Utilisation of Non-Conventional Animal Waste as Feeds by Multiple Livestock Species Farmers in Lake Victoria Crescent of Central Uganda

A cross-sectional survey was conducted to establish the utilisation of non-conventional animal waste in multiple livestock species systems. Farmers (150) were selected from four out of ten districts of Central Uganda in Lake Victoria Crescent. A structured questionnaire was used and descriptive analysis showed that over 80% are smallholder farmers on 3.0) years. Household husbands (80%) significantly (P 1.0) as they cause poor livestock health due to pathogens, parasites and toxins which are associated (OD > 1.0) with poor growth, mortality and condemnation of livestock products. The remedy to unsafe non-conventional feeds is to apply effective solar-heating (75%), chemical and ensiling treatment methods. The study showed that there are no significant (P < 0.001) public health risks associated with utilising treated non-conventional feeds instead it improves production and sustainability of multiple livestock species systems.

Cysticercus Tenuicollis in Visceral Organs of Goats and Sheep in Uganda: A Case Study in Lira Municipal Abattoir

Cysticercus tenuicollis is a metacestode stage of Taenia hydatigena residing in the visceral organs of small ruminants and its effects cause economic losses due to condemnation of visceral organs in slaughterhouses. This study reports on the prevalence of Cysticercus tenuicollis in small ruminants slaughtered in Lira Municipal Abattoir. A total of 70 sheep and 70 goats were sampled and examined after slaughter for the presence of Cysticercus tenuicollis in the visceral organs using standard meat inspection procedures. An abattoir data collection sheet was used to record data, which was then analysed in SPSS version 20. The study revealed 51.4% of goats and 68.6% of sheep to be infested with Cysticercus tenuicollis. Following the district of origin for the small ruminants, Otuke district had the highest prevalence of the parasite (82.6%), followed by Kole (72.4%), Alebtong (66.7%), Apac (59.4%) and Lira (31.4%). Cysticercus tenuicollis was more frequently seen in the intestines (57.8%) of sheep and goats than in any other visceral organs. The liver had a prevalence of 20.7%, the lungs 17.8%, the kidneys 3.5% and the fetal sac;(15.7%) in goats and (12.9%) in sheep. Cysticercus tenuicollis was detected in 68.8% of females and 58.8% of male small ruminants. It is recommended to routinely deworm goats and sheep by farmers most especially in districts with the highest prevalence of Cysticercus tenuicollis infestation. The sale of the condemned parts of sheep and goats and the feeding of dogs on these contaminated materials should be stopped forthwith. It is also being suggested that a national study be carried out to determine the prevalence and economic impact of Cysticercus tenuicollis in small ruminants.

Antimicrobial Drug Resistance and Plasmid Profiles of <i>Salmonella</i>Isolates from Humans and Foods of Animal Origin in Uganda

Salmonella organisms are among the most common causes of human bacterial gastroenteritis worldwide, and food animals are important reservoirs of these bacteria. A further danger lies in the development of drug resistance in these organisms, primarily driven by non-prudent overuse of antiinfectives. The current study compared the plasmid profiles and drug susceptibility patterns of Salmonella isolates from man and foods of animal origin in Uganda. A total of 92 Salmonella isolates (58 from man and 34 from foods of animal origin) were analyzed. Identification was done by using biochemical tests;plasmid profiling by agarose gel electrophoresis while susceptibility testing to tetracycline, ampicillin, chloramphenicol, nalidixic acid, trimethoprim-sulphamethoxazole, ciprofloxacin, ceftriaxone and tetracycline were done by the Kirby Bauer Disc Diffusion method. Among the human isolates, 57/58 (98.3%, 95% CI, 91.8% - 99.9%) were susceptible to Ciprofloxacin compared to 32/34 (94.1%, 95% CI, 81.9% - 91%) of animal-derived isolates. On the other hand, 48/58 (82.7%, 95% CI, 71.4% - 91%) human-derived isolates were resistant to Trimethoprim sulfamethoxazole compared to 29/34(85.3%) of the animal-derived isolates. Fifty four percent (n = 50) of the all the isolates were resistant to at least three antibiotics whereas only 2.2% (n = 2) were susceptible to all the seven drugs tested. Most worrying, however, was the fact that only 45% percent of the isolates were sensitive to all the three drugs (chloramphenicol, nalidixic acid and ciprofloxacin) commonly used in the treatment of salmonellosis in this setting. The risk of ampicillin resistance was three times more likely to occur in animal-derived as compared to human-derived isolates (Odds Ratio = 2.705, 95% CI, 1.3 - 5.8) as was that to nalidixic acid (Odds Ratio = 2.895, 95% CI, 1.17 - 7.2). Plasmid profile analysis showed eight clusters comprising of 68.7% (46/67) of the isolates. In five of the eight clusters, there were both animal and human-derived isolates. Resistant strains of Salmonella are common in this setting and meat/meat products are the commonest source of infection. A majority of the isolates are multi-drug resistant, and there is evidence of cross-species transmission of plasmids, and possibly drug resistance, between animals and humans.

Characterisation of Smallholder Multiple Livestock Species Production Systems in Parts of Lake Victoria Crescent of Central Uganda

A cross-sectional study of 150 purposively selected multiple livestock species farmers was conducted in Central Uganda aimed at distinguishing between mixed and integrated livestock systems. Performance and operational-based challenges misconstrued to cause incorrect comparison between the two systems were considered. Ten multiple-livestock species system with five ruminant species-based and five monogastric species-based combinations were categorised. Poultry, pig, fish, goats and sheep kept in both the 3 and 4-species combinations were considered. Over 80% of the families are male dominated, smallholder and occupying > 1.0 Ha of land. Exotic and crossbred breeds were adopted away from less productive and noncommercial local species. Mixed monogastric-fish systems with monogastric species dominated (P 1000) stock per farm. Stalls dominate pig management systems with 15% of the farmers upgraded to commercial level with (>50) stock per farm. Ineffective livestock policies contribute to inefficient performance of 55% of livestock farmers. In conclusion, mixed livestock systems should be upgraded to integrated livestock systems with input resource synergy for improved production and sustainability.

High Prevalence of Subclinical Mastitis and Multidrug Resistant <i>Staphylococcus aureus</i>Are a Threat to Dairy Cattle Production in Kiboga District (Uganda)

Subclinical mastitis (SCM) is one of the major factors affecting the productivity of dairy cattle all over the world. This study established the burden of SCM and determined the potent antibacterial formulation for control of Staphylococcus aureus (SA) related SCM in selected dairy cattle farms in Kiboga district. A total of 124 dairy cattle from 12 farms were screened for SCM using California Mastitis Test (CMT) from Kiboga Town-Council, Kapeke and Lwamata sub-counties. The offending bacteria were cultured and the antibiogram of SA was carried out using antibacterial susceptibility by the modified Kirby-Bauer disc diffusion method. Additional qualitative data on the factors that predispose cows to SCM was obtained through questionnaires and observation of milking Practice. The prevalence of SCM in the three sub-counties was 87.9%. Over 70% of the dairy cattle screened for SCM had more than 2 udder quarters affected. The majority (90%) of SCM was caused by mixed bacterial infections: Coagulase negative staphylococci (64.4%) and SA (16.6%) being the most prevalent. All the farmers (100%) lacked knowledge on SCM, udder towels, teat dipping and drug cow therapy. Overall, 71.4% of SA isolated was multi-drug resistant. There was a high level of resistance against penicillin (100%), neomycin (85.7%) and tetracycline (71.4%). In contrast, all the above isolates were susceptible to Trimethoprim-Sulphamethazole. In conclusion, the high burden of SCM and emergence of multidrug resistant SA are one of the constraints to dairy production in Kiboga district. Therefore, sensitization of dairy farmers in Kiboga district on proper hygienic, appropriate milking techniques and dry cow therapy using potentiated sulfonamide intra-mammary preparations are highly recommended in SA associated SCM.

Antimicrobial Resistance Patterns and Bovine Sub-Clinical Mastitis Burden in Low and High Tick Acaricide Resistance Regions of Uganda

Mastitis, antimicrobial resistance and acaricide resistance pose significant threats to the development of the dairy industry in sub-Saharan Africa. This study aimed to determine the prevalence of antimicrobial resistance in bacteria isolated from CMT positive cows on farms located in high (HARA) and low (LARA) acaricide resistance challenge regions of Uganda. Among selected herds in both regions, subclinical mastitis (SCM) screening was performed using CMT. CMT positive samples were collected, cultured, bacteria isolated and antibiotic sensitivity tests conducted. Overall, the prevalence of SCM in cows was 71.5% and 27.7% for HARA and LARA respectively. A SCM herd prevalence of 66.3% and 28.2% was recorded for HARA and LARA respectively. Furthermore, 67.5% and 20.8% of the cows in the HARA and LARA groups, respectively, had three out of four udder quarters infected with SCM. Staphylococcus aureus (44.2%) and coagulase-negative Staphylococcus (CNS) (47.6%) were the most prevalent causative agents of SCM isolated from cows from HARA and LARA, respectively. Most isolates from both regions were highly resistant to penicillin (HARA, 84.3%;LARA, 95.6%) and colistin (HARA, 100%;LARA, 97.8%). Tetracycline (77.1%) and oxacillin (76.1%) resistance was high in isolates from HARA and LARA, respectively. Intermediate responses (neither susceptible nor resistant) to antibiotics were more common in isolates from HARA than in those from LARA. With this level of antibiotic resistance, there is a potential risk of failure to control mastitis in dairy cattle using antibiotics, especially in the HARA region, which may possibly jeopardize the growth of the dairy industry in Uganda.

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.

Newcastle Disease Virus Isolation and Its Prevalence in Uganda Poultry Farms

The present research work was carried out to isolate and identify Newcastle disease virus (NDV) by using haemagglutination inhibition (HI) test and HA-HI virus isolation, embryonated eggs (EE) and chicken embryo fibroblasts (CEF). A total of 95 clinical (blood, tracheal and cloacal swabs) and post-mortem (brain, lung, colon and spleen) samples were collected from chickens of field outbreaks of suspected Newcastle disease virus (NDV). The HI and HA-HI were employed to detect NDV in tissue homogenates of all the clinical and post-mortem samples as well as laboratory samples (AF and ICF). Among the four different types of post-mortem samples, virus isolation rate was found to be low in body organs. In CEF cell culture system, the rate of virus isolation from all the aforesaid samples was found to be at 100% with the exception of serum samples;while in tracheal and cloacal swabs, it was at 90%;while in serum, it was at 10%, in all clinical cases. The isolation rate of NDV was higher in CEF culture system (66.7%) compared to that of avian embryos (33.3%). Samples were inoculated and the allantoic fluid (AF) of the dead embryos and the infected culture fluid (ICF) of the CEF were harvested at 24 to 96 hours of the post-infection, respectively, which revealed that the virulent strain of NDV is highly prevalent in the region. The prevalence of NDV was established at 1.1%, 2.1% and 4.2% using HA-HI, EE, and CEF methods. Rapid detection and identification of the virus are crucial for the effective control of the disease as conventional diagnostic methods such as virus isolation on embryonated eggs followed by serological identification in haemagglutination-inhibition test are laborious and time-consuming. The speed of the diagnosis can be considerably increased by using methods based on molecular biology, e.g. reverse transcription—polymerase chain reaction. However, the genetic variability of APMV-1 isolates should be considered carefully as the potential cause for false negative results of genetic-based laboratory tests.

Burden of Multidrug-Resistant Escherichia coli in Pigs Slaughtered in Uganda and Its Implication on Veterinary Public Health

Antimicrobial resistance by bacteria and other microbes has become a global public and animal health threat. In this cross-sectional study, assessed the abattoir workers’ practices regarding pork handling and we investigated antimicrobial susceptibility patterns of Escherichia coli isolated from pigs brought for slaughter at Wambizzi, Uganda’s main pig abattoir. Rectal swabs were collected from a total of 176 live pigs prior to slaughter. Additionally, 24 swabs were taken from the abattoir floor environment. The collected swabs were cultured for the detection and isolation of E. coli followed by antibiotic susceptibility tests. Regarding pork handling practices, absence of hand washing facilities was observed and none of the workers cleaned/disinfected their equipment between slaughters while slaughters took place on the unhygienic floors of the inspection room. Overall, high prevalence (85.1%) of multi-drug resistant E. coli was detected in pigs received from all the regions of Uganda. Swine E. coli isolates exhibited high resistance against erythromycin (87.4%) and the least resistance against ciprofloxacin at 2.3%. At regional level, E. coli isolates from the central region of Uganda showed higher prevalence of multidrug resistant E. coli isolates as follows;amoxicillin (30.4%, p-value = 0.007), erythromycin (34.8%, p-value = 0.002), streptomycin (40.7%), ciprofloxacin (100%), oxytetracycline (31%) and sulphamethoxazole-trimethoprim (42.9%). Furthermore, multidrug-resistant E. coli was also confirmed in the immediate environment where pigs were gathered and slaughtered. From these environmental isolates, the highest resistance was confirmed against erythromycin (100%), whereas no isolates showed resistance against ciprofloxacin. The observed practices coupled with the presence of multidrug-resistant E. coli in the slaughterhouses presents a possible risk of pork contamination with multidrug-resistant E. coli presenting a potential risk of causing foodborne illnesses among pork consumers in Uganda. The current findings could justify active surveillance of antimicrobial resistance among food animals and provides basis for monitoring the quality of pork products to ensure food safety.

Epidemiology of Increasing Hemo-Parasite Burden in Ugandan Cattle

Hemo-parasites (HP) are one of the major constraints to the economic development of the livestock industry in Uganda. Generally, the occurrence and importance of HP is a reflection of complex interactions involving the causative organisms, tick vectors, the vertebrate hosts and the environment. We carried out a cross sectional study to identify and determine the prevalence of the major HPs in Central and Western Uganda, to form a baseline for appropriate interventions. A total of 295 bovine samples were analyzed from 15 districts of Uganda;56.3% being from the Central and 43.7% from the Western region of the country for a period of six months, and a questionnaire was administered to the farmers. Thin peripheral blood smears stained with Giemsa were used during the laboratory identification of the parasites. The disease prevalence was established at 47.4%, 6.7%, 1.9% and 14.4% for Theleria parva, Babesia spp., Trypanasoma brucei, Anaplasma spp. with a corresponding disease risk ratio (DRR) of 67.4%, 9.5%, 2.6%, 20.5% respectively in Uganda. The odds of having an infection from the Central region were 1.7 times greater (P < 0.05) than those from the Western region with a corresponding risk ratio of 1.2 (CI.1.1, 2.84, 95%), which showed that there exist marked differences between the two regions. Mean PCV was at 29.8%, and majority (59%) of infected animals had low PCV which varied across the months. These showed that generally, cattle in the West are more severely affected by HP than those from the Central region. The questionnaire revealed that 100% of the farmer treatments are based on clinical sign presentation, with occasional reliance on veterinarians. In conclusion, the burden of hemo-parasites is steadily increasing across the regions, and the current policies are not helping farmers who are hit the hardest by the development of antibiotic and acaricide resistance. These findings, along with previous studies, suggest that eradication HP is not feasible unless there are radical changes implemented, and that current practices are expensive and unsustainable. Further studies would be carried out to provide knowledge on the level of antibiotic resistance for the promotion of veterinary public health and trade.

Aflatoxin Contamination and Rancidity in Locally Processed Commercial Fish Feeds and Ingredients along the Value Chain in Wakiso and Kampala Districts, Uganda

Aflatoxin contamination and rancidity in locally processed commercial fish feeds and ingredients along value chains is a Public and Animal health hazard. The study established the level of aflatoxin contamination, peroxide value (PV), Anisidine value (AnV), and their associated factors at storage areas among farmers, processors, traders, factories, and landing sites in the Wakiso and Kampala districts. The value chain actors were purposively selected in a cross-sectional study based on access to the feed store and the use of locally processed commercial fish feeds on farms. Data collected were statistically analyzed in SPSS version 20. All the samples (45) were positive for aflatoxin contamination and PV with 51% (23/45) of samples being contaminated with “above acceptable” aflatoxin levels and 66.6% (30/45) of samples with “above acceptable” PV. The overall percentage of “above acceptable” AnV was 11/29 (37.9%). Samples from factories were within acceptable contamination levels. Multivariate logistic regression analysis revealed no significant difference between aflatoxin contamination, peroxide, and Anisidine value with storage factors for locally processed commercial fish feeds and ingredients. The study recommended the purchase of fish feeds from factories and a larger study on storage factors responsible for aflatoxin contamination and rancidity in fish feeds in Uganda.

Analgesic and Anti-Inflammatory Activity of Total Crude Leaf Extract of <i>Phytolacca dodecandra</i>in Wistar Albino Rats

Background: Pain is a common problem encountered in daily life among humans and animal and it is commonly managed conventionally using modern medicines and traditionally by use of medicinal plants. Phytolacca dodecandra is a common herb in Uganda, used traditionally to alleviate pain and inflammatory conditions. However, its activity in alleviating pain and inflammatory diseases has not been fully scientifically evaluated. Aim of Study: To evaluate the analgesic and anti-inflammatory activity of total crude leaf extracts of P. dodecandra in Wistar albino rats. Materials and Methods: It was a laboratory-based experimental study. Acetic acid-induced writhing test was used to determine the analgesic activity and the histamine-induced paw edema formation for anti-inflammatory activity of the extract. Twenty eight animals were divided into 7 groups each with 4 rats and two (2) sets of data were obtained from each animal per group as per guidance of the refinement rule of 3Rs. For analgesic activity, Group I was dosed with 1.0ml of normal saline (negative control), group II, III, IV, V, VI were dosed with 1000.0, 600.0, 150.0, 40.0 and 5.0 mg/kg bwt of extract respectively. Group VII was dosed 10.0 mg/kg bwt diclofenac sodium (Na) drug (positive control). For anti-inflammatory activity, Group I was dosed with 1.0ml of normal saline (negative control), Group II, III, IV, V, VI were dosed with 1000.0, 600.0, 300.0, 40.0 and 5.0 mg/kg bwt of extract respectively. Group VII was dosed 10.0 mg/kg bwt diclofenac Na. The percentage mean paw volume inhibition and percentage writhing protection were determined. Results: The mean percentage paw volume inhibitions were 29.1%, 74.2% and 32.3% at doses of 5.0, 40.0 mg/kg bwt and 10.0 mg/kg bwt diclofenac Na respectively. The mean percentage writhing protection was 8.9%, 10.4%, 78.5% and 98.7% at doses of 150.0, 600.0, 1000.0 mg/kg of extract and 10.0 mg/kg bwt diclofenac Na respectively. Conclusions: Total crude leaf extracts of P. dodecandra has analgesic and anti-inflammatory activity that may be attributed to the presence of polyphenolic, saponins and many others phytochemicals that are present in the plant.

Acute and Sub-Acute Toxicity of Ethanolic Leaf Extracts of <i>Rumex abyssinica</i>Jacq. (Polygonaceae) and <i>Mentha spicata</i>L. (Lamiaceae)

Rumex abyssinica Jacq. (Polygonaceae) is locally used in management of allergies and female reproductive healthcare;whereas Mentha spicata L. (Lamiaceae) is used to treat gastrointestinal and respiratory distress, dandruff, halitosis and malaria in Uganda. Owing to the paucity of data on their safety profiles, this study evaluated the acute and sub-acute toxicities of 70% ethanolic leaf extracts of both plants in mice and Wistar albino rats. The oral acute toxicity of both plants was evaluated in Swiss mice of 7-8 weeks old (16-22 g) body weight and LD50 determined. Sub-acute toxicity was evaluated in Wistar albino rats (6 per group) at dose rates of 500, 1000 and 1500 mg/kg for 28 days. The LD50 of R. abyssinica and M. spicata in mice was 7727 mg/kg and 13,606 mg/kg body weight, respectively. General signs of toxicity due to large doses of both plants extract included hyperurination, abdominal muscle twitches and convulsions. In the sub-acute toxicity test, rats treated with both extracts did not exhibit any clinical signs of toxicity;no mortality and changes in body weight were observed. R. abyssinica did not cause significant changes in haematological indices, except a significant increase in HCT (p 0.05). However, a dose dependant significant decrease in HCT (p 0.05) and a significant increase (p 0.05) in the levels of WBC, LMY and MCHC were observed in rats treated with M. spicata extract. Biochemical test showed that both extracts caused a significant dose dependent increase (p 0.05) in levels of ALT and ALP. Marked increase in the levels of AST was also observed in rats treated with M. spicata extract. Of the two extracts, only rats treated with </

A Survey for Contagious Caprine Pleuropneumonia in Agago and Otuke Districts in Northern Uganda

Background: Contagious Caprine Pleuropneumonia (CCPP) is a devastating disease of goats caused by Mycoplasma capricolum subsp. Capripneumoniae (Mccp). The disease was first confirmed in Uganda in 1995 in Karamoja region. Contagious Caprine Pleuropneumonia negatively impacts on goats’ productivity but its extent and magnitude among the local communities in Uganda remain unknown. A cross sectional study was conducted in the districts of Agago and Otuke neighboring Karamoja in Northern Uganda during the months of July and August 2011 to explore for the status of the disease. Methods: Five hundred and four serum samples from goats were obtained from randomly selected unvaccinated herds and 100 goats from vaccinated herds. Serum samples were examined for antibodies against Mycoplasma capricolum subsp. Capripneumoniae (Mccp) by ELISA method. A total of 162 semi-structured questionnaires were administered to selected farmers to obtain information on their understanding of the disease and the risk factors they associated with CCPP. Eight focus group discussions were also conducted with selected farmer groups to obtain detailed qualitative information on CCPP. Results: Among the unvaccinated goats, seroprevalence of CCPP was 32 (17.7%) and 52 (23.3%) for Agago and Otuke districts respectively. Levels of antibodies against Mccp were higher among vaccinated goats than unvaccinated ones (mean optical densities (ODs) of 0.905 and 0.776, p = 0.08). Majority of the farmers 121 (74.7%) had knowledge on CCPP and recognized that CCPP was among the major challenges to goat production in Uganda. Conclusions: This study demonstrated that CCPP was prevalent in Agago and Otuke districts, which are outside but close to Karamoja region where the disease was previously confirmed. There is a need for wider and detailed studies to investigate further CCPP in other districts of Uganda for effective preventive and control of CCPP in Uganda and the neighboring countries.

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.

Field Evaluation of LED Fluorescence Microscopy for Demonstration of <i>Trypanosoma brucei rhodesiense</i>in Patient Blood

Diagnosis of Trypanosoma brucei rhodesiense human African trypanosomiasis requires demonstration of parasites in body fluids by microscopy. The microscopy methods that are routinely used are difficult to deploy in resource-limited settings due to practical challenges, including lengthy and tedious procedures, and the need for specific equipment to centrifuge samples in glass capillary tubes. We report here on a study that was conducted in a rural region of eastern Uganda to evaluate new methods that take advantage of a field-deployable LED fluorescence microscope. Examination of acridine orange-stained blood smears by LED fluorescence microscopy resulted in a diagnostic accuracy that was similar to that of routine methods, while the time needed to identify parasites was shortened significantly. These findings make these new microscopy methods attractive alternatives to procedures that are currently used for diagnosis of T. b. rhodesiense human African trypanosomiasis.

In Vitro Anti-tuberculosis Activity of Total Crude Extract of Echinops Amplexicaulis against Multi-drug Resistant Mycobacterium Tuberculosis

Background： TB （Tuberculosis） is the second leading killer infectious disease after HIV （human immunodeficiency virus）. Its incidence is worsened by development of multi-drag resistant and extensive drug resistant TB stxains. Available treatment regimens are expensive, toxic and lengtjy resulting to problems of non-adherence and inadequate response. Medicinal plants on the other hand may offer hope for developing alternative medicine for treatment of TB. This study evaluated the anti-tuberculosis activity of Echinops amplexicaulis. Materials and methods： Total crude extracts ofE. amplexicaulis were tested for activity against a wild strain resistant to Rifampicin and Isoniazid （MDR）, a fully susceptible laboratory strain （H37Rv） and Mycobacwrium boris （BCG strain） using disk diffusion method. MIC （minimum inhibitory concentration） was determined using Middlebrook 7H9 broil1. The strains were sub-cultured on Middlebrook 7H10 medium and MBC （minimum bactericidal concentration） determined. Susceptibility was evaluated by measuring zones of inhibition; MIC was obtained as the lowest concentration with no significant growth as shown by clog formation ofMTB （Mycobacwria tuberculosis） cells on the walls of the macro broth tube and MBC was obtained as the lowest concentration that inhibited growth of MTB colonies on Middlebrook 7H10 medium. Results： The extract showed a significant effect at a concentration of 50 mg/mL against all the three test strains F （2, 18） = 437.7, p = 0.00. It exhibited a MIC of 0.0488 mg/mL against MDR-TB and M. boris. Its MBC was the same at 0.0977 mg/mL against both MDR TB and M. boris. The MIC was much lower （0.0122 mg/mL） for the H37Rv strain. Terpenoids, alkaloids and tannins were present in large amount in the extract while saponins were present in small amounts. Flavonoids were not detected in the extract. Conclusion： E. amplexicaulis has the potential to be developed into new anti-TB drug and outcome of tile study supports the folkloric claims of anti-tuberculosis activity of tile plant.

Annual trends of human brucellosis in pastoralist communities of south-western Uganda: a retrospective ten-year study

Background:Human brucellosis is prevalent in both rural and urban Uganda,yet most cases of the disease in humans go unnoticed and untreated because of inaccurate diagnosis,which is often due to the disease not manifesting in any symptoms.This study was undertaken to describe trends in laboratory-confirmed human brucellosis cases at three health facilities in pastoralist communities in South-western,Uganda.Methods:Data were collected retrospectively to describe trends of brucellosis over a 10-year period(2003–2012),and supplemented with a prospective study,which was conducted from January to December 2013.Two public health facilities and a private clinic that have diagnostic laboratories were selected for these studies.Annual prevalence was calculated and linearly plotted to observe trends of the disease at the health facilities.A modified Poisson regression model was used to estimate the risk ratio(RR)and 95%confidence intervals(CIs)to determine the association between brucellosis and independent variables using the robust error variance.Results:A total of 9,177 persons with suspected brucellosis were identified in the retrospective study,of which 1,318(14.4%)were confirmed cases.Brucellosis cases peaked during the months of April and June,as observed in nearly all of the years of the study,while the most noticeable annual increase(11–23%)was observed from 2010 to 2012.In the prospective study,there were 610 suspected patients at two public health facilities.Of these,194(31.8%)were positive for brucellosis.Respondents aged 45–60 years(RR=0.50;CI:0.29–0.84)and those that tested positive for typhoid(RR=0.68;CI:0.52–0.89)were less likely to have brucellosis.Conclusions:With the noticeable increase in prevalence from 2010 to 2012,diagnosis of both brucellosis and typhoid is important for early detection,and for raising public awareness on methods for preventing brucellosis in this setting.

Prevalence of pathogenic free-living amoeba and other protozoa in natural and communal piped tap water from Queen Elizabeth protected area, Uganda

Background:Pathogenic water dwelling protozoa such as Acanthamoeba spp.,Hartmannella spp.,Naegleria spp.,Cryptosporidium spp.and Giardia spp.are often responsible for devastating illnesses especially in children and immunocompromised individuals,yet their presence and prevalence in certain environment in sub-Saharan Africa is still unknown to most researchers,public health officials and medical practitioners.The objective of this study was to establish the presence and prevalence of pathogenic free-living amoeba(FLA),Cryptosporidium and Giardia in Queen Elizabeth Protected Area(QEPA).Methods:Samples were collected from communal taps and natural water sites in QEPA.Physical water parameters were measured in situ.The samples were processed to detect the presence of FLA trophozoites by xenic cultivation,Cryptosporidium oocysts by Ziehl-Neelsen stain and Giardia cysts by Zinc Sulphate floatation technique.Parasites were observed microscopically,identified,counted and recorded.For FLA,genomic DNA was extracted for amplification and sequencing.Results:Both natural and tap water sources were contaminated with FLA,Cryptosporidium spp.and Giardia spp.All protozoan parasites were more abundant in the colder rainy season except for Harmannella spp.and Naegleria spp.which occurred more in the warmer months.The prevalence of all parasites was higher in tap water than in natural water samples.There was a strong negative correlation between the presence of Acanthamoeba spp.,Hartmannella spp.,Cryptosporidium spp.and Giardia spp.with Dissolved Oxygen(DO)(P<0.05).The presence of Cryptosporidium spp.showed a significant positive correlation(P<0.05)with conductivity,pH and Total Dissolved Solids(TDS);whereas the presence of Giardia spp.had only a strong positive correlation with TDS.Molecular genotyping of FLA produced 7 Acanthamoeba,5 Echinamoeba,2 Hartmannella,1 Bodomorpha,1 Nuclearia and 1 Cercomonas partial sequences.Conclusions:All water collection sites were found to be contaminated with pathogenic protozoa that could possibly be the cause of a number of silent morbidities and mortalities among rural households in QEPA.This implies that water used by communities in QEPA is of poor quality and predisposes them to a variety of protozoan infections including the FLA whose public health importance was never reported,thus necessitating adoption of proper water safety measures.