Objective To examine how adults with epilepsy in Uganda experienced epilepsy self-management, stigma, and care following participation in a peer-led intervention (SMART-U) compared to enhanced treatment as usual (ETAU). Methods This qualitative study was embedded within an ongoing randomized controlled trial at two university neurology clinics. A purposive subsample from both study arms completed semi-structured interviews at 13 (n = 16) and 24 weeks post-intervention (n = 16). Interviews explored perceived benefits and challenges of care, self-management behaviors, stigma and recommendations for improvement. Transcripts were analyzed using thematic analysis. Results Four themes emerged: barriers to self-management, self-management behaviors and attitudes, participant perspectives on care, and facilitators of self-management. Participants in both groups described significant structural and social barriers, including stigma, limited support, and challenges accessing care. However, SMART-U participants more frequently reported increased confidence, engagement in proactive self-management (e.g., stress management, planning around seizures), improved communication with providers, and greater ability to cope with stigma. In contrast, ETAU participants more often characterized epilepsy care as provider-driven, with fewer changes in attitudes or behaviors. Over time, SMART-U participants demonstrated clearer shifts toward self-efficacy and a more reflective understanding of epilepsy. Conclusions Peer-led self-management support may enhance engagement, coping, and self-efficacy among people with epilepsy in resource-limited settings. Addressing stigma and strengthening social and healthcare support may be critical for improving outcomes in low-middle income countries.
Bacterial Leaf Blight (BLB), caused by Xanthomonas oryzae pv. oryzae (Xoo), has recently emerged as a critical threat to rice production in East and Southern Africa (ESA). Since 2019, confirmed outbreaks in Tanzania and Madagascar, and more recently, signs of the disease in Kenya and Uganda, have exposed vulnerabilities within the region's rice sector. Despite these developments, published data from ESA remain extremely limited, with only a handful of confirmed reports and scarce molecular characterization beyond Tanzania and Madagascar. This Perspective consolidates the current evidence on the expansion of BLB, reveals critical gaps in research and management and proposes a comprehensive seven-pillar management framework. Building long-term resilience against BLB in ESA will require a unified, science-driven approach that integrates innovative methods with proven practices and effective policy support. Success will also depend on merging traditional and scientific knowledge with forward-thinking research and coordinated policy development. Moreover, leveraging historical data, adopting advanced analytics and using modern technologies, such as early detection sensors, digital advisory services and real-time pathogen tracking, could empower smallholder farmers and improve regional response capacities.
In case of a disease, the family system can function as a burden or a resource and support system. The genogram (a visual depiction of the patient’s family relationships and other relevant information) helps the doctor to get a clear understanding of symptoms, life events, and diseases across three generations. The different phases of the family dialogue are: joining, context and mission clarification, questions about family dynamics and psychological resources and challanges, treatment planning, and conclusion of the interview. The following communication techniques can proof to be useful tools in conducting a family interview: direct disease-related questions, indirect or circular questions, and hypothetical questions.
The COVID-19 pandemic intensified employees' challenges in balancing work and family roles, heightening concerns about work-life conflict (WLC) and turnover intentions (TOIs). This study examines the effect of work-life conflict, captured as work-to-family conflict (WFC) and family-to-work conflict (FWC), on TOIs, and the mediating role of job embeddedness (JE) among health-service employees in India and Uganda. Using survey data, the study conducts separate country-specific analyses and a combined dataset analysis to provide a comparative perspective. Findings reveal that WFC significantly increases TOIs in Uganda, while FWC drives TOIs in India. Job embeddedness reduces TOIs in both countries. In Uganda, both WFC and FWC significantly influence JE, whereas in India, only FWC has a significant effect. JE has a direct effect on TOIs in India but not in Uganda. Mediation results show that FWC indirectly affects TOIs through JE in India, while no indirect effects are observed in Uganda. In the combined-country analysis, both WFC and FWC significantly affect JE and TOIs, with JE partially mediating these relationships. Overall, the findings underscore the importance of contextual differences in shaping work-life conflict dynamics, job embeddedness, and turnover intentions, offering valuable theoretical and managerial insights for emerging economies during crisis periods.
British colonial urban planners in Kampala, Uganda, designed segregated neighborhoods for Europeans, Asians, and Africans, under the colonial public health guidance. No studies have investigated how these historical urban design decisions relate to modern air pollution exposure disparities in African cities. We sought to determine whether colonial-era racial segregation of settlements in Kampala, Uganda, influences modern intra-urban spatial distribution of ambient fine particulate matter (PM2.5) concentrations in the city. Using an urban network of 52 low-cost PM sensors, we estimated monthly PM2.5 concentrations across Kampala from 2021 to 2022. We manually digitized and correlated 2020 satellite imagery and street maps of the three historical boundaries of European/Asian and African settlements from a 1951 map. Extreme gradient boosting trees, random forest models, and empirical Bayes kriging were used to predict gridded monthly PM2.5 averages for the study area. We used non-parametric statistical tests and multivariable linear regression to compare monthly PM2.5 levels between European/Asian and African settlements. We observed significantly higher median monthly PM2.5 concentration in African settlements (median = 33.0 mu g/m3 [interquartile range = 28.2, 39.3]) compared to European/Asian areas (median = 28.8 mu g/m3 [IQR = 25.2, 33.5]). In crude linear regression models, African settlements had a higher PM2.5 concentration by 9.2% (95% CI: 6.4, 18.5). African settlements showed greater seasonal PM2.5 variations and higher current social vulnerability. This study highlights the enduring influence of colonial urban planning on today's environmental health inequalities.
