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Role of killer cell immunoglobulin-like receptors in the functional modulation of NK cell response to HIV-1 viral reservoirs in individuals on antiretroviral therapy
No full textA research report submitted to the Department of Immunology and Clinical Microbiology in partial fulfillment of the requirements for the award of Master’s Degree in Immunology and Clinical Microbiology of Makerere UniversitySub-Saharan Africa has two thirds of the global population living with HIV. Uganda has one of the highest burdens of HIV/AIDS globally, with a significant proportion of individuals on antiretroviral therapy. Complete remission to HIV is still not achieved by individuals on suppressive ART therapy. Studies have been conducted in Italy and in USA looking at how NKp44/Nkp30, NKG2D and blockade of NKG2A receptors on NK cells which can aid in the elimination of viral reservoirs. However, few studies are available in Sub-Saharan Africa as well as in Uganda in the use of NK cells to eradicate HIV viral reservoirs as well as how the Killer cell immunoglobulin-like receptors modulate NK cell function in the elimination of viral reservoirs. To determine the size of HIV-1 viral reservoirs and its association with KIRs on NK cells in individuals who have been on ART for more than 4 years. This was a longitudinal retrospective study using archived samples from the Rakai Community Cohort Study. To determine the frequency of NK cells expressing activating killer cell immunoglobulin-like receptors, NK cells were negatively isolated using an NK cell isolation. DNA was extracted using QIAamp DNA Mini Kit, ensuring high quality genomic material. Specific loci for KIR and HLA genes were amplified by PCR, using primers designed for each gene’s unique sequence regions. KIR genes were genotyped through Sanger sequencing, while HLA class I genes underwent high resolution genotyping using Next generation Sequencing. Sequence data were processed using alignment and variant calling software. To determine the frequency of latent HIV infection, resting CD4+ T cells were negatively isolated. The resting CD4+ T cells were then stimulated in limiting dilutions with PHA and γ- irradiated PBMC and co-cultured with MOLT-4 cells. The co-culture supernatant was then tested by ELISA for p24 on days 14 and 21. This study focused on the capability of NK cells expressing activating killer cell immunoglobulin-like receptors to eliminate HIV-1 viral reservoirs
Evaluation of the tenure-responsive land use planning process: case study of Kitumba Sub-County, Kabale District, Uganda
No full textA thesis submitted to the Department of Geomatics and Land Management in partial fulfilment of the requirements for the award of Master’s Degree of Science in Land ManagementSustainable land management and tenure security are critical issues for many Sub-Saharan African countries, including Uganda. Conventional Land Use Planning practices have often been disconnected from tenure security, leading to inefficient implementation and persistent challenges such as insecure land rights, and unsustainable land use. This study investigates the Tenure-Responsive Land Use Planning (TR-LUP) approach, an innovative model designed to integrate land tenure concerns into LUP processes to promote sustainable development and security of tenure. The research focuses on Kitumba sub- county, Kabale district, which serves as Uganda’s pioneer implementation site for TR- LUP. This research identifies a gap in understanding how TR-LUP is practically applied at the local level and whether it aligns with Uganda’s legal and regulatory frameworks. The study aims to evaluate the TR-LUP approach in comparison to conventional LUP, assess adherence to legal frameworks, and determine the approach's sustainability. Methodologically, the research employed a mixed-methods approach, including qualitative interviews with community members, local leaders, and policy implementers, alongside document analysis of planning records and legal frameworks. Quantitative data were also collected through surveys to assess community participation levels and perceived effectiveness. Data analysis involved thematic coding for qualitative responses and statistical analysis for survey results. The findings indicate that TR-LUP presents significant advantages over conventional LUP, including enhanced community participation and increased tenure security. However, challenges such as limited institutional capacity, inadequate resources, and inconsistent legal alignment were noted. The research highlights that while Kitumba’s experience demonstrates the potential of TR-LUP to support sustainable land management, strategic improvements in capacity building and resource allocation are necessary. The study concludes that TR-LUP, if effectively tailored to local contexts and supported by robust institutional frameworks, can contribute to sustainable land management and tenure security in Uganda. Recommendations include the development of localized guidelines based on TR-LUP principles, enhanced stakeholder collaboration, and targeted training programs to strengthen implementation capacities
Stop scandalising the court: revisiting the concept of contempt in the administration of justice in Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training for the award of a Master of Laws Degree of Makerere UniversityThe concept of Contempt of Court encompasses a range of intricate issues, including compromise and inequities within the administration of justice. These challenges arise despite the primary objective of the concept, which is to safeguard the judiciary and its officers from potential threats and to foster the effective administration of justice. This study highlights the historical progression of the concept. To establish its relevance and applicability, the research adopts a comparative framework, drawing upon the experiences and practices from India, Nigeria, and the United States; these case studies provide compelling insights into the administration of justice as it pertains to contempt of court in Uganda. Utilizing a qualitative research design, the study assesses various practices and the significance of contempt of court. It elucidates the conceptual definitions and proposes a theoretical framework upon which the concept may be founded. The research identifies the issue as one that demands meticulous consideration and critical analysis if contempt is to achieve its intended objectives. The findings reveal that the concept of contempt of court is quite abstract and ambiguous, even among judicial officers. However, its judicious application is essential, as it offers opportunities for enhancement within the justice system of the country. Nonetheless, the study underscores the necessity for checks and balances to ensure that the application of contempt provides consistency and equity within the Ugandan justice system. It is recommended that the concept of contempt can effectively promote the ends of justice if clear legislative guidelines are established, the competencies of judicial officers are improved, and the perception of contempt as a punitive measure is transformed. Moreover, it is imperative to ensure that the application of contempt remains insulated from external and political influences, in addition to conducting extensive research and documentation that would lead to a more meaningful implementation of the concept. Finally, courts should adopt a more open stance towards constructive criticism from legal counsel regarding the judiciary and its personnel
Assessment of the implementation of children’s right to participation in decision – making : a case of families in Gulu District, Northern Uganda
No full textA dissertation submitted to the College of Humanities and Social Sciences in partial fulfillment of the requirement for the award of Degree of Master of Arts in Human Rights of Makerere University.This study aimed to examine the implementation of children's right to participate in decision-making processes within families in Gulu District, Northern Uganda. The key respondents in this study were children aged between seven to seventeen years old and their parents or caregivers. The study was carried out in five (5) villages in Gulu district that were sampled from the sub-counties of Pece, Layibi, Laroo and Unyama. The study’s major objective was to establish the level of awareness of children’s right to participation in decision making in both homes and communities. Data was collected through administering questionnaires, interview guides and observation tools to the sampled population of children, caregivers, and key informants in the responsible for children. The major findings of the study were that majority of the children interviewed were both aware of their right to participation in decision making process and most of the organizations working with children. The research also indicated that there should be equality for all the children to participate. Majority of the respondents interviewed, revealed that Children should be involved in decision-making on all matters affecting their lives though a few had already been involved in making decisions that affected their lives. However, participation was dependent on the issue at hand and how it related to them. The key limitations to children’s right to participation in making decisions were attributed to age, incompetence to comprehend information and regrettable decisions. Due to the above limitations, the study recommended inclusive decision making where children are actively involved, this is through having more regular meetings with adults, especially those that involve decision-making. It was argued that children have a unique perspective to offer which is by virtue of belonging to a ‘different generation’, and therefore they have something new and unique to contribute to the discussion. Children are young and creative in nature, an aspect that is key in problem solving. Their involvement in decision making should be looked at as an asset in helping adults ‘think outside the box. Children are human beings by nature, it makes them rational beings, they have the capacity to acquire knowledge, process it and make rational decisions. Doing so not only benefits the children in terms of developing their negotiating, thinking, and networking skills, but it also helps ground decision-making process in the lived reality of children’s worlds. This further empowers them to enjoy their rights to participation, dignity and have a sense of belonging within the community they live in. In Conclusion although the study noted that different institutions dealing with children had formed school councils, youth forums and individual parents/careers to proactively engage children in decision-making processes, most of the respondents interviewed (children) were generally dissatisfied with the level of input of stakeholders when it came to inclusive decision making in schools, organizations, households, and communities they belonged in. Inherent power differences between children and adults were observed though this power can be negotiated as adults age
Integration of spatial econometric models in determining land values case study: Misindye Parish Mukono District
No full textA thesis submitted to the Department of Geomatics and Land Management for the Award of a Master’s Degree in Geoinformation Science and Technology of Makerere UniversityDetermination of land values is a fundamental aspect of finance because most times, these values are used to facilitate a sale, secured lending purposes, government compensation rates, property taxes. If Land values are not well determined, it can lead to losses and this can affect the economy. Occasionally, property valuers have difficulty in value determination, cases which have seen banks having non-performing loans, government over compensating for properties in compulsory acquisitions and local councils collecting low revenues from properties. Thus, in order to overcome some of these challenges, particularly valuation inaccuracies/variations, client influence, use of heurists and valuer misconduct, this study aims at using Spatial Econometric Models which have been developed and used to more accurately assess the real value of residential propertie
Mobility patterns of index tuberculosis cases and tuberculosis transmission niches in Kampala
No full textA dissertation report submitted to Makerere University in partial fulfilment of the requirements for a Master of Biostatistics DegreeIntroduction: TB control relies on minimizing transmission from infectious to susceptible individuals. In Uganda, Kampala faces significant TB challenges, with index cases playing a key role in disease spread. Understanding the mobility patterns of these cases is crucial for effective TB prevention and control. This study assesses the mobility patterns and potential transmission niches of index TB cases in Kampala city. Methods: A cross-sectional study analyzed secondary data of index TB cases from the Mapping Tuberculosis Transmission Study (MATTs) at baseline, which was conducted in Kampala from 2019 to 2023. MATTs focused on baseline, month 2, and month 6 follow-up visits by the index TB cases. Descriptive statistics summarized socio-demographic and clinical factors in this study. Box plots and a mixed-effects negative binomial model assessed factors associated with mobility patterns, with statistical significance set at p = 0.05. Results: Out of 298 index TB cases, 68.5% were male with a median age of 31 (IQR: 26–39). The majority were aged 31-45 (39.9%). About 48.3% were married, 58.7% had primary education, and 52% reported household incomes above 54 USD. Economic venues were the most visited (40.60%), transportation (18.01%), then social venues (15.74%). Females were 11% less likely than males to visit more locations [adjusted prevalence risk ratio =0.89, 95% CI: 0.83–0.95]. Index TB cases aged 24-30 years were 11% more likely [adjusted prevalence risk ratio =1.11, 95% CI: 0.99–1.21] to visit more places than those aged 18-23 years. Conclusion: Age, sex, and treatment history significantly influence index TB cases' mobility, with younger index TB cases and males with a higher likelihood of visiting more places, and those with treatment history had decreased mobility. Recommendations: To effectively reduce TB transmission risks, it is recommended to target mostly visited locations by highly mobile groups through enhanced screening and education in economic and transportation places with improved monitoring for individuals in the 24-45 age group
Prevalence of chronic kidney disease among young people living with HIV in Sub Saharan Africa: A systematic review and meta-analysis
No full textBackground
Globally, the prevalence of chronic kidney disease (CKD) is increasing among young people living with HIV (YPLHIV), with inconsistent estimates. Aggregated data on the prevalence of CKD are needed in sub-Saharan Africa (SSA) to inform strategies for early diagnosis and management. We conducted a systematic review and meta-analysis to estimate the pooled
prevalence of CKD among YPLHIV in SSA.
Methods
We searched Medline/PubMed, EMBASE, African Index Medicus, and African Journals Online for articles reporting the prevalence of CKD among YPLHIV in SSA using predefined search strategies up to 15th January 2024. The reference lists of identified articles were checked for additional eligible studies. The eligibility criteria were studies among YPLHIV aged 10–24 years reporting CKD prevalence defined by either glomerular filtration rate (GFR), albumin-to-creatinine ratio (ACR) or proteinuria. We used a narrative synthesis to report differences between the included studies. The DerSimonian-Laird random effects model was used to pool the CKD prevalence, and heterogeneity was assessed using the Cochrane Q-test and I-squared values. We assessed the risk of bias in each article using the Joanna Briggs Institute checklist and publication bias in a funnel plot and Egger’s test Results
Of 802 retrieved articles, 15 fulfilled the eligibility criteria and were included in the meta-analysis. Of these, 12 (80%) were cross-sectional studies that used estimated GFR to diagnose CKD. Only one study followed the standard definition of CKD. The pooled CKD prevalence from 15 studies was 12% (95% CI 6.0–19.5%), ranging from 0.8% to 53.1% according to the definition used, with a high degree of heterogeneity (I2 = 97.7%, p<0.001). The included studies were of moderate quality, with no evidence of publication bias. Sensitivity analysis showed that the findings were robust to the methodological and analytic approach.
Conclusion
CKD prevalence among YPLHIV is moderately high and highly heterogeneous across SSA. The standard definition of CKD should be used to enable estimation of CKD prevalence in different studies and settings. HIV programs enrolling YPLHIV should routinely screen for CKD to ensure early diagnosis and management
Nutrition-sensitive determinants of anemia among women of childbearing age in Eastern Uganda : a secondary analysis to inform nutrition programming
No full textA thesis submitted to the Directorate of Research and Graduate Training in partial fulfillment for the award of the Degree of Master of Science in Applied Human Nutrition of Makerere University.Anemia is associated with poor health status and poor birth outcomes among women of childbearing age. It is estimated to contribute to more than 115,000 maternal deaths and 591,000 prenatal deaths globally per year. Globally, in 2019 it was estimated that 30 percent of women 15–49 years were affected by anemia and in Eastern Uganda, the prevalence was 21 percent. In other areas, nutrition sensitive factors like…. are related to anaemia. However, the relationship between nutrition-sensitive determinants such as household women's dietary diversity, water sanitation hygiene, and anemia is less known. The study explored nutrition-sensitive determinants including; Household food security, Women's Dietary Diversity, and Water, Sanitation and Hygiene (WASH) conditions, in relation to anemia among women of reproductive age in Eastern Uganda. Secondary data from the 2019 Uganda National Panel Survey (UNPS) was used. Multistage stratified sampling was used to select 558 women of reproductive age included in the study. Anemia among pregnant women was defined as a hemoglobin value < 11 g/dL and non-pregnant women were < 12 g/ dL. Chi-square was used to assess the association between individual nutrition-sensitive determinants with anemia. The logistic regression model was used to assess the status of anemia, using R. Variance Inflation Factor (VIF) with values below 5 were indicated lack of multicollinearity among independent variables and retained in the logistic regression model. The overall prevalence of anemia among women was 18.3 percent (SD: 38.7 percent). In the pregnant women, the prevalence of anaemia was 24.3 percent (SD: 43.5 percent) and for non-pregnant was 17.8 (SD: 38.3 percent). The results revealed 24.4 percent of women’s households were food secure; 19% had acceptable dietary diversity, 94.3 percent had a source of water for drinking; 22.9 percent sanitation facilities, and only 7.3 percent practiced hand washing. The results show that only the Source of water for drinking: (χ2= 4.9893 p-value = 0.026) was significantly associated with anemia. The results from regression model demonstrated promising performance metrics, including the area under the curve (AUC) (81.2 percent) values. Women's dietary diversity (AOR =0.73; 95CI: 0.56–0.97), hand washing (AOR=0.72; 95CI: 0.14–0.91), pregnancy status (AOR=56.53; 95CI: 20.89–152.95) were associated with increased odds of being anemic while being wealthier reduced risk of anaemia (AOR=0.10; 95CI: 0.02–0.52) among women. The study findings of anaemia among women indicated a mild to moderate public health problem in eastern Uganda, and associated with several nutrition-sensitive determinants like women's dietary diversity, source of water for drinking, and hand washing practice
Continuing professional development of librarians in Public University Libraries in Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the Degree of Doctor of Philosophy in Information Science of Makerere UniversityContinuing professional development (CPD) of librarians is essential to maintain professional competencies for the provision of quality library services. This is particularly important in the rapidly changing digital environment. Despite the growing importance of CPD, librarians’ views and experiences of CPD have not been researched in Uganda. Therefore, the study aimed at exploring librarians’ views and experiences of CPD in public universities in Uganda. The study was grounded within the social constructivist learning theories. From this perspective, learning is viewed as situated in context, through active participation in social practices. The study adopted an interpretivist paradigm and a qualitative multi-case study. Interviews, focus groups, document analysis, and observations were the data collection methods. Purposive, and snowball sampling techniques were used to select 37 librarians. The data were analysed using abductive thematic analysis with the aid of qualitative data analysis software package, ATLAS.ti version 8.4.26. The findings revealed that CPD is a complex concept with various meanings and interpretations. Additionally, the term CPD is not commonly used within the university setting. The participants valued CPD as a means of keeping up-to-date, developing new knowledge, and skills, career advancement, personal growth, and development. The participants valued CPD activities that were relevant to their learning needs, and provided opportunities for active participation networking and collaboration with colleagues. However, several contextual factors affected individual participation in CPD activities positively and negatively. The participants recommended increasing awareness about CPD, personal commitment to CPD, and mandatory CPD. The study concluded that adequate regulatory frameworks should be put in place to strengthen the planning, implementation, monitoring, and evaluation of librarians’ CPD. Finally, a CPD framework for enhancing CPD of librarians in public universities in Uganda was proposed.SID
Challenges in the realisation of reproductive rights among rural women in Uganda: a case study of Namugongo sub-county, Kaliro district in Eastern Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the degree of Master of Arts in Human Rights of Makerere UniversityThis study was carried out on the challenges in the realization of reproductive rights among the rural women in Uganda, with a case study of Namugongo Sub County in Kaliro district. The study set out to identify the contributors to unmet need for contraception, assessed the legal frameworks, and established the measures to address the challenges in the realization of women’s reproductive right to contraception among the rural women. Unmet need for contraception, stands at 28.4% of all married women in Uganda. An understanding of women’s contraceptive behaviors, and the motivations that drive these are key to tackling unmet need, by way of designing, implementing and improving family planning programs to effectively meet the needs of rural women. Analysis of data highlighted three major themes pertaining to the complex, multi-level nature of contributors to unmet need and women’s use of contraception in Namugongo Sub County. With a largely patriarchal society, rural women had to navigate many obstacles. Some of these included: fears about contraceptive side effects; partner opposition, community beliefs and stigma that dissuaded contraceptive use; traditional gender and socio- cultural norms that dictated women’s fertility choices; and service delivery limitations. In order to make contraceptives more accessible to women in Uganda, there is need to increase male acceptance of contraception, encourage joint decision-making on matters of reproductive health and changing the community narratives about family planning through testimonies from satisfied users. Male opposition to contraceptive use leads to the clandestine use of contraceptives and the use of traditional rather than the modern methods of contraception