Prevalence and genotyping of African swine fever virus in apparently healthy pigs in Masaka, Mukono and Kamuli Districts in Uganda

African swine fever (ASF) is a viral hemorrhagic disease associated with death in infected pigs. African swine fever virus (ASFV) is a DNA virus that circulates in blood and lymphoid system of the pigs causing disease. There are various reports on ASF outbreaks in the country with a few confirmed in apparently healthy pigs which pigs show no signs of infection. Therefore a survey of apparently healthy pigs was undertaken to show the extent they habour the antibodies and antigen of ASFV and later determine the genetic diversity of the virus ASF in Kamuli, Mukono and Masaka districts of Uganda using serological, molecular and genotyping techniques. In total 1,192 blood and sera samples were collected and analyzed. All the pigs tested except one (1/1192) were negative for (ASFV) and none for antibodies indicating that ASFV causes a paracute / acute infection in Ugandan pigs with rare detection of virus or antibodies in apparently healthy pigs. Therefore chronically infected pigs are unlikely to be important in the epidemiology of ASF. The positive pig in Kamuli district was infected with genotype IX, the most common circulating ASFV genotype in Uganda. With one positive pig for ASFV, it was not possible to authoritatively associate predictors of infection with disease in tested pig farms. It is thus recommended that these predictors of infection with ASFV are studied in future ASF outbreak areas where the virus or antibodies in pigs may occur in high prevalence

“I feel good when I drink”—detecting childhood-onset alcohol abuse and dependence in a Ugandan community trial cohort

Background Alcohol, substance use, and mental health disorders constitute major public health issues worldwide, including in low income and lower middle-income countries, and early initiation of use is an important predictor for developing substance use disorders in later life. This study reports on the existence of childhood alcohol abuse and dependence in a sub-study of a trial cohort in Eastern Uganda. Methods The project SeeTheChild—Mental Child Health in Uganda (STC) included a sub-study of the Ugandan site of the study PROMISE SB: Saving Brains in Uganda and Burkina Faso. PROMISE SB was a follow-up study of a trial birth cohort (PROMISE EBF) that estimated the effect that peer counselling for exclusive breast-feeding had on the children’s cognitive functioning and mental health once they reached 5–8 years of age. The STC sub-study (N = 148) used the diagnostic tool MINI-KID to assess mental health conditions in children who scored medium and high (≥ 14) on the Strengths and Difficulties Questionnaire (SDQ) in the PROMISE SB cohort N = (119/148; 80.4%). Another 29/148 (19.6%) were recruited from the PROMISE SB cohort as a comparator with low SDQ scores (< 14). Additionally, the open-ended questions in the diagnostic history were analysed. The MINI-KID comprised diagnostic questions on alcohol abuse and dependence, and descriptive data from the sub-study are presented in this paper. Results A total of 11/148 (7.4%) children scored positive for alcohol abuse and dependence in this study, 10 of whom had high SDQ scores (≥ 14). The 10 children with SDQ-scores ≥ 14 had a variety of mental health comorbidities of which suicidality 3/10 (30.0%) and separation anxiety disorder 5/10 (50.0%) were the most common. The one child with an SDQ score below 14 did not have any comorbidities. Access to homemade brew, carer’s knowledge of the drinking, and difficult household circumstances were issues expressed in the children’s diagnostic histories. Conclusions The discovery of alcohol abuse and dependence among 5–8 year olds in clinical interviews from a community based trial cohort was unexpected, and we recommend continued research and increased awareness of these conditions in this age group. Trial registration Trial registration for PROMISE SB: Saving Brains in Uganda and Burkina Faso: Clinicaltrials.gov (NCT01882335), 20 June 2013. Regrettably, there was a 1 month delay in the registration compared to the commenced re-inclusion in the follow-up study: https://clinicaltrials.gov/ct2/show/NCT01882335?term=saving+brains&draw=2&rank=1publishedVersio

Impact of participatory training on biosecurity protocols on the knowledge, attitudes and practices of smallholder pig farmers in Uganda

Irish Ai

Serological and molecular investigation for brucellosis in swine in selected districts of Uganda

Brucellosis is a notifiable zoonotic disease affecting livestock, humans and wildlife in Uganda. Human brucellosis cases are frequently reported and the increasing incidence is suggestive of increasing disease in the livestock population. Pigs are among the livestock species that can be infected with human pathogenic Brucella suis biovars 1 and 3 and can be a significant source of brucellosis for humans. Uganda has a rapidly growing pig population and the pork consumption per capita is the highest in East Africa. The objective of this work was to determine the seroprevalence of brucellosis in Ugandan pigs

Systèmes d’élevage porcin et cysticercose au nord de l’Ouganda

Rudimentary non-market-oriented pig rearing systems have been implicated in the persistence of Taenia solium cysticercosis, an endemic disease of high public health concern in Uganda. We investigated the seroprevalence and key predisposing factors of the disease in Moyo and Lira, two pig-producing districts in Northern Uganda. Cross-sectional serosurveys were conducted in 428 pig farms (Moyo, 262; Lira, 166). Farmers kept on average two adult pigs per herd. Tethering was a common practice in rural areas; free-ranging less so. Confinement of pigs in pens was characteristic of periurban farming systems. Pigs were mainly fed crop residues and forages in the rainy season, and swill and crop residues in the dry season. The majority of farmers of the survey were women (55%) above 45 years old, and 51% of farmers had attained primary school education. A total of 723 pig serum samples were collected, 403 in Moyo, and 320 in Lira. They were analyzed for Taenia spp. antigens using B158C11A10/B60H8A4 Antigen-ELISA. The overall animal seroprevalence of Taenia spp. serum antigen was 10.4% (95% confidence interval [CI]: 4.9–17.6), with 13.2% (95% CI: 7.1– 21.2) the highest in Moyo vs 6.9% (95% CI: 2.9–13.9) in Lira. The herd-level seroprevalence was estimated at 13.7% (95% CI: 9.8–18.5) in Moyo and 11.4% (95% CI: 7.0–17.2) in Lira. Out of 12 explanatory variables assessed for association with the observed seroprevalence, only the district of origin was significant (p = 0.01). Pigs originating from Lira were a protective factor against Taenia spp. cysticercosis (odds ratio: 0.54). These findings highlight the urgent need for an awareness campaign with prevention and control measures to minimize the risk of transmission to pork consumers in these districts

Health managers’ views on the status of national and decentralized health systems for child and adolescent mental health in Uganda: a qualitative study

Background: Robust health systems are required for the promotion of child and adolescent mental health (CAMH). In low and middle income countries such as Uganda neuropsychiatric illness in childhood and adolescence represent 15–30 % of all loss in disability-adjusted life years. In spite of this burden, service systems in these countries are weak. The objective of our assessment was to explore strengths and weaknesses of CAMH systems at national and district level in Uganda from a management perspective. Methods: Seven key informant interviews were conducted during July to October 2014 in Kampala and Mbale district, Eastern Uganda representing the national and district level, respectively. The key informants selected were all public officials responsible for supervision of CAMH services at the two levels. The interview guide included the following CAMH domains based on the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS): policy and legislation, financing, service delivery, health workforce, medicines and health information management. Inductive thematic analysis was applied in which the text in data transcripts was reduced to thematic codes. Patterns were then identified in the relations among the codes. Results: Eleven themes emerged from the six domains of enquiry in the WHO-AIMS. A CAMH policy has been drafted to complement the national mental health policy, however district managers did not know about it. All managers at the district level cited inadequate national mental health policies. The existing laws were considered sufficient for the promotion of CAMH, however CAMH financing and services were noted by all as inadequate. CAMH services were noted to be absent at lower health centers and lacked integration with other health sector services. Insufficient CAMH workforce was widely reported, and was noted to affect medicines availability. Lastly, unlike national level managers, lower level managers considered the health management information system as being insufficient for service planning. Conclusion: Managers at national and district level agree that most components of the CAMH system in Uganda are weak; but perceptions about CAMH policy and health information systems were divergent

Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

Background. Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle- income countries, but PHC providers have limited ability to detect CAMH disorders.We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda. Methods. Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n = 18) to control (n = 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher’s exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056). Results. Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1–18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics’ non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm, p = 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31–4.68); p = 0.005]. Conclusion. In this setting, mhGAP CAMH training of PHC providers increases PHC clinics’ identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance

The importance of on-farm biosecurity: Sero-prevalence and risk factors of bacterial and viral pathogens in smallholder pig systems in Uganda

Background The productivity of pigs in smallholder systems is affected by high disease burden, most of which might not be obvious, with their epidemiology and impact being poorly understood. This study estimated the seroprevalence and identified the risk factors of a range of bacterial and viral pathogens of potential economic and public health importance in domestic pigs in Uganda. A total of 522 clinically healthy pigs were randomly selected from 276 pig farms in Masaka (142) and Lira (134) districts of Uganda in 2015. Results Overall the highest animal prevalence was found for Streptococcus suis 73.0% (CI95: 67.0–78.3) in Lira and 68.2% (CI95: 62.7–73.4) in Masaka; followed by Porcine circovirus type 2 with 50.8% (CI95: 44.5–57.2) in Lira and 40.7% (CI95: 35.2–46.5) in Masaka and Actinobacillus pleuro-pneumoniae, 25.6% (CI95: 20.4–31.6) in Lira and 20.5% (CI95: 16.2–25.6) in Masaka. Mycoplasma hyopneumonia prevalence was 20.9% (CI95: 16.2–26.6) in Lira and 10.1% (CI95: 7.1–14.1) in Masaka, while Porcine parvovirus was 6.2% (CI95: 4.0–9.7) in Masaka and 3.4% (CI95: 1.7–6.6) in Lira. Less common pathogens were Influenza A, 8.5% (CI95: 5.6–12.8) in Lira and 2.0% (CI95: 0.9–4.5) in Masaka and Porcine Reproductive and Respiratory Syndrome Virus, 1.7% (CI95: 0.7–4.3) in Lira and 1.3% (CI95: 0.5–3.5) in Masaka. Even less common was Rotavirus A with 0.8% (CI95: 0.2–3.0) in Lira and 0.7% (CI95: 0.2–2.5) in Masaka; the same was for Aujeszky virus with 0.4% (CI95: 0.7–2.4) in Lira and 0.0% (CI95: 0.0-0.1) in Masaka. Co-infection with two pathogens was common and there was a significant association of M. hyo and PCV2 co-occurrence (p = 0.016). Multivariate analysis showed that for S. suis the use of disinfectant reduced odds of sero-positivitey (OR = 0.15; p = 0.017) and pigs less than 6 months were more likely to be infected than older pigs (OR = 3.35; p = 0.047). For M. hyo, crossbred pigs had higher odd of infection compared to local breeds (OR = 1.59; p < 0.001). Conclusions The studied pathogens have high prevalences in smallholder pig production systems and might be silent killers, thus affecting productivity and there is a possibility that some pathogens could spread to humans. Given the limited knowledge of veterinary workers and the poor diagnostic capacities and capabilities in these systems, the diseases are potentially usually under-diagnosed. These findings constitute baseline data to measure the impact of future interventions aiming to reduce disease burden in the pig production systems in Uganda