Browsing by Author "Njalira, Kassim Rashid"

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    Reflections on Drivers for the Emergence and Spread of Antimicrobial Resistant Bacteria Detected from Chickens reared on Commercial Layer Farms in Mukono District, Uganda
    (Veterinary Medicine: Research and Reports, 2023) Kakooza, Steven; Tayebwa, Dickson Stuart; Njalira, Kassim Rashid; Kayaga, Edrine Beatrice; Asiimwe, Ismail; Komugisha, Mariam; Wanyana, Mariam; Kisekka, Raymond; Kyabarongo, Alex; Kiryabwire, David H.; Nabatta, Esther; Eneku, Wilfred
    Purpose We investigated the fecal carriage of antimicrobial resistant Escherichia coli and potential practices influencing antimicrobial resistance (AMR) dynamics among poultry farm settings in Mukono District, Uganda. Methods Twenty-nine commercial layer farms were visited and samples collected from 10 birds. The samples were then subjected to culture and sensitivity testing. The investigative framework for antimicrobial stewardship practices (IFAP) was used as a participatory tool to generate data through interviews and observations on antimicrobial use, drivers for use, players, and actions following non-responsive treatment outcomes. Results The cultures done on 290 cloacal swabs yielded a total of 273 Escherichia coli isolates (94.1% recovery rate) which were tested in vitro for their sensitivity to different antibiotics. The prevalence of multi-drug resistant E. coli was 59.3% (162/273). A high prevalence of resistance to tetracycline (91.6%, n = 250) and trimethoprim sulphamethoxazole (70.3%, n = 192) was noted. In this collection of isolates, the prevalence of molecular determinants associated with the predominant phenotypes was; tetA (79.3%; 138/174), tetB (17.2%; 30/174), tetC (7.5%; 13/174), sul1 (11.5%; 20/174), and sul2 (60.3%; 105/174). Responses derived using the IFAP revealed several vices related to misuse and overuse of antibiotics, a threat to the poultry industry. The farmers also reported habits of selling off sick birds for slaughter when treatment outcomes were non-responsive. Such a practice could drive dissemination of antimicrobial resistant organisms and antibiotic residues to the consumers of those poultry products. Conclusion The IFAP tool was useful and can be modified, and adopted for use in engaging agricultural communities in participatory AMR surveillance. A high carriage of multi-drug resistant E. coli was detected in the birds. On these farms, the worrying antimicrobial stewardship practices discovered could be sponsoring the emergence and spread of antimicrobial resistant bacteria in the Ugandan context.
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    The danger of free roaming dogs in urban settings: A report of two suspected rabid dogs on rampage that inicted 47 bites to people and domestic animals in peri-urban Uganda
    (Reseaech Sqaure, 2023) Tayebwa, Dickson; Njalira, Kassim Rashid; Eneku, Wilfred; Ssekandi, Colin; Kyabarongo, Alex; Mutesasira, Jesse; Komugisha, Mariam; Atim, Stella Acaye; Kateregga, John; Muhangi, Denis; Tweyongyere, Robert; Tony, Lawrence Goldberg; Biryomumaisho, Savino; Okwee Acai, James
    Background Human rabies cases associated with bites from rabid roaming dogs are prevalent in Uganda. Unfortunately, there is limited documentation of the circumstances surrounding those bites. Here, we documented dog attacks to humans and animals in two peri-urban areas in Central Uganda. Methods We responded to alerts of two suspected rabid dogs on rampage. We traced the dogs responsible for the attacks to diagnose the cause of the aggression and we interviewed the victims and community members to determine the circumstances of the bites and health care sought by the victims. We scheduled follow-up visits after 40 days, to assess compliance of the victims to rabies postexposure prophylaxis (PEP) and to document any challenges encountered in the process. Results The two rabid dogs inflicted 47 recorded attacks to 29 humans, mostly children (75.8%) and 18 domestic animals in Matugga and Mawale parishes in Wakiso and Luweero districts, respectively. Two individuals washed the wound with water and 7 individuals reported to the health facility for treatment in accordance with the WHO-guidelines for preclinical management of bites from suspected rabies cases. By contrast, 17 individuals sought treatment from a traditional healer while 5 individuals self-medicated with herbs at home. We advised those individuals to visit health facilities for proper medical care. All the victims started rabies PEP treatment; however, 2 individuals did not complete their prescription. Although rabies PEP at public health facilities was free, regularly the victims paid 3–5 USD to the clinician as an incentive while the cost at private health facilities was 13–15 USD for a single dose. Due to the unprovoked attacks, the victims and local leaders advocated for elimination of roaming dogs, but the roaming dog owners objected. Conclusions Overall, our results demonstrate the outsized impact that a single-rabid dog can have on a community. They also reveal how poverty, knowledge gaps, community trust in traditional healers, and barriers to healthcare access negatively affect medical care given to dog bite victims in this setting. Educational campaigns and control of roaming dogs should help improve the situation in Central Uganda, as well as in other socioeconomically similar settings.
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    The danger of free-roaming dogs in peri urban settings: Two rabid dogs on rampage that bit 29 humans and 18 domestic animals in Wakiso and Luweero districts, Central Uganda
    (Research Square, 2024) Tayebwa, Dickson Stuart; Njalira, Kassim Rashid; Eneku, Wilfred; Ssekandi, Colin; Kyabarongo, Alex; Mutesasira, Jesse; Komugisha, Mariam; Atim, Stella Acaye; Kateregga, John; Muhangi, Denis; Tweyongyere, Robert; Biryomumaisho, Savino; Okwee Acai, James
    Background Uganda averages 14,000 dog bites annually, with 86% caused by free-roaming dogs. Unfortunately, there is limited documentation to inform interventions. Here, we documented circumstances of attacks from free-roaming dogs on rampage in Central Uganda to identify critical gaps in the detection, preparedness, and response of the community. Methods We conducted an exploratory case study to actively survey attacks from rampaging dogs in Kampala Metropolitan Area, Central Uganda between November 2022 - November 2023. We traced the dogs responsible to immobilise and rule out rabies. We interviewed the victims and community to determine the circumstances of the bites, the healthcare sought and sentiments towards free-roaming dogs. We followed-up after 40 days, to assess adherence to rabies post exposure prophylaxis and to document any challenges encountered. Results Of the 8 cases reported, only two cases that occurred in Matugga and Mawale parishes fulfilled our criteria for rampage while the rest were predation, an incidental bite and straying into someone’s residence. The two rampaging dogs’ bit 29 humans, mostly children (75.8%) and 18 domestic animals. Immobilisation in Matugga failed while the dog in Mawale was killed by the community in a mob. Due to limited knowledge, 93.1% of the victims did not wash the wound and go the medical facility as recommended by WHO. Instead, they sought healthcare from the traditional healer (58.6%), stayed home or applied herbs (20.7%). Parallel with our advice, those victims sought medical care however they encountered challenges not limited to lack of funds and poor services at public health facilities. After inflicting bites, the dogs responsible and other free-roaming dogs were killed by hitting them with sticks in a mob. Conclusions Overall, our findings demonstrate the impact that a lone free-roaming dog with rabies can have on a community. They also reveal how poverty, limited awareness, reliance on traditional healers, and barriers to medical care access impede health care received by dog bite victims in this setting. Implementing educational campaigns and responsible ownership of free-roaming dogs should help reduce dog bites and rabies in Central Uganda, as well as in other socioeconomically similar settings.