Background. Helicobacter pylori (HP) infection is extremely common worldwide, with almost half of the world’s population infected. In Uganda, no study has been done on the trends of the prevalence of H. pylori infection in the affluent population. Therefore, this retrospective cross-sectional study aimed at determining the trend of H. pylori prevalence among affluent patients presenting with gastrointestinal (GIT) symptoms whose stool samples were tested at selected AAR clinics in Kampala area. Patients were tested for Helicobacter pylori infection using the stool antigen test between January 2015 and December 2019. Results. The overall 5-year H. pylori prevalence was 35.7% (1298/3634). The prevalence was higher in males (36.0% (736/2044)) than in females (35.4% (562/1590)), although not statistically significant (OR = 0.97, p = 0.680, 95% CI: 0.84–1.11). The prevalence of H. pylori infection was significantly higher (39.4%) among patients who belonged to the age group of 19–35 years (OR = 1.49, p < 0.001 , 95% CI: 1.22–1.82). The prevalence for H. pylori among the age group of 19–35, the most productive age, could be attributed to work-related factors such as stress. The highest prevalence (43.4%) was recorded in 2018 and the lowest (21.4%) in 2015; however, the trend of H. pylori infection in the 5 years was fluctuating. Conclusion. H. pylori infestation is a preserve of not only the poor but also the elites. Stressful factors, especially in the age group of 19–35 years, should be appropriately managed.

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.

Background Tuberculosis (TB) continues to be the leading cause of morbidity and mortality among human immunodeficiency virus (HIV) infected individuals in Sub Saharan Africa, including Uganda. Isoniazid prophylaxis therapy (IPT) is a major public health intervention to avert the progression of latent tuberculosis to active tuberculosis disease among people living with HIV. However, there is limited information about the influence of IPT on TB incidence and its associated risk factors among HIV positive patients in Uganda especially at Reach out-Mbuya community health initiative hence the study. Methods A cross sectional study was conducted among positive adult patients who completed a 6-months long daily treatment of Isoniazid preventive therapy. Sputum samples and urine samples were collected and analysed using gene xpert and lateral flow urine Lipoarabinomannan (TF LAM) tests respectively for presence of Tuberculosis. Data analysis was performed using STATA. Bivariate and multivariate logistic regression were performed to assess the risk factors associated with tuberculosis among the study population and significance estimated at 95% confidence level. Results A total of 103 HIV positive adults was studied. The mean age of the participants was 42.09 ± 10.49 and median age was 43. The prevalence of tuberculosis among HIV positive adult patients who completed Isoniazid preventive therapy was 5.8% (6/103). Counselling, the only factor significantly associated with TB (aOR:0.028, P-value < 0.001) had a protective effect of influencing HIV patients to complete of IPT and reduce the risk of TB infection. Conclusion Administration of IPT to HIV patients effectively reduces the occurrence of TB. Counselling is a significant predictor of prevention of active TB among HIV patients.

Background The agriculture sector is crucial in economic development of Uganda, with products generating revenue at local, regional (neighbouring countries) and global markets (especially European Union and Arab countries). To maintain market access and competitiveness at the regional and global levels, there is a high demand for consumer protection, compliance to international guidelines, standards and regulations. The mandate to regulate the quality of animal source foods (ASFs) for consumption mainly lies with the government agencies at central and hardly at local levels. In Uganda, regulation is undertaken by National Bureau of Standards and Law enforcement (UNBS) with support from the Ministry of Agriculture, Animal Industry and Fisheries as well as Ministry of trade. Considerable efforts have been undertaken to promote good food standards, quality and safety but have not been successful due to limited holistic involvement of other food value chain stakeholders. To mitigate this challenge, we propose to build capacity of the various animal source foods value chain stakeholders through sensitizations on food safety standards and regulations. This proposition emanates from recommendations made following baseline studies conducted in the different ASF value chains under the Makerere University research and innovations funds first phase. Methodology An online search and desk review was conducted for animal source food safety laws, regulations and policies in Uganda and food safety requirements for trade at local, regional and international levels. Interviews with selected value chain actors, policy formulating, supervisory and enforcement institutions using open ended questionnaire were conducted. Findings Policies and standards reviewed The government has enacted a number of food safety policies which are implemented by various ministries and agencies to strengthen animal source food safety along the food chain from farm to fork. The policies reviewed in this study include; Fish Act (Cap 197), Fish (Beach Management) Rules 2016, adulteration of produce Act (chapter 27), Food and drugs act. (Chapter 278), dairy industry act, public health act, Animal Breeding Act, 2001, Uganda Wildlife Act, 2019, Local government act cp 234, veterinary surgeons act (chapter 277), Animal Diseases Act, Agricultural Chemicals (Control) Act, 2006, National drug policy and authority act 1993, Cattle traders act, Animal’s act (prevention of cruelty) cap 220, Trade regulations 2011, and Uganda National Bureau of Standards Act. Stakeholder interviews All the consulted key stakeholders agreed that implementation of these policies is very wanting in our country and a number of challenges/gaps that contribute to this state and recommendations to revert the situation were put forward. Challenges/gaps · There is no single agency that is responsible for food safety standards, the roles are scattered among ministries, departments and agencies (MDAs). · The responsibility of implementation of food safety standards is mostly executed by UNBS which does not have enough manpower, adequate funds and machinery to implement food safety standards exhaustively. · Regulatory framework (policies and standards) is weak and outdated and do not cover current issues of the countries such as GMOs. · There is irregular implementation of these policies across the country since in some places are implemented and in others, they are not. · The government interest is putting the standards in place, but they don't have interested in how they are implemented. · The process of policy development is top to bottom i.e., the main players of the different value chains are not involved in making these. · Corruption and political interference by political leaders who have power and authority and yet they are involved in similar business, this creates conflict of interest. · Lack of awareness and inadequate advocacy of the animal food safety policies and standards by different key stakeholders along the food chain. Recommendations • Food safety related mandates should be centralized / streamlined under one umbrella. • Allocation of adequate funding by the government for; enabling statutory instruments, research (related on nutrition / malnutrition, food poisoning), public awareness and advocacy. • Alternatively strengthening of the existing implementing agencies like MAAIF, UNBS and Dairy in terms of both human resource and finances. • Update of the regulatory frameworks to fit the current state of the country such as GMOs and aligning them with international standards. • Intense regulation and monitoring of compliance at the right points across the livestock value chain. • Recruitment of public servants should be based on proper vetting for integrity beyond academic qualifications to avert corruption. • Demand for accountability of food safety matters from the political leaders through routine monitoring and evaluation of the responsible agencies • Government through the ministry of trade should organize exhibitions to promote market access of these products. Conclusion There are numerous policies and standards in place that are purposed to ensure animal food safety along the food value chain and enhance market access. However, these are not well enforced and implemented due to various challenges, like decentralization of implementation activities, inadequate funds, lack of awareness among stakeholders, corruption, outdated policies, and poor coordination.

Animal source foods (ASFs) can be sources of illness when poorly handled both at the farms and during processing. Efforts have been undertaken by government to promote good food standards, quality and safety but have not paid off due to limited holistic involvement of all ASFs value chain actors like the farmers, transporters, traders, and the consumers. An assessment was conducted in Kampala and Mbarara districts to determine the level of compliance to existing food control standards.The findings are to help inform policies to adapt, promote and implement standards and quality of ASF products free or with minimal contamination, services to promote local industries and protect consumers as well as facilitate access to international markets. This assessment was carried out in Kampala and Mbarara district with major objective of mapping various institutions involved in designing and implementing food control standards with the core mandate lying with Uganda National Bureau of Standards and assessing of compliance to food control standards along the ASFs value chain.The studies were conducted in Kampala, Uganda’s capital and Mbarara, the second biggest city in the country. These districts constitute the major market hub of agricultural products due to their high consumer population. The ASFs value chain assessments were conducted through workshops using focus group discussions with stakeholders in the meat, milk, poultry and fish value chains.A number of organisations along the food chain were involved in designing and implementing of food safety standards and regulations, as well as regulatory norms for setting and controlling of quality standards for animal source foods in Uganda. These included; farmers, transporters, processors, academia, researchers, trade organisations, government institutions, private organisations, international bodies and consumers’ organisations.Majority of the outlet operators had both operating certificates and health certificates, however the remaining proportion that was noncompliant is still significant considering that they still distribute ASFs products. The study also observed that most of the measures required to ensure safety of ASFs are not followed along the food chain such as; poor transportation of animals and their products and use of antibiotics in animal feeds. It was also observed that product quality and cost of the product greatly contribute to the consumers’ demand and confidence for a particular animal source product.