Literature Review of the Prevalence of Hypertension at Gulu University, Gulu City, Acholi Subregion, Northern Uganda

Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.

Prevalence and Factors Associated with Refractive Errors among University Students at Mbarara University of Science and Technology, Uganda

Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors due to their curriculum that requires a lot of near work affecting their performance and quality of life unknowingly. Genetic and environmental factors are thought to play a role in the development of refractive errors. This study addresses the paucity of knowledge about refractive errors among university students in East Africa, providing a foundation for further research. Objectives: To determine the prevalence and factors associated with refractive errors among students in the Faculty of Medicine at Mbarara University of Science and Technology. Methodology: This was a cross-sectional descriptive and analytical study in which 368 undergraduate students selected using random sampling were assessed for refractive errors from March 2021-July 2021. Eligible participants were recruited and their VA assessment done after answering a questionnaire. Students whose VA improved on pin hole had subjective retinoscopy and results were compiled and imported to STATA 14 for analysis. Results: The prevalence of refractive errors was 26.36% with (95% CI) among university students especially myopia. Myopia is most predominant at 60%, followed by 37% Astigmatism and hyperopia of 3% among medical students. Astigmatism consisted of largely myopic astigmatism 72% (26) and 28% (10) compound/mixed astigmatism only. Student positive family history of refractive error was found to have a statistically significant relationship with refractive errors with AOR 1.68 (1.04 - 2.72) (95% CI) and P (0.032). Conclusion: The prevalence of refractive errors among university students, especially myopia, was found to be high and family history was associated with students having refractive errors.

Challenges Faced by Village Health Teams (VHTs) in Amuru, Gulu and Pader Districts in Northern Uganda

Primary health care provision through innovative community level interventions such as the Village Health Team (VHT) concept in Uganda can be a rational way of achieving universal access to healthcare. This cross-sectional study interviewed 150 VHT members and 16 key informants in three districts in Northern Uganda to establish the roles of VHTs, the service gaps encountered and the measures in place to address these gaps. Quantitative data were analyzed using SPSS 16.0. Direct content analysis of themes of transcribed qualitative data was conducted manually for common codes. The majority of the respondents 64.29% (n = 72) reported to have been VHT volunteers for more than 5 years. Among the roles were community mobilization reported by 99.1% (n = 111) and home visiting of individuals reported by 97.3% (n = 109). Lack of transport, motivation, adequate skills and community appreciation with nearly no measures in place to counteract the challenges was reported by almost all respondents. Although the VHT concept can be a significant means of achieving universal access to primary health care, extensive community involvement and motivation of the volunteers are highly needed for a maximum benefit.

Unsatisfactory COVID-19-Related Knowledge, Attitudes and Practices among Undergraduate University Students in Uganda: An Online Cross-Sectional Survey

Background: This study examined the COVID-19-related knowledge, attitude and practices among undergraduate students in Uganda. Methods: An online cross-sectional survey was conducted from 12th-19th June 2020 among undergraduate students using a standard questionnaire designed using Google Forms sent via WhatsApp Messenger. The data were analyzed using SPSS. Pearson’s Chi-square test was used to test the differences and odds ratios with their 95% confidence intervals were used for quantifying the association between independent and dependent variables. p < 0.05 was considered significant. A cut-off score of ≥80% was used to denote sufficient knowledge, positive attitude, and good practices. Results: Of the 161 respondents, 102 (63.4%) were males with a mean age of 24.2 (5.0) years. The majority 121 (75.2%) were pursuing health-related programs and overall, 110 (68.3%) had sufficient knowledge while 76 (47.2%) had a positive attitude and good practice each. Knowledge and attitude were significantly associated with health-related programs (AOR 4.78, 95% CI 2.06 - 11.07;p < 0.001) and (AOR 3.18, 95% CI 1.33 - 7.62;p = 0.010) respectively. The practice was associated with the male gender (AOR 2.37, 95% CI 1.19 - 4.73;p = 0.014). The most commonly cited sources of COVID-19 information were news media 147 (91.3%), Ministry of Health 134 (83.2%), and social media 125 (77.6%). The ministry of health was considered the most trustworthy source 139 (86.3%) and social media the least 21 (13.0%). Conclusions: COVID-19-related knowledge, attitude and practices among undergraduates in Uganda were low overall. Therefore, concerted efforts to provide tailored health education and behaviour change communication are needed.

GIS and Multi-Criteria Decision Analysis for Land Use Resource Planning

Natural resources management is indispensable in ensuring environmental sustainability and reducing the risk associated with climate change and increasing demand for ecological goods and services. Natural resources planners need to have at their disposal tools that can objectively help in prioritizing land use allocation. Traditional application of land use change model based on economic model, trend analysis, and or scenario analysis present some challenges of data availability and reliability necessary for implementation of the models. However, with the advent of information technology, GIS and remote sensing, biophysical data known for having influence on land use allocation can easily be accessed. The current study explores the application of GIS-Multi-criteria analysis in modeling future land use scenarios for resources planning and management using easy to construct biophysical parameters known for influencing future land use allocation. The decision problems in this study are to find the best spatial allocation of land to future agriculture and forest development, which are considered to present critical land use change in the study area. The afforestation scenarios are meant to offset the pressure on the native forest resources due to the increased demand for fuel and timber and also to contribute to the environmental protection and the agricultural land use scenarios are meant to increase productivity and ensure environmental protection. The land use scenarios did not consider “when” in the future the land use pattern may develop. The analyses of scenarios indicate that afforestation extent in the basin can be increased from 4.6% to 42.9% of the total basin area. However, the afforestation extent of 42.9% may be considered unrealistic, since in practice, it may not be possible to realize up to 42.9% afforestation, nevertheless, the spatial pattern of the afforestation may provide crucial insight into spatial afforestation policies and it future consequences. The agricultural land use can increase from 6.2% to 53.7% of the basin area. The agricultural land use expansion can be realised since the expansion of farm land is primarily the main option to achieve food production increase in the near future. The findings indicate potential use of the methodology in land use planning.

Knowledge and Attitude towards Cervical Cancer Screening among Females Attending out Patient Department in Health Centre IIIs in Oyam District

Cervical cancer is a serious health concern in Uganda. Early screening and detection certainly improves chances of survival and treatment outcome. Sound knowledge and positive attitudes highly influence acceptability and uptake of screening methods. This descriptive cross-sectional study determines knowledge and attitudes towards Cervical Cancer screening amongst female out-patients aged 15 - 49 years, attending Health Centre IIIs in Oyam District, Northern Uganda. A systematically obtained sample of 445 respondents was interviewed using semi-structured questionnaires and focused group discussions. Quantitative data was analyzed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually. Of the 445 respondents, only 62.7% (n = 279) had heard of cervical cancer amongst which only 35.1% (n = 85) had been screened;13.7% (n = 34) did not know what screening was;3.7% (n = 9) were not sure and 5.8% (n = 14) knew it as removal of the cervix. Only 39.1% (n = 174) believed that cervical cancer can be prevented. There is still limited knowledge and lots of misconceptions about cervical cancer screening in the communities, which requires massive sensitization of the population at risk to change negative attitudes and maximize acceptability to screening methods.

Management of HIV in Children Using a Bovine Colostrum-Based Food Product— An Observational Field Study

Aim: Malnutrition increases the severity and mortality of HIV infection. Therefore, this field study was started and aimed to provide a major cohort of HIV-infected children with the colostrum-based food product ColoPlus (ColoPlus AB, Malm&ouml;, Sweden) and to investigate the effects of ColoPlus on the nutritional status and immunological capacity of children including tolerability and safety of the product. Methods: In this major field program comprising 850 malnourished HIV positive children, 50 grams of ColoPlus was administrated for 4 weeks as the first meal in selected health facilities in Northern Uganda. Forty-eight of these children (8 months - 14 years of age) were recruited into a descriptive prospective study and were followed for 12 weeks. At the start (week 0) and at weeks 4, 8 and 12, CD4+ cell counts, serum albumin and hemoglobin were analyzed. The remaining 802 patients were observed to register safety and tolerability of ColoPlus. Results: There was a general improvement of wellbeing of the children with increased body weight and decreased fatigue. In the descriptive study of the 48 children, there was a significant rise of the CD4+ values at week 4 (+15.4% ± 2.8%, p = 0.0001) compared to week 0, and at week 8 (+39.1% ± 3.9%, p < 0.0001), but a return towards the 0-values at week 12 (+2.1%, ±2.8%, NS). Hemoglobin and serum albumin showed an almost similar trend. ColoPlus was well tolerated by all the 850 children and no side effects or adverse events were seen. Conclusion: These results show that addition of a colostrum-based food product to the daily diet is beneficial in HIV-positive malnourished children. An improvement in nutritional status as well as in immune capacity was seen. These effects were prolonged and remained at least 4 weeks after cessation of ColoPlus administration.

Kinetics and Thermodynamic Studies: Adsorption of Pb, Cr and Ni Ions from Spent Lubrication Oil (SLO) Using Acid Modified Clay

Adsorption of Pb, Cr, and Ni ions from spent lubrication oil (SLO) by sulphuric acid modified clay (SAMC) was investigated considering the effect of contact time and temperature of the adsorption system. The removal percentage of the heavy metals was found to be temperature and contact time-dependent. Adsorption of the heavy metals increases with an increase in temperature and contact time with 95.0% - 100% adsorption recorded at the temperature of 331 K with the equilibration time of 12 hours. The thermodynamic and kinetics investigation of the adsorption process showed that the adsorption of these metals by the modified adsorbent is a spontaneous and endothermic physical adsorption process that followed the pseudo-second-order kinetic model.

Growth and Development of <i>Cyperus papyrus</i>in a Tropical Wetland

Relative growth rate (RGR) is an important parameter in plant growth models. However, no field measurements of RGR have been made in Cyperus papyrus (papyrus) wetlands. In this study, the growth dynamics of aerial shoots were investigated in a tropical papyrus wetland. The aim was to estimate temporal changes in the growth rates, and also establish the effect of water level and temperature change on total culm number, culm recruitment and senescence. Dry weights of shoots during their life cycle were determined using a non-destructive method after establishment of relationship between culm diameter and dry weight. Measurements were made over period of seven months. During the course of the measurements, culm density significantly increased from 16.1 to 35.9 culms.m-2. There were significant changes in both culm recruitment and senescence. Maximum RGR of developing culms was 1.04 g g-1 d-1. Using a culm density of 27 per m-2, productivity range was 16.74 to 37.37 g m-2 d-1. There was an inverse and significant relationship between rate of change in leaf weight ratio (LWR) and RGR of the culms. In conclusion, RGR of the aerial shoot development was controlled by rate of change in LWR from 41 to 156 days of growth. There was a strong and negative influence of water level fluctuation on total culm density.

Grain Hermetic Storage Adoption in Northern Uganda: Awareness, Use, and the Constraints to Technology Adoption

Post-harvest storage losses (PHLs) remain significant in Sub-Saharan Africa (SSA) due to several factors mainly insect pests and molds. Hermetic storage technologies (HSTs) are being promoted to address these storage losses. In Uganda, HSTs were first introduced in 2012. However, its use among farming households remains low today. Data were collected from 306 smallholder farmers from four districts of Northern Uganda using a pre-tested semi-structured questionnaire to understand their knowledge, use, and constraints to the adoption of hermetic storage. A multivariate Logit regression model was used to find the significance of the factors affecting adoption. Results showed low awareness and use of hermetic storage among smallholder farmers. Only 53.3% of the interviewed farmers were aware of the use of hermetic storage for grain storage. The SuperGrain bag was the most known form of hermetic storage (35.3%), followed by the Purdue Improved Crop Storage (PICS) bag (34.9%), metallic silo (15.5%), and plastic silo (14.4%). Hermetic storage use was even lower as only 17.6% of the surveyed farmers were using one or more forms of hermetic storage to store their grains. Insect pest management without chemical insecticides was the main reason (83.1%) for hermetic storage use. About 75.5% of those aware of hermetic storage had received training in the technology. Hermetic storage use in farming households led to improved food availability, household income, and nutrition. Lack of local availability (50.2%), high costs (37.8%), and inadequate knowledge (6.9%) were the main constraints hindering the adoption of hermetic storage in Northern Uganda. The logit regression models showed that only training in hermetic storage significantly (p = 0.002) affected farmers’ decision to adopt hermetic storage. Understanding the factors that constrain the adoption of HSTs could provide policymakers with important information to initiate and design policies and programs aimed at reducing crop storage losses.

PFAS: Ecological Implications, Remedial Actions and Ethical Considerations

The C-F bond is one of the strongest in organic chemistry. It is responsible for the great stability of perfluoroalkyl and polyfluoroalkyl substances, commonly referred to as “PFAS”, a group of man-made chemicals that include perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Thermal stability, surface activity, dielectric characteristics, chemical resistance, and inertness are just a few of the technical advantages that this group has over hydrocarbons, and since the 1950s, these chemicals have been largely utilized in a variety of domestic and industrial endeavors. The hydrophilic and lipophilic nature of this class of chemicals accounts for its uniqueness. Up until today, the chemistry and ecotoxicology of these chemicals continue to emerge. Issues concerning the destructive power of ignorance expedited by an ineffective regulatory institution continue to show that manufacturing chemicals are insufficient without giving serious thought to issues of openness and humanity’s awareness of its own safety. When discussing the nature of humanity and how it can be defined or redefined, it is important to allude to the significance of integrating business with ethics in its various forms. This paper highlights the importance of holding polluters accountable for PFAS contamination cleanup costs while emphasizing the need for chemical manufacturers to test and disclose the health and environmental effects of PFAS compounds. In addition, the sources, types, properties, applications, distribution, toxicological implications, regulations, and analytical methods associated with PFAS (per- and polyfluoroalkyl substances) are explored. The effectiveness of the remedial methods described in this paper needs to be progressively tested while exploring other sustainable approaches.

Uptake of Phosphorus from Modified P-Enriched Douglas Fir Biochar and Its Effects on Crop Growth and P Use Efficiency

The potential use of biochar as a sustainable soil amendment has recently gained global recognition. The use of biochar as a soil additive is attributed to its ability to improve soil chemical, physical and biological properties. Studies have shown that biochar amendments can enhance soil nutrient retention and availability, pH, water holding capacity, microbial activity and sequester carbon. In this study using corn (Zea mays L.) as an experimental crop, the influence of P availability from modified P enriched Douglas fir biochar (PEB), triple super phosphate fertilizer (SPF), and modified Douglas fir biochar (MB) on plant growth and P Use Efficiency (PUE) were compared. The rate of P applied (0, 30, 60, 90 and 120 kg·ha-1) was calculated based on % P content of each soil additive. Except for MB treatments, P recovery, crop growth and P Use Efficiency increased with application rates. The maximum above ground dry matter yields corresponding to PEB, SPF and MB treatments were estimated at 3488 kg·ha-1, 2449 kg·ha-1 and 639 kg·ha-1, while their respective agronomic P use efficiency (AGE) rates were 32 kg·kg-1, 17 kg·kg-1, 0.5 kg·kg-1. Also, recovery of K, Mg, Ca, Zn, Fe, Cu, B and Mn improved in both PEB (p value 0.9) and SPF (p value < 0.0058, r2 > 0.9) treatments. More studies at field scale are needed to demonstrate the practicability of using modified P enriched Douglas fir biochar for soil amendments.

Microplastics and Nano-Plastics: From Initiation to Termination

Following the advent of the Industrial Revolution, plastic pollution has been a serious environmental issue while micro- and nano-plastics have been a cynosure of researchers’ attention in the twenty-first century. This is due to the improved knowledge of its ecotoxicological effects and the global pushforward towards sustainability. There is a growing concern that the increasing presence of microplastics and nanoplastics (MNPs) in aquatic habitats poses a threat to marine life, and it is predicted that nanoplastics will be just as ubiquitous as macro- and micro-plastics, but far more destructive to living organisms due to their ability to infiltrate cells. Recent research has shown that marine and freshwater biota become entangled with plastic litter, which disrupts the ecosystem. Aquatic creatures are known to absorb and deposit these new pollutants in their digestive systems, as has been documented in several studies. More recent research has also examined their co-occurrence and toxicity with other emerging contaminants, including their prevalence and effects in food, air, and soil. Using articles extracted from a six-year period from Scopus, ACS Publications and Google Scholar, this review explores the origins, fates, occurrence in the food chain, exposure routes, cellular interactions of microplastics and nano-plastics, in addition to the ecotoxicological impacts, analytical methods, and the potential remedies for combating pollution and toxicity. Ultimately, this review is a comprehensive, updated addendum to available reviews on micro- and nano-plastics.

Microplastics in Marine Environment: Occurrence, Distribution, and Extraction Methods in Marine Organisms

The pervasive presence of microplastics in marine environments has raised significant concerns. This review addresses the pressing issue of microplastic pollution in marine ecosystems and its potential implications for both the environment and human health. It outlines the current state of microplastic occurrence, distribution, and extraction methods within marine organisms. Microplastics have emerged as a significant environmental concern due to their harmful effects on ecosystems and their potential human health risks. These particles infiltrate marine environments through runoff and atmospheric deposition, ultimately contaminating beaches and posing threats to marine life. Despite the gravity of this issue, there has been limited research on the presence and distribution of microplastics in marine organisms. This review aims to bridge this knowledge gap by comprehensively examining the occurrence, distribution, and various extraction methods used to detect microplastics in marine organisms. It emphasizes the urgent need for targeted measures to manage microplastic pollution, highlights the significant role of human activities in contributing to this problem, and underscores the importance of reducing human-induced pollution to safeguard marine ecosystems. While this paper contributes to the understanding of microplastic pollution in marine environments and underscores the critical importance of taking action to protect marine organisms and preserve our oceans for future generations, it also emphasizes that, in effectively tackling the microplastic problem, a well-coordinated approach is essential, involving research initiatives, policy adjustments, public involvement, and innovative technologies. Crucially, prompt and resolute responses must exist to counteract the escalating peril posed by microplastics to the oceans and the global environment.

PFAS: Ecological Implications, Remedial Actions and Ethical Considerations

The C-F bond is one of the strongest in organic chemistry. It is responsible for the great stability of perfluoroalkyl and polyfluoroalkyl substances, commonly referred to as “PFAS”, a group of man-made chemicals that include perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Thermal stability, surface activity, dielectric characteristics, chemical resistance, and inertness are just a few of the technical advantages that this group has over hydrocarbons, and since the 1950s, these chemicals have been largely utilized in a variety of domestic and industrial endeavors. The hydrophilic and lipophilic nature of this class of chemicals accounts for its uniqueness. Up until today, the chemistry and ecotoxicology of these chemicals continue to emerge. Issues concerning the destructive power of ignorance expedited by an ineffective regulatory institution continue to show that manufacturing chemicals are insufficient without giving serious thought to issues of openness and humanity’s awareness of its own safety. When discussing the nature of humanity and how it can be defined or redefined, it is important to allude to the significance of integrating business with ethics in its various forms. This paper highlights the importance of holding polluters accountable for PFAS contamination cleanup costs while emphasizing the need for chemical manufacturers to test and disclose the health and environmental effects of PFAS compounds. In addition, the sources, types, properties, applications, distribution, toxicological implications, regulations, and analytical methods associated with PFAS (per- and polyfluoroalkyl substances) are explored. The effectiveness of the remedial methods described in this paper needs to be progressively tested while exploring other sustainable approaches.

Testing the Proposed Municipality Resilience Index to Climate Change Shocks and Stresses in Mbale Municipality in Eastern Uganda

Since climate change shocks and stresses cannot be fully prevented, building resilient urban areas is gaining more attention in the global community. By building resilience, the negative impacts of climate change shocks and stresses can be alleviated. Several indices have been developed to measure urban resilience. Yet, most of these indices focus more on objective methods which require robust bio-physical and socio-economic data sets which are generally lacking in many developing countries. To reduce this challenge, the use of subjective methods has recently been suggested. This study proposed and tested a Municipality Resilience Index (MRI) which employed a subjective method to assess the resilience of Mbale municipality in Eastern Uganda against climate change shocks and stresses. The proposed MRI includes 46 variables describing the physical, social, economic and institutional dimensions. The MRI can be applied in any municipality in developing countries facing climate related shocks and stresses and with limited survey data. The application of this index to Mbale municipality shows that the municipality has a low resilience index of 0.2. Similarly, most variables in the four dimensions of resilience reflected very low resilience scores with other divisions being more resilient than the others. Furthermore, the social dimension has the lowest score as compared to the physical, economic and institutional dimensions. The findings indicate a spatial variability in the contribution of the resilience dimensions within this small geographic confine. Moreover, the findings show the strengths and weaknesses in the different dimensions of the proposed MRI. This can act as a guide for policy and practitioners on which sectors to target in order to enhance the resilience of Mbale municipality.

Barriers to Global Recognition of Traditional African Medicines: A Systematic Review of Cultural, Scientific, Regulatory, and Economic Factors

Despite the profound cultural and medicinal heritage of traditional African medicines (TAM), their global recognition remains notably limited. This study investigates the factors behind this issue, focusing on cultural perceptions, scientific validation, regulatory frameworks, and pharmaceutical industry influence. Utilizing a systematic literature review (SLR) to provide a thorough and structured overview, the research addresses these factors with transparency and reproducibility. Key findings reveal that negative cultural perceptions, the dominance of Western medicine, and skepticism towards traditional healers, especially in urban and educated populations, marginalize TAM. Additionally, religious beliefs and historical influences, such as colonialism, further devalue indigenous knowledge systems. The study also highlights a significant lack of scientific research and clinical trials, which challenges the conventional validation of TAM’s efficacy. Moreover, inconsistent international and national regulatory frameworks and the pharmaceutical industry’s dominance impede TAM’s integration into global healthcare systems. To enhance TAM’s credibility and global acceptance, the study advocates for standardized regulatory policies, increased scientific research, and a reevaluation of intellectual property laws. This shift towards a more inclusive and integrative approach in global health systems could bridge the gap between traditional and modern medical practices, promoting a more holistic understanding of health and wellness.

Synthesis and Application of Granular Activated Carbon from Biomass Waste Materials for Water Treatment:A Review

There is an increased global demand for activated carbon(AC)in application of water treatment and purification.Water pollutants that have exhibited a greater removal efficiency by AC included but not limited to heavy metals,pharmaceuticals,pesticides,natural organic matter,disinfection by-products,and microplastics.Granular activated carbon(GAC)is mostly used in aqueous so-lutions and adsorption columns for water treatment.Commercial AC is not only costly,but also obtained from non-renewable sources.This has prompted the search for alternative renewable materials for AC production.Biomass wastes present a great potential of such materials because of their availability and carbonaceous nature.This in turn can reduce on the adverse environmental effects caused by poor disposal of these wastes.The challenges associated with biomass waste based GAC are their low strength and attrition resistance which make them easily disintegrate under aqueous phase.This paper provides a comprehensive review on recent advances in production of biomass waste based GAC for water treatment and highlights future research directions.Production parameters such as granulation conditions,use of binders,carbonization,activation methods,and their effect on textural properties are discussed.Factors influencing the adsorption capacities of the derived GACs,adsorption models,adsorption mechanisms,and their regeneration potentials are reviewed.The literature reveals that biomass waste materials can produce GAC for use in water treatment with possibilities of being regenerated.Nonetheless,there is a need to explore 1)the effect of preparation pathways on the adsorptive properties of biomass derived GAC,2)sustainable production of biomass derived GAC based on life cycle assessment and techno-economic analysis,and 3)adsorption mechanisms of GAC for removal of contaminants of emerging concerns such as microplastics and unregulated disinfection by-products.

Stigma and epilepsy in onchocerciasisendemic regions in Africa:a review and recommendations from the onchocerciasisassociated epilepsy working group

Background:In onchocerciasis-endemic areas,particularly in those with a sub-optimal onchocerciasis control programme,a high prevalence of epilepsy is observed.Both onchocerciasis and epilepsy are stigmatizing conditions.The first international workshop on onchocerciasis-associated epilepsy(OAE)was held in Antwerp,Belgium(12-14 October 2017)and during this meeting,an OAE alliance was established.In this paper,we review what is known about epilepsy-associated stigma in onchocerciasis-endemic regions,and present the recommendations of the OAE alliance working group on stigma.Main body:For this scoping review,literature searches were performed on the electronic databases PubMed,Scopus and Science Direct using the search terms"epilepsy AND onchocerciasis AND stigma".Hand searches were also undertaken using Google Scholar,and in total seven papers were identified that addressed epilepsy-related stigma in an onchocercisasis-endemic area.Due to the limited number of published research papers on epilepsyassociated stigma in onchocerciasis-endemic areas,other relevant literature that describes important aspects related to stigma is discussed.The thematic presentation of this scoping review follows key insights on the barriers to alleviating the social consequences of stigma in highly affected onchocerciasis-endemic areas,which were established by experts during the working group on stigma and discrimination at the first international workshop on OAE.These themes are:knowledge gaps,perceived disease aetiology,access to education,marriage restrictions,psycho-social well-being,burden on the care-giver and treatment seeking behaviour.Based on the literature and expert discussions during the OAE working group on stigma,this paper describes important issues regarding epilepsy-related stigma in onchocerciasis-endemic regions and recommends interventions that are needed to reduce stigma and discrimination for the improvement of the psycho-social well-being of persons with epilepsy.Conclusions:Educating healthcare workers and communities about OAE,strengthening onchocerciasis elimination programs,decreasing the anti-epileptic treatment gap,improving the care of epilepsy-related injuries,and prioritising epilepsy research is the way forward to decreasing the stigma associated with epilepsy in onchocerciasis-endemic regions.

Household perceptions and subjective valuations of indoor residual spraying programmes to control malaria in northern Uganda

Background:Insecticide-based tools remain critical for controlling vector-borne diseases in Uganda.Securing public support from targeted populations for such tools is an important component in sustaining their long-run effectiveness.Yet little quantitative evidence is available on the perceived benefits and costs of vector control programmes among targeted households.Methods:A survey was administered to a clustered random sample of 612 households in Gulu and Oyam districts of northern Uganda during a period of very high malaria transmission and following a pilot indoor residual spray(IRS)programme.A discrete choice experiment was conducted within the survey,in which respondents indicated their preferences for different IRS programmes relative to money compensation in a series of experimentally controlled,hypothetical choice sets.The data were analysed using conditional logit regression models to estimate respondents’willingness to accept(WTA)some amount of money compensation in lieu of foregone malaria risk reductions.Latent class models were used to analyse whether respondent characteristics predicted WTA.Results:Average WTA is estimated at$8.94 annually for a 10%reduction in malaria risk,and additional co-benefits of IRS were estimated to be worth on average$54–$56(depending on insecticide type)per round of IRS.Significant heterogeneity is observed:Four in five household heads in northern Uganda have high valuations for IRS programmes,while the remaining 20%experience costly side effects of IRS(valued at between$2 and$3 per round).Statistically significant predictors of belonging to the high-value group include respondent gender,mean age of household members,participation in previous IRS,basic knowledge of mosquito reproduction,and the number of mosquito nets owned.Proxies for household income and wealth are not found to be statistically significant predictors of WTA.Conclusions:This study suggests that the majority of people in areas of high malaria transmission like northern Uganda place a high value on vector control programmes using IRS.However,there is significant heterogeneity in terms of the perceived side effects(positive and negative).This has implications for sustaining public support for these programmes in the long-term.