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Once-daily dolutegravir-based antiretroviral therapy in infants and children living with HIV from age 4 weeks: results from the below 14 kg cohort in the randomised ODYSSEY trial.

BACKGROUND: Young children living with HIV have few treatment options. We aimed to assess the efficacy and safety of dolutegravir-based antiretroviral therapy (ART) in children weighing between 3 kg and less than 14 kg. METHODS: ODYSSEY is an open-label, randomised, non-inferiority trial (10% margin) comparing dolutegravir-based ART with standard of care and comprises two cohorts (children weighing ≥14 kg and <14 kg). Children weighing less than 14 kg starting first-line or second-line ART were enrolled in seven HIV treatment centres in South Africa, Uganda, and Zimbabwe. Randomisation, which…

Growth in HIV-1-exposed but uninfected infants treated with lopinavir-ritonavir versus lamivudine: a secondary analysis of the ANRS 12174 trial.

BACKGROUND: The tolerance of antiretroviral drugs in infants must be carefully evaluated. In previous studies of children with HIV type 1 (H … t HIV-1 transmission by breastfeeding done at four antenatal clinics in Burkina Faso, South Africa, Uganda, and Zambia. HIV-exposed uninfected infants born to asymptomatic mothers not eligible for antiretroviral therapy (CD4 count >350 cells per μL) were randomly assigned (1:1) to receive lopinavir-ritonavir or lamivudine 7 days after birth, with stratif …

Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Nigeria.

BACKGROUND: Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not o … uct or micronutrients during their 2-wk convalescence period. Two trials, one in Nigeria and one in Uganda, were conducted; here we report on the trial that took place in Goronyo, a rural region of northwest Nigeria with high morbidity and malnutrition rates. METHODS AND FINDINGS: We investigated the effect of supplementation with ready-to-use therapeut …

Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies.

BACKGROUND: The prevalence of epilepsy in sub-Saharan Africa seems to be higher than in other parts of the world, but estimates vary substantially for unknown reasons. We assessed the prevalence and risk factors of active convulsive epilepsy across five centres in this region. METHODS: We did large population-based cross-sectional and case-control studies in five Health and Demographic Surveillance System centres: Kilifi, Kenya (Dec 3, 2007-July 31, 2008); Agincourt, South Africa (Aug 4, 2008-Feb 27, 2009); Iganga-Mayuge, Uganda (Feb 2, 2009-Oct 30, 2009); Ifakara, Tanzania (May 4, 2009-Dec 3…

How does academia respond to the burden of infectious and parasitic disease?

BackgroundAcademic research is one of the main avenues through which humans can fight the threat of infectious diseases. However, there have been concerns regarding whether the academic system has provided sufficient efforts to fight infectious diseases we potentially face. Answering these questions could contribute to evidence-based recommendations for setting research priorities and third-mission policies.MethodsWith a focus on one of the most common categories of communicable diseases, infectious and parasitic diseases (IPDs), we searched Web of Science for articles and reviews relevant to

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… Among them, Uganda has the largest publication output, and also bears a high burden of IPDs (ranked eighth and ninth of DALYs in original value and per 1000 population, respectively). Hence, Uganda is chosen as a typical case in this section. … In terms of the specific diseases, parasitic and vector diseases and HIV/AIDS are the two major causes of such high burden in Uganda. Accordingly, among IPDs publications produced by Uganda, almost 70% targeted these two diseases. …

External validation of a treatment decision algorithm for tuberculosis in children living with HIV: a diagnostic cohort study.

BACKGROUND: Tuberculosis is the leading cause of death in children living with HIV, and is challenging to diagnose owing to the limitations … cohort study conducted in seven tertiary hospitals: two in Côte d'Ivoire, two in Mozambique, one in Uganda, and two in Zambia. Eligible participants were children living with HIV, aged 1 month to 14 years, with presumptive tuberculosis. Children who were currently receiving tuberculosis treatment, or who had received treatment within the past 3 months, w …

Efficacy and safety of short-cycle, dolutegravir-based antiretroviral therapy in adolescents living with HIV (BREATHER Plus): a multicentre, open-label, randomised, parallel, two-arm, non-inferiority trial.

BACKGROUND: Short-cycle antiretroviral therapy (ART), comprising 5 days on and 2 days off treatment, offers the potential for ART-free weeke … non-inferiority trial (BREATHER Plus) in five clinical research centres across Kenya, South Africa, Uganda, and Zimbabwe. Adolescents (aged ≥12 years to <20 years) with an HIV-1 viral load of less than 50 copies per mL over the previous 12 months and no documented history of treatment failure were eligible for inclusion. Participants were randomly assign …

Virological and drug-resistance outcomes for people living with HIV initiating or switching to tenofovir, lamivudine, and dolutegravir in six PEPFAR-supported countries: a prospective cohort study.

BACKGROUND: A combined regimen of tenofovir disoproxil fumarate, lamivudine, and dolutegravir is widely prescribed for people living with HI … lamivudine-dolutegravir therapy at 13 PEPFAR-supported sites in Haiti, Kenya, Malawi, South Africa, Uganda, and Zimbabwe. Group 1 switched from non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy (ART), group 2 switched from protease inhibitor-based ART, and group 3 was ART-naive; before switching, group 1A and group 2A had HIV-1 …

Fixed-dose combination bictegravir, emtricitabine, and tenofovir alafenamide in adolescents and children with HIV: week 48 results of a single-arm, open-label, multicentre, phase 2/3 trial.

BACKGROUND: Bictegravir is a potent integrase strand-transfer inhibitor (INSTI) with a high genetic barrier to resistance. Bictegravir, cofo … en and adolescents (aged 6 to <18 years) with HIV at 22 hospital clinics in South Africa, Thailand, Uganda, and the USA. Eligible participants had a bodyweight of at least 25 kg, were virologically suppressed (HIV-1 RNA <50 copies per mL) on a stable ART regimen for at least 6 months before screening, had a CD4 count of at least 200 cells per μL, and an …

Clinically relevant thresholds for ultrasensitive HIV drug resistance testing: a multi-country nested case-control study.

BACKGROUND: Implementation of ultrasensitive HIV drug resistance tests for routine clinical use is hampered by uncertainty about the clinical relevance of drug-resistant minority variants. We assessed different detection thresholds for pretreatment drug resistance to predict an increased risk of virological failure. METHODS: We did a case-control study nested within a prospective multicountry cohort. Our study included patients from 12 clinical sites in Kenya, Nigeria, South Africa, Uganda, and Zambia. We defined cases as patients with virological failure (ie, those who had either viral load …

Latent Rheumatic Heart Disease: Identifying the Children at Highest Risk of Unfavorable Outcome.

BACKGROUND: Screening echocardiography has emerged as a potentially powerful tool for early diagnosis of rheumatic heart disease (RHD). The utility of screening echocardiography hinges on the rate of RHD progression and the ability of penicillin prophylaxis to improve outcome. We report the longitudinal outcomes of a cohort of children with latent RHD and identify risk factors for unfavorable outcomes. METHODS: This was a prospective natural history study conducted under the Ugandan RHD registry. Children with latent RHD and ≥1 year of follow-up were included. All echocardiograms were re-revi…

Incidence and Risk Factors of Chemotherapy-Induced Nausea and Vomiting Among Adult Cancer Patients at Mbarara Regional Referral Hospital: A Prospective Study.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) remains a significant and distressing adverse effect of cancer treatment, adversely affecting patients' quality of life. Despite well-established international guidelines for antiemetic prophylaxis, variability in CINV incidence and guideline adherence persists across different regions and healthcare settings, particularly in low- and middle-income countries (LMICs). OBJECTIVE: This study determined the incidence and associated factors of chemotherapy-induced nausea and vomiting (CINV) among adult cancer patients at Mbarara Regional

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… This study fills critical gap (no prior Uganda CINV data). Conclusion Over half of the participants receiving chemotherapy at the MRRHCU experienced delayed chemotherapy-induced nausea and vomiting, while nearly one-third experienced acute CINV. … These first Uganda CINV data reveal persistent delayed -phase failure (57.4%) despite moderate adherence (73.4%), primarily due to NK1 antagonist absence which is a modifiable LMIC barrier. …

Student Summer Research Awards - SSRAAbstracts of the SSRA September 2022 meeting, UCD School of Medicine.

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… Africa Uganda, Makindye Division, Kampala, Uganda Hospice Africa Uganda (HAU) is a palliative care organisation which provides essential cancer palliation to the community in which it resides. … patients at Hospice Africa Uganda (HAU). …

Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries.

This article provides updated global cancer statistics for the year 2024 based on the GLOBOCAN estimates of the International Agency for Research on Cancer. The authors describe national cancer incidence and mortality by world region and the Human Development Index and predict the burden in 2050 based on demographic trends. In 2024, an estimated 20.6 million new cancer cases (19.5 million excluding nonmelanoma skin cancer) and 9.8 million deaths (9.7 million excluding nonmelanoma skin cancer) occurred worldwide, equivalent to one in five people developing cancer during their lifetime and one i

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… In the African Breast Cancer‐Disparities in Outcomes study, a hospital‐based cohort in Namibia, Nigeria, South Africa, Uganda, and Zambia, 50%–90% of women were diagnosed at stage III or IV (2014–2019) compared with about 30% in the United States (2013–2022). 72 , 73 In the same study, the proportion … This preventable cancer is the leading cause of cancer death in women in 26 countries (Figure 5 ), primarily in sub‐Saharan Africa (e.g., Democratic Republic of Congo, Tanzania, and Uganda) and also in parts of South and Central America (Bolivia, Belize, El Salvador), Melanesia (Solomon Islands, Vanuatu …

Assessment of Treatment Outcomes and Associated Factors Among Pediatric Patients With Burkitt Lymphoma at Kenyatta National Hospital.

BACKGROUND: In developing countries, the treatment outcomes of Burkitt lymphoma are poor due to the poorly equipped healthcare systems. In addition, there is limited comprehensive data within the African continent, including Kenya, about the outcomes of treatment for this cancer. AIMS: To assess treatment outcomes and variables associated with an increased risk of death from disease progression or treatment-related toxicities among Burkitt lymphoma pediatric patients at the Kenyatta National Hospital (KNH). METHODS AND RESULTS: A retrospective one-arm cohort study was conducted to examine th

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… This finding concurs with studies conducted in the United States and Uganda [ 11 , 17 ]. … M., “Incidence and Geographic Distribution of Endemic Burkitt Lymphoma in Northern Uganda Revisited,” International Journal of Cancer 123, no. 11 (2008): 2658–2663. 26. …

[Current status of the female condom in Africa].

The female condom was developed in the 1980s. It is a contraceptive device used by women that protects against both pregnancy and sexually-t … Africa. Pilot marketing studies were launched in 1996 in Guinea, Zambia, South Africa, followed by Uganda and Tanzania. There are local initiatives in Ivory Coast and Zimbabwe. (ABSTRACT TRUNC

Influence of efavirenz pharmacokinetics and pharmacogenetics on neuropsychological disorders in Ugandan HIV-positive patients with or without tuberculosis: a prospective cohort study.

BACKGROUND: HIV infection, anti-tuberculosis and efavirenz therapy are associated with neuropsychological effects. We evaluated the influence of rifampicin cotreatment, efavirenz pharmacokinetics and pharmacogenetics on neuropsychiatric disorders in Ugandan HIV patients with or without tuberculosis coinfection. METHODS: 197 treatment naïve Ugandan HIV patients, of whom 138 were TB co-infected, enrolled prospectively and received efavirenz based HAART. TB-HIV confected patients received concomitant rifampicin based anti-TB therapy. Genotypes for CYP2B6 (*6, *11), CYP3A5 (*3, *6, *7), ABCB1 (c.…

Analysis of the distribution of malignant tumor burden across eight systems in Africa: an epidemiological analysis based on the Global Burden of Disease Study 1990-2021.

ObjectiveAfrica, a continent abundant in natural resources yet facing economic and cultural challenges. This study investigates the burden of cancer in Africa, leveraging data from the Global Burden of Disease Study 2021 to highlight the need for targeted healthcare interventions and policy reforms.Materials and methodsWe analyzed cancer incidence, prevalence, mortality rates, and Disability-Adjusted Life Years per 100 000 population across 54 African countries from 1990 to 2021. The study categorized malignancies into eight major organ systems and utilized the Social Demographic Index (SDI) t

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… Head and neck cancers have the highest incidence in Uganda, with an ASIR of 18.40. Zambia (ASIR = 18.29), Namibia (ASIR = 17.97), and Libya (ASIR = 16.45) also face significant burdens from these cancer types, suggesting the need for increased awareness and early detection efforts. … Lymphatic and hematopoietic system cancers are most prevalent in Libya, with an ASIR of 24.32, followed by Zimbabwe (ASIR = 19.36), Uganda (ASIR = 16.73), and Malawi (ASIR = 16.67) (Fig. 1 ). Figure 1. Incidence of malignant tumor across eight systems in Africa in 2021. …

Cancer: a looming public health crisis in Africa-a call to accelerate equitable access to medicines.

The global incidence of cancer is on the rise, with Africa experiencing a particularly steep increase in both cancer incidence and mortality. This upward trend is driven by a combination of factors, including population growth, poverty, aging, urbanization, and the adoption of lifestyles that increase the risk of cancer. It is projected that from 2022 to 2045, the incidence of cancer in Africa will increase by 106.8%, while cancer mortality will rise by 111.7% if no action is taken. In contrast, Europe is expected to see increases of only 22.5% in incidence and 32.2% in mortality. Despite glob

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… A recent study on access to cancer drugs in 3 countries in sub-Saharan Africa—Kenya, Uganda, and Rwanda—found that cancer treatment regimens based on WHO EML indications, which include novel cancer drugs, were not affordable to governments in sub-Saharan Africa. 51 Some countries did not have cancer … Access to and affordability of World Health Organization essential medicines for cancer in Sub-Saharan Africa: Examples from Kenya, Rwanda, and Uganda. The Oncologist. 2022;27:958-970. 10.1093/oncolo/oyac143 52. Mattila PO, Biritwum RB, Ud-Din Babar Z. …