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Surgical, Obstetric, and Anesthetic Mortality Measurement at a Ugandan Secondary Referral Hospital.

BACKGROUND: The health care systems of low-income countries have severely limited capacity to treat surgical diseases and conditions. There is limited information about which hospital mortality outcomes are suitable metrics in these settings. METHODS: We did a 1-year observational cohort study of patient admissions to the Surgery and the Obstetrics and Gynecology departments and of newborns delivered at a Ugandan secondary referral hospital. We examined the proportion of deaths captured by standardized metrics of mortality. RESULTS: There were 17,015 admissions and 9612 deliveries. A total o…

Treatment of Burkitt lymphoma in children and adults: Lessons from Africa.

Modern chemotherapy for childhood Burkitt lymphoma has its origins in Africa, where treatment evolved from one or two doses of single agents, which were curative in some patients, to combinations of non-cross-resistant drugs. Subsequently, in Europe and the United States, high-dose methotrexate, high-dose cytarabine, etoposide, and ifosfamide were found to be active in children with recurrent disease and were incorporated into primary therapy for patients with high-risk disease. These third-generation protocols produce overall cure rates around 90%. Therapy regimens for adults with Burkitt lym

Диверсификация глобальных тенденций заболеваемости раком ранней стадии: сопоставление с тенденциями заболеваемости раком более поздней стадии и тенденциями смертности от рака ранней стадии.

Глобальное увеличение заболеваемости раком в раннем возрасте (определяемым как рак, диагностируемый на 20-49 ) является серьезной проблемой в области здравоохранения. Мы расследовали 1) отличается ли тенденция заболеваемости раком раннего зарождения от тенденции заболевания раком на более позднем этапе и 2) увеличиваются ли одновременно как частотность, так и смертность от рака раннего возраста. 2000 и 2017 от раковых заболеваний Five Базы данных о смертности на континентах и Всемирной организации здравоохранения (ВОЗ). Общенациональная распространенность ожирения среди взрослых 20-49 Годы был

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… Rica, Croatia, Cyprus, Czech Republic, Denmark, Ecuador, Estonia, Finland, France, Germany, Iceland, India, Ireland, Israel, Italy, Japan, Kuwait, Latvia, Lithuania, Malta, Netherlands, New Zealand, Norway, Philippines, Poland, Republic of Korea, Slovenia, Spain, Sweden, Switzerland, Thailand, Turkey, Uganda … Among these countries, data on early-onset cancer mortality were not available in the following 8 countries: Bahrain, Belarus, China, Iceland, India, Thailand, Turkey, and Uganda. Therefore, we included the remaining 36 countries for comparative analyses of incidence and mortality. …

Systemic immune activation and microbial translocation in dual HIV/tuberculosis-infected subjects.

BACKGROUND: Systemic immune activation is a strong predictor of progression of human immunodeficiency virus type 1 (HIV-1) disease and a prominent feature of infection with Mycobacterium tuberculosis. OBJECTIVE: To understand the role of systemic immune activation and microbial translocation in HIV/tuberculosis dually infected patients over the full spectrum of HIV-1 immunodeficiency, we studied circulating sCD14 and lipopolysaccharide (LPS) and their relationship to HIV-1 activity. METHODS: Two cohorts of HIV/tuberculosis subjects defined by CD4 T-cell count at time of diagnosis of tubercul

Safety, antiviral activity, and pharmacokinetics of long-acting injectable cabotegravir-rilpivirine in virologically suppressed adolescents living with HIV-1 (IMPAACT 2017/MOCHA): 48-week results of a multinational, phase 1/2, single-arm study.

BACKGROUND: Combined intramuscular long-acting cabotegravir-rilpivirine is the first long-acting combination antiretroviral therapy regimen … non-comparative, dose-finding trial conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and the USA, virologically suppressed (HIV-1 RNA <50 copies per mL) adolescents (aged 12-17 years; weight ≥35 kg) with HIV-1 switched prestudy antiretrovirals to 4 weeks of daily oral 30 mg cabotegravir and 25 mg rilpivirine, followed by 600 mg cab …

Exposed yet unmapped: evidence of differential flood exposure in deprived urban areas using citizen science.

BACKGROUND: Due to their immature immune system, neonates are at high risk of infection. This vulnerability when combined with limited resou … e pilot two-arm cluster randomised controlled trial took place in 10 villages around Mbale, Eastern Uganda. Women were eligible and recruited antenatally if their gestation was ≥ 34 weeks. All infants of mothers participating in the BabyGel pilot trial were followed up for the first 3 months of life. Evidence for infant infection was collected using five …

Potential benefit of extended dose schedules of human papillomavirus vaccination in the context of scarce resources and COVID-19 disruptions in low-income and middle-income countries: a mathematical modelling analysis.

BACKGROUND: The WHO Strategic Advisory Group of Experts recommended that an extended interval of 3-5 years between the two doses of the huma … librated to country-specific data for four low-income and middle-income countries (India, Viet Nam, Uganda, and Nigeria). For the extended dose scenarios, we varied the vaccination coverage of the second dose among girls previously vaccinated, the one-dose vaccine efficacy, and the one-dose vaccine duration of protection. We also examined a strategy in w …

Safety, antiviral activity, and pharmacokinetics of long-acting cabotegravir plus long-acting rilpivirine in virologically suppressed adolescents living with HIV-1 (IMPAACT 2017/MOCHA): week 96 and end-of-study results from a multinational, phase 1/2, single-arm trial.

BACKGROUND: Week 24 and week 48 study data from the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT 2017)/ … ho were virologically suppressed were enrolled across 18 sites in Botswana, South Africa, Thailand, Uganda, and the USA. Participants switched from pre-study antiretroviral therapy (ART) to 4 weeks of daily oral cabotegravir plus oral rilpivirine, followed by 600 mg long-acting cabotegravir plus 900 mg long-acting rilpivirine intramuscular (3 mL each) in …

Post-discharge malaria chemoprevention in children admitted with severe anaemia in malaria-endemic settings in Africa: a systematic review and individual patient data meta-analysis of randomised controlled trials.

BACKGROUND: Severe anaemia is associated with high in-hospital mortality among young children. In malaria-endemic areas, surviving children … nthly dihydroartemisinin-piperaquine given at the end of weeks 2, 6, and 10 post discharge (n=1049; Uganda and Kenya). During the intervention period, post-discharge malaria chemoprevention was associated with a 77% reduction in mortality (RR 0·23 [95% CI 0·08-0·70], p=0·0094, I2=0%) and a 55% reduction in all-cause readmissions (HR 0·45 [95% CI 0·36-0·5 …

Cancer survival in sub-Saharan Africa (SURVCAN-3): a population-based study.

BACKGROUND: The Cancer Survival in Africa, Asia, and South America project (SURVCAN-3) of the International Agency for Research on Cancer ai … irobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow- …

Drought and intimate partner violence towards women in 19 countries in sub-Saharan Africa during 2011-2018: A population-based study.

BACKGROUND: Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intim … found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemploye …

Efficacy of adjunctive sertraline for the treatment of HIV-associated cryptococcal meningitis: an open-label dose-ranging study.

BACKGROUND: Cryptococcus is the most common cause of adult meningitis in Africa. We assessed the safety and microbiological efficacy of adjunctive sertraline, previously shown to have in-vitro and in-vivo activity against cryptococcus. METHODS: In this open-label dose-finding study, we recruited HIV-infected individuals with cryptococcal meningitis who presented to Mulago Hospital in Kampala, Uganda between Aug 14, 2013, and Aug 30, 2014. To assess safety and tolerability, the first 60 participants were given sertraline at escalating doses of 100 mg/day, 200 mg/day, 300 mg/day, or 400 mg/day …

Dysregulation of angiopoietin-1 plays a mechanistic role in the pathogenesis of cerebral malaria.

Cerebral malaria is a leading cause of global morbidity and mortality. Interventions targeting the underlying pathophysiology of cerebral malaria may improve outcomes compared to treatment with antimalarials alone. Microvascular leak plays an important role in the pathogenesis of cerebral malaria. The angiopoietin (Ang)-Tie-2 system is a critical regulator of vascular function. We show that Ang-1 expression and soluble Tie-2 expression were associated with disease severity and outcome in a prospective study of Ugandan children with severe malaria and in a preclinical murine model of experiment…

Targeted FMD Vaccines for Eastern Africa: The AgResults Foot and Mouth Disease Vaccine Challenge Project.

As one of the most infectious livestock diseases in the world, foot and mouth disease (FMD) presents a constant global threat to animal trad … e Project targets the following Pool Four countries: Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda. The Project is being run in two phases: a development phase, which will encourage the production of regionally relevant vaccines, and a cost-share phase, designed to help to reduce the price of these vaccines in the marketplace to the end users, wh …

Sir Alan Sterling Parkes: 10 September 1900 - 17 July 1990.

Alan Parkes was one of the most influential figures in the field of reproductive biology in the twentieth century. He had a huge impact on i … ish wild mammals, he became involved in the work of the Nuffield Unit of Tropical Animal Ecology in Uganda, where similar studies were carried out on African animals. Even after retirement from the academic field, he was for some years a consultant to an enterprise in the conservation and captive breeding of green sea turtles in the Cayman Islands. In ad …

Patterns of Care of Cancers and Radiotherapy in Ethiopia.

PURPOSE: Radiotherapy (RT) is an essential component of cancer treatment. There is a lack of RT services in sub-Saharan Africa as well as limited knowledge regarding clinical practices. The purpose of this study was to identify and describe the patterns for RT treatment in Ethiopia. METHODS AND MATERIALS: We performed a retrospective analysis of 1,823 patients treated with cobalt RT at a large referral hospital in Addis Ababa, Ethiopia, from May 2015 through January 2018. Paper charts were reviewed for patient and treatment characteristics. Descriptive statistics were computed using SPSS (IBM

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… diagnosed with cervical cancer (a largely avoidable disease) live in LMICs with limited access to preventative services and treatment. 16 - 18 The prevalence of HIV in our cohort was 3-fold higher than that of the general Ethiopian population (4.6% v 1.5%, respectively), which has also been observed in Uganda … HIV status and associated clinical characteristics among adult patients with cancer at the Uganda Cancer Institute. J Glob Oncol. doi: 10.1200/JGO.17.00112. 10.1200/JGO.17.00112 . 21. Kantelhardt EJ, Moelle U, Begoihn M, et al. …

Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

BackgroundStudies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these conce

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… In 1990 over 10% of the adult population was HIV-positive in three countries (Zambia, Zimbabwe and Uganda); by 2000 the prevalence had risen to 24.8% in Zimbabwe and 14.4% in Zambia but had declined to 7.3% in Uganda. … 0.14 | 0.56 Seychelles | 18.8; 39.0 | 7.1; 15.5 | 11.5; 27.4 | 2.2; 5.9 | 1970 | 57.96 | 72.41 | 0.33 | 0.05 Somalia | 45.6; 49.7 | 13.7; 29.8 | 19.1; 33.2 | 7.1; 7.4 | 1970 | 33.99 | 53.21 | 0.31 | 0.27 South Sudan | 38.5; 51.4 | 13.6; 37.3 | 10.4; 27.3 | 5.4; 6.9 | 1980 | 27.88 | 52.12 | 0.35 | 0.41 Uganda …

Magnitude of cancer-associated thrombosis in Africa: A systematic review and meta-analysis.

Comprehensive data on the epidemiology of cancer-related thrombosis in Africa has been sparse until recently. Thus, this review was aimed to investigate the magnitude of cancer-related thrombosis in Africa. To obtain key articles, comprehensive search was conducted using various databases. A random-effects model was used to determine the pooled magnitude. Heterogeneity across the studies was checked, and publication bias was determined. The pooled magnitude of thrombosis among cancer patients in Africa is 11.65% (95% confidence interval [CI]: 9.02-14.28). Advanced age, comorbidity, and level o

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… | Solid | 2021 | 6.1 | 98 | 48 | Cross-sectional | 8 Mboizi et al. 41 | Uganda | Solid | 2023 | 0.6 | 180 | NR | Cross-sectional | 8 Mbabazi 43 | Uganda | Solid | – | 45 | 200 | NR | Cross-sectional | 8 Mugeni et al. 56 | Rwanda | Mixed | 2019 | 36 | 50 | 41 | Retrospective cross-sectional | 9 Messoudi … Survival of patients with cancer associated thrombosis at the Uganda Cancer Institute. ecancermedicalscience. 2021;15 doi: 10.3332/ecancer.2021.1212. 41. Vincent M., Sereke S.G., Ameda F., Richard O.O., Alfred B. 2023. …

Efficacy and safety of dolutegravir or darunavir in combination with lamivudine plus either zidovudine or tenofovir for second-line treatment of HIV infection (NADIA): week 96 results from a prospective, multicentre, open-label, factorial, randomised, non-inferiority trial.

BACKGROUND: WHO guidelines recommend dolutegravir plus two nucleoside reverse transcriptase inhibitors (NRTIs) for second-line HIV therapy, … treatment failure (HIV-1 RNA ≥1000 copies per mL) were recruited at seven clinical sites in Kenya, Uganda, and Zimbabwe. Following a 2 × 2 factorial design and stratified by site and screening HIV-1 RNA concentration, participants were randomly assigned (1:1:1:1) to receive a 96-week regimen containing either dolutegravir (50 mg once daily) or ritonavir …

The global HIV response at 40.

It is helpful to divide the global HIV response into three phases: The first, from about 1980 to 2000, represents "Calamity". The second, fr … om fifth: Namibia, Botswana, Eswatini (formerly Swaziland), Malawi, South Africa, Tanzania, Zambia, Uganda, Lesotho, Ethiopia, Mozambique, Cote D'Ivoire and Nigeria. Of course, causality is unresolved and there are several possible explanations: (1) low human capital formation may increase HIV transmission; (2) the HIV epidemic may have intergenerational …