The role of institutions as actors influencing Uganda’s cassava sector

We aim at mapping out a detailed framework that reveals the proportionate flow of cassava and its products along the value chain (VC). Furthermore, we aim at establishing the role of institutions and the linkages between institutions and other VC actors that influence the cassava VC in Uganda. We use both primary and secondary data obtained from four regions in Uganda. Results show that farmers, processors, transporters, traders, consumers and institutions are the major actors. There are four categories of institutions, viz, government, non-government, community based organisations and international agencies. Roles performed by institutions include: development and enforcement of policies, Research and Development (RD), capacity building, and creation of market access linkages for cassava and its products. Findings reveal that there is no clear nexus and no coordination among farmers/producers, processors, traders, transporters and consumers. However, institutions are well coordinated and play various roles along the VC to influence the dynamics of actors. Policy-wise it is important to establish strong private-public partnerships to bridge the impaired linkages between the actors (farmers/producers, processors, traders, transporters, and consumers) and institutions. Strong partnerships are envisaged to reduce the associated transaction costs amongst the actors

New sustainable approach to reduce cassava borne environmental waste and develop biodegradable materials for food packaging applications

This is a research article on transforming waste cassava into a sustainable resource that requires a new approach and redesign of the current processing methodologies.Transforming waste cassava into a sustainable resource requires a new approach and redesign of the current processing methodologies. Bitter cassava cultivars have been employed mainly as an emergency famine food, but could also be used as a value-added material for packaging. Processing of intact bitter cassava can minimize waste, and produce low-cost added value biopolymer packaging films for targeted applications. This study developed an improved simultaneous release, recovery and cyanogenesis (SRRC) downstream processing methodology for sustainable reduction of waste and development of film packaging material using intact bitter cassava. SRRC approach produced peeled (BP) and intact (BI) bitter cassava biopolymer derivatives. BI showed significantly higher yields ensuring 16% waste decrease with no environmental impact caused by discard residues. SRRC was very effective in reducing the total cyanogen content to within Codex minimum safety limits, demonstrating that the peeling of bitter cassava process can be avoided. Transparent films were produced using the casting method from both BP and BI derivatives. BI films were more transparent and homogeneous, less soluble, less permeable to moisture, less hydrophilic, more permeable to oxygen and carbon-dioxide, sealable, lower cost, than the BP. Hence, intact bitter cassava and SRRC can be used as sustainable, safe, integrative process solution for high value-added product (e.g., packaging film) production from low-cost biobased materials

COVID-19 vaccination hesitancy and associated factors among the business community in Lira City, Uganda: a cross-sectional research

Background: As of November 26, 2021, at least seven different vaccines across three platforms have been distributed globally. These vaccines include Pfizer/BioNTech released on December 31, 2020, AstraZeneca on February 16, 2021, Janssen by Johnson and Johnson on March 12, 2021, Moderna on April 30, 2021, Sinopharm on May 7, 2021, Sinovac CoronaVac on July 1, 2021, and COVAXIN on November 3, 2021. Despite this unprecedented scientific discovery, vaccine hesitancy is seen as a stumbling block towards achieving herd immunity in the battle to control this global pandemic. The effectiveness of vaccines has been based on the principle that the community was willing to take up the vaccine to achieve herd immunity. This study aimed to assess COVID-19 vaccination hesitancy and associated factors among the business community in Lira City, Uganda.Methods: Descriptive cross-sectional design was conducted among the business community from Lira City in Northern Uganda. The sample size was 421, however, only 407 members of the business community who responded were included in the analysis.Results: Of the 407 participants, 57.3% were females, 52.5% were married, 88.4% were Langi by Tribe, 43.5% had tertiary education, 33.4% were Anglicans, and 40.1% were market vendors. Results also show that about 32.3% of the respondents had either delayed or refused to take the COVID-19 vaccine. The correlates of vaccination hesitance were education level (aOR; 3.63, 95%CI; 1.49-8.79, p=0.04), having a chronic medical condition (aOR; 2.7, 95%CI; 1.39-5.38, p=0.04) and certainty in the COVID-19 vaccines (aOR; 0.27, 95%CI; 0.017-0.51, p=0.02). Respondents who had primary level education had a more than 2-fold increased odds of acceptance of COVID-19 vaccination compared to those who had not attained any formal education. Individuals who had chronic medical conditions had more than 2-fold increased odds of accepting the COVID-19 vaccine compared to those who did not have any chronic medical conditions. Those who were certain about the COVID-19 vaccine were 73% less likely to hesitate vaccination as compared to their counterparts who were uncertain. Conclusion: The study found a substantially high level of COVID-19 vaccination hesitancy in Lira City and its predictors were level of education, chronic medical conditions and certainty in COVID-19 vaccines. For this reason, it is important to raise awareness among the business community about the vaccine. To increase uptake, policymakers and other stakeholders need to create effective communication techniques for behavior change

Evaluation of novel bitter cassava film for equilibrium modified atmosphere packaging of cherry tomatoes

This is a research article on Equilibrium modified atmosphere packaging (EMAP) technology that offers the possibility to maintain produce postharvest quality and extend its shelf-life.Equilibrium modified atmosphere packaging (EMAP) technology offers the possibility to maintain produce postharvest quality and extend its shelf-life. However, EMAP stability depends on well-tuned packaging design parameters to match environmental conditions. This study defined the design requirements of a biobased film EMAP that can preserve the quality and prolong the shelf-life of fresh cherry tomatoes under recommended and simulated abuse supply chain conditions. Optimum EMAP was evaluated based on headspace gas composition at 10–20 °C, 75–95% RH and verified by determining quality changes of packed cherry tomatoes in using a continuous or micro-perforated (0.27 μm) bio-based intact bitter cassava (IBC) film. This was compared with a non-bio-based polymer film (oriented polypropylene, OPP). The IBC film attained equilibrium O2 (2–3%) after 180 h at 10 °C, with 0 and 1 perforation, for 75 and 95% RH while OPP film maintained a downward O2 fall. Continuous and micro-perforated IBC film did not show any major differences in equilibrium headspace O2, thus perforation can be neglected. Based on desirability optimisation results, biobased IBC film demonstrated a better optimized EMAP system in attaining recommended gas and stretching cherry tomato shelf-life as compared to non-biobased (OPP) film. The application of bio-based IBC film offers new possibilities in packaging fresh produce under an equilibrium modified atmosphere without compromising its quality

Novel Intact Bitter Cassava: Sustainable Development and Desirability Optimisation of Packaging Films

This is a research article on novel biomaterials and optimal processing conditions are fundamental in low-cost packaging material production.Novel biomaterials and optimal processing conditions are fundamental in low-cost packaging material production. Recently, a novel biobased intact bitter cassava derivative was developed using an intrinsic, high-throughput downstream processing methodology (simultaneous release recovery cyanogenesis). Processing of intact bitter cassava can minimise waste and produce low-cost added value biopolymer packaging films. The objective of this study was to (i) develop and characterise intact bitter cassava biobased films and (ii) determine the optimal processing conditions, which define the most desirable film properties. Films were developed following a Box-Behnken design considering cassava (2, 3, 4 % w/v), glycerol (20, 30, 40 % w/w) and drying temperature (30, 40, 50 °C) and optimized using multi-response desirability. Processing conditions produced films with highly significant (p < 0.05) differences. Developed models predicted impact of processing conditions on film properties. Desirable film properties for food packaging were produced using the optimised processing conditions, 2 % w/v cassava, 40.0%w/w glycerol and 50 °C drying temperature. These processing conditions produced films with 0.3 %; transparency, 3.4 %; solubility, 21.8 %; water-vapour-permeability, 4.2 gmm/m2/day/kPa; glass transition, 56 °C; melting temperature, 212.6 °C; tensile strength, 16.3 MPa; elongation, 133.3 %; elastic modulus, 5.1MPa and puncture resistance, 57.9 J, which are adequate for packaging applications. Therefore, intact bitter cassava is a viable material to produce packaging films that can be tailored for specific sustainable, low-cost applications

Cassava Biomaterial Innovations for Industry Applications

Breakthrough innovations can spur growth in the modern era industry to realise sustainability and high returns on investments. Nowadays, biobased innovations for application in diverse industry sectors are considered as future pillars to counter resource depletion and ensure positive environmental impacts. Cassava is a strong flagship biomaterial promoting solution for resource-efficient use and green environment. Innovative industrial application of cassava biomaterials enriches literature, presenting cassava as a versatile and unrivalled crop that is cardinal for more sustainable environment and biodegradable industrial products. Work on novel cassava biomaterials, which are low-cost, unexploited and with zero competition for food supply, are included. Using an integrated sustainable process, it shows how to indirectly reduce waste streams, through their effective use, guaranteeing zero carbon footprints and acting as a non-traditional strategy for equilibrium atmosphere and active packaging systems. Applications of Cassava biomaterial in food, as food supplements and in packaging systems are also covered in this chapter

Engineered food supplement excipients from bitter cassava for minimisation of cassava processing waste in environment

This is a research paper unchecked large-scale rudimentary upstream (submerged and solid-state fermentation processes of bitter cassava roots into alcohol have often contributed significantly to agricultural wastes in the environment.Unchecked large-scale rudimentary upstream (sub-merged and solid state) fermentation processes of bitter cas- sava roots into alcohol have often contributed significantly to agricultural wastes into environment. Thus, the study explored a proven valorisation methodology, Simultaneous Release Recovery Cyanogenesis (SRRC) along with intact bitter cassava polysaccharide-rich derivatives (CWF), as an apt to find alternative materials for food supplement excipients. Triplicate CWF powder, peeled or intact bitter cassava roots, were produced and analysed to determine crit- ical properties suitable in tablet making. Exclusion approach, using SRRC and compaction, was performed to select desired powder properties for tablet formulation. Microcrystalline cellulose, with known properties for developing drug excipients, was used as a validation reference material. Tablets, for disintegration time and in- vitro dissolution rates studies were produced using wet-granulation, and their potential to release and bio-avail Iron-Zinc investigated in-vitro (pHs 1.2 and 6.8 solutions, 37 0 C). Morphology and Iron-Zinc dissolution-release mechanisms were examined. Kinetic models were used to describe matrix dissolution and Iron-Zinc release mech- anisms. Intact root powder compaction capacity, depicted by hardness, was 4.3, 4.4 and 4.6 KG at 200, 500 and 700 MPa respectively. Scanning Electron Microscopy (SEM) showed Iron-Zinc inclusion altered tablet morphol- ogy. Efficient matrix dissolution and Iron and Zinc release were achieved, showing apex recovery efficiency (98%, 30–45 min). Fitted models well-explained dissolution and release mechanisms (mean R 2 = 0.95), demonstrating adequacy. SRRC-improved intact bitter cassava was confirmed as potential alternative excipient’s matrix for Iron and Zinc release and bioavailability. Thus, this approach is practical for indirect waste elimination, and can promote strategy for sustainable valorisation of agricultural wastes and alternative functional food supplements delivery system

Integrated process standardisation as a zero-based approach to bitter cassava waste elimination and widely-applicable industrial biomaterial derivatives

This is a research article on Integrated standardised methodology for biopolymer derivatives (BPD) production from novel intact bitter cassava was demonstrated by desirability optimisation of simultaneous release, recovery, cyanogenesis (SRRC) processIntegrated standardised methodology for biopolymer derivatives (BPD) production from novel intact bitter cassava was demonstrated by desirability optimisation of simultaneous release, recovery, cyanogenesis (SRRC) process. BPD were evaluated for yield and colour using buffer (0,2,4 % v/v), cassava waste solids (15,23,30 % w/w), and extraction time (4,7,10 minutes). Nearly all the root was transformed into BPD, with higher yield and colour in comparison to starch extrinsically processed. Maximum global desirability, predicted efficient material balance, buffer 4.0 %w/v, cassava waste solids 23 %w/w and extraction time, 10 minutes, producing BPD yield, 38.8 % wb Validation using buffer, 3.3% w/v, cassava waste solids, 30 % w/w and extraction time, 10 minutes, produced 40.7 % wb BPD. SEM, DSC, TGA, FTIR and moisture barrier analyses revealed a uniform microstructure and high thermal stability of BPD and film, thus demonstrating efficient performance of the standardised integrated methodology. Hence, processing intact cassava root as a standardised integrated methodology could be used to produce sustainable low cost BPD for a broad range of applications. Methodologies designed around standard integrated procedures, matching zero-based approach to contamination, are novel strategies, and if used effectively can eliminate cassava wastes and recover BPD resources as sustainable biomaterials

Effectiveness of the credit-line approach for support of CD4 equipment functionality in northern Uganda

This article examined the effectiveness of the credit-line approach in improving laboratory service delivery by using the functionality of CD4 test equipment as a proxy indicator.Background: Improving laboratory service delivery requires a functioning logistics and supply system. Uganda’s Ministry of Health uses the credit-line approach to provide laboratory supplies including commodities for CD4 test equipment. Objectives: We examined the effectiveness of the credit-line approach in improving laboratory service delivery by using the functionality of CD4 test equipment as a proxy indicator. Method: A cross-sectional survey was conducted at 7 level-three health centres (HC IIIs), 18 level-four health centres (HC IVs), and 10 hospitals in 15 districts of mid-northern Uganda, including the Lango (17 facilities) and Acholi sub-regions (18 facilities), between July 2013 and August 2013. Functionality, was determined through self- and interviewer-administered questionnaires. The chi-squared test was used to assess differences in functionality by sub-region, facility type, and equipment type. Results: A total of 38 CD4 test analysers were assessed. Of these, 26 (68%) were functional. In hospitals, 85% of CD4 analysers were functional, in HC IVs, 67% were functional and in HC IIIs, 43% were functional. The differences did not reach statistical significance. In the Lango sub-region, 72% of analysers were functional; in the Acholi sub-region, 65% were functional. Non-functionality was mainly due to lack of reagents and cartridges, as well as low staffing levels of laboratory technicians with the skills necessary to operate the equipment. Conclusion: The credit-line approach supported the functionality of CD4 equipment in the surveyed facilities. However, there is a need to address issues of staffing and availability of reagents to enhance the functionality of CD4 equipment and improve patient care, especially at HC IIIs

Adherence to Antiretroviral Prophylaxis for HIV Prevention: A Substudy Cohort within a Clinical Trial of Serodiscordant Couples in East Africa

Background: Randomized clinical trials of oral antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention have widely divergent efficacy estimates, ranging from 0% to 75%. These discrepancies are likely due to differences in adherence. To our knowledge, no studies to date have examined the impact of improving adherence through monitoring and/or intervention, which may increase PrEP efficacy, or reported on objective behavioral measures of adherence, which can inform PrEP effectiveness and implementation. Methods and Findings: Within the Partners PrEP Study (a randomized placebo-controlled trial of oral tenofovir and emtricitabine/tenofovir among HIV-uninfected members of serodiscordant couples in Kenya and Uganda), we collected objective measures of PrEP adherence using unannounced home-based pill counts and electronic pill bottle monitoring. Participants received individual and couples-based adherence counseling at PrEP initiation and throughout the study; counseling was intensified if unannounced pill count adherence fell to 80% adherence. Study limitations include potential shortcomings of the adherence measures and use of a convenience sample within the substudy cohort. Conclusions: The high PrEP adherence achieved in the setting of active adherence monitoring and counseling support was associated with a high degree of protection from HIV acquisition by the HIV-uninfected partner in heterosexual serodiscordant couples. Low PrEP adherence was associated with sexual behavior, alcohol use, younger age, and length of PrEP use. Please see later in the article for the Editors' Summar