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Search Results: 1 - 10 of 191353 matches for " D Muhangi "
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Intra-household differences in health seeking behaviour for orphans and non-orphans in an NGO-supported and non-supported subcounty of Luwero, Uganda
WW Muhwezi, D Muhangi, F Mugumya
African Health Sciences , 2009,
Abstract: Objective: Comparing healthcare dynamics among orphans and non-orphans in an NGO supported and a non-supported subcounty so as to identify the level of equity. Design and Methods: This was a cross-sectional unmatched case-control research. A sample of 98 orphans and 98 non-orphans in an NGO supported sub-county and a similar number in a control sub-county participated. For each child, a corresponding caregiver participated. Each respondent was interviewed. Analysis was comparative. Relationships between variables were ascertained using a X2. Results: Fevers were the most common health problem. However, 14.3% of children reported an experience of diarrhoea in an NGO-supported sub-county as opposed to 85.7% in the control sub-county (p = 0.014). Twenty percent of children in the NGO supported sub-county reported skin infections compared to 80% in the control sub-county [p= 0.008]. When orphans fell sick, more caregivers in the supported sub-county consulted village clinics compared to self herbal-medication (p = 0.009). Majority of orphan caregivers compared to those for non-orphans in the control sub-county took their children to village clinics as opposed to health centres (p = 0.002). In the control sub-county, fewer caregivers responded to children’s illness by buying medicines from drug-shops as opposed to taking them to village clinics [(p = 0.040). Conclusion: There were some differences between orphans and non-orphans within each sub-county and between orphans in the two sub-counties. NGO support is critical in cultivating equity, compassion and non-discrimination. The extended family system in Africa was managing orphan care although it displayed cracks in support systems.
Awareness of banana bacterial wilt control in Uganda: 1. Farmers' perspective
F Bagamba, E Kikulwe, W K Tushemereirwe, D Ngambeki, J Muhangi, G H Kagezi, S Green
African Crop Science Journal , 2006,
Impact of awareness campaigns for banana bacterial wilt in Uganda
J Muhangi, C Nankinga, W K Tushemereirwe, M Rutherford, P Ragama, K Nowakunda, S Abeyasekera
African Crop Science Journal , 2006,
Status of banana bacterial wilt in Uganda
W K Tushemereiwe, O O Okaasai, J Kubiriba, C Nankinga, J Muhangi, N Odoi, F Opio
African Crop Science Journal , 2006,
Scaling Up Paediatric HIV Care with an Integrated, Family-Centred Approach: An Observational Case Study from Uganda
Emmanuel Luyirika, Megan S. Towle, Joyce Achan, Justus Muhangi, Catherine Senyimba, Frank Lule, Lulu Muhe
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0069548
Abstract: Family-centred HIV care models have emerged as an approach to better target children and their caregivers for HIV testing and care, and further provide integrated health services for the family unit’s range of care needs. While there is significant international interest in family-centred approaches, there is a dearth of research on operational experiences in implementation and scale-up. Our retrospective case study examined best practices and enabling factors during scale-up of family-centred care in ten health facilities and ten community clinics supported by a non-governmental organization, Mildmay, in Central Uganda. Methods included key informant interviews with programme management and families, and a desk review of hospital management information systems (HMIS) uptake data. In the 84 months following the scale-up of the family-centred approach in HIV care, Mildmay experienced a 50-fold increase of family units registered in HIV care, a 40-fold increase of children enrolled in HIV care, and nearly universal coverage of paediatric cotrimoxazole prophylaxis. The Mildmay experience emphasizes the importance of streamlining care to maximize paediatric capture. This includes integrated service provision, incentivizing care-seeking as a family, creating child-friendly service environments, and minimizing missed paediatric testing opportunities by institutionalizing early infant diagnosis and provider-initiated testing and counselling. Task-shifting towards nurse-led clinics with community outreach support enabled rapid scale-up, as did an active management structure that allowed for real-time review and corrective action. The Mildmay experience suggests that family-centred approaches are operationally feasible, produce strong coverage outcomes, and can be well-managed during rapid scale-up.
The Effectiveness of Educational Support to Orphans and Vulnerable Children in Tanzania and Uganda
Mary H. Shann,Malcolm H. Bryant,Mohamad I. Brooks,Paul Bukuluki,Denis Muhangi,Joe Lugalla,Gideon Kwesigabo
ISRN Public Health , 2013, DOI: 10.1155/2013/518328
Abstract: Little evidence is available to assist policy makers and donors in deciding what kinds of programs in developing countries are more likely to be effective in supporting the entry and continuation of OVC in secondary schools. This is particularly important for females whose education has direct bearing on child mortality in the next generation. This study gathered four kinds of educational outcome measures in two East African countries ravaged by the AIDS/HIV pandemic. The goal was to determine whether direct scholarship aid to individual students versus various forms of block grants would be more effective in promoting lower rates of absenteeism, lower dropout rates, higher national examination scores, and higher pass rates for OVC of both genders. Insufficient evidence was available for recipients of scholarships, but OVC with block grant support performed as well or better than their non-OVC counterparts, and significantly better than OVC without support. Contrary to popular belief, girls had lower rates of absenteeism. There were no gender differences in dropout. However, boys consistently outperformed girls on academic tests. Insufficient data systems continue to impede more detailed analysis. 1. Purpose This research investigated the relative effectiveness of various educational delivery service models to orphans and vulnerable children (OVC) in two East African countries ravaged by the AIDS pandemic. It also examined gender differences in students’ educational outcomes. 2. Perspectives In addition to the intrinsic importance of education and its role in economic growth, a causal link has long been established between education and a range of health outcomes [1, 2]. A meta-analysis of 175 studies showed that for every year of increase in the education of women of reproductive age, child mortality decreased by 9.5% [3]. Increasing access to education and retention at school is instrumental not only in the health and wellbeing of the individual, but also in their future children and families. Being orphaned or made vulnerable can play a role in whether a child goes to school. OVC may lose access to school for several reasons including poverty, need for domestic labor, need for income-generating activities, stigmatization, and parental sickness or death. School enrollment inequities among all types of orphans have been documented throughout sub-Saharan Africa ([4–8]; Bicego et al. [9]). One estimate suggests that orphans are approximately 13% less likely to attend school than nonorphans [4]. Studies have also shown that disparities in grade
Risk Factors for Helminth, Malaria, and HIV Infection in Pregnancy in Entebbe, Uganda
Patrick William Woodburn ,Lawrence Muhangi,Stephen Hillier,Juliet Ndibazza,Proscovia Bazanya Namujju,Moses Kizza,Christine Ameke,Nicolas Emojong Omoding,Mark Booth,Alison Mary Elliott
PLOS Neglected Tropical Diseases , 2009, DOI: 10.1371/journal.pntd.0000473
Abstract: Background Infections during pregnancy may have serious consequences for both mother and baby. Assessment of risk factors for infections informs planning of interventions and analysis of the impact of infections on health outcomes. Objectives To describe risk factors for helminths, malaria and HIV in pregnant Ugandan women before intervention in a trial of de-worming in pregnancy. Methods The trial recruited 2,507 pregnant women between April 2003 and November 2005. Participants were interviewed and blood and stool samples obtained; location of residence at enrolment was mapped. Demographic, socioeconomic, behavioral and other risk factors were modelled using logistic regression. Results There was a high prevalence of helminth, malaria and HIV infection, as previously reported. All helminths and malaria parasitemia were more common in younger women, and education was protective against every infection. Place of birth and/or tribe affected all helminths in a pattern consistent with the geographical distribution of helminth infections in Uganda. Four different geohelminths (hookworm, Trichuris, Ascaris and Trichostrongylus) showed a downwards trend in prevalence during the enrolment period. There was a negative association between hookworm and HIV, and between hookworm and low CD4 count among HIV-positive women. Locally, high prevalence of schistosomiasis and HIV occurred in lakeshore communities. Conclusions Interventions for helminths, malaria and HIV need to target young women both in and out of school. Antenatal interventions for malaria and HIV infection must continue to be promoted. Women originating from a high risk area for a helminth infection remain at high risk after migration to a lower-risk area, and vice versa, but overall, geohelminths seem to be becoming less common in this population. High risk populations, such as fishing communities, require directed effort against schistosomiasis and HIV infection.
Parasite infection is associated with Kaposi's sarcoma associated herpesvirus (KSHV) in Ugandan women
Katie Wakeham, Emily L Webb, Ismail Sebina, Lawrence Muhangi, Wendell Miley, W Thomas Johnson, Juliet Ndibazza, Alison M Elliott, Denise Whitby, Robert Newton
Infectious Agents and Cancer , 2011, DOI: 10.1186/1750-9378-6-15
Abstract: Seroprevalence of KSHV was higher in women with malaria parasitaemia (73% vs 60% p = 0.01), hookworm (67% vs 56% p = 0.001) and Mansonella perstans (69% vs 59% p = 0.05); seroprevalence increased with increasing intensity of hookworm infection (p < 0.001[trend]). No associations were found for HIV, five other parasites or active syphilis. These effects were not explained by socioeconomic status or education.Specific parasite infections are associated with presence of antibodies against KSHV, perhaps mediated via their effect on immune function.Infection with KSHV is the underlying cause of Kaposi's sarcoma (KS), although it may not be sufficient [1]. Immune suppression, such as that caused by human immunodeficiency virus (HIV), significantly increases the risk of KS among KSHV infected people and is associated with increased viral load and viral shedding [2-8]. Among people without HIV infection or other forms of overt immune suppression, geographic and temporal variation in the incidence of KS and in the prevalence of KSHV suggest that cofactors may be important in facilitating both transmission and disease [9-18]. Whether cofactors act directly or via effects on the immune system is unclear [19].Many environmental co-factors for KSHV transmission and disease have been suggested, including volcanic soils [20], limestone [21] and 'oncoweeds' - that is plants with carcinogenic properties or the ability to reactivate KSHV in vitro - although epidemiologic evidence of a role for these agents remains scant [22]. Ecological studies in the Mediterranean area found that eradication of mosquitoes and other blood sucking arthropods was associated with declines both in the prevalence of KSHV and in the incidence of KS [9-14,18,23]. The 'promoter arthropod hypothesis' suggests that insect blood feeding increases KSHV transmission through viral reactivation and KS through inflammatory mechanisms associated with the bite [11,14].Studies of KS in Africa have identified risk facto
Determining Mycobacterium tuberculosis Infection among BCG-Immunised Ugandan Children by T-SPOT.TB and Tuberculin Skin Testing
Gyaviira Nkurunungi, Jimreeves E. Lutangira, Swaib A. Lule, Hellen Akurut, Robert Kizindo, Joseph R. Fitchett, Dennison Kizito, Ismail Sebina, Lawrence Muhangi, Emily L. Webb, Stephen Cose, Alison M. Elliott
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0047340
Abstract: Background Children with latent tuberculosis infection (LTBI) represent a huge reservoir for future disease. We wished to determine Mycobacterium tuberculosis (M.tb) infection prevalence among BCG-immunised five-year-old children in Entebbe, Uganda, but there are limited data on the performance of immunoassays for diagnosis of tuberculosis infection in children in endemic settings. We therefore evaluated agreement between a commercial interferon gamma release assay (T-SPOT.TB) and the tuberculin skin test (TST; 2 units RT-23 tuberculin; positive defined as diameter ≥10 mm), along with the reproducibility of T-SPOT.TB on short-term follow-up, in this population. Methodology/Principal Findings We recruited 907 children of which 56 were household contacts of TB patients. They were tested with T-SPOT.TB at age five years and then re-examined with T-SPOT.TB (n = 405) and TST (n = 319) approximately three weeks later. The principal outcome measures were T-SPOT.TB and TST positivity. At five years, 88 (9.7%) children tested positive by T-SPOT.TB. More than half of those that were T-SPOT.TB positive at five years were negative at follow-up, whereas 96% of baseline negatives were consistently negative. We observed somewhat better agreement between initial and follow-up T-SPOT.TB results among household TB contacts (κ = 0.77) than among non-contacts (κ = 0.39). Agreement between T-SPOT.TB and TST was weak (κ = 0.28 and κ = 0.40 for T-SPOT.TB at 5 years and follow-up, respectively). Of 28 children who were positive on both T-SPOT.TB tests, 14 (50%) had a negative TST. Analysis of spot counts showed high levels of instability in responses between baseline and follow-up, indicating variability in circulating numbers of T cells specific for certain M.tb antigens. Conclusions/Significance We found that T-SPOT.TB positives are unstable over a three-week follow-up interval, and that TST compares poorly with T-SPOT.TB, making the categorisation of children as TB-infected or TB-uninfected difficult. Existing tools for the diagnosis of TB infection are unsatisfactory in determining infection among children in this setting.
Impact of Anthelminthic Treatment in Pregnancy and Childhood on Immunisations, Infections and Eczema in Childhood: A Randomised Controlled Trial
Juliet Ndibazza, Harriet Mpairwe, Emily L. Webb, Patrice A. Mawa, Margaret Nampijja, Lawrence Muhangi, Macklyn Kihembo, Swaib A. Lule, Diana Rutebarika, Barbara Apule, Florence Akello, Hellen Akurut, Gloria Oduru, Peter Naniima, Dennison Kizito, Moses Kizza, Robert Kizindo, Robert Tweyongere, Katherine J. Alcock, Moses Muwanga, Alison M. Elliott
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0050325
Abstract: Background Helminth infections may modulate immune responses to unrelated pathogens and allergens; these effects may commence prenatally. We addressed the hypothesis that anthelminthic treatment in pregnancy and early childhood would improve responses to immunisation and modulate disease incidence in early childhood with both beneficial and detrimental effects. Methods and Findings A randomised, double-blind, placebo-controlled trial was conducted in Entebbe, Uganda [ISRCTN32849447]. In three independent randomisations, 2507 pregnant women were allocated to receive single-dose albendazole or placebo, and praziquantel or placebo; 2016 of their offspring were randomised to receive quarterly single-dose albendazole or placebo from age 15 months to 5 years. Primary outcomes were post-immunisation recall responses to BCG and tetanus antigens, and incidence of malaria, diarrhoea, and pneumonia; incidence of eczema was an important secondary outcome. Analysis was by intention-to-treat. Of 2345 live births, 1622 (69%) children remained in follow-up at age 5 years. 68% of mothers at enrolment, and 11% of five-year-olds, had helminth infections. Maternal hookworm and Schistosoma mansoni were effectively treated by albendazole and praziquantel, respectively; and childhood hookworm and Ascaris by quarterly albendazole. Incidence rates of malaria, diarrhoea, pneumonia, and eczema were 34, 65, 10 and 5 per 100 py, respectively. Albendazole during pregnancy caused an increased rate of eczema in the children (HR 1.58 (95% CI 1.15–2.17), p = 0.005). Quarterly albendazole during childhood was associated with reduced incidence of clinical malaria (HR 0.85 (95% CI 0.73–0.98), p = 0.03). There were no consistent effects of the interventions on any other outcome. Conclusions Routine use of albendazole in pregnancy may not always be beneficial, even in tropical developing countries. By contrast, regular albendazole treatment in preschool children may have an additional benefit for malaria control where helminths and malaria are co-endemic. Given the low helminth prevalence in our children, the effect of albendazole on malaria is likely to be direct. Trial registration Current Controlled Trials ISRCTN32849447
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