Herbal medicine used for the treatment of diarrhea and cough in Kampala city, Uganda

Background Globally, diarrheal and respiratory diseases are among the main causes of mortality and morbidity. In Uganda, cities are facing proliferation of trade in herbal medicines (HM), including those for diarrhea and/or cough. Information on the economic, and the ethnopharmacological aspects of these HM is scarce, deterring the sector from achieving optimal capacity to support national development. We profiled the anti-diarrhea and/or anti-cough HM, and the basic economic aspects of HM trade in Kampala city, to support ethnopharmacological knowledge conservation and strategic planning. Methods A cross-sectional survey was conducted on 65 herbalists using semi-structured questionnaires. This was supplemented by an observational survey using a high-resolution digital camera. Data were collected following the guidelines for research on HM, established by Uganda National Drug Authority, and World Health organization. Results Eighty-four plant species from 41 families were documented. Fabaceae and Myricaceae had the highest number of species (9, 10.7% each). Citrus limon (L.) Osbeck was the most commonly cited for cough, with a relative frequency of citation (RFC) of 1.00, and its relative medical importance was not significantly different from the other top 5 species except for Azadirachta indica A.Juss (RFC = 0.87). Entada abyssinica A. Rich (RFC = 0.97) was the most cited for diarrhea. Trees (34, 40.5%) were mostly used, and mainly harvested from wild habitats (55.2%) in 20 districts across Uganda. These HM were mainly sold as powders and concoctions, in markets, shops, pharmacies, and roadside or mobile stalls. The highest prices were Uganda Shillings (UGX) 48,000 ($13.15)/kg for Allium sativum L, and UGX 16,000 ($4.38)/kg for C. limon. All participants used HM trade as a sole source of basic needs; majority (60.0%) earned net monthly profit of UGX. 730,000 ($200) ≤ 1,460,000 ($400). The main hindrances to HM trade were the; disruptions caused by the COVID-19 pandemic (n = 65, 100%), and the scarcity of medicinal plants (58, 89.2%). Conclusion There is a rich diversity of medicinal plant species traded in Kampala to treat diarrhea and cough. The HM trade significantly contributes to the livelihoods of the traders in Kampala, as well as the different actors along the HM value chain throughout the country.

Cholera outbreak caused by drinking unprotected well water contaminated with faeces from an open storm water drainage: Kampala City, Uganda, January 2019

Background Kampala city slums, with one million dwellers living in poor sanitary conditions, frequently experience cholera outbreaks. On 6 January 2019, Rubaga Division notified the Uganda Ministry of Health of a suspected cholera outbreak in Sembule village. We investigated to identify the source and mode of transmission, and recommended evidence-based interventions. Methods We defined a suspected case as onset of profuse, painless, acute watery diarrhoea in a Kampala City resident (≥ 2 years) from 28 December 2018 to 11 February 2019. A confirmed case was a suspected case with Vibrio cholerae identified from the patient’s stool specimen by culture. We found cases by record review and active community case-finding. We conducted a case–control study in Sembule village, the epi-center of this outbreak, to compare exposures between confirmed case-persons and asymptomatic controls, individually matched by age group. We overlaid rainfall data with the epidemic curve to identify temporal patterns between rain and illnesses. We conducted an environmental assessment, interviewed village local council members, and tested water samples from randomly-selected households and water sources using culture and PCR to identify V. cholerae. Results We identified 50 suspected case-patients, with three deaths (case-fatality rate: 6.0%). Of 45 case-patients with stool samples tested, 22 were confirmed positive for V. cholerae O1, serotype Ogawa. All age groups were affected; persons aged 5–14 years had the highest attack rate (AR) (8.2/100,000). The epidemic curve showed several point-source outbreaks; cases repeatedly spiked immediately following rainfall. Sembule village had a token-operated water tap, which had broken down 1 month before the outbreak, forcing residents to obtain water from one of three wells (Wells A, B, C) or a public tap. Environmental assessment showed that residents emptied their feces into a drainage channel connected to Well C. Drinking water from Well C was associated with illness (ORM–H = 21, 95% CI 4.6–93). Drinking water from a public tap (ORM–H = 0.07, 95% CI 0.014–0.304) was protective. Water from a container in one of eight households sampled tested positive for V. cholerae; water from Well C had coliform counts ˃ 900/100 ml. Conclusions Drinking contaminated water from an unprotected well was associated with this cholera outbreak. We recommended emergency chlorination of drinking water, fixing the broken token tap, and closure of Well C.

Nutrition Supplementation Practices of Recreational Gym Users in Uganda’s Capital City: A Cross Sectional Study

Background: This study focused on investigating the prevalence of nutritional supplement (NS) usage, establishing their source and the motivating factors for the usage of NS among Gym users in Kampala city, Uganda.Methods: The study employed a cross-sectional research design. Multistage random sampling techniques were used to select 45 gym users among the 5 divisions that constitute Kampala city. Data were collected using questionnaires and analyzed using SPSS Version 26, where means, SD, frequencies and percentages were obtained. Chi-square tests were used for categorical comparisons between variables. Results: The results showed that there were more male participants (62.2%) than female participants (37.8%). The majority (76.9%) of gym users obtained NS from retail stores such as pharmacies, (10.2%) from their sports coaches, (7.7%) nutritionists/dieticians, and (5.1%) from team mates. Non-professional gym users (62.3%) reported higher levels of energy drink consumption than professional gym users (26.7%). The consumption of vitamins, herbal products and proteins was also considerably high. We also identified coaches/trainers (30.8%) as the main source of information, followed by nutritionists/dieticians (23.1%) and online websites (20.5%). Most gym users strongly agreed that supplements increase endurance training, increase strength, and make one healthier.Conclusions: The prevalence of nutritional supplement usage among gym users was high, with energy drinks and herbal products being the most preferred supplements.

Herbal Medicine used for the treatment of diarrhea and cough in Kampala city, Uganda

Background: Globally, diarrheal and respiratory diseases are among the top ten causes of mortality, and are the major ailments for which humans seek treatment. Kampala, the capital city of Uganda is facing a proliferation of herbalists that sell herbal medicine (HM) used to manage ailments such as diarrhea and cough. The ethnopharmacological and economic aspects of HM sold in Uganda’s major cities such as Kampala are poorly understood, and this deters the HM sector from achieving its optimal capacity to adequately support health promotion and poverty reduction. The aim of this research was to: (i) profile the plant species used in the treatment of diarrhea and cough, and (ii) determine the basic economic aspects of HM trade in Kampala city. The purpose was to support the conservation of ethnopharmacological knowledge, and the design of strategic plans towards fostering optimal HM trade in urban settings.Methods: A cross-sectional survey was conducted using a mixed methods approach. Sixty-five herbalists were selected in the five divisions of Kampala. The herbalists were interviewed using semi-structured questionnaires. Field observations were used to collect qualitative data. The data was analyzed using descriptive and inferential statistics with STATA version-15.0. Results: Eighty-four plant species from 41 families were documented: Fabaceae and Myricaceae with the highest number of species (9, 10.7% each). Citrus limon was the most commonly cited for cough, with a relative frequency of citation (RFC) of 1.00, and its relative medical importance was not significantly different from the other top 5 species except for Azadirachta indica (RFC=0.87), (χ2 =8.923, p=0.0028). Entada abyssinica (RFC=0.97) was most cited for diarrhea. Trees (34, 40.5%) were mostly used, and mainly harvested from wild habitats (55.2%), found in 20 districts across Uganda. These HM were mainly sold as powders and concoctions, in markets, shops, pharmacies, and roadside or mobile stalls. The highest prices were Uganda Shillings (UGX) 48,000 ($ 13.15)/Kg for Allium sativum, and UGX 16,000 ($ 4.38)/Kg for C. limon. All participants used HM trade as a sole source of basic needs; majority (60.0%) earned net monthly profit of UGX. 730,000 ($ 200) ≤ 1,460,000 ($ 400). The main hindrances to HM trade were the; disruptions caused by the COVID-19 pandemic (n=65, 100%), and the scarcity of medicinal plants (58, 89.2%). Conclusion There is a rich diversity of medicinal plant species traded in Kampala to treat diarrhea and cough. The HM trade significantly contributes to the livelihoods of the traders in Kampala, as well as the different actors along the HM value chain throughout the country

Predictors of Access To Sexual And Reproductive Health Services By Urban Refugees In Kampala City, Uganda

Background: The influx of over 1.3 million refugees in Uganda, with over 10% settling in the capital city Kampala, challenges the ability of urban refugees to access Sexual and Reproductive Health services (SRH) and family planning (FP) amidst the multiple uncertainties of a precarious everyday life. Utilization of SRH services remains low among urban refugees despite the fact that these services are essential to those of reproductive age and vulnerable to unwanted pregnancies and its consequences and contracting sexually transmitted infections (STIs) including HIV. Mildmay Uganda conducted a multimethod outreach program to establish the predictors of access to SRH services by urban refugees in Kampala city. This paper reports on social demographic characteristics that influenced the uptake of SRH services by urban refugees.Methods: A participatory, gender based, community-led, empowerment approach known as Gender Action Learning Systems (GALS) was employed to deliver SRH including family planning services to urban refugees in Kampala between March 2018 and September 2019. Urban refugees enrolled in GALS were interviewed at the beginning and end of the GALS intervention, where both qualitative and quantitative data were collected. Univariate, bivariate, and multivariate analyses were conducted to determine social demographic factors influencing the uptake of SRH services by urban refugees.Results: The​ ​study enrolled 867 participants, with 605 remaining to the end. Median age was 29 (IQR:22-36) years with a standard deviation of 10.7, 52% of the participants had never married. Retention in the study of the sexually active age cohort of primary interest (15 -34) was higher than the 35-54 cohort for both men and women. There were significant associations between SRH use and age, religion and education level among the urban refugees. Pentecostal religion (Adjusted OR 7.9; 3.5-18) and education level of primary (Adjusted OR 3.4; 1.1-11) were associated with uptake of SRH and FP. Conclusion: The participatory, peer-led community approach to delivering SRH services to urban refugees in this research project boosted uptake by the refugees and supported its successful completion and ability to address previously unknown predictors. A continuous awareness campaign using tested models such as GALS to promote services to refugees is needed to successfully integrate newcomers into Uganda’s general healthcare services.

Fuzzy Based Prediction Model for Air Quality Monitoring for Kampala City in East Africa

The quality of air affects lives and the environment at large. Poor air quality has claimed many lives and distorted the environment across the globe, and much more severely in African countries where air quality monitoring systems are scarce or even do not exist. Here in Africa, dirty air is brought about by the growth in industrialization, urbanization, flights, and road traffic. Air pollution remains such a silent killer, especially in Africa, and if not dealt with, it will continue to lead to health issues, such as heart conditions, stroke, and chronic respiratory organ unwellness, which later result in death. In this paper, the Kampala Air Quality Index prediction model based on the fuzzy logic inference system was designed to determine the air quality for Kampala city, according to the air pollutant concentrations (nitrogen dioxide, sulphur dioxide and fine particulate matter 2.5). It is observed that fuzzy logic algorithms are capable of determining the air quality index and therefore, can be used to predict and estimate the air quality index in real time, based on the given air pollutant concentrations. Hence, this can reduce the effects of air pollution on both humans and the environment.