BackgroundIn Uganda, the Government has promoted the use of intermittent preventive treatment of malaria in pregnancy (IPTp) and insecticide-treated bed nets (ITNs) as malaria control strategies for pregnant women. However, their utilization among pregnant women is low. This study aimed at assessing factors associated with use of IPTp for malaria and ITNs by pregnant women in Buwunga sub-county, Bugiri District.MethodsThis was a cross-sectional study, conducted in Buwunga sub-county, Bugiri District, employing quantitative data collection tools. A total of 350 household members were randomly selected to participate in the study. Data were entered and analysed using Epi info version 3.5.1; bivariable and multivariable analysis was done to assess the factors associated with use of IPTp and ITNs among pregnant women.ResultsThe level of uptake of IPTp1 (at least one dose) was 63.7 % while IPTp2 (at least two doses) was 42.0 %. More than half (58.6 %) of the mothers had slept under an ITN the night before the survey. Slightly more than half (51.9 %) of the mothers mentioned stock outs as the major reason for not accessing IPTp and ITNs. The main factors that were statistically significant for IPTp2 uptake were the knowledge of mothers on IPTp2 (AOR 2.48 95 % CI 1.53–4.02) and providing women with free clean water at the antenatal care (ANC) clinic (AOR 3.63 95 % CI 2.06–6.39). Factors that were significant for ITN utilization included education level of mothers (AOR 2.03 95 % CI 1.09–3.78), ease of access (AOR 2.74 95 % CI 1.65–4.52), and parity (AOR 1.71 95 % CI 1.01–1.29).ConclusionThe level of uptake of the two recommended doses of sulfadoxine–pyrimethamine (SP) tablets for malaria prevention (IPTp2) was low, slightly more than half of the mothers slept under an ITN the night before the survey. Appropriate measures to increase the level of uptake of IPTp2 and coverage of ITNs among pregnant women should be implemented, and these include providing health education about IPTp and ITNs, and ensuring that mothers are provided with free safe clean water at ANC clinic.

IntroductionTungiasis is an endemic but neglected health problem in Uganda especially in resource poor communities. It is largely affecting rural communities in the Eastern, West Nile and Central regions. This study assessed prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda.MethodsThis was a cross sectional study that used a semi-structured questionnaire and observational checklist to collect quantitative data from 422 households in 12 villages. Prevalence of tungiasis was defined as presence of Tunga penetrans in the skin of any household member at the time of data collection.ResultsThe prevalence of tungiasis was 22.5%. However, a big percentage 41.5% of households were reported to have had T. penetrans in the previous month while 49.5% had T. penetrans for more than one month. Majority (90.5%)of the participants used a pin, needle, or thorn to remove sand flea from infected body parts. Having dirty feet (AOR 3.86, CI (1.76-8.34)), dirty clothes (AOR 3.46, CI (2.00-5.97)), cracked house floor (AOR =6.28, CI (3.28-12.03)), dirty floor (AOR 3.21, CI (1.38-7.46)), littered compounds (AOR= 2.95, CI (1.66-5.26)) and rearing cattle (AOR 2.38, CI (1.28-4.45)) were associated with tungiasis. However, practicing preventive measures (AOR 0.51, CI (0.29-0.90)) was found protective for disease.ConclusionTungiasis is still a prevalent health problem in rural communities in Eastern Uganda due to a number of individual (host) and environmental factors. There is need to increase awareness regarding improvement in sanitation and hygiene to enable communities’ implements interventions for prevention of T. penetrans.

Background The incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. The population-based survey on the prevalence of TB in Uganda revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). This study aimed to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda. Methods A facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to the World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB diagnosis were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation. Results Two hundred forty-seven (247) patients with presumptive TB exiting at antiretroviral therapy (ART) clinics (n = 132) or general outpatient clinics (n = 115) at public health facilities were recruited into this study. Majority of participants were female (161/247, 65.2%) with a mean + SD age of 35.1 + 11.5 years. Overall, 138 (55.9%) patients with symptoms suggestive of TB disease did not have sputum and/or CXR examinations. Patients who did not inform health workers about their TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio (aPR): 1.68, 95%CI; 1.36–2.08, P < 0.001). However, patients who reported duration of cough of 2 weeks or more were less likely to be missed for TB screening (aPR; 0.69, 95%CI; 0.56–0.86, p < 0.001). Conclusion There are substantial missed opportunities for TB diagnosis in Wakiso District. While it is important that patients should be empowered to report symptoms, health workers need to proactively implement the WHO TB symptom screen tool and complete the subsequent steps in the TB diagnostic cascade.

Soil contamination with heavy metals has severely increased over the last decades, mainly from industrial wastes and human activities. 1,2 Soil pollution by heavy metals is as a result of both natural processes such as weathering of minerals, and anthropogenic activities related to industries, fossil fuel burning, emissions from vehicles, mining, agriculture and metallurgical processes and their waste disposal. 3 The production of steel is vital for the economic growth of Uganda, but its production is a major source of pollution. 4 Solid and liquid wastes, including fumes generated from the steel plant and the raw materials, usually contain notable amounts of heavy metals such as arsenic (As), cadmium (Cd), mercury (Hg), Background. Soil contamination with heavy metals has severely increased over the last few decades, mainly from industrial wastes and human activities. Soil pollution is a source of danger to the health of people globally. Objectives. To assess the level of soil contamination with heavy metals around steel rolling mills in Jinja municipality, Uganda. Methods. Four composite soil samples were collected from each of the sides of the Jinja steel rolling mills, dried and digested. The digested solution samples were analyzed in triplicates for the levels of lead (Pb), zinc (Zn), cadmium (Cd), chromium (Cr), copper (Cu), and nickel (Ni), using a flame atomic absorption spectrometer (Savant AA model 2009); the analytical process was monitored using analytical standard solutions. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 19 and Excel. Mean metal concentrations, standard deviations, medians, and skewness were obtained to describe heavy metal concentrations in the soil. Pollution load index and geo-accumulation indices were calculated to determine the level and extent of heavy metal contamination in the soil. Results. The mean concentration loads of the heavy metals in soils around the Jinja steel rolling mills were 43.15 mg/kg for Pb, 28.16 mg/kg for Zn, 0.93 mg/kg for Cd, 0.22 mg/kg for Cr, 80.96 mg/kg for Cu, and 9.40 mg/kg for Ni. The metal load distribution around the industry was in descending order: Left-hand side > Downwind side > Right-hand side > Upwind side. Results for the geo-accumulation index were 1.30 for Pb,-1.31 for Zn, 2.63 for Cd,-7.25 for Cr, 2.99 for Cu, and-1.19 for Ni. The overall pollution load index was 1.08. Conclusions. The concentration levels of heavy metals around the steel rolling mills did not appear to be of serious concern, except for copper and cadmium, which showed moderate pollution and moderate to strong pollution, respectively. All heavy metals were within the limits of the United States Environmental Protection Agency (USEPA) residential soil standards and the Dutch intervention soil standards. Overall, soils around the Jinja steel rolling mills were slightly polluted with heavy metals, and measures therefore need to be taken to prevent further soil contamination with heavy metals.

Introduction: Laboratories are vital in disease diagnosis, prevention, treatment and outbreak investigations. Although recent decades have seen rapid advancements in modernised equipment and laboratory processes, minimal investments have been made towards strengthening laboratory professionals in Africa. This workforce is characterised by insufficient numbers, skewed rural-urban distribution, inadequate qualifications, inadequate skill-mix and limited career opportunities. These factors adversely affect the performance of laboratory professionals, who are the backbone of quality services. In the era of Global Health Initiatives, this study describes the status of laboratory human resource and assesses the experiences, constrains and opportunities for strengthening them in Uganda. Methods: This paper is part of a study, which assessed laboratory capacity in 21 districts during December 2015 to January 2016. We collected data using a laboratory assessment tool adapted from the WHO and USAID assessment tool for laboratory services and supply chain (ATLAS), 2006. Of the 100 laboratories, 16 were referral laboratories (hubs). To assess human resource constraints, we conducted 100 key informant interviews with laboratory managers and in charges.Results: Across the facilities, there was an excess number of laboratory technicians at Health Center (HC) IV level by 30% and laboratory assistants were in excess by 90%. There was a shortage of laboratory technologists with only 50% of the posts filled at general hospitals. About 87.5% of hub laboratories had conducted formal onsite training compared to 51.2% of the non-hub laboratories. Less than half of HC III laboratories had conducted a formal onsite training; hospital laboratories had not conducted training on the use and maintenance of equipment. Almost all HC III laboratories had been supervised though supervision focused on HIV/AIDS. Financial resources, workload and lack of supervision were major constraints to human resource strengthening. Conclusion: Although opportunities for continuous education have emerged over the past decade, they are still threatened by inadequate staffing, skill mix and escalating workload. Moreover, excesses in staffing are more in favour of HIV, TB and malaria. The Ministry of Health needs to develop work-based staffing models to ensure adequate staff numbers and skill mix. Staffing norms need to be revised to accommodate laboratory technologists and scientists at high-level laboratories. Training needs to extend beyond HIV, TB and malaria.