Background: Food insecurity and malnutrition in children are pervasive public health concerns in Zimbabwe. Previous studies only identified determinants of food insecurity and malnutrition with very little efforts done in assessing related inequalities and decomposing the inequalities across household characteristics in Zimbabwe. This study explored socioeconomic inequalities trend in child health using regression decomposition approach to compare within and between group inequalities. Methods: The study used Demographic Health Survey (DHS) data sets of 2010\11 and 2015. Food insecurity in under-five children was determined based on the WHO dietary diversity score. Minimum dietary diversity was defined by a cut- off point of > 4 therefore, children with at least 3 of the 13 food groups were defined as food insecure. Malnutrition was assessed using weight for age (both acute and chronic under-nutrition) Z-scores. Children whose weight-for-age Z-score below minus two standard deviations (− 2 SD) from the median were considered malnourished. Concentration curves and indices were computed to understand if malnutrition was dominant among the poor or rich. The study used the Theil index and decomposed the index by population subgroups (place of residence and socioeconomic status). Results: Over the study period, malnutrition prevalence increased by 1.03 percentage points, while food insecurity prevalence decreased by 4.35 percentage points. Prevalence of malnutrition and food insecurity increased among poor rural children. Theil indices for nutrition status showed socioeconomic inequality gaps to have widened, while food security status socioeconomic inequality gaps contracted for the period under review. Conclusion: The study concluded that unequal distribution of household wealth and residence status play critical roles in driving socioeconomic inequalities in child food insecurity and malnutrition. Therefore, child food insecurity and malnutrition are greatly influenced by where a child lives (rural/urban) and parental wealth.

Long-term trend analysis at local scale for rainfall and temperature is critical for detecting climate change patterns. This study analysed historical (1980–2009), near future (2010–2039), mid- (1940–2069) and end-century (2070–2099) rainfall and temperature over Karamoja sub-region. The Modern Era-Retrospective Analysis for Research and Applications (MERRA) daily climate data provided by the Agricultural Model Inter-comparison and Improvement Project (AgMIP) was used. The AgMIP delta method analysis protocol was used for an ensemble of 20 models under two representative concentration pathways (RCPs 4.5 and 8.5). Historical mean rainfall was 920.1 ± 118.9 mm and minimum, maximum and mean temperature were 16.8 ± 0.5 °C, 30.6 ± 0.4 °C and 32.0 ± 0.7 °C, respectively. Minimum temperature over the historical period significantly rose between 2000 and 2008. Near future rainfall varied by scenario with 1012.9 ± 146.3 mm and 997.5 ± 144.7 mm for RCP4.5 and RCP8.5 respectively; with a sharp rise predicted in 2017. In the mid-century, mean annual rainfall will be 1084.7 ± 137.4 mm and 1205.5 ± 164.9 mm under RCP4.5 and RCP8.5 respectively. The districts of Kaabong and Kotido are projected to experience low rainfall total under RCP4.5 (mid-century) and RCP8.5 (end-century). The minimum temperature is projected to increase by 1.8 °C (RCP4.5) and 2.1 °C (RCP8.5) in mid-century, and by 2.2 °C (RCP4.5) and 4.0 °C (RCP8.5) in end-century.

Background: Africa is unlikely to end hunger and all forms of malnutrition by 2030 due to public health problems such as the double burden of malnutrition (DBM). Thus, the aim of this study is to determine the prevalence of DBM and degree of socio-economic inequality in double burden of malnutrition among children under 5 years in sub-Saharan Africa. Methods: This study used multi-country data collected by the Demographic and Health Surveys (DHS) Program. Data for this analysis were drawn from the DHS women’s questionnaire focusing on children under 5 years. The outcome variable for this study was the double burden of malnutrition (DBM). This variable was computed from four indicators: stunting, wasting, underweight and overweight. Inequalities in DBM among children under 5 years were measured using concentration indices (CI). Results: The total number of children included in this analysis was 55,285. DBM was highest in Burundi (26.74%) and lowest in Senegal (8.80%). The computed adjusted Erreygers Concentration Indices showed pro-poor socio-economic child health inequalities relative to the double burden of malnutrition. The DBM pro-poor inequalities were most intense in Zimbabwe (−0.0294) and least intense in Burundi (−0.2206). Conclusions: This study has shown that across SSA, among under-five children, the poor suffer more from the DBM relative to the wealthy. If we are not to leave any child behind, we must address these socio-economic inequalities in sub-Saharan Africa.

Background: Malaria remains a major tropical vector-borne disease of immense public health concern owing to its debilitating effects in sub-Saharan Africa. Over the past 30 years, the high altitude areas in Eastern Africa have been reported to experience increased cases of malaria. Governments including that of the Republic of Uganda have responded through intensifying programs that can potentially minimize malaria transmission while reducing associated fatalities. However, malaria patterns following these intensified control and prevention interventions in the changing climate remains widely unexplored in East African highland regions. This study thus analyzed malaria patterns across altitudinal zones of Mount Elgon, Uganda.Methods: Times-series data on malaria cases (2011–2017) from five level III local health centers occurring across three altitudinal zones; low, mid and high altitude was utilized. Inverse Distance Weighted (IDW) interpolation regression and Mann Kendall trend test were used to analyze malaria patterns. Vegetation attributes from the three altitudinal zones were analyzed using Normalized Difference Vegetation Index (NDVI) was used to determine the Autoregressive Integrated Moving Average (ARIMA) model was used to project malaria patterns for a 7 year period.Results: Malaria across the three zones declined over the study period. The hotspots for malaria were highly variable over time in all the three zones. Rainfall played a significant role in influencing malaria burdens across the three zones. Vegetation had a significant influence on malaria in the higher altitudes. Meanwhile, in the lower altitude, human population had a significant positive correlation with malaria cases.Conclusions: Despite observed decline in malaria cases across the three altitudinal zones, the high altitude zone became a malaria hotspot as cases variably occurred in the zone. Rainfall played the biggest role in malaria trends. Human population appeared to influence malaria incidences in the low altitude areas partly due to population concentration in this zone. Malaria control interventions ought to be strengthened and strategically designed to achieve no malaria cases across all the altitudinal zones. Integration of climate information within malaria interventions can also strengthen eradication strategies of malaria in such differentiated altitudinal zones.

Uganda is one of the few countries in Africa that has been experiencing outbreaks of viral hemorrhagic fevers such as Ebola, Marburg and Crimean-Congo Hemorrhagic fevers. In 2017 Uganda experienced a Marburg Virus Disease (MVD) outbreak with case fatality rate of 100% in Kween district. Although hunting for wild meat was linked to the MVD outbreak in Kween district, less was reported on the land use changes, especially the changing animal grazing practices in Kween district. Through Makerere University One Health graduate fellowship program with attachment to Uganda Red Cross Society, a study was conducted among the agricultural communities to elucidate the risk behaviors in Kween district that can be linked to the 2017 Marburg disease outbreak. Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to the MVD outbreak during FGDs, majority of participants linked MVD to settling in caves (inhabited by Fruit Bats) during wet season as upper belts are extensively used for crop production leaving little space for animal grazing. Members also noted side activities like hunting for wild meat during this grazing period that could have predisposed them to Marburg Virus. There is need to integrate One Health concepts within agricultural extension service provision in Uganda so as to enhance the management of such infectious diseases.

Objective: According to the United Nations, nearly 1.25 million people are killed and up to 50 million people are injured on the world’s roads every year. Uganda loses about 10 people daily to road accidents, costing about US$1.2 billion annually, which represents about 5% of the gross domestic product (GDP). The objective of this study was to identify causal factors that can be associated with boda-boda accidents in Uganda. Method: A cross sectional study assessed 200 boda-boda riders in the urban areas of Kampala, Uganda. Interviews using semistructured questionnaires were administered to all participants. Data were entered in Excel and imported to STATA for analysis. Multivariate and bivariate analyses were conducted to determine factors that influenced accident risk perception. All variables that were significant at a bivariate level and thought to be theoretically important in influencing the outcome variable were included in a logistic regression model. All tests were performed at a significance of P < .05. Results: Competition for passengers with other public transport operators (83%), negligence of road safety rules (78%), and inadequate helmet usage (62%) were the main factors perceived to be associated with boda-boda accidents. Other factors identified by the respondents include age of the boda-boda rider (58%) and drug use (56%; P < .05). At multivariate analysis, competition for passengers (adjusted odds ratio [AOR] = 17; 95% confidence interval CI, 1.34–26.5) and being in between 18 and 25 years old (AOR = 19; 95% CI, 1.42–27.1) remained statistically significant. Conclusions: This study revealed behavioral factors by all public transport users as the main factors associated with boda-boda accidents in urban Kampala. This demonstrates the need for holistic interventions to address such boda-boda accidents in Uganda. Such interventions can be through digitization of transport system for clients to engage remotely with the transport operators, routine refresher trainings of all transport operators, and construction of lanes for boda-boda riders.