Profiling lifetime episodes of upper gastrointestinal bleeding among patients from rural Sub-Saharan Africa where schistosoma mansoni is endemic

© Christopher Kenneth Opio et al.Introduction: Severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis. Methods: Through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data. Results: From 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study. Conclusion: Upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research

Adverse impact of banana Xanthomonas Wilt on farmers’ livelihoods in Eastern and Central Africa

Banana is a key crop in the livelihoods of many people in the Great Lakes region of East and Central Africa. For more than a decade now, the crop has been threatened by Banana Xanthomonas Wilt (BXW) which has spread throughout the region but at different rates. The disease attacks all banana cultivars and can cause up to 100% yield losses at farm level if effective control measures are not put in place. However, limited information on impact of BXW at regional level is available to guide interventions. Thus, this study assessed the impact of BXW on farmers’ livelihoods in Kagera basin of Tanzania, Burundi and Rwanda. A total of 436 households (Tanzania 120, Burundi 208 and Rwanda 108) mostly from major banana-producing and BXW-affected districts were sampled and interviewed in a household survey. Thirty-three to seventy-five of the total banana mats per farm in the three countries were infected with BXW. Banana production losses caused by BXW were valued at US$10.2 million and US$ 2.95 million in Tanzania and Rwanda, respectively, banana sales by farmers dropped by 35% while bunch prices unpredictably doubled. Since banana is a key component of these farming communities, the banana production losses resulted in significant reduction in household food security and incomes. To cope with these challenges, most households are diversifying into other food crops such as maize, cassava and sweet potatoes. This poses a number of socio-economic and biological implications that require further investigation

Ebola Hemorrhagic Fever Associated with Novel Virus Strain, Uganda, 2007–2008

Case-fatality rate is lower for this strain than for the other 3 Ebola species known to be pathogenic to humans

Smallholder pig value chains transformation in Uganda: Results, lessons and insights

Irish Ai