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This work synthesized Ag/TiO 2 nanocomposite via an aqueous reduction method using a green and chemical reducing agent. Citrullus lanatus (watermelon) rind extract (WMRE) and sodium borohydride (NaBH 4 ) were used as the reducing agents during green synthesis and chemical synthesis, respectively. During green synthesis, a pH of 12, a reaction time of 45 min, and an operating temperature of 100 °C yielded the best visible light activity. The biosynthesized and chemically-synthesized Ag/TiO 2 were compared using UV-Vis spectroscopy, X-ray fluorescence spectroscopy (XRF), X-ray diffraction spectroscopy (XRD), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy-scanning electron microscopy (EDS-SEM) and transmission electron microscopy (TEM). Synthesis using WMRE yielded spherical Ag nanoparticles modified on the surface of TiO 2 nanoparticles. The Ag nanoparticles had enhanced monodispersity with an average diameter of 7.48  ±  4.06 nm. Therefore, the developed WMRE green synthesis method provides a simple, less chemical-intensive, and effective alternative to chemical synthesis., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Emilly Obuya reports financial support was provided by 10.13039/100000139United States Environmental Protection Agency. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Introduction: Uganda's community health worker (CHW), or village health team (VHT), program faces significant challenges with poor retention and insufficient financial and program investment. Adequate compensation comprising financial and non-financial components is critical to retaining any workforce, including CHWs. This study evaluates the impact of a recognition-based non-financial incentives package on the motivation, performance, and retention of VHTs, as well as on the utilization of health services by the community. The incentive package and intervention were developed in collaboration with the district-level leadership and award VHTs who have met predetermined performance thresholds with a certificate and a government-branded jacket in a public ceremony., Methods: A two-armed cluster randomized controlled trial (RCT), conducted at the parish level in Uganda's Masindi District, will evaluate the effects of the 12-month intervention. The cluster-RCT will use a mixed-methods approach, which includes a baseline/endline VHT survey to assess the impact of the intervention on key outcomes, with an expected sample of 240 VHTs per study arm; our primary outcome is the total number of household visits per VHT and our multiple secondary outcomes include other performance indicators, motivation, and retention; VHT performance and retention data will be validated using monthly phone surveys tracking key performance indicators and through abstraction of VHT-submitted health facility reports; and focus group discussions will be conducted with VHTs and community members to understand how the intervention was received. Data collection activities will be administered in local languages. To assess the impact of the intervention, the study will conduct a regression analysis using Generalized Estimating Equations adjusting for cluster effect. Further, a difference-in-differences analysis will be conducted., Discussion: This study utilized a cluster-RCT design to assess the impact of a recognition-based incentives intervention on the motivation, performance, and retention of VHTs in Uganda's Masindi District. Utilizing a mixed-methods approach, the study will provide insights on the effectiveness and limitations of the intervention, VHT perspectives on perceived value, and critical insights on how non-financial incentives might support the strengthening of the community health workforce., Trial Registration: ClinicalTrials.gov NCT05176106. Retrospectively registered on 4 January 2022., (© 2023. The Author(s).)

Introduction: Health workers' failure to adhere to guidelines for screening, diagnosis and management of HIV-associated cryptococcal meningitis (CM) remains a significant public health concern. We aimed to assess adherence to the standards of care and management of HIV patients at risk of CM per the MoH guidelines and assess stock management of CM supplies in the period of January to June 2021 at selected public health facilities (HFs) in Uganda., Methods: The study employed an observational cross-sectional design to assess the level of adherence of health workers to standards of clinical care and management of HIV positive patients at risk of CM as per the clinical guidelines for Uganda, and stock management of CM supplies in the period of January to June 2021in selected public health facilities. The study team used a survey guide designed by MoH to assess and score the screening, diagnosis and management practices of Health Facilities towards CM. Scoring was categorized as red (< 80%), light green (80%-95%), and dark green (˃95%) in the order from worst to best adherence. The data was transcribed into a spread sheet and analysed using STATA-v15., Results: The study team visited a total of 15 public health facilities including 5 general hospitals, 9 regional referral hospitals (RRHs) and 1 National Referral hospital (NRH). The mean score for adherence to screening and management of CM for all the combined facilities was 15 (64.7%) classified as red. 10 (66.7%) HFs had not performed a baseline CD4 test for eligible patients within 2 weeks of ART initiation. With regards to treatment, 9 (60%) of the HFs were scored as light green on knowledge of the procedure for reconstituting intravenous Liposomal Amphotericin B. None of the HFs visited had potassium chloride tablets in stock., Conclusion: Major MoH guidelines are generally not being adhered to by health workers while managing cryptococcal meningitis. It is vital that government and implementing partners regularly support HFs with training, mentorship, and support supervision on CM management to improve adherence to CM screening and treatment guidelines., Competing Interests: The Authors have declared that no competing interests exists., (Copyright: © 2023 Namuju et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)