Chronic genital ulcer disease with subsequent development of methicillin-resistant Staphylococcus aureus (MRSA ) urethritis and bacteraemia in an HIV-seropositive person – A case observation

HIV-seropositive persons are at increased risk of methicillin-resistant Staphylococcus aureus (MRSA). Genital ulcerative disease and sexually transmitted infection with subsequent MRSA infection in HIV-seropositive persons have been documented only once. We report a case of a 44-year-old man who presented to the Infectious Diseases Institute, Kampala, Uganda, with chronic genital ulcer disease and who subsequently developed MRSA urethritis and bacteraemia. This case also demonstrates that persistent genital ulcer disease in HIV-seropositive persons may be as a result of concurrent MRSA infection

Immune reconsitution inflammatory syndrome among adolescents: a report of cases in a resource-limited setting (Uganda)

We report immune reconstitution inflammatory syndromes in a cohort of adolescents/young adults over a period of 1 year at the Infectious Diseases Institute, Kampala, Uganda

Basis of selection of first and second line highly active antiretroviral therapy for hiv/aids on genetic barrier to resistance: a literature review.

The effectiveness of combination antiretroviral therapy (cART) continues to improve as treatment choices expand with the development of new antiretroviral agents and regimens. However, the successful long-term treatment of HIV/AIDS is under threat from the emergence of drug-resistant strains to multiple agents and entire drug classes.Key words: genetic barrier, highly active antiretroviral therapy, HIV resistanc

A case of palatal perforation caused by toxoplasmosis

We describe the case of a 35-year-old HIV-positive man seen at the Infectious Diseases Institute, Kampala, Uganda, with a 2-week history of palatal perforation

Transitioning behaviourally infected HIV-positive young people into adult care: Experiences from the young person’s point of view

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa.Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning.Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012.Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed.Conclusion. There is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers.S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.88

UPGro Hidden Crisis Research Consortium. Survey 1 Country Report, Uganda

Statistics on the functionality of water points from the Hidden Crisis project in Uganda are presented. The survey, undertaken in 2016, was focussed on boreholes equipped with handpumps (HPBs) within the 112 districts of Uganda. A stratified two stage random sampling approach was adopted and 10 districts identified to sample. A tiered definition of functionality was applied, and all which enabled more nuanced definitions to be reported: The results from the survey indicate: • 55% of HPBs were working on the day of the survey (compared to national figure of 86% for rural water supply ) • 34% of HPBs passed the design yield of 10 litres per minute • 23% passed the design yield and also experienced < 1 month downtime within a year. • 18% passed the design yield and reliability criteria and also water quality criteria The results of the survey indicate the utility of carrying out more detailed assessments of functionality to help unpack national statistics. A linked survey of the performance of the water management arrangements at water points showed that for 70% of the sites water management arrangements were judged to be weak

The impact of cardiovascular medication use on patients’ daily lives: a cross-sectional study

Introduction The management of multiple long-term medicines use in patients with chronic diseases creates a burden for patients. However, limited research is performed on patients’ experienced medication-related burden and its impact on daily lives. Therefore, the aim of this study was to explore the impact of cardiovascular medication on different aspects of patients’ daily lives and to examine the differences of these aspects between adherent and non-adherent patients. Methods A cross-sectional study was performed in two community pharmacies in the Netherlands. Patients (?45 years) using cardiovascular medication participated. Data were collected by means of the Living with Medicines Questionnaire (LMQ-2) measuring the burden of medicines use on patients’ daily lives. Two equally group-sized samples of patients non-adherent to prescribed medicines as assessed with pharmacy refill data, and patients adherent to prescribed medicines were selected. Results In total, 196 patients participated (51% male, 71.0±10.6 years), of whom 96 patients were non-adherent to cardiovascular medication. Substantial proportions of patients experienced medication-related burden on different daily life aspects. This burden was mainly related to the acceptance of long-term medication use, medication-related concerns or dissatisfaction, the interference of medicines with social and daily lives, and the interaction and communication with health care providers. No statistically significant results were found when comparing the impact on patients’ daily lives between the adherent and non-adherent sample. Conclusion Health care providers should acknowledge the impact of multiple long-term medicine use on patient’s daily lives and should make an effort to diminish patients’ medication-related burden by improving patient-provider relationships and by providing adequate treatment information incorporating patients’ individual circumstances and preferences. This may facilitate the integration of long-term medicines use in patients’ daily lives

Sex in the shadow of HIV:A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIVpositive adolescents and youth in sub-Saharan Africa

Background Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Methods Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10-24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. Results 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n=35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored Conclusions Sexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group.</p