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Background The global consumption of herbal medicine is increasing steadily, posing an extinction risk to medicinal plants. Uganda is among the top ten countries with a high threat of herbal medicine extinction, and Traditional Medicinal Knowledge (TMK) erosion. This might be attributed to the inadequate documentation, plus many more unclear hindrances. In this study, plant species used to treat human diseases in Butaleja district in Eastern Uganda and their associated TMK were documented. The conservation methods for medicinal plants were also evaluated. The rationale was to support the preservation of ethnopharmacological knowledge. Methods Data were collected from 80 herbalists using semi-structured questionnaires, from July 2020 to March 2021. Additionally, guided field walks and observations were conducted. Quantitative indices such as, use categories and informant consensus factor (ICF) were evaluated to elucidate the importance of the medicinal plants. Data were analyzed using STATA version-15.0 software. Results In total, 133 species, belonging to 34 families and 125 genera were identified. Fabaceae (65%), and Solanaceae (29%) were the dominant families. Leaves (80%), and roots (15%), were the commonest parts used in medicinal preparations; mostly administered orally as decoctions (34.6%) and infusions (16%). The commonest illnesses treated were cough (7.74%), gastric ulcers (7.42%), and malaria (4.52%). The informant consensus factor was high for all disease categories (≥ 0.8), indicating homogeneity of knowledge about remedies used. Only 73% of the respondents made efforts to conserve medicinal plants. The commonest conservation strategy was preservation of forests with spiritually valued species (100%), while compliance with government regulations was the rarest (4.5%). Overall, efforts to stop the extinction of medicinal plants and TMK were inadequate. Conclusion and recommendations There was enormous dependency on a rich diversity of medicinal plant species and TMK for healthcare and income generation. The potential for medicinal plant biodiversity loss was evident due to habitat destruction. Inclusion of traditional cultural norms in conservation strategies, and laboratory-based efficacy tests for the species identified are necessary, to promote the conservative and utilization of validated herbal medicines and TMK in rural settings.

Hepatitis B virus (HBV) has ten genotypes (A–J) and over 40 sub-genotypes based on the divergence of ≥ 8% and 4 to < 8% in the complete genome respectively. These genotypes and sub-genotypes influence the disease prognosis, response to therapy and route of viral transmission. Besides, infection with mixed genotypes and recombinant genotypes has also been reported. This study aimed at mapping the de novo genotypes and correlate them with the immigration trends in order to inform future research on the underlying reasons for the relative distribution of HBV genotypes from a large sample size pooled from many primary studies. Data was extracted from 59 full research articles obtained from Scopus, PubMed, EMBASE, Willy library, African Journal Online (AJOL) and Google Scholar. Studies that investigated the genotypes, sub-genotypes, mixed genotypes and recombinant were included. The Z-test and regression were used for the analysis. The study protocol is registered with PROSPERO under the registration number CRD42022300220. Overall, genotype E had the highest pooled prevalence significantly higher than all the other genotypes (P < 0.001). By region, genotype A posted the highest pooled prevalence in eastern and southern Africa, E in west Africa and D in north Africa (P < 0.0001). Regarding the emerging genotypes B and C on the African continent, genotype B was significantly higher in south Africa than C (P < 0.001). In contrast, genotype C was significantly higher in east Africa than west Africa (P < 0.0001). The A1 and D/E were the most diverse sub-genotypes and genotype mixtures respectively. Finally, we observed a general progressive decrease in the prevalence of predominant genotypes but a progressive increase in the less dominant by region. Historical and recent continental and intercontinental migrations can provide a plausible explanation for the HBV genotype distribution pattern on the African continent.

Background The epidemiology of hepatitis B virus (HBV) in the general population in east Africa is not well documented. In this meta-analysis, we examined 37 full published research articles to synthesise up-to-date data on the prevalence and predictors of the HBV burden for the effective prevention and management of the virus in our region. Methods We examined 37 full published research articles found using PubMed, Scopus, African Journal Online (AJOL), and Google Scholar between May and October 2020. Dichotomous data on HBV prevalence and predictors of infection were extracted from the individual studies. The HBV prevalence, test of proportion, relative risk, and I 2 statistics for heterogeneity were calculated using MedCalc software version 19.1.3. Begg’s tests was used to test for publication bias. Sources of heterogeneity were analysed through sensitivity analysis, meta-regression, and sub-group analysis at 95% CI. P  < 0.05 was considered significant for all analyses. Results The prevalence of HBV was generally high (6.025%), with publications from Kenya (8.54%), Uganda (8.454%) and those from between 2011 and 2015 (8.759%) reporting the highest prevalence ( P  < 0.05). Blood transfusion, scarification, promiscuity, HIV seropositivity, and being male were independent predictors significantly associated with HBV infection ( P  < 0.05), with the male sex being the most strongly associated predictor of HBV infection. Meta-regressions for the pooled HBV prevalence and sample size, as well as the year of publication, lacked statistical significance ( P  > 0.05). Omitting the study with the largest sample size slightly increased pooled HBV prevalence to 6.149%, suggesting that the studies are robust. Begg’s test showed no evidence of publication bias for overall meta-analysis ( p  > 0.05). Conclusion The burden of HBV is still high, with the male sex, blood transfusion, body scarification, and HIV seropositivity being potential predictors of infection. Thus, it is important to scale up control and prevention measures targeting persons at high risk.

Pregnant women in rural Uganda largely rely on medicinal plants for inducing labor, treating postpartum hemorrhage (PPH), and inducing abortion. 90% of the women in both rural and urban Uganda use plants to manage pregnancy symptoms like constipation, heartburn, morning sickness, body aches, nausea, and vomiting. After delivery women continue using plants to manage postpartum complications and for infant care especially herbal baths. This study documented how ethnomedical folklore has been used to aid childbirth, manage postpartum hemorrhage, and induce abortion. Methods A cross-sectional ethnobotanical survey was conducted from May – December 2023 in Najjemebe sub-county, Buikwe district. 206 respondents from 12 villages were selected using snowball sampling. Key informants included Traditional Birth Attendants (TBAs) and herbalists. Data was collected using semi-structured questionnaires and focus group discussions. Voucher specimens of the plants were identified and authenticated at Makerere University Herbarium. Data were analyzed using descriptive statistics, Informant Consensus factor (ICF), Use Reports (URs), paired comparisons, and GraphPad Prism® version 9.0.0 software. Results All respondents ( N  = 206, 100%), used plants to induce labour, treat PPH, and induce abortion. One hundred four plant species were documented: most cited or preferred were: Hoslundia opposita ( N  = 109, 53%), Phytolacca dodecandra ( N  = 72, 35%), and Commelina erecta ( N  = 47, 23%). The plants belonged to 49 families, Lamiaceae (16.3%) and Fabaceae (14.3%) having the majority of the species. Herbs were 42 (40%) and trees 23 (22%). Oral administration 95(72%) was the commonest, then topical 19 (14.4%) and vaginal 14(10.6%). Conclusion Health surveys revealed that about 27% of deliveries in Uganda take place outside a health facility. Due to the oxytocic effects of plant species reported in this study, they play a triple role of being uterotonics, abortifacients, and treating postpartum haemmorhage. The dilemma lies in the unknown dosages and toxicity levels that could endanger both the mother’s and the unborn child’s lives. Due to Uganda’s high rates of population growth, overall fertility, maternal mortality, and morbidity, policies, and programmes on gendered health provision need to be reevaluated. Integrating herbal medicine into health care systems appears to be a feasible solution.

Introduction Hepatitis B virus (HBV) remains a public health threat in Uganda, despite the introduction of the HBV vaccine and its inclusion in the Expanded Program on Immunization (EPI) more than two decades ago. This study aimed at providing up-to-date information on the epidemiology of HBV in Uganda and inform the way forward when designing the interventions to control and prevent the virus. Methods A systematic search for records published between 1st January 2002 and 30th June 2024 from PubMed and African Journal Online (AJOL) was done from which data on the overall and subgroup prevalence of HBV was extracted. Both the random and fixed effect models were used to pool data for the overall and sub group meta-analysis. The overall and subgroup trend of HBV prevalence over the last two decades was evaluated by meta-regression modelling. The predictors of HBV infection were analysed by using odds ratio (OR). The I 2 index in the primary records was used to evaluate the heterogeneity. Publication bias in the primary studies was assessed by using Egger’s test and funnel plot asymmetry. All analyses were done at 95% confidence interval (CI) and a p  < 0.05 was considered significant. Results A total of 34 original studies were included in the data synthesis with a pooled sample size of 81,416 individuals. The pooled prevalence of HBV was 8.3% but varied with region and study group. It was highest in the eastern region ( p  < 0.05) and among the community-based studies ( p  < 0.05). By meta-regression modelling, there has been an overall decrease in the prevalence of HBV since the integration of the vaccine as part of the EPI in 2002 ( p  < 0.05) and in the central, eastern and northern regions. Conversely, there was an increase in the prevalence of HBV in western Uganda with a strong temporal explanatory power (R² = 0.700). Familial contact with an HBV infected person; odds ratio (OR) = 3.85, p  = 0.006 was the most significant risk factor for HBV infection. In contrast, age < 20 year; OR = 0.52, p  = 0.016 was protective against HBV infection. Conclusion Despite the significant progress registered in reducing the prevalence of HBV since the integration of HepB vaccine as part of the EPI, there are still regional and cohort specific disparities in the prevalence of HBV in Uganda. Thus, different interventions should be designed in tandem with the differences in the prevalence by specific groups and regions.

Background For centuries, farmers in central Uganda have used diverse medicinal plants in ethnoveterinary medicine for treating chicken diseases. However, the unique plant species used, and associated ethnoveterinary knowledge had not been well documented. Hence this research reports the medicinal plants used in the management of chicken diseases in Najjembe sub-county, Buikwe District, Central Uganda to guide the advancement and sustainable use of these plants in the future. Methods An ethnoveterinary survey was conducted among 150 chicken farmers who were purposively sampled from ten villages within Najjembe sub-county, Buikwe district from January to September 2021. Voucher specimens of the plants were prepared, identified and authenticated at Makerere University Herbarium. Numerical data summarized using percentages, frequencies, Informant Consensus factor (ICF) and paired comparisons. Results All farmers (150), atleast used medicinal plants to treat chicken diseases, with majority of them aged 25 to 44 years (65.3%) and acquired this indeginous knowledge from family members (48%). Fifty-nine plant species were reported with the most cited or preferred being; Aloe vera (L.) Burm.f., (64), Capsicum frutescens L., (60), Nicotiana tabacum L. (55) , Cannabis sativa L. (50), Bidens pilosa L.(12) , Momordica foetida Schumach.(10). The plants belonged to 59 genera and 31 families: mostly Asteraceae (n=8, 13.6%), Fabaceae (n =5, 8.5%), Rosaceae (n=5, 8.5%), Myrtaceae (n=4, 6.8%) and Lamiaceae (n=4, 6.8%). Most medicinal plants were herbs (45.8%) and trees (25.4%). Leaves (66.1%) were the most used parts and were largely prepared as decoctions (38.9%). Most plant species had ICF greater than 0.7 for given chicken disease implying a high consensus in the community. Nicotiana tobacum L. had ICF values of 0.98, 0.98, 0.90, 0.98, 0.86 and 0.88 for swollen eyes, manson’s eye worm, eye infections, diarrhea, fowl typhoid and flue. The major challenges reported were failure to determine doses and scarcity of medicinal plants due to the escalating deforestation of Mabira Central Forest Reserve. Conclusion There is widespread use of herbal medicines in the treatment of several chicken ailments in Najjembe sub-county, Buikwe District. The rich diversity of medicinal plants provides good prospects for development of novel ethnopoultry drugs that might provide a solution to the escalating global resistance against conventional chicken drugs. Although some of the species are exotic in Uganda, there is an urgent need to conserve the threatened plant species against increasing deforestation, climate change, human settlement and agricultural expansion.

Background There is plenitude of information on HIV infection among pregnant mothers attending antenatal care (ANC) in sub-Saharan Africa. However, the epidemiology of HBV–HIV co-infections in the same cohort is not clear despite the common route of transmission of both viruses. The aim of our study was to synthesize data on the prevalence of HBV–HIV co-infection among pregnant women attending ANC in Sub-Saharan Africa to assist in the design of public health interventions to mitigate the challenge. Methods The study was done in tandem with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and the Cochran’s Q test, I 2 statistics for heterogeneity and the prevalence were calculated using commercially available software called MedCalcs ( https://www.medcalc.org ). A random effect model was used to pool the prevalence since all the heterogeneities were high (≥ 78%) and P het  < 0.05 indicated significant heterogeneities. The risk factors and risk differences for HBV–HIV co-infection were analyzed. Any likely sources of heterogeneity were analyzed through sensitivity analysis, meta-regression and sub-group analysis. All analyses were done at 95% level of significance and a P  < 0.05 was considered significant. Results The overall pooled prevalence of HBV–HIV co-infection among pregnant mothers in sub-Saharan Africa was low 3.302% (95%CI = 2.285 to 4.4498%) with heterogeneities (I 2 ) of 97.59% ( P  > 0.0001). Within regional sub group meta-analyses, West Africa had significantly higher prevalence of 5.155% (95% = 2.671 to 8.392%) with heterogeneity (I 2 ) of 92.25% ( P  < 0.0001) than any other region ( P  < 0.001). Articles published from 2004–2010 had significantly higher prevalence of 6.356% (95% = 3.611 to 9.811%) with heterogeneity (I 2 ) 91.15% ( P  < 0.0001) compared to those published from 2011 to 2019 ( P  < 0.001). The HIV positive cohort had significantly higher prevalence of HBV–HIV co-infection of 8.312% (95% CI = 5.806 to 11.22%) with heterogeneity (I 2 )94.90% ( P  < 0.0001) than the mothers sampled from the general population with a prevalence of 2.152% (95% CI = 1.358 to 3.125%) ( P  < 0.001). The overall and sub group analyses had high heterogeneities (I 2  > 89%, P  < 0.0001) but was reduced for South Africa (I 2 ) = 78.4% ( P  = 0.0314). Age, marital status and employment were independent factors significantly associated with risk of HBV–HIV co-infection ( P  < 0.001) but not extent of gravidity and education level ( P  > 0.05). After meta-regression for year of publication and sample size for HBsAg positivity, the results were not significantly associated with HBV pooled prevalence for sample size ( P  = 0.146) and year of publication ( P  = 0.560). Following sensitivity analysis, the HBsAg pooled prevalence slightly increased to 3.429% (95% CI = 2.459 to 4.554%) with heterogeneity I 2  = 96.59% (95% CI = 95.93 to 97.14%), P < 0.0001 Conclusion There is an urgent need for routine HBV screening among HIV positive pregnant mothers attending antenatal care in sub-Saharan Africa to establish the extent of HBV–HIV co-infection in this cohort. Future studies need to investigate the putative risk factors for HBV–HIV co-infection and prioritize plausible control strategies.

The Hepatitis B virus (HBV) is a highly infectious virus and is endemic in Uganda. It is one of the major etiological agents for liver diseases including liver cancer. In this work, we evaluated the prevalence of the HBV serological markers and the associated socio-demographic factors among hepatitis B surface antigen (HBsAg) seronegative persons screened during routine immunization against the virus in eastern Uganda. Data on the socio-demographic characteristics were collected using a structured questionnaire, while that on the serological markers were obtained from serum samples and evaluated by using the 5-panel HBV One Step Hepatitis B Virus Combo Test Device (Fastep R , HBV-P43M). The following markers were evaluated by the panel: HBsAg, HBsAb, HBcAb, and HBeAb. Data were analyzed using SPSS (version 26), and multinomial logistic regression was used to elicit the adjusted odds ratio. All the analysis were performed at a 95% confidence limit, and a P value ≤ 0.05 was considered significant. The 424 participants included in this study were mainly female (62.3%), married (55.4%) and aged 30 years and above (54.2%). The seropositivity of the HBsAb, HBeAb, HBcAb marker prevalence rates was 48(11.3%), 73(17.2%) and 45(10.6%) respectively. The majority of the participants (327, 77.1%) did not present with any marker. Married paricipants were significantly associated with reduced HBsAb seropositvity rate, whereas young people aged 18–29 years were associated the with increased odds of HBsAb seropositivity (p < 0.05). Male participants were significantly associated with the HBeAb and HBcAb seropositivity (p < 0.05). Similarly, contact with an HBV infected person was significantly associated with HBeAb and HBcAb seropositivity (p < 0.05). Further still, blood transfusion was significantly associated with the increased risk of HBcAb seropositivity (P < 0.05). This study has revealed a prevalence of HBV serological markers among the HBsAg seronegative persons in this community and an increased risk of transmission of the virus in the community. Our findings have key consequences pertaining the interventions that are pertinent in the control and prevention of the spread of the virus among apparently health persons.

Background: In the East African region, herbal plants are essential in the treatment and control of cancer. Given the diverse ecological and cultural makeup of the regional states, it is likely that different ethnic groups will use the same or different plants for the same or different diseases. However, since 2019, this has not been compiled into a single study. Purpose: The study aimed to compile and record the medicinal plants utilized in East Africa from April 2019 to June 2023 to treat various cancer types. Materials and methods: The study examined 13 original studies that included ethnobotanical research conducted in East Africa. They were retrieved from several internet databases, including Google Scholar, Scopus, PubMed/Medline, Science Direct, and Research for Life. The study retrieved databases on plant families and species, plant parts used, preparation methods and routes of administration, and the country where the ethnobotanical field surveys were conducted. Graphs were produced using the GraphPad Prism 8.125 program (GraphPad Software, Inc., San Diego, CA). Tables and figures were used to present the data, which had been condensed into percentages and frequencies. Results: A total of 105 different plant species from 45 different plant families were identified, including Asteraceae (14), Euphorbiaceae (12), Musaceae (8), and Apocynaceae (7). Uganda registered the highest proportion (46% of the medicinal plants used). The most commonly mentioned medicinal plant species in cancer management was Prunus africana. Herbs (32%), trees and shrubs (28%), and leaves (45%) constituted the majority of herbal remedies. Most herbal remedies were prepared by boiling (decoction) and taken orally (57%). Conclusion: East Africa is home to a wide variety of medicinal plant species that local populations and herbalists, or TMP, frequently use in the treatment of various types of cancer. The most frequently used families are Asteraceae and Euphorbiaceae, with the majority of species being found in Uganda. The most frequently utilized plant species is Prunus africana. Studies on the effectiveness of Prunus africana against other malignancies besides prostate cancer are required.

The increasing global use of unvalidated herbal products poses substantial health risks, highlighting the importance of rigorous toxicity evaluations. In the Elgon sub-region, Rhoicissus tridentata extracts are traditionally used to treat prostate cancer, but the absence of standardized dosages restricts their potential use and limits evidence for informing chemotherapeutic applications. This study aimed to investigate the subacute toxicity of R. tridentata extracts in Wistar albino rats. We used 84 Wistar albino rats to assess clinical toxicity symptoms, hematological and biochemical parameters, and histopathological changes using advanced equipment like hematology machines and COBAS INTEGRA Chemistry Plus 600. A total of 84 Wistar albino rats were used to assess clinical symptoms, hematological, biochemical parameters and majar organ histopathological changes. Histological biomarkers were analyzed using Coulter Counter Hamatology analyzer while biochemical indices were analyzed using COBAS INTEGRA Chemistry Plus 600, but eosinophils increased significantly ( p  ≤ 0.0001), confirming mild toxicity. To guarantee the safe use of R. tridentata in therapy, determining the maximum dose that produces no adverse effects (NOAEL) is essential to inform dosing in sub-chronic and sub-acute toxicity. Regulatory agencies evaluating herbal products containing R. tridentata should exercise caution and require standardized dosing protocols and comprehensive toxicity assessments to safeguard public health.