Appropriateness, barriers, and facilitators of multi-month dispensing of tuberculosis drugs in rural eastern Uganda: A qualitative study to inform a non-inferiority randomized trial.

Multi-month dispensing of tuberculosis (TB) drugs is an innovative strategy that may reduce frequent clinic visits and travel costs among people with TB (PWTB) in rural areas. To inform a planned trial, we explored the appropriateness, barriers, and facilitators to multi-month dispensing among PWTB and healthcare providers in rural eastern Uganda. We used qualitative methods situated within the Consolidated Framework for Implementation Research to explore two refill schedules for multi-month dispensing of TB drugs-a four- or five-visit refill schedule.

Addressing Stigma, Mental Well-Being, and Alcohol Use among People with Tuberculosis in Sub-Saharan Africa: A Call for an Integrated Care Model.

Tuberculosis (TB) remains a major public health challenge in sub-Saharan Africa (SSA), with stigma, mental health issues, and alcohol use significantly affecting treatment outcomes. Stigma delays TB diagnosis, reduces treatment adherence, and disrupts care continuity. Mental health conditions, such as depression and anxiety, further undermine adherence, whereas alcohol use accelerates TB disease progression and leads to poor treatment outcomes.

Effect of community-led total sanitation on open defecation in Uganda: A propensity score-matched analysis.

A substantial proportion (7%) of people in Uganda practice open defecation. A Community-Led Total Sanitation (CLTS) project was started in 2011 to reduce indiscriminate disposal of excreta but the effect has not been rigorously evaluated. We, therefore, evaluated the effect of CLTS on reducing open defecation in the program intervention districts in Uganda.

Enhancing Global Health Security in Sub-Saharan Africa: The case for integrated One Health surveillance against zoonotic diseases and environmental threats.

Integrated One Health surveillance is pivotal to Africa's future health security, particularly in preventing and managing zoonotic and environmental health threats. The One Health strategy recognizes the interconnectedness of human, animal, and environmental health, allowing a holistic framework for tracking and responding to emerging and re-emerging pathogens. The One Health approach facilitates cross-sectoral data sharing and enhances surveillance, enabling the early detection and response to potential outbreaks.

Effect of Health Profession Students' Community Engagement on Open Defecation-Free Status: A Quantitative Assessment of a Community-Led Total Sanitation and Hygiene Program in Southwestern Uganda.

Introduction Uganda's Community-Led Total Sanitation (CLTS) strategy is based on the use of health extension workers (HEWs) for its implementation at the community level. However, identification of other facilitators to improve and accelerate the scaling up of the CLTS intervention has not been explored. This study evaluated the effect of a student-led CLTS intervention on open defecation and open defecation-free status outcomes.

Multi-month dispensing of tuberculosis medications in sub-Saharan Africa: A feasible, person-centered care model.

The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus.

Effect of alcohol consumption and tobacco smoking on psychological distress: a quasi-experimental study using the 2022 Kenya demographic health survey data.

Objective: Alcohol consumption and tobacco smoking have the potential to increase psychological distress. We evaluated the effect of alcohol consumption and tobacco smoking on psychological distress among adults in Kenya using a quasi-experimental study.

Design: Quasi-experimental study.

Correction: Prevalence of chronic kidney disease among young people living with HIV in Sub Saharan Africa: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.

Initiation of breastfeeding among mothers attending a regional referral hospital in central uganda: a cross-sectional study.

Background: Breastfeeding initiation within the first hour of birth is beneficial in reducing the risk of maternal and neonatal mortality. However, a significant proportion of mothers delay initiating breastfeeding within an hour of birth, but the association with age has not been rigorously studied. We examined the association between maternal age and delayed initiation of breastfeeding in a large urban referral hospital in central Uganda.

Dietary diversity and associated factors among people with tuberculosis in Kampala, Uganda: A cross-sectional study.

Unlabelled: Rationale.Dietary diversity (DD) is important in enhancing the nutritional status of people with tuberculosis (TB), but has been understudied in Uganda.

Objective: To investigate the frequency of adequate DD and the associated factors among people with pulmonary TB aged ≥ 18 years in Kampala, Uganda.

Return to care of children and adolescents living with HIV who missed their clinic visits or were lost to follow-up: a continuous quality improvement study in Uganda.

Background: While the UNAIDS 95-95-95 targets have been met among adults, those for children and adolescents remain suboptimal. This study aimed to improve the return-to-care rates among children and adolescents living with HIV (CALHIV) who missed clinic appointments at a county-level rural health facility in eastern Uganda.

Methods: Between January 2023 and January 2024, we conducted a continuous quality improvement (CQI) study.

Completion of Multidose COVID-19 Vaccination Among Adolescents and Adults in Urban Informal Settlements in Nairobi, Kenya.

Completion of vaccine doses is essential for robust immunity and long-term protection against specific diseases. This study aimed to investigate factors associated with the completion of multidose coronavirus disease 2019 (COVID-19) vaccines (MDVs) among adolescents and adults in two informal urban settlements in Nairobi, Kenya. We analyzed data from the Kenya Multisite Integrated Serosurveillance project.

Hypertension and cognitive impairment among older persons in rural Northern Uganda: a cross-sectional study.

Background: Hypertension is common among older adults and negatively affects cognitive function. Available data on this association is mostly from resource-rich settings and has been understudied in resource-limited settings especially rural areas where the majority of older persons live. We examined the association between hypertension and cognitive impairment in older persons in Kole, a rural district in Uganda, and examined whether sex modifies the association.

Impact of differentiated service delivery models on quality of life among people living with HIV in Uganda- a quasi-experimental study.

Background: Differentiated service delivery (DSD) models in resource-limited settings reduce strain on health services and improve clinical outcomes such as retention and viral suppression, but little is known about the impact of HIV DSD models on quality of life (QoL), which is essential for optimizing person-centered care. This study assessed the impact of DSD models on Quality of life, loss to follow-up (LTFU), and mortality among persons living with HIV (PLHIV) on Antiretroviral therapy (ART) over time at a large urban HIV clinic in Uganda.

Methods: Records of 1,000 PLHIV enrolled in a 10-year cohort at the Infectious Diseases Institute (IDI) clinic in Kampala, Uganda were retrospectively analyzed.

Quality of life and retention in care among people living with HIV initiated on ART in the era of "Universal Test and Treat" policy at a large HIV Clinic in South Western Uganda.

Background: Anti-retroviral therapy (ART) improves the quality of life (QoL) among people living with human immunodeficiency virus (PLWH). Most studies documenting the gains in QoL have been conducted among persons starting treatment at advanced HIV disease. In the era of Universal Test and Treat (UTT) policy, most PLWH start ART early with high CD4 counts.

Effect of COVID-19 pandemic on smoking, alcohol consumption, and substance use in persons aged 15 years and older in Uganda.

In Uganda, the effect of the COVID-19 pandemic on substance and drug use at the national level has not been studied. Our study evaluated the effect of the COVID-19 pandemic on the frequency of smoking, alcohol consumption, and substance use among Ugandans aged ≥ 15 years based on a large, nationally representative survey. This quasi-experimental study used the Uganda National Household Survey data collected between June 2019 and November 2020, with the COVID-19 pandemic as the primary exposure and outcomes as smoking, alcohol consumption, and substance use frequency before and during the COVID-19 pandemic, measured on an ordered scale (none, less than daily, and daily).

Causal inference methodologies to assess the effect of missed clinic visits on treatment success rate among people with tuberculosis in rural Uganda.

Background: Although randomized controlled trials are the gold standard design for cause-effect analysis, high costs and challenges around practicability, feasibility, and ethics may limit their use. In such situations, causal inference methods can improve the rigor of cause-effect analysis using observational data but such methods have infrequently been applied in tuberculosis (TB) research. We conducted a parallel comparison across three causal inference methods in order to assess the causal association between missed clinic visit/s and treatment success among people with drug-susceptible bacteriologically confirmed pulmonary TB.

Text message reminders to improve the timeliness of birth dose vaccine administration among newborns in an urban informal settlement in Kenya.

Background: We evaluated the effectiveness of text message reminders on the timely administration of birth dose vaccines among newborns in Viwandani urban informal settlement in Nairobi County, Kenya.

Methods: In a pilot stepped-wedge cluster-randomized trial, we sequentially randomized pregnant women to receive text message reminders or routine care. Three standardized text messages were sent notifying pregnant women to take their newborn for vaccination at birth during the intervention period.

Protocol for the effectiveness of multimonth refill of antituberculosis drugs (MORAD) on treatment success among people with drug-susceptible tuberculosis in rural eastern Uganda: a non-inferiority randomised trial.

Introduction: Multimonth dispensing of antituberculosis (TB) drugs reduces frequent visits and costs associated with longer travel distances to a TB clinic. We will evaluate the effectiveness of multimonth dispensing of anti-TB drugs on treatment success in individuals with drug-susceptible TB in rural eastern Uganda, and explore its relevance and appropriateness from the stakeholders' perspectives.

Methods And Analysis: In this open-label, non-inferiority, individually randomised trial, we will randomise 260 participants to either the intervention (multimonth dispensing of anti-TB drugs) or control arm (routine care) and follow-up for 6 months.

High prevalence of multidrug-resistant bacteria on patient medical file surfaces at five critical care units in Kampala, Uganda: an explanatory sequential mixed-methods study.

Introduction: Intensive care units (ICUs) and high-dependency units (HDUs) care for critically ill patients, many of whom have multi-drug-resistant (MDR) bacteria. We investigated the prevalence and distribution of MDR bacteria on the surfaces of patient medical files in three ICUs and two HDUs in Kampala.

Method: We conducted a cross-sectional study that used simple random sampling to select patient medical files through unique codes recorded in a health information electronic system.

Effect of Active Follow-Up on Viral Load Suppression among People Living with HIV on Intensive Adherence Counseling in Uganda: An Instrumental Variable Analysis.

We assessed the effect of active follow-ups on viral load (VL) suppression among people living with HIV (PLWH) who had missed their clinic visit(s) and were receiving intensive adherence counseling (IAC) at a large referral hospital in mid-western Uganda. We designed a quasi-experimental study, using a locator map (a local map showing residence) as an external factor (instrumental variable) that influenced active follow-up. We performed instrumental variable analysis.

Impact of the Stopcut project on the practice of Female Genital Mutilation/Cutting in Southwest Nigeria: a quasi-experimental study.

Background: Female Genital Mutilation/Cutting (FGM/C) is a harmful practice recognized as a gross violation of human rights and violence against women. Nigeria has been identified to share an overwhelming amount of burden as regards FGM/C. Despite several interventions having been implemented to tackle the practice of FGM/C, progress has been slow, and the results are generally mixed coupled with weak law enforcement, inadequate public awareness, and deeply rooted cultural beliefs.

Impact of Differentiated Service Delivery Models on Quality of Life among People living with HIV in Uganda - A Quasi-Experimental Study.

Background: Differentiated service delivery (DSD) models in resource-limited settings have reduced strain on health services and improved client experience, retention and viral suppression, but little is known about the impact of HIV DSD models on quality of life (QoL), which is essential for optimizing person-centered care. This study assessed the impact of DSD models on QoL, loss to follow-up (LTFU), and mortality among persons living with HIV (PLHIV) on ART over time at a large urban HIV clinic in Uganda.

Methods: We analyzed records of 1,000 PLHIV who had been on ART for 10 years and followed up for eight years, starting in 2014 or 2015 at the Infectious Diseases Institute clinic in Kampala, Uganda.

Treatment success and mortality among people with multi-drug resistant and rifampicin resistant-tuberculosis on bedaquiline-based regimen at three referral hospitals in Uganda: A retrospective analysis.

Introduction: In Uganda, people with multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) have been treated with a bedaquiline-based regimen since 2020. Still, their treatment outcomes have not been rigorously studied. We describe the treatment outcomes of people with MDR/RR-TB treated with a bedaquiline-based regimen and analyze the factors associated with their treatment success at three referral hospitals in Uganda.