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Oral rehydration for severe malnutrition in children with moderate and severe dehydration (GASTROSAM): a phase 2, open-label, superiority randomised controlled trial.

BACKGROUND: International guidelines for treatment of children with severe acute malnutrition advise against giving standard oral rehydratio … d controlled trial conducted at six hospitals in four African countries (Kenya, Niger, Nigeria, and Uganda). Children aged 6 months to 12 years with severe acute malnutrition who were admitted to hospital with severe (stratum A) or moderate (stratum B) dehydration and diarrhoea were randomly assigned in a 1:1 ratio to receive ReSoMal or low-osmolarity WH …

Safety of combined long-acting injectable cabotegravir and long-acting injectable rilpivirine in virologically suppressed adolescents with HIV (IMPAACT 2017/MOCHA): a phase 1/2, multicentre, open-label, non-comparative, dose-finding study.

BACKGROUND: Long-acting cabotegravir and long-acting rilpivirine constitute a completely intramuscular antiretroviral therapy (ART) regimen for adults with HIV. We aimed to assess the safety, antiviral activity, and pharmacokinetics of oral cabotegravir and rilpivirine followed by a combination of long-acting cabotegravir and long-acting rilpivirine in virologically suppressed adolescents with HIV. METHODS: The IMPAACT 2017/MOCHA study is a phase 1/2, multicentre, open-label, non-comparative, dose-finding trial being conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and t…

Epstein-Barr virus and cytomegalovirus co-infections and mortality risk in patients with HIV-associated cryptococcal meningitis: a post-hoc analysis of a prospective nested cohort in the AMBITION-cm randomised controlled trial.

BACKGROUND: HIV-associated cryptococcal meningitis case fatality remains greater than 25%. Co-prevalent infections might contribute to poor … -cm was done at seven hospital sites across five African countries (Botswana, Malawi, South Africa, Uganda, and Zimbabwe). The primary endpoint of the trial was all-cause mortality at 10 weeks. Quantitative PCR (qPCR) was used to measure baseline cytomegalovirus and EBV viral loads in these samples. Baseline demographic and clinical data including antire …

A randomized, controlled Phase 1b trial of the Sm-TSP-2 Vaccine for intestinal schistosomiasis in healthy Brazilian adults living in an endemic area.

BACKGROUND: Recombinant Schistosoma mansoni Tetraspanin-2 formulated on Alhydrogel (Sm-TSP-2/Alhydrogel) is being developed to prevent intes … results have led to initiation of a Phase 2 clinical trial of this vaccine in an endemic region of Uganda. TRIAL REGISTRATION: NCT03110757.

Point-of-care C-reactive protein-based tuberculosis screening for people living with HIV: a diagnostic accuracy study.

BACKGROUND: Symptom-based screening for tuberculosis is recommended for all people living with HIV. This recommendation results in unnecessa … l to 350 cells per μL who were initiating antiretroviral therapy (ART) from two HIV/AIDS clinics in Uganda. CRP concentrations were measured at study entry with a point-of-care assay using whole blood obtained by fingerprick (concentration ≥10 mg/L defined as screen positive for tuberculosis). Sputum samples were collected for Xpert MTB/RIF testing and c …

Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial.

BACKGROUND: HIV antiretroviral therapy (ART) is often managed without routine laboratory monitoring in Africa; however, the effect of this approach is unknown. This trial investigated whether routine toxicity and efficacy monitoring of HIV-infected patients receiving ART had an important long-term effect on clinical outcomes in Africa. METHODS: In this open, non-inferiority trial in three centres in Uganda and one in Zimbabwe, 3321 symptomatic, ART-naive, HIV-infected adults with CD4 counts less than 200 cells per microL starting ART were randomly assigned to laboratory and clinical monitorin…

Prophylactic antibiotics to reduce pelvic infection in women having miscarriage surgery - The AIMS (Antibiotics in Miscarriage Surgery) trial: study protocol for a randomized controlled trial.

BACKGROUND: The estimated annual global burden of miscarriage is 33 million out of 210 million pregnancies. Many women undergoing miscarriage have surgery to remove pregnancy tissues, resulting in miscarriage surgery being one of the most common operations performed in hospitals in low-income countries. Infection is a serious consequence and can result in serious illness and death. In low-income settings, the infection rate following miscarriage surgery has been reported to be high. Good quality evidence on the use of prophylactic antibiotics for surgical miscarriage management is not availabl

HIV, HCMV and mycobacterial antibody levels: a cross-sectional study in a rural Ugandan cohort.

OBJECTIVES: A growing evidence base implicates human cytomegalovirus (HCMV) as a risk factor for TB disease. We investigated total IgG and mycobacteria-specific antibodies in a cross-sectional study nested within a rural Ugandan General Population Cohort (GPC), in relation to HIV infection and the magnitude of HCMV IgG response. METHODS: Sera from 2189 individuals (including 27 sputum-positive TB cases) were analysed for antibodies against mycobacteria (Ag85A, PPD, LAM, ESAT6/CFP10) and HCMV, tetanus toxoid (TT) and total IgG. RESULTS: Anti-mycobacterial antibodies increased with age until a…

Determinants of Uptake of Cervical Cancer Screening Services at a No-cost Reproductive Health Clinic Managed by Nurse-Midwives.

BACKGROUND: The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS. OBJECTIVE: The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives. METHODS: A descriptive design and a structured interview questionnaire were used to collect data from 236 women

Benzathine penicillin adherence for secondary prophylaxis among patients affected with rheumatic heart disease attending Mulago Hospital.

INTRODUCTION: Rheumatic heart disease (RHD) frequently occurs following recurrent episodes of acute rheumatic fever (ARF). Benzathine penicillin (benzapen) is the most effective method for secondary prophylaxis against ARF whose efficacy largely depends on adherence to treatment. Various factors determine adherence to therapy but there are no data regarding current use of benzapen in patients with RHD attending Mulago Hospital. The study aims were (1) to determine the levels of adherence with benzapen prophylaxis among rheumatic heart disease patients in Mulago Hospital, and (2) establish the

Whole-genome sequencing and phylogenetic analysis of Salmonella isolated from pullets through final raw product in the processing plant of a conventional broiler complex: a longitudinal study.

UNLABELLED: Salmonella are Gram-negative, rod-shaped, entero-invasive foodborne bacteria and are frequently detected in chicken houses and f … S. Johannesburg, S. Montevideo, S. Mbandaka, S. Newport, S. Senftenberg, S. Inverness, S. Ohio, S. Uganda, and N/A (9:z29:-). Phylogenetic analysis showed strong genetic relationship among bacterial strains isolated from different stages. It also suggests diverse movement patterns of bacterial strains and possibility of multiple critical points for bact …

The TB vaccine clinical trial centre directory: An inventory of clinical trial centres in Sub-Saharan Africa.

BACKGROUND: There are over ten vaccine candidates for tuberculosis (TB) in the clinical pipeline that require testing in TB-prevalent popula … could potentially conduct TB vaccine trials, followed by Tanzania (5), Kenya (5), Nigeria (3), and Uganda and Ethiopia (2 each). Trial sites in other countries were underrepresented, based on this survey. CONCLUSION: The establishment of a clinical trial centre directory can provide a basis for decision-making by various stakeholders. Despite some limi …

Rural-urban differentials in the association between sex preference for children and marital dissolution in sub-Saharan Africa.

BACKGROUND: Marital dissolution, which refers to being divorced or separated, is considered one of the most dramatic demographic events that … 95% CI:8.78-8.99), with the lowest prevalence in Mali (3.30%; 95% CI: 2.91-3.69) and the highest in Uganda (18.60%; 95% CI: 17.95-19.25). For rural sub-Saharan Africa, the pooled prevalence was 4.11% (95% CI: 4.03-4.18), with the lowest (0.80%; 95% CI: 0.65-0.95) and highest (14.40%; 95% CI: 13.51-15.29) prevalences in Burkina Faso and Mozambique, respec …

Quality of clinical management of children diagnosed with malaria: A cross-sectional assessment in 9 sub-Saharan African countries between 2007-2018.

BACKGROUND: Appropriate clinical management of malaria in children is critical for preventing progression to severe disease and for reducing … d 24,756 direct clinical observations of outpatient sick-child visits across 9 countries, including Uganda (2007), Rwanda (2007), Namibia (2009), Kenya (2010), Malawi (2013), Senegal (2013-2017), Ethiopia (2014), Tanzania (2015), and Democratic Republic of the Congo (2018). We assessed the proportion of children with a malaria diagnosis who received a bl …

Outcomes and microbiological patterns of bacteremia in chemotherapy-related febrile neutropenia at a tertiary facility in Kenya.

IntroductionFebrile neutropenia (FN) is a major cause of mortality and morbidity in patients with malignancy post-chmotherapy. Current guidelines for managing FN recommend starting empiric antibiotic therapy (EAT) promptly. The choice of antibiotic is based on the patient's condition, local data on common microorganisms isolated, and their resistance patterns. Of note, there is a growing trend of isolating multi-drug-resistant gram-negative bacteria in these patients. In sub-Saharan Africa, there are insufficient data on the mortality rates of FN. There is also a lack of local epidemiologic da

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… Our results are also in keeping with studies from SSA and the Middle East in Uganda and Lebanon, respectively, where gram-negative bacteria were isolated from 57.3-66.7% of BSI [ 5 , 13 ]. … Bacteremia in febrile cancer patients in Uganda. BMC Res Notes. 2019;12:464. doi: 10.1186/s13104-019-4520-9. 14. Sigurdardottir K., Digranes A., Harthug S., Nesthus I., Tangen J.M., Dybdahl B., et al. …

Impact of non-communicable diseases on maternal and perinatal outcomes in a low resource setting.

BACKGROUND: Non-communicable diseases (NCDs) are increasingly prevalent among women of reproductive age and may pose significant risks to maternal and perinatal health. Despite their growing burden, data on their impact in low-resource settings remains limited. This study aimed to investigate the impact of pre-pregnancy NCDs on severe maternal and adverse perinatal outcomes among pregnant women admitted at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. METHODS: We prospectively enrolled pregnant women admitted to the maternity ward of MRRH from July 2022 to October 2023. We…