Cost-effectiveness analysis of integrated community case management delivery models utilizing drug sellers and community health workers for treatment of under-five febrile cases of malaria, pneumonia, diarrhoea in rural Uganda.

Background: Malaria, pneumonia and diarrhoea continue to be the leading causes of death in children under the age of five years (U5) in Uganda. To combat these febrile illnesses, integrated community case management (iCCM) delivery models utilizing community health workers (CHWs) or drug sellers have been implemented. The purpose of this study is to compare the cost-effectiveness of delivering iCCM interventions via drug sellers versus CHWs in rural Uganda.

High Levels of Antibiotic Resistance Patterns in Two Referral Hospitals during the Post-Ebola Era in Free-Town, Sierra Leone: 2017-2019.

The Post-Ebola era (2017-2019) presented an opportunity for laboratory investments in Sierra Leone. US CDC supported the Ministry of Health and Sanitation to establish a microbiological unit for routine antimicrobial sensitivity testing in two referral (pediatric and maternity) hospitals in Freetown. This study describes resistance patterns among patients' laboratory samples from 2017 to 2019 using routine data.

A case study on chemistry classroom practices in the Rwandan secondary schools.

This study aims at assessing the classroom practices of Rwandan chemistry teachers in secondary schools, the second grade (S2), age range between 14 to 16 years old. The classroom observation conducted using the Classroom Observation Protocol for Undergraduate STEM (COPUS). In general, the best practice of group work or collaborative learning and students' engagement was observed.

Structure of Chimpanzee Gut Microbiomes across Tropical Africa.

Understanding variation in host-associated microbial communities is important given the relevance of microbiomes to host physiology and health. Using 560 fecal samples collected from wild chimpanzees (Pan troglodytes) across their range, we assessed how geography, genetics, climate, vegetation, and diet relate to gut microbial community structure (prokaryotes, eukaryotic parasites) at multiple spatial scales. We observed a high degree of regional specificity in the microbiome composition, which was associated with host genetics, available plant foods, and potentially with cultural differences in tool use, which affect diet.

HIV infection modifies the relationship between distance to a health facility and treatment success rate for tuberculosis in rural eastern Uganda.

Rationale: Distance from residence to a health facility especially in rural areas presents a physical barrier and may influence tuberculosis (TB) treatment outcomes.

Objectives: We examined the association between distance from residence to a health facility and TB treatment outcomes namely treatment success rate (TSR) and mortality, and whether HIV influences this relationship among people with TB in Kumi district in rural eastern Uganda.

Methods: In this cross-sectional design, we abstracted data from TB unit registers across four large health facilities.

Perceived stigma and school attendance among children and adolescents with epilepsy in South Western Uganda.

Background: Epilepsy is a neurological disorder that has a high worldwide prevalence with eighty percent of the global burden being in low and middle-income countries. There is a high level of perceived stigma among children and adolescents with epilepsy, which has severe debilitating effects and affects school attendance.

Objective: To assess the effect of perceived stigma on school attendance patterns among children and adolescents with epilepsy.

Long-distance truck drivers and the increasing risk of COVID-19 spread in Uganda.

Objective: To examine the patterns of COVID-19 transmission in Uganda.

Methods: We reviewed ten weeks of press releases from the Uganda Ministry of Health from the day when the first case was announced, March 22, through May 29, 2020. We obtained the press releases from the MoH website and the Twitter handle (@MinofHealthUG).

The Association of Malnutrition and Disease Conditions in Mortality of Pediatric Patients Presenting to a Rural Emergency Department in Uganda.

Objectives: The main objectives of this study were to determine the effect of concurrent malnutrition on disease condition and the primary outcome of mortality in children younger than 5 years hospitalized after presenting to a rural emergency department (ED) in Uganda and to identify a high-risk patient population who may benefit from acute ED intervention.

Methods: A retrospective, observational study was performed to examine the effect of any form of malnutrition on the primary disease conditions of lower-respiratory tract infection (LRTI), malaria, and diarrheal illness. This study was conducted via review of a quality assurance database between January 2010 and July 2014.

Death audits and reviews for reducing maternal, perinatal and child mortality.

Background: The United Nations' Sustainable Development Goals (SDGs) include reducing the global maternal mortality rate to less than 70 per 100,000 live births and ending preventable deaths of newborns and children under five years of age, in every country, by 2030. Maternal and perinatal death audit and review is widely recommended as an intervention to reduce maternal and perinatal mortality, and to improve quality of care, and could be key to attaining the SDGs. However, there is uncertainty over the most cost-effective way of auditing and reviewing deaths: community-based audit (verbal and social autopsy), facility-based audits (significant event analysis (SEA)) or a combination of both (confidential enquiry).

'We are all serving the same Ugandans': A nationwide mixed-methods evaluation of private sector surgical capacity in Uganda.

Introduction: Half of all Ugandans (49%) turn to the private or private-not-for-profit (PNFP) sectors when faced with illness, yet little is known about the capacity of these sectors to deliver surgical services. We partnered with the Ministry of Health to conduct a nationwide mixed-methods evaluation of private and PNFP surgical capacity in Uganda.

Methods: A standardized validated facility assessment tool was utilized to assess facility infrastructure, service delivery, workforce, information management, and financing at a randomized nationally representative sample of 16 private and PNFP hospitals.

Assessment of the quality of stored blood for transfusion at Mbarara Regional Referral Hospital, Southwestern Uganda.

To assess the quality of blood stored for transfusion at Mbarara Regional Referral Hospital (MRRH) regarding bacterial contamination, malaria infection, and laboratory audit status. Whole blood and packed red blood cells at MRRH were critically inspected for visual anomalies, and a portion of this blood was aseptically collected and analyzed for and bacterial contamination using culture methods. For culture positive samples, drug susceptibility testing (DST) was done using the Kirby-Bauer disc diffusion method.

High Incidence of Intended Partner Pregnancy Among Men Living With HIV in Rural Uganda: Implications for Safer Conception Services.

Background: Many men with HIV express fertility intentions and nearly half have HIV-uninfected sexual partners. We measured partner pregnancy among a cohort of men accessing antiretroviral therapy in Uganda.

Methods: Self-reported partner pregnancy incidence and bloodwork (CD4, HIV-RNA) were collected quarterly.

Diagnostic and Treatment Challenges of Paroxysmal Nocturnal Hemoglobinuria in Uganda.

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a very rare disorder of the hematopoietic stem cells which is often underdiagnosed. Its incidence is about 5 cases per million inhabitants in a year, and currently, there are only 1610 patients in the International PNH Registry. In this report, we describe a case of PNH in southwestern Uganda.

Parents' and caretakers' perceptions and concerns about accessibility of antenatal services by pregnant teenagers in Mbarara Municipality, Uganda.

Background: Uganda has one of the highest teenage pregnancy rates in Sub-Saharan Africa and the world. About a quarter of teenagers become pregnant annually. This is much higher than the global rate of 11%.

HPV-Chlamydial Coinfection, Prevalence, and Association with Cervical Intraepithelial Lesions: A Pilot Study at Mbarara Regional Referral Hospital.

Background: Human Pappilloma Virus (HPV) is the necessary cause of cervical cancer. A number of risk factors are believed to influence the role of HPV in the development of cervical cancer. This is so because majority of HPV infections are cleared and only a few are able to result into cancer.

A systematic review protocol of stigma among children and adolescents with epilepsy.

Background: Epilepsy is a neurological condition that is highly prevalent among children and adolescents with 80% of the victims living in low- and middle-income countries (LMIC). Epilepsy is associated with high levels of both perceived and enacted stigma, which vary geographically and greatly affects the victims' quality of life and self-esteem. High rates of stigma are also a significant barrier to accessing medical care.

Prevalence and risk factors of brucellosis among febrile patients attending a community hospital in south western Uganda.

Human brucellosis, a chronic disease contracted through contact with animals and consuption of unpasteurized dairy products is underreported in limited-resource countries. This cross-sectional study aimed to determine the prevalence and risk factors of brucellosis among febrile patients attending a community hospital in South western Uganda. A questionnaire that captured socio-demographic, occupational and clinical data was administered.

Utility of Clinical and Laboratory Decision Rules in Identifying Bacterial Meningitis Among Children with Suspicion of Central Nervous System Infections in a Malaria-Endemic Area, Mbarara, Uganda.

Several decision rules combining clinical and biological parameters have been proposed to distinguish bacterial from aseptic meningitis, but have not been evaluated in Africa. In children hospitalized with suspected central nervous system infections in Uganda, we found that the Bacterial Meningitis Score and Meningitest showed lower performance than in European children, and that a decision rule designed specifically using parameters associated with bacterial meningitis also showed inadequate diagnostic performance for clinical use.

Influence of Climatic Factors on Malaria Epidemic in Gulu District, Northern Uganda: A 10-Year Retrospective Study.

Background: Globally, 15 countries, mainly in Sub-Saharan Africa, account for 80% of malaria cases and 78% of malaria related deaths. In Uganda, malaria is endemic and the mortality and morbidity due to malaria cause significant negative impact on the economy. In Gulu district, malaria is the leading killer disease among children <5 years.

Health professionals' knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in Ugandans with diabetes: a cross-sectional survey.

Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals' perspective. The aim of the study was to describe healthcare professionals' knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes.

Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda.

You pray to your God: A qualitative analysis of challenges in the provision of safe, timely, and affordable surgical care in Uganda.

Background: Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception.

Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda.

Background: Quantification of human interactions relevant to infectious disease transmission through social contact is central to predict disease dynamics, yet data from low-resource settings remain scarce.

Methods: We undertook a social contact survey in rural Uganda, whereby participants were asked to recall details about the frequency, type, and socio-demographic characteristics of any conversational encounter that lasted for ≥5 min (henceforth defined as 'contacts') during the previous day. An estimate of the number of 'casual contacts' (i.