Use of Modern Family Planning Methods in Fishing Communities of Lake Victoria,Uganda

Introduction

Fishing communities (FCs) in Uganda have high HIV infection rates but poor access to health services including family planning (FP). Although FP is a cost-effective public health intervention, there is a paucity of data on knowledge and use of modern FP in FCs. This study determined knowledge and use of modern FP methods in FCs of Uganda.

Methods

Data were accrued from a 12-month follow up of 1,688 HIV-uninfected individuals, 18–49 years from 8 FCs along Lake Victoria, between September 2011 and March 2013. Data on knowledge and use of modern FP were collected through a semi-structured questionnaire. Prevalence Risk Ratios with corresponding 95% CIs were used to determine factors associated with Modern FP knowledge and use.

Results

The mean age was 31.4 years, with nearly half (48.8%) being females while more than half (58.6%) had attained up to primary education level. Knowledge of modern FP was high, 87.5% (1477/1688); significantly higher among females [adj. PRR = 4.84 (95% CI; 3.08, 7.61)], among older respondents (25–29 years) [adj. PRR = 1.83 (95% CI; 1.12, 2.99)] compared to younger ones (18–24 years) and among those conducting business [adj. PRR = 2.42(95% CI; 1.02, 5.74)] relative to those primarily in fishing. Just over a third (35.2%, 595/1688) reported use of at least one modern FP method. Use of modern FP methods was significantly higher among females [adj. PRR = 2.04 (95% CI; 1.56, 2.65, and among those reporting multiple sexual partnerships [adj. PRR = 2.12, 95% CI; 1.63, 2.76)]. Nonuse of modern methods was mostly due to desire for more children (30.6%), fear of side effects (12.2%) and partner refusal (5.2%).

Conclusion

Despite their high knowledge of FP, FCs have low use of modern FP methods. Key barriers to use of modern FP methods were high fertility desires, fear of perceived side effects and partner refusal of methods.     

Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria,Uganda

Background

In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC) strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3–5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria.

Methods

We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda.

Results

There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients’ physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient’s first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing.

Conclusions

Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers, misconceptions, and community-held beliefs. Interventions should also incorporate female partners into the SMC decision-making process and develop compensation strategies to address lost income during SMC recovery.     

Incidence of HIV-1 infection in a rural region of Uganda.

OBJECTIVE--To determine the incidence of infection with HIV-1 and the risk factors associated with seroconversion in three geographical strata of a rural Ugandan district. DESIGN--Serological, sociodemographic, and behavioural surveys of everyone aged 13 or more in 21 randomly selected communities at baseline and one year later. SETTING--Rural population of Rakai district, southwestern Uganda, residing in main road trading centres, secondary trading villages, and agricultural villages. SUBJECTS--In 1989, 1292 adults provided a blood sample and interview data; one year later, 778 survivors (77%) who had been seronegative at baseline provided follow up data. MAIN OUTCOME MEASURES--Incidence of HIV infection in relation to individual characteristics and risk factors, including place of residence. RESULTS--Incidence of HIV infection in all adults was 2.1/100 person years of observation (SE 0.5 (95% confidence interval 1.1 to 3.1)); in people aged 15-39 the incidence was 3.2/100 person years. Incidence was highest in men and women aged 20-24 (9.2/100 person years (3.9) and 6.8/100 person years (2.9) respectively). Risk factors significantly associated with seroconversion were age 24 and under and two or more sexual partners. Between the surveys the proportion of all respondents reporting high risk behaviour (two or more partners) significantly increased from 8.9% to 12.3%. CONCLUSIONS--Despite preventive programmes and substantial knowledge about AIDS the incidence of HIV infection remains high in this rural population. Prevention aimed at vulnerable rural communities is urgently needed to contain the HIV epidemic.     

Diversity of vascular plants on Ssese islands in Lake Victoria, central Uganda

Diversity and distribution of trees [≥5 cm diameter at breast height (dbh)], shrubs and herbs was assessed in thirty 0.05‐ha (10 × 50 m) plots of a tropical high forest in the Ssese islands of Lake Victoria, central Uganda. The aim was to determine the floristic richness and composition of the forests. We recorded 179 species belonging to 70 families and 146 genera. Of these, nine families had five species or more. Rubiaceae was the richest with fourteen species followed by Euphorbiaceae (thirteen), Apocynaceae (ten) and Moraceae (nine). The majority of the families (35) were represented by one species each. Fifty‐eight herbaceous species, 39 lianas, ten shrubs and 72 species of trees were recorded. The commonest species recorded in the forest included: Uapaca guineensis Mull. Arg., Tabernaemontana pachysiphon Stapf., and Aframomum luteoalbum (K Schum.) K. Schum. Among the rare species encountered were Ficus densistipulata De Willd., Englerophytum oblanceolatum (S. Moore) Pennington, and Afromomum zambeziacum (Bak.) K. Schum. The present study has shown that the Ssese islands are floristically rich in species and compare well with other mainland forests. Species richness, rarity and uniqueness of habitats can be considered as approaches in the prioritization of conservation sites within the fragmented forests of Ssese islands.     

Occult Glucose Intolerance: Incidence in a General Population

A survey of two-hour postprandial glycemic responses to an oral dose of 100 gm of glucose was conducted in 456 appparently healthy adult members of a small Southern California community. Serum glucose levels of 32 per cent of the men and 36 per cent of the women exceeded 140 mg per 100 ml at the two-hour sampling period.In both sexes, there was a tendency for hyperglycemia to become more conspicuous with age.Under the age of 50, a much higher percentage of women than men had seemingly excessive serum glucose values.These findings may suggest a need for modifying criteria currently used for interpreting glycemic responses to oral glucose challenges.     

Characterization of a Novel Population of Low-Density Granulocytes Associated with Disease Severity in HIV-1 Infection

The mechanisms resulting in progressive immune dysfunction during the chronic phase of HIV infection are not fully understood. We have previously shown that arginase, an enzyme with potent immunosuppressive properties, is increased in HIV seropositive (HIV+) patients with low CD4⁺ T cell counts. Here we show that the cells expressing arginase in peripheral blood mononuclear cells of HIV+ patients are low-density granulocytes (LDGs) and that whereas these cells have a similar morphology to normal-density granulocyte, they are phenotypically different. Importantly, our results reveal that increased frequencies of LDGs correlate with disease severity in HIV+ patients.     

A simulation model for nitrogen retention in a papyrus wetland near Lake Victoria,Uganda (East Africa)

Papyrus wetlands around Lake Victoria, East Africa play an important role in the nutrient flows from the catchment to the lake. A dynamic model for nitrogen cycling was constructed to understand the processes contributing to nitrogen retention in the wetland and to evaluate the effects of papyrus harvesting on the nitrogen absorption capacity of the wetlands. The model had four layers: papyrus mat, water, sludge and sediment. Papyrus growth was modelled as the difference between nitrogen uptake and loss. Nitrogen uptake was modelled with a logistic equation combined with a Monod-type nitrogen limitation. Nitrogen compartments were papyrus plants, organic material in the floating mat; and total ammonia, nitrate and organic nitrogen in the water, sludge and sediment. Apart from the uptake and decay rates of the papyrus, the model included sloughing and settling of mat material into the water, mineralization of organic matter, and nitrification and diffusion of dissolved inorganic nitrogen. Literature data and field measurements were used for parameterization. The model was calibrated with data from Kirinya wetland in Jinja, Uganda which receives effluent from a municipal wastewater treatment plant. The model simulated realistic concentrations of dissolved nitrogen with a stable biomass density of papyrus and predicted accumulation of organic sludge in the wetland. Assuming that this sludge is not washed out of the wetland, the overall nitrogen retention of the wetland over a three-year period was 21.5 g N m⁻² year⁻¹ or about 25% of input. Harvesting 10, 20 and 30% of the papyrus biomass per year increased nitrogen retention capacity of the wetland to 32.3, 36.8 and 38.1 g m⁻² year⁻¹, respectively. Although the nutrient flows estimated by the model are within the ranges found in other papyrus wetlands, the model could be improved with regard to the dynamics of detrital nitrogen. Actual net retention of nitrogen in the sludge is likely to be lower than 21.5 g N m⁻² year⁻¹ because of flushing out of the sludge to the lake during the rainy season.     

Highly Heterogeneous Soil Bacterial Communities around Terra Nova Bay of Northern Victoria Land,Antarctica

Given the diminished role of biotic interactions in soils of continental Antarctica, abiotic factors are believed to play a dominant role in structuring of microbial communities. However, many ice-free regions remain unexplored, and it is unclear which environmental gradients are primarily responsible for the variations among bacterial communities. In this study, we investigated the soil bacterial community around Terra Nova Bay of Victoria Land by pyrosequencing and determined which environmental variables govern the bacterial community structure at the local scale. Six bacterial phyla, Actinobacteria, Proteobacteria, Acidobacteria, Chloroflexi, Cyanobacteria, and Bacteroidetes, were dominant, but their relative abundance varied greatly across locations. Bacterial community structures were affected little by spatial distance, but structured more strongly by site, which was in accordance with the soil physicochemical compositions. At both the phylum and species levels, bacterial community structure was explained primarily by pH and water content, while certain earth elements and trace metals also played important roles in shaping community variation. The higher heterogeneity of the bacterial community structure found at this site indicates how soil bacterial communities have adapted to different compositions of edaphic variables under extreme environmental conditions. Taken together, these findings greatly advance our understanding of the adaption of soil bacterial populations to this harsh environment.     

The reproductive cycle of Mormyrus kannume Forsk. (Osteoglossomorpha, Mormyriformes) in Lake Victoria Uganda

The reproductive cycle of Mormyrus kannume Forsk. was studied for one year, at two locations near the equator in Lake Victoria. Samples taken on a typical feeding-ground indicate that the species is monoestrous; ripe specimens being found from November to January, maturation taking place gradually over the remaining nine months of the year. Samples taken at a typical spawning-ground, however, contain ripe fish over a prolonged period, from October to May and possibly June, and the period available for maturation is correspondingly short. The difference in the reproductive cycles at the two localities appears to be the result of successive waves of immigration to the spawning ground by different populations within the lake, each having a 12-month annual cycle, but not in phase with each other.     

Temporal and spatial variation in the occurrence of Palearctic warblers around Lake Victoria

Goudswaard, K. & Wanink, J.H. 2000. Temporal and spatial variation in the occurrence of Palearctic warblers around Lake Victoria. Ostrich 71 (1 & 2): 210–212.

Only one Palearctic warbler species, the Sedge Warbler, wintered at the south-eastem shores of Lake Victoria. Willow Warbler and Garden Warbler occurred mainly on passage, with peak values in the first lunar quarter, the period in which lakeflies would normally swarm. Higher warbler densities have been reported from the north-western shores. This agrees with our idea that the prevailing eastern winds will result in a higher availability of lakeflies to warblers at the western side of the lake.     

Natural Incidence of Metarhizium flavoviride Infection in Two Grasshopper Communities in Northern Benin

The infection of grasshoppers by naturally occurring entomopathogenic fungi was monitored at two sites in Malanville, northern Benin, Africa. Grasshoppers were collected during the monsoon seasons of 1993, 1994 and 1995. At the first site, 982 individuals of 38 grasshopper species were incubated. At the second site, 899 individuals of 33 grasshopper species were incubated. Two hyphomycete fungi (Deuteromycotina: Hyphomycetes), Metarhizium flavoviride Gams and Rozsypal and Sorosporella sp., were found infecting grasshoppers. The mean incidence of M. flavoviride infection was 0.3-1.7% at the first site and 1.2-3.2% at the second site for all grasshopper species. Sorosporella sp. was only collected from two grasshopper individuals in 1993. The majority of infected species had adult quiescence or continuously reproducing life cycles, and were either arboricolous or terricolous. Comparisons are made with a previous study of the two sites performed during 1992.     

Relatively Low HIV Infection Rates in Rural Uganda,but with High Potential for a Rise: A Cohort Study in Kayunga District,Uganda

Background

Few studies have been conducted in Uganda to identify and quantify the determinants of HIV-1 infection. We report results from a community-based cohort study, whose primary objectives were to determine HIV-1 prevalence, incidence, and determinants of these infections, among other objectives.

Methodology

Consenting volunteers from the rural district of Kayunga in Uganda aged 15–49 years were enrolled between March and July 2006. Participants were evaluated every six months. A questionnaire that collected information on behavioral and other HIV-1 risk factors was administered, and a blood sample obtained for laboratory analysis at each study visit.

Principal Findings

HIV-1 prevalence among the 2025 participants was 9.9% (95% CI = 8.6%–11.2%). By the end of 12 months of follow-up, 1689.7 person-years had been accumulated, with a median follow-up time of 11.97 months. Thirteen HIV-1 incident cases were detected giving an annual HIV-1 incidence of 0.77% (95% CI = 0.35–1.19). Prevalence of HSV-2 infection was 57% and was strongly associated with prevalent HIV-1 infection (adjusted Odds Ratio = 3.9, 95% CI = 2.50–6.17); as well as incident HIV-1 infection (adjusted Rate Ratio (RR) = 8.7, 95% CI = 1.11–67.2). The single most important behavioral characteristic associated with incident HIV infection was the number of times in the past 6 months, a participant had sex with person(s) they suspected/knew were having sex with others; attaining statistical significance at 10 times and higher (adjusted RR = 6.3, 95% CI = 1.73–23.1). By the end of 12 months of follow-up, 259 participants (13%) were lost to follow-up, 13 (0.6%) had died, and 2 (0.1%) had withdrawn consent.

Conclusions

Despite relatively low HIV-1 incidence observed in this community, prevalence remains relatively high. In the presence of high prevalence of HSV-2 infection and the behavioral characteristic of having sex with more than one partner, there is potential for increase in HIV-1 incidence.     

Reproductive biology of Bagrus docmak in the Victoria Nile,Uganda

Aspects of the reproductive biology of Bagrus docmak in the Victoria Nile were investigated between November 2005 and October 2006. Macroscopic and histological analysis of the gonads confirmed it as an asynchronous batch spawner which spawns throughout the year with bimodal spawning peaks coinciding with rainfall seasons. The first spawning peak occurred from March to May, the second from September to November. The sex ratio did not significantly deviate from 1:1. Length at sexual maturity was 33.6 cm and 31.6 cm fork length (FL) for females and males, respectively. Batch fecundity ranged from 1 000 eggs in 34 cm FL fish to 43 000 eggs in 79 cm FL fish, and correlated linearly with FL (r = 0.72) and body weight (r = 0.79). Mean relative batch fecundity was 6 eggs g^?1 (SE 2). These results could guide research into the possibility of artificially inducing the fish to spawn, and its subsequent culture.     

Deep Identity,Shallow Time: Sustaining a Future in Victorian Fishing Communities

Like commercial fishers everywhere, it seems, those living in coastal communities of Victoria perceive themselves to be under threat from recreational fishers, environmentalists, imposed management regimes, and modernisation and globalisation of the industry. In responding to these threats they appeal to conventional props of tradition—to continuity in genealogical time, affiliation with place and specialised knowledge and practice. This seems paradoxical, given that most established fishers in Victoria are first or second generation members of an industry that, through its 150‐year history, has been characterised by innovation and mobility. That paradox, we argue, is more apparent than real. Fisher identity is grounded primarily in engagement with an environment that is not familiar to outsiders. The paradox arises because fishers, like others who seek to sustain a future in the face of threat from outsiders, reshape strongly felt identity as tradition.     

Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria,Australia

BackgroundOut-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, AustraliaMethodsWe conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates.ResultsOver the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008–2010 to 68.6% in 2010–2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs.ConclusionSignificant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.     

Anaerobic Microbial Communities in Lake Pavin, a Unique Meromictic Lake in France

The Bacteria and Archaea from the meromictic Lake Pavin were analyzed in samples collected along a vertical profile in the anoxic monimolimnion and were compared to those in samples from the oxic mixolimnion. Nine targeted 16S rRNA oligonucleotide probes were used to assess the distribution of Bacteria and Archaea and to investigate the in situ occurrence of sulfate-reducing bacteria and methane-producing Archaea involved in the terminal steps of the anaerobic degradation of organic material. The diversity of the complex microbial communities was assessed from the 16S rRNA polymorphisms present in terminal restriction fragment (TRF) depth patterns. The densities of the microbial community increased in the anoxic layer, and Archaea detected with probe ARCH915 represented the largest microbial group in the water column, with a mean Archaea/Eubacteria ratio of 1.5. Terminal restriction fragment length polymorphism (TRFLP) analysis revealed an elevated archaeal and bacterial phylotype richness in anoxic bottom-water samples. The structure of the Archaea community remained rather homogeneous, while TRFLP patterns for the eubacterial community revealed a heterogeneous distribution of eubacterial TRFs.