University of Occupational and Environmental Health Japan

ABSTRACTThis study evaluates microcredit outcomes in Uganda, where non‐farm enterprises are critical for complementing farming incomes and diversifying livelihoods. It investigates the effects of microcredit on the performance of non‐farm microenterprises (MEs) run by female small‐holder farmers, using quasi‐experimental cross‐sectional and panel designs. The average loan amount was $278, while the monetary worth of MEs for old borrowers (OBs) and new borrowers (NBs) were $280 and $184, respectively. Propensity score matching (PSM) revealed a 24% and 47% increase in funds used to restock and in ME monetary value, respectively, but no differences in ME profits. Difference‐in‐difference analysis (DiD) over 1 year showed improvements in ME monetary value and employee numbers but no effect on profits, trade expenses, or restocking. Across both methods, no improvement in ME profit levels was observed. However, the increase in monetary worth suggests potential profit growth over time. The borrowing context, repayment terms, and the type and size of MEs appeared to limit profitability. This study highlights the importance of understanding microcredit impacts in contexts where non‐farm enterprises are pivotal to rural livelihoods.

This study presents a mathematical model incorporating both asymptomatic and symptomatic HIV-infected individuals to analyze the dynamics of HIV/AIDS. This expanded model offers a more comprehensive understanding of the epidemic’s spread. We calculate the basic reproduction number (R0) to quantify the virus’s transmission potential. To achieve accurate and robust simulations, we introduce the Nonstandard Finite Difference Scheme (NSFD). Compared to traditional methods like RK-4, NSFD offers improved dynamical consistency and numerical precision, leading to enhanced stability and efficiency in simulating infectious diseases like HIV/AIDS. Local and global stability analysis are performed using the Routh-Hurwitz method. The NSFD method effectively captures the dynamics of HIV propagation under various scenarios, providing valuable insights into HIV/AIDS progression. We demonstrate the superiority of the NSFD approach compared to existing methods, paving the way for further research in modeling viral infections.

In Uganda, social economic challenges continue to hinder attainment of HIV prevention and treatment targets for children. Aidsfonds and partners in Uganda implemented an eight-year ‘Towards an AIDS Free Generation in Uganda’ (TAFU) programme in central, western and eastern, Uganda with Village Savings and Loan Associations (VSLAs) as a key component. In this paper we document experiences of caregivers, children and health workers and lessons learnt from VSLAs as part of the TAFU programme in Uganda. A qualitative case study was conducted between July and August 2022 in Ntungamo, Kyenjojo Mityana, Mubende and Soroti, districts. Data were collected through 31 focus group discussions (FGDs) with VSLA members, children and adolescents living with HIV, networks of people living with HIV and Village Health Team members (VHTs). In addition, we conducted 11 interviews with children and their caregivers at TAFU supported health facilities as well as 43 interviews with health workers and district officials involved in HIV programming. Content thematic approach was used for data analysis. The VSLAs under the TAFU programme were a source of economic resources in form of loans for income generation activities and to pay for health care costs which facilitated access to HIV care for children. Members developed lasting friendships and networks of support which helped them to meet the material and psychological needs of children. The VSLA groups provided safe spaces for caregivers to share challenges and to learn more about HIV prevention and treatment from expert clients which improved the care for children living with HIV. Group training, integration of expert clients in VSLA groups, provision of VSLA kits, provision of financial top-up and linking groups to other service providers were critical success factors. However, poverty, poor leadership characterised by domination by select individuals in decision making, favoritism in giving out loans and lack of transparency in handling group activities as well as the COVID-19 were key challenges. The VSLAs under TAFU were an effective strategy that enabled caregivers to respond to social, economic and psychological barriers that hinder retention of children in HIV care. Such support should be prioritised by policy makers and programme implementers in Uganda and other low income countries.

Abstract Catastrophic earthquakes in Uganda have the potential for detrimental consequences on the socio-economic welfare and resilience of communities. Despite considerable efforts in predicting earthquake risk across Africa, a national comprehensive seismic risk study for Uganda does not exist. With increasing population, urbanisation and rapid construction, seismic risk is escalating fast and is compounded by the high vulnerability of buildings and scanty disaster prevention and mitigation strategies. This study uses the probabilistic event-based risk calculator of the OpenQuake-engine to assess potential risks resulting from future earthquakes. Although the building exposure model is largely inferred and projected from the national population and housing census of 2014, total replacement costs are obtained by performing series of interviews with local engineering practitioners. Analytical vulnerability curves are selected from Global Earthquake Model (GEM) database. Seismic hazard studies confirm that western Uganda is exposed to the highest level of seismicity where peak ground accelerations on rock ground can reach up to 0.27 g over a 475-year return period. Relative to Uganda’s gross domestic product, the associated seismic risk estimates indicate mean economic loss ratios of 0.36%, 2.72% and 4.94% over 10, 50 and 100-year return periods respectively; with mean annual economic loss of US$ 74.7 million (0.34% relative to the total replacement value) and annual deaths averaging 71 persons across the whole country. It is envisaged that the findings will inform strategic land use planning patterns, earthquake insurance pricing and foster the continuous improvement of Uganda’s National Policy for Disaster Preparedness and Management.

Abstract The main burden in treating human immunodeficiency virus (HIV) infection currently, is the side effects of the antiretroviral therapy (ART) used, because each treatment is toxic to the liver. This study uses optimal control theory applied to a mathematical model that describes the dynamics of HIV infection in the liver. The optimal controls are presented as therapy efficacy of reverse transcriptase inhibitors (RTIs), integrase inhibitors (INs) and protease inhibitors (PIs). An objective function is defined with an aim to investigate the optimal control strategy that minimises toxicity, viral load and cost of first-line and second-line HIV regimen. Results indicate that, in the first-line regimen with INs, a patient has to take medication for at least 98% of the treatment time and the regimen should be close to 100% efficacious regardless of the intervention cost. For second-line regimen, the period of drug administration of PIs largely depends on the weight constants. Inclusion of INs in the first-line regimen yields better HIV DNA suppression, as they are more efficacious than NRTIs. Of all drugs studied, nevirapine is highly efficacious but most toxic. The study recommends routine transaminase tests because results indicate liver enzyme elevation even with very low viral load. Numerical results with pharmacokinetic parameters further indicate an increase in HIV load at initiation of therapy, due to viral redistribution in plasma.

Abstract Background A key concern for global public health is nosocomial infections. Essential to the fight against nosocomial infection, is healthcare professionals’ knowledge and attitudes. Therefore, this study investigated healthcare professionals’ knowledge and attitudes toward nosocomial infection at the Kiruddu Referral Hospital, Kampala, Uganda. Methods A facility-based cross-sectional study was carried out at Kiruddu Referral Hospital in Kampala, Uganda. We selected the participants using simple random sampling. Data were collected from a total of 78 healthcare personnel using pretested, structured, self-administered questionnaires. We used SPSS version 20.0 for data analysis and applied descriptive statistics to present the frequencies and percentages. Pearson’s Chi-square test was used to evaluate the association between independent factors and knowledge and attitude (KA) ratings on hospital-acquired infection (HAI) prevention. P-values less than 0.05 were regarded as statistically significant. Results Among the different categories of health workers, doctors exhibited the highest level of knowledge. There was a significant association between knowledge scores and occupation (χ2LR = 25.610; P = 0.000). The mean knowledge scores across different infection prevention aspects were as follows: hand hygiene (82.2 ± 18.9), PPE use (71.8 ± 23.1), sharp disposal and sharp injuries (59.2 ± 25.7), and waste management (57.4 ± 29.9). Notably, 20.5% of participants did not change PPE between patients, and 44.9% indicated that their workload negatively impacted their ability to follow infection prevention standards. Conclusion The study highlighted gaps in healthcare personnel’s knowledge and attitudes toward infection prevention. It is therefore important to provide regular targeted training programs emphasizing underrepresented areas, PPE availability, strengthen policy enforcement, and integrate infection prevention education into medical and nursing curricula.

Namanya L., Mukhokosi E.P., Mugampoza E.

Aflatoxin B1 (AFB1) is a highly strong mycotoxin that contaminates cereals and other stored grains. It causes immune-suppressive effects, raising the risk of mutagenicity, carcinogenicity, teratogenicity, hepatotoxicity, and embryonic toxicity, as well as increasing illness and death. Liver damage is a result of prolonged exposure to AFB1, which raises the prevalence of liver cancer and cirrhosis. Different biosensors have been fabricated using various nanoparticles to detect aflatoxins in food. This review provides the recent developments on the occurrence of AFB1 in cereals, different biosensors based on nanomaterials applied for AFB1 detection in cereals, and offers future directions for the production of affordable analytical equipment for detection of AFB1, based on nanomaterials to address some open questions regarding their limit of detection, stability, and affordability. Electrochemical biosensors are more reliable, selective, and affordable analytical tools with better detection limits and shorter response times than other biosensors. However, more studies are needed to address the automatic simultaneous detection of various aflatoxins in real samples and a biosensing system that integrates with microarray technology.

Abstract Regulating ecosystem services (RES) play a very critical role in the sustenance of environmental health and human well-being, yet their valuation remains a complex and dynamic field. The variety of valuation methods, each with its strengths and limitations, as well as the limited methodological guidance for the selection of appropriate methods, poses a challenge in the valuation of RES. This review examined RES valuation studies in Africa, focusing on growth trends, methodological preferences, and policy reporting approaches. Drawing on the existing literature, we also explored the use of decision trees to support the choice of appropriate methods. A synthesis of peer-reviewed literature identified 31 studies, and their analysis revealed the dominant use of single-valuation methods in the assessment of RES and a varied growth rate in the number of valuation studies over the period under review. Furthermore, a notable heterogeneity exists in the methods used to report policy impact across various value assessments. This review contributes valuable insights into the current state of RES valuation research, necessary to advance methodologies, guide future research, and inform policy discussions on the sustainable management of ecosystems.

In Uganda, indigenous knowledge, total polyphenol content and cytotoxicity of Canarium schweinfurthii Engl. have not been documented, which may limit its utilization. Henceforth, this study aimed at conducting an ethnobotanical survey and determining total phenolic content, antioxidant capacity and cytotoxicity of C. schweinfurthii fruit pulp. The ethnobotanical survey was conducted in Kamuli, Luwero, and Mayuge districts, Uganda using validated questionnaires following purposive and snowball sampling. Following cold and hot water extraction of the fruit pulp extract, Total Polyphenol Content (TPC) was determined using the Folin-Ciocalteu method while the antioxidant capacity on human colon (Caco-2) cell lines was determined using the oxidative stress and 2′,7′-dichlorodihydrofluorescein diacetate staining model. Cytotoxicity at 1:2, 1:5, 1:10, 1:25, 1:50, 1:100, 1:200 and 1:1000 concentrations was determined using the human colon (Caco-2) cell lines and resazurin assay. The study revealed that various parts of C. schweinfurthii are used in the management of various health complications whereas the fruit is utilized as food. The TPC obtained for C.schweinfurthii fruit pulp was 2.48 ± 0.10 and 2.88 ± 0.02 mg GAE/g dry weight for cold and hot extracts, respectively. There was no significant antioxidant activity observed after treatment of human colon (Caco-2) cell lines with the different fruit pulp extract concentrations. Zero to very low cytotoxicity was observed in cell lines treated with 1:10, 1:25, 1:50, 1:100, 1:200 and 1:1000 fruit pulp extract. The findings of this study suggest that in addition to its utilization as a food, C.schweinfurthii fruit pulp is a potential therapeutic agent.

For centuries, urban agriculture has been a vital livelihood strategy of urban households in developing countries. Previous studies looked at urban agriculture at a point in time as an urban livelihood for the urban poor that struggle with eking out a living, without the current dynamism, which attracts the non-poor into the practice. Having become an integral part of the urban economy, the study objective was to use poultry farming, to explore the role of urban agriculture as an evolved and dynamic urban livelihood that attracts the non-poor. The study was conducted in Kampala, Uganda’s capital city. The unit of analysis were urban farming households. Data were collected through four (4) Focus Group Discussions (FGDs), sixteen (16) key informants and twenty (20) In-Depth Interviews (IDIs) using purposive sampling techniques. Data were collected for a period of two (2) months using unstructured research instruments, triangulated and thematically analysed. Our results indicate that; urban agriculture is an evolving urban activity. This evolution and continuities were driven by the merits of urban agriculture (food, jobs and income) to urban dwellers. Urban agriculture also contributed to the economic inclusion of women and the urban poor. There was household resource logic in practicing urban agriculture, especially in the private sector, where jobs were scarce. In view of these innovations, the urban authorities were supporting urban farmers with demonstrations and certified inputs for farmers in Kampala and beyond. To further develop urban agriculture, it is recommended that farmers organize themselves into viable groups to further realize corporate advantages such as better resource access such as affordable financing, access to better inputs and linkages with various institutions and stakeholders in production, value addition, policy and marketing for better returns and sustainable farming practices. These findings if used in perspective by planners and regional managers have utility for the anchoring of urban agriculture in the urbanisation agenda for Uganda and beyond. It is envisaged that, stakeholders can draw useful actions relating to sustainable urban food production (consumer food shed), waste management, incomes, job creation, training, research and innovations in urban areas.

Adolescents with intellectual disability (ID) are often deficient in knowledge about HIV/AIDS. This pilot study evaluated the impact and acceptability of an HIV education intervention for adolescents with mild-to-moderate ID delivered in a peri-urban setting in Uganda. This quasi-experimental study involved 60 adolescents with mild to moderate ID evenly split between the intervention and control groups. Data were collected using a questionnaire that included sociodemographic information, HIV knowledge and attitudes, and acceptability measures, administered at baseline, immediately postintervention, and 3 months later. Approximately 53.3% of the participants were male, and 50% had mild ID. Immediately post-intervention, the intervention group reported a significantly higher increase in HIV knowledge (8.5 vs. −0.2, p < .001) and attitudes (3.9 vs. 0.1, p < .001) than the control group. A similar significant increase was maintained at 3 months post-intervention. These findings show that tailored education programs can improve HIV knowledge and attitudes in adolescents with ID.

ABSTRACT The inference of stellar parameters (such as radius and mass) through asteroseismic forward modelling depends on the number, accuracy, and precision of seismic and atmospheric constraints. ESA’s Gaia space mission is providing precise parallaxes which yield an additional constraint to be included in the model grid search. Using a handful of main-sequence benchmark stars, we perform a uniform characterization of these stars. We assess the accuracy and precision of stellar parameters inferred from grid-based searches when a Gaia-based luminosity is combined with different stellar constraints. We also examine the precision needed for an interferometric radius (model-independent radius) to have a significant contribution towards the determination of stellar mass in the optimization process. Our findings show that more precise stellar masses are inferred for some stars when seismic and spectroscopic constraints are complemented with a Gaia-based luminosity, with a scatter varying from 1.9 per cent to 0.8 per cent. However, the inferred stellar radii are underestimated when compared to the interferometric radii and yield a scatter of $\sim$1.9 per cent. In addition, we demonstrate that a precisely measured interferometric radius ($\lesssim$1 per cent) when applied in the optimization process yields a mass with a precision $\lesssim$1.5 per cent. Finally, we find that when only $l=0$ mode oscillation frequencies are available, robust masses and radii are still attainable. However, this requires precise and numerous $l=0$ mode oscillations frequencies (>8) to be coupled with atmospheric constraints.