Consumer awareness of the presence of pesticides in fruits and vegetables and associated health r... more Consumer awareness of the presence of pesticides in fruits and vegetables and associated health risks influences the actions they undertake to reduce their exposure. This study was carried out to explore consumers’ awareness of pesticide residues in fruits and vegetables and perceptions towards associated health effects in Kampala Metropolitan Area (KMA) in Uganda. Eight focus group discussions (FGDs) were done with fruit and vegetables consumers in KMA. The FGDs consisted of females and males living in urban and rural areas. Discussions were recorded and transcribed. The transcripts were coded inductively and analysed using conventional content analysis. Consumers were aware of the presence of pesticide residues in fruits and vegetables. Non-compliance to good agricultural practices, desire to produce good quality fruits and vegetables, and conflict of interest were thought to be the underlying reasons for the contamination. Consumers thought that their health is at risk of chronic and acute health effects, and that this risk is unavoidable. They emphasized that long term exposure to the pesticide residues puts them at risk of conditions like reproductive defects and noncommunicable diseases like cancer, hypertension, obesity, kidney and heart diseases among others. To reduce the risk, consumers were aware of and relied on mitigation measures including washing, peeling, drying and cooking or applied them in combination. Consumers were aware of the presence of pesticide residues on fruits and vegetables, potential short and long term health risks due to exposure, and domestic processing methods to reduce health risks. There is need for authorities to ensure adherence to good agricultural practices and ensure that farmers and consumers understand that pesticide are used to control pests and disease but not to primarily increase shelf life of fruits and vegetables.
Background The role of human, animal and environmental health workers is increasingly being recog... more Background The role of human, animal and environmental health workers is increasingly being recognized and linked to the emergence and transmission of antimicrobial resistance (AMR). Little has been done in low and middle-income countries despite the seriousness of this public health challenge. Our study explored the perspectives of health workers on the occurrence, transmission, and management of AMR at the human-animal-environment interface. Methods We conducted a descriptive qualitative study within Wakiso district, central Uganda between August and October 2022, using focus group discussions (4) with village health teams (VHTs) and key informant interviews (12) with other cadres of health workers. Data were managed in NVivo 12 and analyzed using thematic network analysis exploiting both deductive and inductive approaches. Findings: Animal health workers had better knowledge of AMR occurrence compared to their counterparts from the human and environmental health sectors. VHTs had...
Background: The utilization of “on-site excreta decomposition technology” known as “Ecological sa... more Background: The utilization of “on-site excreta decomposition technology” known as “Ecological sanitation (Ecosan)” has a rational use of human excreta. It is a resource-oriented sanitation mostly feasible in areas with rocky soil and prone to agriculture. This technology was implemented in Rwanda for more than a decade. However, little is known about Ecosan utilization in the process of scale-up in the community. Aim: The study was carried out to determine enablers and barriers associated with the utilization of Ecosan in Burera district, Rwanda. Methods: A mixed method study was surveyed in 374 households with Ecosan. A systematic random sampling was used to select respondents and a sample was drawn from the 3 administrative sectors of Burera district. We interviewed 20 key informants that included community leaders and sanitation actors. Bivariate, ordered logistic regression with thematic content analysis were used. Results: Ecosan users were unable to practice both urine divers...
BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) ar... more BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) are a leading cause of acute respiratory symptoms, and long-term health impacts such as respiratory diseases, heart diseases and cancers. In Uganda, literature on the effects of IAP on respiratory outcomes in informal settlements is limited. This study investigated the association of selected IAPs and cooking fuels with respiratory symptoms among children and adults.MethodsThis study was conducted among 284 households in an informal settlement in Uganda from April to May 2022. Information on indoor air conditions, fuel type and adults reported the respiratory symptoms of their children as well as their respiratory symptoms within the previous 30 days. Same-day concentrations of PM less than 2.5 μm (PM2.5) and less than 10 μm(PM10) in diameter were monitored from 9 am to 2 pm using Temptop M2000c 2nd edition particle sensor while CO was measured using a carbon monoxide meter. Robust Poisson...
Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates ... more Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates the use of several malaria prevention methods holistically, has been proposed. However, before conducting an RCT, it is recommended that a feasibility study is carried out to provide information to support the main study, particularly for such a complex intervention. Therefore, a feasibility study for an RCT on integrated malaria prevention in Uganda was conducted. Methods The qualitative study carried out in Wakiso District employed focus group discussions (FGDs) and key informant interviews (KIIs) to explore community willingness to participate in the RCT as well as assess stakeholder perspectives on the future study. The participants of the FGDs were community members, while the key informants were selected from malaria stakeholders including Ministry of Health officials, health practitioners, local leaders, district health team members, and community health workers (CHWs). Thematic a...
Objective Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural U... more Objective Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural Ugandan population. Methods In a cross-sectional study, 171 smallholder farmers performed spirometry with copd-6, and a diagnostic-quality spirometer. Results and discussion The copd-6 underestimated FEV1 at low flows and overestimated FEV1 at high flows. Across all participants, the device slightly overestimated FEV1 by 0.04 [0.02; 0.06] L. Calibration data showed similar patterns. Conclusion The copd-6 could be considered as an affordable tool for research on lung function impairment in resource-constrained settings. However, further validation in a study population with obstructive lung disease is needed.
Introduction and aimExposure to some insecticides may cause airway obstruction, but existing evid... more Introduction and aimExposure to some insecticides may cause airway obstruction, but existing evidence is limited by cross-sectional designs and inadequate confounder control. We investigated the relation between organophosphate and carbamate insecticides and pulmonary function in a prospective study accounting for important confounders.MethodsIn a cohort of 364 smallholder farmers in Uganda (69% women), participants underwent pre-bronchodilator spirometry at baseline (September/October 2018) and at two follow-up visits (November/December 2018 and January/February 2019). Exposure to carbamate and organophosphate insecticides was assessed using haemoglobin-adjusted erythrocyte acetylcholinesterase (AChE/Hb). Less than 3% of participants were lost to follow-up. We calculated Z-scores for FEV1, FVC and FEV1/FVC using the Global Lung Function Initiative equations. Data were analysed in linear mixed and fixed effect models accounting for family relationships and repeated measures of expos...
Consumer awareness of the presence of pesticides in fruits and vegetables and associated health r... more Consumer awareness of the presence of pesticides in fruits and vegetables and associated health risks influences the actions they undertake to reduce their exposure. This study was carried out to explore consumers’ awareness of pesticide residues in fruits and vegetables and perceptions towards associated health effects in Kampala Metropolitan Area (KMA) in Uganda. Eight focus group discussions (FGDs) were done with fruit and vegetables consumers in KMA. The FGDs consisted of females and males living in urban and rural areas. Discussions were recorded and transcribed. The transcripts were coded inductively and analysed using conventional content analysis. Consumers were aware of the presence of pesticide residues in fruits and vegetables. Non-compliance to good agricultural practices, desire to produce good quality fruits and vegetables, and conflict of interest were thought to be the underlying reasons for the contamination. Consumers thought that their health is at risk of chronic and acute health effects, and that this risk is unavoidable. They emphasized that long term exposure to the pesticide residues puts them at risk of conditions like reproductive defects and noncommunicable diseases like cancer, hypertension, obesity, kidney and heart diseases among others. To reduce the risk, consumers were aware of and relied on mitigation measures including washing, peeling, drying and cooking or applied them in combination. Consumers were aware of the presence of pesticide residues on fruits and vegetables, potential short and long term health risks due to exposure, and domestic processing methods to reduce health risks. There is need for authorities to ensure adherence to good agricultural practices and ensure that farmers and consumers understand that pesticide are used to control pests and disease but not to primarily increase shelf life of fruits and vegetables.
Background The role of human, animal and environmental health workers is increasingly being recog... more Background The role of human, animal and environmental health workers is increasingly being recognized and linked to the emergence and transmission of antimicrobial resistance (AMR). Little has been done in low and middle-income countries despite the seriousness of this public health challenge. Our study explored the perspectives of health workers on the occurrence, transmission, and management of AMR at the human-animal-environment interface. Methods We conducted a descriptive qualitative study within Wakiso district, central Uganda between August and October 2022, using focus group discussions (4) with village health teams (VHTs) and key informant interviews (12) with other cadres of health workers. Data were managed in NVivo 12 and analyzed using thematic network analysis exploiting both deductive and inductive approaches. Findings: Animal health workers had better knowledge of AMR occurrence compared to their counterparts from the human and environmental health sectors. VHTs had...
Background: The utilization of “on-site excreta decomposition technology” known as “Ecological sa... more Background: The utilization of “on-site excreta decomposition technology” known as “Ecological sanitation (Ecosan)” has a rational use of human excreta. It is a resource-oriented sanitation mostly feasible in areas with rocky soil and prone to agriculture. This technology was implemented in Rwanda for more than a decade. However, little is known about Ecosan utilization in the process of scale-up in the community. Aim: The study was carried out to determine enablers and barriers associated with the utilization of Ecosan in Burera district, Rwanda. Methods: A mixed method study was surveyed in 374 households with Ecosan. A systematic random sampling was used to select respondents and a sample was drawn from the 3 administrative sectors of Burera district. We interviewed 20 key informants that included community leaders and sanitation actors. Bivariate, ordered logistic regression with thematic content analysis were used. Results: Ecosan users were unable to practice both urine divers...
BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) ar... more BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) are a leading cause of acute respiratory symptoms, and long-term health impacts such as respiratory diseases, heart diseases and cancers. In Uganda, literature on the effects of IAP on respiratory outcomes in informal settlements is limited. This study investigated the association of selected IAPs and cooking fuels with respiratory symptoms among children and adults.MethodsThis study was conducted among 284 households in an informal settlement in Uganda from April to May 2022. Information on indoor air conditions, fuel type and adults reported the respiratory symptoms of their children as well as their respiratory symptoms within the previous 30 days. Same-day concentrations of PM less than 2.5 μm (PM2.5) and less than 10 μm(PM10) in diameter were monitored from 9 am to 2 pm using Temptop M2000c 2nd edition particle sensor while CO was measured using a carbon monoxide meter. Robust Poisson...
Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates ... more Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates the use of several malaria prevention methods holistically, has been proposed. However, before conducting an RCT, it is recommended that a feasibility study is carried out to provide information to support the main study, particularly for such a complex intervention. Therefore, a feasibility study for an RCT on integrated malaria prevention in Uganda was conducted. Methods The qualitative study carried out in Wakiso District employed focus group discussions (FGDs) and key informant interviews (KIIs) to explore community willingness to participate in the RCT as well as assess stakeholder perspectives on the future study. The participants of the FGDs were community members, while the key informants were selected from malaria stakeholders including Ministry of Health officials, health practitioners, local leaders, district health team members, and community health workers (CHWs). Thematic a...
Objective Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural U... more Objective Evaluate the accuracy and precision of the copd-6 mini-spirometer for FEV1 in a rural Ugandan population. Methods In a cross-sectional study, 171 smallholder farmers performed spirometry with copd-6, and a diagnostic-quality spirometer. Results and discussion The copd-6 underestimated FEV1 at low flows and overestimated FEV1 at high flows. Across all participants, the device slightly overestimated FEV1 by 0.04 [0.02; 0.06] L. Calibration data showed similar patterns. Conclusion The copd-6 could be considered as an affordable tool for research on lung function impairment in resource-constrained settings. However, further validation in a study population with obstructive lung disease is needed.
Introduction and aimExposure to some insecticides may cause airway obstruction, but existing evid... more Introduction and aimExposure to some insecticides may cause airway obstruction, but existing evidence is limited by cross-sectional designs and inadequate confounder control. We investigated the relation between organophosphate and carbamate insecticides and pulmonary function in a prospective study accounting for important confounders.MethodsIn a cohort of 364 smallholder farmers in Uganda (69% women), participants underwent pre-bronchodilator spirometry at baseline (September/October 2018) and at two follow-up visits (November/December 2018 and January/February 2019). Exposure to carbamate and organophosphate insecticides was assessed using haemoglobin-adjusted erythrocyte acetylcholinesterase (AChE/Hb). Less than 3% of participants were lost to follow-up. We calculated Z-scores for FEV1, FVC and FEV1/FVC using the Global Lung Function Initiative equations. Data were analysed in linear mixed and fixed effect models accounting for family relationships and repeated measures of expos...
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Papers by John Ssempebwa