BackgroundThere is limited data on Methicillin resistant Staphylococcus aureus (MRSA) in Uganda where, as in most low income countries, the routine use of chromogenic agar for MRSA detection is not affordable. We aimed to determine MRSA prevalence among patients, healthcare workers (HCW) and the environment in the burns units at Mulago hospital, and compare the performance of CHROMagar with oxacillin for detection of MRSA.ResultsOne hundred samples (from 25 patients; 36 HCW; and 39 from the environment, one sample per person/item) were cultured for the isolation of Staphylococcus aureus. Forty one S. aureus isolates were recovered from 13 patients, 13 HCW and 15 from the environment, all of which were oxacillin resistant and mecA/femA/nuc-positive. MRSA prevalence was 46% (41/89) among patients, HCW and the environment, and 100% (41/41) among the isolates. For CHROMagar, MRSA prevalence was 29% (26/89) among patients, HCW and the environment, and 63% (26/41) among the isolates. There was high prevalence of multidrug resistant isolates, which concomitantly possessed virulence and antimicrobial resistance determinants, notably biofilms, hemolysins, toxin and ica genes. One isolate positive for all determinants possessed the bhp homologue which encodes the biofilm associated protein (BAP), a rare finding in human isolates. SCCmec type I was the most common at 54% prevalence (22/41), followed by SCCmec type V (15%, 6/41) and SCCmec type IV (7%, 3/41). SCCmec types II and III were not detected and 10 isolates (24%) were non-typeable.ConclusionsHyper-virulent methicillin resistant Staphylococcus aureus is prevalent in the burns unit of Mulago hospital.
Multi-stakeholder platforms have become mainstream in projects, programmes and policy interventions aiming to improve innovation and livelihoods systems, i.e. research for development interventions in low- and middle-income contexts. However, the evidence for multi-stakeholder platforms’ contribution to the performance of research for development interventions and their added value is not compelling. This paper focuses on stakeholder participation as one of the channels for multi-stakeholder platforms’ contribution to the performance of research for development interventions, i.e. stakeholder participation. It uses a quantitative approach and utilizes descriptive statistics and ARIMA models. It shows that, in three Ugandan multi-stakeholder platform cases studied, participation increased both in nominal and in unique terms. Moreover, participation was rather cyclical and fluctuated during the implementation of the research for development interventions. The study also shows that, in addition to locational and intervention factors such as type of the area along a rural–urban gradient targeted by the intervention and human resources provided for multi-stakeholder platform implementation, temporal elements such as phases of research for development intervention objectives and the innovation development process play significant roles in influencing participation. The study concludes that contribution of multi-stakeholder platforms to the performance of research for development projects, programs, policies and other initiatives is constrained by locational and temporal context and conditional on the participation requirements of the objectives pursued by research for development intervention.
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