Knowledge, perceptions and practices towards blood donation among undergraduate medical students in an upcountry Ugandan university: A mixed methods study.

BACKGROUND: Due to the different factors affecting the maintenance of a constant supply of human blood in health facilities, this study aimed at exploring the knowledge, perceptions, and practices towards blood donation among under graduate medical students at Busitema University Faculty of Health Sciences (BUFHS). METHODS: Using a convergent parallel mixed methods study design, 384 students were recruited into the study. Questionnaires and focused group discussions were used to collect the data. Stata version 15.0 and thematic analysis were used to analyze quantitative and qualitative data respectively. RESULTS: Of the respondents, 151 (39.4%) had ever donated blood and 50.4% had good knowledge about blood donation. The commonest motivating factor towards blood donation was "to save someone's life". Factors associated with practices towards blood donation included: religion, year 2 of study and prior blood donation history. Being Jehovah's Witness reduced the willingness to donate blood by 88% compared to other religions. Thematic analysis revealed four themes namely; students' experiences and thoughts, driving forces to donate blood, fears and misconceptions, and suggestions to increase blood donors. CONCLUSION: The proportion of undergraduate medical students who had adequate level of knowledge about blood donation was moderately high, however, some of their perceptions towards it were unconventional. To ensure safe and adequate blood supply, design of strategies and tailored programs that promote blood donation is highly recommended..

Acute and subacute toxicity profile of ethanolic stem bark extract of Albizia coriaria Welw. ex Oliv. in Wistar albino rats.

Albizia coriaria (Fabaceae) crude extracts are key ingredients of several licensed and unlicensed herbal products in East Africa. However, there is limited and often contradicting information regarding its toxicity. We therefore evaluated the acute and subacute toxicity of the ethanolic stem bark extract of A. coriaria in mature healthy Wistar albino rats following Lorke's method and OECD guidelines 407. The LD50 of the ethanolic stem bark extract of A. coriaria was 2000 mg/kg. The acute toxicity signs observed included piloerection, hyperventilation, lethargy, and loss of righting reflex. There was a significant increase in aspartate aminotransferase, alkaline phosphatase, red blood cells and haemoglobin in rats after 28 days at the dose of 500 mg/kg. Histological analyses revealed multifocal random parenchymal necrosis and scattered periportal mononuclear inflammatory cells infiltration in the liver, interstitial nephritis in the kidney and multifocal lymphoid accumulation in the peribronchiolar and perivascular lung tissue at 500 mg/kg. The ethanolic stem bark of A. coriaria was therefore moderately toxic to the rats when administered in a single high oral dose within 24 h. The extract caused a dose dependent toxicity with significant damage to the kidney, liver and lung tissues at a dose of 500 mg/kg after 28 days. Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of toxicity particularly at higher doses greater than 500 mg/kg.

Knowledge and attitude towards sickle cell anemia among care givers of paediatric sickle cell patients at a tertiary hospital in Eastern Uganda: a cross sectional study.

OBJECTIVE: To explore the knowledge and attitude towards sickle cell disease (SCD) among care givers of paediatric sickle cell patients at Mbale regional referral hospital in Eastern Uganda. METHODS: A cross sectional study was conducted at Mbale regional referral hospital. We used simple random sampling technique to recruit participants from among the care givers of pediatric sickle cell patients admitted at the hospital, administered questionnaires and conducted multivariable logistic regression to establish the association between the different factors. RESULTS: 372 respondents participated in the study, 82.26% of which were female. 57.80% of the respondents had ever heard of SCD/SCA. 36.02% were willing to stay in a relationship with their partner despite the risk of having a child with SCD/SCA. A multivariate analysis revealed that variables; "number of children", "children with sickle cell can cope with life" and "willing to stay in a relationship despite the risk of a having a child with sickle cell" were statistically significant. CONCLUSION: There was a high level of general awareness about SCD/SCA but comprehensive knowledge about its cause and prevention was low and the majority did not find a reason as to why it should influence their marital decisions. Inclusion of SCD/SCA in existing health education programs is highly recommended.

Sub-acute and sub-chronic toxicity assessment of the antimicrobial peptide Dermaseptin B2 on biochemical, haematological and histopathological parameters in BALB/c mice and Albino Wistar rats.

Background: Dermaseptins (Drs) are peptides found in the skin secretions of a variety of Hylid frogs, particularly those belonging to the Agalychnis and Phyllomedusa families. Dermaseptin B2 (Drs B2), an amphipathic, α-helical polypeptide was reported as the most active of the Dermaseptin B family. We have previously shown that Drs B2 has strong anti-proliferative activities against RD cells in vitro and thus required further evaluations for future medical applications. Aim: The aim the study was to evaluate the 14-day sub-acute and 90-day sub-chronic toxicities Drs B2 in vivo. Materials and Methods: BALB/c mice were treated with increasing concentrations of 5-25 mg/kg of Drs B2. Rats were treated with 2, 4 and 10-fold concentrations of the calculated LD50 of Drs B2 following OECD recommendations. At the end of the experimentation periods, the animals were sacrificed and dissected to collect blood and selected organs for analysis of any effects caused by Drs B2 treatment on the biochemical, haematological, and histological parameters. Results: The 14-day sub-acute toxicity tests did not cause significant alteration in the biochemical, hematological and histological parameters. The 90-day sub-chronic toxicity study showed lower ALT and AST than control at doses 1.9 mg/kg and 4.6 mg/kg, respectively. Their haematology results also showed higher platelet count than the controls but the differences were not statistically significant. Histological analysis showed increased megakaryocytes in the spleen for both the mice and the rats. Conclusion: The results of this study indicate that short term treatment of Drs B2 could be safe to the animals, however, long-term treatment can have mild effects on the liver parameters and cause an inflammatory response in the spleen.

Sickle cell trait screening in students in a Ugandan university: a cross-sectional study.

OBJECTIVE: To determine the uptake, knowledge level and attitude towards sickle cell trait screening in students aged 18 to 35 years in a Ugandan university. METHODS: This was a university-based, cross-sectional study of students aged 18 to 35 years who were students at the Busitema University Faculty of Health Sciences. We used a simple random sampling technique to recruit participants. We conducted multivariable logistic regression to establish the association between factors such as age, year of study, marital status and uptake of sickle cell trait screening (SCTS) services. RESULTS: A total of 315 students participated in the study. The uptake rate of SCTS was 24.4%. The knowledge level regarding sickle cell disease/SCTS was 93.7%, and 73.3% of respondents had a positive attitude towards SCTS, with a mean score of 23.32 ± 5.84. A multivariate analysis showed that those aged 25 to 29 years were 7.8 times more likely to have SCTS, while married respondents were 1.3 times more likely to be screened. CONCLUSION: The uptake of SCTS services was low relative to the total number of participants recruited in this study. Therefore, the uptake of SCTS needs to be encouraged in students at universities.

A qualitative exploration of Ugandan mental health care workers' perspectives and experiences on sexual and reproductive health of people living with mental illness in Uganda.

BACKGROUND: People with Mental Illness experience vast sexual and reproductive health challenges due to the affected mental health. Globally, prevalence of mental illness is on the rise with subsequent increase in the number of people with sexual and reproductive challenges warranting urgent public health intervention. However, information on the perceptions and experiences of mental health workers, the key health care providers for this population is generally lacking yet it's essential for formulation of appropriate policies and public health interventions. AIM: To explore Ugandan mental health care worker's perspectives and experiences on the sexual and reproductive health of people living with mental illness in Uganda in order to generate recommendations to the ministry of health on how it can be improved. MATERIALS AND METHODS: Qualitative study design was employed with utilization of phone call semi-structured in-depth interviews to collect data from 14 mental health workers from Uganda's National mental referral hospital, Butabika. Purposive sampling and convenience recruitment was done and the collected data was analyzed using Thematic content analysis. RESULTS: Four themes were generated which included people with Mental illness having normal sexual needs, mental illness effect on sexuality and relationships, practices for safeguarding sexuality of people with mental illness and the barriers encountered in the provision of sexual and reproductive health services at a mental hospital. CONCLUSION: People with mental illness experience a multitude of sexual and reproductive health challenges that need public health interventions. However, the integration of sexual and reproductive health services in a mental hospital are not yet successful making people with mental illness to remain with unaddressed health challenges. Policies should therefore be developed and implemented to ensure successful integration of sexual and reproductive health at all mental health service care provision points.

Sexual and reproductive health knowledge and practices among youth with and without mental illness in Uganda: a comparative study.

BACKGROUND: Sexual and reproductive health challenges among youth in low-income countries have persistently remained a public health challenge. In addition to these challenges, approximately 25% of youth experience a mental health illness, a situation anticipated to steeply increase especially in sub-Saharan Africa. However, there is still a scarcity of knowledge on the sexual and reproductive health of youth with mental illness in comparison to youth without mental illness in low-income countries. In this paper, the objective was to compare the sexual and reproductive health knowledge and practices among youth with mental illness and without mental illness at Mbarara Regional Referral Hospital (MRRH), South Western Uganda. METHODS: Using a cross-sectional comparative study design, 104 youth with mental illness and 101 youth without mental illness were recruited as they sought medical health care services at MRRH. Structured interviews were conducted and they covered sexual and reproductive health knowledge and sexual practices. RESULTS: 205 youth were interviewed and of these 53 males and 51 females had mental illness while 49 males and 52 females did not have a mental illness. More youth without mental illness (61.7%) had more knowledge of sexual and reproductive health compared to youth with mental illness (38.3%) with a prevalence odds ratio of 0.29 (CI 0.16-0.52) and p value of 0.001. All youth were knowledgeable about contraceptive methods. Youth with MI engaged more in risky sexual practices though the difference wasn't statistically significant. CONCLUSIONS: Youth generally have low sexual and reproductive health knowledge and this was found to be significantly lower in youth with mental illness compared to those without mental illness and they generally tend to engage in risky sexual behavior. It is recommended to incorporate SRH services among the mainstream general youth health care and mental health care services is critical to reducing sexual and reproductive health challenges among youth.

Sub-Acute Toxicity Effects of Methanolic Stem Bark Extract of Entada abyssinica on Biochemical, Haematological and Histopathological Parameters in Wistar Albino Rats.

Background: Whereas the efficacy of Entada abyssinica (fabaceae) extracts against various ailments has been scientifically validated, its safety has not been established. This study was undertaken to evaluate the toxicity effects of methanolic stem bark extract of E. abyssinica on biochemical, haematological and histological parameters of Wistar albino rats following repeated oral administration. Methods: Wistar albino rats of both sexes were randomized into groups and orally administered daily with determined doses (150, 300 and 600 mg/kg) of E. abyssinica methanolic extract using 1% tween 80 in distilled water as a control for 28 days. On the 29th day, all the animals were sacrificed and dissected to collect blood and selected organs. The serum and whole blood were assayed for biochemical and haematological parameters respectively while selected organs were examined for histopathological lesions. Numerical data was analyzed using graph pad prism and expressed as mean ± standard error of mean. The differences between the treatment and control groups were tested for statistical significance using one-way analysis of variance and/or Student's t-test. Results: In repeated daily oral doses (150, 300 and 600 mg/kg), the methanolic stem bark extract of E. abyssinica did not cause significant alteration in majority of the biochemical and hematological indices. However, the extract significantly elevated the level of uric acid (all doses), aspartate aminotransferase (300 and 600 mg/kg), low density lipoproteins (150 mg/kg) and mean corpuscular heamoglobin concentration (all doses). On the other hand, the extracts reduced high density lipoproteins (150 and 300 mg/kg), mean corpuscular volume (all doses), haematocrit (150 and 600 mg/kg), mean platelet volume (150 and 600 mg/kg) and procalcitonin (150 mg/kg). In the vital organs, there were no significant lesions observed except at the highest dose (600 mg/kg) where there was mild evidence of lymphocyte infiltration in the liver and focal interstitial nephritis. Conclusion: The methanolic stem bark extract of E. abyssinica is relatively safe in Wistar albino rats when repetitively administered orally in small doses for a prolonged period of time. We recommend more chronic toxicity studies and clinical trials on herbal remedies containing this plant to ensure that its use is free of potential toxicity to humans.

Annona muricata silver nanoparticles exhibit strong anticancer activities against cervical and prostate adenocarcinomas through regulation of CASP9 and the CXCL1/CXCR2 genes axis.

BACKGROUND: Green synthesized nanoparticles have been earmarked for use in nanomedicine including for the development of better anticancer drugs. OBJECTIVE: The aim of this study was to undertake biochemical evaluation of anticancer activities of green synthesized silver nanoparticles (AgNPs) from ethanolic extracts of fruits (AgNPs-F) and leaves (AgNPs-L) of Annona muricata. METHODS: Previously synthesized silver nanoparticles were used for the study. The effects of the AgNPs and 5-Fluorouracil were studied on PC3, HeLa and PNT1A cells. The resazurin, migration and colonogenic assays as well as qRT-PCR were employed. RESULTS: The AgNPs-F displayed significant antiproliferative effects against HeLa cells with an IC50 of 38.58µg/ml and PC3 cells with an IC50 of 48.17µg/ml but selectively spared normal PNT1A cells (selectivity index of 7.8), in comparison with first line drug 5FU and AgNPs-L whose selectivity index were 3.56 and 2.26 respectively. The migration assay revealed potential inhibition of the metastatic activity of the cells by the AgNPs-F while the colonogenic assay indicated the permanent effect of the AgNPs-F on the cancer cells yet being reversible on the normal cells in contrast with 5FU and AgNPs-L. CASP9 was significantly over expressed in all HeLa cells treated with the AgNPs-F (1.53-fold), AgNPs-L (1.52-fold) and 5FU (4.30-fold). CXCL1 was under expressed in HeLa cells treated with AgNPs-F (0.69-fold) and AgNPs-L (0.58-fold) and over expressed in cells treated with 5FU (4.95-fold), but the difference was not statistically significant. CXCR2 was significantly over expressed in HeLa cells treated with 5FU (8.66-fold) and AgNPs-F (1.12-fold) but under expressed in cells treated with AgNPs-L (0.76-fold). CONCLUSIONS: Here we show that biosynthesized AgNPs especially AgNPs-F can be used in the development of novel and better anticancer drugs. The mechanism of action of the AgNPs involves activation of the intrinsic apoptosis pathway through upregulation of CASP9 and concerted down regulation of the CXCL1/ CXCR2 gene axis.

Traditional Medicinal Uses, Phytoconstituents, Bioactivities, and Toxicities of Erythrina abyssinica Lam. ex DC. (Fabaceae): A Systematic Review.

BACKGROUND: Many studies have been undertaken on the medicinal values of Erythrina abyssinica Lam. ex DC. (Fabaceae). The details, however, are highly fragmented in different journals, libraries, and other publication media. This study was therefore conducted to provide a comprehensive report on its ethnobotany, ethnomedicinal uses, phytochemicals, and the available pharmacological evidence supporting its efficacy and safety in traditional medicine. METHOD: We collected data using a PROSPERO registered systematic review protocol on the ethnobotany, phytochemistry, and ethnopharmacology of Erythrina abyssinica from 132 reports that were retrieved from electronic databases. Documented local names, morphology, growth habit and habitat, ethnomedicinal and nonmedicinal uses, diseases treated, parts used, method of preparation and administration, extraction and chemical identity of isolated compounds, and efficacy and toxicity of extracts and isolated compounds were captured. Numerical data were summarized into means, percentages, and frequencies and presented as graphs and tables. RESULTS: Erythrina abyssinica is harvested by traditional herbal medicine practitioners in East, Central, and South African communities to prepare herbal remedies for various human and livestock ailments. These include bacterial and fungal infections, tuberculosis, malaria, HIV/AIDS, diarrhea, cancer, meningitis, inflammatory diseases, urinary tract infections, wounds, diabetes mellitus, and skin and soft tissue injuries. Different extracts and phytochemicals from parts of E. abyssinica have been scientifically proven to possess anti-inflammatory, antibacterial, antioxidant, antiplasmodial, antiproliferative, antifungal, antimycobacterial, antidiarrheal, anti-HIV 1, antidiabetic, and antiobesity activities. This versatile pharmacological activity is due to the abundant flavonoids, alkaloids, and terpenoids present in its different parts. CONCLUSION: Erythrina abyssinica is an important ethnomedicinal plant in Africa harboring useful pharmacologically active phytochemicals against various diseases with significant efficacies and minimal toxicity to mammalian cells. Therefore, this plant should be conserved and its potential to provide novel molecules against diseases be explored further. Clinical trials that evaluate the efficacy and safety of extracts and isolated compounds from E. abyssinica are recommended.

Viral load Suppression and Associated Factors among HIV Patients on Antiretroviral Treatment in Bulambuli District, Eastern Uganda: A Retrospective Cohort Study.

BACKGROUND: HIV viral load suppression (VLS) is the most important indicator of successful antiretroviral therapy. In 2016, Bulambuli District started monitoring HIV patients on ART using viral load tests in an effort to meet the third 90 of the UNAIDS 90-90-90 strategy which is VLS. The objective of this study was to determine the progress in Bulambuli District towards achievement of VLS among HIV infected patients on ART and associated factors that affect this programme. METHODS: A retrospective cohort study design was used. One thousand, one hundred and one medical records of HIV infected patients on ART who attended HIV clinic at Muyembe Health Centre IV from June 2016 to April 2018 were reviewed. A data abstraction tool was used for data collection. Chi Square was used to determine factors associated with VLS and logistic regression was used to determine the magnitude by which the ART and clinical factors influence VLS. Data were summarized using descriptive statistics for categorical variables and by computing proportions, means and standard deviation for continuous variables. RESULTS: Of the patients (n = 944, 85.7%) had attained VLS. Adjusting for known confounders, only adherence to ART was a significant predictor of VLS. Individuals with fair adherence (80%-95%) had 2.667 times the odds of VLS, CI = 1.122-9.370, P-value of <.002 compared to individuals with good (>95%) adherence which was used as the reference while those with poor (<80%) adherence had 4.553 times the odds of attaining VLS, CI = 1.31-13.930, P-value of <.001 compared to individuals with good adherence. CONCLUSION: These findings suggest that Bulambuli District, at 85.7% VLS is on track to attaining the third 90 of the 90, 90, 90 global targets by 2020. It further reveals that adherence is the only significant predictor of VLS in the District.

A Mathematical Model Approach for Prevention and Intervention Measures of the COVID-19 Pandemic in Uganda

The human-infecting corona virus disease (COVID-19) caused by the novel severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) was declared a global pandemic on March 11th, 2020. Current human deaths due to the infection have raised the threat globally with only 1 African country free of Virus (Lesotho) as of May 6th, 2020. Different countries have adopted different interventions at different stages of the outbreak, with social distancing being the first option while lock down the preferred option for flattening the curve at the peak of the pandemic. Lock down is aimed at adherence to social distancing, preserve the health system and improve survival. We propose a Susceptible-Exposed-Infected-Expected recoveries (SEIR) mathematical model to study the impact of a variety of prevention and control strategies Uganda has applied since the eruption of the pandemic in the country. We analyze the model using available data to find the infection-free, endemic/infection steady states and the basic reproduction number. In addition, a sensitivity analysis done shows that the transmission rate and the rate at which persons acquire the virus, have a positive influence on the basic reproduction number. On other hand the rate of evacuation by rescue ambulance greatly reduces the reproduction number. The results have potential to inform the impact and effect of early strict interventions including lock down in resource limited settings and social distancing.

Baseline Assessment of Risk Factors of Presumptive Tuberculosis among under Five Children Living with an Index Client under Treatment in Mbale District, Eastern Uganda.

BACKGROUND AND AIMS: Children in contact with adults having pulmonary Tuberculosis (TB) are vulnerable to TB infection and hence contact tracing and screening is important for early detection of infection. However, there are few contacts traced and the prevalence and risk factors for transmission are not well studied. The objective of this study was to determine the prevalence of infection and risk factors associated with TB transmission among under five children in household contact with adult pulmonary TB patients. MATERIALS AND METHODS: A cross sectional study was carried out in three health facilities with a high TB burden in Mbale District, Eastern Uganda involving all under five household contacts of adults with pulmonary tuberculosis recorded in the TB register from October 2018 to March 2019 and still on treatment. Structured questionnaires were administered to the index clients to obtain their demographic and clinical data about TB, HIV as well as information on the children. Children were screened using the intensive case finding forms to identify presumptive cases. RESULTS: The total number of index TB Clients line listed were 70. Number of clients traced was 38, 21 (%) of whom had children under five years and a total of 33 children were identified. The number of presumptive cases was 9/33 (27.27%). 77.8% of the presumptive cases were living in poorly ventilated houses. CONCLUSION: The study identified children with presumptive TB and various risk factors for TB transmission. Intensive contact tracing can therefore help reduce TB transmission within the communities. It is recommended to undertake studies aiming at improving contact tracing and strategies to eliminate the risk factors to TB transmission.

In search of new anticancer drugs: Data for cytotoxic activities of green synthesized silver nanoparticles from ethanolic extracts of fruits and leaves of Annona muricata and 5-Fluorouracil against HeLa, PC3 and PNT1A cell lines.

In this article, we present data on the anticancer activities of green synthesized silver nanoparticles (AgNPs) from ethanolic extracts of fruits (AgNPs-F) and leaves (AgNPs-L) of Annona muricata and standard anticancer drug 5-Fluorouracil (5-FU) on two cancer cell lines, i.e. cervical adenocarcinoma (HeLa cells) and prostate adenocarcinoma (PC3 cells) as well as on an immortalized normal prostate cell line, PNT1A. The cytotoxicity on the cells was determined by measuring the absorbance signal of resazurin dye. It has long been known that metabolically active cells change the resazurin from blue (oxidized) to red (reduced) forms, corresponding to the absorbance signals at a wavelength of 570nm (A570) and 600nm (A600) respectively, from which therefore the effects of any treatments on percentage cell viability/death can be elucidated. The raw data values of the treatments against the HeLa, PC3 and PNT1A cells are shown in the different Tables. Examples of how the data can be analyzed have been illustrated using different growth inhibition curves. The data can be used by academics, students, and researchers working on development of anticancer drugs.

Towards universal health coverage: Data for determinants of immunization coverage of Pneumococcal and Rota virus vaccines among under five children in Busolwe Town Council, Butaleja District, Eastern Uganda.

The data described stipulates the factors influencing the immunization coverage of Pneumococcal and Rota Virus Vaccines among under five children (U5C) in Butaleja district in Eastern Uganda. The data was obtained in three major sections of demographic characteristics, knowledge, and attitude and perceptions of care takers of U5C on immunization. Both qualitative and quantitative types of data obtained from Primary and Secondary data sources are presented. The Primary sources included administration of questionnaires to the caretakers of U5C in communities surrounding different health centers in Butaleja district. The secondary source of data was majorly the Health Management Information Systems (HMIS) records of Busolwe District Hospital. The data includes raw data from individual participants in form of Google forms portable document format, the consolidated raw data from all the participants in Microsoft excel format, as well as raw data from secondary HMIS record on immunization coverage in form of Microsoft excel format. The data provides a general outlook on the state of Butaleja district in terms immunization coverage of Pneumococcal and Rota Virus Vaccines. The data can be useful in taking action to decrease the burden of vaccine preventable diseases in Butaleja and elsewhere in similar settings. The data described is freely available in the Mendeley Data repository at the following site: https://doi.org/10.17632/zr2w886dg2.1 (Nabwana et al., 2019).

Advances in green nanobiotechnology: Data for synthesis and characterization of silver nanoparticles from ethanolic extracts of fruits and leaves of Annona muricata.

In this data article, data obtained from an efficient, eco-friendly and low-cost method for the synthesis and recovery of Silver nanoparticles (AgNPs) using ethanolic extracts of Annona muricata fruits and leaves as reducing, stabilizing and capping agents has been reported. 99.7% pure silver nitrate was used as the inorganic ion source. The data was obtained using different spectroscopic and microscopic techniques. The data is presented in form of images, Microsoft excel sheets, graphs,.raw files,.dpt files, PDF files, among others. Methods of analysis and interpretation of the data have also been presented. The data can be most useful to researchers, research students, industrialists and academicians to acquire knowledge on the green synthesis of AgNPs and related applications. The data is deposited in the Mendeley Data Repository as two independent datasets accessible at https://doi.org/10.17632/jkj2x782wh.1 Gavamukulya et al., 2019 and https://doi.org/10.17632/f4mb6b488n.1 Gavamukulya et al., 2019.

Prevalence and clinical outcomes of Plasmodium falciparum and intestinal parasitic infections among children in Kiryandongo refugee camp, mid-Western Uganda: a cross sectional study.

BACKGROUND: The prevalence of Plasmodium falciparum and Intestinal Parasitic Infections (IPIs) - with the corresponding pathogenesis among children remain uncertain. This study aimed at determining the prevalence and the outcomes (including anaemia) of the respective infections and co-infections. Anaemia is a condition in which the number of red blood cells transporting oxygen to the various body parts is not sufficient to meet the needs of the body. METHODS: This was a cross sectional study conducted among 476-refugee camp school children. Kato-Katz technique was used to screen stool samples for intestinal parasites. Microscopy was used for malaria testing while the portable Haemoglobin (Hb) calorimeter was used to measure haemoglobin concentration. RESULTS: The overall prevalence of the mixed infections was 63.03%. Plasmodium falciparum was most prevalent of the single infections 262(55.04%) followed by Taenia spp. 14 (2.9%), Schistosoma mansoni 12(2.5%), Giardia lamblia 7 (2.9%), Trichuris trichiura 2(0.4%), Hookworm 2(0.4%) and Strongyloides stercoralis 1(0.2%). The odds of developing simple or uncomplicated malaria infection or anaemia was 14 times higher in individuals with dual co-infection with Plasmodium falciparum + Taenia sp. compared to single parasitic infection (Odds = 14.13, P = 0.019). Co-infection with Plasmodium falciparum + Taenia spp, was a strong predictor of Malaria and anaemia. CONCLUSION: This study shows that Plasmodium falciparum and Taenia spp. co-infections is a stronger predictor of malaria and anaemia. The prevalence of malaria and anaemia remains higher than the other regions in Uganda outside restricted settlements. The findings of this study underline the need for pragmatic intervention programmes to reduce burden of the co-infections in the study area and similar settlements.

Socio-demographic Determinants of Vaccine Coverage for Pneumococcus and Rotavirus among under Five Children in Busolwe Town Council, Butaleja District, Eastern Uganda: A Cross Sectional Study.

BACKGROUND AND AIMS: There is a high burden of vaccine-preventable diseases in the children under five years of age, particularly pneumonia diarrhea and which is greatly affected by low immunization coverage despite the existing efforts and policies. This study was carried out in Butaleja district and was aimed at establishing the socio-demographic determinants of vaccine coverage for pneumococcus and rotavirus among under five children (U5C) in the district. STUDY DESIGN: This was a mixed methods cross-sectional study. PLACE AND DURATION OF STUDY: Busolwe Town Council, Butaleja District, Eastern Uganda. METHODOLOGY: Structured researcher administered questionnaires were administered to 434 caregivers of U5C in different parts of Butaleja district. In-depth interviews with key informants and focused group discussions with Village Health Teams and community members were conducted. Review of Health Management Information Systems records was done. STATA 15 was used to analyze the data. RESULTS: The study found that there is a declining trend in completion of the doses of Pneumococcal vaccine (PCV) and Rotavirus vaccine. For example, in quarter 1 of 2019, out of the 312 children who started immunization, only 2 completed Rota virus immunization and only 117 completed PCV vaccinations a trend that has been observed since 2016. The factors that showed a significant association with the the fact that they gave their child at least one dose of the vaccine were having been sensitized on the current immunisation schedule(P-value = <0.001), misunderstanding that vaccine is harmful for child (P-value = 0.007), willingness to take children to vaccination (P-value = <0.001), and social factors such as family (P-value = <0.030). Gender also played a key determinant role where the children's fathers lacked knowledge on significance of immunization and thus discouraged the mothers from taking the children for immunization. Inadequate funding was also highlighted from the Focus Group Discussions. CONCLUSION: Vaccine coverage for pneumococcus and rotavirus is still low in Butaleja district mainly due to the attitudes and perceptions of caregivers as well as the knowledge gap. There is need for extensive sensitization of all community members to enable them understand the significance of immunization. It would further be important to increase the funding of the immunization programme to intensify and ensure effectual outreaches as well as the establishment and enforcement of a policy for immunization compliance.

Annona muricata: Is the natural therapy to most disease conditions including cancer growing in our backyard? A systematic review of its research history and future prospects.

Annona muricata (A. muricata) is a tropical plant species belonging to family Annonaceae and known for its many medicinal uses. This review focuses on the research history of its traditional uses, phytochemicals, pharmacological activities, toxicological aspects of the extracts and isolated compounds, as well as the in vitro propagation studies with the objective of stimulating further studies on this plant for human consumption and treatment. A. muricata extracts have been identified in tropical regions to traditionally treat diverse conditions ranging from fever to diabetes and cancer. More than 200 chemical compounds have been identified and isolated from this plant, the most important being alkaloids, phenols and acetogenins. Using in vitro studies, its extracts and phytochemicals have been characterized as antioxidant, anti-microbial, anti-inflammatory, insecticidal, larvicidal, and cytotoxic to cancer cells. In vivo studies have revealed anxiolytic, anti-stress, anti-inflammatory, immunomodulatory, antimalarial, antidepressant, gastro protective, wound healing, hepato-protective, hypoglycemic, anticancer and anti-tumoral activities. In silico studies have also been reported. In addition, clinical studies support the hypoglycemic as well as some anticancer activities. Mechanisms of action of some pharmacological activities have been elucidated. However, some phytochemical compounds isolated from A. muricata have shown a neurotoxic effect in vitro and in vivo, and therefore, these crude extracts and isolated compounds need to be further investigated to define the magnitude of the effects, optimal dosage, and mechanisms of action, long-term safety, and potential side effects. Additionally, more clinical studies are necessary to support the therapeutic potential of this plant. Some studies were also found to have successfully regenerated the plant in vitro, but with limited success. The reported toxicity notwithstanding, A. muricata extracts seem to be some of the safest and promising therapeutic agents of the 21st century and beyond that need to be studied further for better medicinal formulations and diseases management.

Phytochemical screening, anti-oxidant activity and in vitro anticancer potential of ethanolic and water leaves extracts of Annona muricata (Graviola).

OBJECTIVE: To determine the phytochemical composition, antioxidant and anticancer activities of ethanolic and water leaves extracts of Annona muricata (A. muricata) from the Eastern Uganda. METHODS: Phytochemical screening was conducted using standard qualitative methods and a Chi-square goodness of fit test was used to assign the relative abundance of the different phytochemicals. The antioxidant activity was determined using the 2, 2-diphenyl-2-picrylhydrazyl and reducing power methods whereas the in vitro anticancer activity was determined using three different cell lines. RESULTS: Phytochemical screening of the extracts revealed that they were rich in secondary class metabolite compounds such as alkaloids, saponins, terpenoids, flavonoids, coumarins and lactones, anthraquinones, tannins, cardiac glycosides, phenols and phytosterols. Total phenolics in the water extract were (683.69±0.09) µg/mL gallic acid equivalents (GAE) while it was (372.92±0.15) µg/mL GAE in the ethanolic extract. The reducing power was 216.41 µg/mL in the water extract and 470.51 µg/mL GAE in the ethanolic extract. In vitro antioxidant activity IC50 was 2.0456 mg/mL and 0.9077 mg/mL for ethanolic and water leaves extracts of A. muricata respectively. The ethanolic leaves extract was found to be selectively cytotoxic in vitro to tumor cell lines (EACC, MDA and SKBR3) with IC50 values of 335.85 µg/mL, 248.77 µg/mL, 202.33 µg/mL respectively, while it had no cytotoxic effect on normal spleen cells. The data also showed that water leaves extract of A. muricata had no anticancer effect at all tested concentrations. CONCLUSIONS: The results showed that A. muricata was a promising new antioxidant and anticancer agent.