Gulu Regional Referral Hospital, commonly known as Gulu Hospital is a hospital in Gulu, northern Uganda. It is the referral hospital for the districts of Amuru, Gulu, Kitgum, Lamwo and Pader. The hospital also serves as one of the teaching hospitals of Gulu University.
ABSTRACT Background Complementary and Alternative Medicine (CAM) contributes significantly to the utilization of healthcare services in mental health care in sub-Saharan Africa. However, there is limited evidence on the utilization of CAM in the particular setting of post-conflict northern Uganda. This study sought to establish the prevalence, forms, and socio-demographic determinants of CAM use among patients attending the Mental Health Unit at Gulu Regional Referral Hospital (GRRH). Methods This is a cross-sectional study conducted in a hospital setting from June to August 2025. Convenience sampling was employed to recruit 407 participants. A structured questionnaire was employed for data collection. Data analysis was done using STATA software version 18.0. Descriptive statistics were calculated, and bivariate analysis with Prevalence Ratios (PR) with 95% confidence intervals was employed to determine factors that are significantly associated with the use of CAM. Results The lifetime prevalence of CAM use was 63.4% (258/407), with 41.3% (168/407) using CAM currently. The most frequent CAM practices used were herbal medicine (50.4%), spiritual practices (33.7%), and traditional medicine (19.8%). For current users, spiritual practices were most frequent (88.7%). The reasons for using CAM were recommendations from others (84.8%) and cultural or religious beliefs (63.4%). Predictors of CAM use were primary education (PR = 1.36, p = 0.017), living in an urban area (PR = 1.23, p = 0.007), separated (PR = 1.39, p = 0.050), and having a mental health disorder for six or more months (PR range = 1.55-1.72). Catholics (PR = 0.72, p = 0.0007) and Protestants (PR = 0.76, p = 0.011) were less likely to use CAM than Born Again Christians. Conclusion The level of CAM use among patients accessing mental health services in GRRH of northern Uganda is significantly high, while the reporting of CAM use to healthcare providers is remarkably low. This is a challenge that requires urgent attention. Recommendations include integrating the use of CAM into medical practice, developing national policy guidelines on CAM, working in collaboration with traditional/spiritual healers, and conducting public education campaigns.
COVID-19 and adolescent-youth reproductive health in acholi sub-region in Uganda Agatha Alidri1, Simon Okello2*, Emily Kayeny Uramba3, Filda Anicia4, Winnie Apio5, Patrick Ochen6, Richard Musaasizi7, Samson Tumany8 and Susan Awor12, discuss the silent impact of the pandemic, specifically COVID-19, on adolescent and youth reproductive health in the Acholi sub-region of Uganda. The COVID-19 lockdowns (2020-2022) severely disrupted global sexual and reproductive health (SRH) services, disproportionately affecting vulnerable adolescents and youth (WHO, 2020). In Uganda, the closure of over 73,000 schools displaced millions of learners, exacerbating risks to education, protection, and SRH (Tumwesigye, 2020; Namulondo et al., 2024; UNFPA, 2020). These disruptions, combined with economic strain and increased household tensions, heightened exposure to unintended pregnancies, sexually transmitted infections (STIs), and gender-based violence (GBV) (Henttonen et al., 2008; Otieno et al., 2021).
Background Emergency abdominal surgeries (EASs) in children are often necessary to address life-threatening congenital and acquired conditions. This study aimed to determine short-term outcomes and predictors of in-hospital mortality after EAS in children at Mbarara Regional Referral Hospital (MRRH), South-Western Uganda.Methods This prospective study was conducted from June to September 2024 and included children aged 0-17 years who underwent EAS at MRRH. Outcomes measured were 30-day in-hospital mortality, complications, and length of hospital stay. Overall survival after EAS was plotted using Kaplan-Meier curves. Cox regression analysis was used to determine predictors of in-hospital mortality after EAS.Results The 30-day mortality rate for all pediatric abdominal surgery was 152 per 10 000 person-days of hospitalization. Among 96children who required EAS at MRRH, the risk of death was significantly increased in those who had hypoxemia (adjusted hazard ratio (aHR) 12.4, p=0.011) and hypokalemia (aHR 5.02, p=0.044). Forty-one patients (42.7%) developed postoperative complications, the most common being surgical site infection (14.58%) and pneumonia (5.2%).Conclusion The 30-day mortality rate after pediatric EAS in our setting is high and children who present with hypokalemia and hypoxemia are at increased risk of mortality after EAS.
Background:Malaria is one of the most devastating infectious diseases in humans, and antimalarial drugs have been used to combat it with minimal success. Worldwide, malaria treatment is threatened by the emergence and spread of artemisinin resistance, which is associated with mutations in the PfK13 propeller domain. In Sub-saharan Africa, data relating to the prevalence of Plasmodium falciparum malaria infection in association with the Kelch 13 mutations are mainly from research settings outside disease-endemic areas. This study is aimed at establishing the prevalence of P. falciparum malaria infection in association with Kelch 13 mutations among patients presenting with fever at Gulu Regional Referral Hospital (GRRH) in northern Uganda. Methods:This cross-sectional study enrolled all participants presenting with fever at GRRH between April 2022 and January 2024. Data on adults and children aged ≥ 6 months with fever and confirmed diagnosis of malaria using mRDT, microscopy, and PCR were collected. Parasite DNA was extracted using the Chelex method and sequenced for multidrug resistance genes, and Sanger customized CRF forms were used to capture variables on social demographics, clinical presentation, and treatment. Data were analyzed using IBM SPSS Version 25, and the sequenced data were analyzed using molecular evolutionary genetic analysis (MEGA) Version 11.1.10. All sequences from a single population were aligned using the National Center for Biotechnology Information (NCBI) database. Results:In total, 353 participants were recruited, and the overall prevalence of P. falciparum malaria was 60.6% (n = 214), with the highest number of cases registered in Gulu City (24.9%). Women were the most affected participants (37.1%). The most common clinical presentations among the participants were fever (91.8%; n = 324), chills (90.7%; n = 320), and headaches (72.0%; n = 254). Genotyping results of the mutant genes showed that of all 214 P. falciparum isolates examined, the pfmdr1 SNP at Codon 1034 1042 (29.6%, n = 94) had the highest prevalence, followed by the pfmdr SNP at Codon 86 184 (28%, n = 89), and the SNP fragment at codon 1246 (25.8%, n = 82) recorded the lowest prevalence. Kelch 13 propeller gene, known to be associated with artemisinin resistance, was also isolated in 16.7% (n = 53) of the samples. There was a 90.1% (n = 318) prevalence of the SNPs 86 184, 1034 1042 of the pfmdr1 gene, and K13 propeller gene, with no significant difference between the sexes (p = 0.756). The SNP at Codon 1246 of pfmdr1 showed a significant difference between the location and mutation (p = 0.017). The median parasite load in patients with mutations in 86 184, 1034 1042, and K13 propeller genes varied significantly among patients who received treatment p ≤ 0.0001, p = 0.0061, and p = 0.012, respectively. Conclusion:The presence of pfmdr1 mutant genes suggests resistance of P. falciparum to most antimalarial drugs used in treatment. Therefore, it is important to monitor the prevalence of Kelch 13 mutations and P. falciparum to contribute to global efforts to control and eliminate malaria.
OBJECTIVES:Chronic pulmonary aspergillosis (CPA) is a frequent complication of pulmonary tuberculosis (PTB), particularly in high-burden settings where access to reliable serological diagnostics remains limited. We evaluated the diagnostic performance of two immunochromatographic technology (ICT) lateral flow assays (LFAs) and an ELISA for CPA screening among patients with active or previously treated PTB. METHODS:In this two-year prospective multicentre diagnostic evaluation, serum from adults with prior or active PTB was tested using the Era Biology Aspergillus IgG ICT LFA, LDBio Aspergillus IgG/IgM ICT LFA, and Bordier Aspergillus fumigatus IgG ELISA. CPA diagnosis was established using a consensus composite reference standard incorporating clinical, immunological, radiological, and microbiological criteria. The Bordier ELISA was used as part of the immunological component of the consensus CPA diagnosis, with a cutoff optical density of ≥1.0. Diagnostic accuracy, agreement statistics, receiver operating characteristic analysis, and latent class analysis (LCA) were performed. RESULTS:Among 340 participants, 24 (7.06%) had CPA. Proportion of participants with positive antibody tests among all tested individuals were 6.76% for LDBio ICT LFA, 20.0% for Era Biology ICT LFA, and 11.47% for Bordier ELISA. Against consensus CPA diagnosis, Bordier ELISA showed 87.50% sensitivity and 94.30% specificity, LDBio ICT LFA 58.33% sensitivity and 97.15% specificity, and Era Biology LFA 66.67% sensitivity and 83.54% specificity. LCA estimated CPA prevalence at 7.72%. LCA-derived sensitivities and specificities were 86.58% and 99.92% for LDBio ICT LFA, 83.39% and 85.31% for Era Biology LFA, and 79.10% and 94.19% for Bordier ELISA. CONCLUSIONS:The Bordier ELISA showed high sensitivity and specificity, while the LDBio ICT LFA demonstrated very high specificity with strong LCA-derived performance. These findings support the use of ELISA for laboratory diagnosis and ICT as a point-of-care screening tool for CPA in resource-limited settings. Era Biology Aspergillus IgG LFA demonstrated moderate sensitivity and acceptable diagnostic performance, indicating its potential utility as a supplementary screening assay for CPA in settings where rapid, point-of-care testing is required.
