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Winner of the 2011 African Studies Association Herskovits Award Beyond the Royal Gazeshifts the perspective from which we view early African politics by asking what Buganda, a kingdom located on the northwest shores of Lake Victoria in present-day Uganda, looked like to people who were not of the center but nevertheless became central to its functioning. Drawing on insights from a variety of disciplines-history, historical linguistics, archaeology, and anthropology-Neil Kodesh argues that the domains of politics and public healing were intimately entwined in Buganda from the sixteenth through the early nineteenth centuries. Drawing on extensive fieldwork conducted throughout Buganda, Kodesh demonstrates how efforts to ensure collective prosperity and perpetuity-usually expressed in the language of health and healing-lay at the heart of community-building processes in Buganda. Kodesh's work offers a novel approach to the use of oral sources and opens up new possibilities for researching and writing histories of more distant periods in Africa's past.Beyond the Royal Gazewill appeal to students and scholars of health and healing, political complexity, and the production of knowledge in places where limited documentary evidence exists.

Background To date, few HIV-related population-based data are available for refugee populations. Household surveys typically require reliable population counts and well-defined geographic areas, which are often not available for refugee settlements. We describe the gridded population sampling approach as an option for conducting such a survey in Uganda and describe its application for a household survey in Uganda and assess its utility among refugee populations. Methods The Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) 2021 was a cross-sectional, population-based HIV survey among refugee households in Ugandan settlements, excluding Kampala. We collected shapefiles and population counts for the refugee settlements. These shapefiles from the various geographic areas of interest represented the aggregated refugee settlement zones (including all settlements with available zone shapefiles) and served as the base for creating the sample frame. The sample frame was constructed by disaggregating United Nations High Commission for Refugees population counts from large refugee settlement zones into 100 × 100 m grid cells using WorldPop’s peanutButter-Disaggregate app that uses building footprint information to distribute the population into the grid cells. We then utilized a gridded population sampling approach which redistributed the population into manageable-sized areas of contiguous grid cells based on their estimated population size, forming enumeration area-like sampling units using the publicly available GridEZ algorithm. Results The resulting gridded population dataset had 43,193 100 m x 100 m cells with an estimated mean of 31 people per cell and a range from 2 to 1028. The final gridded population sample frame had 2636 GridEZ units with an average population of 500 ranging from 178 to 1531. The sample frame performed well for survey activities, with few issues encountered in the field, although the size measures for number of households had some inaccuracies, due to issues such as compounds having multiple structures. Conclusions Gridded population sampling was successfully utilized for this refugee study, saving time and money that would have been needed if enumeration of all the refugee settlements had been required. Gridded population sampling is a useful tool when census data are outdated or unavailable or when the population is dynamic, such as with refugees or other mobile or at-risk populations for surveillance or as part of a humanitarian response.

The world is awash with claims about the effects of health interventions. Many of these claims are untrustworthy because the bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Yet, most people lack the necessary skills to appraise the reliability of health claims. The Informed Health Choices (IHC) project aims to equip young people in Ugandan lower secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. To ensure that we create resources that are suitable for use in Uganda's secondary schools and can be scaled up if found effective, we conducted a context analysis. We aimed to better understand opportunities and barriers related to demand for the resources, how the learning content overlaps with existing curriculum and conditions in secondary schools for accessing and using digital resources, in order to inform resource development. We used a mixed methods approach and collected both qualitative and quantitative data. We conducted document analyses, key informant interviews, focus group discussions, school visits, and a telephone survey regarding information communication and technology (ICT). We used a nominal group technique to obtain consensus on the appropriate number and length of IHC lessons that should be planned in a school term. We developed and used a framework from the objectives to code the transcripts and generated summaries of query reports in Atlas.ti version 7. Critical thinking is a key competency in the lower secondary school curriculum. However, the curriculum does not explicitly make provision to teach critical thinking about health, despite a need acknowledged by curriculum developers, teachers and students. Exam oriented teaching and a lack of learning resources are additional important barriers to teaching critical thinking about health. School closures and the subsequent introduction of online learning during the COVID-19 pandemic has accelerated teachers' use of digital equipment and learning resources for teaching. Although the government is committed to improving access to ICT in schools and teachers are open to using ICT, access to digital equipment, unreliable power and internet connections remain important hinderances to use of digital learning resources. There is a recognized need for learning resources to teach critical thinking about health in Ugandan lower secondary schools. Digital learning resources should be designed to be usable even in schools with limited access and equipment. Teacher training on use of ICT for teaching is needed.

Glycated hemoglobin (HbA1c) measures the average blood sugar level over the past three months. As a vital biomarker of blood glucose levels, it is used to diagnose Type-2 diabetes mellitus (T2D) and monitor glycemic control. A heritability estimate of 47% to 59% suggests that about half of the variation in HbA1c levels can be attributed to genetic factors. Despite African populations being the most genetically diverse and unique for fine-mapping, there is a paucity of data on the genetic drivers of HbA1c in African individuals. In this study, we performed functional annotation and a Phenome-Wide Association Study (PheWAS) of HbA1c-associated variants in two African populations. In this study, we utilized summary statistics of the HbA1c GWAS meta-analysis of 7,526 individuals from South Africa and Uganda to conduct a PheWAS using GWASATLAS. We also performed a functional analysis using the functional mapping and annotation (FUMA) tool. Single nucleotide polymorphisms (SNPs) were prioritized using the SNP2GENE function, while the gene expression patterns and shared molecular functions were explored in the GENE2FUNC. Three genome-wide significant loci were identified with the lead SNPs: rs6724428, rs148228241, and rs8045544 - mapped to GULP1, HBA1, and ITFG3 genes, respectively. The minor allele frequencies of rs148228241 (0.07) and rs8045544 (0.19) are rare or non-existent in non-African populations. Both rs8045544 and rs148228241 are significantly associated with the mean corpuscular hemoglobin concentration (MCHC). A lower MCHC is associated with alpha thalassaemia, resulting from deletions in HBA1 and HBA2 genes. Such deletions are prevalent in malaria-endemic regions of Africa due to their selective survival advantage. The rs6724428 variant is associated with skeletal functions, reflecting the link between glucose metabolism and bone mineral density. Our findings highlight the interplay between glucose metabolism, erythropoiesis, and skeletal health. The significant associations of HbA1c-variants with both skeletal function and MCHC underscore the potential of these variants to impact broader physiological processes. A large-scale study of African individuals will be essential to unravel genetic variants influencing HbA1c.

Background Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member’s perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. Methods This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). Results The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls’ and parents’ acceptance of HPV vaccination. Parents’ increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. Conclusions The perceived benefits and safety of HPV vaccination enhanced girls’ and parents’ acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.

Depression is one of the most prevalent mental health challenges in low- and middle-income countries. However, the mechanisms of parental depression on children’s development are understudied in these countries. This study examined the prevalence of parental depression, contextual predictors of parental depression, and the associations between parental depression, parenting and children’s development in one of the Sub-Saharan African countries-Uganda. Three hundred and three Ugandan parents of young children were recruited and interviewed. Results indicated that about 28 % of parents were depressed. Contextual factors such as low educational attainment, food insecurity, low social support, and high number of children were associated with parental depression. Structural equation modeling also indicated that Ugandan parents’ depression was associated with less optimal parenting, and higher problem behavior, lower social competence, and poorer physical health and school functioning in children. Results provide several cross cultural consistency evidence in associations among parental depression, parenting, and child development.

Background Insects are widely recognized as a valuable source of protein and solution to food security, particularly in developing countries like Uganda. This study documents the local knowledge and practices of edible insects consumed and perception and attitudes towards edible insects by different ethnic groups in northern Uganda. Methods This cross-sectional study was conducted from October 2023 to January 2024 in the districts of Adjumani, Nwoya, Oyam and Zombo in northern Uganda, where 600 questionnaires which comprised of both closed and open-ended questions were administered to randomly selected respondents (60% female, 40% male) in 24 villages spread across four ethnic groups (Acholi, Langi, Alur and Madi). We aimed to find out, whether differences exist in the types of edible insects consumed and which ones were preferred based on ethnicity, age, gender and education level. Results Our study revealed that eleven edible insect’s species belonging to two orders (Orthoptera and Isoptera) and four families—Tettigoniidae, Termitidae, Gryllotalpidae and Acrididae were consumed as food among the Acholi, Alur, Madi and Langi. These species include: Ruspolia differens, Locusta migratoria, Kraussaria angulifera, Macrotermes subhyalinus, Macrotermes bellicosus, Macrotermes michaelseni, Pseudacanthotermes militaris, Syntermes spp. soldiers , Lanista varelai and Gryllotalpa africana . L. varelai , locally known as ‘Ocene-labolo’ in Acholi, is reported as edible insect for the first time. Additionally, one unidentified edible insect, locally known as ‘Mumu’ in Alur or ‘Lakwinyekimo’ in Acholi, was reported to be used as food. Preference for edible insects varied among the ethnic groups, with R. differens being the most preferred among Alur (85%) and Acholi (41%). Conversely, M. subhyalinus (33%) and M. bellicosus (64%) were the most popular among the Langi and Madi, respectively. The respondents had positive perception on edible insect’s consumption as an alternative protein source (98%) to conventional protein source, particularly for insects that were already known to be eaten in the study areas. Conclusions The high diversity of utilized edible insects identified in our study area and the responses indicate that entomophagy is a common practice in the region. Therefore, along with being an important delicacy and traditional foods, edible insects can improve household nutrition status by providing an alternative protein source to alleviate food insecurity and malnutrition among rural communities.