Background: TB (Tuberculosis) is the second leading killer infectious disease after HIV (human immunodeficiency virus). Its incidence is worsened by development of multi-drug resistant and extensive drug resistant TB strains. Available treatment regimens are expensive, toxic and lengthy resulting to problems of non-adherence and inadequate response. Medicinal plants on the other hand may offer hope for developing alternative medicine for treatment of TB. This study evaluated the anti-tuberculosis activity of Echinops amplexicaulis. Materials and methods: Total crude extracts of E. amplexicaulis were tested for activity against a wild strain resistant to Rifampicin and Isoniazid (MDR), a fully susceptible laboratory strain (H37Rv) and Mycobacterium bovis (BCG strain) using disk diffusion method. MIC (minimum inhibitory concentration) was determined using Middlebrook 7H9 broth. The strains were sub-cultured on Middlebrook 7H10 medium and MBC (minimum bactericidal concentration) determined. Susceptibility was evaluated by measuring zones of inhibition; MIC was obtained as the lowest concentration with no significant growth as shown by clog formation of MTB (Mycobacteria tuberculosis) cells on the walls of the macro broth tube and MBC was obtained as the lowest concentration that inhibited growth of MTB colonies on Middlebrook 7H10 medium. Results: The extract showed a significant effect at a concentration of 50 mg/mL against all the three test strains F (2, 18) = 437.7, p = 0.00. It exhibited a MIC of 0.0488 mg/mL against MDR-TB and M. bovis. Its MBC was the same at 0.0977 mg/mL against both MDR TB and M. bovis. The MIC was much lower (0.0122 mg/mL) for the H37Rv strain. Terpenoids, alkaloids and tannins were present in large amount in the extract while saponins were present in small amounts. Flavonoids were not detected in the extract. Conclusion: E. amplexicaulis has the potential to be developed into new anti-TB drug and outcome of the study supports the folkloric claims of anti-tuberculosis activity of the plant.

There is a high prevalence of phenotypic PZA resistance among TB patients in Uganda. The low sensitivity of pncA gene sequencing confirms the already documented discordances suggesting other mechanisms of PZA resistance in Mycobacterium tuberculosis.data collection and analysis, decision to publish, or preparation of the manuscript.

Background With shortages of face-masks continuing to be reported worldwide, critical questions like whether or not there is an adequate alternative to commercially manufactured face-masks continue to linger especially in low- and middle- income settings. This study aimed at addressing this through testing and comparing various materials and forms of face-masks for filtration efficiency, breathability, microbial cleanliness, distance-dependent fitness, and re-usability of different face-masks procured from face-mask vendors in Kampala, Uganda. Methods This was a laboratory-based descriptive study that applied new protocols and already existing protocols with substantive modifications to ten different types of face-mask types each in quadruplicate to achieve each specified aim. Results Surgical face-masks had better filtration efficiency, distance-dependent fitness and breathability compared to other face-masks tested. Decontamination of these face-masks with 70% ethanol negatively affected their efficacy. Locally-made double layered face-masks had better: filtration efficiency, distance-dependent fitness and breathability compared to other locally-made cloth face-masks, and re-usability compared to all the face-mask types that had been tested. Discussion/conclusions Locally-made double layered cloth face-masks could serve as alternative face-masks especially for populations in low- and middle- income settings like Uganda while allowing restricted use of surgical face-masks and other respirators like the KN95 to high-risk groups only.

With shortages of face masks being reported worldwide, it is critical to consider alternatives to commercially manufactured face masks. This study aimed to test and compare the efficacy of various makes of locally made or homemade cloth face masks obtained from face-mask vendors in Kampala, Uganda, during the COVID-19 pandemic. The testing was performed to assess the bacterial filtration efficiency (BFE), breathability, distance-dependent fitness, and reusability of the locally made or homemade cloth face masks, while considering the most commonly used non-published face-mask decontamination approaches in Uganda. During laboratory experimentation, modified protocols from various face-mask testing organizations were adopted. Ten different face-mask types were experimented upon; each face-mask type was tested four times for every single test, except for the decontamination protocols involving washing where KN95 and surgical face masks were not included. Among the locally made or homemade cloth face masks, the double-layered cloth face masks (described as F) had better BFE and distance-dependent fitness characteristics, they could be reused, and had good breathability, than the other locally made or homemade cloth face masks. Despite these good qualities, the certainty of these face masks protecting wearers against COVID-19 remains subject to viral filtration efficiency testing.

Background: Drug-Resistant Tuberculosis (DR-TB) is one of the key challenges toward TB control. There is an urgent need for rapid and accurate drug susceptibility tests (DST) for the most commonly used 1st and 2nd line TB drugs.   Design and Methods: In a blinded, laboratory-based cross-sectional study, we set out to validate the performance of the Xpert® MTB/XDR test for DST of M. tuberculosis. Sputum samples or culture isolates collected between January 2020 and December 2021 from patients with rifampicin resistance –TB and/or with higher suspicion index for isoniazid (INH) resistance and/or 2nd line fluoroquinolones (FQ) and injectable agents (IAs) were tested using the Xpert® MTB/XDR test from 11/September 2021 to 26/May /2022. Diagnostic accuracy and factors for laboratory uptake of Xpert® MTB/XDR test were compared to MGIT960 and the Hain Genotype® MTBDRplus and MDRsl assays (LPA) as reference DST methods.   Results: A total of 100 stored sputum samples were included in this study. Of the samples tested using MGIT960, 65/99 (65.6%) were resistant to INH, 5/100 (5.0%) resistant to FQ and none were resistant to IAs. The sensitivity and specificity, n (%; 95%Confidence Interval, CI) of Xpert® MTB/XDR test for; INH were 58 (89.2; 79.1-95.5) and 30 (88.2; 72.5-96.6), FQ; 4 (80.0; 28.3-99.4) and 95 (100; 96.2-100), respectively. The specificity for AIs was 100 (100; 96.3- 100).   Using LPA as a reference standard, a total of 52/98 (53.1%) were resistant to INH, 3/100 (3.0%) to FQ, and none to IA. The sensitivity and specificity, n (%; 95%CI) of Xpert® MTB/XDR test compared to LPA for; INH was 50 (96.1; 86.7-99.5) and 34 (74.0; 58.8-85.7) and FQ 3 (100; 29.2-100) and 96 (99.0; 94.3-99.9) respectively.  The specificity of IAs was 96 (100; 96.2-100).   The factors for laboratory uptake and roll-out included; no training needed for technicians with previous Xpert-ultra experience and one day for those without, recording and reporting needs were not different from those of Xpert ultra, the error rate was 4/100 (4%), no uninterpretable results reported, test turn-around-time was 1hr/45 minutes and workflow similar to that of the Xpert-ultra test.   Conclusion: There is high sensitivity and specificity of Xpert® MTB/XDR test for isoniazid, fluoroquinolones, and Injectable agents.  There are acceptable Xpert® MTB/XDR test attributes for test uptake and roll-out.