Barriers and facilitators to interprofessional simulation-based learning in a Ugandan medical school: a qualitative study.

Background: Although Interprofessional Education (IPE) is an important component of medical education, it has only recently come under consideration in Sub-Saharan Africa. IPE occurs when two or more professions learn from, about and with each other regarding effective collaboration and the improvement of health outcomes. Current academic programs focus more on traditional approaches to training physicians, pharmacists, respiratory therapists, physiotherapists and nurses like they were independent entities.

Delays in Care for Children With Low Anorectal Malformations in Southwestern Uganda.

Introduction: Disparities in anorectal malformation (ARM) outcomes between high- and low-income countries may be due to delayed diagnosis in the latter setting. The Three Delays model, comprising delays in seeking, accessing, and receiving care, provides a framework for exploring these challenges. We sought to examine the frequency and nature of the preoperative delays in children presenting for surgical correction of low ARMs.

Effectiveness of primary repair for low anorectal malformations in Uganda.

Background: Anorectal malformations (ARMs) have an incidence of up to 1 in 4000 live births and can require immediate neonatal surgery due to associated intestinal blockage. Due to limited surgical access, Ugandan children present late and undergo three separate staged operations: (1) initial colostomy formation; (2) repair of the ARM (called anoplasty); and (3) colostomy closure. Three operations result in long treatment duration, potential complications with each procedure, delays in care, and stigmata associated with colostomies.

Associations Between Non-communicable Diseases and Obstetric Complications: A Retrospective Records Review at a Tertiary Referral Hospital in Uganda.

Objective: Non-communicable diseases (NCDs) increasingly contribute to maternal morbidity and mortality. We determined the association between NCDs and obstetric complications at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda.

Methods: In this retrospective records review, we randomly selected records of women admitted for delivery at MRRH each month from January to December 2022, and extracted their socio-demographic and clinical histories.

Effect of missed clinic visits on treatment outcomes among people with tuberculosis: a quasi-experimental study utilizing instrumental variable analysis.

Objectives: Missed clinic visits disrupt the continuity of care and potentially impact tuberculosis (TB) treatment outcomes negatively. We evaluated the effect of missed clinic visits on mortality and treatment success among people with bacteriologically confirmed pulmonary TB in rural eastern Uganda.

Methods: Using routine TB clinic data, we designed a quasi-experimental study and used instrumental variable analysis to estimate a cause-effect.

Experiences and lessons learned from a global research administration capacity building project to support and expand HIV/AIDS research in southwestern Uganda.

International collaborative research projects conducted at academic research institutions, including complex basic science, clinical, and translational HIV/AIDS research, require intensive communication, coordination, and thoughtful relationship-building at all institutional levels and especially require the support of experienced and well-trained Research Administrators. To be successful, global research teams must be not only scientifically adept, but supported by a staff skilled in identifying opportunities, submitting proposals, and managing all aspects of award administration and reporting. Using a National Institutes of Health, Fogarty International Center funded training grant, the project team aimed to develop a comprehensive Research administration capacity-building program that would improve the support provided to investigators at Mbarara University of Science and Technology in Uganda through collaboration with the University of Virginia in the United States and expand future funding success for innovative HIV/AIDS and HIV-related research.

Malnutrition is a risk factor for tuberculosis disease among household contacts: A case-control study in Uganda.

Objective: Household contacts (HHCs) of persons with tuberculosis (TB) including rifampicin-resistant or multi-drug-resistant TB (RR/MDR-TB) are at risk for TB infection. We investigated whether index patient-level clinical and socio-demographic factors of persons with MDR-TB are associated with TB disease among their HHCs in Uganda.

Methods: We designed an unmatched case-control study.

Malnutrition and unsuccessful tuberculosis treatment among people with multi-drug resistant tuberculosis in Uganda: A retrospective analysis.

Rationale: Multi-drug-resistant tuberculosis (MDR-TB) poses a significant public health challenge to the control and successful eradication of TB globally. Suboptimal treatment outcomes are common among persons with MDR-TB necessitating a need to understand the contextual factors.

Objective: We determined the factors associated with unsuccessful TB treatment among persons with MDR-TB at a large TB Unit in Central Uganda.

Incidence of Acute Kidney Injury and Associated Mortality among Individuals with Drug-Susceptible Tuberculosis in Uganda.

Key Points: AKI is thought to be a rare complication in patients with tuberculosis (TB) infection and is mostly attributed to TB drugs. Our findings show AKI occurs more often than previously thought and approximately 33% of patients with drug-susceptible TB may have kidney dysfunction. According to our study findings, monitoring kidney function should be routine among patients diagnosed with TB even before treatment initiation.

Association between metabolic syndrome and cervical cancer among women in Southwestern Uganda: A case-control study.

Objective: To determine the association between MetS and its components with cervical cancer among women in South-western Uganda.

Methods: We conducted an unmatched case-control study on 470 participants in a 1:2 case-to-control ratio among women in southwestern Uganda. We recruited 157 women with cervical cancer as cases and 313 women without cervical cancer as controls at the Mbarara Regional Referral Hospital Cervical Cancer Clinic.

Late Stage at Diagnosis of Cervical Cancer and Its Correlates at a Large Regional Referral Hospital in Uganda: A Cross-Sectional Study.

Background The stage of disease at diagnosis is one of the major determinants of survival in women with cervical cancer. Most women with cervical cancer in low- and middle-income countries (LMICs) present to hospitals with advanced stages, thus reducing their survivorship following the diagnosis. Factors correlated with late-stage disease at diagnosis are not completely explored.

Effect of metabolic syndrome and its components on the risk and prognosis of cervical cancer: A literature review.

Despite the global implementation of preventive strategies against Human Papilloma Virus (HPV) infection, the incidence of invasive cervical cancer rose by nearly 1.3-fold, from 471,000 annual cases in 2000 to 604,000 cases in 2020. With over 340,000 deaths annually, cervical cancer is the fourth leading cause of cancer mortality in women globally.

Negative effects of undernutrition on sputum smear conversion and treatment success among retreatment cases in Uganda: A quasi-experimental study.

Rationale: The causal relationship between undernutrition and response to anti-tuberculosis (TB) treatment and TB treatment outcomes among people with retreatment TB is understudied.

Objective: To evaluate the effect of undernutrition on treatment success and sputum smear conversion among people with retreatment drug-susceptible TB in Kampala, Uganda.

Methods: We conducted a quasi-experimental study utilizing propensity score weighting among people with retreatment drug-susceptible TB aged ≥ 15 years treated between 2012 and 2022 in Kampala.

Voluntariness of consent in paediatric HIV clinical trials: a mixed-methods, cross-sectional study of participants in the CHAPAS-4 and ODYSSEY trials in Uganda.

Objectives: To examine the voluntariness of consent in paediatric HIV clinical trials and the associated factors.

Design: Mixed-methods, cross-sectional study combining a quantitative survey conducted concurrently with indepth interviews.

Setting And Participants: From January 2021 to April 2021, we interviewed parents of children on first-line or second-line Anti-retroviral therapy (ART) in two ongoing paediatric HIV clinical trials [CHAPAS-4 (ISRCTN22964075) and ODYSSEY (ISRCTN91737921)] at the Joint Clinical Research Centre Mbarara, Uganda.

Magnitude and trends in cervical cancer at Mbarara Regional Referral Hospital in South Western Uganda: Retrospective analysis of data from 2017-2022.

High-income countries have documented a significant decline in the incidence and mortality of cervical cancer over the past decade but such data from low and middle-income countries such as Uganda is limited to ascertain trends. There is also paucity of data on the burden of cervical cancer in comparison to other gynaecologic malignancies and there is a likelihood that the incidence might be on the rise. To describe the current trends and magnitude of cervical cancer in comparison to other gynaecological malignancies histological types, we conducted a retrospective records review of charts of patients admitted with gynaecological malignancies on the gynaecological ward of Mbarara Regional Referral Hospital (MRRH) between January 2017 and December 2022.

Trust in Medical Research: A Comparative Study among Patients at a Regional Referral Hospital and Community Members in Lira District, Northern Uganda.

Events such as the Tuskegee syphilis study shaped how the public perceives and trusts medical research globally. However, few studies have examined trust in medical research in developing countries. We tested the hypothesis that levels of trust may be lower among community members compared to hospitalized persons in Uganda.

Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution.

Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines.

Case fatality rate for Ebola disease, 1976-2022: A meta-analysis of global data.

An up-to-date pooled case fatality rate (CFR) for Ebola disease (EBOD) at the global level is lacking. We abstracted EBOD data from 1976 to 2022 for 16 countries and 42 outbreaks to conduct a meta-analysis. The pooled CFR was 60.

High prevalence of risky sexual behaviour among key populations receiving antiretroviral therapy at a large HIV clinic in northern Uganda.

Background: Risky sexual behaviour (RSB) among key populations pose a significant risk of human immunodeficiency virus (HIV) infection but remains understudied.

Objectives: We assessed the prevalence and factors associated with RSB among key populations living with HIV (KPLHIV) in the post-conflict region of northern Uganda.

Methods: We designed a cross-sectional study using secondary data, with the outcome as RSB defined as having multiple sexual partners, or condomless sex in the past 3 months, or sexual intercourse with a commercial sex worker in the past 3 months, or sexual intercourse under the influence of substance use in the past 3 months.

Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study.

Background: Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs.

Utilization of health insurance by patients with diabetes or hypertension in urban hospitals in Mbarara, Uganda.

Background: Diabetes and hypertension are among the leading contributors to global mortality and require life-long medical care. However, many patients cannot access quality healthcare due to high out-of-pocket expenditures, thus health insurance would help provide relief. This paper examines factors associated with utilization of health insurance by patients with diabetes or hypertension at two urban hospitals in Mbarara, southwestern Uganda.