Makerere University

About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Public health. The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.

Temporal patterns of crop raiding by elephants: a response to changes in forage quality or crop availability?

Abstract: Temporal patterns of crop raiding by elephants were studied for 13 months in 1996/1997 at Kibale Forest National Park, Uganda. To determine the influence of environmental factors on the timing of raiding, we tested for correlations between crop raiding patterns and the quality of natural forage within the forest as well as crop availability beyond park boundaries. Crop raiding occurred throughout the year with peaks in dry seasons when crop availability was high. Bananas and maize were the main crops raided. Variations in forage quality were moderate with small seasonal fluctuations and peaks in dry seasons. Monthly crop raiding incidences were not influenced by forage quality but by ripening of maize. Comparison of forage quality and temporal distribution of crop raiding between savanna and forest habitats suggests that crop availability is more important in forest habitats, whereas in savanna habitats large seasonal fluctuations in forage quality have a greater influence on temporal patterns of crop raiding. Resume Les modeles temporels de l'incursion des cultures par elephants etaient etudies pendant 13 mois en 1996/97 au parc national de Kibale Forest au Uganda. Afin de determiner l'influence d’elements liea l'environnement sur le timing des incursions, nous avons essaye de trouver les correlations entre les modeles d'incursion et la qualite du fourrage naturel dans la foret ainsi que la disponibilite de cultures au-dela des frontieres du parc. L'incursion des cultures s'est produite a travers l'annee et culminait pendant les periodes seches quand la disponibilite des cultures etaient au plus eleve. Les cultures ciblees le plus souvent etaient les bananes et le mais. Des variations dans la qualite de fourrage etait moderees, avec les petites fluctuations saisonnieres et les points culminants pendant les periodes seches. Les survenances mensuelles d'incursion des cultures n’etaient pas influencees par la qualite de fourrage mais par le murissement du mais. Une comparaison de qualite de fourrage et la distribution temporale des incursions entre les habitats forestiers et savanes suggere que la question de disponibilite est plus important dans les habitats forestiers, tandis que dans les habitats savanes des grandes fluctuations saisonnieres au niveau de la qualite de fourrage exercent un influence plus marquee sur les modeles temporels de l'incursion des cultures.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda

Abstract: Assessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda. 1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997). 62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis. the OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided.

Immunoadjuvant Prednisolone Therapy for HIV-Associated Tuberculosis: A Phase 2 Clinical Trial in Uganda

Abstract: Tuberculosis (TB) is a common and serious complication of HIV-1 infection in the developing world, especially in sub-Saharan Africa [1]. Since the emergence of the HIV epidemic in Africa, the incidence rates of TB have increased dramatically, overwhelming national TB control programs across Africa. More than one-half of patients with TB presenting to TB clinics are infected with HIV, and these patients often present at early stages of HIV infection. Although HIV-infected patients with TB respond to effective antituberculous therapy [2–4], their prognosis remains poor [3, 5–8]. Deaths early during treatment are often attributable to TB [3, 6], whereas deaths late during treatment are attributable to complications of HIV infections other than TB. Epidemiologic observations indicate that TB may increase the rate of opportunistic infections in HIV-infected patients [9, 10] and may reduce survival [9, 11, 12], especially among patients with CD4+ T cell counts ≥200 cells/μL [13, 14]. Mounting evidence from immunologic and virologic studies supports the concept of copathogenesis in which TB triggers cellular immune activation [15, 16], mediated by cytokines such as tumor necrosis factor (TNF)–α, which, in turn, stimulates HIV replication, leading to higher viral load and accelerating HIV infection. One point of attack in efforts to stop this cascade is to attenuate expression of cytokines and thereby reduce the stimulus for HIV replication in latently infected cells [17]. Phase 1 and 2 clinical trials of selective TNF-α inhibitors—such as thalidomide, pentoxifylline, and etanercept—in HIV-associated TB have shown that these inhibitors offer short-term clinical benefits and reduce viral load despite only partial inhibition of TNF-α [18–20]. Since the immune activation of TB is mediated through a network of cytokines, less selective and more potent agents, such as glucocorticoids, may be more effective at interrupting the effects of TB on HIV than are selective cytokine inhibitors. In an observational study of HIV-infected patients without AIDS, the use of corticosteroids was associated with sustained increases in CD4+ T cell counts, with a minimum of adverse events [21, 22]. Prednisolone is an attractive choice for immunoadjuvant therapy in HIV-associated TB because it reduces expression of cytokines [23, 24], is effective in managing inflammatory complications of extrapulmonary TB [25], and is an inexpensive and widely available glucocorticoid agent. Like all corticosteroids, however, prednisolone can produce serious adverse events that may limit its use, even if shown to be effective. The balance of benefit and risk for prednisolone therapy has not been established for patients with HIV-associated TB. The aim of the present study was to assess the safety and biological effect of oral, self-administered prednisolone therapy as an immunoadjuvant treatment for HIV-associated TB among patients with CD4+ T cell counts ≥200 cells/μL.

Non-adherence to diabetes treatment at Mulago Hospital in Uganda: prevalence and associated factors

Abstract: Background: Non-adherence to diabetes treatment leads to poor glucose control and increases the risk of disease complications. The prevalence and factors associated with non-adherence in resource limited settings should be determined so as to lower the impact of a disease that is on the increase, on the health systems which are already overburdened with communicable diseases. Objectives: To determine the prevalence and factors associated with non-adherence to diabetes treatment. Methods: A cross sectional study was carried out from February to April 2004 in Mulago Hospital, Uganda. The participants were 402 type 1 and 2 diabetic patients selected from the outpatients’ diabetic clinic using systematic sampling. They were aged 18 years and above, had been taking diabetes treatment for at least one month and gave informed consent to participate. Non-adherence was assessed using patients’ self reports. Results: The prevalence of non-adherence was 28.9% (n = 116, 95%CI = 24.5 – 33.3%). Factors that were independently associated with non-adherence were: female gender (OR = 2.9, 95%CI = 1.4 – 6.3), not understanding the drug regimen well (OR = 4.0, 95%CI = 1.0 – 16.3), affording only some or none of prescribed drugs (OR = 3.7, 95%CI = 1.8 – 7.6) and longer time since last since last visit to a health worker (OR = 7.3, 95%CI = 2.7 – 19.9). Conclusions: Adherence to diabetic treatment was suboptimal. There is need to improve it through strategies helping patients understand their drug regimens, always availing drugs in the hospital so that they do not have to buy them and giving shorter time between visits to health worker. Further studies should be done to find out why females were not adhering to treatment so as to improve their adherence. African Health Sciences 2008; 8(2): 67-73