Lira Regional Referral Hospital, commonly known as Lira Hospital, is a hospital in Lira in the Northern Region of Uganda. It is the referral hospital for the districts of Amolatar, Apac, Dokolo, Lira, Kole, and Oyam.
Malaria remains a major public health concern in Uganda, with prevalence in Lira City rising sharply in recent years despite ongoing interventions. Women of reproductive age are particularly vulnerable, yet little is known about their use of available preventive measures. This study assessed knowledge, attitudes, perceptions, and utilization of malaria control interventions, and examined factors influencing their uptake.A cross-sectional study was conducted with 629 randomly selected women of reproductive age in Lira City. Quantitative data were collected using semi structured questionnaires, while qualitative insights were obtained through focus group discussions. Descriptive statistics were used to summarize knowledge, attitudes, perceptions, and use of insecticide-treated nets (ITNs), intermittent preventive treatment (IPT), and indoor residual spraying (IRS). Chi-square tests were used to examine associations, and multivariate logistic regression was applied to identify predictors of utilization. Qualitative data were analyzed thematically to explore barriers to uptake, and findings were triangulated with quantitative results for validation and deeper interpretation.ITN utilization was high (84.1%), IPT uptake moderate (68%), and IRS coverage low (32.8%). Almost all participants (96.8%) were knowledgeable about ITNs, mainly gained through health workers, and expressed positive attitudes toward malaria prevention (mean score: 4.34, SD = 0.67). While most (91.9%) perceived IRS as effective, concerns included bad odor and discomfort (51.7%), doubt about safety (21.9%), and effectiveness (17.3%). Age, type of house, challenges faced with nets, marital status, and exposure to health education were significant predictors of utilization.Despite widespread ITN use, IRS uptake remains limited due to persistent concerns and misconceptions. Strengthening targeted health education, addressing community fears, and improving access to interventions are critical for enhancing malaria control in high-transmission settings like Lira City.
BACKGROUND:Inflammation in and around the brain in patients with meningitis can lead to confusion, cognitive dysfunction, and behavioral changes associated with mental health disorders. Stigma associated with HIV or mental illness can complicate meningitis, leading to misdiagnosis or delays in diagnosis and care. The frequency of misdiagnosis and/or co-occurrence of meningitis and mental illness among people living with HIV (PLWH) remains uncertain. We explored the experiences of meningitis patients and the barriers and facilitators to care related to HIV stigma and mental illness. METHODS:We conducted a convergent mixed-methods study to evaluate experiences of patients who were hospitalized with HIV-associated meningitis from February 2017 to May 2022 at Lira Regional Referral Hospital in Uganda. Experiences among patients who survived and family members of patients who died were explored. Surveys were conducted to obtain demographic information, investigate stigma, and assess symptoms of mental illness. Semi-structured interviews probed the overall experience of patients with HIV and meningitis regarding social support, mental health, and stigma. RESULTS:Twenty-four patients with HIV-associated meningitis and 20 family members of deceased meningitis patients were enrolled. Family members reported that 80% of deceased patients experienced stigma, whereas 29.2% of surviving patients reported experiencing stigma. Combined responses from surviving patients and family members identified 31.8% of patients with mental illness symptoms described as overthinking, depression, and/or anxiety, while 60.8% experienced HIV-related stigma. Among participants who died, family members reported mental illness symptoms in 40%, compared to self-reports of 25% in survivors. Barriers to HIV care included (a) lack of HIV education, (b) mental illness symptoms, (c) lack of social support, and (d) stigma or shame. While common facilitators were (a) access to HIV clinics and ART medication, (b) having a life purpose, and (c) social support. CONCLUSION:Stigma and symptoms of mental illness were common among patients with HIV and meningitis, which likely affected antiretroviral therapy (ART) adherence and HIV care. Recommendations include (1) adding mental health screening during hospital admission for all meningitis patients, especially among PLWH, for early evaluation and treatment and (2) increasing community awareness to dispel misconceptions and reduce HIV-related stigma.
Introduction and importance:Esophageal perforation is a life-threatening emergency associated with high morbidity and mortality. Case presentation:A 28-year-old female presented with a cervical esophageal stab injury. An initial primary repair failed, and the patient developed severe sepsis. Surgical re-exploration revealed two esophageal perforations. The lateral perforation was repaired, and a T-tube was inserted through the anterior defect to create a controlled fistula. A feeding jejunostomy was also performed. The patient recovered fully following 9 weeks of T-tube drainage and enteral feeding. Clinical discussion:Cervical esophageal perforations present unique management challenges due to their proximity to vital structures and the high risk of mediastinal sepsis. Primary repair is preferred when feasible; however, failure can result in uncontrolled leakage and infection. In such cases, T-tube drainage provides a controlled fistula that allows decompression, sepsis control, and spontaneous closure once healing occurs. Compared to advanced techniques such as endoscopic stenting or vacuum-assisted closure, T-tube diversion is simple, inexpensive, and suitable for resource-limited environments. Adequate drainage, nutritional support through feeding jejunostomy, and close follow-up are critical to achieving favourable outcomes. Conclusion:T-tube drainage is a valuable salvage option in the management of complicated oesophageal perforations in resource-limited settings and nutritional support through feeding jejunostomy are key to optimizing outcomes.
Cardiovascular disease (CVD) morbidity and mortality are increasing globally, including among patients living with human immunodeficiency virus (HIV). We aimed to determine the risk of all-cause mortality and morbidity in patients with CVD, comparing those with and without HIV infection, and whether mortality differed by HIV status during hospitalization for Major Adverse Cardiovascular Events (MACE) components (stroke, acute myocardial infarction (AMI), and heart failure) in northern Uganda. We conducted a retrospective cohort study at two hospitals in northern Uganda, comparing outcomes in CVD patients with and without HIV hospitalized from January 2015 to June 2023. We utilized a logistic regression model for crude, adjusted, and stratified analyses of MACE components and mortality by HIV status. Among 2,127 CVD patient records analyzed, 292 (13.7
Abstract Background C-terminal binding protein 2 (CtBP2) has been implicated in metabolic regulation, but its association with specific measures of adiposity and lipid profiles in humans remains unclear. This study examined the relationship between circulating CtBP2 levels and key components of metabolic syndrome, focusing on body fat distribution and lipid markers. Methods Data from 508 participants (259 men, 249 women) from a publicly available dataset were analyzed. Serum CtBP2 concentrations were measured using ELISA. Associations with obesity markers (BMI, waist circumference, waist-to-hip ratio) and lipid profiles (triglycerides, HDL cholesterol) were assessed using Spearman correlation and linear regression, adjusting for age and sex. Results CtBP2 levels showed weak but statistically significant positive correlations with all measures of adiposity, with the strongest association observed for waist circumference (ρ = 0.150, p < 0.001), followed by BMI (ρ = 0.120, p = 0.007) and waist-to-hip ratio (ρ = 0.098, p = 0.027). No significant correlations were found with triglycerides or HDL cholesterol. In the regression model predicting BMI, age, and sex were significant predictors, while CtBP2 demonstrated a trend toward association (β = 0.080, p = 0.052). Conclusion Circulating CtBP2 appears to be modestly associated with measures of adiposity, particularly abdominal fat, but not with lipid abnormalities. These findings suggest a potential role for CtBP2 in obesity-related metabolic dysregulation and underscore the need for further mechanistic studies to clarify its clinical relevance.
