Brucellosis is one of the most common zoonotic infections globally. Lack knowledge about brucellosis may affect health-seeking behavior patients, thus leading to sustained transmission in these communities. Our study assessed and perceptions among pastoral communities adjacent Lake Mburo National Park (LMNP), Kiruhura District, Uganda. A community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed...

To model the cost-effectiveness in Uganda of combination antiretroviral therapy (ART) to prevent mother-to-child transmission human immunodeficiency virus (HIV).The ART was evaluated on assumption that reduces risk an HIV-positive pregnant woman transmitting HIV her baby from 40% (when is left untreated) 25.8%, 17.4% and 3.8%, respectively, when given: (i) single-dose nevirapine (at estimated total drug cost 0.06 United States dollars [US$]); (ii) dual with zidovudine lamivudine for 7 weeks...

Due to a limited health workforce, many care providers in Africa must take on leadership roles with minimal formal training leadership. Hence, the need equip practical skills required lead high-impact programs. In Uganda, Afya Bora Global Health Leadership Fellowship is implemented through Makerere University College of Sciences (MakCHS) and her partner institutions. Lessons learned from program, presented this paper, may guide development in-service opportunities enhance workers...

Studying the microbial profile and their antibiotic resistance in paediatric appendicitis is essential for tracking susceptibility, guiding treatment choices ensuring effectiveness. Understanding variations therapies can improve outcomes reduce complications. Despite its importance, limited research has been conducted South Africa on profiles appendicitis. To identify bacteria cultured from pus specimens obtained patients with acute determine susceptibility. This was a prospective case...

Introduction The existing diagnostic algorithms for sputum smear-negative tuberculosis (TB) are complicated, time-consuming, and often difficult to implement. decision initiate TB treatment in resource-limited countries is largely based on clinical predictors. We sought determine the predictors accuracy of empiric initiation HIV-infected suspects using culture as a reference standard. Setting Out-patient HIV-TB integrated urban clinic Kampala, Uganda. Methods were screened smear microscopy,...

Syphilis infection during pregnancy leads to avoidable morbidity and mortality remains a significant problem in sub-Saharan Africa. Despite global initiatives increase the proportion of pregnant women screened, implementation has been slow. We sought investigate feasibility adding syphilis screening within an integrated antenatal HIV clinic. Pregnant attending clinic were sequentially enrolled consenting participants answered questionnaire on sexual behavior previous pregnancies, provided...

We describe older (>50 years) HIV-infected adults after antiretroviral therapy (ART) initiation, evaluating immunological recovery by age category, considering individual trajectories based on the pretreatment CD4. also mortality ART and its risk factors category including contribution of poor at a large urban clinic in Kampala, Uganda.We performed cohort analysis adult (>18 patients who initiated between January 1, 2004 3, 2012. Immunological response was evaluated using mixed-effects...

Background Two manufacturers, Maxim Biomedical and Sedia Biosciences Corporation, supply CDC-approved versions of the HIV-1 Limiting Antigen Avidity EIA (LAg) for detecting 'recent' HIV infection in cross-sectional incidence estimation. This study assesses compares performance two assays surveillance. Methods We ran both on a panel 2,500 well-characterized HIV-1-infected specimens. analysed concordance assay results, assessed reproducibility using repeat testing estimated mean durations...

As the number of HIV infections continues to rise, search for effective health education strategies must intensify. A new educational board game was developed increase peoples' attention and knowledge sexually transmitted (STIs) information. The object this study assess effect on uptake knowledge.A randomized controlled trial where patients attending Infectious Diseases Clinic, Kampala, Uganda were either play (intervention arm) or attend a talk (standard care arm). Participants' assessed...

Introduction. While the introduction of highly active antiretroviral therapy decreased HIV-related morbidity and mortality rates in sub-Saharan Africa, a subsequent increase metabolic abnormalities has been observed. We sought to determine prevalence HIV-associated among patients on first-line (ART) an ART clinic Kampala, Uganda. Methods. Four hundred forty-two consecutive for at least 12 months were screened eligibility cross-sectional study, 423 enrolled. Pre-ART patient characteristics...

Recent studies have evaluated cumulative human immunodeficiency virus type 1 (HIV-1) viral load (cVL) for predicting disease outcomes, with discrepant results. We reviewed the disparate methodological approaches taken and prognostic utility of cVL in a resource-limited setting. Using data on Infectious Diseases Institute (Makerere University, Kampala, Uganda) cohort, who initiated antiretroviral therapy 2004–2005 were followed up 9 years, we calculated patients' time-updated by summing area...

Background Short-medium term studies from sub-Saharan Africa show that, despite high early mortality, substantial loss to program, and rates toxicity, patients on antiretroviral treatment have achieved outcomes comparable those in developed settings. However, these were unable account for long of as they stayed longer treatment. Objectives We aim describe ten years one the first cohort HIV positive started (ART) Sub-Saharan Africa. Methods report 10-years including retention, CD4-count...

In the past decade, global health research has seen a growing emphasis on integrity and fairness. The concept of emerged in response to reproducibility crisis science during late 2000s. Research fairness initiatives aim enhance ownership inclusivity involving partners with varying powers, decision-making roles resource capacities, ultimately prioritising local needs. Despite extensive academic discussions, empirical data these aspects, especially context health, remain limited.

Our objective was to evaluate outcomes in patients with sustained viral suppression compared those episodes of viremia. Methods . In a prospective cohort started on ART Uganda and followed for 48 months, were categorized according load (VL): (1) sustained-suppression: (VL ≤1,000 copies/mL) (2) VL 1,001–10,000, or (3) >10,000. Results Fifty-Three (11.2%) 84 (17.8%) had first episode intermediate high viremia, respectively. Patients better CD4+ T cell count increases over time viremic ()....

Background: Sexually transmitted infections (STIs) significantly increase HIV transmission. may be asymptomatic and therefore remain undiagnosed in HIV-positive persons. Routine screening treatment of STIs high-risk populations sub-Saharan Africa have not been described previously. Methods: We reviewed data from an population at the Infectious Diseases Institute, Makerere University, a large urban clinic, between July 2011 April 2012. Our cohort included female sex workers, long-distance...

Introduction There are Challenges in statistically modelling immune responses to longitudinal HIV viral load exposure as a function of covariates. We define Bayesian Markov Chain Monte Carlo mixed effects models incorporate priors and examine the effect different distributional assumptions. prospectively fit these an as-yet-unpublished data from Tshwane District Hospital treatment clinic South Africa, determine if cumulative log load, indicator long-term exposure, is valid predictor...

Ugandan national guidelines recommend initiation of combination antiretroviral therapy (cART) at CD4+ T cell (CD4) count below 350 cell/μl, but the implementation this is limited due to availability medication. However, cART higher CD4 increases survival, albeit lifetime treatment cost. This analysis evaluates cost-effectiveness initiating a between 250-350 cell/μl (early) versus <250 (delayed).Life expectancy cART-treated patients, conditional on baseline count, was modeled based published...

Background Light emitting diode (LED) fluorescence microscopy (FM) is an affordable, technology targeted for use in resource-limited settings and recommended widespread roll-out by the World Health Organization (WHO). We sought to compare operational performance of three LED FM methods compared light a cohort HIV-positive tuberculosis (TB) suspects at urban clinic high TB burden country. Methods Two spot specimens collected from were included study. Smears stained using auramine O method...

There is conflicting data on long-term CD4 immune recovery after combination antiretroviral therapy (ART) in resource-limited settings. Virologic suppression rarely documented cohorts from sub-Saharan Africa so objective evidence of adherence biologically unsubstantiated. We sought to investigate patterns Ugandan patients ART with sustained viral suppression.A prospective cohort starting between April, 2004 and 2005 at the Infectious Diseases Institute (viral load ≤ 400 copies/ml month 6 12)...

It is unclear whether ongoing CD4 monitoring needed following immunologic and virologic response to antiretroviral therapy (ART). We investigated the proportion of clients who achieved a then had subsequent count <200 cells/μL despite continued suppression. Included in this analysis were receiving ART through Rakai Health Sciences Program between June 2004-May 2013 ≥200 VL ≤400 copies/mL three sets measurements (defined as sequence) within 390 day period. A decline was defined any drop...

Background: The purpose of this study was to assess patients’ experience and satisfaction with pharmacy-only refill program (PRP) compare those who were removed from the PRP still in program. Methods: A sample 446 patients selected 1503 on antiretroviral therapy that had been enrolled for at least 24 months. used interviewer-administered questionnaires PRP. Results: Of patients, 133 (29.8%) By multivariate analysis, it found wanting see a clinician before their scheduled clinic visit,...