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Lack of effect of intermittent preventive treatment for malaria in pregnancy and intense drug resistance in western Uganda
(Malaria Journal, 2015) Braun, Vera; Rempis, Eva; Schnack, Alexandra; Decker, Sarah; Rubaihayo, John; Tumwesigye, Nazarius Mbona; Theuring, Stefanie; Harms, Gundel; Busingye, Priscilla; Mockenhaupt, Frank P.
Background: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine–pyrimethamine (SP) is widely
implemented in sub-Saharan Africa for the prevention of malaria in pregnancy and adverse birth outcomes. However,
in areas of intense SP resistance, the efficacy of IPTp may be compromised.
Methods: A cross-sectional study among 915 delivering women (728 analysable live singleton deliveries) was conducted
in Fort Portal, western Uganda, to assess associations of reported IPTp use, Plasmodium falciparum infection,
maternal anaemia, low birth weight, and preterm delivery, and to estimate the degree of SP resistance as reflected by
pfdhfr/pfdhps mutations.
Results: Plasmodium falciparum infection was detected by PCR in 8.9 % and by microscopy of placental blood
samples in 4.0 %. Infection was significantly associated with stillbirth, early neonatal death, anaemia, low birth
weight, and pre-term delivery. Eighty percent of the women had taken at least one dose of IPTp, and more than half
had taken two doses. As compared to women without chemoprophylaxis against malaria, IPTp had no significant
influence on the presence of P. falciparum infection (13.8 vs. 9.6 %, P = 0.31). Nor was it associated with reductions
in anaemia, low birth weight or preterm delivery. P. falciparum with intense SP resistance (pfdhfr/pfdhps quintuple or
sextuple mutations) were observed in 93 % (pfdhps 581G, 36 %), and the additional high resistance allele pfhdr 164L
in 36 %.
Conclusions: In Fort Portal, Uganda, reported use of IPTp with SP does not provide an observable benefit. The
molecular markers of P. falciparum indicate high grade SP resistance reaching the threshold set by WHO for the discontinuation
of IPTp with SP. Alternative approaches for the prevention of malaria in pregnancy are urgently needed.
Problem drinking and physical intimate partner violence against women: evidence from a national survey in Uganda
(BMC, 2012) Tumwesigye, Nazarius Mbona; Kyomuhendo, Grace Bantebya; Greenfield, Thomas Kennedy; Wanyenze, Rhoda K
Background: Problem drinking has been identified as a major risk factor for physical intimate partner violence
(PIPV) in many studies. However, few studies have been carried on the subject in developing countries and even
fewer have a nationwide perspective. This paper assesses the patterns and levels of PIPV against women and its
association with problem drinking of their sexual partners in a nationwide survey in Uganda.
Methods: The data came from the women’s dataset in the Uganda Demographic and Health Survey of 2006.
Problem drinking among sexual partners was defined by women’s reports that their partner got drunk sometimes
or often and served as the main independent variable while experience of PIPV by the women was the main
dependent variable. In another aspect problem drinking was treated an ordinal variable with levels ranging from
not drinking to getting drunk often. A woman was classified as experiencing PIPV if her partner pushed or shook
her; threw something at her; slapped her; pushed her with a fist or a harmful object; kicked or dragged her, tried to
strangle or burn her; threatened/attacked her with a knife/gun or other weapon. General chi-square and chi-square
for trend analyses were used to assess the significance of the relationship between PIPV and problem drinking.
Multivariate analysis was applied to establish the significance of the relationship of the two after controlling for key
independent factors.
Results: Results show that 48% of the women had experienced PIPV while 49.5% reported that their partners got
drunk at least sometimes. The prevalence of both PIPV and problem drinking significantly varied by age group,
education level, wealth status, and region and to a less extent by occupation, type of residence, education level
and occupation of the partner. Women whose partners got drunk often were 6 times more likely to report PIPV
(95% CI: 4.6-8.3) compared to those whose partners never drank alcohol. The higher the education level of the
women the less the likelihood of experiencing PIPV (ptrend<0.001). Similar relationship was found between wealth
status and experiencing PIPV.
Conclusions: Problem drinking among male partners is a strong determinant of PIPV among women in Uganda.
PIPV prevention measures should address reduction of problem drinking among men. Longerterm prevention
measures should address empowerment of women including ensuring higher education, employment and
increased income.
Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda
(BMC, 2016) Nyeko, Richard; Tumwesigye, Nazarius Mbona; Halage, Abdullah Ali
Background: According to World Health Organization (WHO) estimates, 80 % of the population living in rural
areas in developing countries depends on traditional medicine for their health needs, including use during
pregnancy. Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is
limited and that some herbal products may be teratogenic, data on the extent of use of herbal medicines by
women during pregnancy in the study setting is largely unknown. We determined the prevalence and factors
associated with herbal medicine use during pregnancy among women attending postnatal clinics in Gulu district,
Northern Uganda.
Methods: This was a descriptive cross-sectional study which involved 383 women attending postnatal care
across four sites in Gulu district using quantitative and qualitative methods of data collection. A structured
questionnaire was used to collect quantitative data while qualitative data were obtained using focus group
discussions and key informant interviews. The selection of the study participants was by systematic sampling
and the main outcome variable was the proportion of mothers who used herbal medicine. Quantitative data
was coded and entered into a computerized database using Epidata 3.1. Analysis was done using Statistical
Package for Social Scientists version 13, while thematic analysis was used for qualitative data.
Results: The prevalence of herbal medicines use during the current pregnancy was 20 % (78/383), and was
commonly used in the second 23 % (18/78) and third 21 % (16/78) trimesters. The factors significantly associated
with use of herbal medicines during pregnancy were perception (OR 2.18, CI 1.02-4.66), and having ever used
herbal medicines during previous pregnancy (OR 2.51, CI 1.21-5.19) and for other reasons (OR 3.87, CI 1.46-10.25).
Conclusions: The use of herbal medicines during pregnancy among women in Gulu district is common, which
may be an indicator for poor access to conventional western healthcare. Perception that herbal medicines are
effective and having ever used herbal medicines during previous pregnancy were associated with use of herbal
medicines during current pregnancy. This therefore calls for community sensitization drives on the dangers of
indiscriminate use of herbal medicine in pregnancy, as well as integration of trained traditional herbalists and all
those community persons who influence the process in addressing the varied health needs of pregnant women.
EFFECT OF SOIL AND WATER CONSERVATION TECHNOLOGIES ON SOIL PROPERTIES IN MAZIBA SUB CATCHMENT, KABALE__UGANDA
(Kenyata University, 2018) Ndemere, Julius
Soil and water resources are important for sustaining life on earth since they are the main
components of sub catchment, however they are under threat of deterioration due to human
activities (NEMA, 2011). Maziba sub catchment have high population pressure which have led
to deforestation, over cultivation and wetland encroachment leading to soil erosion problems
causing severe tension on soil and water resources while little attention is paid to their effects
(NEMA, 2011). The purpose of the study was to analyze the effect of soil and water conservation
technologies on soil properties in Maziba sub catchment of Kabale District, Uganda. The specific
objectives of the study were to: (i) Identify soil and water conservation technologies used at
different landscape positions by farmers in Maziba sub catchment, (ii) Evaluate the effects of
selected soil and water conservation technologies on saturated hydraulic conductivity, organic
matter and bulk density and (iii) Determine the factors influencing farmers’ use of soil and water
conservation technologies in Maziba sub catchment. The study employed both descriptive and
analytical research designs utilizing mixed methodologies. Probability sampling technique was
used to select 99 respondents, who were selected to obtain predominantly used soil and water
conservation technologies and socio-economic data using semi-structured questionnaire. Thirty
six soil samples were collected from mulched and trenched plots at 0-5 cm depth using soil core
to analyze BD and OM from the laboratory and sat K was measured in situ using inversed augur
hole technique. Statistical analysis of the data collected was done using statistical packages for
social scientists (SPSS 16.0) and Microsoft Excel 2007. The results obtained from treatment
(mulched plots) were compared to those of control (none mulched plots) from the same sub
catchment and conclusions regarding the soil properties were drawn based on internationally
acceptable standards. Descriptive statistics were used to describe soil and water conservation
technologies practiced in the study area. Chi-square tests were used to test the association
between socio-economic data and soil and water conservation technologies used by farmers. The
study revealed that terracing (36.4%), mulching (21.2%) and trenching (13.1%) were the
predominant soil and water conservation technologies reported. The study results indicated that
plots under mulching and trenching (treatment) significantly affects the soil OM (4.45 %), Soil
BD (1.32 g /cm3) and sat K (6.1310-2 cm/s) compared to results obtained from control plots
OM (3.31%), BD (1.45 g/cm3) and sat K (11.9210-2 cm/s) which was all within acceptable
range. The study further revealed that marital status of respondents, age of respondents, level of
education, fertility of the soil, farmland slope, size of land and land tenure influenced farmers’
use of soil and water conservation technologies. The study recommends extensive use of
mulching and trenching since they were proved to be effective in improvingOM , BD and sat K
in the study area.
Vegetation based climate solutions for soil management in smallholder farmlands of Kabale and Rubanda districts, Uganda
(Springer Nature, 2024) Ndemere, Julius; Brahima, Kone; Bamwerinde, Wilson
Understanding and appreciating climate solutions for soil management in smallholder farmlands are paramount. These
climate solutions inform smallholder farmers’ actions, choices, decisions and priorities to tackle specific climate change
problems and opportunities. The study used structured and semi structured questionnaires to collect field data to ascertain
smallholder farmers’ knowledge about vegetation based climate solutions for soil management in Kabale and
Rubanda districts, Uganda. A purposive sampling technique was used to collect data from 367 smallholder farmer
household head respondents. Regression model, specifically linear to test multicollinearity and multinomial logistic
and descriptive statistics was utilised to examine vegetation based climate solutions for soil management. Vegetation
based climate solutions such as crop residues, selected trees, Napier grass and Seteria grass (dependent) and gender, age
and marital status, and level of education information (independent) were determined predictor variables. The findings
revealed that both genders, males (51.5%) and females (48.5%), witnessed climate change as demonstrated in Fig. 2.
The chi-square test (χ2 = 376.337) indicated a significant difference between smallholder farmers’ implementing climate
solutions. The study observed positive Kendall’s tau (0.357 and 0.118) and a p-value (0.002 and 0.289) of temperature and
rainfall respectively. Most farmers (69.2%) relied on fellow farmers as a major source of climate information to manage
soil and enhance soil fertility. Vegetation based climate solutions 33.8%, (planting Napier grass, selected tree species, and
crop residues) were revealed as suitable and effective soil management interventions to control soil erosion and fertility
improvement in smallholder farmlands. Climate solutions were significantly influenced by level of education (0.000) and
farmland size (0.001) at 0.05. Therefore, there is a need to incorporate vegetation based climate solutions into government
development programmes and agendas to enhance soil fertility and erosion management in smallholder farmers’
farmlands with a focus on livelihood improvement through increasing crop yields and hunger alleviation.