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This study assessed the veterinary drug supply chain in Uganda, the constraints faced by the actors, and how the challenges influence the use of antimicrobial (AMs) by livestock farmers. We carried out stakeholder consultation workshops, key informant interviews and a knowledge, practices, and awareness survey with actors of the veterinary drug supply chain. We also profiled drugs stored in 23 urban and peri-urban drug shops in Lira and Mukono districts to record the commonly sold drugs. The veterinary drug supply chain is made of several actors including wholesalers, retailers, Animal Health Service Providers (AHSP) and farmers. Nearly ninety per cent of drug retailers and veterinary practitioners did not receive specialized training in veterinary medicine, and most of veterinary practitioners have been in the drug business market for more than 10 years. Antibiotics and anti-helminthics were the most stocked drugs by retailers, with antibiotics ranking highest in terms of contribution to annual financial profits, accounting for 33%. The choice of a drug by veterinary practitioners was mainly informed by past success with efficacy of the drug, and financial capacity of the client (the farmer) to meet the treatment cost. Many veterinary practitioners were not conversant with veterinary drug policies of the country, with Mukono having a higher number (72%) compared to Lira (37%). Veterinary practitioners from Lira district compared to Mukono and those mainly serving small scale farmers relative to large scale smallholders were more knowledgeable about antibiotics and AMR. Several supply chain constraints were identified as potential drivers of misuse of antibiotics that could contribute to AMR. These included low level of education of supply chain actors, particularly drug retailers, poor handling of drugs at purchase and administration practices, low enforcement of policies and regulations, and lack of awareness of stakeholders about policies that regulate drug use. Thus, future interventions to reduce misuse of AM drugs in livestock production systems in Uganda such as capacity building, should also target veterinary input suppliers, and deliberately involve a strong policy advocacy component.

Rudimentary non-market-oriented pig rearing systems have been implicated in the persistence of Taenia solium cysticercosis, an endemic disease of high public health concern in Uganda. We investigated the seroprevalence and key predisposing factors of the disease in Moyo and Lira, two pig-producing districts in Northern Uganda. Cross-sectional serosurveys were conducted in 428 pig farms (Moyo, 262; Lira, 166). Farmers kept on average two adult pigs per herd. Tethering was a common practice in rural areas; free-ranging less so. Confinement of pigs in pens was characteristic of periurban farming systems. Pigs were mainly fed crop residues and forages in the rainy season, and swill and crop residues in the dry season. The majority of farmers of the survey were women (55%) above 45 years old, and 51% of farmers had attained primary school education. A total of 723 pig serum samples were collected, 403 in Moyo, and 320 in Lira. They were analyzed for Taenia spp. antigens using B158C11A10/B60H8A4 Antigen-ELISA. The overall animal seroprevalence of Taenia spp. serum antigen was 10.4% (95% confidence interval [CI]: 4.9–17.6), with 13.2% (95% CI: 7.1– 21.2) the highest in Moyo vs 6.9% (95% CI: 2.9–13.9) in Lira. The herd-level seroprevalence was estimated at 13.7% (95% CI: 9.8–18.5) in Moyo and 11.4% (95% CI: 7.0–17.2) in Lira. Out of 12 explanatory variables assessed for association with the observed seroprevalence, only the district of origin was significant (p = 0.01). Pigs originating from Lira were a protective factor against Taenia spp. cysticercosis (odds ratio: 0.54). These findings highlight the urgent need for an awareness campaign with prevention and control measures to minimize the risk of transmission to pork consumers in these districts.

BackgroundHepatitis B is a global health problem. Trainees in the health-related fields are exposed to occupational risk of Hepatitis B Virus. In Uganda, there is scarcity of information on vaccination among students in health-care. The objective of this study was to assess hepatitis B vaccination status of the students and factors associated.Methods and findingsThis was a cross sectional study, conducted at Makerere University College of Health Sciences among undergraduate students who were eligible. A self-report on Hepatitis B vaccination status and various characteristics were collected on each participant, using a standardized structured self-administered questionnaire. Descriptive statistics were computed, bivariate and multivariate analysis were done using Stata 14.ResultsOut of 760 participants, 44.3% (95% CI 35.2-52.8) reported full vaccination. Vaccination was associated with gender, course, year of study and student's sponsorship. Males were less likely to be vaccinated, Prevalence Ratio (PR) 0.79; P-value ConclusionFull vaccination was low and given the high prevalence of needle injuries, it raises a safety concern. Vaccination should be mandatory for all students prior to clinical exposure. There is need for targeted interventions to increase uptake.