the same way they would do in classes with fewer learners. The students also continued to learn as if they were in an environment of fewer individuals in small classes (62.8%). This lack of sensitivity, creativity and innovations for large classes by science teachers could be the reason why comprehension of science concepts is low in a majority of learners in large USE classes, especially in rural secondary schools. The study recommends incorporation of interactive learner-centered science pedagogical approaches in teacher education programmes and endorsement of the TESSA approaches, use of OER and explicit attention to be given on how to facilitate active learner engagement in large and overcrowded science classrooms. Keywords: pedagogical innovation, creativity, large classe

Plants used to manage type II diabetes mellitus in selected districts of central Uganda.

Background: Chronic diseases such as diabetes mellitus are increasing in incidence in sub-Saharan Africa. African traditional medicine is part and parcel of the health care system in Uganda. Majority of the indigenous population will have visited a traditional health care practioner or self-administered herbal medicines before seeking conventional health care. However, documentation of the various medicinal plants is still lacking, necessitating a well-organized information search for such knowledge through research. Such information can lay a firm and clear foundation for scientific investigation of the purported therapeutic benefits of the said plants. The objective of this study was to collect names of medicinal plants used to manage diabetes mellitus type II in selected districts of central Uganda.Methods: In this ethnobotanical survey, names, of plants used to manage diabetes mellitus type II as well as the methods of preparation, routes of administration and the plant parts used in the districts of Mukono, Kampala, Wakiso and Masaka in the central region of Uganda were documented using a researcher administered questionnaire. Participants were recruited using a snow ball approach in which one individual directed us to another. Informant consensus was determined for each of the plants mentioned.Results: A total of 18 names of medicinal plants were recorded of which Aloe vera var, Solanum indicum and Vernonia amygydalina were the most commonly mentioned plants and thus had the highest informant consensus. Leaves were the main parts that were used to prepare the herbal medicine while water as the solvent used in all the preparations. In all the cases, only the oral route was used for administration of the medicines.Conclusion: Documentation of medicinal plants used to manage diabetes can further improve on the formalization process of the Ugandan traditional medicine system as well as lay a basis for further scientific investigation with emphasis on the plants whose informant consensus is high.Key words: Medicinal Plants, diabetes mellitus, Ugand

Evaluation of the American yam bean (Pachyrhizus spp.) for storage root yield across varying eco-geographic conditions in Uganda

Open Access Article; Published online: 15 June 2019The American yam bean (Pachyrhizus spp.) is a legume crop that is exclusively used for its storage roots. The seeds are inedible due to presence of toxic rotenone. It produces high storage root yields comparable of major root crops like cassava or sweetpotato. And flower pruning more than doubles its root yield performance. Using twenty five yam bean accessions, the current study aimed to determine root yield stability and adaptability, and presence of yam bean production mega environments in Uganda. Trials were planted at three stations, Namulonge, Serere, and Kachwekano during two consecutive seasons of 2011. Fresh storage root yields were significantly different (p < 0.05) across locations with the ideal location being Namulonge (fresh storage root yield of 10.1 t ha-1), followed by Serere (8.0 t ha-1), and Kachwekano (3.1 t ha-1). Results of AMMI analysis indicated the presence of genotype-by-environment interaction for fresh storage root yield. Through AMMI estimates and GGE visual assessment, genotype 209017 was the highest yielding with mean yield of 20.7 t ha-1. Genotype 209018 with mean yield of 15.5 t ha-1 was the most stable and adapted accession in the entire discriminating environment in Uganda. From the environmental focusing plot, the six environments were grouped into two putative mega environments for yam bean production

Proliferation and shoot recovery among the East African highland banana

Production of East African highland banana (EA-AAA banana) ( Musa spp.) is limited by scarcity of planting materials, attributable to their low natural proliferation ability. Under natural field conditions, the EA-AAA bananas greatly differ in suckering ability. In vitro micropropagation has been adopted as an alternative means for production of banana planting materials. In this study, the in vitro proliferation potential of seven EA-AAA banana cultivars, with different suckering ability was determined on Murashige and Skoog (MS) medium, to enhance development of micropropagation protocols for their multiplication. Commonly cultivated non EA-AAA banana cultivars were used to compare proliferation of the seven EA-AAA cultivars. There was a wide variation in the number and morphology of shoots and buds produced by the different cultivars. The EA-AAA banana cultivars produced 3-4 new shoots in each subculture cycle, and 57-169 recoverable shoots from one starting shoot-tip explant in 18 weeks. Non-EA-AAA banana cultivars, namely Sukali Ndizi (AAB) and Yangambi Km5 (AAA), showed higher proliferation levels, 5 and 9 shoots, from each subculture cycle and 322 and 352 recoverable shoots, respectively. The EA-AAA banana cultivars showed higher efficiency to produce recoverable shoots from shoot buds (53 - 66% except for cv. Kabula at 36%) compared to Sukali Ndizi (52%) and Yangambi Km5 (32%). The study demonstrates the potential of in vitro approach for production of banana planting materials. In vitro proliferation ability and in particualr efficiency to produce recoverable shoots of the different EA-AAA banana cultivars could be improved by varying the culture conditions during the subsequent subculture cycles.La production de la banane (EA-AAA banana) ( Musa spp.) dans les montagnes de l\u2019Afrique de l\u2019Est est limit\ue9e par le manque du mat\ue9riel de plantation suite \ue0 leur base capacit\ue9 de prolif\ue9ration. En conditions naturelles au champs, les bananes EA-AAA different consid\ue9rablement en leur capacit\ue9 de succion. La propagation in vitro a \ue9t\ue9 adopt\ue9e comme moyen alt\ue9rnatif pour la production du mat\ue9riel de plantation de la banana. Dans cette \ue9tude, le potentiel de prolif\ue9ration in vitro de sept cultivars de banana EA-AAA de capacit\ue9 de succion diff\ue9rente, \ue9tait d\ue9termin\ue9 sur les media de Murashige et Skoog (MS), afin d\u2019am\ue9liorer le d\ue9veloppement de protocoles de micropropagation pour leur multiplication. Des cultivars commun\ue9ment cultiv\ue9s autre que la banana EA-AAA \ue9taient utilis\ue9s pour faire la comparaison avec la proliferation des sept cultivars EA-AAA. Il y\u2019avait eu une large variation dans le nombre et la morphologie des pousses et bourgeons de diff\ue9rents cultivars. Les cultivars de bananes EA-AAA ont produit 3-4 nouvelles pousses dans chaque cycle de sous culture et 57-169 pousses recouvrables d\u2019un explant de pousse dans 18 semaines. Les cultivars de bananes non-EA-AAA nom\ue9ment Sukali Ndizi (AAB) and Yangambi Km5 (AAA), ont montr\ue9 de niveaux \ue9lev\ue9s de proliferation, 5 et 9 pousses de chaque cycle de sous culture et 322 et 352 pousses recouvrables, respectivement. Les cultivars de bananes EA-AAA ont montr\ue9 un niveau d\u2019efficacit\ue9 \ue9lev\ue9 quant \ue0 la production de de pousses recouvrables \ue0 partir de bourgeons (3566% except\ue9 pour cv. Kabula \ue0 36%) en comparaison avec Sukali Ndizi (52% et Yangambi km5 (32%). Cette \ue9tude d\ue9montre le potentiel de production du mat\ue9riel de plantation de la banana par l\u2019approche in vitro. La capacit\ue9 de proliferation in vitro et en particulier l\u2019efficacit\ue9 de produire de pousses recouvrables de diff\ue9rents cultivars pourrait \ueatre am\ue9lior\ue9 en variant les conditions de cultrure Durant les cycles sous culturales

Antiretroviral Choice for HIV Impacts Antimalarial Exposure and Treatment Outcomes in Ugandan Children.

BACKGROUND: The optimal treatment of malaria in human immunodeficiency virus (HIV)-infected children requires consideration of critical drug-drug interactions in coinfected children, as these may significantly impact drug exposure and clinical outcomes. METHODS: We conducted an intensive and sparse pharmacokinetic/pharmacodynamic study in Uganda of the most widely adopted artemisinin-based combination therapy, artemether-lumefantrine. HIV-infected children on 3 different first-line antiretroviral therapy (ART) regimens were compared to HIV-uninfected children not on ART, all of whom required treatment for Plasmodium falciparum malaria. Pharmacokinetic sampling for artemether, dihydroartemisinin, and lumefantrine exposure was conducted through day 21, and associations between drug exposure and outcomes through day 42 were investigated. RESULTS: One hundred forty-five and 225 children were included in the intensive and sparse pharmacokinetic analyses, respectively. Compared with no ART, efavirenz (EFV) reduced exposure to all antimalarial components by 2.1- to 3.4-fold; lopinavir/ritonavir (LPV/r) increased lumefantrine exposure by 2.1-fold; and nevirapine reduced artemether exposure only. Day 7 concentrations of lumefantrine were 10-fold lower in children on EFV vs LPV/r-based ART, changes that were associated with an approximate 4-fold higher odds of recurrent malaria by day 28 in those on EFV vs LPV/r-based ART. CONCLUSIONS: The choice of ART in children living in a malaria-endemic region has highly significant impacts on the pharmacokinetics and pharmacodynamics of artemether-lumefantrine treatment. EFV-based ART reduces all antimalarial components and is associated with the highest risk of recurrent malaria following treatment. For those on EFV, close clinical follow-up for recurrent malaria following artemether-lumefantrine treatment, along with the study of modified dosing regimens that provide higher exposure, is warranted

Artemether-Lumefantrine Pharmacokinetics and Clinical Response Are Minimally Altered in Pregnant Ugandan Women Treated for Uncomplicated Falciparum Malaria.

Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses between 30 pregnant women and 30 nonpregnant adults with uncomplicated Plasmodium falciparum malaria. All participants were uninfected with HIV, treated with a six-dose regimen of artemether-lumefantrine, and monitored clinically for 42 days. The pharmacokinetics of artemether, its metabolite dihydroartemisinin, and lumefantrine were evaluated for 21 days following treatment. We found no significant differences in the overall pharmacokinetics of artemether, dihydroartemisinin, or lumefantrine in a direct comparison of pregnant women to nonpregnant adults, except for a statistically significant but small difference in the terminal elimination half-lives of both dihydroartemisinin and lumefantrine. There were seven PCR-confirmed reinfections (5 pregnant and 2 nonpregnant participants). The observation of a shorter terminal half-life for lumefantrine may have contributed to a higher frequency of reinfection or a shorter posttreatment prophylactic period in pregnant women than in nonpregnant adults. While the comparable overall pharmacokinetic exposure is reassuring, studies are needed to further optimize antimalarial efficacy in pregnant women, particularly in high-transmission settings and because of emerging drug resistance. (This study is registered at ClinicalTrials.gov under registration no. NCT01717885.)

Spatial dynamics of malaria transmission

The Ross-Macdonald model has exerted enormous influence over the study of malaria transmission dynamics and control, but it lacked features to describe parasite dispersal, travel, and other important aspects of heterogeneous transmission. Here, we present a patch-based differential equation modeling framework that extends the Ross-Macdonald model with sufficient skill and complexity to support planning, monitoring and evaluation for Plasmodium falciparum malaria control. We designed a generic interface for building structured, spatial models of malaria transmission based on a new algorithm for mosquito blood feeding. We developed new algorithms to simulate adult mosquito demography, dispersal, and egg laying in response to resource availability. The core dynamical components describing mosquito ecology and malaria transmission were decomposed, redesigned and reassembled into a modular framework. Structural elements in the framework—human population strata, patches, and aquatic habitats—interact through a flexible design that facilitates construction of ensembles of models with scalable complexity to support robust analytics for malaria policy and adaptive malaria control. We propose updated definitions for the human biting rate and entomological inoculation rates. We present new formulas to describe parasite dispersal and spatial dynamics under steady state conditions, including the human biting rates, parasite dispersal, the “vectorial capacity matrix,” a human transmitting capacity distribution matrix, and threshold conditions. An package that implements the framework, solves the differential equations, and computes spatial metrics for models developed in this framework has been developed. Development of the model and metrics have focused on malaria, but since the framework is modular, the same ideas and software can be applied to other mosquito-borne pathogen systems

In-vivo Mathematical Modelling fo the Coinfection Dynamics of HIV-1 and HHV-8

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