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Prevalence of Commonly Consumed Drugs in Mbarara City, Uganda
(EAST AFRICAN NATURE & SCIENCE ORGANIZATION, 2026-02-23) Habimaana, Samuel,; Kemigisha ,Chalrotte; Nnamuyomba, Proscovia; Ntambi Emmanuel; Adaku ,Christopher
Pharmaceutical consumption is rising globally, with significant implications for environmental pollution and antimicrobial resistance (AMR). In sub-Saharan Africa, weak prescription control, widespread self-medication, and insufficient wastewater treatment amplify risks of pharmaceutical residues entering aquatic systems. Studies in Uganda have detected active pharmaceutical ingredients in urban waters, including River Rwizi, a critical domestic and agricultural water source for Mbarara City. However, systematic data linking patterns of drug consumption to environmental risks in Mbarara City remain scarce. Through a descriptive cross-sectional survey, drug use prevalence across public and private healthcare outlets in Mbarara City was assessed, focusing on 30 essential medicines listed in the Uganda Clinical Guidelines (2023). Data was collected from 81 drug outlets in strategically selected clusters adjacent to the River Rwizi and analysed using descriptive statistics.
Results show extremely high prevalence of paracetamol (97.5%), amoxicillin (96.3%), ibuprofen (93.8%), azithromycin (86.4%), ciprofloxacin (82.7%), metronidazole (84.0%), coartem (80.2%), eftriaxone (77.8%), and doxycycline (76.5%), indicating a narrow subset of medicines that dominate urban consumption. These drugs address the city’s burden of febrile illnesses, malaria, and bacterial infections, but their widespread and unregulated use heightens risks of AMR development and pharmaceutical pollution.
The findings indicate an urgent need for integrated pharmaceutical stewardship, improved wastewater treatment, and environmental monitoring of the River Rwizi. By establishing a baseline of commonly consumed drugs in Mbarara City, this study provides essential evidence for guiding rational drug use policies, waste management strategies, and interventions to safeguard both public health and aquatic ecosystems.
Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies
(MBC., 2023-08) Awor Silvia; Bongomin Flexi; Kaggwa Mark Mohan; Pebalo Francis; Epila Jackie; Malinga Geoffrey Maxwell; Oryema Christine; Nnamuyomba Proscovia; Abola Benard; Ongwech Acaye; Musoke David
Background Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.
Methods The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords “liver function”, “renal function”, “sickle cell disease”, and “Africa”
on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2. Results Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI − 2.99–20.23, I2 = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI − 0.16–15.80, I2 = 99%, p < 0.01) and alkaline phosphatase (ALP) − 2.54 (95% CI − 64.72 – 59.64, I2 = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine − 3.15 (95% CI − 15.02; 8.72, I2=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was − 0.57 (95% CI − 3.49; 2.36, I2 = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89–28.68 mL/min/1.73 m2, I2 = 87%, p < 0.01) compared to controls. Conclusion People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I2) > 50%, there was substantial variation in the reported articles’ results.
Trace Elements in Marketed Rastreneobola Argentea and Clarias Werneri Caught from Selected Aquatic Ecosystems in Uganda
(International Journal of Current Trends in Engineering & Technology, 2015-08) Nnamuyomba, Proscovia; Mbabazi, Jolocam; Ntale, Muhammad
Samples of two fish species Rastreneobola argentea and Clarias werneri from Lake Victoria, Lake Kyoga and Nakivubo and Lubigi wetlands were analysed for Cu, Zn, Pb and Cd using an Atomic Absorption Spectrophotometer - Perkin-Elmer Model 2380.
The results revealed that Zn concentrations were the highest in both species, followed by Cu; Pb and Cd being the lowest. The concentrations of Cu, Zn, Pb and Cd in R. argentea from Lake Victoria ranged between 20.5- 115 µg/Kg, 175 - 495 µg/kg, 15 - 77.5 µg/Kg and 2.5 - 4.45 µg/kg respectively, mean while their concentrations in the same fish species from Lake Kyoga ranged between 12.5 - 37.5 µg/kg (Cu), 35-100 µg/kg (Zn), 5-12.5 µg/kg (Pb), 0.5-1.5 µg/kg (Cd) dry weight. In C.werneri, heavy metals varied between 197-337.5 µg/kg (Cu), 235-670 µg/kg (Zn), 60-77.5 µg/kg (Pb) and 2.5-6.98 µg/kg (Cd) in Lubigi wetland and in Nakivubo wetland, concentrations of heavy metals ranged between 7521320 µg/kg for Cu, 1230-1437 µg/kg for Zn, 85-97.5 µg/kg for Pb and 2.2-7.75 µg/kg for Cd. Heavy metal concentrations obtained in this study were below permissible limits issued by WHO/FAO.
Therefore, the consumption of these fish species may not pose any threat to human health. However periodic monitoring of these metals in the fish caught from water bodies located in urban areas is highly essential to public health
"We Cure Sickle Cell Disease with Herbs”: Perspectives of Herbal Medicine Practitioners Treating Sickle Cell Disease in the Acholi Sub Region
(Doverpress, 2025-07-28) Awor, Silvia; Opee, Jimmyy; Ocaya Denis; Ocaya Jimmy; Abola Benard; Malinga, Geoffrey Maxwell; Oryema Christine; Arwenyo, Beatrice; Ongwech Acaye; Musoke, David; Nnamuyomba Proscovia; Epila Jackie
Sickle cell disease (SCD) is a genetic blood disorder that results in the deformation of red blood cells under low oxygen conditions, causing vaso-occlusive crises and severe complications. While hydroxyurea has been Introduced as a treatment for SCD, herbal medicines remain widely used across Africa. Northern Uganda has a high SCD prevalence of 20.5%, yet limited research exists on alternative treatment options within local communities. This study aimed to explore the perspectives of herbal medicine practitioners in the Acholi sub-region.
Methods: We conducted in-depth interviews between October and December 2024 involving 24 herbal medicine practitioners in the Acholi sub-region, selected through referrals and non-probability snowball sampling. All data collected were recorded, transcribed verbatim, and analyzed using thematic content analysis, and emerging themes were presented. Results: All participants believed herbal medicine could cure SCD, and the majority reported successfully treating patients. However, some practitioners remembered some patients who reported being sick with sickle cell crises many years after the “cure”. “When they report improvement, I stop medication after some time…” thereafter, “I encourage them to go to the hospital, but they do not. They can stay without falling sick for a long time and declare themselves healed”.
Findings suggest herbal medicines are commonly used for SCD management in the Acholi sub-region. Most herbal medicine practitioners rely on the hospital diagnoses, although a few can tell who has sickle cell disease by looking at or touching them. A lot of mistrust exists between herbal medicine practitioners, the government, and researchers. This hinders efforts to integrate traditional medicine into mainstream healthcare and limits opportunities for scientific validation.
Conclusion: Herbal medicine practitioners believe herbs can treat sickle cell disease; however, further research is needed to investigate the nature of these herbs and their mechanisms of action, thereby facilitating the integration of herbal medicine into conventional care.
We discuss some implications of the study for practice and policy.
Safety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis
(PMJ ONE HEALTH, 2024-12-16) Awor, Silvia,; Bongomin Felix; Kaggwa Mohan ,Mark; Pebalo, Francis; KivumbiMuganga, Ronald; Malinga, Geoffrey Maxwell ,; Acaye Ongwech; Nnamuyomba, P; Oryema, Christine; Abola, B; Epila, J.; Musoke, David
This systematic review and meta-analysis evaluated the safety and efficacy of herbal remedies used to manage sickle cell disease (SCD) in Africa. Before the advent of western medicine, people depended on herbal medicines for treating different illnesses. Using herbal medicines to sickle cell disease (SCD) is still common in Africa.
However, data on the safety and efficacy of any of these remedies are limited. We searched PubMed, Embase, Google Scholar and Web of Science from inception to 11thJanuary 2024 using the keywords "herbal medicine" and "sickle cell" and the name of each of the countries in Africa without language restrictions. We included cross-sectional studies that reported the safety or efficacy of herbal medicine for managing sickle cell disease. Two reviewers assessed all included studies for suitability for inclusion in this review. All included articles were assessed using ROBINS-1, a tool for assessing the risk of bias in non-randomized studies of interventions. We used the random effect model to pool the efficacy and safety profiles of the herbal medicines using RStudio version 4.2.2. Overall, we included five studies involving 1,489 individuals with SCD. Of these, 789 (53.0%) used herbal remedies like Aloe barbadensis (Aloe vera), Zingiber officinale (ginger), Cymbopogon citratus (lemongrass), Forever Living products, Golden Neo-Life Diamite International (GNLD) diet supplements and ginseng products. About 22.9% (181 out of 789) of the participants who used herbal remedies reported side effects, while 38.5% (304 out of 789) reported improving their symptoms. There was a high risk of publication bias in the articles included in this review.
The pooled adverse effects of the herbal medicines for SCD treatment were 48% lower (Odds ratio: 0.52, 95% confidence interval (CI): 0.26 - 1.05, I²= 82%, p<0.01) while the pooled efficacy of herbal remedies for treating SCD was nearly 100% higher (odds ratio= 2.07, 95% confidence interval 0.99 - 4.32, I²= 78%, p<0.01) among the users than controls. However, these findings were not statistically significant.
Our findings indicate no significant difference in the safety and efficacy of herbal medicines among people with SCD who used or did not use herbal remedies. However, the sample sizes of the primary studies were small. Thus, more extensive controlled studies with better-defined endpoints are required to inform the use of herbal medicines in managing SCD in Africa.