Effectiveness of Potential Interventions to Change Gendered Social Norms on Prevalence of Intimate Partner Violence in Uganda: a Causal Inference Approach

Prevention Science - Evidence of the effectiveness of programs to change gendered social norms related to intimate partner violence (IPV) is growing, but their potential to significantly impact...     

Efficacy of New Low-Cost Filtration Device for Recovering Schistosoma haematobium Eggs from Urine

A new, inexpensive filtration device for the diagnosis of urinary schistosomiasis was tested against the commonly used Millipore device. The experimental protocol was performed with 25 urine samples known to be positive for Schistosoma haematobium. The results suggest that the new device is as effective as the Millipore device for the diagnosis of urinary schistosomiasis. Its low cost will be attractive to schistosomiasis control programs.     

A randomized community trial of enhanced family planning outreach in Rakai, Uganda

A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community-based family planning outreach program was implemented in two phases—1999–2000 (early) and 2001 (late)—and its impact was evaluated by means of population surveys in 2002–03. At follow-up, hormonal contraceptive prevalence was 23 percent in the intervention communities, compared with 20 percent in the control communities. The differential was greater in the early-intervention communities than the late-intervention communities. Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities. No differentials in condom use were found between study arms. Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates, but the impact of this outreach program was modest.     

Multicenter plastic surgery outreach services for underserved Ghanaian communities

This paper describes the efforts of one plastic surgery team composed of Ghanaians from one of the major metropolitan areas in Ghana to meet the plastic surgery needs of rural Ghanaian communities. The aim was to analyze retrospectively the cases managed by the team, the difficulties which arose over a 14-year period, and the provision of recommendations for such future work. This study reviewed the medical records of patients treated during 86 outreach visits to nine centers from October 1995 to September 2009. The team, drawn from three hospitals, comprised a plastic surgeon and surgical support staff. They mostly treated Buruli ulcers, postburns scar contractures, chronic ulcers, facial clefts, tumors, and breast diseases. In all, 2,284 patients were managed during the period under review, giving an average of 163 patients per year and 254 per center. Buruli ulcers accounted for the largest group of cases treated during the outreaches (41%). Other common diagnoses were postburn scar contractures and cleft lip and palate deformities. This paper provides an example of the possibilities for surgical outreach work that exist and how challenges that come up during surgical outreach visits can be handled effectively. It also highlights the need for outreach medical work in developing countries like Ghana, especially since there is a reduction in foreign outreach medical missions. The authors encourage all stakeholders involved in health care delivery to initiate and support local medical outreach teams to provide care to rural communities.     

Awareness of Breast Developmental Anomalies: A Study in Jamasi, Ghana

Background  

Few global studies investigating breast developmental anomalies (BDA) among young females have been conducted. This study aimed to evaluate the degree of BDA awareness among young females in central Ghana.     

Association of brucellosis to abortions in humans and domestic ruminants in Kagera ecosystem,Tanzania

Brucellosis is a worldwide zoonotic disease of socio‐economic importance. Understanding the association of this disease with pregnancy outcome has the potential of contributing to the reduction of its reproductive burden in humans and animals among pastoral communities in Tanzania. A prospective cohort study was conducted in Kagera Region on pregnant women (n = 76) and gravid ruminants (121 cattle, 125 goats and 111 sheep). Exposed and non‐exposed groups to brucellosis were followed for 6 months (from 15 November 2017 to 15 April 2018). Sera were collected and analysed using Rose Bengal Test (RBT) and Fluorescence polarization assay (FPA) test. Measures of effect, univariable and multivariable logistic regression analyses were computed. Positivity to both RBT and FPA tests was 21% (95% CI: 12.5–32) in pregnant women and 5% (95% CI: 3.1–8) in gravid ruminants. Among aborted cases, four women (out of nine), two cows (out of seven), two goats (out of 26) and zero sheep (out of 11) were positive to brucellosis. The abortion rate in humans and ruminants was 11.8% and 12.3%, respectively. Seropositivity to brucellosis was similar in aborted and non‐aborted cases in humans (p = .08) and in ruminants (p = .2). At the population level, brucellosis was associated with abortions (population attributable risk: PAR) at 3.5% in pregnant women and at 0.5% in gravid ruminants in the study area. Infections to brucellosis were increased in exposed pregnant women (OR = 19; 95% CI: 1.8–203, p = .01) and in cattle (OR = 11; 95% CI: 1.3–88, p = .02). There is an indication that brucellosis could be contributing to abortions in pregnant women and domestic ruminants Kagera Region. Molecular tools could support more the results from serological tests to avoid cross‐reaction with other pathogen agents. Control of brucellosis in animals is likely to reduce the threat of abortions in humans.     

Benzoic acid-degrading bacteria from the intestinal tract of Macrotermes michaelseni Sjöstedt

The intestinal tracts of termites host a wide variety of microbial symbionts, which have been implicated in degradative processes. In this study, a fungus-cultivating termite, Macrotermes michaelseni was found to harbor 2.2 x 10(6) bacterial cells per ml of gut homogenates capable of degrading benzoic acid. Two benzoic acid degrading bacteria were isolated from the highest dilution of gut homogenates in oxic media with benzoic acid as the sole carbon source. Isolate CBC was related to Stenotrophomonas maltophila LMG 958(T), Xanthomonas campestris DSM 3586(T) and Stenotrophomonas acidaminophila DSM 13117(T) with a sequence similarity of 98.3%, 94.7% and 94.2%, respectively. Isolate CBW was related to Enterobacter aerogenes JCM 1235(T) and Raoultella ornithinolytica ATCC 31898(T) with sequence similarity of 98.4% and 97.8%, respectively. In addition to growing on benzoic acid (up to 9 mM) aerobically, isolate CBW also degraded benzoic acid under anoxic conditions with nitrate as electron acceptor. Isolate CBC did not degrade bezoic acid with nitrate but could degraded resorcinol under oxic conditions.     

Characterization of Healthy Housing in Africa: Method,Profiles, and Determinants

Housing is a key social determinant of health with implications for both physical and mental health. The measurement of healthy housing and studies characterizing the same in sub-Saharan Africa (SSA) are uncommon. This study described a methodological approach employed in the assessment and characterization of healthy housing in SSA using the Demographic and Health Survey (DHS) data for 15 countries and explored healthy housing determinants using a multiple survey-weighted logistic regression analysis. For all countries, we demonstrated that the healthy housing index developed using factor analysis reasonably satisfies both reliability and validity tests and can therefore be used to describe the distribution of healthy housing across different groups and in understanding the linkage with individual health outcomes. We infer from the results that unhealthy housing remains quite high in most SSA countries. Having a male head of the household was associated with decreased odds of healthy housing in Burkina Faso (OR = 0.80, CI = 0.68–0.95), Cameroon (OR = 0.65, CI = 0.57, 0.76), Malawi (OR = 0.70, CI = 0.64–0.78), and Senegal (OR = 0.62, CI = 0.51–0.74). Further, increasing household size was associated with reducing odds of healthy housing in Kenya (OR = 0.53, CI = 0.44–0.65), Namibia (OR = 0.34, CI = 0.24–0.48), Nigeria (OR = 0.57, CI = 0.46–0.71), and Uganda (OR = 0.79, CI = 0.67–0.94). Across all countries, household wealth was a strong determinant of healthy housing, with middle and rich households having higher odds of residing in healthy homes compared to poor households. Odds ratios ranged from 3.63 (CI = 2.96–4.44) for households in the middle wealth group in the DRC to 2812.2 (CI = 1634.8–4837.7) in Namibia’s wealthiest households. For other factors, the analysis also showed variation across countries. Our findings provide timely insights for the implementation of housing policies across SSA countries, drawing attention to aspects of housing that would promote occupant health and wellbeing. Beyond the contribution to the measurement of healthy housing in SSA, our paper highlights key policy and program issues that need further interrogation in the search for pathways to addressing the healthy housing deficit across most SSA countries. This has become critical amid the COVID-19 pandemic, where access to healthy housing is pivotal in its control.     

Impact of a COVID-19 National Lockdown on Integrated Care for Hypertension and HIV

Research Letter Introduction: Measures to limit the spread of COVID-19, such as movement restrictions, are anticipated to worsen outcomes for chronic conditions such as hypertension (HTN), in part due to decreased access to medicines. However, the actual impact of lockdowns on access to medicines and HTN control has not been reported. Between March 25 and June 30, 2020, the Government of Uganda instituted a nationwide lockdown. Health facilities remained open, however motor vehicle transportation was largely banned. In Ugandan public health facilities, HTN services are offered widely, however the availability of HTN medicines is generally low and inconsistent. In contrast, antiretrovirals for people with HIV (PWH) are free and consistently available at HIV clinics. We sought to evaluate the impact of the lockdown on access to medicines and clinical outcomes among a cohort of Ugandan patients with HTN and HIV.