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Topical microbicides for prevention of sexually transmitted infections.

BACKGROUND: Two decades of research on topical microbicides for prevention of sexually transmitted infections (STIs) have had limited succes … ually active women between 2004 and 2011; in Benin, Ghana, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, Zimbabwe, India, and the US. A small proof-of-concept RCT found that tenofovir (a nucleotide reverse transcriptase inhibitor) reduced the risk of HIV acquisition (one trial, 889 women; risk ratio (RR) 0.63; 95% CI 0.43 to 0.93). Effectivene …

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 20

Anthracycline-Induced Cardiotoxicity in Breast Cancer Patients from Southern Sri Lanka: An Echocardiographic Analysis.

Anthracycline-induced cardiotoxicity has never been investigated in Sri Lanka. Therefore, this study was conducted to determine the prevalence of anthracycline-induced cardiotoxicity in breast cancer patients using echocardiographic findings. A prospective cohort study was performed. All newly diagnosed breast cancer patients who were administered with anthracycline and cyclophosphamide (AC schedule) for the first time were enrolled in the study. In the hospital setting, anthracycline is administered only as a combination therapy, and only this combination was selected to limit the effect of o

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… A study conducted in Uganda for adult cancer patients who received anthracycline chemotherapy showed 66.4% of EF at the baseline and 63.9% three months after the completion of anthracycline chemotherapy which showed a significant difference ( p < 0.05) against the baseline results [ 23 ]. … Anthracycline induced cardiotoxicity in adult cancer patients: a prospective cohort study from a specialized oncology treatment centre in Uganda. African Health Sciences. 2019;19(1):1647–1656. doi: 10.4314/ahs.v19i1.40. 24. Dhesi S., Chu M. P., Blevins G., et al. …

The paradoxical relationship between ligamentum flavum hypertrophy and developmental lumbar spinal stenosis.

Genomic sequencing of worldwide butterfly fauna followed by phylogenetic analysis of protein-coding genes informs butterfly classification throughout the taxonomic hierarchy, from families to species. As a rule, we attribute the same taxonomic rank to more prominent clades of comparable divergence (i.e., at the same level in the tree). For species delimitation, we use criteria based on relative genetic differentiation and the extent of gene exchange between populations. We analyze the current taxonomic classification of butterflies in the light of genomic phylogenies and encounter clades that

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… Previous studies have recorded high prevalence of SCT for countries such as Democratic Republic of Congo (23.3%) [ 32 ], Gabon (21.1%) [ 33 ], and Nigeria (19.68% - 45%) [ 34 , 35 ], and Uganda (19.8%) [ 36 ]. … Ndeezi G Kiyaga C Hernandez AG Munube D Howard TA Ssewanyana I Nsungwa J Kiguli S Ndugwa CM Ware RE Burden of sickle cell trait and disease in the Uganda sickle surveillance study (US3): a cross-sectional study Lancet Glob Health 2016 4 3 e195 e200 10.1016/S2214-109X(15)00288-0 26833239 37. …

Cancer medicines: a private vice for public benefit?

Cancer medicines have become one of the most dominant global medical technologies. They generate huge profits for the biopharmaceutical industry as well as fuel the research and advocacy activities of public funders, patient organisations, clinical and scientific communities and entire federal political ecosystems. The mismatch between the price, affordability and value of many cancer medicines and global need has generated significant policy debate, yet we see little change in behaviours from any of the major actors from public research funders through to regulatory authorities. In this polic

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… Access to and affordability of World Health Organization essential medicines for cancer in sub-Saharan Africa: examples from Kenya, Rwanda, and Uganda. Oncologist. 2022;27(11):958–970. doi: 10.1093/oncolo/oyac143. 25. Morgan SG, Bathula HS, Moon S. …

Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC).

BACKGROUND: The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative stress. However, there is currently no information on the extent and predictors of HM at Kinshasa University Clinics (KUC), DR Congo (DRC). This study evaluated the impact of bio-clinical factors, exposure to polluted environments, and interactions between global climate changes (EL Nino and La Nina) and local climate (dry and rainy seasons) on the incidence of HM. METHODS: This

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… Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-cancer registry match study. Int J Cancer. 2006;118(4):985–990. doi: 10.1002/ijc.21443. 27. Sasco AJ, Jaquet A, Boidin E, et al. The challenge of AIDS-related malignancies in sub-Saharan Africa. …

The 4th Global Congress on Sickle Cell Disease Abstract Book 2022

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… Results: A total of 635 children with HbSS from Angola, Democratic Republic of Congo, Kenya, and Uganda enrolled, and 606 started hydroxyurea treatment. … We initiated hydroxyurea to children meeting Uganda Ministry of Health SCA hydroxyurea treatment criteria at the time of the study, which included: > 5 pain crises, stroke, and baseline Hb<6g/dL, and history of or new acute chest syndrome (ACS). …

Quality indicators and patient outcome measures for palliative care in cancer patients: a systematic review.

IntroductionWith the exponential rise in global cancer incidence, the surge in demand for palliative care has outstripped capacity, limiting patients' access to quality and holistic palliative care, especially in low- and middle-income countries. Despite an upturn in research activity, evidence in palliative care remains limited, given its complexity as well as the shortage of standardised quality indicators (QIs) and patient outcome measures (POMs). The objective of this systematic review is to assess the QIs and POMs used to evaluate palliative care service on aggregated and individual level

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… Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire core 30 version 3 (EORTC QLQ-C30), Multidimensional fatigue inventory (MFI), Major depression inventory (MDI), concerns about cancer recurrence questionnaire (CARQ-4), decision regret scale (DRS), CAT cognitive functioning Uganda … | Namisango et al [ 35 ] | The meaning of healing to adult patients with advanced cancer | National Institutes of Health Clinical Centre, Uganda | Qualitative | Phenomenology, Interview | 35 | Cancer | To explore the meaning of the term healing from the perspective of adult patients with advanced cancer …

Determination of drug-related problems in the hematology service: a prospective interventional study.

BackgroundPatients with hematological malignancies often require multidrug therapy using a variety of antineoplastic agents and supportive care medications. This increases the risk of drug-related problems (DRPs). Determining DRPs in patients hospitalized in hematology services is important for patients to achieve their drug treatment goals and prevent adverse effects. This study aims to identify DRPs by the clinical pharmacist in the multidisciplinary team in patients hospitalized in the hematology service of a university hospital in Turkey.MethodsThis study was conducted prospectively betwee

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… Frequency, severity, and factors associated with clinically significant drug-drug interactions among patients with cancer attending Mbarara Regional Referral Hospital Cancer Unit, Uganda. BMC Cancer. 2022;22(1):1–11. doi: 10.1186/s12885-022-10396-8. 33. …

Global variations in elderly cancer mortality pattern in 2020 & prediction to 2040: A population-based study.

Background & objectives Cancer contributes to decreasing life expectancy, especially in low- and middle- income countries (LMIC) and countries in transition where resources for diagnosis and care are limited. As the world population is ageing, and by 2050, two-thirds of the population in LMIC will be elderly, the greater impact of cancer on the expectation of life in years at a given age of an adult will be seen in these countries. Methods Estimated cancer mortality for older adults (60 yr or above) was estimated using statistics available on Globocan 2020 platform (gco.iarc.fr). This platform

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… Population-based survival (CONCORD programme) of breast cancer shows the five-yr net survival estimates range from higher than 85 per cent in many high-income countries to less than 60 per cent in some regions of sub-Saharan Africa, and country-specific survival estimates are as low as 12 per cent in Uganda …

Virological outcomes and genotypic resistance on dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial.

BACKGROUND: ODYSSEY showed superior efficacy for dolutegravir-based antiretroviral therapy (ART) versus standard of care (SOC) in children living with HIV starting first-line or second-line ART aged 4 weeks or older. Here, we aim to compare virological outcomes and resistance in the dolutegravir group versus SOC for first-line and second-line ART up to 96 weeks. METHODS: ODYSSEY was an open-label, multicentre, randomised, non-inferiority trial done in 29 centres in seven countries (Germany, Spain, South Africa, Thailand, the UK, Uganda, and Zimbabwe). ODYSSEY recruited children living with HI…

Efficacy of a bivalent (D614 + B.1.351) SARS-CoV-2 recombinant protein vaccine with AS03 adjuvant in adults: a phase 3, parallel, randomised, modified double-blind, placebo-controlled trial.

BACKGROUND: COVID-19 vaccines with alternative strain compositions are needed to provide broad protection against newly emergent SARS-CoV-2 … r at 54 clinical research centres in eight countries (Colombia, Ghana, India, Kenya, Mexico, Nepal, Uganda, and Ukraine). Participants were recruited from the community and randomly assigned (1:1) by use of an interactive response technology system to receive two intramuscular 0·5 mL injections, 21 days apart, of the bivalent vaccine (5 μg of ancestral [ …

Treatment outcomes in HIV infected patients older than 50 years attending an HIV clinic in Harare, Zimbabwe: A cohort study.

There is a growing number of older people living with HIV (OPLHIV). While a significant proportion of this population are adults growing into old age with HIV, there are also new infections among OPLHIV. There is a lack of data describing the outcomes of OPLHIV who commenced antiretroviral therapy (ART) after the age of 50 years in sub-Saharan Africa. We conducted a cohort study of patients who enrolled in care at Newlands Clinic in Harare, Zimbabwe, at ages ≥50 years between February 2004 and March 2020. We examined demographic characteristics, attrition, viral suppression, immunological and

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… Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda. Neurology . 2017 ; 89 : 485 – 491 . doi: 10.1212/WNL.0000000000004136 28679596 PMC5539731 39 Islam FM , Wu J , Jansson J , Wilson DP . … Outcomes in a cohort of patients started on antiretroviral treatment and followed up for a decade in an urban clinic in Uganda. PLoS ONE. 2015 ; 10 : 1 – 11 . doi: 10.1371/journal.pone.0142722 26642214 PMC4671641 44 Chimbetete C , Shamu T , Roelens M , Bote S , Mudzviti T , Keiser O . …

Models of care for children and adolescents with type 1 diabetes in low- and middle-income countries: a scoping review.

BACKGROUND: In order to improve the outcomes of children and adolescents with type 1 diabetes mellitus (T1DM), access to and quality of comp … WHO regions. African Region We identified models of care in Cameroon, Kenya, Rwanda, Tanzania, and Uganda, largely supported by international initiatives like Changing Diabetes in Children (CDiC) and Life for a Child (LFAC). Models were implemented between 2004 and 2012, and aimed to enhance infrastructure and care delivery, including access to insulin, …

Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment.

BACKGROUND: Pregnancy increases the risk of malaria and this is associated with poor health outcomes for both the mother and the infant, esp … n Nigeria (three trials), The Gambia (three trials), Kenya (three trials), Mozambique (two trials), Uganda (two trials), Cameroon (one trial), Burkina Faso (one trial), and Thailand (two trials). Six different antimalarials were evaluated against placebo or no intervention; chloroquine (given weekly), pyrimethamine (weekly or monthly), proguanil (daily), …

Lamivudine induced pure red cell aplasia and HIV-1 drug resistance-associated mutations: a case report.

Adverse effects linked to antiretroviral therapy (ART) may contribute to poor adherence on the patient's side. Consequently, human immunodeficiency virus (HIV) drug resistance mutations could emerge, negatively impacting the body's immune system. Meanwhile, severe immunosuppression can lead to several conditions, including anemia. The cause of anemia in HIV infection is multifactorial, and can be mainly explained by deleterious direct effects of the virus on the bone marrow, and opportunistic infections such as Parvovirus B19. Other causes include blood loss resulting from neoplasms and gastro

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… Experiences of individuals with poor viral suppression in Uganda. AIDS Res Ther 2019;16:2. 9. Nakamura K, Tateyama M, Tasato D, Haranaga S, Tamayose M, Yara S et al. …

Impact of population ageing on cancer-related disability-adjusted life years: A global decomposition analysis.

BACKGROUND: As the global population ages, the burden of cancer is increasing. We aimed to assess the impact of population ageing on cancer-related disability-adjusted life years (DALYs). METHODS: We used the decomposition method to estimate the impact of ageing, population growth, and epidemiological change on cancer-related DALYs from 1990 to 2019, stratified by 204 countries/territories and by their sociodemographic index (SDI). This approach separates the net effect of population ageing from population growth and change in age-specific DALY rates. RESULTS: Cancer-related DALYs among indi

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… of Korea | 8.16 | Russian Federation | 4.31 9 | Indonesia | 10.32 | France | 6.59 | Republic of Korea | 3.61 10 | Thailand | 10.31 | Italy | 6.39 | Germany | 3.48 195 | Somalia | −0.09 | Burkina Faso | −0.26 | Mali | −0.17 196 | Chad | −0.13 | Guinea | −0.29 | Cameroon | −0.17 197 | Guinea | −0.13 | Uganda … | −0.33 | Burkina Faso | −0.19 198 | Mali | −0.16 | Mali | −0.33 | Mozambique | −0.25 199 | Democratic Republic of the Congo | −0.17 | Democratic Republic of the Congo | −0.40 | Uganda | −0.33 200 | Mozambique | –0.18 | Mozambique | −0.42 | Democratic Republic of the Congo | −0.35 201 | Ethiopia | − …

Circumcision devices versus standard surgical techniques in adolescent and adult male circumcisions.

BACKGROUND: Medical circumcisions are among the most common surgical procedures performed in males. The usual indications are phimosis (inab … usion criteria. Trials were conducted in China, South Africa, Kenya and Zambia, Mozambique, Rwanda, Uganda and Zimbabwe. Primary outcomes Serious adverse events: there were no serious adverse events in either treatment arm (11 trials, 3472 participants). Moderate adverse events: there may be a slight increase in moderate adverse events when devices are u …

Efficacy and safety of dolutegravir with emtricitabine and tenofovir alafenamide fumarate or tenofovir disoproxil fumarate, and efavirenz, emtricitabine, and tenofovir disoproxil fumarate HIV antiretroviral therapy regimens started in pregnancy (IMPAACT 2010/VESTED): a multicentre, open-label, randomised, controlled, phase 3 trial.

BACKGROUND: Antiretroviral therapy (ART) during pregnancy is important for both maternal health and prevention of perinatal HIV-1 transmissi … inical research sites in nine countries (Botswana, Brazil, India, South Africa, Tanzania, Thailand, Uganda, the USA, and Zimbabwe). Pregnant women (aged ≥18 years) with confirmed HIV-1 infection and at 14-28 weeks' gestation were eligible. Women who had previously taken antiretrovirals in the past were excluded (up to 14 days of ART during the current pr …

BREATHER (PENTA 16) short-cycle therapy (SCT) (5 days on/2 days off) in young people with chronic human immunodeficiency virus infection: an open, randomised, parallel-group Phase II/III trial.

BACKGROUND: For human immunodeficiency virus (HIV)-infected adolescents facing lifelong antiretroviral therapy (ART), short-cycle therapy (S … d changes in therapy. DESIGN: Open, randomised, non-inferiority trial. SETTING: Europe, Thailand, Uganda, Argentina and the USA. PARTICIPANTS: Young people (aged 8-24 years) on EFV plus two nucleoside reverse transcriptase inhibitors and with a HIV-1 ribonucleic acid level [viral load (VL)] of < 50 copies/ml for > 12 months. INTERVENTIONS: Young peop …