PubMed | 4 Holy Family Virika Hospital, Institute of Tropical Medicine, Mountains of the Moon University and Makerere University
Type: Journal Article | Journal: AIDS patient care and STDs | Year: 2016
Since 2012, lifelong antiretroviral therapy for all HIV-positive pregnant women (Option B+) is recommended by WHO for the prevention of mother-to-child transmission of HIV (PMTCT). Many sub-Saharan African countries have since introduced this regimen, but to date, longer-term outcome evaluations are scarce. We conducted an observational study in Fort Portal Municipality, Uganda, to describe uptake and adherence of Option B+ during pregnancy. HIV-positive women approaching antenatal care (ANC) services in two hospitals were enrolled and followed-up at monthly routine ANC visits until delivery. At each visit, next to sociodemographic and clinical data, we assessed drug adherence through pill counts. In total, 124 HIV-positive pregnant women were enrolled in our study; from these, 80.8% had not been aware of their positive serostatus before. Forty-five PMTCT clients (36.3%) never returned to ANC after their first visit. Protective factors (p<0.05) for immediate loss to care included previous HIV status knowledge, status disclosure before or at first ANC visit, and tertiary education. Among those clients starting Option B+, the median adherence during pregnancy was 95.7% pill intake. Rather low adherence (<80%) was observed in 21.1% of clients, while more than half achieved an adherence level of 95%, with 40.8% of all clients being 100% adherent. The cohorts median adherence remained stable throughout the course of pregnancy. Healthcare providers should place high emphasis on individual PMTCT counseling at first ANC encounter, and pay special attention to those women previously unaware of their HIV status. However, after initial uptake, high adherence seems to be feasible for Option B+.
Agency: Cordis | Branch: FP7 | Program: CP-FP-SICA | Phase: ENV.2010.2.1.1-1 | Award Amount: 4.16M | Year: 2011
Threats to the environment and natural resources, coupled with poor management, have serious implications for both poverty reduction and sustainable economic development. Degrading natural resources in Africa therefore result in an inreased vulnerability of the poor as a result of ecosystem stress, competition for space, soaring food and energy prices, climate change and demographic growth. Nowadays, it is widely accepted that reversing these trends asks for integrated management frameworks. Despite the availability of many tools, expertise, strategies, local practices and indigenous knowledge, the concept of INRM has hardly been brought into practice and the building blocks of INRM (see description acronym) in many cases still need to be integrated. AFROMAISON will make use of what is available regarding INRM and will contribute to a better integration of the components of INRM. In view of the decentralization policy in Africa, we aim to focus on the operational requirements of INRM for sub-national (or meso-scale) authorities and communities. The main outputs of AFROMAISON are a toolbox, short-term to long-term strategies, quick wins (much gains with little effort) and operational strategies for adaptation to global change. In order to enhance the potential impact, we will put strong efforts in integrated capacity building and a solid dissemination strategy. In order to do so, we will integrate tools, frameworks, strategies and processes for landscape functioning, livelihood & socio-economic development (incl. vulnerability to global change), local knowledge, institutional strenghtening and improved interaction between sectors, scales and communities. For the development of concrete operational strategies for adaptation to global change, AFROMAISON will focus on the three groups of tools: strategies for restoration and adaptation (including sustainable landscape intensification), economic tools and incentives for INRM and tools for spatial planning.
De Steur H.,Ghent University |
Wesana J.,Mountains of the Moon University |
Blancquaert D.,Ghent University |
Van Der Straeten D.,Ghent University |
Gellynck X.,Ghent University
Annals of the New York Academy of Sciences | Year: 2016
Building upon the growing interest and research on genetically modified (GM) biofortification, its socioeconomic potential has been increasingly examined. We conducted two systematic reviews and meta-analyses to provide comprehensive evidence of consumers' willingness to pay (11 economic valuation studies, 64 estimates) and cost-effectiveness/benefits (five economic evaluation studies, 30 estimates). Worldwide, consumers were willing to pay 23.9% more for GM biofortified food crops. Aside from crop and design-related differences, information provision was deemed crucial. Positive information (nutrition and GM benefits) is associated with the highest consumer willingness to pay, compared with negative, objective, and conflicting GM information, especially when negative information was mentioned last. This health intervention would reduce the aggregated micronutrient deficiency burden in Asia (15.6 million disability-adjusted life years (DALYs)) by 12.5-51.4%, at a low cost of USD 7.9-27.8 per DALY in a pessimistic and optimistic scenario, respectively. Given that GM biofortified crops could tackle hidden hunger in a cost-effective and well-accepted way, its implementation is worth pursuing. A case study on folate biofortification further elaborates on the importance of socioeconomic research and the determinants of their market potential. © 2016 The New York Academy of Sciences.
PubMed | Mountains of the Moon University, Ghent University and Brunel University
Type: | Journal: Waste management (New York, N.Y.) | Year: 2016
The interest to reduce food losses and wastes has grown considerably in order to guarantee adequate food for the fast growing population. A systematic review was used to show the potential of Value Stream Mapping (VSM) not only to identify and reduce food losses and wastes, but also as a way to establish links with nutrient retention in supply chains. The review compiled literature from 24 studies that applied VSM in the agri-food industry. Primary production, processing, storage, food service and/or consumption were identified as susceptible hotspots for losses and wastes. Results further revealed discarding and nutrient loss, most especially at the processing level, as the main forms of loss/waste in food, which were adapted to four out of seven lean manufacturing wastes (i.e. defect, unnecessary inventory, overproduction and inappropriate processing). This paper presents the state of the art of applying lean manufacturing practices in the agri-food industry by identifying lead time as the most applicable performance indicator. VSM was also found to be compatible with other lean tools such as Just-In-Time and 5S which are continuous improvement strategies, as well as simulation modelling that enhances adoption. In order to ensure successful application of lean practices aimed at minimizing food or nutrient losses and wastes, multi-stakeholder collaboration along the entire food supply chain is indispensable.
Rubaihayo J.,Makerere University |
Rubaihayo J.,Mountains of the Moon University |
Tumwesigye N.M.,Makerere University |
Konde-Lule J.,Makerere University
BMC Infectious Diseases | Year: 2015
Background: After more than a decade of establishing and expanding access to highly active antiretroviral therapy (HAART), empirical evidence on its impact on trends of opportunistic infections (OIs) associated with the deadly human immunodeficiency virus (HIV) in resource poor settings is scarce. The primary objective of this study was to assess the effect of HAART coverage on trends of five most common OIs in Uganda. Methods: Observational data from January 2002 to December 2013 for 5972 HIV positive individuals attending the AIDS Support Organisation (TASO) HIV/AIDS care programme in Uganda were extracted and analysed. Trends were analysed using autoregressive moving average time series and mixed effects linear regression models adjusting for all available potential confounders. Results: A total of 204,871 monthly medical reports were retrieved and analysed. Majority of the participants were female (73%) with a median age of 32 years (inter-quartile range 26-39). Overall, significant decreasing mean annual prevalence trends were observed for Mycobacterium tuberculosis, herpes zoster, genital ulcer and oral candidiasis (p < 0.05, X2 trend). Non-significant declining mean annual prevalence trend was observed for cryptococcal meningitis (p = 0.181, X2 trend). The largest impact of HAART was observed in Oral candidiasis and TB whose average annual prevalence reduced by 61% and 43% respectively following the introduction of HAART. Monthly series for TB, Herpes zoster and genital ulcers differed significantly by age and clinic but only genital ulcer series differed significantly by sex (p < 0.05, kruskal wallis). After controlling for the effects of age, sex and clinic (fixed) and monthly clustering (random effect) in a mixed effects linear regression model, all the five OIs showed a significant monthly change in prevalence (p < 0.001). Conclusion: Overall, prevalence of most OIs declined especially after the introduction of HAART. However significant variations exist in the trends of different OIs in different geographical areas in Uganda. It is therefore important that site specific factors are properly identified to enable the development of targeted interventions. © Rubaihayo et al.; licensee Biomed Central.
Mechtenberg A.R.,University of Michigan |
Borchers K.,University of Michigan |
Miyingo E.W.,Makerere University |
Hormasji F.,University of Michigan |
And 3 more authors.
Energy for Sustainable Development | Year: 2012
Human development and electrical energy co-exist seamlessly in high Human Development Index (HDI) countries. 11The United Nations Development Programme defines the human development index (HDI) with education, health, and economic indicators. "Co-exist seamlessly" means that it is almost assumed that a building will have access to electricity and that it is reliable. where reliability and availability of electricity is greater than 95%. In numerous low HDI countries,. 22Low HDI countries are defined with human development indexes at or below 0.50. there is 5-50% electric grid availability. These electric grids can have reliability below 50% due to faults and extreme load shedding. Unavailable and unreliable electric grid events are situations disconnected from a centralized grid (if the grid fails then it is off-line). In Africa, renewable energy portfolios include solar, wind, biomass, biogas, small hydroelectric power and recently nuclear energy (MEMD, 2005, 2006, 2008, 2009) and are cited to meet the disconnected grid situations. However, Human Power (HP) is a missing portfolio option and, if implemented in countries with average electrical power consumed below 20. W/Capita, would impact human development directly. The technologies include merry-go-round generators in schools, hand crank lighting in hospitals and health clinics during electricity outages and bicycle generators for off-grid businesses. This result is derived from (1) a new energy concept defined as PACE (People-based Activities Caloric Energy), (2) estimations from children's play - energy harvesting as free energy (3) disconnected-grid fuel costs for petrol and diesel generators, and (4) policy empowerment which is based on designing and building microgrids. These designs result from an innovative Physics and Business of Energy (PBE) curriculum, in conjunction with University of Michigan (USA), taught in Uganda at Mountains of the Moon University, Makerere University and St. Joseph's Technical Institute with an association called Uganda Small Scale Industries Association (USSIA). The HP-module is part of a multi-module curriculum for . Empowering Ugandans to Power Uganda. The overall educational and design policies create a key missing gateway to co-designed and locally built microgrids. These policies are applicable in many, if not all, low HDI countries. © 2012 Elsevier Ltd.
Vrebos D.,University of Antwerp |
Staes J.,University of Antwerp |
Vandenbroucke T.,Antea Group |
D'Haeyer T.,Antea Group |
And 4 more authors.
Ecosystem Services | Year: 2015
Natural resource management requires spatially explicit tools to assess the current state of landscapes, to analyse trends and to develop suitable management strategies and interventions. The concept of ecosystem services can help in understanding the importance of natural resources for different stakeholders and at different spatial and temporal scales. Simple methods to map ecosystem services using scoring of land cover types are particularly useful in data scarce regions, but do not reflect the dynamics of supply and demand. Within this study, GIS scripts were developed to represent and assess several different modes of ecosystem service flows between supply and demand, using ecosystem services scoring tables. By integrating the flows, the ecosystem services can be better evaluated. The outcomes do not give quantitative information on whether supply meets demand, but indicate the spatial distributions of both supply and delivery and where ecosystem services are under threat because of changes in ecosystem or flow mechanisms. The scripts allow us to identify sites that are vulnerable to ecosystem service loss and to evaluate possible management scenarios. © 2014 Elsevier B.V.
Rubaihayo J.,Makerere University |
Rubaihayo J.,Mountains of the Moon University |
Tumwesigye N.M.,Makerere University |
Konde-Lule J.,Makerere University
AIDS Research and Therapy | Year: 2015
Background: Trends in prevalence of opportunistic infections (OIs) associated with the human immunodeficiency virus (HIV) in resource poor settings have previously not been well documented. The objective of this study was to describe the trends in prevalence of Diarrhoea, Bacterial pneumonia, Kaposi's sarcoma, Malaria and Geohelminths among HIV positive individuals over a 12 year period in Uganda. Methods: Observation data for 5972 HIV positive individuals enrolled with the AIDS support organisation (TASO) in Uganda were analysed. Study participants were drawn from three HIV clinics located in different geographical areas of Uganda and followed from January 2002 to December 2013. The prevalence trends for the above OIs were plotted using the Box Jenkins moving average technique. X2-test for trend was used to test for the significance of the trends and Pearson's correlation coefficient used to test for the strength of linear relationship between OI prevalence and calendar time. Mixed effect linear regression was used to estimate average monthly change in prevalence with monthly variation modelled as a random effect. Results: A total of 204,871 monthly medical reports were retrieved and analysed. 73 % (4301/5972) were female with a median age of 32 years (inter-quartile range 26-39). Overall, significant decreasing mean annual prevalence trends (p < 0.05, X2trend) were observed for Diarrhoea (<1 month) with Pearson's correlation coefficient (r = -0.89), Malaria (r = -0.75), Bacterial Pneumonia (r = -0.52), and Geohelminth (r = -0.32). Non-significant increasing mean annual prevalence trend was observed for Kaposis sarcoma (p = 0.20, X2trend; r = +0.26). After adjusting for age, sex and clinic in a mixed effects linear regression model, average monthly prevalence declined significantly at a rate of 0.4 % for Kaposis sarcoma, 0.3 % for Geohelminths, 2 % for Malaria, 1 % for Bacterial Pneumonia and 3 % for Diarrhoea(<1 month). However, the rate of decline per month differed significantly (p < 0.05) by HIV clinic for Diarrhoea (<1 month), and age, sex and clinic for malaria. Conclusions and recommendations: Overall, decreasing trends were observed in the above OIs. However the trends differed significantly by OI, geographical location and demographic characteristics. There is urgent need to integrate interventions targeting malaria and geohelminths in HIV programmes. © Rubaihayo et al.
Zhu C.,Vrije Universiteit Brussel |
Justice Mugenyi K.,Vrije Universiteit Brussel |
Justice Mugenyi K.,Mountains of the Moon University
Technology, Pedagogy and Education | Year: 2015
This research examines the strengths, weaknesses, opportunities and threats (SWOT) to integrating e-learning perceived by academic staff at a university in Uganda and a university in Tanzania. Mixed-methods research was used in which a main qualitative study was complemented by a quantitative method. The sample participants were academic staff from Mountains of the Moon University in Uganda (n = 20) and Mzumbe University in Tanzania (n = 20). The SWOTs from three aspects are analysed: institution-related, instruction-related and investment-related aspects. The results show that at both universities the institutions and teachers understand the need to integrate e-learning, which provides strengths and opportunities for the universities; however, the lack of capacities in terms of institutional policies, teacher competences and internal investment constitutes the weaknesses and threats for the universities. © 2015 Association for Information Technology in Teacher Education.
PubMed | Catholic University of Leuven, Mountains of the Moon University and Vrije Universiteit Brussel
Type: | Journal: The Science of the total environment | Year: 2016
Landslides affect millions of people worldwide, but theoretical and empirical studies on the impact of landslides remain scarce, especially in Sub-Saharan Africa. This study proposes and applies a method to estimate the direct impact of landslides on household income and to investigate the presence of specific risk sharing and mitigation strategies towards landslides in a tropical and rural environment. An original cross-sectional household survey is used in combination with geographical data to acquire detailed information on livelihoods and on hazards in the Rwenzori mountains, Uganda. Ordinary least square regressions and probit estimations with village fixed effects are used to estimate the impact of landslides and the presence of mitigation strategies. Geographical information at household level allows to disentangle the direct impact from the indirect effects of landslides. We show that the income of affected households is substantially reduced during the first years after a landslide has occurred. We find that members of recently affected households participate more in wage-employment or in self-employed activities, presumably to address income losses following a landslide. Yet, we see that these jobs do not provide sufficient revenue to compensate for the loss of income from agriculture. Given that landslides cause localized shocks, finding a significant direct impact in our study indicates that no adequate risk sharing mechanisms are in place in the Rwenzori sub-region. These insights are used to derive policy recommendations for alleviating the impact of landslides in the region. By quantifying the direct impact of landslides on household income in an agricultural context in Africa this study draws the attention towards a problem that has been broadly underestimated so far and provides a sound scientific base for disaster risk reduction in the region. Both the methodology and the findings of this research are applicable to other tropical regions with high landslide densities.