Knowledge, attitudes, and adherence relating to COVID-19 and its prevention measures in high-risk districts of Uganda in 2020.

Introduction: COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. There were no licensed vaccines or explicit medicines available for treatment at the time of conducting this study. Public health and social measures (PHSM) have been widely adopted to reduce the transmission of COVID-19. Hence, assessing people's knowledge, attitudes, and adherence/practices related to the management of COVID-19 is crucial for identifying the factors that may promote or hinder adherence to the implementation of PHSM. Methods: We conducted a cross-sectional study in the Amuru, Kyotera, Wakiso, and Kampala districts of Uganda. We used a simple random sampling technique to select households and conducted face-to-face interviews in selected households. We administered questionnaires to respondents to assess the factors that promote or hinder adherence to and knowledge about PHSM implementation. We used a Likert scale to assess respondents' attitudes toward COVID-19. Results: Out of the 270 respondents, 54 (20%), 73 (27%), 42 (15.6%), and 101 (37.4%) were from the Kampala, Amuru, Wakiso, and Kyotera districts, respectively. Most of the respondents had adequate knowledge (72.2%), a high level of adherence (63.7%), and approximately 57.8% had good attitudes relating to COVID-19 and its prevention measures. An inferential analysis revealed that people from the Kampala district had higher chances (odds ratio = 4.668) of having a high level of knowledge compared to people from the Amuru district. It was also found that respondents who had a high level of (adequate) knowledge were twice as likely to have good attitudes compared to those with a low level of knowledge. In addition, people with good attitudes were 2.5 times as likely to adhere to the COVID-19 prevention measures compared to those with poor attitudes. Conclusion: Most respondents had limited knowledge though the majority of them had adopted practices to prevent the spread of COVID-19. Respondents with low knowledge of COVID-19 need to be targeted, to improve their attitude toward the disease and their adherence to safe prevention practices.

Employment status of AFROHUN-Uganda one health alumni, and facilitators and barriers to application of the one health approach: a tracer study.

BACKGROUND: The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers to application of the OH approach in their organisations. METHODS: We conducted an embedded mixed-methods study among a random sample of 182 AFROHUN-Uganda alumni of the 2013-2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis. RESULTS: While the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% had worked with their current employer for at least a year, and 39% held managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach. CONCLUSION: Notably, more than two-thirds of the OH alumni were employed, and more than a third held managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce.

Using the Kolb's experiential learning cycle to explore the extent of application of one health competencies to solving global health challenges; a tracer study among AFROHUN-Uganda alumni.

BACKGROUND: The Africa One Health University Network (AFROHUN) with support from the United States Agency for International Development (USAID), has since 2012 conducted pre and in-service One health (OH) trainings with the objective of improving global health security. These trainings aim to build competencies that, enhance a multidisciplinary approach to solving global health challenges. Despite the investment in OH trainings, there is limited documentation of the extent of acquisition and application of the OH competencies at workplaces. This tracer study explored the extent of acquisition and application of the OH competencies by the AFROHUN-Uganda alumni. METHODS: A cross-sectional study was conducted among a random sample of 182 AFROHUN-Uganda alumni of 2013-2018 cohorts. A blended approach of interviewer-administered and self-administered questionnaires was used. Virtual platforms such as Zoom, Microsoft teams, and Skype, and phone interviews were used to collect data when face-to-face interactions with alumni were not possible. Data were collected electronically, either through a link or with the aid of the KoboCollect mobile application, pre-installed on android enabled devices, and analysed using STATA14.0. RESULTS: The majority of respondents, 78.6% (143/182) had jobs that required application of OH knowledge and skills, 95.6% (174/182) had learned employable skills from OH activities and 89.6% (163/182) had applied such skills when searching for employment. About 21.7% (34/180) to a very high extent required OH field-specific theoretical knowledge at their workplaces, 27.4% (43/80) to a very high extent required OH field-specific practical knowledge/skills, 42.7% (67/180) to a high extent required a change in attitude and perceptions towards working with people from different disciplines, 49.0% (77/180) required collaboration and networking skills, and more than half, 51.0% (80/180) required team building skills. CONCLUSIONS: The majority of OH alumni to a very high extent acquired and applied OH competences such as teamwork, effective communication, community entry and engagement, report writing and problem-solving skills. This study revealed the significant contribution of the AFROHUN Uganda OH activities towards supportive work environments, and highlights areas of improvement such as supporting the trainees to acquire people-management skills, innovation, and an entrepreneurial mind set.

Lessons from a community based interdisciplinary learning exposure: benefits for both students and communities in Uganda.

BACKGROUND: Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles of One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities in the communities in a One Health approach. In this paper, we present students' experiences and their contributions to the communities of attachment. METHODS: This was a cross-sectional study, utilizing qualitative data collection methods. The study involved students who participated in the OHI field attachment and community members in a One Health demonstration site-Western Uganda. Four focus group discussions (FGDs) and four in-depths interviews (IDIs) were conducted among the students, while four FGDs and twelve IDIs were conducted among community members. All interviews were audio-recorded, transcribed and analysed manually. RESULTS: The four themes that emerged are: students' understanding and appreciation of One Health concept, their experiences and gains from the multi-disciplinary field attachment, students' contributions to the community, and challenges faced by the students. Students had good knowledge of One Health. They appreciated that health cannot be achieved by one discipline or sector and thus the need to collaborate across sectors. Regarding experiences and gains during the multi-disciplinary field attachment, the students appreciated that each discipline had a role to play in achieving health in the community. They appreciated the training citing skills gained in communication, team work and collaboration. They also reported a feeling of gratitude and accomplishment because they felt they made a positive change to the community by putting in place interventions to address some of the community challenges. Similarly, the communities appreciated the students' contribution in solving their health challenges, ranging from conducting health education to improving sanitation and hygiene. CONCLUSIONS: Through the OHI, students gained One Health competencies including communication, teamwork, and collaboration. Adopting an interdisciplinary model in university teaching system especially during field placement would strengthen skills of collaboration, team work and communication which are critical for a multi-disciplinary approach which is needed among the future workforce in order to solve the current health challenges.

Operationalizing the One Health Approach in Uganda: Challenges and Opportunities.

Uganda is considered as a 'hot spot' for emerging and re-emerging infectious disease epidemics. The country has experienced several epidemics including; Ebola, Marburg, plague, Rift Valley fever, yellow fever and Crimean Congo haemorrhagic fever. Epidemics overwhelm health systems, devastate economies and cause global health insecurity. These public health challenges arising from the interaction of humans-animals-environment link require a holistic approach referred to as One Health (OH). OH is the collaborative effort of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals, and the environment. Given its situation, Uganda has embraced the OH approach in order to be able to predict, prepare and respond to these public health challenges effectively, though still in infancy stages. In this paper, we present major achievements and challenges of OH implementation, and make recommendations for systematic and sustainable OH implementation. Achievements include: formation of the National One Health (NOH) platform with a Memorandum of Understanding between sectors; a national priority list of zoonotic diseases, the NOH Strategic Plan and a One Health communication strategy to strengthen engagement across sectors and stakeholders. There have also been efforts to integrate OH in academia. The challenges are related to inadequate; coordination across sectors, government commitment, advocacy and awareness creation and research. For systematic and sustainable OH engagements, urgent efforts should be made through government support to address current and related future challenges.

Application of one health approach in training at Makerere University: experiences from the one health workforce project in Uganda.

The interconnections of humans, domestic animals, wildlife and the environment have increasingly become complex, requiring innovative and collaborative approaches (One Health approach) for addressing global health challenges. One Health is a multidisciplinary and multi-sectoral collaborative approach to human, animal, plant and environmental health. The role of academia in training professionals oriented in One Health is critical in building a global workforce capable of enhancing synergies of various sectors in improving health. Makerere University, Uganda has implemented pre-service capacity building initiatives aimed to foster One Health competencies among students who are future practitioners. In addition to incorporating the One Health concept in didactic curricula, Student One Health Innovation Clubs, undergraduate field placements in 11 demonstration sites, graduate fellowships, small grants to support research and innovations, and cross-college collaborative training approaches have greatly aided the assimilation of One Health into the fabric of university offerings. Partnerships with government ministries, private sector and international agencies were initiated to benefit the students, as well as chart a path for experiential learning and in-service offerings in the future. One major challenge, however, has been the tendency to focus on infectious diseases, especially zoonoses, with less consideration of other health issues. The opportunity for improvement, nonetheless, lies in the increasing emerging and re-emerging health concerns including epidemics, environmental pollution and related challenges which justify the need for countries and institutions to focus on building and strengthening multidisciplinary health systems.

Milk Hygiene in Rural Southwestern Uganda: Prevalence of Mastitis and Antimicrobial Resistance Profiles of Bacterial Contaminants of Milk and Milk Products.

Mastitis and antimicrobial resistance are a big challenge to the dairy industry in sub-Saharan Africa. A study was conducted in Kashongi and Keshunga subcounties of Kiruhura District (in Uganda) where the government and private sector have deliberate programs to improve production efficiency, quality, and safety of milk and its products. The study aimed to determine the prevalence of mastitis, its common causative agents, antimicrobial sensitivity of mastitis causing organisms, and contaminants of processed milk products: yoghurt and ghee. Seventy-one milk, fourteen yoghurt, and three ghee samples were collected from nine farms. Of the 71 cows tested, 54 (76.1%) had mastitis. The mastitis cases from Keshunga were 32 (59.3%) and Kashongi contributed 22 (40.7%) of the cases. The common mastitis causative agents were Staphylococcus spp. (30.8%), Streptococcus spp. (12.3%), Corynebacterium spp.(15.4%), and E. coli (7.7%). Some of the isolates were resistant to tetracycline and penicillin. Prevalent contaminants of yoghurt were Staphylococcus spp. (8.3%), Streptococcus spp. (8.3%), Corynebacterium spp. (8.3%), and E. coli (8.3%), whereas all ghee contained Streptococcus spp. (100%). Prevalence of mastitis, antimicrobial resistance, and contamination of milk products are high in the study area. Targeted programs to prevent and control mastitis as well as antibiotic resistance are recommended.

Knowledge, attitudes and practices in tamarind (Tamarindus indica L) use and conservation in Eastern Uganda.

BACKGROUND: Tamarindus indica L is one of the indigenous fruit tree species that traditionally contributes to food security and ecosystem stability in sub-Saharan Africa. We hypothesized that the indigenous people of Eastern Uganda have used T. indica for generations and developed practices that promote its conservation and therefore we expected that they possess an elaborate indigenous knowledge (IK) system and that most of them have planted the species. The aim of this study was to assess the influence of IK, attitudes and practices on the use and conservation of T. indica. METHODS: A cross sectional survey was conducted in two districts purposively selected from the T. indica natural range. Focus group discussions, key informant interviews, semi-structured interviews and observation were used to collect data. Data was processed using qualitative analytical methods. RESULTS: Tamarindus indica was highly valued by the majority of the population. Tamarindus indica was used for food, medicinal, cultural, social, environmental amelioration and income generation purposes. The population possessed a high level of IK about T. indica evidenced by 18 categories of uses and multiple modes of use. Fruit pulp was the most commonly used tamarind product. Relative frequency of citation of the different uses provides insight into usage levels and IK possessed. The communities' food and medicinal uses concurred with scientific reports of health benefits of consuming T. indica. Approximately half of respondents had T. indica on their compounds or homegardens (53%). Fifty two percent of the tamarind population was self-propagated, 45% were planted while the propagation history for the remaining 3% was not known. Constraints towards planting T. indica included limited land, long maturation period and low monetary value. Fifty three percent of those who were growing T. indica did not carry out any silvicultural practices. The majority of T. indica encountered (87%) was intercropped with other crops or trees. Several beliefs and taboos regarding T. indica persist. CONCLUSION: Tamarindus indica has a high use value in the study area evidenced by multiple uses. Indigenous knowledge and uses concurred with scientifically proven nutritional and medicinal attributes of T. indica in literature which is significant given current trends towards affordable functional foods. The high level of IK has not translated into high rates of planting T. indica. There is need to encourage value-addition so as to maximize T. indica benefits and enhance conservation.

One Health capacity building in sub-Saharan Africa.

BACKGROUND: Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach. OBJECTIVES: The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world. METHODS: Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa. RESULTS: Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA). CONCLUSIONS: Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.

Human brucellosis: sero-prevalence and associated risk factors in agro-pastoral communities of Kiboga District, Central Uganda.

BACKGROUND: Brucellosis remains a neglected zoonotic disease among agro-pastoral communities where unprocessed milk and milk products are consumed. A cross-sectional study was carried out in Kiboga district to determine the seroprevalence and risk factors associated with human brucellosis in communities where livestock rearing in a common practice. METHODS: A total of 235 participants were involved in the study. Blood samples from the participants were collected and screened for Brucella using Serum Agglutination Test and Rose Bengal Plate Test. A questionnaire was used to collect data on socio-demographic characteristics and human brucellosis related risk factors. RESULTS: Human Brucella seroprevalence was at 17.0 % (n = 235). The prevalence was highest among males (20.5 %, n = 78) and the elderly - above 60 years (22.2 %, n = 18). Residence in rural areas (OR 3.16, 95 % CI: 1.16-8.56), consuming locally processed milk products (OR 2.54, 95 % CI: 1.12-5.78) and being single (OR 2.44, 95 % CI: 1.05-5.68), were associated with increased risk of brucellosis. DISCUSSION: Human brucellosis seroprevalence was high at 17 %, this was parallel with animal brucellosis prevalence that has been reported to range from 10.2 % to 25.7 % in cattle in the region. The participants were from communities known to habitually consume raw milk and milk products, know to process milk products using bare hands which are major risk factors for brucellosis in humans. This also explains why consumption of unpasteurized milk products was associated with the occurrence of brucellosis in study area. This strengthened the argument that humans get infected through consumption of contaminated animal products as reported in other earlier studies. Males and elderly being more affected because of traditional roles of these groups they play in livestock care and management. The single were also to be more associated to brucellosis, due to the fact that this group consume milk and milk products more as it is readily available in the informal markets as highly nutritious fast foods in this community as also observed in USA. CONCLUSIONS: Brucellosis is highly prevalent in Kiboga district, and therefore, an important public health problem. The transmission risk was aggravated by consumption of unpasteurized milk products, residing in rural settings and being single. There is a need to initiate screening, treat infected humans early, and educate the public about risk factors and appropriate preventive measures of brucellosis.

Comparative nutrient composition of selected wild edible mushrooms from two agro-ecological zones, Uganda.

In Uganda, wild mushrooms are mainly collected during the rainy season and valued as a traditionally nutritious food by the rural poor. However, their nutritional attributes have not been adequately studied and documented. Comparative nutrient composition of five wild edible mushroom species was determined, namely: P. tenucuilus, T. tyleranus, T. clypeatus, V. speciosa and T. microcarpus of sub-humid and humid agro-ecological zones. Standard analytical techniques following the AOAC were used for proximate and mineral contents determinations. Vitamins determination followed the established standard protocols of the laboratories where the analyses were conducted. Combined use of nutrient concentration and scores were used to compare the level of the contents in the mushroom species. Significant differences (p < 0.05) in nutrient values were demonstrated between and among the mushroom species obtained from the two agro-ecological zones. On dry weight basis, all proximate compositions were high in mushroom species obtained from the humid zone with exception of the total carbohydrates and energy values. Irrespective of the source of the mushrooms, significant amounts were demonstrated in protein, dry matter, ash and total carbohydrates ranging between 11.56-27.42%, 82.34-99.76%, 10.79-16.87%, and 37.12-61.05%, respectively. In comparison with recommended dietary daily intakes, the K, P, Se, Mn, Cu and Fe contents were relatively high with low Ca, Mg, Zn and Na. Thiamin, folic acid, vitamin C, and niacin levels were high but below the recommended FAO references. Considering mushrooms from different agro-ecological zones, significant differences (p < 0.05) were observed in all mushroom species in P except in T. clypeatus, T. tyleranus, T. microcarpus and T. clypeatus in potassium, T. clypeatus and T. microcarpus in Mg. Mushrooms from humid agro-ecological zones had relatively high overall mineral and vitamin supply potential. In conclusion, consumption of these mushrooms should be encouraged in supplementation of the staple food of the poor people. Hence, solving malnutrition problems in children, pregnant mothers, and the immune compromised patients such as the HIV/AIDs.

Characterization of the goat feeding system among rural small holder farmers in the semi-arid regions of Uganda.

Goats (Capra hircus) are widely distributed in Africa and Asia, and are important to the subsistence and economic livelihoods of many people in these areas. The goat feeding system among rural small holder farmers in Buyende district (Uganda) was characterised by determining the goat rearing practices, feed resources fed on by goats and availability of browse species mentioned by small holder farmers. Data was gathered using ethnobotanical and ecological approaches. Results from the ethnobotanical survey revealed that farmers were rearing indigenous goat breeds that are managed by tethering in natural pastures during the rainy season but free ranging during the dry season (i.e. when no crops are susceptible of damage). Major challenges facing goat production in the study area were diseases, shortage of land and inadequate pastures. The reduction of grazing land due to crop farming, has led to tethering of animals which in turn leads to restricted feeding. Goats were known to feed on 48 plant species distributed in 18 families and 39 genera dominated by trees and shrubs. Browse species were known to stay longer in the dry season when the grass and herbaceous species were no longer available. The most frequently mentioned browse species were Ficus natalensis, Harrisonia abyssinica, Acalypha psilostachya, Artocarpus heterophyllus and Lantana camara while Panicum maximum and Impeata cylindrica were the most mentioned herbaceous species. 31 browse species were encountered in the ecological survey. These were dominated by Combretum molle, L. camara, A. zygia, M. indica, and Albizia coriaria. In conclusion, the rearing practices of goats in Buyende district are comprised of indigenous goats tethered in natural pastures especially browses which stay longer through the dry season. However, most of the preferred browses are rare according to the computed IVI (i.e. less than 30%).

The burden and spatial distribution of bovine African trypanosomes in small holder crop-livestock production systems in Tororo District, south-eastern Uganda.

BACKGROUND: African animal trypanosomiasis (AAT) is considered to be one of the greatest constraints to livestock production and livestock-crop integration in most African countries. South-eastern Uganda has suffered for more than two decades from outbreaks of zoonotic Human African Trypanosomiasis (HAT), adding to the burden faced by communities from AAT. There is insufficient AAT and HAT data available (in the animal reservoir) to guide and prioritize AAT control programs that has been generated using contemporary, sensitive and specific molecular techniques. This study was undertaken to evaluate the burden that AAT presents to the small-scale cattle production systems in south-eastern Uganda. METHODS: Randomised cluster sampling was used to select 14% (57/401) of all cattle containing villages across Tororo District. Blood samples were taken from all cattle in the selected villages between September-December 2011; preserved on FTA cards and analysed for different trypanosomes using a suite of molecular techniques. Generalized estimating equation and Rogen-Gladen estimator models were used to calculate apparent and true prevalences of different trypanosomes while intra cluster correlations were estimated using a 1-way mixed effect analysis of variance (ANOVA) in R statistical software version 3.0.2. RESULTS: The prevalence of all trypanosome species in cattle was 15.3% (95% CI; 12.2-19.1) while herd level trypanosome species prevalence varied greatly between 0-43%. Trypanosoma vivax (17.4%, 95% CI; 10.6-16.8) and Trypanosoma brucei rhodesiense (0.03%) were respectively, the most, and least prevalent trypanosome species identified. CONCLUSIONS: The prevalence of bovine trypanosomes in this study indicates that AAT remains a significant constraint to livestock health and livestock production. There is need to implement tsetse and trypanosomiasis control efforts across Tororo District by employing effective, cheap and sustainable tsetse and trypanosomiasis control methods that could be integrated in the control of other endemic vector borne diseases like tick-borne diseases.

Improvements on restricted insecticide application protocol for control of Human and Animal African Trypanosomiasis in eastern Uganda.

BACKGROUND: African trypanosomes constrain livestock and human health in Sub-Saharan Africa, and aggravate poverty and hunger of these otherwise largely livestock-keeping communities. To solve this, there is need to develop and use effective and cheap tsetse control methods. To this end, we aimed at determining the smallest proportion of a cattle herd that needs to be sprayed on the legs, bellies and ears (RAP) for effective Human and Animal African Trypanosomiasis (HAT/AAT) control. METHODOLOGY/PRINCIPAL FINDING: Cattle in 20 villages were ear-tagged and injected with two doses of diminazene diaceturate (DA) forty days apart, and randomly allocated to one of five treatment regimens namely; no treatment, 25%, 50%, 75% monthly RAP and every 3 month Albendazole drench. Cattle trypanosome re-infection rate was determined by molecular techniques. ArcMap V10.3 was used to map apparent tsetse density (FTD) from trap catches. The effect of graded RAP on incidence risk ratios and trypanosome prevalence was determined using Poisson and logistic random effect models in R and STATA V12.1 respectively. Incidence was estimated at 9.8/100 years in RAP regimens, significantly lower compared to 25.7/100 years in the non-RAP regimens (incidence rate ratio: 0.37; 95% CI: 0.22-0.65; P<0.001). Likewise, trypanosome prevalence after one year of follow up was significantly lower in RAP animals than in non-RAP animals (4% vs 15%, OR: 0.20, 95% CI: 0.08-0.44; P<0.001). Contrary to our expectation, level of protection did not increase with increasing proportion of animals treated. CONCLUSIONS/SIGNIFICANCE: Reduction in RAP coverage did not significantly affect efficacy of treatment. This is envisaged to improve RAP adaptability to low income livestock keepers but needs further evaluation in different tsetse challenge, HAT/AAT transmission rates and management systems before adopting it for routine tsetse control programs.

Collateral benefits of restricted insecticide application for control of African trypanosomiasis on Theileria parva in cattle: a randomized controlled trial.

BACKGROUND: Tick and tsetse-borne diseases (TTBDs) constrain livestock production in tropical and subtropical regions of the world. Of this community of endemic diseases, East coast fever (T. parva) is the most important tick-borne disease (TBD) accounting for 70% of all losses due to TBDS in this region where control efforts target either tsetse or TBDs and seldom both. In those instances where simultaneous pyrethroid insecticide TTBD control is implemented, collateral benefits of tsetse control on TBD control have not been quantified. In the interest of guiding future TTBD control efforts, the effect of restricting pyrethroid insecticides to the legs, belly and ears (RAP) of cattle for tsetse and trypanosomiasis control on T. parva prevalence in crop-livestock production systems in Tororo district, south-eastern Uganda was determined. METHODS: We randomly allocated 16 villages to diminazene diaceturate (DA) and 3 graded RAP (25%, 50% and 75% of village herd sprayed respectively) treatment regimens. All cattle were ear-tagged, treated with diminazene diaceturate (DA) and those in regimens 2-4 received monthly graded RAP. Blood samples taken fourteen days post DA treatment and once three monthly were analysed by molecular techniques for T. parva. RESULTS: In total, 8,975 samples from 3,084 animals were analysed. Prevalence of T. parva varied between 1-3% in different treatment regimens. RAP regimens were associated with slightly lower average risk of infection compared to DA. However, the confidence interval was broad and the result was not statistically significant. There was no evidence of a dose response relationship between graded RAP and T. parva prevalence. These findings are discussed herein with regard to endemic stability development to different TBDs. CONCLUSIONS: We found only a slight effect of RAP on T. parva infection. Since sample size determination was based on trypanosomes incidence, the study was underpowered given the low T. parva prevalence. While the findings need to be confirmed in future studies, the observed slight reduction in the risk of infection with T. parva might not compromise endemic stability.

Prevalence and spatial distribution of Theileria parva in cattle under crop-livestock farming systems in Tororo District, Eastern Uganda.

BACKGROUND: Tick-borne diseases (TBDs) present a major economic burden to communities across East Africa. Farmers in East Africa must use acaracides to target ticks and prevent transmission of tick-borne diseases such as anaplasmosis, babesiosis, cowdriosis and theileriosis; the major causes of cattle mortality and morbidity. The costs of controlling East Coast Fever (ECF), caused by Theileria parva, in Uganda are significant and measures taken to control ticks, to be cost-effective, should take into account the burden of disease. The aim of the present work was to estimate the burden presented by T. parva and its spatial distribution in a crop-livestock production system in Eastern Uganda. METHODS: A cross sectional study was carried out to determine the prevalence and spatial distribution of T. parva in Tororo District, Uganda. Blood samples were taken from all cattle (n: 2,658) in 22 randomly selected villages across Tororo District from September to December 2011. Samples were analysed by PCR and T. parva prevalence and spatial distribution determined. RESULTS: The overall prevalence of T. parva was found to be 5.3%. Herd level prevalence ranged from 0% to 21% with majority of the infections located in the North, North-Eastern and South-Eastern parts of Tororo District. No statistically significant differences in risk of infection were found between age classes, sex and cattle breed. CONCLUSIONS: T. parva infection is widely distributed in Tororo District, Uganda. The prevalence and distribution of T. parva is most likely determined by spatial distribution of R. appendiculatus, restricted grazing of calves and preferential tick control targeting draft animals.

Ethnodiagnostic skills of the digo community for malaria: a lead to traditional bioprospecting.

Malaria is a major public health problem that is presently complicated by the development of resistance by Plasmodium falciparum to the mainstay drugs. Thus, new drugs with unique structures and mechanism of action are required to treat drug-resistant strains of malaria. Historically, compounds containing a novel structure from natural origin represent a major source for the discovery and development of new drugs for several diseases. This paper presents ethnophytotherapeutic remedies, ethnodiagnostic skills, and related traditional knowledge utilized by the Digo community of the Kenyan Coast to diagnose malaria as a lead to traditional bioprospecting. The current study was carried out in three Digo villages of Diani sub-location between May 2009 and December 2009. Data was collected using semi-structured interviews, and open and close-ended questionnaires. A total of 60 respondents (34 men and 26 women) provided the targeted information. The results show that the indigenous knowledge of Digo community on malaria encompasses not only the symptoms of malaria but also the factors that are responsible for causing malaria, attributes favoring the breeding of mosquitoes and practices employed to guard against mosquito bites or to protect households against malaria. This knowledge is closely in harmony with scientific approaches to the treatment and control of the disease. The Digo community uses 60 medicinal plants distributed in 52 genera and 27 families to treat malaria. The most frequently mentioned symptoms were fever, joint pains, and vomiting while the most frequently mentioned practices employed to guard against mosquito bites and/or to protect households against malaria was burning of herbal plants such as Ocimum suave and ingestion of herbal decoctions and concoctions. The Digo community has abundant ethnodiagnostic skills for malaria which forms the basis of their traditional bioprospecting techniques.