Geological Conditions and Petroleum Exploration Potential of the Albertine Graben of Uganda

The Albertine Graben in western Uganda is a Mesozoic-Cenozoic rift basin with petroleum exploration potential. A fundamental evaluation of petroleum potential of the graben is given based on field research, data processing of gravity and magnetism, analysis of graben structure, geochemistry, reservoir and composition research. The basin has a double-layered framework and a large thickness of sediments. Gravity highs shown in a residual anomaly map might indicate central uplift zones. There exist at least two sets of mature or low-maturity source rocks corresponding to a certain source rock in the Cretaceous or Paleogene and Neogene strata. The graben has basement rock with potential reservoirs and Tertiary sandstone reservoirs and thus has petroleum exploration potential.

Assessment of Cadmium and Lead in Dried Sewage Sludge from Lubigi Feacal Sludge and Wastewater Treatment Plant in Uganda

Sludge contains organic and inorganic compounds including traces of heavy metals such as lead (Pb), cadmium (Cd), copper (Cu), nickel (Ni), chromium (Cr) and others. These metals restrict the use of sludge in agriculture because their accumulation is harmful to the environment and particularly the food chain. Cadmium and lead are among the most common heavy metals found in municipal wastewater treatment plant sludge. They are capable of bioaccumulation in plant tissues like roots and leaves and are non-biodegradable and therefore they remain in the sludge which is disposed on land or used as fertilizers on farms. The presence of heavy metal pollutants serves as a great threat to soils and also makes plants grown on such soils unfit for animal and human consumption as they may have detrimental effects to animal and human life. For instance, Pb and Cd are known to be human carcinogens. This study therefore aimed to investigate the levels of Cd and Pb in the treated dry sludge from Lubigi Feacal Sludge and Wastewater treatment plant located in Kawempe division, Kampala city, Uganda so as to ascertain its safety for use on agricultural lands. Two batches of samples were collected and analyzed at Government Analytical laboratory in Wandegeya, Uganda. The acid digested sludge samples were analyzed using Atomic Absorption Spectroscopy (AAS) method. The average concentrations of Pb found in collected sludge samples, batch 1 (11.912 mg/kg dm) and batch 2 (5.304 mg/kg dm) were far below the Environment Protection Agency (EPA) maximum permissible concentration (840 mg/kg) for any land application. Cadmium was not detected in all the sludge samples collected;there is an implication that it is either completely absent in the sludge generated by the plant or present but far below detectable levels. The sludge generated from Lubigi fecal sludge and wastewater treatment plant is therefore safe for application on agricultural lands as far as Pb and Cd concentrations are concerned.

A Limited Dependent Variable Analysis of Integrated Pest Management Adoption in Uganda

Integrated Pest Management （IPM） technologies can reduce pest damage to crops by emphasizing non-chemical control methods thereby reducing potential negative effects of chemicals on the environment while preserving profitability. This study investigates the adoption of eight IPM practices including intercropping, crop rotation, two improved varieties, incorporating a ＂striga chaser＂ in sorghum production, changing planting dates, altering planting density and fertilizer use. Explanatory variables include economic factors, social factors, management factors, and institutional factors. Results were consistent across logit and ordered logit analyses. Most factors affecting adoption across all crops and technologies are economic factors, including labor availability, technology resource requirements, technology complexity, and the level of expected benefits. Social factors are generally less associated with IPM technology adoption than either market or institutional factors. Results indicate that the evaluated technologies were scale-neutral and that farmer age and education level did not affect technology adoption.

Water Resources of Uganda: An Assessment and Review

Water resources of a country constitute one of its vital assets that significantly contribute to the socio-economic development and poverty eradication. However, this resource is unevenly distributed in both time and space. The major source of water for these resources is direct rainfall, which is recently experiencing variability that threatens the distribution of resources and water availability in Uganda. The annual rainfall received in Uganda varies from 500 mm to 2800 mm, with an average of 1180 mm received in two main seasons. The spatial distribution of rainfall has resulted into a network of great rivers and lakes that possess big potential for development. These resources are being developed and depleted at a fast rate, a situation that requires assessment to establish present status of water resources in the country. The paper reviews the characteristics, availability, demand and importance of present day water resources in Uganda as well as describing the various issues, challenges and management of water resources of the country.

Contractor Monitoring and Performance of Road Infrastructure Projects in Uganda: A Management Model

An understanding of the influence of contractor monitoring on performance of road infrastructural projects in Uganda provided an impetus for this study. The objectives of the study were to: assess the relationship between contractors monitoring and performance of national road infrastructure projects and the relationship between contractor monitoring components and performance of national road infrastructure projects in Uganda. Purposive sampling was employed in selecting the procurement professionals, engineers and simple random sampling was adopted in selecting private consultants, members of parliament and respondents from the civil society organizations. Data for this study were collected using a closed ended questionnaire and interviews. Some of the major finding from this study include: weak procurement rules which lead to awarding road projects to incompetent contractors;contractor monitoring being handled by unqualified, incompetent and inexperienced professionals;lack of contractors and contract supervisors appraisal system;delay of contractors payments which affects timelines in services delivery;lack of a strong internal project monitoring and evaluation mechanism at the Uganda National Roads Agency (UNRA). The research therefore recommends the establishment of an Independent Public Infrastructure Development and Monitoring Unit by government and adoption of systems that appraise both contractors and contract supervisors with clear disciplinary actions for unsatisfactory performance by the UNRA.

Coping with Firewood Scarcity in Soroti District of Eastern Uganda

This study investigated how rural households cope with firewood scarcity in dryland areas of Eastern Uganda. A household survey was conducted in December 2008 to January 2009, where 490 respondents were randomly interviewed. Focus Group Discussions (FGDs) were also held with community elders and women. Responses were analyzed both descriptively and qualitatively. Findings indicated that 99% of the households used firewood for cooking with a per capita consumption of 542.32 Kilograms. Commonly used tree species included Combretnum molle (42.7%) and Acacia polyacantha willd (18.2%). Over 78% of the households have a preference for acacia tree species for firewood. In particular, Acacia polyacantha willd (60.3%), Acacia hockii (16.9%) and Combretum collinum (9.6%) were the most preferred tree species. The scarcity of firewood supply was eminent from the average distance (2 ± 7 Km) traveled by collectors in search of them. Firewood collectors spent 1 to 10 hours with an average of 3 hours weekly in firewood collection activities. This resulted in per annum estimated opportunity cost of Shillings 432,000 (US 232 dollars) for those who collected on weekly basis and Shillings 1,080,000 shillings (US 580 dollars) for those who collected on daily basis. The frequency of collection decreased as distance increased among 89% of the households. Minority of households (1%) have resorted to deliberately planting trees on their own farms to ease problems of firewood shortage, and to modification of biomass stove so as to use less firewood. Households in their endeavour to circumvent the problem of continued scarcity have resorted to poorer quality tree/bushes for firewood (71.2%), alongside other coping strategies such as cooking meals once a day, avoidance of cooking some food types (70%), and using crop residues as fuel source (60%). There is a need for scaling-up on-farm tree planting as well as the use of improved biomass cook stoves in the region.

An Appraisal of Adaptation Measures to Climate Variability by Smallholder Irish Potato Farmers in South Western Uganda

Climate change and variability are a reality and have had marked effects on both human and ecological systems. Adaptation to such effects either directly or indirectly is viewed as a novel way of reducing the spread of the associated risks. The study was conducted in Rubanda District with a general aim of evaluating the effectiveness of adaptation measures to climate variability used by smallholder Irish potatoes farmers. Specifically, we sought to appraise small-holder Irish potato farmers’ perceptions about the effectiveness of climate variability adaptation measures and implications on Irish potato productivity. We undertook a cross-sectional study to collect data from total of 197 farmers using a structured questionnaire. Other participatory methods such as focus group discussions and key informant interview were also used to complement the household survey. Data were analyzed using SPSS Version 23 to generate descriptive statistics as well as relationships between the adaptation measures and the productivity of the Irish potatoes using a Cobb-Douglas production function. The Cobb-Douglas model revealed that the use of fertilizers was significantly and positively associated with productivity of Irish potato (P < 0.001). Furthermore, Smallholder Irish potato farmers perceived the use of technology, terracing, early planting and application of fertilizers as the most effective climate variability adaptation measures. The study recommends that measures that are cost-effective, efficient and coherent should be promoted to offset the impacts of climate variability which would include the adoption of improved potato varieties and use of fertilizers with proper management of erosion. Off-season planting of Irish potatoes in the wetlands should be discouraged by the local administration and the National Environment Management Authority. This calls for a collective action involving the agricultural practitioners and inline civil society organizations to ensure that farmers have access to such inputs.

Drivers of Fuel Choice for Cooking among Uganda’s Households

This paper examines the factors that Uganda’s households consider when making fuel choices for cooking and investigates the key drivers of fuel choice. The study adopts a quantitative cross sectional research design. The dependent variable of the empirical model is a qualitative response variable which defines three mutually exclusive and highly differentiated discrete choices for cooking fuels, namely: the traditional fuel (firewood), the transitional fuel (charcoal), and the modern (LPG & electricity). Results from the study show that the most important drivers of fuel choice for cooking in Uganda’s households are: household income, age of household head, gender of household head, marital status, education levels of household head and location of a household. Results also reveal high dependency of firewood as cooking energy source among households in Uganda.

Firm Risk Profile, Agency Incentives and Corporate Performance： Corporate Governance Perspective of Uganda

This paper focuses on the relationship between firm risk profile, agency incentives and corporate performance using correlation study and cross-sectional approach. We conceptualise firm risk profile using the balanced score card and differ from previous studies, on the above variables, by capturing the perceptual sets of strategic leadership of Ugandan firms who are members of corporate governance of Uganda. We post a significant negative relationship between firm risk profile and corporate performance, a significant negative relationship between firm risk profile and agency incentives and a positive relationship between agency incentives and corporate performance By employing Joseph and Scott （2006）＇s utilization of the balanced score card to identify the four forms of firm risk （namely, financial, customer, internal and learning and growth risks）, our results support the application of agency theory as a relevant theoretical framework for dealing with managers who are risk averse.

Climate Variability and Soil Nutrients Status along Altitudinal Gradient in Kigezi Highlands, Southwestern Uganda

Kigezi highlands currently experiences changes in precipitation and temperature which modify the evaporation and soil moisture storage leading to alterations in runoff and other components of hydrological systems. Extreme events, like floods and droughts, are more intense and frequent. Furthermore heavy unpredictable rainfall has become frequent in the area, causing soil erosion and floods that destroy crops. Soil erosion is particularly a pressing challenge due to steep-sided hills leading to deterioration of soil nutrients including soil fertility. The unpredictable rains and droughts are attributed to climate change and variability. Consequently, climate change and variability have caused a significant impact on soil nutrients which have affected the agricultural productivity in the area. This paper presents findings of empirical study which explored the climate variability and soil nutrient status along altitudinal gradient. The paper particularly addresses key questions of: land management practices in the study area, nutrient availability and their effects on productivity of selected crops along altitudinal gradient in changing climate and variability. Independent variables such as topographic sequence along altitudinal gradient were evaluated against dependent variables such as yield harvests of selected grown crops and soil nutrients. Samples for crop yields were collected along transect of 0.5 kilometer using a quadrant of 4 × 4 m2 along attitudinal gradient. Soil samples were taken from selected plots at 0-20cm soil depth for nutrient analysis. Analysis of physical and chemical soil parameters was carried out on soil samples and these include: soil pH, soil organic content, total nitrogen, available soil phosphorous and exchangeable bases (Ca, Mg, K and Na). The study showed that middle parts of the transects had the highest concentration of most soil nutrients, probably because the middle parts could have been a deposition centre for some organic matter from the upper parts of the hills, and lower lying areas were being affected by floods that affects the decomposition of organic matter which is the main source of nutrients. Similarly, the middle parts of the study were the most fertile due to the high concentration of soil nutrient compositions. This indicates that crop yields were significantly affected by availability of soil nutrients along same gradient, attributable to the severity in soil erosion, nutrients leaching and farming practices.

Productivity and energy balance of forest plantation harvesting in Uganda

The study evaluated the productivity and energy balance of the harvesting and the extraction of wood in plantation of exotic tree species, i.e., Pinus patula （Schiede ex Schlectendahl et Chamisso） and Cupressus lusitanica （Mill.）. The harvesting and extraction operations concerned clear-cut felling on two different types of terrain （gentle and steep terrain） and two levels of prun- ing. The results show that cutting is not affected by the terrain gradient whereas the pruning condition shows a significant effect on the delimbing operation. The productivity of cutting is evaluated at 28.1 m3.d-1 for unpruned trees and at 30.2 m3.d t for pruned trees. For the extraction phase, rolling was significantly affected by terrain conditions. On steep terrain, the gross productivity can be evaluated at 22.5 m3.d 1 for an extraction distance of 40 m, while for the same distance on gentle terrain the productivity decreases to 14.1 m3.d~. As a result, the steep terrain condition showed higher energy efficiency, suggesting that it is the more efficient system of extraction. The productivity model and the energy balance resulting from the study provide a better understanding of the variables af- fecting motor-manual cutting and rolling extraction in exotic plantations in Uganda.

Hematology and blood serum chemistry reference intervals for children in Iganga district of Uganda

In this study, normal ranges for hematology and serum biochemistry in children aged 1 to 5 years inUgandawere determined. By a cross-sectional study, 1168 children from Iganga, a prospective site for clinical trials in Uganda, were screened. From 1168 households, 460 children were selected for enrollment, while 600 (58%) were excluded because of either a history of fever in the previous 24 hours, presence of asexual malaria parasites in the peripheral blood or presence of fever. Accordingly, 460 children (39.4%) of median age = 3 years were enrolled in the baseline study. While the lower limits of hemoglobin, hematocrit levels, mean corpuscular volume and platelet counts for the Ugandan children were found to be less than conventional reference values of Caucasisan children, the white blood cell count reference values were higher than the international intervals. On the other hand, the upper limits of the reference intervals for serum transaminases, bilirubin, creatinine, urea, total protein and albumin in sera of the Ugandan children were higher than the corresponding values for a Caucasian pediatric population. This study showed that, if hematology test results of the Ugandan children were assessed against “imported” international reference values, up to 44.6% of the study participants would have been excluded from clinical trials or would have been reported as adverse events in such trials. The present study was not only the first report of serum biochemistry reference ranges for children aged one to five years in Uganda but also one of very few such studies in Africa.

Infraspecific Delimitation of <i>Acacia senegal</i>(Fabaceae) in Uganda

The wide variation in Acacia senegal has presented taxonomic uncertainties and unresolved contradictions in previous studies. In this study numerical taxonomic principles and multivariate analysis (UPGMA PCoA and PCA) were used basing on 69 characters derived from growth form, branchlets, leaves, flowers, pods and seed. Three taxa, namely;variety senegal, leiorhachis and kerensis have been discerned and described significantly improving the delimitations of previous studies. The wide variation within var. senegal has been split into three recognizable variants and that of var. leiorhachis into two. The most important characters for differentiating the taxa include leaf breadth and length, pinna length and its ratio to pinna breadth, number of leaflet pairs, petiolar gland shape, petiolar and rachis gland size, stem and branch bark texture, stem and branchlet colour, under-bark colour for stem and branches, pod apical shape, growth form, crown shape, and prickly state of leaves. An identification key has been constructed which, for the first time, can be used to assign herbarium specimens to their respective taxa.

The role of civil society organisations (CSOs) in healthcare delivery system: A case study of child immunisation in Kabarole district, Uganda

Background: The importance of civil society organisations in health care delivery systems cannot be under-rated in sub-SaharanAfricaand other developing nations worldwide. Civil society organisations play a central role in service delivery and development of democracy. However, little is known about the roles and achievements of Civil Society Organisations (CSOs) in healthcare. The study aimed at exploring the role of civil society organisations in health care delivery system particularly in children immunization. Methods: A questionnaire survey involving 282 households was conducted. Data were analysed using descriptive statistics followed by multivariable logistic regression. Results: Ninety seven percent (97%) confirmed that CSOs/NGOs healthcare facilities played a major role in healthcare service delivery. 84% travelled long distances to access the healthcare services including child immunisation services. Travelling long distances (>2 km) to access for health care services including immunization compared to short distance (<1 km) (OR = 0.4, P = 0.0001), possessing a food stores (enguli) compared to not having a food store (enguli) (OR = 2.3, P = 0.002), having separate animal houses compared to not having livestock houses (OR = 0.09, P = 0.0001), and owning a bicycle compared to not having a bicycle (OR = 2.2, P = 0.005) are important determinants for the number of clients at CSO health centers. Further, possessing and using a cellphone compared to no cellphone (OR = 3.7, P = 0.001), Possessing and watching a television compared to not having a television (OR = 2.4, P = 0.002), educated compared to not acquiring any formal education (OR = 0.084, P = 0.0001), and female compared to male respondent (OR = 0.49, P = 0.0045) are other most important factors likely to determine the numbers of clients at the CSO healthcare. Conclusion: Geographies of CSO and community socioeconomics strongly determine the operations and the roles played by the CSO healthcare services in Uganda. Further studies to assess the role of CSO health service providers in other healthcare services need to be done.

Accessibility and availability of health care services to internally displaced persons, in Kitgum and Pader districts, northern Uganda

Introduction: During 1986-2009, an estimated 1.6 million persons were internally displaced from northern and eastern regions of Uganda due to civil war. We investigated accessibility to and availability of health care services for the internally displaced persons in Kitgum and Pader districts, northern Uganda. Methods: This was a cross-sectional study conducted in Kitgum and Pader districts, northern Uganda. We interviewed a total of 1383 respondents comprising 968 (70%) adults and 415 (30%) adolescents;60% were females and 40% males, randomly selected from 35 of 67 (52.2%) internally displaced persons (IDP) camps. We held 27 key informant interviews and 52 focus group discussions. Data were entered in EPI data version 3.02 and analysed using SPSS version 12.00 statistical packages. Findings: Two thirds of the respondents 67.5% lived within 5 km distance of a health facility. The majority 62.9% of respondents mentioned that health related information was readily provided. 43.5% of health providers were always available in a health facility. A quarter 25.1% of health facilities always had drugs available, while 56.9% of the drugs prescribed were always available. Two thirds of the respondents 65.9% were satisfied with the health care services provided. The main reasons for the choice of a health facility were proximity 29.6%, provision of free treatment 24.7% and availability of drugs 17.2%. Main barriers to health care access were due to the lack of financial resources, trained personnel, and inadequate drugs and supplies in the health facilities. Conclusions and Recommendations: The majority of IDPs lived in close proximity to health facilities and obtained health care services from public health facilities. Access to health care was determined mainly by proximity and availability of free services and drugs. Although geographic accessibility to health services was high, lack of finances, information and decision power hindered access to health care services.

Readiness to Screen for Domestic Violence against Women in Healthcare Uganda: Associations with Demographic, Professional and Work Environmental Factors

Aim: We assessed demographic, professional and work environmental determinants of readiness to screen for Intimate Partner Violence among healthcare practitioners in healthcare Uganda. Methods: The Domestic Violence Healthcare Provider Survey Scale and the Demand-Control-Support questionnaire was administered to a random sample of 376 health care providers (n = 279 valid responses) from Gulu, Anaka, Lacor and Iganga hospital situated in northern and eastern Uganda. Correlation tests, t-tests, ANOVA and Multiple Linear regression were used to analyse the data. Results: Male care providers were more likely than female peers to blame the victim for the occurrence of Intimate Partner Violence in a relationship. Participants from Lacorhospital graded a lower self-efficacy and a poorer support network with regard to screening for Intimate partner violence, and a higher propensity to blame the victim when contrasted with other hospitals. Doctors experienced a lower self-efficacy with regard to IPV screening than other professions. Blaming the victim for abuse was associated with a high work load and low support at work. In addition, with increasing work control and support, participants’ appraisal of system support and self-efficacy increased. Conclusion: Gender, profession, facility of work, work demand, control and support are important determinants of the readiness to screen for IPV in healthcare Uganda, and should inform strategy for the introduction and implementation of routine IPV inquiry in healthcare Uganda.

Spatiotemporal Analysis of Nodding Syndrome in Northern Uganda 1990-2014

The emergence of nodding syndrome (NS) in Northern Uganda has generated controversial views with respect to patterns, natural history, and aetiology of the disease which is yet unknown. This study explored spatial patterns of NS using spatial-temporal methods to establish its clustering patterns across both space and time. Village and year of NS onset for individual patients between the years 1990 and 2014 were entered as input for spatial and temporal analysis in the 6 districts in northern Uganda where it is prevalent. Our temporal results showed that NS onset started before the population was moved in Internally Displaced People’s (IDPs) camps. It also shows that NS continued to be reported during the IDPs and after people had left the IDPs. Our spatial and spatiotemporal analysis showed that two periods had persistent NS clusters. These were 2000-2004 and 2010-2014, coinciding with the period when the population was in the IDP camps and when the population was already out of the camps, respectively. Our conclusion is that the view of associating NS outbreak with living conditions in IDP camps is thus coincidental. We, therefore, contend that the actual aetiological factor of NS is still at large.

Healthcare providers’ perceptions on screening for Intimate Partner Violence in healthcare: A qualitative study of four health centres in Uganda

The current qualitative study explored the perceptions of healthcare providers on screening for Intimate Partner Violence (IPV) in healthcare in Uganda, to develop a conceptual framework for factors likely to hinder/promote IPV screening in the country. Using purposive sampling, the study enlisted 54 healthcare workers (doctors and nurses) from four hospitals (i.e. Gulu referral hospital, Iganga referral hospital, Lacor hospital, Anaka hospital) to participate in eight focus group discussions. Data was thematically analysed using Template Analysis. The study found support for an ecological framework suggesting a complex interaction of factors at the individual (e.g. poor skills in detection of IPV by health workers and unwillingness to disclose abuse by patients), organisational (e.g. understaffing and lack of protocols for IPV screening) and societal (e.g. societal acceptance of abuse of women and poor policy on IPV management) levels as potential barriers to the practice of IPV screening in healthcare Uganda. These findings have important implications on further training of healthcare workers to adequately screen for IPV, re-organisation of the healthcare system so that it is fully-fledged to accommodate IPV screening and improved collaboration between the health sector and other community advocates in IPV management. These initiatives should run concurrently with a concerted community sensitization effort aimed at modifying attitudes towards IPV among care providers and recipients a like, as well as preparing the general population to will-fully disclose IPV to healthworkers. Study limitations and implications for further research are discussed.

Social Dynamics of Ebola Virus Disease: A Case of Bundibugyo District, Uganda

Background: Ebola Virus Disease (EVD) presents with a high global mortality and is known to be a highly infectious disease with devastating and gendered effects on the social fabric, yet most of the science has focused on the disease’s biology. However, little has been documented with regard to the gender and social aspects of Ebola Virus Disease (EVD) in two sub counties (Kikyo and Bundibugyo Town Council) in Bundibugyo District in Western Uganda. The study was set to examine the gender differences in the level of knowledge, attitudes and perceptions about EVD. Methods: The study employed a cross-sectional design using both quantitative and qualitative data collection methods. A structured questionnaire was administered to 254 respondents, 50% of whom were women. Simple random sampling was used to select the participants. Questionnaire data were analysed using SPSS at univariate and bivariate levels. Qualitative methods such as key informant interviews (with 6 participants) and Focus Group Discussions (three, one with men alone, another with women alone and the last one with both men and women) were also used to collect additional information from participants. Results: The findings indicated that socio-demographically, the majority (35%) of the respondents were aged between 20 and 29 years, 53% of whom were females. More women (about 56%) compared to men (44%) attained secondary education while more men (about 51% versus 49% of the women) reported that they were married. In terms of religion, the majority of the survey participants were Catholics (59% females and 49% males). With regard to communities’ knowledge about EVD, there was no significant relationship between men and women in terms of prior knowledge about EVD, risk factors and control measures. However, slightly more males (about 51%) than females (49%) had heard about EVD and more males (about 52%) than females (48%) admitted that they were at risk of contracting the disease. On the control measures, slightly more females than males (about 53% vs. 47% respectively) proposed avoiding contact with infected persons. The results further revealed that more males (about 51%) than females (49%) were willing to relate with EVD survivors, and this was due to the latter’s fear of contracting the disease. The major devastating effects of EVD that were reported included loss of lives, disruption of peoples movements, isolation of people, disruption of children’s school activities, stigma and discrimination of survivors. More females (about 52%) than males (about 48%) reported that EVD survivors were discriminated during the EVD outbreak in Bundibugyo District. Conclusions: This study has shown that whereas both men and women demonstrate average knowledge about EVD, there is need for more training and sensitization targeting women who have delusions about the severity of the disease, its risk factors, stigma and the integration of survivors in the affected communities. Communities also need to be sensitized about the gender roles that increase both the burden of EVD and the risk of men and women contracting the disease. This will lead to more culturally sensitive responses to EVD outbreaks in future.

Quality of Sputum Specimen Samples Submitted for Culture and Drug Susceptibility Testing at the National Tuberculosis Reference Laboratory-Uganda, July-October 2013

Setting: The Uganda National Tuberculosis Reference Laboratory (NTRL) in Kampala. Objective: The proportion of poor quality specimens received for drug susceptibility testing (DST) at the NTRL and factors contributing to poor specimen quality were assessed. Design: A cross-sectional study was conducted of sputum samples received at the NTRL from patients at high risk for multi-drug-resistant tuberculosis (MDR TB) during July-October 2013. Demographic, clinical, and bacte-riological data were abstracted from laboratory records. A poor quality sample failed to meet any one of four criteria: ≥3 milliliter (ml) volume, delivered within 72 hours, triple packaged, and non-salivary appearance. Results: Overall, 365 (64%) of 556 samples were of poor quality;89 (16%) were not triple packaged, 44 (8%) were <3 mls, 164 (30%) were not delivered on time, and 215 (39%) were salivary in appearance. Poor quality specimens were more likely to be collected during the eighth month of TB treatment (OR = 2.5, CI = 1.2 - 5.1), from the East or Northeast zones (OR = 2.2, CI = 1.1 - 4.8), and from patients who previously defaulted from treatment (OR = 1.9, CI = 1.1 - 3.2). Conclusion: The majority of sputum samples had poor quality. Additional efforts are needed to improve quality of samples collected at the end of treatment, from East and Northeast zones, and from patients who had previously defaulted.