Rabies is a zoonotic disease that is mainly transmitted to humans through dog bites. It remains a major public health threat in many Asian and African countries, including Uganda. The main objective of this study was to investigate awareness, knowledge, and perceptions of communities toward human and dog health related to rabies prevention, as well as dog management practices within Masaka district, central Uganda. Data collection involved nine key informant interviews (KIIs) and six focus group discussions (FGDs). Methods used during focus group discussions included qualitative interviews (using open-ended questions), simple ranking, and proportional piling. Data from KIIs and FGDs were analyzed using content analysis in NVivo (version 12.0). This study reveals that community members in the rural settings uses herbal concoctions in replacement or as an alternative to dog vaccination. Furthermore, the study reveals that dogs play the vital roles in the households like as they offer protection to people and household properties, despite being ranked second least among the household animals. The commonest livelihood activity was a small-scale mixed farming. Most of the households kept dogs, but they are ranked at second lowest in terms of economic value among all domestic animals. Free roaming and tethering were the common dog-keeping systems, and home-based feed (food leftovers, bones) was provided mainly to the tethered dogs. Rabies, also locally known as “Eddalu Lyembwa” (that can be translated as “madness of the dogs”), was ranked as the disease of most important among dogs, besides other common diseases such as skin diseases, venereal diseases, worm infestations, and tick infestations. Inadequate vaccination services for both humans and dogs were reported, and dog bite victims traveled a long distance to seek for post-exposure prophylaxis after dog bites. It can be concluded that there is a clear request for periodic mass vaccination campaigns against rabies among dogs, and access to vaccines within reasonable distances by humans after a rabies exposure, but also pre-emptive vaccination for those at high risk, such as veterinarians, needs to be improved.

Background The occurrence of extended spectrum beta-lactamase (ESBL) producing bacteria such as Escherichia coli has increasingly become recognized beyond hospital settings. Resistance to other types of antibiotics limits treatment options while the existence of such bacteria among humans, animals, and the environment is suggestive of potential zoonotic and reverse-zoonotic transmission. This study aimed to establish the antibiotic susceptibility profiles of the ESBL-producing Escherichia coli (ESBL-EC) from human, animal, and environmental isolates obtained among farming households within Wakiso district using a One Health approach. Methods A total of 100 ESBL-EC isolates from humans 35/100 (35%), animals 56/100 (56%), and the environment 9/100 (9%) were tested for susceptibility to 11 antibiotics. This was done using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed in STATA ver. 16 and graphs were drawn in Microsoft excel ver. 10. Results Most of the ESBL-EC isolates (98%) were resistant to more than two antibiotics. ESBL-EC isolates were most susceptible to meropenem (MEM) (88.0%), and imipenem (82.0%) followed by gentamicin (72%). ESBL-EC isolates from humans were most susceptible to meropenem (MEM) followed by imipenem (IPM)> gentamicin (CN)> ciprofloxacin (CIP). Animal samples were more susceptible to MEM, IPM, and CN but were highly resistant to cefotaxime (CTX)> cefepime (FEP)>other antibiotics. Multidrug resistance (MDR) was mostly reported among households keeping goats under intensive husbandry practices. Seven percent of the isolates exhibited carbapenem resistance while 22% showed aminoglycoside resistance. Similar resistance patterns among humans, animals, and environmental samples were also reported. Conclusion Our study provides baseline information on non-hospital-based MDR caused by ESBL-EC using a One Health approach. ESBL-EC isolates were prevalent among apparently healthy community members, animals, and their environment. It is important to conduct more One Health approach studies to generate evidence on the drivers, resistance patterns, and transmission of ESBL-producing organisms at the human-animal-environmental interface.

BackgroundCryptosporidiosis is a common cause of diarrheal disease in livestock and dogs, and it can result in significant economic losses due to decreased productivity and higher treatment costs. The cryptosporidiosis burden in livestock and dogs is largely unknown and underexploited. We designed a cross-sectional research study to determine the prevalence and factors associated with cryptosporidiosis in livestock and dogs.MethodsThe questionnaire data was downloaded from the Kobotoolbox server in excel format for cleaning and analysis. Laboratory results were matched with the questionnaire data and statistical analysis was performed using STATA version 14 and R version 4.2.2. Descriptive statistics were conducted to determine the frequencies, percentages, and proportions of the different study variables. For the categorical variables, 95% binomial and multinomial confidence intervals were obtained using the commands BinomCI(), with Jeffreys approach, and MultinomCI() available in the DescTools package. To adjust for potential clustering within household, a logistic mixed model approach with household as random effect was chosen and performed using the package glmmTMB. The outcome was a positive or negative test result of each dog. A likelihood ratio test using the lmtest package was used to determine if a predictor was significantly associated with the outcome. To adjust for multiple comparisons, the multcomp package with Tukeys approach was used. First all variables were included in a univariable approach. Second all variables with p-values <0.2 were included in a multivariable model..ResultsDogs were over 50times more likely to have the cryptosporidium infection compared to goat. With aOR 56.07, 95%CI= [10.2569,306.5307] and p-value <0.001. Furthermore, being of Mukonjo tribe was over 20times more likely to have cryptosporidiosis compared to being Musongora. At aOR 24.92, 95%CI= [3.6971,168.0655], p-value 0.0010. Additionally, persons who drunk water from the river ponds were 76.93 times more likely to have cryptosporidium infection compared to the counterparts whose source of drinking water were from protected sources with aOR 76.93, 95% CI= [3.71,1595.324] p-value= 0.0050.ConclusionCryptosporidiosis still remains a big public health problem in Kasese District. Dogs are more at risk of having cryptosporidiosis whereas drinking from river ponds was highly attributed to acquiring cryptosporidiosis.

Background The role of human, animal and environmental health workers is increasingly being recognized and linked to the emergence and transmission of antimicrobial resistance (AMR). Little has been done in low and middle-income countries despite the seriousness of this public health challenge. Our study explored the perspectives of health workers on the occurrence, transmission, and management of AMR at the human-animal-environment interface. Methods We conducted a descriptive qualitative study within Wakiso district, central Uganda between August and October 2022, using focus group discussions (4) with village health teams (VHTs) and key informant interviews (12) with other cadres of health workers. Data were managed in NVivo 12 and analyzed using thematic network analysis exploiting both deductive and inductive approaches. Findings: Animal health workers had better knowledge of AMR occurrence compared to their counterparts from the human and environmental health sectors. VHTs had a limited understanding of the AMR concept, even though they believed that drug-resistant infections were a growing concern in the community. Advancement in technology was viewed as being both a facilitator and a barrier to AMR occurrence and management. Cultural norms underlying animal production and close interactions between humans and animals were reported as key drivers for AMR spillover and amplification. Laxity in policy implementation, unskilled human resource, and weak surveillance systems for AMR were reported to be the underlying gaps in its management. Most participants advocated for a One Health strategy in combatting AMR at a community level. Conclusion Culture-driven solutions, diagnosis before treatment, more sensitization of community health workers, and improved regulation of drug use as well as multi-sectoral collaborations may create a suitable environment for the implementation of one-health approaches in the management of AMR.

Background: Bacterial resistance to antibiotics is fast becoming a big challenge as resistance to multiple drugs is rising rapidly. The emergence of resistant Staphylococcus aureus worldwide is life-threatening in both humans and animals and yet little is known about the burden of antimicrobial resistance (AMR) in developing countries including Uganda. Therefore, the aims of this study were to: (a) determine the prevalence of AMR in S. aureus among humans and animals in two districts of Uganda; (b) assess the knowledge, attitude, and practices (KAPs) of farmers in Uganda regarding AMR of S. aureus. Methods: This was a cross-sectional study conducted between July and September 2020 in 147 randomly selected cattle keeping households in Isingiro and Kamuli districts. A structured questionnaire uploaded in Kobocollect online data collection tool was used to assess farmers’ perceptions and practices pertaining to AMR in each of the selected households. Nasal swab samples were collected from both animals and humans (farmers), placed in Stuart Transport medium and taken to the laboratory for processing. Bacterial isolation and confirmation was done using gram-staining and biochemical tests. This was followed by Antimicrobial susceptibility testing (AST) by the Kirby Bauer disc diffusion method. A cleaned Ms excel data file from Kobocollect tool was imported into STATA version 14 to generate descriptive statistics of the AMR patterns, farmers’ perceptions of AMR as well as the practices associated with AMR occurrence in the two districts. Results: Only 14/147 (9.5%) cattle samples and 45/147(30.6%) human samples tested positive for S. aureus and, were assessed for AMR. All (100%) cattle S. aureus isolates were resistant to Nitroimidazoles while 92.9% were resistant to Penicillins. None of the isolates were resistant to Fluoroquinolones (0.0%) and Aminoglycosides (0.0%). All the 14 isolates exhibited antimicrobial resistance (AMR) to at least one of the assessed antibiotics and 92.9% (13/14) showed evidence of multidrug resistance (MDR). Likewise, S. aureus human isolates showed high levels of resistance to Nitroimidazoles (100%) and Penicillins (93.3%), with none of the isolates having resistance to Aminoglycosides (0.0%), and only 1 exhibiting resistance to Fluoroquinolones (2.2%). All the 45 human isolates exhibited AMR to at least a one antibiotic while 93% (42/45) had MDR. Most farmers had good perceptions about AMR, with a significantly higher proportion of respondents from Isingiro showing a better understanding of AMR than those from Kamuli. Conclusion: This study provides evidence of occurrence of AMR to antibiotics commonly used in both humans and livestock in Isingiro and Kamuli districts. There is a need to promote appropriate stewardship of antibiotics to minimize the risk of AMR.