George William Nasinyama

Kitchen practices used in handling broiler chickens and survival of Campylobacter spp. on cutting surfaces in Kampala, Uganda.

Cross-contamination during food preparation has been identified as an important factor associated with foodborne illnesses. Handling practices used during preparation of broiler chickens in 31 fast-food restaurants and 86 semisettled street stands (street vendors) were assessed by use of a standard checklist. These establishments used wood, plastic, or metal cutting surfaces during the preparation of broiler chickens. The survival of Campylobacter spp. on kitchen cutting surfaces was determined by inoculating approximately 10(6) CFU of Campylobacter jejuni onto sterile plastic, wooden, and metal cutting boards. The concentrations of the organisms were then assessed in triplicate on each type of cutting board over a 3-h period using standard microbiological methods for thermophilic Campylobacter spp. In 87% of food establishments, the same work area was used for preparation of raw and cooked chicken, and in 68% of these establishments the same cutting boards were used for raw and cooked chicken. None of the establishments applied disinfectants or sanitizers when washing contact surfaces. Campylobacter spp. survived on wooden and plastic but not on metal cutting boards after 3 h of exposure. The handling practices in food preparation areas, therefore, provide an opportunity for cross-contamination of Campylobacter spp. to ready-to-eat foods.

Isolation and Molecular Characterization of Brucella Isolates in Cattle Milk in Uganda

Brucellosis is endemic in livestock and humans in Uganda and its transmission involves a multitude of risk factors like consumption of milk from infected cattle. To shed new light on the epidemiology of brucellosis in Uganda the present study used phenotypic and molecular approaches to delineate the Brucella species, biovars, and genotypes shed in cattle milk. Brucella abortus without a biovar designation was isolated from eleven out of 207 milk samples from cattle in Uganda. These isolates had a genomic monomorphism at 16 variable number tandem repeat (VNTR) loci and showed in turn high levels of genetic variation when compared with other African strains or other B. abortus biovars from other parts of the world. This study further highlights the usefulness of MLVA as an epidemiological tool for investigation of Brucella infections.

Prevalence of and factors associated with Brucella sero-positivity in cattle in urban and peri-urban Gulu and Soroti towns of Uganda

Brucellosis is a key zoonosis of major public health, animal welfare and economic significance, and is endemic in livestock in Uganda. A cross-sectional epidemiological study was carried out to estimate the sero-prevalence of brucellosis and identify factors associated with sero-positivity in cattle in urban and peri-urban Gulu and Soroti towns of Northern and Eastern Uganda, respectively. A total of 1007 sera and data on biologically plausible risk factors from 166 herds and their spatial locations, were collected from cattle reared in urban and peri-urban Gulu and Soroti towns of Uganda. The sera were analyzed using indirect ELISA and sero-positive reactors confirmed by competitive ELISA. Multivariable models were used to investigate for risk factors. The overall animal-level and herd-level sero-prevalence was 7.5% (76/1007, 95% Confidence Interval (CI): 6.15–9.4%) and 27.1% (45/166, 95% CI: 20.9–34.3%), respectively. Herd-level sero-prevalence was significantly (P<0.001) higher in Soroti than Gulu. In Gulu town, sero-positivity increased with an increase in herd size (P=0.03) and age (P=0.002), and was higher in cattle brought in from western Uganda (P<0.0001). In Soroti town, introduction of new cattle into a herd was significantly (P=0.027) associated with herd sero-positivity. There was a geographically differential risk (clustering) of Brucella sero- positivity in herds in Soroti, while sero-positivity was homogeneously distributed in Gulu. The data highlight brucellosis occurrence and major risk factors for its transmission in cattle in urban and peri-urban areas.

Changing Trends in Urban Agriculture in Kampala

Kampala in the 21st century is the showcase of Uganda’s economic, political and social transformation following the economic decay and civil war of the 1970s and 1980s. A capital city that reflects the country’s diversity, it is also the site of the historic Buganda Kingdom and its traditions, including agriculture. This and other socio-economic factors have contributed to agriculture being a visible part of the city’s life.

Health Impact Assessment of Urban Agriculture in Kampala

While the Urban Harvest-supported studies described in the previous three chapters were going on in Kampala, an opportunity arose to complement them with an exploration of the health impacts associated with urban agriculture (UA) in the city. The Kampala City Council had expressed concern about the health risks associated with some forms of UA and the research team welcomed the chance to examine ways to reduce health risks and increase health benefits. A parallel research process was therefore set up, governed by a Health Coordinating Committee comprising researchers and policy-makers. Scholars from universities and research institutes in Uganda and Canada, in collaboration with local government and non-governmental organizations, were supported by the Canadian International Development Agency (CIDA) and the International Development Research Centre (IDRC). This chapter is essentially a summary of a companion book titled “Healthy City Harvests: generating evidence to guide policy on urban agriculture”, which contains all these studies (Cole et al. 2008). As in that book, the research findings are translated into policy implications, not only for Kampala but also for other cities with similar conditions.

Analysis of environmental chemical residues in products of emerging aquaculture industry in Uganda as case study for Sub-Saharan Africa

A study was conducted to analyse market-regulated heavy metals (lead, mercury and cadmium), organochlorine pesticides and total polychlorinated biphenyls (PCBs) in samples of 38 farmed fish comprising Nile tilapia (Oreochromis niloticus) (20 samples) and African catfish (Clarias gariepinus) (18 samples) from ten selected fish farms in Uganda. The goal of this case study was to understand the safety of aquaculture products from Sub-Saharan Africa. Lead was detected in all the 38 samples (maximum = 1.08 mg kg−1 (dry weight)), mercury in 31 out of 38 samples (maximum = 0.35 mg kg−1 (dry weight)), and cadmium in two samples (maximum = 0.03 mg kg−1 (dry weight)). Total levels of PCBs were below the limit of detection of 0.02 mg kg−1 (wet weight) in all the samples. Traces of 4,4′-dichloro-diphenyldichloroethylene (DDE) were detected in ten out of 38 samples (maximum = 0.01 mg kg−1 (wet weight)) making it the most prevalent organochlorine pesticide. Other pesticides detected were: 4,4′-dichloro-diphenyl-trichloroethane (DDT) and endosulfan sulphate, which were found in one fish sample (both 0.002 mg kg−1 (wet weight)). There was no statistically significant difference between the levels of lead and mercury in catfish and tilapia (t-test at p = 0.05). More catfish samples (eight) contained DDE as compared with tilapia (two). Cadmium, DDT and endosufan sulphate were only detected in catfish implying that catfish is more prone to contamination than tilapia. The levels of contaminants were below the US Food and Drug Administration (USFDA) action levels and European Union maximum residue limits (MRLs), indicating that such fish have the potential for export to these markets.

Prevalence of porcine cysticercosis in the Lake Kyoga Basin, Uganda

BackgroundTaenia solium is a zoonotic helminth with the potential to cause life threatening epilepsy in people through the aberrant larval infection of the brain called Neurocysticercosis (NCC). The pig is the intermediate host for T. solium where the larval form, cysticercus cellulosae, normally develops after the pig eats eggs of the parasite. Humans are the definitive host where the adult tapeworm develops and are infected through the consumption of poorly cooked, infected meat. T. solium has been acknowledged by the World Health Organization (WHO), Food and Agriculture Organization (FAO) and UK Department for International Development (DFID) as being a neglected zoonotic disease, and was recently included in the WHO roadmap for control of neglected tropical diseases. This neglect encompasses a lack of epidemiological data and a lack of validated, effective control strategies being adopted. Understanding the epidemiology of this parasite in the intermediate host is the first step towards designing suitable intervention strategies for the improvement of public health. This study was undertaken to provide an accurate and up-to-date estimate for the prevalence of porcine cysticercosis in the Lake Kyoga basin.ResultsSera from 378 pigs were analysed with the HP10 Antigen Enzyme Linked Immunosorbant Assay (ELISA) and the prevalence was found to be 25.7% (95% confidence interval 21.0% to 30.0%). Previous sero- surveillance in this region, using the B158/B60 Ag Elisa had indicated a prevalence of 8.6% in 2005 indicating a dramatic increase in prevalence (J. Parasitol Res, Article ID 375493, 2009) within a 6 year period.ConclusionThis increasing prevalence in the disease indicates to us that there is currently no effective control of this parasite and that in this region of Uganda at least; cysticercosis remains a neglected zoonotic disease.

Brucellosis: Community, medical and veterinary workers’ knowledge, attitudes, and practices in Northern Uganda

Aim: This study aimed at determining the knowledge, attitudes, and practices of the community, medical and veterinary workers regarding brucellosis. Materials and Methods: A cross-sectional study was conducted at selected health facilities in Apac, Gulu, Lira, and Pader districts of Northern Uganda using a standardized questionnaire. A total of 251 patients testing positive for brucellosis using the Brucella plate agglutination test, 59 medical and 29 veterinary workers were studied. Chi-square test at 95% confidence level was used to analyze data. Results: Only 8% patients, 15.3% medical, and 21.4% veterinary workers were knowledgeable on transmission methods and symptoms for brucellosis and knowledge differed according to the level of education among patients (p=0.001), medical (p=0.001), and veterinary workers (p=0.012). Over 80% patients, medical and veterinary workers had a positive attitude. Only 8% patients, 13.6% medical, and 7.1% veterinary workers had good practices regarding brucellosis control. Conclusion: Poor knowledge, poor practices, and positive attitude provide an opportunity for health education and policy formulation for the control of brucellosis. The prevalence studies of human and animal brucellosis are recommended to determine the magnitude of the problem.

National studies as a component of the World Health Organization initiative to estimate the global and regional burden of foodborne disease

Background The World Health Organization (WHO) initiative to estimate the global burden of foodborne diseases established the Foodborne Diseases Burden Epidemiology Reference Group (FERG) in 2007. In addition to global and regional estimates, the initiative sought to promote actions at a national level. This involved capacity building through national foodborne disease burden studies, and encouragement of the use of burden information in setting evidence-informed policies. To address these objectives a FERG Country Studies Task Force was established and has developed a suite of tools and resources to facilitate national burden of foodborne disease studies. This paper describes the process and lessons learned during the conduct of pilot country studies under the WHO FERG initiative. Findings Pilot country studies were initiated in Albania, Japan and Thailand in 2011 and in Uganda in 2012. A brief description of each study is provided. The major scientific issue is a lack of data, particularly in relation to disease etiology, and attribution of disease burden to foodborne transmission. Situation analysis, knowledge translation, and risk communication to achieve evidence-informed policies require specialist expertise and resources. Conclusions The FERG global and regional burden estimates will greatly enhance the ability of individual countries to fill data gaps and generate national estimates to support efforts to reduce the burden of foodborne disease.

Prevalence of brucellosis among patients attending Wau Hospital, South Sudan

Brucellosis is a zoonotic disease of public health importance; its prevalence varies globally. In low-income countries, brucellosis is an endemic and neglected disease affecting both animals and humans. This study was intended to establish brucellosis sero-prevalence among patients attending Wau hospital, South Sudan. Across sectional study, was done among randomly selected patients attending Wau hospital. Data was collected using questionnaires and laboratory investigations. Rose Bengal plate Test (RBPT), Serum agglutination test (SAT) and Competitive Enzyme Linked Immuno Sorbent Assay (c-ELISA) was used in the analysis of blood samples serially starting with RBPT which is more sensitive and least specific then SAT. c-ELISA test which is most specific and less sensitive compared to RBPT and SAT was then used to confirm presence of Brucella antibodies in the samples. A total of 416 participants out of 1664 were enrolled to this study. The majority of participants were between 7-to-76 years of age with mean age of 30.72 (SD+/- 12.83). The sero-positivity of patient’s blood samples for brucellosis using c-ELISA was 23.3% (97/416) among patients presenting to Wau hospital. Socio-demographic characteristics, occupation, clinical signs of disease and types of animals reared by animal owners showed no significant correlation with occurrence of sero-positivity among patient’s blood samples for brucellosis. While ethnicity (Nilotic), knowledge of zoonotic disease, and consumption of animal urine were statistically significant (p<0.05). The study found a high prevalence of brucellosis among febrile patients attending Wau hospital general outpatient clinic. There is need for co-ordination and collaboration between veterinary and health sectors of government to help prevent and control brucellosis in the region.