Background The prevalence of Plasmodium falciparum and Intestinal Parasitic Infections (IPIs) - with the corresponding pathogenesis among children remain uncertain. This study aimed at determining the prevalence and the outcomes (including anaemia) of the respective infections and co-infections. Anaemia is a condition in which the number of red blood cells transporting oxygen to the various body parts is not sufficient to meet the needs of the body. Methods This was a cross sectional study conducted among 476-refugee camp school children. Kato-Katz technique was used to screen stool samples for intestinal parasites. Microscopy was used for malaria testing while the portable Haemoglobin (Hb) calorimeter was used to measure haemoglobin concentration. Results The overall prevalence of the mixed infections was 63.03%. Plasmodium falciparum was most prevalent of the single infections 262(55.04%) followed by Taenia spp. 14 (2.9%), Schistosoma mansoni 12(2.5%), Giardia lamblia 7 (2.9%), Trichuris trichiura 2(0.4%), Hookworm 2(0.4%) and Strongyloides stercoralis 1(0.2%). The odds of developing simple or uncomplicated malaria infection or anaemia was 14 times higher in individuals with dual co-infection with Plasmodium falciparum + Taenia sp. compared to single parasitic infection (Odds = 14.13, P = 0.019). Co-infection with Plasmodium falciparum + Taenia spp, was a strong predictor of Malaria and anaemia. Conclusion This study shows that Plasmodium falciparum and Taenia spp. co-infections is a stronger predictor of malaria and anaemia. The prevalence of malaria and anaemia remains higher than the other regions in Uganda outside restricted settlements. The findings of this study underline the need for pragmatic intervention programmes to reduce burden of the co-infections in the study area and similar settlements. Electronic supplementary material The online version of this article (10.1186/s12879-019-3939-x) contains supplementary material, which is available to authorized users.
Background Uganda ranks third in the number of deaths attributable to malaria and has some of the highest recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated with detrimental effects for the mother and unborn baby and these effects seem to have long term effects and consequences on the life of the baby. Despite the preventive measures put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy is still high. We determined the use of malaria preventive strategies during pregnancy and the presence of plasmodium infection, anemia, and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. Methods A cross-sectional study was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, antenatal care, and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for Plasmodium infection by both microscopy of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2 mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia was determined by the use of an automated hemoglobin analyzer. Data were analyzed using descriptive and analytical statistics. Results Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively. PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at
Background The World Health Organization (WHO) recommends prompt malaria diagnosis with either microscopy or malaria rapid diagnostic tests (RDTs) and treatment with an effective anti-malarial, as key interventions to control malaria. However, in sub-Saharan Africa, malaria diagnosis is still often influenced by clinical symptoms, with patients and care providers often interpreting all fevers as malaria. The Ministry of Health in Uganda defines suspected malaria cases as those with a fever. A target of conducting testing for at least 75% of those suspected to have malaria was established by the National Malaria Reduction Strategic Plan 2014–2020. Methods This study investigated factors that affect malaria testing at health facilities in Uganda using data collected in March/April 2017 in a cross-sectional survey of health facilities from the 52 districts that are supported by the US President’s Malaria Initiative (PMI). The study assessed health facility capacity to provide quality malaria care and treatment. Data were collected from all 1085 public and private health facilities in the 52 districts. Factors assessed included supportive supervision, availability of malaria management guidelines, laboratory infrastructure, and training health workers in the use of malaria rapid diagnostic test (RDT). Survey data were matched with routinely collected health facility malaria data obtained from the district health information system Version-2 (DHIS2). Associations between testing at least 75% of suspect malaria cases with several factors were examined using multivariate logistic regression. Results Key malaria commodities were widely available; 92% and 85% of the health facilities reported availability of RDTs and artemether–lumefantrine, respectively. Overall, 933 (86%) of the facilities tested over 75% of patients suspected to have malaria. Predictors of meeting the testing target were: supervision in the last 6 months (OR: 1.72, 95% CI 1.04–2.85) and a health facility having at least one health worker trained in the use of RDTs (OR: 1.62, 95% CI 1.04–2.55). Conclusion The study findings underscore the need for malaria control programmes to provide regular supportive supervision to health facilities and train health workers in the use of RDTs.
Objective: This study aimed to estimate pneumococcal carriage and determine antibiotic susceptibility patterns of the pneumococci isolated in the mother-baby pairs in Ngora district after the roll out of the pneumococcal vaccine. We hypothesized that high carriage of S. pneumoniae in mothers leads to carriage in their babies and hence a greater chance of contacting pneumoniae. Results: Consecutive sampling technique was used to select 152 mother-baby pairs from the community visits and those seeking care at the health facility. We collected nasal swabs from both baby and mother for culture and sensitivity using the Kirby-Bauer’s agar disc diffusion method. This study found that there was a low prevalence of pneumococcal carriage in the mother-baby pair in Ngora district. We also observed high rates microbial resistance to Penicillin which is the first-line management of pneumonia in Uganda. The relationship between pneumococcal carriage and immunization status suggest that Pneumococcal vaccine is protective against pneumococcal carriage. Resistance of S. pneumoniae to the commonly used antibiotics was high. Key words: Pneumococcal carriage, mother-baby pair, antibiotic susceptibility pattern, immunization with PCV 10, Eastern Uganda.
Background Optimum laboratory performance remains cardinal to definitive clinical disease diagnosis, prognosis and surveillance. In low and middle-income countries (LMICs) most public health clinical diagnostic laboratory capacity and their sustainability are at various levels of development. The objective of this study was to asses available opportunities and challenges faced by public health clinical diagnostic laboratories in Uganda so as to provide data to inform capacity building in such and similar settings. Methods A descriptive cross-sectional study was conducted between 10th Dec 2018 and 31 Jan 2019. All the 14 public health clinical diagnostic laboratories in Ministry of Health Regional Referral Hospital establishments in Uganda were purposively sampled. A standardized data abstraction tool was developed from the elements of ISO 15189 and 17025 laboratory standards and check list. Data were analysed using PRISM data analysis program and excel. Proportions were computed and some correlations deduced. Ethical approval was obtained before data collection commenced. Results Thirteen (13) of the laboratories participated in the study and their data included in the analysis. All the laboratories had: qualified laboratory staff, conducted quality improment meetings and kept laboratory records and documents. Of these, 12 (92.3%) had organizational structures endorsed by the respective hospital administration, functional basic laboratory equipment in the departments of haematology, microbiology, parasitology, clinical chemistry, Immunology and molecular biology. All the laboratories were government supported and offered free diagnostic services while 11 (84.6%) offerd surrveilance services. Eight (61.5%) laboratories were licenced by Allied Health Professionals, twelve (92.3%) were involved in internal quality control programs, eleven (84.6%) were enrolled on External Quality assurance testing programs while one (7.7%) was fully accredited by South African National Accreditation System (SANAS). The challenges identified included; under-staffing 10 (76.9% ), insufficient infrastructure 1 (7.7%), supplies stock-outs 3 (23.1%), inadequate equipment 2 (15.4%) and hard copy laboratory results. Additionally, they lacked independent budgets, finance management and autonomous financing. Conclusion Various challenges identified hindered public health diagnostic laboratories in Uganda to operate at full diagnostic capacity, overcoming them will standardise quality and attain equity of services across the country.
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