A Cross-Sectional Study to Determine Urinary Tract Infections and Antibiotic Susceptibility Patterns among Pregnant Women attending Antenatal Clinic at Kawempe National Referral Hospital, Uganda.

Background: Urinary Tract Infection (UTI) is a disease of the urinary system. This type of infection involves urethritis, pyro nephritis, or cystitis. Symptoms can be pelvic pain, increased urge to urinate, pain on passing out urine, and blood in the urine (blander infections). A kidney UTI may cause back pain, nausea vomiting, and fever. Methods: This study was a cross-sectional-quantitative study carried out among 300 pregnant mothers attending ANC at Kawempe regional referral hospital in August 2021. Questionnaires were administered to get the biodata of Participants. Urine samples were collected using sterile containers. Urine culture was performed, urine chemistry using ten parameter strip then urine microscopy was done. Chemistry was done using ten parameter strips, urine microscopy and then later culture and sensitivity was done on urine samples with proteinuria. Results: Urine samples with proteinuria were 5.7 % (n=17), more than half of the Urine Samples 52%( n=156) had positive White blood cell cells and 48 %( n=144) had no abnormality detected. Culture on urine samples showed the following isolation, Escherichia.coli 24.3 %( n=9), Klebsiella pneumonia 21.6 %( n=8), Pseudomonas euroginosa 18.9 %( n=7) Staphylococcus aureus 16.22 %(n=6) Enterococcus spp 2.7%(n=1) and Candida albicans16.2 %( n=6). Conclusion: UTI is an infection of some part of your body’s urinary system which may include: kidneys, ureters, bladder, and urethra. Organisms causing UTIs in pregnancy are the same uropathogens that commonly cause UTI in non-pregnant patients with Escherichia coli being the most commonly isolated organism. Other bacteria include klebishella pneumoniae, staphulococuus, streptococcus,  enterococcus, and pseudomonas. Recommendations: Kawempe National Referral Hospital. Should improve the Laboratory to perform microbiology tests

Assessment of risk compensation following use of the dapivirine vaginal ring in southwestern Uganda.

OBJECTIVES: Participation in HIV prevention trials could trigger risk compensation among participants. We evaluated potential risk compensation following use of a vaginal ring microbicide by women in a phase III trial in southwestern Uganda. METHODS: We used markers of sexual risk behaviour documented on standardised questionnaires, tested for STIs at baseline and quarterly for 2 years. Risk compensation was defined as a significant increase (trend p<0.05) in the proportion of women reporting risky sexual behaviour or a diagnosed STI between baseline and end of follow-up. RESULTS: Between September 2013 and December 2016, 197 women (active arm: n=132 and placebo: n=65) were enrolled at the Masaka site. There were decreases in all markers of sexual risk behaviour with statistically significant decreases in only the proportion of women reporting ≥2 sexual partners, p=0.026 and those diagnosed with Trichomonas vaginalis p<0.001 and or Neisseria gonorrhoeae p<0.001 CONCLUSIONS: No evidence of risk compensation was observed in this trial. TRIAL REGISTRATION NUMBER: NCT01539226

Prevalence and Factors Associated With Genital Chlamydial Infections among Women Attending the Gynaecology Clinic At Mbarara Regional Referral Hospital

Background: Chlamydia trachomatis is responsible for the most common bacterial sexually transmitted bacterial infection. The largest burden is in low income countries. These organisms are not screened for in Mbarara, and information about the burden of disease is no available. This study aimed at establishing the prevalence and factors associated with genital Chlamydia infection among women of reproductive age attending the gynecology clinic at Mbarara Regional Referral Hospital. Methods: In a cross-sectional study done at Mbarara Regional Referral Hospital, 324 women aged 15-49years were consented and interviewed. Data on socio-demographics, maternal medical conditions, obstetric and gynaecological factors and endocervical swabs were collected consecutively from November 2015 to January 2016 from women attending gynaecology clinic at Mbarara Regional Referral Hospital. Samples were analysed using a using CTK biotech Chlamydia kit, which is a rapid immunoassay test for the detection of genital chlamydial antigen in urogenital samples. Results were analysed using STATA 13, Logistic regression models were used to estimate level of significance, the odds ratios (OR) and 95 % CI of the association between the factors and genital infections. Significance was set at a p value of &lt;0.05. Results: Of the 324 samples collected,86 were positive for C. trachomatis antigen giving a prevalence rate of 26.5%. Of all the associated factors examined, only type of residence was significantly associated with C. trachomatis infection (p= 0.0413) with those living in peri-urban areas at greater risk of infection ( aOR 2.4  95%CI (1.22-4.82). Other social demographic ,medical obstetric and gynecological factors were not associated with C. trachomatis infection. No symptom or clinical sign was significant for the infection. Conclusion and recommendation: The prevalence of genital C. trachomatis infection among women attending gynecology clinic is high. Genital Chlamydia infection has no predictive signs and symptoms in our setting. Screening of women in reproductive age should be encouraged. Keywords; Genital Chlamydia trachomatis, endocervical swabs, gynaecology clinic.

The Molecular Epidemiology and Transmission Dynamics of HIV Type 1 in a General Population Cohort in Uganda

The General Population Cohort (GPC) in south-western Uganda has a low HIV-1 incidence rate (25 years (aOR = 1.52; 95% CI, 1.16-2.0) and being a resident in the GPC (aOR = 6.90; 95% CI, 5.22-9.21). Phylogeographic analysis showed significant viral dissemination (Bayes Factor test, BF > 3) from the GPC without significant viral introductions (BF < 3) into the GPC. The findings suggest localized HIV-1 transmission in the GPC. Intensifying geographically focused combination interventions in the GPC would contribute towards controlling HIV-1 infections

Thirty years of change in HIV incidence among adults in the Kyamulibwa General Population Cohort in rural southwest Uganda, 1989-2021

Objectives To document the changes in HIV incidence over thirty years in Kalungu district, Uganda. Methods Since 1989, residents aged ≥15 years old have been tested for HIV, and data were collected on HIV risk factors annually and later, biennially in the Kyamulibwa open cohort. In the 2019-2021 survey, people living with HIV self-reported on knowledge of their HIV status, antiretroviral therapy (ART) use, and their most recent viral load data were obtained from health facilities. The HIV seroconversion dates were randomly imputed between the last negative and first positive test dates using a uniform distribution. Results Among 20,959 residents who were HIV-negative, 669 seroconverted within 176,659 person-years. Data showed a downward trend in age-adjusted HIV incidence over 30 years (

Barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health screening and intervention in people with mental illness: a pilot study from Uganda

Background: People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. Objectives: The aim of this pilot study was to assess the barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health, prevention and treatment in Uganda. Methods: Twenty-eight nurses (39% female, 30.9\ub16.9 years) completed the Metabolic \u2013 Barriers, Confidence, Attitudes and Knowledge Questionnaire and the physical activity prescription rate item of the Exercise in Mental Illness Questionnaire. Results: More than 75% had a positive attitude towards metabolic screening and intervention and more than 50% were confident in providing smoking cessation advice, and physical activity and nutritional counseling. However, 57% stated that their heavy workload prevented them from doing health screening and promotion activities. There was a negative correlation (\u3c1=-0.54, P=0.003) between the frequency of physical activity prescription and the perception of the inability of patients to change. Conclusion: The present findings suggest that nurses are generally supportive of metabolic health screening and intervention but their high workload prevents them from implementing metabolic health interventions

Amilorides inhibit SARS-CoV-2 replication in vitro by targeting RNA structures

The SARS-CoV-2 pandemic, and the likelihood of future coronavirus pandemics, emphasized the urgent need for development of novel antivirals. Small-molecule chemical probes offer both to reveal aspects of virus replication and to serve as leads for antiviral therapeutic development. Here, we report on the identification of amiloride-based small molecules that potently inhibit OC43 and SARS-CoV-2 replication through targeting of conserved structured elements within the viral 5′-end. Nuclear magnetic resonance–based structural studies revealed specific amiloride interactions with stem loops containing bulge like structures and were predicted to be strongly bound by the lead amilorides in retrospective docking studies. Amilorides represent the first antiviral small molecules that target RNA structures within the 5′ untranslated regions and proximal region of the CoV genomes. These molecules will serve as chemical probes to further understand CoV RNA biology and can pave the way for the development of specific CoV RNA–targeted antivirals

Effect of the "universal test and treat" policy on the characteristics of persons registering for HIV care and initiating antiretroviral therapy in Uganda.

We examined the effect of the Universal Test and Treat (UTT) policy on the characteristics of people living with HIV (PLHIV) at enrolment in HIV care and initiation of antiretroviral therapy (ART) in Uganda using data from 11 nationally representative clinics of The AIDS Support Organisation (TASO). We created two retrospective PLHIV cohorts: pre-UTT (2004-2016), where ART initiation was conditional on CD4 cell count and UTT (2017-2022), where ART was initiated regardless of World Health Organisation (WHO) clinical stage or CD4 cell count. We used a two-sample test of proportions and Wilcoxon rank-sum test to compare proportions and medians, respectively, between the cohorts. A total of 244,693 PLHIV were enrolled at the clinics [pre-UTT, 210,251 (85.9%); UTT, 34,442 (14.1%)]. Compared to the pre-UTT cohort, the UTT cohort had higher proportions of PLHIV that were male (p 69 years, never married (p 500 cells/μL (47.3% vs. 13.2%, p < 0.001) and WHO stage 1 (31.7% vs. 4.5%, p < 0.001) at ART initiation. Adoption of the UTT policy in Uganda was successful in enrolling previously unreached individuals, such as men and younger and older adults, as well as those with less advanced HIV disease. Future research will investigate the effect of UTT on long-term outcomes such as retention in care, HIV viral suppression, morbidity, and mortality