Feeding patterns of sitatunga (Tragelaphus Speki) in the Rushebeya‐Kanyabaha wetland,south western Uganda

Feeding patterns and habits of sitatunga were assessed in Rushebeya‐Kanyabaha wetland between June 2006 and July 2007. Sixty transects were cut at intervals of 250 m along which sitatunga dung piles, habitats used and diet were identified from feeding signs or plant damage. Household interviews were also conducted in villages adjacent to the wetland to understand plants and crops known to be fed on by sitatunga, type of damage, frequency of sitatunga farm visits and their methods to control crop raiding. Sitatunga mostly fed on leaves (60%) and in the wetland edge (WE) habitat (49%). Forty plant species were recorded to be eaten with herbs as majority (33%) and of crops sweet potatoes were most raided. Sitatungas are basically solitary species with 73% of the sightings being of a single individual. They had mornings and late evenings as their movement peaks and preferred to feed on broad leaved plants. There were significant relationships between both habitat use and food preferences with seasons. We predict that because of seasonal food variations, crop raiding would increase and may result into more negative attitudes by farmers to sitatunga. More research on farmers’ sensitization, population census, behaviours and ecotourism are necessary for this species conservation.     

Digital adherence technology for tuberculosis treatment supervision: A stepped-wedge cluster-randomized trial in Uganda

BackgroundAdherence to and completion of tuberculosis (TB) treatment remain problematic in many high-burden countries. 99DOTS is a low-cost digital adherence technology that could increase TB treatment completion.Methods and findingsWe conducted a pragmatic stepped-wedge cluster-randomized trial including all adults treated for drug-susceptible pulmonary TB at 18 health facilities across Uganda over 8 months (1 December 2018–31 July 2019). Facilities were randomized to switch from routine (control period) to 99DOTS-based (intervention period) TB treatment supervision in consecutive months. Patients were allocated to the control or intervention period based on which facility they attended and their treatment start date. Health facility staff and patients were not blinded to the intervention. The primary outcome was TB treatment completion. Due to the pragmatic nature of the trial, the primary analysis was done according to intention-to-treat (ITT) and per protocol (PP) principles. This trial is registered with the Pan African Clinical Trials Registry (PACTR201808609844917). Of 1,913 eligible patients at the 18 health facilities (1,022 and 891 during the control and intervention periods, respectively), 38.0% were women, mean (SD) age was 39.4 (14.4) years, 46.8% were HIV-infected, and most (91.4%) had newly diagnosed TB. In total, 463 (52.0%) patients were enrolled on 99DOTS during the intervention period. In the ITT analysis, the odds of treatment success were similar in the intervention and control periods (adjusted odds ratio [aOR] 1.04, 95% CI 0.68–1.58, p = 0.87). The odds of treatment success did not increase in the intervention period for either men (aOR 1.24, 95% CI 0.73–2.10) or women (aOR 0.67, 95% CI 0.35–1.29), or for either patients with HIV infection (aOR 1.51, 95% CI 0.81–2.85) or without HIV infection (aOR 0.78, 95% CI 0.46–1.32). In the PP analysis, the 99DOTS-based intervention increased the odds of treatment success (aOR 2.89, 95% CI 1.57–5.33, p = 0.001). The odds of completing the intensive phase of treatment and the odds of not being lost to follow-up were similarly improved in PP but not ITT analyses. Study limitations include the likelihood of selection bias in the PP analysis, inability to verify medication dosing in either arm, and incomplete implementation of some components of the intervention.Conclusions99DOTS-based treatment supervision did not improve treatment outcomes in the overall study population. However, similar treatment outcomes were achieved during the control and intervention periods, and those patients enrolled on 99DOTS achieved high treatment completion. 99DOTS-based treatment supervision could be a viable alternative to directly observed therapy for a substantial proportion of patients with TB.Trial registrationPan-African Clinical Trials Registry (PACTR201808609844917).

Adithya Cattamanchi and co-workers report on a stepped-wedge trial of digital tuberculosis treatment supervision done in Uganda.