62 research outputs found

    Divergent climate smartness priority setting by practitioners vis-à-vis advisors: implications on inclusivity, one-health achievement, and enabling environment

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    By capturing the prioritization of 22 innovations by 71 farmers against those of advisors, this paper examines the level of awareness and contextualized conceptualization of 31 indicators of Climate Smartness Plus (equity, one health and enabling environment). Concordance analysis reveals differences in prioritization among farmers and agricultural advisors: with advisors giving relatively higher ratings as they set broader goals than farmers. We find that farmers give equal priority to productivity, adaptation, and mitigation while advisors overly prioritise productivit

    Entebbe Mother and Baby Study - Data at one year

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    Dataset and supporting documentation collected as part of the Entebbe Mother and Baby Study (EMaBS), a clinical trial that investigated potential benefits of treating worm infections during pregnancy and early childhood. The dataset contains variables collected from mothers (at registration) and infants (when the child was one-year of age), including maternal age, education, parity and infection status (malaria, S. mansoni, hookworm, filariasis), and infant sex and immune responses (to HiB, diphtheria, Hepatitis B, pertussis, FHA, pertactin)

    The impact of prenatal exposure to parasitic infections and to anthelminthic treatment on antibody responses to routine immunisations given in infancy: Secondary analysis of a randomised controlled trial.

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    BACKGROUND: Chronic parasitic infections are associated with active immunomodulation which may include by-stander effects on unrelated antigens. It has been suggested that pre-natal exposure to parasitic infections in the mother impacts immunological development in the fetus and hence the offspring's response to vaccines, and that control of parasitic infection among pregnant women will therefore be beneficial. METHODOLOGY/PRINCIPAL FINDINGS: We used new data from the Entebbe Mother and Baby Study, a trial of anthelminthic treatment during pregnancy conducted in Uganda, to further investigate this hypothesis. 2705 mothers were investigated for parasitic infections and then randomised to albendazole (400mg) versus placebo and praziquantel (40mg/kg) during pregnancy in a factorial design. All mothers received sulfadoxine/pyrimethamine for presumptive treatment of malaria. Offspring received Expanded Programme on Immunisation vaccines at birth, six, 10 and 14 weeks. New data on antibody levels to diphtheria toxin, three pertussis antigens, Haemophilus influenzae type B (HiB) and Hepatitis B, measured at one year (April 2004 -May 2007) from 1379 infants were analysed for this report. Additional observational analyses relating maternal infections to infant vaccine responses were also conducted. Helminth infections were highly prevalent amongst mothers (hookworm 43.1%, Mansonella 20.9%, Schistosoma mansoni 17.3%, Strongyloides 11.7%, Trichuris 8.1%) and 9.4% had malaria at enrolment. In the trial analysis we found no overall effect of either anthelminthic intervention on the measured infant vaccine responses. In observational analyses, no species was associated with suppressed responses. Strongyloidiasis was associated with enhanced responses to pertussis toxin, HiB and Hep B vaccine antigens. CONCLUSIONS/SIGNIFICANCE: Our results do not support the hypothesis that routine anthelminthic treatment during pregnancy has a benefit for the infant's vaccine response, or that maternal helminth infection has a net suppressive effect on the offspring's response to vaccines. TRIAL REGISTRATION: ISRCTN.com ISRCTN32849447

    Widespread exposure to Crimean-Congo haemorrhagic fever in Uganda might be driven by transmission from Rhipicephalus ticks: evidence from cross-sectional and modelling studies

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    BACKGROUND: Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral infection, present across Africa and Eurasia, which might pose a cryptic public health problem in Uganda. We aimed to understand the magnitude and distribution of CCHF risk in humans, livestock and ticks across Uganda by synthesising epidemiological (cross-sectional) and ecological (modelling) studies. METHODS: We conducted a cross-sectional study at three urban abattoirs receiving cattle from across Uganda. We sampled humans (n=478), livestock (n=419) and ticks (n=1065) and used commercially-available kits to detect human and livestock CCHF virus (CCHFV) antibodies and antigen in tick pools. We developed boosted regression tree models to evaluate the correlates and geographical distribution of expected tick and wildlife hosts, and of human CCHF exposures, drawing on continent-wide data. FINDINGS: The cross-sectional study found CCHFV IgG/IgM seroprevalence in humans of 10·3% (7·8-13·3), with antibody detection positively associated with reported history of tick bite (age-adjusted odds ratio=2·09 (1·09-3·98)). Cattle had a seroprevalence of 69·7% (65·1-73·4). Only one Hyalomma tick (CCHFV-negative) was found. However, CCHFV antigen was detected in Rhipicephalus (5·9% of 304 pools) and Amblyomma (2·9% of 34 pools) species. Modelling predicted high human CCHF risk across much of Uganda, low environmental suitability for Hyalomma, and high suitability for Rhipicephalus and Amblyomma. INTERPRETATION: Our epidemiological and ecological studies provide complementary evidence that CCHF exposure risk is widespread across Uganda. We challenge the idea that Hyalomma ticks are consistently the principal reservoir and vector for CCHFV, and postulate that Rhipicephalus might be important for CCHFV transmission in Uganda, due to high frequency of infected ticks and predicted environmental suitability. FUNDING: UCL Global Challenges Research Fund (GCRF) and Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET) funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) under the EU Horizon 2020 Framework Programme for Research and Innovation

    Feasibility and acceptability of undertaking postmortem studies for tuberculosis medical research in a low income country

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    IntroductionIf we are to break new ground in difficult-to-treat or difficult-to-vaccinate diseases (such as HIV, malaria, or tuberculosis), we must have a better understanding of the immune system at the site of infection in humans. For tuberculosis (TB), the initial site of infection is the lungs, but obtaining lung tissues from subjects suffering from TB has been limited to bronchoalveolar lavage (BAL) or sputum sampling, or surgical resection of diseased lung tissue.MethodsWe examined the feasibility of undertaking a postmortem study for human tuberculosis research at Mulago National Referral Hospital in Kampala, Uganda.ResultsPostmortem studies give us an opportunity to compare TB-involved and -uninvolved sites, for both diseased and non-diseased individuals. We report good acceptability of the next-of-kin to consent for their relative’s tissue to be used for medical research; that postmortem and tissue processing can be undertaken within 8 hours following death; and that immune cells remain viable and functional up to 14 hours after death.DiscussionPostmortem procedures remain a valuable and essential tool both to establish cause of death, and to advance our medical and scientific understanding of infectious diseases

    Entry stategies of new principals: Neophyte perceptions of becoming a secondary school principal in Cameroon

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    The dissertation inquired into new secondary school principal transition to the principalship in Cameroon and theories that will rationalize the findings. The sample of principals was obtained through snowballing. All principals were given a questionnaire to which they responded in the comfort of their homes. Quantitative and qualitative data were collected. The quantitative data were analyzed for central tendencies and dispersions in the taking-charge process. The qualitative data were coded in order to bring out themes in the taking-charge process. Both data were corroborated to establish commonalities in the entry strategies of new principals. Three strategies were discovered: First was strategic learning, which is ecological and has to do with finding out where a school is and where it should be. Learning, therefore, focuses on the discrepancy status of the school. This status in a way defines the specific role of the new principal in a school. Learning underscores the self-development of new principals. Learning challenges new principals to have feedback structures, to engage in professional development, and to rethink career advancement. Andragogical theory, an adult learning theory as opposed to pedagogy, explains the kind of learning that new principals should be engaged in. Change is a second strategy associated with doing the job of the principal. Change includes the planned activities by which a new principal closes the gap between where the school is and where it should be. The advantages of change as a taking-charge strategy are that change reinstates the principalship in its proper place, puts the responsibility of school improvement on the shoulders of principals, and reinforces the stance that school administration is a craft. Change challenges new principals to define their philosophy of education and to deinstitutionalize the responsibility for school change. Change agent role theory is a theory that makes change understandable. Vision is the third taking-charge strategy and it orients, integrates, and focuses the activities in the learning and change strategies. It is the strategy through which new principals craft the future of their school. It spells out the difference that the new principal wants to make in the school. As a management strategy vision has the advantage of defining the parameters of a new principal\u27s creativity, checking school stagnation, and facilitating decision making. A basic challenge that is inherent in vision is how to align the vision of the new principals with the vision of the school

    Determining Mycobacterium tuberculosis infection among BCG-immunised Ugandan children by T-SPOT.TB and tuberculin skin testing.

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    BACKGROUND: Children with latent tuberculosis infection (LTBI) represent a huge reservoir for future disease. We wished to determine Mycobacterium tuberculosis (M.tb) infection prevalence among BCG-immunised five-year-old children in Entebbe, Uganda, but there are limited data on the performance of immunoassays for diagnosis of tuberculosis infection in children in endemic settings. We therefore evaluated agreement between a commercial interferon gamma release assay (T-SPOT.TB) and the tuberculin skin test (TST; 2 units RT-23 tuberculin; positive defined as diameter ≥10 mm), along with the reproducibility of T-SPOT.TB on short-term follow-up, in this population. METHODOLOGY/PRINCIPAL FINDINGS: We recruited 907 children of which 56 were household contacts of TB patients. They were tested with T-SPOT.TB at age five years and then re-examined with T-SPOT.TB (n = 405) and TST (n = 319) approximately three weeks later. The principal outcome measures were T-SPOT.TB and TST positivity. At five years, 88 (9.7%) children tested positive by T-SPOT.TB. More than half of those that were T-SPOT.TB positive at five years were negative at follow-up, whereas 96% of baseline negatives were consistently negative. We observed somewhat better agreement between initial and follow-up T-SPOT.TB results among household TB contacts (κ = 0.77) than among non-contacts (κ = 0.39). Agreement between T-SPOT.TB and TST was weak (κ = 0.28 and κ = 0.40 for T-SPOT.TB at 5 years and follow-up, respectively). Of 28 children who were positive on both T-SPOT.TB tests, 14 (50%) had a negative TST. Analysis of spot counts showed high levels of instability in responses between baseline and follow-up, indicating variability in circulating numbers of T cells specific for certain M.tb antigens. CONCLUSIONS/SIGNIFICANCE: We found that T-SPOT.TB positives are unstable over a three-week follow-up interval, and that TST compares poorly with T-SPOT.TB, making the categorisation of children as TB-infected or TB-uninfected difficult. Existing tools for the diagnosis of TB infection are unsatisfactory in determining infection among children in this setting

    Occurrence and antibiotic susceptibility of fish bacteria isolated from Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish) in Uganda.

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    The intention of this study was to identify the bacterial pathogens infecting Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish), and to establish the antibiotic susceptibility of fish bacteria in Uganda. A total of 288 fish samples from 40 fish farms (ponds, cages, and tanks) and 8 wild water sites were aseptically collected and bacteria isolated from the head kidney, liver, brain and spleen. The isolates were identified by their morphological characteristics, conventOccurrence and antibiotic susceptibility of fish bacteria isolated from Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish) in Uganda.publishedVersio
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