Urinary tract infections (UTIs) are one of the major causes of morbidity and comorbidities in patients with underlying conditions, and it accounts for the majority of the reasons for hospital visit globally. Sound knowledge of factors associated with UTI may allow timely intervention that can easily bring the disease under control. This study was designed to determine the prevalence of UTI by isolating and characterizing the different bacterial etiological agents and to evaluate the factors associated with UTI. In this cross-sectional study, a total of 267, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions. The study revealed 86/267 (32.2%) UTI prevalence among patients attending hospitals in Bushenyi District, Uganda. Escherichia coli was the most prevalent bacterial uropathogen with 36/86 (41.9%) followed by Staphylococcus aureus 27/86 (31.4%), Klebsiella pneumoniae 10/86 (11.6%), Klebsiella oxytoca 6/86 (7.0%), Proteus mirabilis 3/86 (3.5%), Enterococcus faecalis 3/86 (3.5%), and Proteus vulgaris 1/86 (1.2%). This study has demonstrated that age ≤19 years, female gender, married individuals, genitourinary tract abnormalities, diabetes, hospitalization, indwelling catheter <6 days, and indwelling catheter >6 days had statistically significant relationships (p<0.05) with UTI. Screening for UTI in hospitalized patients, female gender, married individuals, genitourinary tract abnormalities, indwelling catheter, and diabetics should be adopted.

Aims: Bidens pilosa is an extraordinary source of phytochemicals particularly flavonoids especially in leaves which have been attributed in various studies due to its antibacterial properties. The present study aimed at addressing bio-burden of chronic wound through proving a possible source of new antimicrobial product for wound healing. Methodology: Solvent-solvent extraction method was used to isolate crude flavonoid fraction from leaves of B.  pilosa using ether, chloroform, ethylacetate and methanol (1:1:1). Thin-layer chromatography was used to identify crude flavonoid fraction using methanol/n-hexane (1:2: v/v) as mobile phase solvents. Agar well diffusion method was used to determine anti-bacterial activity of crude flavonoid against bacterial pathogens: Susceptible Pseudomonas aeruginosa ATCC®27853™, resistant Pseudomonas aeruginosa susceptible Staphylococcus aureus ATCC®25923™, methicillin resistant Staphylococcus aureus, Streptococcus pneumoniae and methicillin resistant Staphylococcus epidermidis. Minimum inhibitory concentration (MIC) and Minimum bactericidal contrition (MBC) were also determined using broth dilution and culture methods. Results: Thin-layer chromatographic profiling revealed an identity of three different spots with flavonoids from B. pilosa leaves showing three bands with Rf values 0.51, 0.60 and 0.63. The mean and standard deviation zone of inhibition of crude flavonoids ranged from 11.50±0.50 mm to 17.50±1.50 mm. The mean and standard deviation of positive controls (Ciproflaxacin, Co-Amoxiclay and Voncomycin) ranged from 0.00±0.00 to 22.50±0.50 mm. MIC and MBC of crude flavonoids ranged from 12.5-25.0 mg/mL and 50 to 200 mg/mL respectively. The flavonoid fraction was more effective against gram positive bacteria than on gram negative bacteria and it exhibited bactericidal effect on Methicillin resistant Staphylococcus aureus, resistant P. aureginosa, sensitive P.aureginosa and S. pneumonia. Conclusion: B. pilosa leaves could be a potential source for future drug development from flavonoid to address the issue of need for new antibiotics due to alarming burden of antimicrobial resistance in last resort antibiotics.

Trypanosomes are the causative agents of animal African trypanosomiasis (AAT) and human African trypanosomiasis (HAT), the former affecting domestic animals prevalent in Sub-Saharan Africa. The main species causing AAT in cattle are T. congolense, T. vivax, and T. b. brucei. Northern Uganda has been politically unstable with no form of vector control in place. The return of displaced inhabitants led to the restocking of cattle from AAT endemic areas. It was thus important to estimate the burden of trypanosomiasis in the region. This study was designed to compare the prevalence of animal African trypanosomes in cattle in Lira District using microscopy and polymerase chain reaction amplification (PCR) methods. In this cross-sectional study, a total of 254 cattle from the three villages of Acanakwo A, Barropok, and Acungkena in Lira District, Uganda, were selected by simple random sampling technique and screened for trypanosomiasis using microscopy and PCR methods. The prevalence of trypanosomiasis according to microscopic results was 5/254 (2.0%) as compared to 11/254 (4.3%) trypanosomiasis prevalence according to PCR analysis. The prevalence of trypanosomiasis infection in the animal studied is 11/254 (4.3%). Trypanosoma congolense was the most dominant trypanosome species with a proportion of 9/11 (81.8%), followed by T. vivax 1/11 (9.1%) and mixed infection of T. congolense/T. vivax1/11 (9.1%). Barropok village had the highest prevalence of trypanosomiasis with 6/11 (54.5%). There is a statistically significant relationship ( OR = 6.041 ; 95% CI: 1.634-22.331; p < 0.05 ) between abnormal PCV and trypanosome infection. Polymerase reaction amplification was the most reliable diagnostic method due to its high sensitivity and specificity as compared to the conventional microscopic method. Polymerase reaction amplification appears to have adequate accuracy to substitute the use of a microscope where facilities allow. This study, therefore, underscores the urgent need for local surveillance schemes more especially at the grassroots in Uganda to provide data for reference guideline development needed for the control of trypanosomiasis in Uganda.

Background Malaria remains a major vector borne disease globally, with the majority of the casualties reported in Africa. Despite this fact, there is drastic reduction in malaria infection using Artemisinin combined therapies (ACTs). Malaria is characterized by significant inconsistency in different geographical locations due to different confounding factors. There is need to identify zone-specific malaria trends and interventions to completely eliminate the disease. Thus the study was aimed at assessing the 11-year trend of microscopically confirmed malaria cases in Kisii County, Kenya, so as to devise area-specific evidence-based interventions, informed decisions, and to track the effectiveness of malaria control programs. Methods This was a retrospective study carried out to determine 11-year malaria trend rates centered on the admission and laboratory records from health facilities located at four Sub-Counties in Kisii County, Kenya. Parasitological positivity rates of malaria were determined by comparing with the register records in health facilities which recorded confirmed malaria cases with the total number of monthly admissions over the entire year. Data was analyzed by using descriptive tools and chi-square test. Results There were 36,946 suspect cases, with 8449 (22.8%) confirmed malaria cases reported in this study. The overall malaria slide positivity rate over the last 11 years in the study area was 22.6%. The months of April and August showed the largest number of malaria cases (63%). The age group of ≥18 years contained the most positive confirmed cases, having a prevalence rate of 2953 (35.45%). Out of the confirmed malaria cases, 2379 (28.1%) were males and 6070 (71.9%) were females The highest malaria prevalence rate was recorded in 2014, with Marani Sub-County recording the highest positivity rate of 37.94%. Conclusion From the observed trends, malaria prevalence and transmission still remains stable in the study area. Thus more interventions need to be scaled up.

Introduction bacterial resistance to fluoroquinolones is on the rise globally, bacteria causing urinary tract infections (UTIs) are no exception to this fact. Judicious use of the current antibiotics by clinicians is therefore deemed necessary to combat development of resistance. This study determined fluoroquinolone resistant profiles, multiple antibiotic resistance indices (MARI), factors associated with fluoroquinolone resistance and their strength among patients attending hospitals in Bushenyi District, Uganda. Methods this was a cross-sectional study in which a total of 86 bacterial uropathogens isolated previously by standard microbiological methods were subjected to antibiotic susceptibility testing using Kirby Bauer disk diffusion method. Data for factors suspected to be associated with fluoroquinolone resistant UTI were obtained by use of questionnaires. Results the most resisted fluoroquinolone was ofloxacin with 29/83 (34.9%), followed by moxifloxacin 27/83 (32.5%), levofloxacin 24/86 (27.9%) and ciprofloxacin 23/86 (26.7%). The bacterial uropathogens that exhibited the highest frequency of fluoroquinolone resistant strains were P. mirabilis with 2/3 (66.7%) and E. faecalis with 2/3 (66.7%), followed by E. coli 19/36 (52.8%), S. aureus 13/27 (48.1%), K. oxytoca 2/6 (33.3%), K. pneumoniae 2/10 (20.0%) and P. vulgaris 0/1 (0.0%). All the bacterial uropathogens tested showed MARI of ≥ 0.2. Hospitalization, history of fluoroquinolones use in the last 12 months and wrong prescription of antibiotics were found to bear statistically significant relationships (p < 0.05) with fluoroquinolone resistant UTI. Conclusion antibiotic susceptibility testing of the first generation quinolones such as nalidixic acid in hospitalized patients, patients with history of fluoroquinolones' use in the last 12 months and wrong prescription of antibiotics should be adopted to avoid fluoroquinolone abuse. For empiric treatment of UTIs in Bushenyi District, ciprofloxacin still remains the first line of choice among the fluoroquinolone class of antibiotics.

Introduction Drug resistance remains a major challenge in malaria treatment, especially after the emergence of resistance to artemisinin-based combined therapies. Plasmodium falciparum Kelch13 gene mutations are implicated in conferring artemisinin resistance. Thus, this study was aimed at determining the occurrence of Kelch13 ( K13 ) propeller resistance gene polymorphism mutations in Bushenyi district, Uganda. Methods Participants suspected to have malaria were recruited. P. falciparum was confirmed using antigen histidine-rich protein 2 (HRP2) (Pf) (Access Bio, Inc, USA) and microscopy. Malaria-positive patients were treated with artemeter-lumefantrine (AL). Blood was withdrawn from participants who tested positive for parasites after day 3 and kept in blood filter papers (ET31CHR; Whatman Limited, Kent, UK). DNA was extracted using chelex-suspension method. Nested polymerase chain reaction (PCR) was conducted and the second-round products sequenced using Sanger’s method. Sequenced products were analyzed using DNAsp 5.10.01 software and then blasted on to the NCBI for K13 -propeller gene sequence identity using the Basic Local Alignment Search Tool (BLAST). Results Out of 283 enrolled participants, 194 completed the follow-up schedule. A total of 134 (69%) had no parasites on day 3, while 60 (31%) had parasites on that day. Out of the 60 samples, 40 (62%) were positively amplified as P. falciparum , with polymorphisms in the K13 -propeller gene detected in 3 (7.5%) out of the 40 amplicons. Polymorphisms at codon 1929, 1788 and 1801 were detected separately in one sample each. Sequences have been deposited in NCBI with accession numbers PRJNA720348 and PRJNA720800. Conclusion Polymorphisms in the K13 -propeller gene previously reported to be associated with artemisinin resistance were not detected in the P. falciparum isolates from Bushenyi district, Uganda. More studies need to be conducted on the new mutations detected so as to understand their association, if any, with ACT resistance.

Introduction: Malaria remains the major vector borne disease in the world. Currently Kenya the ministry of health has scaled up interventions with chemotherapy and vector control standing out as a major strategy. Therefore, this study examined the influence of vector control and chemotherapy interventions on the treatment outcomes in Kisii County. Methods: Multi-stage random sampling was used for this study. The study was conducted from February 2021 to June 2021. Malaria-positive 275 participants were recruited into the study, treated with ACTs and followed for a period of 28 days at specified follow up days for parasite diagnosis. Occurrence of malaria clinical symptoms on the patients was also conducted. Molecular analysis was done by characterizing Merozoite proteins (MSP2) on the samples showing parasite recurrence. A Questionnaire was administered to determine the utilization of drugs for malaria treatment prior to this study and the usage of vector control after patient treatment with ACTs. Meanwhile, emphasis was laid on intervention strategies such as the use the usage of insecticide-treated nets (ITNs), Indoor residual spraying and chemotherapeutic practices as recommended by the World Health Organization (WHO). Results: Early treatment failure was reported among 27(12%) respondents, late clinical failures 20(8%), late parasitological failures 11(5%), and adequate clinical and parasitological outcomes 173(75%).Chemotherapeutic practices influencing treatment outcomes included; previous self-medication (OR=0.417; 95% CI: 0.153-1.385; p=0.035), ability of previously finishing doses (OR=0.328; 95% CI: 0.168-0.941; p=0.003,) and Frequency of previous antimalarial usage (OR=3.259; 95% CI: 1.054-4.721; p=0.004). While vector control interventions influencing treatment outcomes included; usage of indoor residual spraying (OR=0.408; 95% CI: 0.132-0.682; p=0.002), sleeping under the mosquito net (OR=0.218; 95% CI: 0.119-0.909; p=0.025,) and mosquito net treatment (OR=0.262; 95% CI: 0.092-0.823; p=0.003).With the molecular analysis detecting 10 samples with parasite recrudescence. Conclusions: Based on these findings, Antimalarial usage practices prior to current usage of ACTs and vector control after treatment remain important predictor factors for treatment outcomes.

In Uganda, only 19% of adolescents utilize adolescents’ reproductive health services yet complications of pregnancy, abortions, and childbirth are the leading cause of disability and death among the same age group. The purpose of this study was to assess factors that were contributing to the low utilization of adolescents’ reproductive health services. A quantitative cross-sectional study employed simple random sampling among 85 adolescents that were attending Kampala international university outpatient clinic. Results found out that majority 46(53.4) of adolescents were aged from 15-16 years, 46(53.4%) were male, 28(32.5%) were Catholics most 81(94.1%) were single. 18(36%) had got the information from their friends, 28(56%) of adolescents said that the information about adolescents' reproductive health services was not freely shared in their communities and 33(66%) said that their communities did not accept adolescents sexual reproductive health services where 7(50%) gave a reason they expected to be young to have sexual intercourse. 43(86%) of adolescents were from within 1-5km, 28(73.8%) mentioned lack of privacy at the facility, and 30(79%) said that health workers segregated adolescents that needed similar reproductive health services. In conclusion, factors that were contributing to the low hindering utilization of adolescents’ reproductive health services were both demographic, socio-economic, and facility related. Keywords: Adolescents, Reproductive, Health Services, Uganda.