Peter Wasswa

Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo

BackgroundAdherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo.MethodsThis was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study.ResultsA total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001).ConclusionAlthough the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services.

Morbidity and mortality due to malaria in Est Mono district, Togo, from 2005 to 2010: a times series analysis

BackgroundIn 2004, Togo adopted a regional strategy for malaria control that made use of insecticide-treated nets (ITNs), followed by the use of rapid diagnostic tests (RDTs), artemisinin-based combination therapy (ACT). Community health workers (CHWs) became involved in 2007. In 2010, the impact of the implementation of these new malaria control strategies had not yet been evaluated. This study sought to assess the trends of malaria incidence and mortality due to malaria in Est Mono district from 2005 to 2010.MethodsSecondary data on confirmed and suspected malaria cases reported by health facilities from 2005 to 2010 were obtained from the district health information system. Rainfall and temperature data were provided by the national Department of Meteorology. Chi square test or independent student’s t-test were used to compare trends of variables at a 95% confidence interval. An interrupted time series analysis was performed to assess the effect of meteorological factors and the use of ACT and CHWs on morbidity and mortality due to malaria.ResultsFrom January 2005 to December 2010, 114,654 malaria cases (annual mean 19,109 ± 6,622) were reported with an increase of all malaria cases from 10,299 in 2005 to 26,678 cases in 2010 (p<0.001). Of the 114,654 malaria cases 52,539 (45.8%) were confirmed cases. The prevalence of confirmed malaria cases increased from 23.1 per 1,000 in 2005 to 257.5 per 1,000 population in 2010 (p <0.001). The mortality rate decreased from 7.2 per 10,000 in 2005 to 3.6 per 10,000 in 2010 (p <0.001), with a significant reduction of 43.9% of annual number of death due to malaria. Rainfall (β-coefficient = 1.6; p = 0.05) and number of CHWs trained (β-coefficient = 6.8; p = 0.002) were found to be positively correlated with malaria prevalence.ConclusionThis study showed an increase of malaria prevalence despite the implementation of the use of ACT and CHW strategies. Multicentre data analysis over longer periods should be carried out in similar settings to assess the impact of malaria control strategies on the burden of the disease. Integrated malaria vector control management should be implemented in Togo to reduce malaria transmission.

The ability of cultivars of sweetpotato in East Africa to 'revert' from Sweet potato feathery mottle virus infection.

Asymptomatic field plants are the normal source of the vine cuttings used as sweetpotato planting material in Africa. Previous and new tests of such East African material, mostly using the very sensitive method of graft inoculation to the indicator plant Ipomoea setosa, showed that a majority tested virus-negative. This was despite their never having undergone any science-based therapy. To investigate how this occurs, in a replicated greenhouse experiment, plants of susceptible cultivars from the USA and Peru and three resistant Ugandan cultivars were graft-inoculated with Sweet potato feathery mottle virus (SPFMV), the commonest virus infecting sweetpotato. When the grafts were established, cuttings were taken, rooted and proved to be infected. The health status of each of these new plants was then followed over a 10-week period using a quantitative polymerase chain reaction assay. Most of the plants of the Ugandan cultivars eventually tested SPFMV-negative whereas those of the USA and Peru seldom did. Furthermore, in subsequent graft-inoculations of scions from the tip, top, middle and base of the vine of every plant to I. setosa plants, again, most of the scions of the Ugandan cultivars tested SPFMV-negative whereas those of the USA and Peru seldom did. These tests demonstrate the phenomenon of reversion in the Ugandan cultivars and can explain how most unprotected Ugandan sweetpotato field plants tested SPFMV-negative.

Deinbollia mosaic virus: a novel begomovirus infecting the sapindaceous weed Deinbollia borbonica in Kenya and Tanzania

Four isolates of a bipartite begomovirus from naturally infected Deinbollia borbonica plants exhibiting yellow mosaic symptoms in Kenya and Tanzania were molecularly characterised. The DNA-A was most closely related to that of tomato leaf curl Mayotte virus (AM701764; 82%), while the DNA-B shared the highest nucleotide sequence identity with that of East African cassava mosaic virus (AJ704953) at 65%. Based on the current ICTV species demarcation criterion for the genus Begomovirus (≥91% sequence identity for the complete DNA-A), we report the full-length genome sequence of this novel bipartite begomovirus. The results reveal additional diversity and reservoir hosts of begomoviruses in East Africa.

Cryptosporidium infection in calves and the environment in Asembo, Western Kenya: 2015

Introduction Cryptosporidium species, a zoonotic enteric coccidian parasite, is among the leading causes of diarrhea in children. We evaluated the prevalence of Cryptosporidium infections in calves, factors associated with calf infection, environmental contamination of manure by Cryptosporidium and factors that expose humans to zoonotic transmission in Asembo. Methods in a cross-sectional study conducted from January to July 2015, we collected fecal specimens from 350 randomly selected calves aged ≤ 6 months old and 187 manure samples from the same farms. We assessed farmers’ knowledge about Cryptosporidium and collected data on characteristics using structured questionnaires. Modified Ziehl Nielsen staining was used to detect Cryptosporidium oocysts from calves’ stool and manure. The prevalence of infected calves and 95% confidence interval (CI) were calculated. Odds ratios (OR) and 95% (CI) were calculated to identify possible factors associated with Cryptosporidium infection; multivariable logistic regression performed to identify factors independently associated with the presence of Cryptosporidium. Results calves’ fecal Cryptosporidium prevalence was 8.3% (95% CI: 5.7-11.8) and 7.5% (95% CI: 4.2-12.2) in manure. Odds of infection was higher in calves with loose stool compared to those with normal stool (AOR = 6.1, 95% C.I: 2.2-16.9), calves ≤ 2 months old compared to older calves (AOR=12.7, 95% C.I: 4.5-35.8) and calves in poor sanitation compared to calves in good hygienic conditions (AOR = 9.9, 95% C.I: 3.1-30.7). Conclusion presence of Cryptosporidium species in calves and environment and reported human contact with animals increases zoonotic risk. We recommend further studies that determine specific Cryptosporidium species infecting animals and humans which would better estimate risk of disease transmission to humans.

Community vaccine perceptions and its role on vaccination uptake among children aged 12-23 months in the Ileje District, Tanzania: a cross section study

Introduction Underutilization of vaccines still remains a challenge in many regions across the world. Ileje district is one of the districts in Tanzania with consistently low pentavalent vaccine uptake (69%) and with drop out of 15%. We determined the vaccination completion with regard to Oral Polio virus, Measles, Bacillus Calmette-Guérin, and pentavalent vaccines and its association with community perceptions on vaccines. Methods We conducted a cross sectional study in Ileje district from October to December 2013. We sampled 380 mothers using a multistage random sampling technique. We analysed data using EPI INFO. We summarized descriptive variables using mean and standard deviation and categorical variables using proportions. We conducted bivariate and multivariate logistic regression to identify factors influencing vaccination uptake, statistical significance was assessed at 95% confidence interval. Results Mean age of the mothers was 27 years (SD 6.5 years) while that of their children was 16 months (SD 3.6 months). Fully vaccinated children were 71.1% and partially vaccinated were 28.9%, 99.2% were vaccinated with BCG vaccine and 73.4% were vaccinated with all OPV vaccine. Predictors of vaccination completion included negative perception on the vaccine provider-client relationship (AOR 1.86, 95%CI1.03-3.35), Perceived satisfaction with vaccination services (AOR 2.63, 95%CI 1.1 - 6.3). Others include child being born in the health facility (AOR 13.8 95% CI 8.04-25.8) and younger age of a child (AOR 0.51, 95%CI 0.29-0.9). Conclusion Improving quality of vaccination services, promoting health education and sensitizing community on health facility delivery will improve child vaccination completion in the district

Bovine tuberculosis: a retrospective study at Jos abattoir, Plateau State, Nigeria

Introduction Nigeria has the thirteenth highest burden of human tuberculosis. The current increasing incidence of tuberculosis in humans, particularly in immune-compromised persons, has given interest in the zoonotic importance of Mycobacterium bovis in developing countries like Nigeria. This study determined the prevalence of bovine tuberculosis as a background information for effective control measures in Plateau State in cattle population. Methods We reviewed surveillance records on cattle slaughtered and suggestive tuberculosis lesions from cattle slaughtered annually from 2007-2012 in Jos abattoir, Plateau State. Bovine tuberculosis cases at post mortem were based on examination of characteristics TB lesion on organs by Veterinary officers. We performed descriptive analysis using Epi info version 3.5.3 and Microsoft Excel 2007. Results A total of 52, 262 cattle were slaughtered from 2007-2012, out of which 4, 658 (11.2%) had evidence of tuberculosis lesion at post mortem. The average yearly prevalence was 9.1% but varied from a high of 16.3% in 2007 to a low of 3.1% in 2012. Trend analysis showed that bovine tuberculosis had a seasonal variation and peaked mostly in July and August. The number of suggestive Tb lesion cases was highest in the month of August and lowest in the month of January, 2007-2012. Conclusion This study shows that bovine tuberculosis is endemic in Plateau State. Trend analysis showed that bovine tuberculosis is seasonal and peaked mostly in July and August. Continuous surveillance through meat inspection is required to prevent zoonotic transmission of bovine tuberculosis.