BackgroundRotavirus remains the commonest cause of severe dehydrating diarrhea among children worldwide. Children in developing countries die more because of several factors including poorer access to hydration therapy and greater prevalence of malnutrition. Hitherto, the magnitude of rotavirus disease in Uganda has remained unknown. This study was therefore done to determine the prevalence and factors associated with rotavirus infection among children aged 3-59 months admitted with acute diarrhea to paediatric emergency ward of Mulago Hospital, UgandaMethodsThree hundred and ninety children, aged between 3-59 months with acute diarrhoea were recruited. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples were tested for rotavirus antigens using the DAKO IDEIA rotavirus EIA detection kit.ResultsThe prevalence of rotavirus infection was 45.4%. On multivariate analysis rotavirus was significantly associated with a higher education (above secondary) level of the mother [OR 1.8; 95% CI 1.1-2.7]; dehydration [OR 1.8; 95% CI 1.1-3.0] and breastfeeding [OR 2.6; 95% CI 1.4-4.0]. Although age was significantly associated with rotavirus on bivariate analysis; this association disappeared on multivariate analysis. No significant association was found between rotavirus infection and nutritional status, HIV status and attendance of day care or school.ConclusionsRotavirus infection is highly prevalent among children with acute diarrhoea admitted to Mulago Hospital in Uganda.

A lack of capacity to diagnose tuberculosis (TB) in children at peripheral health facilities and limited contact screening and management contribute to low case finding in TB-endemic settings. O B J E C T I V E : To evaluate the implementation of a pilot project that strengthened diagnosis, treatment and prevention of child TB at peripheral health facilities in Uganda. M E T H O D S : In June 2015, health care workers at peripheral health facilities were trained to diagnose and treat child TB. Community health care workers were trained to screen household TB contacts. Beforeand-after analysis as well as comparisons with nonintervention districts were used to evaluate impact on caseload and treatment outcomes.

Background The COVID-19 pandemic has disrupted health care access in many countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. Methods This was across-sectional study carried out from April 2020 to May 2020 in Uganda. A questionnaire was administered online to participants aged 18 to 30 years. Subjects were recruited using a snowballing approach. STATA version 14.2 was used for statistical analysis.Results Of 724 participants, 203 (28%) reported that they did not have access to information and/or education concerning sexual and reproductive health (SRH). More than a quarter of the participants (26.9%, n=195) reported that testing and treatment services of sexually transmitted infections were not available during the lockdown. 27.2% could not obtain contraceptive supplies. Access to HIV services and menstrual supplies were also impaired. Lack of transportation was the commonest factor cited as limiting access to SRH services during the lockdown (68.7%), followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and the curfew (39.1%). Sexually transmitted infections were the commonest SRH problems related to SRH during the lockdown (40.4%) followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Marital, educational, and employment status were significantly correlated with the reported experiences of the participants. Conclusion Access to SRH information and services for Ugandan youths was restricted during the COVID-19 lockdown and may have increased the incidence of poor SRH outcomes. Lack of transportation, distance to health facilities, and high cost of services were important limiting factors. The Government and other stakeholders should incorporate SRH among the priority services to be preserved during future outbreaks.

Childhood tuberculosis (TB) is consistently under-detected in most high-burden countries, including Uganda, especially in young children at high risk for severe disease and mortality. TB preventive treatment (TPT) for high-risk child contacts is also poorly implemented. The centralised concentration of services for child TB at the referral level is a major challenge in the prevention, detection and treatment of TB in children. In 2015, the DETECT Child TB Project was implemented in two districts of Uganda and involved decentralisation of healthcare services for child TB from tertiary to primary healthcare facilities, along with establishing linkages to support community-based household contact screening and management. The intervention resulted in improved case finding of child and adult TB cases, improved treatment outcomes for child TB and high uptake and completion of TPT for eligible child contacts. A detailed description of the development and implementation of this project is provided, along with findings from an external evaluation. The ongoing mentorship and practical support for health workers to deliver optimal services in this context were critical to complement the use of training and training tools. A summary of the project’s outcomes is provided along with the key challenges identified and the lessons learnt.

Objectives: To determine the prevalence, clinical characteristics and outcomes of HIV and severe acute respiratory syndrome coronavirus 2 (SARS−CoV−2) co−infection. Methods: We searched Medline, Embase, Cochrane and Web of Science databases and grey literature for studies reporting epidemiological and clinical data of patients with HIV and SARS−CoV−2 co−infection. Eligible studies were all observational or interventional studies and commentaries in English language that reported patient data on HIV/SARS−CoV−2 co−infection. We used random effect meta−analysis to determine the pooled prevalence and mortality. Results: Of the 17 eligible studies, there were 3 retrospective cohorts, 1 survey, 5 case series, 7 case reports and 1 commentary that reported on a total of 146 HIV infected individuals. The pooled prevalence of HIV among individuals with SARS−CoV−2 infection was 1.0% (95% CI: 0.0 − 3.0, I2 = 79.3%, p=0.01), whereas the prevalence of SARS−CoV−2 among HIV patients was 0.68% (95% CI: 0.34 − 1.34). There were 110 (83.8%) HIV/ SARS−CoV−2 co−infected males, and the age (range) of the co−infected was 30 − 60 years. A total of 129 (97.0%) were anti−retroviral therapy experienced, and 113 (85.6%) had a suppressed HIV viral load. The CD4 count (range) was 298 − 670 cells/mm3 (n = 107). The commonest symptoms were fever (73.5%, n=75) and cough (57.8%, n = 59). Sixty−two (65.3%) patients had at least one other comorbid condition, of which hypertension (26.4%, n = 38) was the commonest. Chest radiological imaging abnormalities were found in 46 (54.1%) cases. Twenty-eight cases (56.0%) were reported as mild. Recovery occurred in 120 (88.9%) cases, and the pooled mortality was 9% (95% CI: 3.0 − 15.0, I2 = 25.6%, p =0.24). Conclusion: The prevalence of HIV/SARS−CoV−2 co−infection was low. The clinical characteristics and outcomes of HIV/SARS−CoV−2 co−infection are comparable to those reported among HIV negative SARS−CoV−2 cases.

BackgroundThe COVID-19 pandemic has caused a wide range of disruptions in health care access in many low and middle income countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. MethodsThis was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years were recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having access to testing and treatment services of sexually transmitted infections during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to accessing SRH services during the lockdown followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and curfew conditions (39.1%). Sexually transmitted infections were the commonest (40.4%) problems related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Limiting factors were more prevalent among the co-habiting youths [CPR: 1.3 (1.13-1.49) and APR:1.2 (1.06-1.41)] followed by unemployed [CPR: 1.3 (1.09 - 1.53) and APR:1.2 (1 - 1.42)] and non-salaried [APR:1.2 (1- 1.42)] than other participants. The bivariate and multivariate regression analyses indicate that problems were more prevalent among the co-habiting youths [CPR: 2.7 (1.88 - 3.74) and APR: 2.3 (1.6 - 3.29)] followed by the unemployed [CPR: 2 (1.27 - 3.2) and APR: 1.6 (1.03 - 2.64)] than in other categories. ConclusionThe findings of this study show that Ugandan youths had limited access to SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed youths were the most affected by problems related to SRH. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The findings call for concerted efforts from the Government and other stakeholders to incorporate SRH among the priority services when designing responses to any outbreak crisis.

IntroductionSexual and Reproductive Health access to Information services is still a pressing need for youth in Uganda even during the COVID-19 pandemic, which has disrupted health care access in many countries. The aim of this study was to explore the challenges in access and utilization of sexual and reproductive health services as faced by youth during the COVID-19 pandemic lockdown in Uganda.MethodsThis was a cross-sectional study carried out from 28th April 2020 to 11th May 2020 in Uganda. An online questionnaire was disseminated to youth aged between 18 and 30 years over a period of 14 days. The snowball sampling method was used to recruit participants. STATA version 14.2 was used for statistical analysis.ResultsOf 724 participants, 203 (28%) reported that they did not have access to information and/or education concerning sexual and reproductive health (SRH). More than a quarter of the participants (26.9%, n = 195) reported that testing and treatment services of sexually transmitted infections were not available during the lockdown, and 27.2% could not obtain contraceptive supplies. Access to HIV/AIDS care services and menstrual supplies was also impaired. Lack of transportation was the commonest factor cited as limiting access to SRH services during the lockdown (68.7%), followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and the curfew (39.1%). Sexually transmitted infections were the commonest SRH problems related to SRH during the lockdown (40.4%) followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Marital, educational, and employment status were significantly correlated with the reported experiences of the participants.ConclusionAccess to SRH information and services for Ugandan youth was restricted during the COVID-19 lockdown and leaving them vulnerable to various SRH risks and adverse outcomes. Lack of transportation, long distances to health facilities, and high cost of services were important limiting factors. The Government and other stakeholders should incorporate SRH among the priority services to be preserved during future outbreaks.

Background The COVID-19 pandemic threatens access to sexual and reproductive health and rights. With global health emergencies, there is often a total reversal of priorities and sexual and reproductive health rights services may become challenging. The aim of this study was to establish the challenges to sexual and reproductive health and rights among Ugandan youth during the lockdown due to COVID-19 pandemic. Methods This was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18 to 30 years recruited using the snowballing approach. The statistical analysis was done using STATA version 14.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.5%) reported not having testing and treatment services of Sexual transmitted Infections available during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to access to SRH services during the lockdown followed by the long distance from home to health facility where to get the services (55.2%), cost of services (42.2%) and curfew (39.1%). Sexually transmitted diseases were the commonest (40.4%) challenge relating to SRH during this lockdown followed by unwanted pregnancy (32.4%) and sexual abuses (32.4%). The Multivariate Regression Analysis shows that challenges were more prevalent among the co-habiting youth [APR: 2.3 (1.6 - 3.29), p<0.001] followed by unemployed (Volunteer or unpaid) [APR: 1.6 (1.03 - 2.64), p: 0.037] than others participants. Conclusions The findings of this study show that Ugandan youths have challenges to access to SRHR information and services during lockdown due to COVID-19. Cohabiting and unemployed participants were mostly affected among Ugandan youths. Lack of transport means and cost of services were the limiting factors to access SRHR services among youths. Therefore, effective measures should be put in place to ensure access and availability of SRHR for Ugandan youths during the COVID-19 lockdown.