Background. Artisanal and small-scale gold mining is a human health concern, especially in low-income countries like Uganda due to the use of mercury (Hg) in the mining process. Objective. The aim of the present study was to assess Hg exposure among artisanal and small-scale gold miners in Uganda through biologic monitoring parameters and Hg-related clinical manifestations. Methods. A cross-sectional study was conducted from June to July 2018 among 183 miners from Ibanda (Western region), Mubende (Central region), Amudat (Karamoja region) and Busia (Eastern region) in Uganda. An interviewer-administered questionnaire and health assessment were used to collect socio-demographic, exposure and self-reported Hg poisoning symptoms. In addition, 41 urine, 41 blood and 26 environment samples were assessed. Descriptive statistics, Kruskal-Wallis test and Wilcoxon signed-rank test for comparison of Hg levels in urine and blood among miners were performed while logistic regression was used to assess associations between exposure and Hg poisoning-related symptoms. Results: The miners ranged from 15 to 65 years old and were primarily male (72.6%). The majority (73.3%) had worked directly with Hg for an average duration of 5.3 years. Symptoms associated with working directly with Hg included chest pain (odds ratio (OR)=9.0, confidence interval (CI)=3.3 to 24.6), numbness (OR=8.5, CI=2.1 to 34.4), back pain (OR=6.2, CI= 2.2 to 17.5), fatigue and stress (OR=5.4, 2.0 to CI=14.9), headache (OR=4.7, CI=1.9 to 11.3), dizziness (OR=3.8, CI=1.5 to 9.7) joint pain (OR=3.2, CI=1.3 to 8.3) and respiratory problems (3.2, 1.0 to 10.1). Statistically significant differences in Hg levels with p-values less than 0.05 were observed across district, gender and type of work. Mubende had the highest blood and urine levels (136 μg/l and 105.5 μg/l) in comparison with Busia (60 μg/l and 70.6 μg/l) and Ibanda (43 μg/l and 58 μg/l). Females (84.7 μg/l), panners (109 μg/l) and those with knowledge of occupational health and safety measures (95.6 μg/l) reported higher levels of Hg in urine. The average levels of Hg in water and soil samples were 23.79 μg/l and 0.21 μg/l, respectively. Conclusions. Variation in Hg levels were attributed to varied duration of exposure across geographical sites. There was considerable exposure to Hg as indicated by both clinical manifestations and biologic parameters among miners in Uganda with Hg in urine exceeding the recommended thresholds. Participant Consent. Obtained Ethics Approval. Ethical approval was obtained from the Makerere University School of Health Science Institutional Review Board (reference number SHSREC REF 2018–2019) and Uganda National Council for Science and Technology (reference number SS 4577) Competing Interests. The authors declare no competing financial interests.

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Background: Health inequalities in unmet need for family planning have been documented in Uganda, however, little is known about their magnitude and whether these have remained the same. Objective This study sought to examine health inequalities in unmet need for family planning among Ugandan women between 15-49 years of age in the years 2014 to 2018. Methods: Five data sets of the Performance Monitoring Accountability 2020 family planning cross-sectional surveys were used to assess health inequalities in unmet need for family planning across four socio-economic position variables (age, education, wealth status and geographical location) at five time points (2014 to 2018).Chi-square (χ 2 ) test and a logistic regression-based measure, the Relative Index of Inequality (RII) were used to assess differences and relative health inequalities respectively. Results: The data of 19,670 women aged 15 to 49 years were analysed. Between 2014 and 2018, unmet need for family planning (limiting, spacing and total) were 2 or more times more prevalent among the uneducated (RII value range:1.94 to 2.73), and poorest women(RII value range:1.90 to 3.78), in comparison with women with post-secondary education and richest women respectively. Unmet need for family planning was more prevalent among women older than 35 years (RII between 0.41 and 0.63). No geographic-related health inequalities were observed. Education-related inequalities reduced, wealth-related health inequalities increased, while age-related inequalities remained fairly consistent. Conclusion: Age, education and wealth related health inequalities were observed in unmet need for family planning. The magnitude of health inequalities varied between 2014 and 2018, with largest inequalities based on wealth status variable.

Mass gatherings frequently include close, prolonged interactions between people, which presents opportunities for infectious disease transmission. Over 20,000 pilgrims gathered at Namugongo Catholic and Protestant shrines to commemorate 2022 Uganda Martyr’s Day. We described syndromes suggestive of key priority diseases particularly COVID–19 and viral hemorrhagic fever (VHF) among visiting pilgrims during May 25−June 5, 2022. A suspected COVID–19 case was defined as ≥2 signs or symptoms of: fever >37.50C, flu, cough, and difficulty in breathing whereas a suspected VHF case was defined as fever >37.50C and unexplained bleeding among pilgrims who visited Namugongo Catholic and Protestant shrines from May 25 to June 5, 2022. Pilgrims were sampled systematically at entrances and demarcated zonal areas to participate in the survey. Additionally, we extracted secondary data on pilgrims who sought emergency medical services from Health Management Information System registers. Descriptive analysis was conducted to identify syndromes suggestive of key priority diseases based on signs and symptoms. Among 1,350 pilgrims interviewed, 767 (57%) were female. The mean age was 37.9 (±17.9) years. Nearly all pilgrims 1,331 (98.6%) were Ugandans. A total of 236 (18%) reported ≥1 case definition symptom and 25 (2%) reported ≥2 symptoms. Twenty-two (1.6%) were suspected COVID–19 cases and three (0.2%) were suspected VHF cases from different regions of Uganda. Among 5,582 pilgrims who sought medical care from tents, 538 (9.6%) had suspected COVID–19 and one had suspected VHF. Almost one in fifty pilgrims at the 2022 Uganda Martyrs’ commemoration had at least one symptom of COVID–19 or VHF. Overall, we identified 4 Viral Hemorrhagic Fever and 560 COVID-19 suspected cases during the 2022 Uganda Martyrs’ commemoration. Intensified syndromic surveillance and planned laboratory testing capacity at mass gatherings is important for early detection of public health emergencies that could stem from such events.

BackgroundUganda National Association of Community and Occupational Health (UNACOH) implemented a workplace and community based alcohol control intervention in the districts of Masindi and Jinja in Uganda where alcohol is highly consumed. UNACOH therefore conducted an end-of year evaluation with a main focus on two of the project’ anticipated outcomes. These include:1) Reduced risky alcohol consumption patterns among the communities in the project area especially among vulnerable and high risk groups (elderly, youth, women, commercial motorcyclists and fisher folk) by 2021 and 2) Legal restrictions on density of alcohol outlets, accessibility to minors and availability are in place in Masindi and Jinja district by 2021 .The main objective was therefore to assess alcohol consumption patterns among drinkers, perceptions about community awareness of alcohol control regulations and their perceived effectiveness in the project area (Masindi and Jinja) in the year 2020.MethodsThis was a cross-sectional evaluation conducted among 310 respondents in selected villages within the intervention Sub Counties of the Districts in the project area. These included; These included Karujubu Division,Miirya and Pakanyi Sub Counties in Masindi District, and Bugembe Town Council,Walukuba- Masese Division and Budondo Sub County in Jinja District. The primary outcomes were; reduced risky alcohol consumption patterns among the communities and presence of legal restrictions on density of alcohol outlets, accessibility to minors and availability. Quantitative data were entered and cleaned using Epi-data version 4.6.0.2 analyzed using STATA version 12.0. Descriptive analysis was used to generate information on the alcohol consumption patterns.Results Findings indicated that majority drinkers were male (71.34%) with only 0.93% below the age of 18 years. Spirits were the commonest type of alcohol consumed (40.78%). Risky alcohol consumptions were reported by nearly half (48.71%) of the drinkers. Male drinkers (81.88%) and those in Jinja (58.97%) reported significantly higher alcohol consumption in comparison with female drinkers (18.12%) and those in Masindi (38.31%) respectively. (χ2 =15.74 and p value of 0.000 and χ2=13.24 and p = 0.000).ConclusionVariation in risky alcohol consumption between the project areas could be attributed to differences in implementation of alcohol control regulations. In some project areas, communities were aware of alcohol control regulations and thought these had been beneficial in reducing alcohol related harm. Risky consumption among drinkers remained relatively high. If these negative trends are not reversed they could significantly increase the non-communicable disease burden including mental health.