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Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

Mass gatherings frequently include close, prolonged interactions between people, which presents opportunities for infectious disease transmission. Over 20,000 pilgrims gathered at Namugongo Catholic and Protestant shrines to commemorate 2022 Uganda Martyr’s Day. We described syndromes suggestive of key priority diseases particularly COVID–19 and viral hemorrhagic fever (VHF) among visiting pilgrims during May 25−June 5, 2022. A suspected COVID–19 case was defined as ≥2 signs or symptoms of: fever >37.50C, flu, cough, and difficulty in breathing whereas a suspected VHF case was defined as fever >37.50C and unexplained bleeding among pilgrims who visited Namugongo Catholic and Protestant shrines from May 25 to June 5, 2022. Pilgrims were sampled systematically at entrances and demarcated zonal areas to participate in the survey. Additionally, we extracted secondary data on pilgrims who sought emergency medical services from Health Management Information System registers. Descriptive analysis was conducted to identify syndromes suggestive of key priority diseases based on signs and symptoms. Among 1,350 pilgrims interviewed, 767 (57%) were female. The mean age was 37.9 (±17.9) years. Nearly all pilgrims 1,331 (98.6%) were Ugandans. A total of 236 (18%) reported ≥1 case definition symptom and 25 (2%) reported ≥2 symptoms. Twenty-two (1.6%) were suspected COVID–19 cases and three (0.2%) were suspected VHF cases from different regions of Uganda. Among 5,582 pilgrims who sought medical care from tents, 538 (9.6%) had suspected COVID–19 and one had suspected VHF. Almost one in fifty pilgrims at the 2022 Uganda Martyrs’ commemoration had at least one symptom of COVID–19 or VHF. Overall, we identified 4 Viral Hemorrhagic Fever and 560 COVID-19 suspected cases during the 2022 Uganda Martyrs’ commemoration. Intensified syndromic surveillance and planned laboratory testing capacity at mass gatherings is important for early detection of public health emergencies that could stem from such events.

Background The kidney is one of the common target organs for HIV infection. Early detection of microalbuminuria, the earliest marker of renal damage is critical to slowing down progression to end stage renal disease if appropriate intervention is made. The burden of microalbuminuria and its associated factors in HIV−infected ART naive patients has not been determined in Uganda.Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic on adult HIV−infected ART naïve outpatients. Data was collected on age, sex, level of education, marital status, religion, address, and history of alcohol intake, diabetes mellitus, hypertension, medications and smoking. Measurement of blood pressure, weight and height to determine body mass index (BMI) and investigations including complete blood count (CBC),serum urea and creatinine, Liver function tests(LFTs), CD4+ count, spot morning urine albumin and urine creatinine to determine microalbuminuria were conducted. Logistic regression was used to estimate the strength of association between variables.ResultsA total of 185 adult participants were consecutively enrolled into the study. The mean (SD) age was 34.2(±9.0) years and majority (63.8%) were female. The mean (SD) CD4+ count 466±357 cells/µL, and BMI 23.1 (±4.9) kg/m 2 . The prevalence of microalbuminuria was 18.9%. None of the participants had albuminuria. CD4+ count <350cells/µL and BM1<18.5kg/m 2 were associated increased risk of microalbuminuria OR 3.8 (95%CI 1.7-8.3) (p value=0.01) and OR 4.7 (95%CI 1.82-12.4) (p value=0.03) respectively. Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria.Conclusion Microalbuminuria was highly prevalent in adult HIV−infected ART patients especially those with low CD4+ count and low BMI. There is need to study the effect of ART on microalbuminuria in adult HIV−infected patients. Key words: HIV, microalbuminuria, Uganda, ART naïve