Exploring barriers to accessing treatment for Lymphatic Filariasis through a socio-ecological lens in Buvuma and Napak districts, Uganda.

Background: The World Health Organization launched the Global Programme to Eliminate Lymphatic Filariasis in 2000, which aimed at eradicating the disease by 2030. This goal depends on community mass drug administration and essential care. Despite these efforts, many rural communities still face untreated lymphatic filariasis and lack access to treatment and self-management.

Clinical predictors of 3-month isoniazid rifapentine (3HP)-related adverse drug reactions (ADR) during tuberculosis preventive therapy (PAnDoRA-3HP study): an observational study protocol.

Introduction: Tuberculosis (TB) is the leading infectious cause of death globally. Despite WHO recommendations for TB preventive therapy (TPT), challenges persist, including incompletion of treatment and adverse drug reactions (ADRs). There is limited data on the 3-month isoniazid and rifapentine (3HP) pharmacokinetics, pharmacogenomics and their relation with ADRs.

Temporal changes in Plasmodium falciparum genetic diversity and multiplicity of infection across three areas of varying malaria transmission intensities in Uganda.

Background: Malaria is a significant public health challenge in Uganda, with Plasmodium falciparum (P. falciparum) responsible for most of malaria infections. The high genetic diversity and multiplicity of infection (MOI) associated with P.

"I Haven't Told Other People. I Want to Keep My Dignity": HIV Related Stigma Among the Elderly in Uganda.

Purpose: Numerous studies focus on stigma, HIV disclosure's impact on treatment compliance, especially in younger groups. Limited research exists about older individuals. We therefore explored issues related to disclosure of HIV status and HIV-related stigma in the elderly.

Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis.

Background: Pneumococcal disease, caused by Streptococcus pneumoniae, imposes a significant global health burden, particularly affecting vulnerable groups such as the elderly and immunocompromised. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is designed to protect against 23 serotypes of Streptococcus pneumoniae. However, there is ongoing debate about its effectiveness in reducing all-cause mortality.

Weekly dihydroartemisinin-piperaquine versus monthly sulfadoxine-pyrimethamine for malaria chemoprevention in children with sickle cell anaemia in Uganda and Malawi (CHEMCHA): a randomised, double-blind, placebo-controlled trial.

Background: In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention with monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, the efficacy of these interventions is compromised by high-grade antifolate resistance of Plasmodium falciparum and poor adherence. We aimed to compare the efficacy of weekly dihydroartemisinin-piperaquine and monthly sulfadoxine-pyrimethamine for the prevention of clinical malaria in children with sickle cell anaemia in areas with high-grade sulfadoxine-pyrimethamine resistance of P falciparum in Uganda and Malawi.

Hydroxyurea therapy for neurological and cognitive protection in pediatric sickle cell anemia in Uganda (BRAIN SAFE II): Protocol for a single-arm open label trial.

Background: Children with sickle cell anemia (SCA) in Sub-Saharan Africa are at high risk of sickle cerebrovascular injury (SCVI). Hydroxyurea, a commonly used disease-modifying therapy, may reduce SCVI resulting in potential impact on reducing stroke and cognitive dysfunction. We aim to test the impact of daily hydroxyurea therapy on these outcomes in Ugandan children with SCA.

Self-Reported Physical Activity Levels in Patients With Arthritis: A Retrospective Study.

Introduction Arthritis affects a significant number of adults in the United States, leading to pain and limited mobility. This study explores the impact of physical activity on patients with arthritis, including rheumatoid arthritis, gout, lupus, and fibromyalgia. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), it examines how exercise may improve symptoms and quality of life for these patients.

Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.

Background: Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status.

Methods: Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave).

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

'Some parts of the consent form are written using complex scientific language': community perspectives on informed consent for research with pregnant and lactating mothers in Uganda.

Background: Appropriate language use is essential to ensure inclusion of diverse populations in research. We aimed to identify possible language-related barriers regarding the informed consent process and propose interventions to improve clarity and understanding of pregnant and breastfeeding women participating in research.

Methods: A cross-sectional qualitative study employing focus group discussions (FGD) was conducted in Uganda from August 2023 to September 2023, involving a diverse group of stakeholders from the community, including community members, research participants, and Community Advisory Board members.

Acceptability of a resource-oriented approach (DIALOG+) among patients with chronic physical illnesses in primary health care-Uganda, a qualitative study.

Background: Chronic physical illnesses are often associated with significant psychological distress and chronic mental illnesses are often co-morbid with physical illnesses. Efforts to integrate mental health into primary health care in Uganda are underway. However, there are enormous logistical challenges.

'Some patients demand for a prescription of an antibiotic': an assessment of barriers and facilitators to rational antimicrobial use in a private health facility in Uganda.

Background: Antimicrobial misuse and overuse propagate antimicrobial resistance, yet data on factors influencing antibiotic prescription decisions in low-resource settings are limited. We describe factors influencing antimicrobial prescription at a large tertiary care private not-for-profit hospital in Uganda.

Methods: We conducted a descriptive phenomenology qualitative study involving face-to-face in-depth interviews of 12 purposively selected prescribers (four intern doctors, six medical officers and two Internal Medicine physicians) in a private not-for-profit hospital in Kampala, Uganda.

Performance of a score to characterise adequate contact among the social network of persons with TB.

Background: Transmission of requires adequate contact between an infectious case and a susceptible host. The aim of this analysis was to validate a recently developed contact score that assessed settings of exposure and relationships between the case and contact.

Methods: In a cross-sectional study from Kampala, Uganda, we estimated the prevalence of tuberculous infection (TBI) in social contacts of adult TB cases according to the setting and relationship domains of the contact score.

A mixed methods evaluation of 99DOTS digital adherence technology uptake among adolescents treated for pulmonary tuberculosis in Uganda.

Introduction: Adolescents and young adults are at risk of poor adherence to tuberculosis (TB) treatment and subsequently worse TB treatment outcomes. Digital adherence technologies, including the mobile phone-based 99DOTS platform, can support TB treatment, but there is limited data on their use among adolescents.

Objective: To evaluate factors associated with the uptake of 99DOTS among adolescents with TB.

Impact of a multicomponent strategy including decentralized molecular testing for tuberculosis on mortality: planned analysis of a cluster-randomized trial in Uganda.

Background: Rapid diagnosis of tuberculosis (TB) is important for improving outcomes and reducing transmission. Previous studies assessing the impact of Xpert MTB/RIF (Xpert), a molecular assay that provides results within 2 h, on mortality have been inconclusive. In this planned analysis of a pragmatic cluster-randomized trial in Uganda, we assessed whether a multicomponent strategy, including decentralized Xpert testing, decreased mortality among adults evaluated for TB.

Dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy: a systematic review and individual participant data meta-analysis.

Background: High-grade resistance to sulfadoxine-pyrimethamine in East and Southern Africa has prompted numerous trials evaluating intermittent preventive treatment in pregnancy (IPTp) with dihydroartemisinin-piperaquine as an alternative to sulfadoxine-pyrimethamine.

Methods: We conducted individual participant data meta-analyses of randomised trials comparing IPTp with dihydroartemisinin-piperaquine to sulfadoxine-pyrimethamine on maternal, birth, and infant outcomes. We searched the WHO International Clinical Trials Registry Platform, ClinicalTrials.

Advancing pharmacometrics in Africa-Transition from capacity development toward job creation.

Trained pharmacometricians remain scarce in Africa due to limited training opportunities, lack of a pharmaceutical product development ecosystem, and emigration to high-income countries. The Applied Pharmacometrics Training (APT) fellowship program was established to address these gaps and specifically foster job creation for talent retention. We review the APT program's progress over 3 years and encourage collaboration to enhance local clinical data analysis in Africa.

C-reactive Protein-based Screening of People with Tuberculosis Symptoms: A Diagnostic Accuracy Study.

: C-reactive protein (CRP)-based tuberculosis (TB) screening is recommended for people with HIV (PWH). However, its performance among people without HIV and in diverse settings is unknown. : In a multi-country study, we aimed to determine whether CRP meets the minimum accuracy targets (sensitivity ≥90%, specificity ≥70%) for an effective TB screening test.

Building Capacity for Pediatric Hematological Diseases in Sub-Saharan Africa.

The spectrum of hematological diseases in African children includes anemias, bleeding disorders, thromboses, and oncological diseases such as leukemias. While data are limited, outcomes for these diseases are poorer in Africa. The dearth of specialists, and lack of infrastructure that supports diagnosis and management, have been identified as key barriers to improving outcomes for childhood hematological disorders in sub-Saharan Africa (SSA).