In the dry, isolated area of Karamoja in northeastern Uganda \u2013 the country\u2019s poorest sub-region \u2013 children have long suffered from malnutrition and water shortages.<\/p>\n
Now a study has shown that nearly half the food and water consumed by under-fives in the region is contaminated with drug-resistant Salmonella, further limiting their chances of survival.<\/p>\n
The peer-reviewed study, published in\u00a0BioMed Central,\u00a0found contamination in samples of both raw and cooked foods, as well as in community and household water.<\/p>\n
More than 90 per cent of the\u00a0Salmonella enterica\u00a0strains identified by researchers were resistant to azithromycin, one of the most common antibiotics, while more than a third were resistant to multiple drugs.<\/p>\n
Ronald Mpagi, the study\u2019s lead author and a microbiology researcher at Uganda\u2019s Gulu University, told\u00a0SciDev.Net\u00a0he was driven to investigate persistent malnutrition in Karamoja after years of government and donor programmes showed little progress.<\/p>\n
A semi-arid area, Karamoja suffers chronic water scarcity, leaving families without reliable safe drinking water. Most households are nomadic pastoralists living in\u00a0manyattas, enclosed homesteads where cattle are kept close to people.<\/p>\n
Toilets missing<\/p>\n
Over 60 per cent of the population\u00a0practices open defecation, overwhelming limited sanitation systems.<\/p>\n
\u201cThe available toilets cannot really accommodate the growing population of the Karamoja people,\u201d Mpagi told\u00a0SciDev.Net.<\/p>\n
\u201cMost of the toilets are built in designated places, but because many families are nomadic, they move with their animals and cannot return to use these facilities before continuing their journey.\u201d<\/p>\n
These conditions create a cycle where human waste, livestock, food and water intersect, spilling contamination into children\u2019s meals. Diarrhea, a common outcome, is among the five leading causes of under-five mortality.<\/p>\n
Repeated diarrheal illness prevents children from absorbing nutrients, leaving them weak and vulnerable.<\/p>\n
Bwambale Benard, a Ugandan public health nutritionist and food systems specialist, says that once first-line antibiotics fail, children stay sick longer, malnutrition worsens, and mortality rises.<\/p>\n
Whole community hit<\/p>\n
But Benard points out that children are not the only ones at risk. Infections also affect pregnant women, the elderly, and whole households, leaving families unproductive and draining limited incomes.<\/p>\n
\u201cSo we are going to have a community that is ill, sickly, that cannot be productive, and so they are not contributing productively to the GDP of a country, or even they are not able to sustain their families,\u201d he told\u00a0SciDev.Net.<\/p>\n
A USAID-funded project in 2017\u00a0projected malnutrition will cost Uganda an estimated 19 trillion Ugandan Shillings (US$7.7 billion) in lost productivity by 2025.<\/p>\n
Benard believes that if left unchecked, drug-resistant Salmonella could also undermine Uganda\u2019s development targets.<\/p>\n
He stressed the need for safer food handling to prevent recontamination, adding that ending open defecation requires tackling both cultural and practical barriers.<\/p>\n
Tracking resistance<\/p>\n
Andrew Kambugu, executive director of the Infectious Diseases Institute at Makerere University, Uganda, says the country has developed systems to detect antimicrobial resistance before it escalates.<\/p>\n
In partnership with Uganda\u2019s Ministry of Health, his team runs a surveillance network supported by the UK Aid\u2013funded Fleming Fund.<\/p>\n
Operating in seven referral hospitals across the country, the system monitors resistance patterns and provides early warnings.<\/p>\n
\u201cWith the surveillance system, it means that if we see what we call clusters of patients that present diarrhea due to Salmonella, we will be able to see that because we are collecting the data \u2013 and it will act as an early warning system to tell us that in that hospital there is a problem,\u201d Kambugu told\u00a0SciDev.Net.<\/p>\n
He says hospitals are tracked closely and while clusters do not always confirm diarrhea outbreaks, they prompt further investigation and guide the Ministry of Health\u2019s response.<\/p>\n
Kambugu said the recent findings from Karamoja were striking.<\/p>\n
\u201cIn the regions that have been [by his institute], we do not have this high rate. I think it is unusual,\u201d he said, adding that the cultural practices and access to water issues in Karamoja could be responsible for the situation.<\/p>\n
Improving outcomes<\/p>\n
Daniel Kyabayinze, director of public health at Uganda\u2019s Ministry of Health, told\u00a0SciDev.Net\u00a0the government was reinforcing hygiene education in Karamoja and training farmers on safer post-harvest handling.<\/p>\n
He linked these measures to\u00a0Uganda\u2019s National Action Plan on Antimicrobial Resistance, now in its fifth year and aligned with the WHO Global Action Plan.<\/p>\n
Under the plan, referral hospitals feed lab data into antibiograms \u2013 laboratory reports that show which antibiotics are effective against different bacteria \u2013 which shape procurement and treatment decisions.<\/p>\n
Kyabayinze said the study revealed an important opportunity to improve outcomes. While widely used drugs like azithromycin and ciprofloxacin showed high resistance, older and cheaper medicines such as co-trimoxazole still had very low resistance.<\/p>\n
\u201cSo we can roll out the cheaper and more friendly drugs, especially in regions like Karamoja,\u201d he said.<\/p>\n
Source:<\/p>\n
Journal reference:<\/p>\n
Mpagi, R., et al. (2025). Prevalence and antibiotic resistance characteristics of non-typhoidal Salmonella enterica serotypes isolated from food and water consumed by children under five years in Karamoja sub-region of Uganda.\u00a0Food Safety and Risk. doi.org\/10.1186\/s40550-025-00117-x<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"In the dry, isolated area of Karamoja in northeastern Uganda \u2013 the country\u2019s poorest sub-region \u2013 children have…\n","protected":false},"author":2,"featured_media":45823,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[14238,33853,4103,9563,33854,33855,424,426,103,61,60,11365,2746,8702,2361,31517],"class_list":["post-45822","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-antimicrobial-resistance","tag-azithromycin","tag-children","tag-chronic","tag-contamination","tag-diarrhoea","tag-drugs","tag-food","tag-health","tag-ie","tag-ireland","tag-malnutrition","tag-microbiology","tag-mortality","tag-public-health","tag-salmonella"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/45822","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=45822"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/45822\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/45823"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=45822"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=45822"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=45822"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}