Showing papers by "Makerere University published in 2001"

Extending the Cross-Cultural Validity of the Theory of Basic Human Values with a Different Method of Measurement

Abstract: Several studies demonstrate that Schwartz’s (1992) theory of human values is valid in cultures previously beyond its range. We measured the 10 value constructs in the theory with the Portrait Values Questionnaire (PVQ), a new and less abstract method. Analyses in representative samples in South Africa (n = 3,210) and Italy (n = 5,867) and in samples of 13- to 14-year-old Ugandan girls (n = 840) yielded structures of relations among values similar to the theoretical prototype. In an Israeli student sample (n = 200), the values exhibited convergent and discriminant validity when measured with the PVQ and with the standard value survey. Predicted relations of value priorities with a set of 10 background, personality, attitude, and behavioral variables in the four samples supported the construct validity of the values theory with an alternative method of measurement.

Selection and fading of resistance mutations in women and infants receiving nevirapine to prevent HIV-1 vertical transmission (HIVNET 012).

Abstract: Objective To examine the emergence and fading of NVP resistance (NVP(R)) mutations in HIV-1-infected Ugandan women and infants who received single dose NVP to prevent HIV-1 vertical transmission. Design We examined NVP(R) in women and infants who received NVP in the HIVNET 012 clinical trial, including 41 out of 48 women with infected infants, 70 randomly-selected women with uninfected infants, and 33 out of 49 infected infants. Methods Plasma HIV-1 was analyzed using the Applied Biosystems ViroSeq HIV-1 Genotyping System. Results NVP(R) mutations were detected in 21 out of 111 (19%) women tested 6-8 weeks after delivery. The rate of NVP(R) was similar among women whose infants were or were not HIV-1 infected. K103N was the most common mutation detected. NVP(R) mutations faded from detection within 12-24 months in all 11 evaluable women. High baseline viral load and low baseline CD4 cell count were associated with development of NVP(R). NVP(R) mutations were detected in 11 out of 24 (46%) evaluable infants who were infected by 6-8 weeks of age. The most common NVP(R) mutation detected in infants was Y181C. Those mutations faded from detection by 12 months of age in all seven evaluable infants. Of nine evaluable infants with late HIV-1 infection, only one had evidence of NVP(R). Conclusions NVP(R) was detected more frequently in infants than women following NVP prophylaxis, and different patterns of NVP(R) mutations were detected in women versus infants. NVP(R) was detected infrequently in infants with late HIV-1 infection. NVP-resistant HIV-1 faded from detection in women and infants over time.

HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda.

Abstract: Evidence of condom effectiveness for HIV and sexually transmitted disease (STD) prevention is based primarily on high-risk populations. The authors examined condom effectiveness in a general population with high HIV prevalence in rural Africa. Data were from a randomized community trial in Rakai Uganda. Condom usage information was obtained prospectively from 17264 sexually active individuals aged 15-59 years over a period of 30 months. HIV incidence and STD prevalence was determined for consistent and irregular condom users compared to non-users. Adjusted rate ratios (RR) of HIV acquisition were estimated by Poisson multivariate regression and odds ratios (ORs) of STDs estimated by logistic regression. Only 4.4% reported consistent condom use and 16.5% reported inconsistent use during the prior year. Condom use was higher among males and younger unmarried and better educated individuals and those reporting multiple sex partners or extramarital relationships. Consistent condom use significantly reduced HIV incidence [RR 0.37; 95% confidence interval (CI) 0.15-0.88] syphilis (OR 0.71; 95% CI 0.53-0.94) and gonorrhea/Chlamydia (OR 0.50; 95% CI; 0.25-0.97) after adjustment for sociodemographic and behavioral characteristics. Irregular condom use was not protective against HIV or STD and was associated with increased gonorrhea/Chlamydia risk (OR 1.44; 95% CI 1.06-1.99). The population attributable fraction of consistent use for prevention of HIV was -4.5% (95% CI -8.3 to 0.0) due to the low prevalence of consistent use in the population. Consistent condom use provides protection from HIV and STDs whereas inconsistent use is not protective. Programs must emphasize consistent condom use for HIV and STD prevention. (authors)

Injury patterns in rural and urban Uganda

Abstract: Objectives—To describe and contrast injury patterns in rural and urban Uganda. Settings—One rural and one urban community in Uganda. Methods—Community health workers interviewed adult respondents in households selected by multistage sampling, using a standardized questionnaire. Results—In the rural setting, 1673 households, with 7427 persons, were surveyed. Injuries had an annual mortality rate of 92/100 000 persons, and disabilities a prevalence proportion of 0.7%. In the urban setting 2322 households, with 10 982 people, were surveyed. Injuries had an annual mortality rate of 217/100 000, and injury disabilities a prevalence proportion of 2.8%. The total incidence of fatal, disabling, and recovered injuries was 116/1000/year. Leading causes of death were drowning in the rural setting, and road traffic in the city. Conclusion—Injuries are a substantial burden in Uganda, with much higher rates than those in most Western countries. The urban population is at a higher risk than the rural population, and the patterns of injury differ. Interventions to control injuries should be a priority in Uganda.

Polymorphisms in the Plasmodium falciparum pfcrt and pfmdr-1 Genes and Clinical Response to Chloroquine in Kampala, Uganda

Abstract: The molecular mechanism of chloroquine resistance in Plasmodium falciparum remains uncertain. Polymorphisms in the pfcrt and pfmdr-1 genes have been associated with chloroquine resistance in vitro, although field studies are limited. In evaluations of known polymorphisms in parasites from patients with uncomplicated malaria in Kampala, Uganda, the presence of 8 pfcrt mutations and 2 pfmdr-1 mutations did not correlate with clinical response to therapy with chloroquine. Most notably, the pfcrt lysinerthreonine mutation at position 76, which recently correlated fully with chloroquine resistance in vitro, was present in 100% of 114 isolates, of which about half were from patients who recovered clinically after chloroquine therapy. These results suggest that, although key pfcrt polymorphisms may be necessary for the elaboration of resistance to chloroquine in areas with high levels of chloroquine resistance, other factors, such as host immunity, may contribute to clinical outcomes. Resistance of the malaria parasite Plasmodium falciparum to commonly used antimalarial agents is a large and growing problem. In particular, resistance to chloroquine, which remains the standard therapy for malaria in most of Africa, is an urgent concern [1]. The molecular basis of chloroquine resistance remains uncertain. Chloroquine resistance has been correlated with mutations in a number of P. falciparum genes, although some results have been inconsistent [2]. In initial studies of the P. falciparum multidrug resistance gene (pfmdr-1), an AsnrTyr mutation at amino acid 86 (N86Y) and other mutations in this gene correlated with chloroquine resistance [3]. However, in several field studies, associations between pfmdr-1 point mutations and in vivo or in vitro chloroquine resistance were not consistent [2]. More recently, transfection studies showed that the replacement of mutant pfmdr-1 with the wild-type sequence in resistant parasites decreased chloroquine resistance from high to moderate levels [4]. Thus, it appears that, although mutations

Duration of efficacy of treatment of latent tuberculosis infection in HIV-infected adults.

Abstract: Background: Treatment of latent infection is needed to protect HIV-infected individuals against tuberculosis. A previous report addressed short-term efficacy of three regimens in HIV-infected adults. We now report on long-term efficacy of the study regimens. Methods: Three daily self-administered regimens were compared in a randomized placebo-controlled trial in 2736 purified protein derivative (PPD)-positive and anergic HIV-infected adults. PPD-positive subjects were treated with isoniazid (INH) for 6 months (6H), INH plus rifampicin for 3 months (3HR), INH plus rifampicin and pyrazinamide for 3 months (3HRZ), or placebo for 6 months. Anergic subjects were randomized to 6H or placebo. Results: 6H initially protected against tuberculosis in PPD-positive individuals; however, benefit was lost within the first year of treatment. Sustained benefit was observed in persons receiving 3HR and 3HRZ. In a Cox regression analysis, the adjusted relative risk for tuberculosis compared with placebo was 0.67 [95% confidence interval (CI), 0.42‐1.07] for 6H, 0.49 (95% CI, 0.29‐0.82) for 3HR, and 0.41 (95% CI, 0.22-0.76) for 3HRZ. When the rifampicin-containing regimens were combined, the adjusted relative risk for tuberculosis compared with placebo was 0.46 (95% CI, 0.29‐0.71). Among anergic subjects, a modest degree of protection with 6H was present (adjusted relative risk, 0.61; 95% CI, 0.32‐1.16). Treatment of latent tuberculosis infection had no effect on mortality. Conclusion: Six months of INH provided short-term protection against tuberculosis in PPD-positive HIV-infected adults. Three month regimens including INH plus rifampicin or INH, rifampicin and pyrazinamide provided sustained protection for up to 3 years.

A case‐control study of human immunodeficiency virus infection and cancer in adults and children residing in Kampala, Uganda

Abstract: Uganda offers a unique setting in which to study the effect of human immunodeficiency virus-1 (HIV-1) on cancer. HIV-1 is prevalent there, and cancers which are known to be HIV-associated, such as Kaposi's sarcoma and Burkitt's lymphoma, are endemic. Adults residing in Kampala, Uganda, presenting with cancer in city hospitals were interviewed and had an HIV test. Of the 302 adults recruited, 190 had cancers with a potentially infectious aetiology (cases). The remaining 112 adults with tumours not known to have an infectious aetiology formed the control group. In addition, 318 children who were also Kampala residents were recruited and tested for HIV: 128 with cancer (cases) and 190 with non-malignant conditions (controls). HIV seroprevalence was 24% in adult controls and 6% in childhood controls. The odds of HIV seropositivity among cases with specific cancers (other than Kaposi's sarcoma in adults) were compared with that among controls, using odds ratios (ORs), estimated with unconditional logistic regression. All ORs were adjusted for age (<5, 5-14, 15-19, 30-44, 45+) and sex and, in adults, also for the number of lifetime sexual partners (1 or 2, 3-9, 10+). In adults, HIV infection was associated with a significantly (p < 0.05) increased risk of non-Hodgkin's lymphoma [OR = 6.2, 95% confidence interval (CI) 1.9-19.9, based on 21 cases] and conjunctival squamous-cell carcinoma (OR = 10.9, 95% CI 3.1-37.7, based on 22 cases) but not with cancer at other common sites, including liver and uterine cervix. In children, HIV infection was associated with a significantly increased risk of Kaposi's sarcoma (OR = 94.9, 95% CI 28.5-315.3, based on 36 cases) and Burkitt's lymphoma (OR = 7.5, 95% CI 2.8-20.1, based on 33 cases) but not with other cancers. The pattern of HIV-associated cancers in Uganda is broadly similar to that described elsewhere, but the relative frequency of specific cancers, such as conjunctival carcinoma, in HIV-infected people differs.

Situation analysis for cervical cancer diagnosis and treatment in East, Central and Southern African countries

Abstract: OBJECTIVE: To determine the factors influencing cervical cancer diagnosis and treatment in countries of East, Central and Southern Africa (ECSA). METHODS: Data were collected from randomly selected primary health care centres, district and provincial hospitals, and tertiary hospitals in each participating country. Health care workers were interviewed, using a questionnaire; the facilities for screening, diagnosing, and treating cervical cancer in each institution were recorded, using a previously designed checklist. FINDINGS: Although 95% of institutions at all health care levels in ECSA countries had the basic infrastructure to carry out cervical cytology screening, only a small percentage of women were actually screened. Lack of policy guidelines, infrequent supply of basic materials, and a lack of suitable qualified staff were the most common reasons reported. CONCLUSIONS: This study demonstrates that there is an urgent need for more investment in the diagnosis and treatment of cervical cancer in ECSA countries. In these, and other countries with low resources, suitable screening programmes should be established.

Antibacterial and antifungal activities of extracts of Zanthoxylum chalybeum and Warburgia ugandensis, Ugandan medicinal plants

Abstract: Measles is a killer disease of children in Uganda. The treatment of the disease is mainly directed at the secondary microbial infections. A large proportion of the population in Uganda still relies on the use of herbal remedies, which have been claimed to produce beneficial responses. In this study, the efficacy of Warburgia ugandensis and Zanthoxylum chalybeum against common bacteria and fungi was investigated. Bactericidal and antifungal assays were done using extracts derived from Z. chalybeum and W. ugandensis (agar well diffusion, disc diffusion and colony count assays). All extracts (ethanolic, petroleum ether and aqueous) of Z. chalybeum did not show antimicrobial activity. Phytochemical investigations of Zanthoxylum chalybeum (seed) yielded a pure crystalline alkaloid (27–135D) which was characterized as skimianine based on 1H-NMR spectroscopy and comparison with spectra of authentic samples. Skimmianine did not have antimicrobial activity in this test system. W. ugandensis water extracts elicited antibacterial activity against both Escherischia coli and Staphylococcus aureus in the agar well assay but not in the disc diffusion assay. Warburgia ugandensis water extracts and fraction 27-163D also showed antifungal activity against Candida albicans. Chromatography of extracts of Warburgia ugandensis stem bark afforded compound 49–169K, which was characterized as the sesquiterpine muzigadial (by 1H-NMR spectroscopy), which did not show antibacterial activity but had antifungal activity against C. albicans. Therefore, the claimed efficacy of W. ugandensis could be attributable to antibacterial and antifungal activity of its components. Since Z. chalybeum extracts had neither antifungal nor antibacterial activities, its mode of action is unclear from these results.

Eviction and dispersal in co-operatively breeding banded mongooses (Mungos mungo)

Abstract: The mode by which individuals disperse, and the cost of dispersal, are of great importance in attempts to understand variation in reproductive skew in animal societies. In this paper we report detailed information on dispersal and pack formation in banded mongooses Mungos mungo. Six pack fission events were recorded among 11 packs over 22 months. Pack fission occurred under two distinct circumstances. First, groups of individuals were evicted from their natal group as a result of intense aggression from other group members. A small fraction of group members was responsible for most of the aggression. Both sexes helped to attack and evict individuals from the group, and both males and females were driven out of their natal groups en masse. The second mode of pack fission occurred when groups of same-sex individuals left their natal group voluntarily to join dispersing individuals of the opposite sex, thereby forming new packs. Dispersing groups were more frequently involved in fights with rival packs of mongooses compared to established groups, and in one instance these fights seemed to be responsible for severe injury and increased mortality among members of a dispersing group. The observations of eviction provide one line of evidence that the presence of subordinates is sometimes detrimental to dominants, contrary to the assumptions of concession models of reproductive skew.

Impact of Human Immunodeficiency Virus Type 1 (HIV-1) Subtype on Women Receiving Single-Dose Nevirapine Prophylaxis to Prevent HIV-1 Vertical Transmission (HIV Network for Prevention Trials 012 Study)

Abstract: In Uganda, the HIV Network for Prevention Trials (HIVNET) 012 study recently demonstrated that single-dose nevirapine (Nvp) prophylaxis is effective for preventing mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1). This exploratory study examines the relationship between HIV-1 subtype, MTCT, and the development of Nvp resistance (Nvp(R)) in women enrolled in HIVNET 012. For 102 women (32 whose infants were HIV-1 infected by age 6-8 weeks and 70 whose infants were uninfected), HIV-1 subtypes included 50 (49%) subtype A, 35 (34%) subtype D, 4 (4%) subtype C, 12 (12%) recombinant subtype, and 1 unclassified. There was no apparent difference in the rate of MTCT among women with subtype A versus D (adjusted odds ratio [OR], 1.24; 95% confidence interval [CI], 0.45-3.43). Nvp(R) mutations were detected more frequently at 6-8 weeks postpartum in women with subtype D than in women with subtype A (adjusted OR, 4.94; 95% CI, 1.21-20.22). Additional studies are needed to further define the relationship between HIV-1 subtype and Nvp(R) among women receiving Nvp prophylaxis.

Predatory behavior of crowned hawk-eagles (Stephanoaetus coronatus) in Kibale National Park, Uganda

Abstract: Evaluating the nature and significance of preda- tion on populations of wild primates has been difficult given a paucity of data regarding the phenomenon. Here we addressed this problem in a 37-month study of the pre- datory behavior of crowned hawk-eagles living at the Ngogo study site in Kibale National Park, Uganda. We collected prey remains underneath the nests of two pairs of eagles and census data on potential prey species to in- vestigate prey selection and the ecological impact of predation on the Ngogo primate population. Results indi- cate that primates form the vast majority of all prey items. Eagles prey selectively on monkeys according to sex and species. Male primates were taken more often than fe- males, while two species, redtail monkeys and manga- beys, were captured significantly more and less, respec- tively, than chance expectation. In addition, there was no bias in the age of prey: adult and non-adults were killed in numbers roughly equal to their proportional representa- tions in the forest. Further analyses indicate that a non- trivial fraction of the entire primate population at Ngogo succumbs to crowned hawk-eagle predation each year. These results reveal both parallels and contrasts with those reported previously. Some of the parallels are due to simi- larities in prey availability, while contrasts are likely relat- ed to methodological differences between studies, inter- individual variations in predator hunting styles, and differ- ences in prey abundance, demography, and behavior.

Campylobacteriosis, salmonellosis, and shigellosis in free-ranging human-habituated mountain gorillas of Uganda.

Abstract: For conservation purposes and due to growing ecotourism, free-ranging mountain gorillas (Gorilla gorilla beringei) have been habituated to humans. Fecal specimens (n = 62) collected in January 1999 from mountain gorillas of the Bwindi and Mgahinga National Parks, Uganda, were tested for Campylobacter spp., Salmonella spp., and Shigella spp., and the overall prevalence of infection was 19%, 13%, and 6%, respectively. The prevalence of positive specimens was not related to the year of habituation of a gorilla group to humans. Campylobacter spp., Salmonella, and Shigella spp. infections were not distributed equally among the age classes of gorillas; most of the enteropathogens (80%), and all Shigella spp. organisms, S. sonnei, S. boydii, and S. flexneri, were isolated from subadults and adult gorillas with ages ranging from 6.0 to 11.9 yr. The prevalence of Campylobacter spp. and Salmonella spp. infections among human-habituated gorillas has doubled during the last 4 yr, and isolation of Shigella spp. for the first time from mountain gorillas, may indicate enhanced anthropozoonotic transmission of these enteropathogens.

Anemia and Interleukin-10, Tumor Necrosis Factor Alpha, and Erythropoietin Levels among Children with Acute, Uncomplicated Plasmodium falciparum Malaria

Abstract: Anemia is an important complication of malaria, and its pathogenesis is not well understood. To gain insight into potential age-related relationships between tumor necrosis factor alpha (TNF-α), interleukin 10 (IL-10), erythropoietin, and anemia during acute malaria, 273 children of ages 12 to 120 months presenting with acute, uncomplicated malaria in Kampala, Uganda, were monitored at enrollment and 3 and 7 days later. Younger children had higher geometric mean erythropoietin, TNF-α, and α1-acid glycoprotein (AGP) concentrations than older children. Univariate regression analysis revealed that age, log10 erythropoietin levels, IL-10/TNF-α ratio, and AGP levels were each significantly associated with hemoglobin levels at baseline. Hemoglobin concentrations were inversely correlated with the log10 erythropoietin level at all three visits. For the older age groups, higher levels of TNF-α were significantly associated with higher IL-10 levels at all three visits, but this relationship was significant only at baseline for younger children. These data suggest that younger children do not maintain IL-10 production in response to the inflammatory process, and this mechanism may contribute to the more severe anemia found in younger children. Acute malaria is an illness whose incidence and severity are largely age dependent. Further studies are needed to understand the relationships between age-related immune responses to malaria and their role in the pathogenesis of malarial anemia.

Severity of Human Immunodeficiency Virus Infection Is Associated with Decreased Phase Angle, Fat Mass and Body Cell Mass in Adults with Pulmonary Tuberculosis Infection in Uganda

Abstract: Although coinfection with tuberculosis and human immunodeficiency virus (HIV) is emerging as a major problem in many developing countries, nutritional status has not been well characterized in adults with tuberculosis and HIV infection. We compared nutritional status between 261 HIV-positive and 278 HIV-negative adults with pulmonary tuberculosis in Kampala, Uganda, using anthropometry and bioelectrical impedance analysis. Among 163 HIV-positive and 199 HIV-negative men, intracellular water-to-extracellular water (ICW:ECW) ratio was 1.48 +/- 0.26 and 1.59 +/- 0.48 (P = 0.006) and phase angle was 5.42 +/- 1.05 and 5.76 +/- 1.30 (P = 0.009), respectively. Among 98 HIV-positive and 79 HIV-negative women, ICW:ECW was 1.19 +/- 0.16 and 1.23 +/- 0.15 (P = 0.11) and phase angle was 5.35 +/- 1.27 and 5.43 +/- 0.93 (P = 0.61), respectively. There were no significant differences in BMI, body cell mass, fat mass or fat-free mass between HIV-positive and HIV-negative adults. Among HIV-positive subjects, BMI, ICW:ECW, body cell mass, fat mass and phase angle were significantly lower among those with CD4(+) lymphocytes 200 cells/microL. In sub-Saharan Africa, coinfection with pulmonary tuberculosis and HIV is associated with smaller body cell mass and intracellular water, but not fat-free mass, and by large differences in ICW:ECW and phase angle alpha.

Knowledge, attitude and practice about sexually transmitted diseases among University students in Kampala

Abstract: Background: Sexually transmitted diseases (STDs) remain an important cause of morbidity and mortality among women in the child-bearing age. In order to institute appropriate preventive measures there is need to establish the profile of knowledge of the predisposing factors and causation of STDs, attitude to sexual practice and sexual patterns among the susceptible young people, such as university students. Study population: Non medical university students, Makerere University Design: Descriptive cross sectional study Methods: A detailed questionnaire identifying socio-demographic characteristics, sexual patterns, knowledge of STDs as well as attitudes towards prevention of STDs was administered to 400 non-medical students of Makerere University. Results: Knowledge of the clinical features of gonorrhoea and AIDS was high; most knew the predisposing factors for STDs (multiple sexual partners 90%; unprotected sexual intercourse 93%; rape 81%; sex outside marriage 78%, and sex under the influence of alcohol 73%) but not so for syphilis. Males were three times more likely to contract STDs (27%) than their female (9%) counterparts. Whereas knowledge on methods of prevention was high (>90%) it was not followed by appropriate behavioural patterns. More female (33.5%) students had heard about Trichomonas vaginalis than males (23%); (X2 = 17.1; < 0.0001). This study has shownthat more female than male students got informationfrom their parents (X2= 25.3; P < 0.001) while more male students had their information from previous sexual intercourse (X2= 12.9; P = 0.001). Conclusion: The level of knowledge about STDs and their prevention is not matched by sexual behavioural patterns, and male students undertake more risky sexual behaviour, Sexual education should be introduced at the university as a means of increasing students' awareness about the problem and prevention of sexually transmitted diseases including HIV/AIDS. African Health Sci. 2001; 1(1) 16 - 20

Cryptosporidium parvum Genotype 2 infections in free-ranging mountain gorillas ( Gorilla gorilla beringei ) of the Bwindi Impenetrable National Park, Uganda

Abstract: For behavioral research and due to growing ecotourism, some populations of free-ranging mountain gorillas (Gorilla gorilla beringei) have become habituated to humans. Molecular analysis of two Cryptosporidium sp. oocyst isolates originating from two human-habituated gorilla groups and two oocyst isolates from non-habituated gorillas yielded positive identification of C. parvum Genotype 2 (G2; i.e., "cattle", "animal-adapted", or "zoonotic"). As G2 is cross-transmissible between humans and animals, C. parvum infections can be propagated in the habitats of human-habituated, free-ranging gorillas through both zoonotic and anthroponotic transmission cycles.

DNA evidence for elephant social behaviour breakdown in Queen Elizabeth National Park, Uganda

Abstract: Elephant social structure is matrilineal, with family units composed only of maternally related females and their juvenile offspring, while adult males are mostly solitary and seldom congregate into bachelor herds. In such a social structure, we expect females in the same family unit to have the same mitochondrial genome, which may or may not differ from that of individuals in other family units in the population. Such social structuring also results in the mating males and females having different allele frequencies at nuclear microsatellite loci. This is manifested as an excess of heterozygotes relative to the expected Hardy‐Weinberg proportions, a phenomenon which maintains genetic variation within the population by minimizing inbreeding. We analyzed mitochondrial nucleotide sequences and allele frequencies at four microsatellite loci in nine family units of the African elephant (Loxodonta africana) in Queen Elizabeth National Park and found more than one distinct mitochondrial genotype in three of the family units and no significant excess heterozygosity at microsatellite loci in eight of the families. We interpreted these findings as an indication of a breakdown in social structure of this population caused by social stress due to factors like excessive poaching that has taken place in this national park over the last three decades. Ecological and management implications of these findings for elephant populations are discussed.

Completeness in an African cancer registry.

Abstract: Objective: A high level of completeness of case-finding is essential if data from cancer registries are to be useful for comparative studies. A large case series, collected independently of the cancer registry case-finding mechanisms, as part of a study of the influence of HIV infection on cancer risk, was used to evaluate the completeness of the registry in Kampala, Uganda, for the years 1994–1996.

Vector transmission of Banana streak virus in the screenhouse in Uganda

Abstract: Summary Although mealybug transmission of Banana streak virus.(BSV) by Planococcus citri and Saccharicoccus sacchar has been demonstrated elsewhere, these mealybugs have not been identified on bananas in Uganda and their role and that of other agents in BSV transmission is not well documented. Insect samples were collected from banana farms in sites with low, moderate and high BSV infections in Uganda. Subsequently, live mealybugs and aphids were again collected and used in acquisition, retention and transmission tests, and BSV diagnosed using TAS-ELISA. Dysmicoccus brevipes (pineapple mealybug), S. sacchari (sugarcane mealybug) and Pentalonia nigronervosa (banana aphid) were the most abundant insect species from banana fields sampled. Abundance of D. brevipes was positively and significantly correlated with BSV incidence unlike that of. P. nigronervosa. Transmission studies in the screenhouse showed that mealybugs acquired BSV one day after feeding on virus sources and approached optimum acquisition after the third day. Pineapple and sugarcane mealybugs retained BSV up to 5 days from the day of transfer from the virus source. BSV was first detected in the recipient banana plants 4 wk after transmission using pineapple mealybug and 6 wk after inoculation using sugarcane mealybug. Under screenhouse conditions, both mealybugs therefore appear to transmit BSV semipersistently.

Prevalence of Kaposi sarcoma-associated herpesvirus compared with selected sexually transmitted diseases in adolescents and young adults in rural Rakai District, Uganda

Abstract: BackgroundKaposi sarcoma-associated herpesvirus (KSHV) is transmitted by routes such as homosexual intercourse and is associated with HIV infection in industrialized countries. However, there is little information about its transmission in developing countries where Kaposi sarcoma is an endemic dise

Population-based HIV testing and counseling in rural Uganda: participation and risk characteristics.

Abstract: The aim of this study was to assess self-selection in a population-based voluntary HIV testing and counseling (VTC) program by comparing the HIV risk characteristics of users and nonusers of VTC in rural Uganda. A 1994-95 community-randomized trial in the Rakai District of Uganda enrolled adults aged 15-59 years and ascertained their HIV status sociodemographic characteristics risk behaviors and AIDS-associated symptoms. All subjects were offered confidential individual VTC at no cost. The authors compared users and nonusers of VTC among 10950 participants (4764 male and 6186 female) enrolled at baseline using multivariate logistic regression. Women were significantly less likely to receive VTC than men (31.5% versus 34.8% p < 0.001). In multivariate analysis younger age HIV-positive status and having no sexual partners in the past 5 years (and significant for women only having 2 or more sexual partners) were associated with lower VTC participation for both men and women. Among women higher VTC participation was associated with symptoms suggestive of AIDS and other illnesses and shopkeeper occupations. During the initial phase of a population-based free VTC program in rural Uganda certain high-risk groups were under-represented among VTC recipients. There is a need to target VTC to ensure participation by high-risk individuals most in need of services. (authors)

Lymphatic filariasis in Uganda: baseline investigations in Lira, Soroti and Katakwi districts

Abstract: Baseline epidemiological investigations on lymphatic filariasis were conducted for the first time in Uganda in 3 communities in the districts of Lira (Alebtong area), Soroti (Lwala area) and Katakwi (Obalanga area), located to the north of Lake Kyoga at an altitude of 1000-1100 m above sea level. Individuals from the communities were examined, in April-August 1998, for Wuchereria bancrofti specific circulating antigen (by ICT card test), microfilaraemia (by counting chamber and stained blood-smear techniques) and chronic clinical manifestations of lymphatic filariasis. Endophilic mosquitoes were sampled and dissected for filarial larvae. Prevalences of circulating filarial antigen positivity were 29%, 18% and 30% in the Alebtong, Lwala and Obalanga communities, respectively. Microfilaria (mf) prevalences were 18%, 9% and 21%, and geometric mean mf intensities among mf-positive individuals were 306, 171 and 402 mf/mL blood, in the same communities. Examination of stained blood smears revealed mf of both W. bancrofti and Mansonella perstans, but more than 80% of mf-positive individuals harboured the first of these parasites. Prevalences of hydrocoele in adult (> or = 20 years) males were 28%, 7% and 17%, and prevalences of limb elephantiasis in adults were 9%, 4% and 4%, in the Alebtong, Lwala and Obalanga communities, respectively. Anopheles gambiae s.l. (mainly An. gambiae s.s.) and An. funestus were common in all 3 communities, and showed W. bancrofti infectivity rates of 1.1-1.7% and 1.3-2.9%, respectively. It is concluded that lymphatic filariasis is highly endemic in these high-altitude areas of Uganda, with An. gambiae s.l. and An. funestus being the main vectors.