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Prevalence and risk factors of nutritional anaemia among female school children in Masindi district, western Uganda
(African Journal of Food, Agriculture, Nutrition and Development, 2013-07-01) Barugahara, EI; Kikafunda, J; Gakenia, WM
Anaemia is the most widespread nutrition related public health problem world-wide and yet in Uganda, there is little national data on anaemia and its likely causes amongst school children. The aim of this study was to assess the prevalence, dietary and health risk factors of nutritional anaemia amongst 11-14 year old girls attending primary schools in Masindi District of Western Uganda. Two schools, one urban and the other rural, were selected for this cross-sectional study. A total of 109 girls from the upper primary section were randomly selected from both schools. The Lovibond comparator was used to assay Hemoglobin (Hb) level in the whole blood after conversion of Hb to oxyhemoglobin by ammonia. Pre-tested structured questionnaires were used to collect data. Incidences of malaria were self reported. The dietary intake of iron, protein, folate, riboflavin, energy, vitamin C, dietary fibre and vitamin A was estimated from the East African food composition table used to analyze the 24-hour dietary recalls. Associations between anaemia and factors under investigation were examined using Pearsonfs chi-square test and Pearsonfs correlation coefficient analysis. Statistical significance was considered at p< 0.05. The overall prevalence of anaemia was 46%. It was twice as high in the urban school (61%) compared to the rural school (31%). There was a high intake of plant . based diets; majority of the school children with excess intake of fibre, inadequate intake of iron, protein, folate, riboflavin, energy and vitamin A were anaemic (p . 0.001). Malaria incidences were many and though de-worming was common in schools, it was not consistent. Performance of de-worming by nurses had more impact than that of the teachers. Anaemia was positively correlated with inadequate dietary intake (r = 0.61, p < 0.001), malaria incidences (r = 0.54, p = 0.02) and improper de-worming (r = 0.51, p = 0.04). A high prevalence of anaemia was found amongst the girls, particularly in the urban school. Improper de-worming, malaria incidences and poor feeding were the risk factors of nutritional anaemia. There is, therefore, an urgent need for a national anaemia assessment among this age group and the strengthening of the current School Health Program to address aspects of health and feeding in schools in Masindi district and Uganda as a whole.
Food as a human right during disasters in Uganda
(Elsevier: Food Policy, 2014-12) Rukundo, Peter Milton; Iversen, Per Ole; Oshaug, Arne; Omuajuanfo, Lovise Ribe; Rukooko, Byaruhanga; Kikafunda, Joyce; Andreassen, Bård Anders
Natural and human induced disasters are a threat to food security, economic progress and livelihoods in Uganda. However, we have limited knowledge regarding the putative role of the human rights dimension to the impact and management of such tragedies. In this article we assessed the present policies, legislation and institutional capabilities to ascertain whether they could assure the right to adequate food during disaster situations in Uganda. Using purposive sampling, 52 duty bearers working in institutions deemed relevant to food security, nutrition and disaster management were interviewed using a semi-structured guide. Relevant provisions from policy, legislation, institutional budgets and records of Parliament provided the context for analysis. The most important concern coming from the analyses of the information retrieved were inadequate preparedness mechanisms and capabilities. Whereas Uganda’s Constitution proclaims the right to adequate food, and the need to establish a contingencies fund and commission responsible for disaster preparedness and management, they had not been instituted. Implementation of relevant policies appeared slow, especially with regard to assuring adequate relief food as a State obligation. Legislation to guarantee funding and institutionalisation of necessary disaster preparedness and management capabilities was not in place. An ambitious 5-year Uganda Nutrition Action Plan adopted in 2011 had not yet been funded by mid-2013, implying a reality gap in nutrition programming. Budget architecture and financing to disaster management have in effect fallen short of assuring adequate relief food as a human right. Due to capacity constraints, an approach of humanitarian relief may be entrenched in contradiction of State obligations to respect, protect and fulfil human rights. To stay ahead of the potential threats, the Government with support of the Parliament and relevant partners need to enact legislation to appropriate budget resources needed to institute a mechanism of capabilities to implement the constitutional and policy provisions on the right to adequate food and disaster management.
Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda
(BMC International Health and Human Rights volume, 2015-04-25) Rukundo, Peter M; Iversen, Per O; Andreassen, Bård A; Oshaug, Arne; Kikafunda, Joyce; Rukooko, Byaruhanga
Despite the instruments on the right to adequate food adopted by the United Nations, there exists limited information on how this right is perceived. Following a major 2010 landslide disaster in the Bududa district of Eastern Uganda and the resettlement of some affected households into the Kiryandongo district in Western Uganda, we surveyed both districts to explore perceptions about the right to adequate food among households with different experiences; disaster-affected and controls. Methods: We deployed qualitative and quantitative techniques to a cross-sectional survey. The index respondent was the head of each randomly selected household from the landslide affected communities and controls from a bordering sub-county. Data was collected by interviews and focus group discussions (FGDs). Structured entries were tested statistically to report associations using Pearson’s Chi-square at the 95% CI. Information from FGDs was transcribed, coded, sequenced and patterned. Findings from both techniques were triangulated to facilitate interpretations. Results: Analysis included 1,078 interview entries and 12 FGDs. Significant differences between the affected and control households (P < 0.05) were observed with: age; education level; religious affiliation; existence of assets that complement food source; and having received relief food. Analysis between groups showed differences in responses on: whether everyone has a right to adequate food; who was supposed to supply relief food; whether relief food was adequate; and preferred choice on the means to ensure the right to adequate food. FGDs emphasized that access to land was the most important means to food and income. Affected households desired remedial interventions especially alternative land for livelihood. Despite the provision of adequate relief food being a state’s obligation, there was no opportunity to exercise choice and preference. Comprehension and awareness of accountability and transparency issues was also low. Conclusion: Though a significant proportion of participants affirmed they have a right to adequate food, relief food was largely perceived as insufficient. Given the high regard for land as a preferred remedy, a resettlement policy is of the essence to streamline post-landslide displacement and resettlement. Information materials need to be assembled and disseminated to stimulate awareness and debate on the right to adequate food.
Food variety consumption and household food insecurity coping strategies after the 2010 landslide disaster : the case of Uganda
(Cambridge University Press: Public Health Nutrition, 2016-06-09) Rukundo, Peter M; Oshaug, Arne; Andreassen, Bård A; Kikafunda, Joyce; Rukooko, Byaruhanga; Iversen, Per O
To evaluate the nutritional situation of the victims of the 2010 landslide disaster in Uganda, food varieties consumed and coping strategies were assessed. Design Cross-sectional. Food variety scores (FVS) were obtained as the total of food items eaten over the last week while an index was based on severity weighting of household food insecurity coping strategies. We included 545 affected and 533 control households. Setting Victims in the affected Bududa district in Eastern Uganda and those victims resettled in the Kiryandongo district, Western Uganda. Results Adjusted for covariates, in Bududa significantly higher mean FVS were observed among: affected than controls; farmers than others; and relief food recipients. Control households scored higher means (SE) on severity of coping: 28·6 (1·3) v. 19·2 (1·2; P<0·01). In Kiryandongo, significantly higher FVS were observed among: control households; household heads educated above primary school; those with assets that complement food source; and recipients of relief food. Severity of coping was significantly higher among affected households and non-recipients of relief food. Affected households had a higher likelihood to skip a day without eating a household meal in Bududa (OR=2·31; 95 % CI 1·62, 3·29; P<0·01) and Kiryandongo (OR=1·77; 95 % CI 1·23, 2·57; P<0·01). Conclusions Whereas FVS and severity of coping showed opposite trends in the two districts, resettlement into Kiryandongo led to severe coping experiences. Administrative measures that provide a combination of relief food, social protection and resettlement integration may offset undesirable coping strategies affecting diet.
Socioeconomic and Demographic Factors Influencing Feeding Practices, Morbidity Status, and Dietary Intakes of Children Aged 7–24 Months in Rural Uganda
(Ecology of Food and Nutrition, 2016-11-14) Barugahara, Evyline Isingoma; Mbugua, Samuel; Karuri, Edward; Maina, Gakenia Wamuyu
The objective of this study was to analyze the nutritional and morbidity patterns of children aged 7–24 months in relationship to household socioeconomic and demographic characteristics. Structured questionnaires and repeated 24-hour recalls were used to collect data. Maternal education and age influenced timing of complementary foods, dietary diversity score, meal frequency, and diarrhea incidences (p < .05). This resulted in 53%, 59%, 48%, 43%, and 22% of the study children having inadequate intake of energy, protein, vitamin A, iron, and zinc, respectively. Households need to be empowered to utilize available resources for improving nutrient intake and health among their children.
Realization of the right to adequate food and the nutritional status of land evictees: a case for mothers/caregivers and their children in rural Central Uganda
(BMC International Health and Human Rights, 2018-05-24) Nahalomo, Aziiza; Iversen, Per Ole; Rukundo, Peter Milton; Kaaya, Archileo; Kikafunda, Joyce; Eide, Wenche Barth; Marais, Maritha; Wamala, Edward; Kabahenda, Margaret
In developing countries like Uganda, the human right to adequate food (RtAF) is inextricably linked to access to land for households to feed themselves directly through production or means for its procurement. Whether RtAF is enjoyed among Ugandan land evictees, is unknown. We therefore explored this among land evictees (rights-holders) in Wakiso and Mpigi districts in rural Central Uganda. We assessed food accessibility and related coping strategies, diet quality and nutritional status of children 6–59 months old, and their caregivers. Effectiveness of the complaint and redress mechanisms in addressing RtAF violations was also explored. Methods: In this cross-sectional study, quantitative data was collected using a structured questionnaire, with food security and nutritional assessment methods from a total of 215 land evictees including 187 children aged 6–59 months. Qualitative data was collected by reviewing selected national and international documents on the RtAF and key informant interviews with 15 purposively sampled duty-bearers. These included individuals or representatives of the Uganda Human Rights Commission, Resident District Commissioner, Sub-county Chiefs, and local Council leaders. Results: We found that 78% of land evictees had insufficient access to food while 69.4% had consumed a less diversified diet. A majority of evictees (85.2%) relied on borrowing food or help from others to cope with food shortages. Of the 187 children assessed, 9.6% were wasted, 18.2% were underweight and 34.2% were stunted. Small, but significant associations, were found between food accessibility, diet quality, food insecurity coping strategies; and the nutritional status of evictees. We observed that administrative, quasi-judicial and judicial mechanisms to provide adequate legal remedies regarding violations of the RtAF among evictees in Uganda are in place, but not effective in doing so. Conclusion: Land eviction without adequate legal remedies is a contributor to food insecurity and undernutrition in rural Central Uganda. It is essential that the Government strengthens and enforces the policy and legal environment to ensure adequate and timely compensation of evictees in order to reduce their vulnerability to food insecurity.
Nutritional status of children 7–36 months old from millet consuming communities of Masindi District, Western Uganda
(BMC nutrition, 2019) Evyline, Isingoma Barugahara; Samuel, Kuria Mbugua; Gichohi, Karuri Edward
Background Several national reports have indicated poor nutritional status among children from Western Uganda where millet porridge is a predominant complementary food. However, little is known about the nutritional status of 7–36 months old children from millet consuming communities of Western Uganda. Methods A cross-sectional study was conducted in Bujenje County of Masindi District. A total of 636 children from 23 villages within Bwijanga and Budongo sub counties were randomly selected. Anthropometric measurements of children were taken. Data on demographic and socioeconomic characteristics of children’s households, their dietary practices and morbidity patterns was collected using a self-administered questionnaire. A statistical Package for the Social Sciences (SPSS) version 20 and Emergency Nutritional Assessment (ENA) Software Version 2010 were used for analysing data. The relationship between demographic and socioeconomic characteristics of households and children’s nutritional status was determined using Chi-square tests. Pearson’s correlation coefficient was used to determine the association between children’s nutritional status and the amount of millet porridge consumed. A p-value of < 0.05 indicated statistical significance. Results A proportion of 30.5% children were stunted, 11.6% underweight and 7.4% wasted. Underweight and wasting were significantly high in Budongo sub county at p = 0.044 and p = 0.005 respectively. Stunting and underweight were highest between 12 and 23 months at p = 0.005 and 0.020 respectively. Although millet porridges formed the bulk of children’s meals, they could only cater for < 60% of the recommended daily nutrient intake. Children with diarrhoea were 1.4 and 2 times likely to become stunted and underweight at p = 0.025 and 0.007 respectively. Feeding practices for children with diarrhoea were contrary to World Health Organisation’s recommendations in more than 50% of the studied children. There was a significant association between Height-for-Age Z scores, Weight-for-Height Z scores and the amount of millet porridge consumed by children (r = − 0.20, p < 0.001 and r = 0.14, p < 0.001 respectively). Conclusions Results showed slightly higher percentages of stunted, underweight and wasted children compared to national figures. This was attributed to high incidences of diarrhoea and inadequate feeding practices especially for children 12–36 months old.
Factors associated with nutritional status of women 18-59 years in Mukono municipality, Uganda
(Kyambogo University, 2019-11) Athieno, Justine
Recent findings indicate an increase in obesity and persistent underweight among women in Uganda. Obesity, overweight and underweight have been associated with diet and physical activity. It is however not clear which socio demographic, physical activity and dietary factors are most important influencers of nutritional status among urban women in Uganda. Identifying these will go a long way in determining appropriate intervention strategies for the control of obesity and the associated complications in Uganda. The aim of the study was to assess the prevalence of underweight, overweight and obesity and how they are associated with socio demographic, dietary and physical activity factors among women 18-59 years in Mukono Municipality. Participants were randomly selected. A semi structured socio demographic questionnaire, semi quantitative food frequency questionnaire and the Global Physical Activity Questionnaire were used to collect data. Data was analyzed using SPSS version 20, frequencies and percentages used to ascertain the prevalence and multinomial logistic regression models used to predict factors at 95% confidence interval. The study revealed that prevalence of BMI-defined overweight was 29.7%, obesity 20.7% and underweight 2.9%. Older women were less likely to have healthy WHR (AOR 0.2; 95% CI: 0.04-0.90; P<0.05), those with moderate monthly expenditure were less likely to be obese (AOR 0.3; 95% CI: 0.1-0.9; P<0.05). Frequent consumption of foods from: meat and eggs group increased the likelihood of having excessive abdominal fat (AOR 1.7; 95% CI: 1.02-2.8; P<0.05), (AOR 1.2; 95% CI: 1.0-1.5; P<0.05) respectively, nuts and seeds increased the likelihood of being overweight (AOR 1.2; 95% CI: 1.0-1.5; P<0.03), plantains decreased the likelihood of healthy waist circumference (WC) (AOR 0.8; 95% CI: 0.7-0.9; P<0.01), poultry decreased the likelihood of moderately unhealthy WC (AOR 0.7; 95% CI: 95% CI:1.0-1.4; P<0.05). There was low (31%) attainment of minimum dietary diversity for women. Non-participation in active transport related physical activity (PA) increased the likelihood of being over fat (AOR=1.8 95% CI: 1.5–3.0; P<0.05) while more time spent in work related PA decreased the likelihood of having severely unhealthy WHR (AOR=0.9 95% CI: 0.9–2.0; P=0.01). Attainment of WHO standard of PA was at 47.1%. In conclusion, obesity and abdominal obesity were prevalent among the respondents. They are associated with age, high parity, expenditure per month, time spent in work activity and reliance on walking for transport. They are also associated with a high frequency of consumption of meat, eggs, nuts and seeds and with a low consumption of poultry and vegetables. Key words: Socio demographic, diet, physical activity, nutritional status and women.
The association of urine markers of iodine intake with development and growth among children in rural Uganda: a secondary analysis of a randomised education trial
(Public health nutrition, 2020-07) Prudence, Atukunda; Grace, KM Muhoozi; Lien, M Diep; Jens, P Berg; Ane, C Westerberg; Per, O Iversen
Objective: We examined associations of urine iodide excretion, proxy for iodine intake, with child development and growth. Design: This is a secondary analysis of a 1:1 cluster-randomised trial with a 6-month nutrition/stimulation/hygiene education intervention among mothers of children aged 6–8 months to improve child development and growth. Development was assessed using Bayley Scales of Infant and Toddler Development–III (BSID-III) and Ages and Stages Questionnaire (ASQ), whereas anthropometry was used to assess growth. Urine iodide concentration (UIC) and urine iodide/creatinine ratio (ICR) were measured. Setting: The current study was conducted in southern Uganda. Participants: We randomly selected 155 children from the 511 enrolled into the original trial and analysed data when they were aged 20–24 and 36 months. Results: Median UIC for both study groups at 20–24 and 36 months were similar (P > 0·05) and within the normal range of 100–199 μg/l (0·79–1·60 μmol/l), whereas the intervention group had significantly higher ICR at 20–24 months. The BSID-III cognitive score was positively associated (P = 0·028) with ICR at 20–24 months in the intervention group. The ASQ gross motor score was negatively associated (P = 0·020) with ICR at 20–24 months among the controls. ICR was not significantly associated with anthropometry in the two study groups at either time-point. Conclusions: Following the intervention, a positive association was noted between ICR and child’s cognitive score at 20–24 months, whereas no positive association with ICR and growth was detected. Iodine sufficiency may be important for child’s cognitive development in this setting.
The association between dietary diversity and development among children under 24 months in rural Uganda: analysis of a cluster-randomised maternal education trial
(Public health nutrition, 2021-03) Paul, Kakwangire; Cami, Moss; Nicholas, Matovu; Prudence, Atukunda; Ane, C Westerberg; Per, O Iversen; Grace, Muhoozi
Objective: To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children. Design: A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6–8 months with child development domains (communication, fine motor, gross motor, personal–social and problem solving) at 20–24 months of age. Setting: Rural areas in Kabale and Kisoro districts of south-western Uganda. Participants: Children under 24 months. Results: After multivariable analysis, DDS at 6–8 months were positively associated with normal fine motor skills development at 20–24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6–8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05). Conclusions: We found an association between child DDS at 6–8 months and improvement in fine motor skills development at 20–24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20–24 months.
Longitudinal assessments of child growth: a six-year follow-up of a cluster-randomized maternal education trial
(Elsevier, 2021-08) Prudence, Atukunda; Moses, Ngari; Xi, Chen; Ane, C. Westerberg; Per, O. Iversen; Grace, Muhoozi
Background & aims: Child growth impairments are rampant in sub-Saharan Africa. To combat this important health problem, long-term follow-up studies are needed to examine possible benefits and sustainability of various interventions designed to correct inadequate child growth. Our aim was to perform a follow-up study of children aged 60e72 months whose mothers participated in a two-armed cluster-randomized education intervention trial lasting 6 months in rural Uganda when their children were 6e8 months old with data collection at 20e24 and at 36 months. The education focused on nutrition, hygiene, and child stimulation. Methods: We measured growth using anthropometry converted to z-scores according to WHO guide- lines. We also included assessments of body composition using bioimpedance. We used multilevel mixed effect linear regression models with maximum likelihood method, unstructured variance-covariance structure, and the cluster as a random effect component to compare data from the intervention (receiving the education and routine health care) with the control group (receiving only routine health care). Results: Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of the children in the intervention and control group, respectively, were available for the current follow-up study. We found no significant differences in any anthropometrical z-score between the two study groups at child age of 60e72 months, except that children in the intervention group had lower (P ¼ 0.006) weight-for-height z-score than the controls. There were no significant differences in the trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child age of 60e72 months. Neither did we detect any significant difference between the intervention and control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60 e72 months. Separate gender analyses had no significant impact on any of the growth or body composition findings. Conclusion: In this long-term study of children participating in a randomized maternal education trial, we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity or body composition.
Malnutrition and associated risk factors among children 6–59 months old in the landslide-prone Bududa District, Eastern Uganda: a cohort study
(Current Developments in Nutrition : American Society for Nutrition, 2022-01-18) Nahalomo, Aziiza; Iversen, Per Ole; Andreassen, Bård Anders; Kaaya, Archileo Natigo; Rukooko, Archangel Byaruhanga; Tushabe, Gerald; Nateme, Nancy Catherine; Rukundo, Peter Milton
Background The United Nations Sustainable Development Goal 2.2 calls for an end to all forms of malnutrition. This might be derailed due to persistent landslide disasters in low-income countries like Uganda. Objectives The prevalence of malnutrition and the impact of seasonal variations and associated factors were assessed among children aged 6–59 mo in the landslide-affected households in Bududa District, eastern Uganda. Methods A prospective cohort study using a 2-stage simple random technique was applied to select 422 households including 392 children during May–August (food-plenty season) 2019. After 6 mo, in January–March (food-poor season) 2020, 388 households and 366 children were assessed. Socioeconomic and demographic data were collected using structured questionnaires. Child malnutrition outcomes were defined according to WHO criteria. Factors associated with malnutrition outcomes were identified by bivariate and multivariate logistic regression.
An exploration of teachers and trainers use of instruction practices and development of students interpersonal abilities in hospitality training: the Ugandan perspective
(Journal of Vocational Education & Training, 2022-02-07) Ajambo, Lucy; Sannerud, Ronny; Nabagaala, Justine
Interpersonal abilities as critical competencies are a prevalent subject in hospitality training. However, there remains a need to further study how teachers and trainers apply instruction practices to develop and strengthen students’ interpersonal abilities. This study aimed at identifying instruction practices used by teachers and trainers to ensure students’ development of interpersonal abilities and establishing students interpersonal abilities from teachers and trainers use of instructional practices. A qualitative research approach using a descriptive study design was used. A sample of 26 participants was purposively selected from vocational institutions and workplaces. In-depth interviews and observations were used to collect data. The study found out that discussions and presentations strengthened by mentoring were key to inculcating and strengthening the students’ interpersonal abilities. However, some students were confronted with challenges; remembrance of what was discussed, teacher and trainers acting as barricades during the use of instructional practices leading to student passiveness, being laughed at by fellow peers, understanding what has been discussed and in task-specific- feedback from trainers at the beginning of the workplace training. Thus, the study concluded that teacher-trainer collaboration was crucial for clear harmonization of instructional practices of students’ interpersonal abilities development and strengthening.
Child saliva microbiota and caries: a randomized controlled maternal education trial in rural Uganda
(Scientific Reports, 2022-05-12) Muhoozi, Grace K. M.; Li, Kelvin.; Atukunda, Prudence.; Skaare, Anne B.; Willumsen, Tiril.; Enersen, Morten.; Westerberg, Ane C.; Morris, Alison.; Vieira, Alexandre R.; Iversen, Per O.; Methé, Barbara A.
Undernutrition is a public health challenge in sub-Saharan countries, including Uganda. In a previous randomized controlled trial (RCT) with a nutrition, hygiene and stimulation education intervention among mothers of 6 months’ old children, we found less caries in the intervention group when the children were 36 months of age. We now examined the effects of (i) the intervention on the microbiota, (ii) microbiota on caries, and (iii) the intervention and microbiota on caries. The original RCT comprised 511 mother/child pairs whereas in the current study we had access to data from 344/511 (67%) children aged 36 months. The saliva microbiota was determined using 16S rRNA gene sequencing. Carious lesions (a proxy for dental health) were identified using close-up intra-oral photographs of the upper front teeth. Statistical models were used to determine host-microbiota associations. The intervention had a significant effect on the microbiota, e.g. an increase in Streptococcus abundance and decreases in Alloprevotella and Tannerella. Significant associations between the microbiota and dental caries were identified: Positive associations of Capnocytophaga and Tannerella suggest that these taxa may be deleterious to dental health while negative associations of Granulicatella, Fusobacterium, and Abiotrophia suggest taxa potentially beneficial or benign contributors to dental health. Based on taxonomic profiles, the effects of the intervention and microbiota on dental health may be independent of one another. Educational interventions with emphasis on nutrition and oral hygiene may provide a feasible strategy to decrease progression of childhood caries in low-resource settings.
Automated wearable cameras for improving recall of diet and time use in Uganda: a cross-sectional feasibility study
(Nutrition journal, 2023-01) Andrea, L. S. Bulungu; Luigi, Palla; Joweria, Nambooze; Jan, Priebe; Lora, Forsythe; Pamela, Katic; Gwen, Varley; Bernice, D. Galinda; Sarah, Nakimuli; Kate, Wellard; Elaine, L. Ferguson
Background Traditional recall approaches of data collection for assessing dietary intake and time use are prone to recall bias. Studies in high- and middle-income countries show that automated wearable cameras are a promising method for collecting objective health behavior data and may improve study participants’ recall of foods consumed and daily activities performed. This study aimed to evaluate the feasibility of using automated wearable cameras in rural Eastern Ugandan to collect dietary and time use data. Methods Mothers of young children (n = 211) wore an automated wearable camera on 2 non-consecutive days while continuing their usual activities. The day after wearing the camera, participants’ dietary diversity and time use was assessed using an image-assisted recall. Their experiences of the method were assessed via a questionnaire. Results Most study participants reported their experiences with the automated wearable camera and image-assisted recall to be good (36%) or very good (56%) and would participate in a similar study in the future (97%). None of the eight study withdrawals could be definitively attributed to the camera. Fifteen percent of data was lost due to device malfunction, and twelve percent of the images were "uncodable" due to insufficient lighting. Processing and analyzing the images were labor-intensive, time-consuming, and prone to human error. Half (53%) of participants had difficulty interpreting the images captured by the camera. Conclusions Using an automated wearable camera in rural Eastern Uganda was feasible, although improvements are needed to overcome the challenges common to rural, low-income country contexts and reduce the burdens posed on both participants and researchers. To improve the quality of data obtained, future automated wearable camera-based image assisted recall studies should use a structured data format to reduce image coding time; electronically code the data in the field, as an output of the image review process, to eliminate ex post facto data entry; and, ideally, use computer-assisted personal interviews software to ensure completion and reduce errors. In-depth formative work in partnership with key local stakeholders (e.g., researchers from low-income countries, representatives from government and/or other institutional review boards, and community representatives and local leaders) is also needed to identify practical approaches to ensuring that the ethical rights of automated wearable camera study participants in low-income countries are adequately protected.
First physicochemical analysis of stingless bee honey from Uganda
(Journal of Apicultural Research, 2023-01) Charles, Oromokoma; Patrice, Kasangaki; Perpetra, Akite; Ronald, Mugume; Robert, Kajobe; Gilbert, Mangusho
Following years of its exploitation from only wild colonies, the stingless bee (Meliponula bocandei Spinola, 1853) was recently domesticated in Uganda. Products currently harvested by the beekeepers are honey and propolis. Studies from other countries have shown that stingless bees produce honey that is distinct in physicochemical properties. Therefore, in an effort to lay a foundation for the development of quality standards for stingless bee honey in Uganda, we collected M. bocandei honey from the Western Highlands and Lake Victoria Crescent agroecological zones. A selected set of physicochemical properties (moisture content, viscosity, water activity, electrical conductivity and HMF) of the honey were determined. Results reveal the following means of the physicochemical properties: moisture content (26.45 ± 3.9%), viscosity (38.32 ± 2.25 Pa.s), water activity (0.71 ± 0.04%), electrical conductivity (0.229 ± 86.91 mS/cm), pH (4.15 ± 0.68), and HMF (5.42 ± 4.78 mg kg−1), The low mean HMF reveals that stingless bee honey from these two agroecological zones is of good quality. Overall, the mean values of the physicochemical parameters measured are within the figures in the East African Community standards for stingless bee honey. We recommend investigations to establish the diversity of forage plant resources used by the stingless bee M. bocandei in order to boost meliponiculture.
Differential COVID-19 vaccination uptake and associated factors among the slum and estate communities in Uganda: a cross-sectional population-based survey
(MDPI, 2023-02) Joseph, Kawuki; Joweria, Nambooze; Paul, Shing-fong Chan; Siyu, Chen; Xue, Liang; Phoenix, K. H. Mo; Zixin, Wang
Vaccination against COVID-19 remains one of the ultimate solutions to the ongoing pandemic. This study examined and compared the completion of primary COVID-19 vaccination series and associated factors in the slum and estate communities of Uganda. This was a cross-sectional survey conducted among 1025 slum and estate residents. Logistic regression models were fitted. Of the 1025 participants, 511 were slum residents and 514 were estate residents. Completion of COVID-19 vaccination was 43.8% in the slum community and 39.9% in the estate community (p = 0.03). Having more knowledge about COVID-19 was positively associated with completing COVID-19 vaccination in both communities. Perceived benefits and cues to action also had a positive association, but only among the slum residents. However, perceiving people infected with COVID-19 as having a high death rate, perceived barriers such as serious side effects and long distances, and depressive symptoms had negative associations with vaccine uptake among the slum community, but not in the estate community. Addressing barriers to vaccination, strengthening and utilizing the various cues to action, engagement of religious and cultural leaders, and continued community education and sensitization tailored to the needs of each community are potentially vital strategies in raising vaccination rates. Consideration of socioeconomic impact-alleviation strategies, especially among the urban poor, would also be beneficial.
A comparative study on the role of microcredit on agricultural production improvement among resource-poor rural women.
(2023-03) Faith, Muyonga Mayanja Namayengo; Johan, A. C. van Ophem; Gerrit, Antonides
The objective of the study was to compare agricultural investment and agricultural production of rural agrarian women in Uganda that had received microcredit to those that had not. A quasi-experimental was used to assess differences between performance indicators of agricultural enterprises for existing and incoming borrowers of Bangladesh Rural and Advancement Committee (BRAC) microfinance. Propensity score matching was used to ensure the comparability of the groups and to assess differences between existing borrowers and in- coming borrowers, before they received their first loan. Results indicated that the major reason for borrowing was education of children. There was no difference in investment in agricultural production between the study groups. The existing borrowers had lower monetary value of all harvested crops and for maize and beans than the in-coming borrowers. Total number of animals owned, types of animals kept and reported monetary value for goats and local cattle were also less for existing borrowers than for in-coming borrowers. It was observed that the loan repayment protocols did not match income from agriculture. The results reveal a need to modify loan repayment protocols to address the latent period between agricultural investment and output.
Social capital and sustainable growth of full-service restaurants in the global south: testing the mediating role of dynamic capabilities
(Journal of Work-Applied Management, 2023-05) Shamirah, Najjinda; Kasimu, Sendawula; Samson, Omuudu Otengei; Ahmad, Walugembe; Saadat, Nakyejwe Lubowa Kimuli
Purpose – The purpose of this study is to establish whether dynamic capabilities mediates the association between social capital and sustainable growth of full-service restaurants in Kampala, Uganda. Design/methodology/approach – This study is cross-sectional and correlational in nature. A self-administered questionnaire was used to gather data from 154 full-service restaurants in Kampala. Statistical Package for the Social Sciences (SPSS.25) and Medgraph – Excel Version were used to conduct correlation, hierarchical regression and mediation analysis on the data in order to establish the mediating role of dynamic capabilities. Findings – Study findings revealed that first, social capital and dynamic capabilities significantly predict sustainable growth of full-service restaurants, second, social capital is significantly associated with dynamic capabilities and third, dynamic capabilities significantly mediate social capital and sustainable growth of full-service restaurants. Originality/value – The study confirmed that dynamic capabilities significantly mediate social capital and sustainable growth of full-service restaurants unlike the previous studies that focused on the direct association between the study variables in explicating sustainable growth.
Cognitive development among children in a low-income setting: Cost-effectiveness analysis of a maternal nutrition education intervention in rural Uganda
(Plos one, 2023-08) Montasir, Ahmed; Grace, K. M. Muhoozi; Prudence, Atukunda; Ane, C. Westerberg; Per, O. Iversen; Knut, R. Wangen
Inadequate nutrition and insufficient stimulation in early childhood can lead to long-term defcits in cognitive and social development. Evidence for policy and decision-making regarding the cost of delivering nutrition education is lacking in low and middle-income countries (LMIC). In rural Uganda, we conducted a cluster-randomized controlled trial (RCT) examining the effect of a maternal nutrition education intervention on developmental outcomes among children aged 6–8 months. This intervention led to significantly improved cognitive scores when the children reached the age of 20–24 months. When considering the potential for this intervention’s future implementation, the desired effects should be weighed against the increased costs. This study therefore aimed to assess the cost-effectiveness of this education intervention compared with current practice. Health outcome data were based on the RCT. Cost data were initially identified by reviewing publications from the RCT, while more detailed information was obtained by interviewing researchers involved in processing the intervention. This study considered a healthcare provider perspective for an 18-months’ time horizon. The control group was considered as the current practice for the future large-scale implementation of this intervention. A cost-effectiveness analysis was performed, including calculations of incremental cost-effectiveness ratios (ICERs). In addition, uncertainty in the results was characterized using one-way and probabilistic sensitivity analyses. The ICER for the education intervention compared with current practice was USD ($) 16.50 per cognitive composite score gained, with an incremental cost of $265.79 and an incremental cognitive composite score of 16.11. The sensitivity analyses indicated the robustness of these results. The ICER was sensitive to changes in cognitive composite score and the cost of personnel. The education intervention can be considered cost-effective compared with the current practice. The outcome of this study, including the cost analysis, health outcome, cost-effectiveness, and sensitivity analysis, can be useful to inform policymakers and stake- holders about effective resource allocation processes in Uganda and possibly other LMIC.

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