Fort Portal Regional Referral Hospital, commonly known as Fort Portal Hospital, sometimes referred to as Buhinga Hospital, is a hospital in the town of Fort Portal, in Fort Portal District, Western Uganda. It is the referral hospital for the districts of Bundibugyo, Kabarole, Kamwenge, Kasese, Ntoroko and Kyenjojo.
BACKGROUND:People living with HIV and hospitalised with sepsis in Africa are at risk of death due to tuberculosis but diagnostics for tuberculosis might be delayed or inaccessible for people presenting for critical care. We aimed to compare the effects of immediate empirical and high-dose antituberculosis therapy on 28-day mortality in adult people living with HIV with sepsis in east Africa. METHODS:ATLAS was a phase 3, open-label, randomised, controlled, 2 × 2 factorial, superiority trial conducted at four hospitals in Tanzania and Uganda. Participants were aged 18 years or older, living with HIV, and had been admitted to hospital with sepsis with two or more modified quick Sequential Organ Failure Assessment score criteria. Exclusion criteria were active tuberculosis or receipt of antituberculosis therapy within 6 months of hospitalisation, pregnancy or lactation, allergies to antituberculosis therapy, another investigational drug within the past month, chronic liver disease, heavy alcohol use, positive serum cryptococcal antigen, or anticipated significant drug-drug interaction with rifampicin. A computer-generated permuted-block algorithm with allocation concealment and random block sizes of four and eight randomly assigned participants (1:1) to receive either immediate or diagnosis-dependent antituberculosis therapy, and (1:1) to receive either high-dose or conventional WHO-recommended weight-based dose antituberculosis therapy. Allocation was stratified by country and the presence of altered mental status at the time of randomisation. Participants randomly assigned to conventional-dose antituberculosis therapy received fixed-dose combination tablets of rifampicin approximately 10 mg/kg, isoniazid approximately 5 mg/kg, pyrazinamide, and ethambutol, plus pyridoxine 50 mg orally. Participants randomly assigned to receive high-dose antituberculosis therapy received rifampicin approximately 30 mg/kg and isoniazid approximately 7·5 mg/kg as a combination of single formulation tablets and fixed-dose combination tablets that included WHO-recommended weight-based doses of pyrazinamide and ethambutol, plus pyridoxine. Participants continued immediate antituberculosis therapy for 28 days. All medications were administered daily. Participants in the diagnosis-dependent antituberculosis therapy groups received treatment based on a clinical or microbiological diagnosis of tuberculosis. All participants received 2 g intravenous ceftriaxone daily for 7 days. The primary endpoint was 28-day mortality analysed in the modified intention-to-treat population and in the subgroup with later confirmed tuberculosis. We defined the survival time for each participant as the time from randomisation until death, discharged (alive) by day 28, or censored (alive) at day 28. We graded adverse events according to recommendations from the National Institutes of Health Division of AIDS. This study was registered with ClinicalTrials.gov, NCT04618198, and is completed. FINDINGS:Between Jan 5, 2022, and Dec 9, 2024, 707 people were screened for eligibility and 437 were randomly assigned (110 to immediate conventional-dose, 112 to immediate high-dose, 107 to diagnosis-dependent conventional-dose, and 108 to diagnosis-dependent high-dose antituberculosis therapy). 395 patients (226 [57%] of whom were female and 169 [43%] were male; all participants were Black) received study intervention and were analysed for the primary outcome of 28-day mortality. We confirmed tuberculosis in 204 (52%) patients. There was no evidence of differences in 28-day mortality in immediate antituberculosis therapy groups (50 deaths [25%] in 198 patients) compared with diagnosis-dependent groups (50 deaths [25%] in 197 patients; adjusted hazard ratio [aHR] 0·99 [95% CI 0·67-1·46]; p=0·95), or in high-dose antituberculosis therapy groups (51 deaths [26%] in 199 patients) compared with conventional-dose groups (49 deaths [25%] in 196 patients; aHR 1·07 [0·72-1·59]; p=0·73). In patients with microbiologically confirmed tuberculosis, the 28-day mortality relative to the diagnosis-dependent conventional-dose group (18 deaths [34%] in 53 patients) was lower for the immediate conventional-dose group (six deaths [12%] in 51 participants; aHR 0·32 [95% CI 0·13-0·82]; p=0·015); for the diagnosis-dependent high-dose group (11 deaths [20%] in 56 patients) was 0·51 (0·24-1·08; p=0·079); and for the immediate high-dose group (11 deaths [26%] in 43 patients) was 0·63 (0·29-1·36; p=0·24). No significant differences in adverse events occurred between treatment groups but numerically more events of drug-induced liver injury occurred in the immediate high-dose group compared with any other group. INTERPRETATION:Among all participants with HIV-related sepsis, 28-day mortality was not significantly reduced with immediate or high-dose antituberculosis therapy. In the subgroup with later confirmed tuberculosis, immediate conventional-dose antituberculosis therapy significantly reduced 28-day mortality, suggesting, as in other forms of bacterial sepsis, that hours to active treatment might determine survival. FUNDING:US National Institutes of Health.
Ebola continues to be a great public health challenge in Uganda where it is vulnerable to future Ebola outbreaks. Survivors are likely to continue experiencing the after effects of Ebola during the recovery period. The study was conducted to explore experiences of Ebola survivors during and after the recovery period. A descriptive qualitative study was conducted in central Uganda. We conducted 14 in-depth among Ebola Virus Survivors who had previously had a diagnosis of EVD using purposive sampling. Data was collected from 18th November to 28th November 2024. Thematic deductive analysis was applied to analyze the data. Participants had varied response to Ebola diagnosis. Participants were initially hesitant to seek care, but they eventually agreed with their Ebola diagnosis and complied with medical treatment. Ebola survivors had conspiracy theories regarding Ebola which persisted even after survival. Ebola was attributed to witchcraft, while others thought it was introduced to reduce their population size and as a vehicle for organ donation. Survival was attributed to trade-offs with government and pretense of being sick. Ebola patients and survivors had formal and informal support from government and non-governmental organization which helped meet their social, physical and emotional needs during and after admission. Ebola patients and survivors had emotional, social, and physical challenges during admission and after discharge. Ebola patients experienced enormous emotional trauma related to worries of survival. Emotional and physical challenges persisted after discharge and they emanated from stigma, discrimination, financial constraints, marital problems and persisting physical ailments. EVD survivors experience significant health concerns and poor coping mechanisms. This mainly as result of the fatal and stigmatizing nature of Ebola virus Disease. Ensuring patients understand and adopt coping mechanisms reduces this stigma. There is need for community-based mental health and psychosocial interventions integrated within a broader package of care for EVD survivors.
HIV remains a global public health issue; Uganda has nearly 7% of infants born to HIV positive mothers getting infected despite initiation on Nevirapine prophylaxis against HIV transmission among HIV-exposed infants. There is paucity of data regarding adherence to NVP in Western Uganda. This study aimed at assessing the predictors of adherence to nevirapine prophylaxis among HIV -exposed infants aged 0 to 6 months. A cross-sectional study was done among 200 HIV-exposed infants aged 0 to 6 months. Participants were consecutively recruited. Data was analyzed using SPSS version 26, logistic regression was used to infer predictors of Nevirapine adherence. Adherence to Nevirapine prophylaxis was at 95.0% (CI: 89-98). Factors associated with adherence included; disclosure of HIV status [aOR = 0.083; 95% CI: 0.007-0.92, P < .005] and having more than 1 child [aOR = 0.08; 95% CI: 0.007-0.82, P < .005]. Adherence to Nevirapine was suboptimal (95.0%) in comparison to the national set goals of 100% adherence by 2030.
Background: Although blood and blood components are well established as medical therapies, they are not without risk and they have the potential for transmission of infectious diseases from donors to recipients. The study aim was to assess the seroprevalence and predictors of blood transfusion transmissible infections among blood donors at Fort Portal Regional Blood Bank. Materials and Methods: We conducted a retrospective cross-sectional study of donor data from 3211 blood donors who donated blood between January and September, 2021, at Fort Portal Regional Blood Bank. The seroprevalence of transfusion transmissible infections (TTIs) was determined by tabulating the proportion of donors who tested for at least one TTI. A bivariate logistic regression was used to determine the association between the prevalence of TTIs and sociodemographic characteristics. Results: Majority of the blood donors were below 27 years (41.9%) with a mean age of 30.64 (SD:10.75) years, and males accounted for 86.9% of the donors, while more than half (53.8%) were repeat donors. The overall seroprevalence of transfusion transmissible infections was at 7.4%. The prevalence of HBV, HCV, HIV and Syphilis was 1.96%, 0.4%, 1.68% and 3.39%, respectively, of the total units tested. Syphilis was the most prevalent of all TTIs, accounting for 109 (45.6%) of all positive TTIs in the study. Blood donors between 39 and 49 and 50-60 years of age had significantly higher odds of HBV infection (COR 0.51, 95% CI 0.26-0.98, P = 0.04) and HIV infection (COR 0.42 95% CI 0.15-1.12, P = 0.05) respectively, and males were more likely to test for HIV (COR 1.91, 95% CI 0.99-3.66, P = 0.05). Conclusion and Recommendation: The study found substantial levels of Transfusion Transmissible Infections among blood donors. Strict donor recruitment strategies should be maintained to minimize potential transmission and reduce blood discard.
Background The integration of palliative care into public health services is a global priority, but it remains uneven in low-income settings. This study evaluated palliative care unit attendance, utilisation relative to need, and the model of care at Fort Portal Regional Referral Hospital (FPRRH) between 2019 and 2025. Methods A retrospective descriptive case study was conducted at FPRRH, a referral‑level hospital serving the Rwenzori subregion of Uganda. Facility records and palliative care unit documentation were reviewed to quantify patient attendance by diagnosis and age group, estimate the proportion of patients receiving specialist palliative care relative to those likely to need it, and describe the unit’s model of care. Data sources included HMIS 008 registers (2019–2024), the EAFYA electronic medical records system (2024/2025), and District Health Information System (DHIS2) reports. Attendance was analysed using descriptive statistics, and the model of care was derived through thematic analysis of reported activities. Results Between July 2019 and June 2025, 1,773 patients attended the palliative care unit. Of these, 959 (54.1%) had cancer and 814 (45.9%) had non‑cancer diagnoses. Overall, 89% of cancer patients accessed the unit compared with 5.1% of sickle cell disease patients and 1.4% of those with HIV‑related complications. Children comprised 6% of attendees. Attendance increased in 2024–2025, primarily driven by outpatient visits (73.6%). Across the hospital, 4,807 patients were identified as potentially requiring palliative care, of whom 1,108 (23%) accessed services. The hospital‑based model emphasised symptom control, collaborative care planning, psychosocial support, care continuity, and mentorship. Conclusion FPRRH has made measurable progress in integrating specialist palliative care, achieving higher coverage than commonly reported national and global estimates. Persistent gaps include low paediatric access, limited inpatient utilisation, and under‑representation of non‑cancer conditions. The hospital’s model offers a replicable framework for strengthening palliative care in referral hospitals.
