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Uganda Ready to Launch Full War against Malaria-President Museveni

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By Davidson Ndyabahika

Uganda’s President Yoweri Kaguta Museveni has made a commitment on behalf of Uganda in efforts towards the end of Malaria in Uganda. The president said in absence of a vaccine against malaria, community mobilisation, political will and strengthening research capacity will be prioritized in the fight against Malaria. 

“I have never known why the vaccine (against plasmodium) is impossible. But we are ready. I am ready to launch a full war against the mosquito and the plasmodium so that we are free from Malaria,” said President Museveni at the virtual webinar titled Rethinking Malaria in the Context of COVID-19 on Wednesday September 1, 2021.

His statement came after scientists highlighted the community engagement, commitment at both local and national level and evidence based decision making sine qua non in the successful fight against malaria.

The East African country has the 3rd highest global burden of malaria cases (5%) and the 8th highest level of deaths (3%) with the highest proportion of malaria cases in East and Southern Africa 23.7% according to the 2019 World Malaria Report of the World Health Organisation.

This global discussion sponsored by Harvard University, Makerere University among other partners sought to ‘take stock’ of the global malaria situation and offer insights on the most effective and innovative response to control and eliminate malaria across the globe. 

Research evidence show that Uganda has a stable, perennial malaria transmission in 95 percent of the country, with Anopheles gambiae s.l. and An. funestus s.l. being the most common malaria vectors.

Despite this, the country has made gains in so far prolonged robust and multipronged interventions.

A recent World Malaria Report shows that between 2016 and 2019, the estimated number of malaria cases decreased 7.2%, from 283 to 263 per 1 000 000 of the population at risk, while deaths fell 9.5% from 0.34 to 0.31 per 1000 of the population at risk over the same period.

However, in 2019, malaria cases increased in comparison to 2018 as the transmission peak was untypically long due to increased rains and aging of mosquito nets distributed in 2017/2018.

But president Museveni said Uganda has “been a bit leisurely in our handling of Malaria.” He contends that Ugandans have lived with Malaria for centuries but have not been as scared as of Coronavirus or with Ebola.

“In the case of Uganda, without a very acute health problem like the one of Ebola, corona, we were diverted with so many other things. Initially we were engaged in minimum recovery of the economy, we are now struggling with development and transformation but we actually take it up. And I would want to look at the figures. Supposing we eliminated Malaria and we reduce it to zero, how much would we save?” President Museveni.

He further observes that Malaria can be defeated citing that while the use of chemicals is good, he worries about their inefficiency since malaria causing parasites Plasmodium mutates and becomes immune to the therapeutics.

“We used to have Quinine therapy, I don’t know what happened to it. Then we had Chloroquine, I hear that it no longer affects Malaria. Whatever we are using now, the question is why should we preserve it? Why don’t we get rid of these mosquitoes? Or immunize people so that they become immune from the plasmodium?” President Museveni asked scientists.

He also underscored the role of behavioral change as a key public health measure in disease prevention. He highlights that majority diseases affecting Africans have in the past been managed and others can be managed through behavioral change.

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Boy Children Report More Physical & Emotional Abuse

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Men in the intervention group during the Parenting for Responsibility (PfR) project training session.

By George Kisetedde

On 3rd August, 2022, the CHDC (Child Health and Development Centre) disseminated study findings from one of the research studies carried out at the centre. These findings were presented under the title,“The Prevention of Violence against Children and Women: Baseline and Implementation Science Results from Parenting Cluster Randomised Trial.” Moderated by Dr. Anthony Batte, a lecturer at CHDC. Study findings were presented by Joseph Kahwa, the trial manager of the Parenting for Responsibility (PfR) project, under which this study falls.

Kahwa described PfR as a community based parenting programme delivered to both male and female parents. This programme aims to improve parenting skills, prevent violence against children, and to improve spousal relationships.

Findings from the study

Findings from this study showed that parents maltreat boy children more than girl children. The boys reported more emotional and physical violence than girls. Furthermore, the boy children reported that male caregivers specifically, maltreat them more. On the other hand, the girl children reported more sexual violence from caregivers than boys. On the whole, the children reported that female caregivers emotionally and physically abused them more compared to male caregivers.

More findings, according to Kahwa, showed that 46.5% of parents in Amuru can provide their children with soap to wash, 44.5% can provide school fees, 44.4% can provide school materials, 44.2% can provide new clothes, 43.3% can buy school uniform, and 35.9% can provide a pair of shoes.

How the research is conducted

The study is divided into 16 group sessions. The first 9 sessions are single sex, that is, male caregivers and female caregivers train separately. The next 7 sessions are mixed with male and female participants combined during training.

A mixed group parenting session for both men and women.
A mixed group parenting session for both men and women.

Kahwa explained that this programme was initiated to deal with VAC (violence against children) and IPV (intimate partner violence). These two vices are closely linked and have a significant impact on how children turn out.

Kahwa added that the PfR research programme aims at addressing the four major factors that may lead to VAC/IPV. These include; poor parental bonding, harsh parenting, unequal gender socialisation and spousal relationships.Poor parental bonding refers to the absence of a healthy close connection between a parent and their child. When a parent and child are not close, the parent may lack empathy for the child and the ability to perceive and respond to their child’s needs. When this bond is weak, a parent is unable to appreciate a child’s needs and can end up being unrealistically tough, which results in harsh parenting. Unequal gender socialisation generally refers to the different expectations that parents have of their children depending on their gender-male or female. The quality of the spousal relationship between parents also affects a child’s life. These four areas are what the parenting sessions concentrate on during the training.

The PfR study employed a cluster randomised controlled trial (RCT) design. Male and female caregivers were recruited from cluster villages in the Wakiso and Amuru districts in Uganda. One child aged 10 to 14 per household was randomly selected and assessed.

The caregivers were divided into two groups; the intervention group and the control group. The intervention group underwent all the 16 sessions of the training while the control group underwent a 2 session lecture on parenting. The impact of the PfR intervention was then ascertained by comparing baseline and endline results (or the before-and-after experiences of parents). The study participants were from 54 Villages selected in both Amuru and Wakiso districts. 108 caregiver groups (54 groups per intervention)were selected. This resulted in 2328 parents recruited and 886 children.

In conclusion, Mr. Kahwa said that maltreatment is still prevalent in the population. Generally, the PfR programme was well-received by parents and it had ad good attendance from parents. The programme also registered good male engagement. The peer facilitators who were recruited also had great potential in expanding the PfR programme at community level.

This study was conducted by Dr Siu Godfrey as the Principal Investigator. Other members of the team included Carolyn Namutebi, Richard Sekiwunga, Joseph Kahwa, Dr Betty Okot, and Martha Atuhaire. They were supported by the Director from CHDC, Dr. Herbert Muyinda and the CHDC Finance & Administration team. The team from Glasgow & Oxford Universities in the UK included, Prof Daniel Wight, Dr Jamie Lachman , Francisco Calderon and Dr Qing Han. On the other side, the team from the SOS Children’s Village from Gulu and Wakiso included, Rachel Kayaga, Sindy Auma Florence and Godfrey Otto.

Contact: George Kisetedde – kisetedde@gmail.com | Edited by Agnes Namaganda – agnesvioletnamaganda@gmail.com

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Makerere Medical Journal: Golden Jubilee Edition 2022

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Cover Page of the Makerere Medical Journal Golden Jubilee Edition 2022.

It’s with great pleasure that I welcome you to the Golden Jubilee edition of this phenomenal journal. Yes, The Makerere Medical Journal marks 50 years of publication with this year’s edition and all this has been made possible by the endless efforts and contributions of the Makerere University College of Health Sciences Staff and students because without your research submissions and financial support, the journal wouldn’t have made it this far. To you reading this, thank you for contributing to the sustainability of this great project, year in year out.

Here’s a quote to ponder on as you delve into this year’s well-crafted articles and it’s by Zora Hurston (1891-1960), “Research is formalized curiosity. It is poking and prying with a purpose.” And doesn’t that just define our purpose as researchers?!

This edition’s articles cover pertinent topics ranging from Antimicrobial Stewardship, COVID-19 interventions, Oral Health amongst others. It also features student projects, write-ups on student-led organizations and societies that are making a difference in the life of a health sciences’ student and many more interesting writings. Featured in this issue are international manuscripts from countries like Nigeria and we were also honored to work with other universities within the country and feature some of their students’ articles.

I would like to extend my most sincere gratitude to my team of editors that engaged in a rigorous peer review process to ensure that the articles published are up to standard. As the editorial team, we are quite pleased to see the number of undergraduates involved in research steadily increasing and all the efforts that have been put in by the different stakeholders to see this happen are commendable.

With that said, I hope you enjoy every second of your read!!!

LINDA ATULINDA,
MBChB IV

EDITOR-IN-CHIEF,
Research and Writers’ Club 2021-2022

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Call for Applications: HEPI Masters Support Fellowship

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Panelists L-R: Professor Elsie Kiguli-Malwadde, Professor Francis Omaswa, Professor Jehu Iputo and Professor Joel Okullo at the HEPI-ACHEST Health Professions Education Symposium, 17th June 2022, Makerere University.

Applications are invited for the Health Professional Education Partnership Initiative (HEPI-SHSSU) Masters fellowship programme support from postgraduate students of:

  • Makerere University College of Health Sciences (MakCHS)
  • Kabale University School of Medicine
  • Clarke International University
  • Faculty of Health Sciences, Busitema University

The programme will support graduates in their final year of training leading to the award of a Masters degree on any of the Master’s graduate training programs at the stated University for a maximum of 19 successful candidates.

The closing date for the receipt of applications is 30th September 2022.

Inquiries and Applications must be submitted to hepishssu@gmail.com

See attachment for more details 

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