Uganda Red Cross Society

INTRODUCTION: Invasive cervical cancer (ICC) is preventable and curable. However, it is the fourth leading cause of cancer mortality among women globally, especially in low- and middle-income countries. Whereas studies reveal the existence of ICC pre-cancerous lesion screening services in Kenya and Uganda, uptake of these services remains low, highlighting the existence of unidentified barriers. This study explored factors that impede access and utilization of pre-cancerous cervical screening services among women living with HIV in low resource settings in Uganda and Kenya. METHODS: a cross-sectional study design was used in six selected health facilities in Uganda and Kenya. A systematic cluster randomized sampling was used to select health facilities for women living with HIV who were invited to participate in the interviews. Data collection, coding, categorization, and statistical analysis of quantitative data were employed to rank and correlate among the most critical factors of the Health Belief Model framework. RESULTS: the results showed a negative correlation between the perceived barriers and the risk of accessing the services (-0.95, p-value 0.003) and the perceived severity (-0.95, p-value 0.004), both mean that the barriers for the women are so high that they prefer to delay the visit to the hospital. More, there was a positive correlation between perceived risk for ICC and perceived severity (0.90, p-value 0.01), meaning that a high perception of risk of ICC will increase its severity. Health system barriers to access such as lack of supplies, information, and limited staffing were also revealed. CONCLUSION: the study uncovered the health system barriers affecting ICC screening services at health facilities in Kenya and Uganda and their effects on the perceived illness. Also, it highlights the strengths and challenges while providing recommendations to promote health that includes the most vulnerable women with HIV living in socially deprived areas.

BackgroundUganda is one of the few countries in Africa that has been experiencing outbreaks of viral hemorrhagic fevers such as Ebola, Marburg and Crimean-Congo Hemorrhagic fevers. In 2017 Uganda experienced a Marburg Virus Disease (MVD) outbreak with case fatality rate of 100% in Kween district. Although hunting for wild meat was linked to the MVD outbreak in Kween district, less was reported on the land use changes, especially the changing animal grazing practices in Kween district.MethodsThrough Makerere University One Health graduate fellowship program with attachment to Uganda Red Cross Society, a study was conducted among the agricultural communities to elucidate the risk behaviors in Kween district that can be linked to the 2017 Marburg disease outbreak.ResultsResults show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to the MVD outbreak during FGDs, majority of participants linked MVD to settling in caves (inhabited by Fruit Bats) during wet season as upper belts are extensively used for crop production leaving little space for animal grazing. Members also noted side activities like hunting for wild meat during this grazing period that could have predisposed them to Marburg Virus.ConclusionsThere is need to integrate One Health concepts within agricultural extension service provision in Uganda so as to enhance the management of such infectious diseases.

BackgroundRift Valley fever (RVF) is classified as viral hemorrhagic fever and is endemic in East and West Africa. RVF is caused by an arthropod borne virus (RVFV); the disease is zoonotic and affects human, animal health as well as international trade. In livestock it causes abortions, while human infection occurs through close contact with infected animals or animal products.MethodsA quantitative observational study using stratified sampling was conducted in the western region of Uganda. Blood samples and abortion events from 1000 livestock (goats, sheep and cattle) was collected and recorded. Serum was analyzed for RVFV IgG reacting antibodies using competitive ELISA test.ResultsThe overall RVFV seroprevalence was of 10.4% (104/1000). Cattle had the highest seroprevalence (7%) followed by Sheep (2.2%) then goats (1.2%). Species specific RVFV seroprevalence was highest in cattle (20.5%) followed by sheep (6.8%) then goats (3.6%). RVFV seroprevalence in northern highlands (21.8%) was significantly higher (p < 0.001) than in the southern lowlands (3.7%). Overall prevalence of abortion was (17.4%), sheep had the highest prevalence of abortion (7.8%) followed by goats (6.3%) and then cattle (3.3%). Species specific abortion prevalence was highest in Sheep (24.1%) followed by goats (18.8%) and then 9.7% in cattle.ConclusionRVFV is endemic in Kisoro district and livestock in the highland areas are more likely to be exposed to RVFV infection compared to those in the southern lowlands. Out breaks in livestock most likely will lead to zoonotic infection in Kisoro district.