Browsing by Author "Waako, Paul"

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    Acute and subacute toxicity profile of ethanolic stem bark extract of Albizia coriaria Welw. ex Oliv. in Wistar albino rats
    (Toxicology Reports, 2024-01) Obakiro, Samuel Baker; Kiyimba, Kenedy; Owor, Richard Oriko; Andima, Moses; Lukwago, Tonny Wotoyitide; Kawuma, Carol; Gavamukulya, Yahaya; Nabatanzi, Alice; Kibuule, Dan; Kato, Charles Drago; Anywar, Godwin; Waako, Paul
    Albizia coriaria (Fabaceae) crude extracts are key ingredients of several licensed and unlicensed herbal products in East Africa. However, there is limited and often contradicting information regarding its toxicity. We therefore evaluated the acute and subacute toxicity of the ethanolic stem bark extract of A. coriaria in mature healthy Wistar albino rats following Lorke’s method and OECD guidelines 407. The LD50 of the ethanolic stem bark extract of A. coriaria was 2000 mg/kg. The acute toxicity signs observed included piloerection, hyperventilation, lethargy, and loss of righting reflex. There was a significant increase in aspartate aminotransferase, alkaline phosphatase, red blood cells and haemoglobin in rats after 28 days at the dose of 500 mg/kg. Histological analyses revealed multifocal random parenchymal necrosis and scattered periportal mononuclear inflammatory cells infiltration in the liver, interstitial nephritis in the kidney and multifocal lymphoid accumulation in the peribronchiolar and perivascular lung tissue at 500 mg/kg. The ethanolic stem bark of A. coriaria was therefore moderately toxic to the rats when administered in a single high oral dose within 24 h. The extract caused a dose dependent toxicity with significant damage to the kidney, liver and lung tissues at a dose of 500 mg/kg after 28 days. Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of toxicity particularly at higher doses greater than 500 mg/kg.
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    Acute and subacute toxicity profile of ethanolic stem bark extract of Albizia coriaria Welw. ex Oliv. in Wistar albino rats Author links open overlay panel
    (Elsevier Ltd, 2024-06) Obakiro, Samuel Baker; Kiyimba, Kenedy; Owor, Richard Oriko; Andima, Moses; Lukwago, Tonny Wotoyitide; Kawuma, Carol; Gavamukulya, Yahaya; Nabatanzi, Alice; Kibuule, Dan; Kato, Charles Drago; Anywar, Godwin; Waako, Paul
    Abstract Albizia coriaria (Fabaceae) crude extracts are key ingredients of several licensed and unlicensed herbal products in East Africa. However, there is limited and often contradicting information regarding its toxicity. We therefore evaluated the acute and subacute toxicity of the ethanolic stem bark extract of A. coriaria in mature healthy Wistar albino rats following Lorke’s method and OECD guidelines 407. The LD 50 of the ethanolic stem bark extract of A. coriaria was 2000 mg/kg. The acute toxicity signs observed included piloerection, hyperventilation, lethargy, and loss of righting reflex. There was a significant increase in aspartate aminotransferase, alkaline phosphatase, red blood cells and haemoglobin in rats after 28 days at the dose of 500 mg/kg. Histological analyses revealed multifocal random parenchymal necrosis and scattered periportal mononuclear inflammatory cells infiltration in the liver, interstitial nephritis in the kidney and multifocal lymphoid accumulation in the peribronchiolar and perivascular lung tissue at 500 mg/kg. The ethanolic stem bark of A. coriaria was therefore moderately toxic to the rats when administered in a single high oral dose within 24 h. The extract caused a dose dependent toxicity with significant damage to the kidney, liver and lung tissues at a dose of 500 mg/kg after 28 days. Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of toxicity particularly at higher doses greater than 500 mg/kg. ga1 • This study assesed the acute and subacute toxicity effects of the ethanolic stem bark extract of A. coriaria, a key ingredient of several licensed and unlicensed herbal products on Uganda market. • The ethanolic stem bark extract of A. coriaria was found to be moderately toxic when administered in a single high oral dose within 24 h with a median lethal dose of 2000 mg/kg. • In repeated daily doses of 500 mg/kg, the ethanolic stem bark extract of A. coriaria caused significant toxicity to the lungs, liver and kidney tissues. • Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of associated toxicity particularly at higher doses greater 500 mg/kg.
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    The Anti-Mycobacterial Activity and Safety Profile of Selected Crinum Species in Northwestern Uganda
    (African Journal of Pharmacy and Pharmacology, 2021) Candia, Milton; Katuura, Esther; Waako, Paul
    Crinum species is a source of many bioactive molecules with both antimicrobial and anti-tumor properties. Chloroform, methanol and aqueous extracts of Crinum scabrum and Crinum macowanii bulbs and leaves were investigated for their anti-mycobacterial activity against Mycobacteria tuberculosis using agar well diffusion, and broth dilution methods. Rifampicinstreptomycin resistant (R.S), pan African sensitive (H37Rv) and wild type (Sou 14827) strains of the bacteria were used. The investigation aimed to determine the anti-mycobacterial activity and safety profile of the crude extracts of Crinum scabrum and Crinum macowanii. The extracts had antimycobacterial activity that ranged between 1-5μg/ml. Their patterns of inhibition varied with the plant extract, solvent used for extraction and the organisms tested. Different concentrations of methanol extract were compared with similar concentrations of chloroform and aqueous extracts for their maximum zones of inhibition. All the extracts of Crinum macowanii were found inactive against Mycobacteria tuberculosis. Methanol leaf extract of Crinum scabrum was the most active, with minimum inhibitory concentration (MIC) less than1μg/ml and minimum bactericidal concentration (MBC) of 1μg/ml. acute toxicity test in mice for Crinum scabrum leaf was found to have LD50 greater than 2000mg/kg.
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    The anti-mycobacterial activity of Lantana camara a plant traditionally used to treat symptoms of tuberculosis in South-western Uganda
    (African health sciences, 2009) Kirimuhuzya, Claude; Waako, Paul; Joloba, Moses; Odyek, Olwa
    Tuberculosis continues to be a devastating public health problem. Many communities in Uganda use medicinal plants to treat various infections, including respiratory tract infections. There are claims that some can treat tuberculosis. Verifying some of these claims could lead to discovery of lead compounds for development of a TB drug. Methods: Chloroform and methanol extracts of L. camara collected from South-western Uganda were screened against three strains of Mycobacterium tuberculosis using the agar-well diffusion method. H37Rv, the rifampicin-resistant TMC-331 and a non-resistant wild strain (28-25271). The MIC and MBC were determined using the Agar dilution method on Middle brook 7H11. Results: The methanol extract showed the highest activity against all the three strains used, with zones of inhibition of 18.0-22.5 mm and MIC values of 20 μg/ml for H37Rv and 15 μg/ml for both TMC-331 and wild stain. The values for rifampicin were 1.0 μg/ml for both H37Rv and wild strain but rifampicin hardly showed any activity on TMC-331. The MBC value for the methanol extract of L. camara was 30μg/ml for the H37Rv, and 20μg/ml for both the TMC-331 and wild strains of M. tuberculosis. The MBC for rifampicin was 2.0μg/ml for both H37Rv and the wild strain.
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    Anti-tubercular activity of Callistemon citrinus and Piptadenistrum africanum on resistant strains of Mycobacterium tuberculosis using Microplate alamar blue assay
    (ScopeMed, 2015) Bunalema, Lydia; Tabuti, John; Sekagya, Yahaya; Ogwang, Sam; Waako, Paul
    Tuberculosis (TB) is one of the leading causes of death among infectious diseases in the world. It is responsible for killing approximately 1.4 million people per year worldwide. This devastating situation has steadily worsened, exacerbated by the emergence of drug-resistance and Human Immunodeficiency Virus (HIV) co-infection. The objectives of the study were to determine the minimum inhibitory concentration (MIC) of selected plant species on three TB strains and to determine different phytochemicals contained in the plant species. Methods: Microplate Alamar Blue Assay (MABA) was used to determine the MIC of two commonly mentioned plant species, Piptadenistrum africanum and Callistemon citrinus on resistant variant strains of Mycobacterium tuberculosis. Qualitative tests were used to determine the phytochemicals in the plants. Results: The chloroform extract of Callistemon spp. had MICs of 0.048mg/ml, 0.158mg/ml and 0.19mg/ml on the pan sensitive, isoniazid resisistant and rifampicin resistant strains respectively. P. africanum had MICs of 0.395 mg/ml, 0.395 mg/ml and 0.78 mg/ml on the pan sensitive, rifampicin and isoniazid resistant strains respectively. Conclusion: These plant species appear to be active not only on the pan sensitive strains of TB but also on resistant strains and could be developed into drugs for the treatment of Multi drug resistant (MDR) TB.
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    Antimicrobial activity and phytochemical fingerprints of five crude extracts obtained from indigenous medicinal plants of Uganda
    (2017) Katuura, Esther; Bossa, Godfrey Sande; Waako, Paul; Ogwal -Okeng, Jasper
    Five crude extracts from four Ugandan plants were screened in vitro for their antimicrobial activity and phytochemical composition. They included the chloroform extracts of Bothliocline longipes, Maesa lanceolata, Trimeria bakeri, Rhus natalensis and the petroleum ether extract of T. bakeri. The plant crude extracts were tested against Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 49619) and Entamoeba sp. Antimicrobial activities of the plants were determined by using the agar well diffusion and agar well dilution methods. The plant extracts showed activity against all the tested organisms with the zones of inhibition ranging from 4 to 19 mm. All the extracts inhibited the growth of S. aureus while the strongest activity was found for T. bakeri against S. aureus and Entamoeba sp. at 19 mm. Other plant extracts that induced strong antimicrobial activity were the chloroform extract of R. natalensis with an inhibition diameter of 13 mm against both S. aureas and P. aeruginosa and 9 mm diameter inhibition against E. coli. Only T. bakeri showed growth inhibition of S. aureus (4 mm). The minimum inhibitory concentration (MIC) was observed against S. aureus at 0.25 g/ml by the T. bakeri and B. longipes plant extracts. Sterol and triterpenes, fatty acids, flavanoids, coumarins and alkaloids were determined in T. bakeri, B. longipes, R. natalensis and M. lanceolata. The presence of these compounds indicates that the plants may contain an active compound or one that can be used as a template for the development of a new antimalarial or antibiotic medicine
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    Antiplasmodial activity of extracts of selected medicinal plants used by local communities in western Uganda for treatment of malaria
    (African Journal of Ecology, 2007) Katuura, Esther; Waako, Paul; Tabuti, John R. S.; Bukenya-Ziraba, Remigius; Ogwal -Okeng, Jasper
    This study investigated the antiplasmodial activity of ten medicinal plants used to treat malaria in Southwestern Uganda. The study plants were Bothlioclines longpipes (Olive and Hiern), N.E.Br., Toddalia asiatica (L.) Lam., Maesa lanceolata Forssk., Indigofera emerginella steud. Ex A. Rich., Lantana trifolia L., Vernonia lasiopus O. Hoffm., Trimmeria bakeri Gilg., Rhus natalensis Bernh. ex. Krauss Erythrophleum pyrifolia and Conyza sp. Dry powdered plant material was extracted by sequential cold maceration using petroleum ether, chloroform and ethanol solvents respectively. Extracts were subjected to in vitro antiplasmodial screening against wild strains of Plasmodium falciparum using the nitro-tetrazolium blue-based lactate dehydrogenase assay. The chloroform extract of M. lanceolata (EC50 1.60 μg ml−1.), showed the highest antiplasmodial activity followed by R. natalensis (EC50 1.80 μg ml−1). Other extracts with significant activity were the chloroform leaf extract of Bothriocline longipes (EC50 3.66 μg ml−1) and the petroleum ether root extract of T. bakeri (EC50 3.955 μg ml−1).
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    The availability of six tracer medicines in private medicine outlets in Uganda
    (Journal of pharmaceutical policy and practice, 2014) Birabwa, Catherine; Murison, Jude; Evans, Valerie; Obua, Celestino; Agaba, Amon; Waako, Paul; Pollock, Allyson
    Many low income countries struggle to provide safe and effective medicines due to poor public health care infrastructure, budgetary constraints, and lack of human resource capacity. Private sector pharmacies and drug shops are used by a majority of the population as an alternative to public pharmacies. This study looks at the availability of six essential medicines in private drug outlets across Uganda. Methods: A standardised medicines availability survey developed by the World Health Organization and Health Action International was adapted for use in this project to collect availability data for six tracer medicines in 126 private medicine outlets across four districts in Uganda from September 2011 to October 2012. Results: Artemisinin-based combination treatments and metformin were the most commonly found medicines in the private medicine outlets surveyed. Ninty-nine percent of all outlets carried artemisinin-based combinations while 93% of pharmacies and 53% of drug shops stocked metformin. Oxytocin was found in one third of outlets surveyed. Fluoxetine was in 70% of pharmacies yet was not found in any drug shops. Rifampicin and lamivudine were found infrequently in outlets across all districts; 10% and 2%, respectively. Not all brands found in surveyed outlets were listed on the Ugandan National Drug Register. In particular, five unlisted brands of rifampicin were found in private medicine outlets. Conclusions: The regulatory process should be improved through the enforcement of outlet licensing and medicine registration. Additional studies to elucidate the reasons behind the use of private medicine outlets over the public sector would assist the government in implementing interventions to increase use of public sector medicine outlets.
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    Barriers and enablers of adherence to infant nevirapine prophylaxis against HIV 1 transmission among 6-week-old HIV exposed infants: A prospective cohort study in Northern Uganda
    (PLoS ONE, 2020) Napyo, Agnes; Tylleska, Thorkild; Mukunya, David; Tumuhamye, Josephine; Musaba, Milton W.; Arach, Anna Agnes O.; Waako, Paul; Tumwine, James K.; Ndeezi, Grace
    Sub-optimal adherence to infant prophylaxis has been associated with mother-to-child transmission of HIV. However, the factors associated have not been well characterized in different settings. This study describes barriers and enablers of adherence to infant prophylaxis among 6-week-old HIV exposed infants in Lira district, Northern Uganda.
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    Callistemon Citrinus (Curtis) Skeels as A Source of Antitubercular Compounds
    (Research Square, 2021) Bunalema, Lydia; Wabo Fotso, Ghislain; Waako, Paul; Yeboah, Samuel
    Tuberculosis (TB) is still a principal cause of death in the world. There is considerable emphasis for search of novel drugs against TB due to increased Mycobacterium tuberculosis drug resistance and co infection with Human Immunodeficiency virus (HIV) that are challenging to treat. Callistemon citrinus (Curtis) skeels is one of the medicinal plants that are used in treatment of tuberculosis by local communities in Uganda. Though crude extracts from the plant have shown antimycobacterial activity invitro, the specific phytochemicals responsible for this activity are not known. The study aimed at isolating and characterizing compounds from C. citrinus and testing the compounds on different strains of M. tuberculosis.
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    Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomised controlled trial in Northern Uganda
    (British Medical Journal Publishing Group, 2024-02) Nankabirwa, Victoria; Mukunya, David; Ndeezi, Grace; Odongkara, Beatrice; Arach, Agnes A; Achora, Vicentina; Mugenyi, Levi; Sebit, Mohammad Boy; Wandabwa, Julius N; Waako, Paul; Tylleskär, Thorkild; Tumwine, James K
    Abstract ObjectiveTo assess the effect of an integrated intervention package compared with routine government health services on the frequency of health facility births.SettingThree subcounties of Lira district in Northern Uganda.DesignA cluster randomised controlled trial where a total of 30 clusters were randomised in a ratio of 1:1 to intervention or standard of care.ParticipantsPregnant women at ≥28 weeks of gestation.InterventionsParticipants in the intervention arm received an integrated intervention package of peer support, mobile phone messaging and birthing kits during pregnancy while those in the control arm received routine government health services (‘standard of care’).Primary and secondary outcome measuresThe primary outcome was the proportion of women giving birth at a health facility in the intervention arm compared with the control arm. Secondary outcomes were perinatal and neonatal deaths.ResultsIn 2018–2019, 995 pregnant women were included in 15 intervention clusters and 882 in 15 control clusters. The primary outcome was ascertained for all except one participant who died before childbirth. In the intervention arm, 754/994 participants (76%) gave birth at a health facility compared with 500/882 (57%) in the control arm. Participants in the intervention arm were 35% more likely to give birth at a health facility compared with participants in the control arm, (risk ratio 1.35 (95% CI 1.20 to 1.51)) and (risk difference 0.20 (95% CI 0.13 to 0.27)). Adjusting for baseline differences generated similar results. There was no difference in secondary outcomes (perinatal or neonatal mortality or number of postnatal visits) between arms. Conclusion The intervention was successful in increasing the proportion of facility-based births but did not reduce perinatal or neonatal mortality.Trial registration numberNCT02605369
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    CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors
    (Laboratory Medicine, 2011) Nanzigu, Sarah; Waako, Paul; Petzold, Max; Kiwanuka, Gertrude; Dungu, Henry; Makumbi, Fred; Gustafsson, Lars L.; Eriksen, Jaran
    Given the importance of CD4-T-lymphocyte monitoring in HIV/ART management, we established CD4/CD8 reference ranges in Uganda and studied factors associated with CD4/CD8 in a normal population. Blood samples for 206 HIV seronegative healthy volunteers from the Mbarara and Kampala districts in Uganda were analyzed using the PanLeucogating protocol.
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    Chewing-stick practices using plants with anti-streptococcal activity in a Ugandan rural community
    (Frontiers in pharmacology, 2011) Okot Odongo, Charles; Odongo, Okot; Lubowa Musisi, Nathan; Waako, Paul; Obua, Celestino
    The high dental disease burden in developing countries has created a need to explore and develop cheap and accessible methods of dental disease prevention. Traditional toothbrushes (chewing-sticks) prepared from specific plants have been used for dental hygiene for generations. When properly used, chewing-sticks may be as effective as synthetic toothbrushes. This study set out to describe traditional chewing-stick practices in a Ugandan rural community, and evaluate the antibacterial activity of two most commonly used plants. Methods: Interviews were done to identify chewing-stick plants and obtain socio-cultural information relating to the practice in two villages in rural Uganda. Field walks were done to pick and voucher the plants, for taxonomical identification and storage. For the two most reported plants, aqueous extracts were prepared and tested for antibacterial activity against Streptococcus mutans using the agar-well diffusion method.
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    A Consortium Approach to Competency‑based Undergraduate Medical Education in Uganda: Process, Opportunities and Challenges
    (Educ Health, 2014) Kiguli, Sarah; Mubuuke, Roy; Baingana, Rhona; Kijjambu, Stephen; Maling, Samuel; Waako, Paul; Obua, Celestino; Ovuga, Emilio; Kaawa‑Mafigiri, David; Nshaho, Jonathan; Kiguli‑Malwadde, Elsie; Bollinger, Robert; Sewankambo, Nelson
    Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non‑communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda’s disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency‑based medical education (CBME).
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    Detectable HIV-RNA Viral Load Among HIV-Infected Pregnant Women on Treatment in Northern Uganda
    (International Journal of Maternal and Child Health and AIDS, 2020) Napyo, Agnes; Tumwine, James K.; Mukunya, David; Tumuhamye, Josephine; Ojok Arach, Anna A.; Ndeezi, Grace; Waako, Paul; Tylleskär, Thorkild
    Detectable HIV viral load among HIV-infected pregnant women remains a public health threat. We aimed to determine factors associated with detectable viral load among HIV-infected pregnant women in Lira, Northern Uganda. Methods: We conducted a cross-sectional survey among 420 HIV-infected pregnant women attending Lira Regional Referral Hospital using a structured questionnaire and combined it with viral load tests from Uganda National Health Laboratories. We conducted multivariable logistic regression while adjusting for confounders to determine the factors associated with detectable viral load and we report adjusted odds ratios and proportion of women with viral load less than 50 copies/ml and above 1000 copies,respectively.
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    Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial
    (PLoS ONE, 2021) Musaba, Milton W.; Wandabwa, Julius N.; Ndeezi, Grace; Weeks, Andrew D.; Mukunya, David; Waako, Paul; Nankabirwa, Victoria; Tulyamuhika Mugabe, Kenneth; Semakula, Daniel; Tumwine, James K.; Barageine, Justus K.
    Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labor (dystocia). Its effectiveness and safety among women with obstructed labor is not known. Objective To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labor (OL) in Mbale hospital. Methods We conducted a double blind, randomized controlled trial from July 2018 to September 2019. The participants were women with OL at term (�37 weeks gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements.
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    Efficacy of Cryptolepis sanguinolenta root extract on slow-growing rifampicin resistant Mycobacterium tuberculosis
    (Journal of Medicinal Plants Research, 2012) Kirimuhuzya, Claude; Bunalema, Lydia; Waako, Paul; Tabuti, John R. S.; John, Orodho; Magadula Jangu, Joseph; Otieno, Nicholas; Okemo, Paul
    We report here, the results from total crude methanol extract as well as serial ether, chloroform, and methanol extracts of the root of Cryptolepis sanguinolenta (Lindl) Schltr that were screened against three strains of Mycobacterium tuberculosis. The strains used included the pan sensitive H37Rv, the rifampicin-resistant TMC-331 and a wild strain of Mycobacetrium avium (MA) isolated from a Ugandan patient. The disc diffusion method was used for susceptibility tests on solid Middle brook 7H10 while the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by the microtitre plate method using Middle brook 7H9 broth. We report that the total crude methanol extract showed the highest activity against H37Rv and TM-331 with complete clearance of quadrants at 50 mg/ml and zones of inhibition of 10.0 to 11 mm at 25 mg/ml concentration although it was not effective against M. avium. The corresponding MIC values were 1.17 mg/ml for H37Rv and 1.56 mg/ml for TMC-331. The values for isoniazid were 0.25 and 9.38 μg/ml for H37Rv and TMC-331, respectively, while for rifampicin the MIC value was 0.25 μg/ml for H37Rv but it was not active on TMC- 331. Acute toxicity test gave an LD50 of 758.5 mg/kg body weight while the phytochemical analysis showed the presence of alkaloids, tannins and flavonoids.
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    Ethnobotanical survey and phytochemistry of medicinal plants used in the management of HIV/AIDS in Eastern Uganda
    (Elsevier Ltd, 2024-06) Owor, Richard Oriko; Kawuma, Carol; Nantale, Gauden; Kiyimba, Kenedy; Obakiro, Samuel Baker; Ouma, Simple; Lulenzi, Jalia; Gavamukulya, Yahaya; Chebijira, Mercy; Lukwago, Tonny Wotoyitide; Egor, Moses; Musagala, Peter; Andima, Moses; Kibuule, Dan; Waako, Paul; Hokello, Joseph
    Currently, highly active antiretroviral therapy is unable to cure HIV/AIDS because of HIV latency. This study aimed at documenting medicinal plants used in the management of HIV/AIDS in Eastern Uganda so as to identify phytochemicals with HIV latency reversing potential. An ethnobotanical survey was conducted across eight districts in Eastern Uganda. Traditional medicine practitioners were interviewed using semi-structured questionnaires. Qualitative and quantitative phytochemical tests were respectively, performed to determine the presence and quantity of phytochemicals in frequently mentioned plant species. Data were analysed and presented using descriptive statistics and Informant Consensus Factor (ICF). Twenty-one plant species from fourteen plant families were reported to be used in the management of HIV/AIDS. Six plant species with the highest frequency of mention were: Zanthoxylum chalybeum, Gymnosporia senegalensis, Warbugia ugandensis, Leonatis nepetifolia, Croton macrostachyus and Rhoicissus tridentata. Qualitative phytochemical analysis of all the six most frequently mentioned plant species revealed the presence of flavonoids, tannins, terpenoids, alkaloids and phenolics. Quantitative analysis revealed the highest content of flavonoids in L. nepetifolia (20.4 mg/g of dry extract) while the lowest content was determined in C. macrostachyus (7.1 mg/g of dry extract). On the other hand, the highest content of tannins was observed in L. nepetifolia. (199.9 mg/g of dry extract) while the lowest content was found in R. tridentata. (42.6 mg/g of dry extract). Medicinal plants used by traditional medicine practitioners in Eastern Uganda to manage HIV/AIDS are rich in phytochemicals including flavonoids and tannins. Further studies to evaluate the HIV-1 latency reversing ability of these phytochemicals are recommended to discover novel molecules against HIV/AIDS.
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    Exclusive breastfeeding among HIV exposed infants from birth to 14 weeks of life in Lira, Northern Uganda: a prospective cohort study
    (Global Health Action, 2020) Napyo, Agnes; Tumwine, James K.; Mukunya, David; Waako, Paul; Tylleskär, Thorkild; Ndeezi, Grace
    Breastfeeding is important for growth, development and survival of HIV exposed infants. Exclusive breastfeeding reduces the risk of morbidity, mortality and increases HIV free survival of infants. Evidence on risk factors for inappropriate breastfeeding in Northern Uganda is limited. Objective: This study determined the risk factors for non-exclusivity of breastfeeding in the first 14 weeks of life.
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    Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study
    (Journal of global antimicrobial resistance, 2021) Kawala Kagoya, Enid; Royen, Kathleen Van; Waako, Paul; Royen, Paul Van; Iramiot, Jacob Stanley; Obakiro, Samuel Baker; Kostyanev, Tomislav; Anthierens, Sibyl
    This study aimed to explore the experiences and views of healthcare professionals on antibiotic prescription in Eastern Uganda. Methods: This was an exploratory qualitative study using semi-structured interviews. Participants included 16 healthcare professionals from Mbale and Soroti Regional Referral Hospitals. Additionally, two workshops were held (one in each hospital) with a total of 56 healthcare professionals to discuss the findings. Thematic analysis was used to analyse the data. Results: Healthcare professionals’ prescriptions are influenced by (i) healthcare workers’ perceptions and practices, (ii) patients’ perceptions and beliefs, and (iii) contextual factors. Healthcare workers’ prescriptions depend on the presence of bacterial infection and the severity of the condition, the availability and cost of medication, previous experience with antibiotic prescribing, patient character- istics, and trial and error. They also have limited knowledge and share little information on the use of antibiotics with patients. Patient factors included demand for a particular antibiotic, inability to afford expensive drugs, and limited knowledge about antibiotic use and resistance. Contextual factors that contributed to antibiotic prescribing were an overburdened healthcare system, the influence of pharmaceutical companies and pharmacies, the use of (treatment) guidelines, and difficulties with laboratory services. Conclusion: This study showed that healthcare professionals are aware of the problem of antibiotic resistance but do not feel ownership of the problem. Instead, they rather blame the overburdened system, local drug shops, pharmacies, drug representatives and patients. There is a need for a multisectoral and holistic approach toward fighting antibiotic resistance.