BackgroundBrucellosis is one of the most common zoonotic infections globally. Lack of knowledge about brucellosis may affect the health-seeking behavior of patients, thus leading to sustained transmission in these communities. Our study assessed knowledge and perceptions of brucellosis among pastoral communities adjacent to Lake Mburo National Park (LMNP), Kiruhura District, Uganda.MethodsA community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed between June and August 2012. Data collected included communities’ knowledge on causes, symptoms, transmission, treatment, prevention and risk factors of brucellosis. Multivariable logistic regression analysis was performed to explore strength of association between overall knowledge of brucellosis and various individual factors using odds ratios and 95% confidence intervals.ResultsOnly 70 (19%) knew the symptoms of brucellosis in animals, and three quarters (279, 75.5%) mentioned joint and muscle pain as a common symptom in humans. Almost all participants (370, 99.3%) had ever heard about brucellosis, majority (311, 84.7%) believed it affects all sexes and two thirds (67.7%) of the respondents believed close proximity to wildlife contributes to the presence of the disease. Almost all (352, 95.4%) knew that brucellosis in humans could be treatable using modern drugs. The main routes of infection in humans such as consumption of unpasteurized dairy products were known by 97% (360/371); eating of half-cooked meat by 91.4% and eating contaminated pasture in animals by 97.4%. There was moderate overall knowledge of brucellosis 197 (53.1%). Factors associated with higher overall knowledge were being agro-pastoralists (aOR: 2.08, CI: 1.17-3.71) compared to pure pastoralists while those who reported that the disease was a health problem (aOR: 0.18, CI: 0.06-0.56) compared to those who said it was not were less likely to be knowledgeable.ConclusionsThere was moderate overall knowledge of human and animal brucellosis among the participants. Majority of the participants believed that close proximity to wildlife contributes to the presence of the disease in the area. There is a need for collaboration between the public health, veterinary and wildlife sectors to provide health education on brucellosis for better management of the disease in the communities.
BackgroundBrucellosis is a zoonotic disease of veterinary, public health, and economic significance in most developing countries, yet there are few studies that show integrated human and veterinary health care intervention focusing on integration at both activity and actors levels. The aim of our study, therefore, was to explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis in Uganda.MethodsThis study used a qualitative design where six Focus Group Discussions (FGDs) that were homogenous in nature were conducted, two from each sub-county, one with the local leaders, and another with pastoralists and farmers. Five Key Informant Interviews (KIIs) with two public health workers and three veterinary extension workers from three sub-counties in Kiruhura district, Uganda were conducted. All FGDs were conducted in the local language and tape recorded with consent from the participants. KIIs were in English and later transcribed and analyzed using latent content data analysis method.ResultsAll the groups mentioned that they lacked awareness on brucellosis commonly known as Brucella and its vaccination in animals. Respondents perceived improvement in human resources in terms of training and recruiting more health personnel, facilitation of the necessary activities such as sensitization of the communities about brucellosis, and provision of vaccines and diagnostic tests as very important in the integration process in the communities. The FGD participants also believed that community participation was crucial for sustainability and ownership of the integration process.ConclusionsThe respondents reported limited knowledge of brucellosis and its vaccination in animals. The community members believed that mass animal vaccination in combination with health education about the disease is important and possible if it involves government and all other stakeholders such as wildlife authorities, community members, local to national political leaders, as well as the technical personnel from veterinary, medical and public health sectors since it affects both humans and animals.
BackgroundElectronic health records (EHRs) are especially important in low-resource settings due to their potential to address unique challenges such as a high number of patients requiring long-term treatments who are lost to follow-up, the frequent shortages of essential drugs, poor maintenance and storage of records, and inefficient clinical triaging. However, there is a lack of affordable and practical EHR solutions. Stre@mline is an EHR platform that has been locally developed by Ugandan clinicians and engineers in Southwestern Uganda. It is tailored to the specific context and needs of low-resource hospitals. It operates without internet access, incorporates locally relevant standards and key patient safety features, has a medication inventory management component, has local technical support available, and is economically sustainable without funding from international donors. Stre@mline is currently used by over 60,000 patients at 2 hospitals, with plans to expand across Uganda.ObjectiveThe purpose of this article is to describe the key opportunities and challenges in EHR development in sub-Saharan Africa and to summarize the development and implementation of a “Made-for-Africa” EHR, Stre@mline, and how it has led to improved care for over 60,000 vulnerable patients in a rural region of Southwestern Uganda.MethodsA quantitative user survey consisting of a set of 33 questions on usability and performance was conducted at Kisiizi Hospital. Users responded to each question through a Likert scale with the values of strongly disagree, disagree, agree, and strongly agree. Through purposive sampling, 30 users were identified and 28 users completed the survey.ResultsWe found that users were generally very satisfied with the ease of use of Stre@mline, with 96% (27/28) finding it easy to learn and 100% (28/28) finding it easy to use. Users found that Stre@mline was helpful in improving both clinical efficiency and enhancing patient care.ConclusionsThe partnership of local clinicians and developers is crucial to the design and adoption of user-centered technologies tailored to the specific needs of low-resource settings. The EHR described here could serve as a model for the development of future technologies suitable for developing countries.
Background: Biomass currently meets more than 97% of the total energy requirements in Uganda. However, contrary to this heavy reliance on biomass, there is paucity of information regarding the fuel value indices (FVIs) of woodfuel species used in different locations of the country such as Masindi and Nebbi districts. This study therefore sought to identify ten woodfuel species commonly used by the communities in these two districts and examine their FVIs from basic properties, namely; moisture content, density and gross calorific value. Methods: A semi-structured interview using a checklist of guiding questionnaire was conducted to generate a woodfuel species list. The familiarity index (FI) was calculated for each species and then used to rank ten commonly used species for further analysis. The moisture content, density and gross calorific value of the selected species were determined in triplicate. The FVI of each species was then determined from these basic properties. One-way ANOVA, Pearson product moment correlation, and Spearman rank correlation coefficient analyses were performed in SPSS ver.16.0 to examine the variation and relationship of variables. Results: Ten woodfuel species belonging to seven families and eight genera were identified as commonly used species. Combretum collinum was mentioned by every respondent as a suitable woodfuel species. A significant variation in moisture content and density was recorded among the species (F (df = 9) = 92.927, p = 0.0001) unlike in gross calorific value (F (df = 9) = 1.400, p = 0.253). There was a positive correlation between density and gross calorific value (r = 0.895, n = 30, p = 0.0001) and a negative correlation between moisture content and gross calorific value (r = −0.518, n = 30, p = 0.003). The FVIs obtained ranged from 1.10 in Ficus natalensis to 13.09 in Albizia grandibracteata. There was also a positive relationship (rho = 0.62) between FVIs and FIs using Pearson rank correlation coefficient. Conclusions: Moisture content and density are important properties in the selection of woodfuel species than gross calorific value. On the proposition of the FVIs, A. grandibracteata is a suitable woodfuel species than F. natalensis. These findings fit well into the ongoing efforts by Government and Civil Society Organizations to encourage woodlot management to ensure the sustainability of woodfuel in the country.
How can multi-stakeholder dialogue help assess and address the roots of environmental resource competition and conflict? This article summarises the outcomes and lessons from action research in large lake systems in Uganda, Zambia, and Cambodia. Dialogues linking community groups, NGOs and government agencies have reduced local conflict, produced agreements with private investors, and influenced government priorities in ways that respond to the needs of marginalised fishing communities. The article details policy guidance in four areas: building stakeholder commitment, understanding the institutional and governance context, involving local groups in the policy reform process, and embracing adaptability in programme implementation.
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