The Infectious Diseases Institute (IDI), established within Makerere University, is a Ugandan not-for-profit organization which aims to strengthen health systems in Africa, with a strong emphasis on infectious diseases; through research and capacity development. In pursuit of its mission both in Uganda and Sub-Saharan Africa, IDI provides care to People Living with HIV (PLHIV) and other infectious diseases, builds capacity among healthcare workers through training and ongoing support, maintains a focus on prevention, and carries out relevant research.
Swine acute diarrhoea syndrome coronavirus (SADS-CoV), which originates from zoonotic transmission of bat coronaviruses in the HKU2 lineage, causes severe illness in pigs and carries a high risk of spreading to humans. At present, there are no licenced therapeutics for the treatment of SADS-CoV. In this study, we examined the effectiveness of recombinant porcine interferon delta 8 (IFN-δ8) against SADS-CoV both in vitro and in vivo. In vitro experiments showed that IFN-δ8 inhibited SADS-CoV proliferation in a concentration-dependent manner, with complete inhibition occurring at a concentration of 5 μg/mL. In vivo experiments demonstrated that two 50 μg/kg doses of IFN-δ8 injected intraperitoneally protected piglets against lethal challenge, blocked viral shedding, attenuated intestinal damage, and decreased the viral load in the jejunum and ileum. Further findings suggested that IFN-δ8 inhibited SADS-CoV infection by increasing the expression of IFN-stimulated genes. These results indicate that IFN-δ8 shows promise as a biological macromolecule drug against SADS-CoV infection.
Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increases as this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continents within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening availability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit link function to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reported cervical cancer screening by cytology or human papillomavirus (HPV) testing on-site, and 88% (194/220) reported cervical cancer screening by any method, including visual inspection. At sites serving predominantly rural populations, 62% (29/47) exclusively performed screening by visual inspection. Overall, 23% (50/220) of sites performed cytology-based anal cancer screening on-site, and 16% (35/220) had availability of high-resolution anoscopy, either on-site or by referral. Screening for cancer of the liver, colon, lung, prostate, or breast (by imaging) were each available at less than 43% of sites. The odds of cervical cancer screening availability increased by 16% annually from 2017 through 2023 (aOR = 1.16, 95% CI: 1.07-1.27, p = 0.001), while the relative odds of anal cancer screening availability decreased by 9% annually (aOR = 0.91, 95% CI: 0.84-0.99, p = 0.023). Lack of trained staff was the most frequently reported barrier, followed by lack of equipment. Understanding current practices and capacity is essential for the continued integration of cancer prevention in HIV care.
Background Persistent global health security risks require countries to establish effective, standards-aligned biosafety and biosecurity systems. Sub-Saharan Africa carries a disproportionate burden of infectious disease threats, yet systematic laboratory biorisk management (BRM) remains nascent in most low-income countries. Uganda's National Health Laboratory and Diagnostic Services (NHLDS) launched a national, risk- and performance-based BRM programme spanning the human health, animal health, water, and environmental laboratory sectors. This article describes the programme design, implementation trajectory, and outcomes between 2022 and 2025. Methods A national implementation evaluation employing a repeated cross-sectional design with a within-facility matched-cohort sub-analysis was conducted across Uganda’s One Health laboratory sectors. Four national BRM instruments were developed and validated: a biosafety and biosecurity manual, a training curriculum, a structured mentorship toolkit, and an ISO 35001:2019/ISO 15190:2020-aligned assessment checklist. Capacity was built through a three-tier cascade training model. Compliance assessments were conducted in 200 laboratories generating 337 assessment events. Within-facility change was analyzed for 29 mentored laboratories with paired 2023–2025 data; statistical testing used the paired t-test and Wilcoxon signed-rank test. Results The programme trained more than 1,500 laboratory personnel, including 25 national master trainers, 41 mentors, and 27 ISO 19011-certified auditors, and provided structured mentorship to 80 laboratories. System-level mean BRM compliance increased from 26.3% in 2022 to 48.7% in 2025 across all assessed laboratories. Within the matched mentored cohort (n = 29), mean compliance rose from 57.2% to 66.3% (within-facility mean change + 9.1 percentage points; 95% CI + 2.0 to + 16.3; p = 0.019; Wilcoxon p = 0.024; Cohen’s d = 0.46). The proportion of mentored laboratories classified as Low Risk or better (≥ 65%) increased from 21% to 55%. An inverse gradient was observed between baseline performance and subsequent gain. Conclusion A standardized, ISO-aligned BRM framework is operationally feasible at national scale in a low-resource, One Health setting. Structured multi-cycle mentorship, cascade training, and engaged leadership were associated with measurable within-facility performance gains. The programme provides a replicable model for countries seeking to operationalize international BRM standards across heterogeneous laboratory sectors.
OBJECTIVE:To evaluate the feasibility and acceptability of same-day initiation of emtricitabine/tenofovir alafenamide (F/TAF) pre-exposure prophylaxis (PrEP) and test the impact of drug-level feedback on PrEP adherence among transgender women (TGW) in Uganda. DESIGN:Randomized controlled trial. METHODS:HIV-negative TGW were randomly assigned 1 : 1 to intervention (drug-level feedback with tailored adherence counseling) or standard-of-care (SOC), and followed quarterly for 12 months (November 2021-July 2023; NCT04491422). Quarterly clinic visits included demographic and socio-behavioral data collection, PrEP refills, STI testing, and quarterly PrEP adherence assessment using tenofovir levels in dried blood spots (DBS; long-term) and urine (short-term). RESULTS:We enrolled 200 TGW (100 per arm), median age 21 years. Same-day F/TAF PrEP initiation was 100%. Tenofovir detection in urine (intervention arm) was 79, 80, 85, and 70% at the 3, 6, 9, and 12-month visits, respectively. Tenofovir detection in DBS was 46, 40, 35, and 31% at 3, 6, 9, and 12 months, respectively. Median tenofovir DBS concentrations were 40.6 and 47.0 fmol/punch in intervention and SOC arms, respectively. There was no intervention effect on PrEP adherence (DBS tenofovir levels) [adjusted incidence rate ratio (aIRR) 1.06; 95% CI: 0.82-1.37]. Never being harassed by police for being transgender (aIRR 1.66; 95% CI: 1.24-2.23), history of taking daily medication for more than 7 days (aIRR 1.51; 95% CI: 1.18-1.93) and higher monthly income (aIRR 1.44; 95% CI: 1.10-2.04) were associated with PrEP adherence. CONCLUSION:Oral F/TAF PrEP adherence among TGW in Uganda was low and not affected by drug-level feedback or tailored adherence counseling. Long-acting injectable PrEP formulations should be considered for this population.
Vitiligo is a chronic depigmenting autoimmune skin disease that may be associated with a significant quality-of-life burden and psychosocial comorbidities. Reliable and comparable prevalence rates are critical in building an evidentiary foundation for understanding the full landscape of vitiligo disparities. This study aimed to assess the prevalence of vitiligo among adults in the USA and in five European countries (5EU; France, Germany, Italy, Spain, and the UK). This study used data from the 2024 US and 5EU National Health and Wellness Survey (NHWS), a population based, self-reported, syndicated cross-sectional survey of adults (age ≥ 18 years). Respondents were recruited from large internet panels and completed the survey online. Results were weighted to reflect demographic distributions of the general adult population in each country. Self-reported prevalences of ever experiencing vitiligo or having vitiligo diagnosed by a clinician and proportions of patients having had a healthcare provider visit in the last 6 months were reported. Data from 75,013 participants in the USA and 62,022 in Europe were included. The prevalence of adults self-reporting that they ever experienced vitiligo was 2.3
