Browsing by Author "Muhangi, D."

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    Community Understanding of the Concept of Pre-Referral Treatment and How this Impacts on Referral Related Decision-Making Following the Provision of Rectal Artesunate: A Qualitative Study in Western Uganda
    (BMC health services research, 2018) Strachan, C. E.; Nuwa, A.; Muhangi, D.; Okui, A. P.; Helinski, M. E. H.; Tibenderana, J. K.
    Successful pre-referral treatment with rectal artesunate (RA) for suspected severe malaria requires operational linkages between community health workers (CHWs) and referral facilities, acceptance of pre-referral treatment and adherence to referral practices by CHWs and caregivers. This qualitative study investigated how community understanding of the concept of ‘pre-referral treatment’ is used in referral related decision-making following provision of RA in Uganda.Narrative interviews were conducted with 30 caregivers of children under five who received RA within the previous three months and the 30 associated CHWs who provided the treatment. Nineteen focus group discussions incorporating vignettes from the interviews were held with further caregivers, and 12 with CHWs and women representatives. Twenty traditional healers were targeted for semi-structured interview. Thematic analysis followed a ‘meaning-based’ approach.CHWs were aware of essential information to be given to caregivers on prescribing RA as indicated by the job aid, specifically urgency for referral, yet there was insufficient emphasis on RA not being a full treatment for severe malaria. Information shared by the CHW appeared to be influenced by the perceived urgency with which the CHW needed to act and the time of day or night the child was seen. Seven of the 32 caregivers did not complete referral post RA administration. Caregivers seemed more likely to adhere to referral advice if they perceived their child’s condition to be severe. Previous caregiver experience and CHW comparisons with Artemisinin-based Combination Therapy (ACT) as a treatment for uncomplicated malaria appeared to raise misperceptions that RA is a complete treatment for severe malaria, thus reducing likelihood to complete referral. CHW implication, or caregiver interpretation, of the need to monitor the child, and some prescription of ACT post RA administration, also confused the need for referral. Both CHWs and caregivers requested further information about the role of RA.CHW advice should emphasise RA as providing temporary relief prior to facility-based treatment, the importance of referral whether or not a change is seen in the child’s condition, and the dangers of not completing referral. Social behaviour change communication, training and support supervision activities could help promote these messages.
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    East African pigs have a complex Indian, Far Eastern and Western ancestry
    (Animal genetics, 2015) Noce, A.; Amills, M.; Manunza, A.; Muwanika, V.; Muhangi, D.; Aliro, T.; Mayega, J.; Ademun, R.; Egbhalsaied, S.; Mercad, A.; Masembe, C.
    In this study, we have characterized the mitochondrial diversity of 81 swine from Uganda. Median-joining network analysis of D-loop sequences from these individuals and others characterized in previous studies allowed us to determine that Ugandan pigs cluster with populations from the West (Europe/North Africa), Far East and India. In addition, partial sequencing of the Y-chromosome UTY locus in 18 Ugandan domestic pigs revealed the segregation of a single HY1 lineage that has a cosmopolitan distribution. A Western and Far Eastern ancestry for East African pigs had been already reported, but this is the first study demonstrating an additional contribution from the Indian porcine gene pool. This result is consistent with the high frequency of zebuine alleles in cattle from East Africa. The geographic coordinates of East Africa, at the crossroads of many trading routes that, through the ages, linked Europe, Africa and Asia, might explain the rich and complex genetic heritage of livestock native to this area.
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    Practices in the pig value chain in Uganda; implications to African swine fever transmission
    (Livestock research for rural development, 2014) Muhangi, D.; Masembe, C.; Berg, M.; Ståhl, K.; Ocaido, M.
    Uganda has the largest pig industry in eastern Africa, with majority of farmers still smallholders. African swine fever (ASF) is arguably one of the major constraints in the region, where it is considered endemic. Although the sylvatic cycle exists here, the pig-pig cycle of transmission is more important. The pig value chain is one critical area where there is need for study of the role it plays in the spread of ASF. In this study, different practices and their association with the transmission of ASF within and between farms were investigated on 101 pig farms in Uganda. Practices by 30 traders in pigs and pig products (slaughter slab, pork butchery and roasted pork restaurant operators) were investigated in the districts of Kabarole, Mityana, Moyo, Mukono, Soroti, and Tororo. Key informant interviews with the District Veterinary Officers (DVOs) about pig trade, pig slaughter infrastructure, ASF status and its Management in the districts were conducted as well between May-November 2011. Questionnaires were administered to both pig farmers and the traders.Twenty six percent of the farmers reported having had the disease on the farm in the last one year.Although none of the risk factors was statistically significant for ASF outbreaks, results demonstrated presence of potential risk factors for ASF on the farms and the rest of the pig value chain.