High HIV-1 incidence rates were reported among persons in fisherfolk communities (FFC) Uganda who selected for high risk behaviour. We assessed the of and associated factors a general population FFC to determine population-wide HIV rates.A community-based cohort study was conducted random sample 2191 participants aged 18-49 years. At baseline 12 months post-baseline, data collected on socio-demographic characteristics risky behaviors (including number partners, new condom use, use alcohol...

Introduction HIV epidemics in sub‐Saharan Africa are generalized, but high‐risk subgroups exist within these epidemics. A recent study among fisher‐folk communities (FFC) Uganda showed high prevalence (28.8%) and incidence (4.9/100 person‐years). However, those findings may not reflect population‐wide rates FFC since the population was selected for behaviour. Methods Between September 2011 March 2013, we conducted a community‐based cohort to determine representative willingness participate...

Abstract Background New, sensitive diagnostic tests facilitate identification and investigation of milder forms tuberculosis (TB) disease. We used community-based TB testing with the Xpert MTB/RIF Ultra assay (“Ultra”) to characterize individuals previously undiagnosed compare them those from same community who were diagnosed through routine care. Methods offered sputum adult residents a well-defined area (population 34 000 adults) in Kampala, Uganda, via door-to-door screening venue-based...

Although the association between alcohol consumption and HIV risk is well documented, few studies have examined magnitude of new infections that could be prevented by controlling use. We report population attributable fraction (PAF) incident due to among high-risk fishing communities along Lake Victoria, Uganda.In a community-based cohort study, 1607 sero-negative participants aged 18-49 years were enrolled from eight Uganda. At follow up 12 months later, 1288 (80.1%) seen interviewed....

An effective HIV vaccine is still elusive. Of the 9 preventive efficacy trials conducted to-date, only one reported positive results of modest efficacy. More need to be before or more vaccines are eventually licensed. We assessed suitability fishing communities in Uganda for future trials.A community-based cohort study was among a random sample 2191 participants aged 18-49 years. Data were collected on socio-demographic characteristics, risky behaviors, and willingness participate (WTP)....

Rationale C-reactive protein (CRP) has demonstrated utility as a point-of-care triage test for tuberculosis (TB) in clinical settings, particularly among people with HIV, but its performance general-population TB screening is not well characterized. Objective To assess the accuracy of CRP detecting pulmonary disease individuals undergoing community-based or presenting evaluation symptoms Kampala, Uganda. Methods We pooled data from two case-control studies conducted between May 2018 and...

Background Clinical tuberculosis diagnosis and empiric treatment have traditionally been common among patients with negative bacteriologic test results. Increasing availability of rapid molecular diagnostic tests, including Xpert MTB/RIF the new Ultra cartridge, may alter role treatment. Methods We prospectively enrolled outpatients age > = 15 who were evaluated for pulmonary at three health facilities in Kampala, Uganda. Using sputum mycobacterial culture, interviews, clinical record...

ABSTRACT Background A “trace” result from the Xpert Ultra molecular TB test indicates Mycobacterium tuberculosis DNA detection but may not always signify disease. Little is known about experiences of individuals with trace results who are immediately treated. Methods We enrolled Ugandan adults and adolescents sputum results, plus positive negative controls, community-screening clinic settings. After a comprehensive evaluation, participants recommended to start treatment were closely...

Abstract Background For people with “trace” sputum results (PWTS) on Xpert MTB/RIF Ultra, further evaluation and monitoring rather than reflex TB treatment may be appropriate. Patients’ preferences regarding deferral have not been explored. Reported anxiety among participants trace positive over 6 months of follow up Methods We enrolled PWTS identified through community screening or clinic-based diagnostic evaluation, in Kampala, Uganda. They underwent extensive clinical, microbiological,...

Systematic screening for tuberculosis using Xpert Ultra generates "trace" results of uncertain significance. Additional microbiological testing in this context is often negative, but individuals with trace might have early disease or elevated risk tuberculosis. We screened Uganda, enrolling trace-positive and Ultra-negative controls. Participants without on extensive initial evaluation were followed, repeat at 1, 3, 6 months after results, 12 24 all participants. estimated cumulative...

Diagnosing childhood pulmonary tuberculosis (TB) is a challenge. This led the Uganda National Tuberculosis and Leprosy Program (NTLP) to develop clinical treatment decision algorithm (TDA) for children. However, there limited data on its accuracy, how it compares new World Health Organization (WHO) TB TDAs study aimed evaluate compare accuracy of 2017 NTLP diagnostic with 2022 WHO among We analyzed four years from children <15 old in Kampala, Uganda. Children were classified as per...

Background: Computer-aided detection (CAD) software analyzes chest X-rays for features suggestive of tuberculosis (TB) and provides a numeric abnormality score. However, estimates CAD accuracy TB screening in general populations are hindered by the lack confirmatory data among people with lower scores, including those without symptoms. Additionally, appropriate score thresholds obtaining further testing may vary according to population client characteristics. Methods: We screened Ugandan...

Some patients who test trace-positive on Xpert MTB/RIF Ultra ("Ultra"), a highly sensitive molecular diagnostic platform, may not have tuberculosis (TB) disease. A better understanding of the prevalence TB disease, associated clinical characteristics, and utility additional tests among people with trace sputum (PWTS) could aid decision-making. We enrolled adults adolescents initial evaluation in Uganda South Africa. Participants were extensively evaluated at enrollment; those uncertain...

Abstract Background “Trace” results on Xpert MTB/RIF Ultra (“Ultra”; Cepheid) —a molecular diagnostic test for tuberculosis (TB)—are often interpreted as an indication TB treatment, but may also represent detection of nonviable bacilli or analytical error. In community-screening settings where individual risk is low, there limited guidance how to interpret Ultra-trace results. Methods We conducted systematic screening adults and adolescents (≥15 years) in Kampala, Uganda, through...

Introduction Fishing communities (FCs) in Uganda have high HIV infection rates but poor access to health services including family planning (FP). Although FP is a cost-effective public intervention, there paucity of data on knowledge and use modern FCs. This study determined methods FCs Uganda. Methods Data were accrued from 12-month follow up 1,688 HIV-uninfected individuals, 18–49 years 8 along Lake Victoria, between September 2011 March 2013. collected through semi-structured...

Routine tuberculosis (TB) notifications are geographically heterogeneous, but their utility in predicting the location of undiagnosed TB cases is unclear. We aimed to identify small-scale geographic areas with high notification rates based on routinely collected data and evaluate whether these have a correspondingly rate prevalent TB. used evaluated extent which correlated during subsequent community-wide active case finding intervention Kampala, Uganda. first enrolled all adults who lived...

Background Systematic screening is a potential tool for reducing the prevalence of tuberculosis (TB) and counteracting COVID-19-related disruptions in care. Repeated community-wide can also measure changes TB over time. Methods We conducted serial, cross-sectional case finding campaigns one community Kampala, Uganda, 2019 2021. Both sought sputum testing (Xpert MTB/RIF Ultra) from all adolescents adults. estimated among participants each campaign compared characteristics people with across...

The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% people living with are unaware their status. current testing policy which strictly blood-based poses several challenges including: a need for high level laboratory skills, stringent waste disposal needs, painful sample collection. It envisaged that introduction rapid, painless oral fluid test as potential alternative likely to increase the number testing. aim this study was determine diagnostic accuracy acceptability rapid among...

fishing communities in Uganda are key populations for HIV, with persistently higher prevalence and incidence than the general population.between March August 2014, a cross sectional survey was conducted 10 of Lake Victoria Uganda. Data collected on socio-behavioural characteristics using interviewer administered questionnaires venous blood HIV testing. Prevalent infections among adolescents young people aged 13 to 24 years estimated factors associated those determined multi variable logistic...

Background In highly resource-limited settings, many clinics lack same-day microbiological testing for active tuberculosis (TB). these contexts, risk of pretreatment loss to follow-up is high, and a simple, easy-to-use clinical score could be useful. Methods findings We analyzed data from adults tested TB with Xpert MTB/RIF across 28 primary health in rural South Africa (between July 2016 January 2018). used least absolute shrinkage selection operator regression identify characteristics...

BACKGROUND: Population-based active case-finding (ACF) identifies people with TB in communities but can be costly. METHODS: We conducted an empiric costing study within a door-to-door household ACF campaign urban community Uganda, where all adults, regardless of symptoms, were screened by sputum Xpert Ultra testing. used combination direct observation and self-reported logs to estimate staffing requirements. Study budgets reviewed collect costs overheads, equipment, consumables. Our primary...

Uganda´s fishing communities experience a high burden of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), with limited access to healthcare. Knowledge on healthcare use and treatment seeking will help identify unmet needs facilitate appropriate allocation resources.

High retention (follow-up) rates improve the validity and statistical power of outcomes in longitudinal studies effectiveness programs with prolonged administration interventions. We assessed participant a potential HIV vaccine trials population fishing communities along Lake Victoria, Uganda. In community-based individual randomized trial, 662 participants aged 15–49 years were to either mobile phone or physical contact tracing reminders followed up at months 1, 2, 3, 6, 12 18...

Abstract Problem Biological mechanisms of foreskin HIV acquisition are poorly defined. The inner is preferentially infected in explant models, so we hypothesized that this site would be enriched for HIV‐susceptible CD4 + T cells and proinflammatory/chemoattractant cytokines. Method study A total 42 HIV‐uninfected Ugandan men without genital symptoms provided tissues swabs at the time elective penile circumcision. immune phenotype foreskin‐derived entry a CCR5‐tropic pseudovirus was...