Background: Muscle-invasive bladder cancer (MIBC) is a significant cause of cancer-related mortality in sub-Saharan Africa, yet its genomic landscape remains poorly characterised. In Uganda, nearly 60% of urothelial carcinoma cases are muscle-invasive (MIUC), with a near-equal sex distribution, in contrast to global trends. We aimed to define the somatic mutational landscape of Ugandan MIUC using whole-exome sequencing (WES). Methods: In this descriptive cross-sectional study, 57 formalin-fixed paraffin-embedded MIUC tissue blocks were consecutively selected. DNA extraction and exome library preparation were performed for all; 47 passed quality control and 33 remained in the final dataset. Sequencing was performed on the Illumina NovaSeq 6000 platform. Reads were aligned to hg19/GRCh37, and variants called using GATK Mutect2 in tumor-only mode with stringent artefact filters. Variants were annotated with COSMIC, ClinVar, REVEL, and classified according to ACMG/AMP guidelines. Eighteen samples were resequenced on the Aviti platform to validate the low frequency of TP53 mutations. Clinical and histopathological data were also reviewed. Results: All patients presented with gross hematuria, with a median age of 56 years; 17/33 (51.5%) were male. Histological variants occurred in 23/33 (69.7%), most commonly the squamous, microcystic, and nested types (each accounting for 5/23; 21.7%). LVI was present in 28/33 (84.8%). A total of 305 coding mutations were identified, averaging 9.2 ± 6.5 per tumor. Squamous and microcystic variants showed the highest burdens (16.4% and 14.4%). At the nucleotide level, 200/331 (60.4%) substitutions were C>T or C>G, consistent with APOBEC mutagenesis. Missense variants predominated (274/305; 89.8%), followed by frameshifts (31/305; 10.2%). PDE4DIP was the most frequent alteration (8/33; 24.2%), although it was not a canonical driver. Canonical recurrent drivers included FGFR3 (18.2%), FOXA1 (15.2%), BAP1 (15.2%), KMT2C (15.2%), and ERCC2 (12.1%). TP53 mutations were rare (2/33; 6.1%), and Aviti resequencing confirmed the same two variants, with additional low-confidence calls excluded. Mutations were broadly distributed, enriched on chromosomes 1, 16, 7, 19, and 17. Conclusion: Ugandan MIUC displays a heterogeneous mutational profile, marked by frequent missense mutations, a high VUS burden, low TP53 frequency, and APOBEC signatures, with PDE4DIP a non-canonical gene emerging as the most frequently mutated. These findings underscore the need for African-specific genomic references to guide precision oncology. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Clearance was obtained from Makerere University School of Medicine research and ethics committee under protocol reference number Mak-SOMREC-2021-257 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files.

Background: Preexposure prophylaxis (PrEP) reduces new human immunodeficiency virus(HIV) infections by up to 96% and is recommended for key populations by the World Health Organization. Understanding the knowledge and willingness to use PrEP is essential for effective implementation. This study assessed these factors and identifiedcharacteristics associated with differences in knowledge among key populations in Kampala, Uganda. Methods: We administered a cross-sectional survey to a systematic sample of 497 participants from fisherfolk (283, 56.9%), men who have sex with men (MSM) (93, 18.7%), and female sex worker (FSW) (121, 24.4%) communities in Kampala Central, where PrEP had not yet been rolled out. Data on sociodemographic characteristics, PrEP awareness, and HIV-related behavioralfactors were collected. Knowledge about PrEP was measured using an adopted questionnaire comprising five key questions about PrEP knowledge, graded as no knowledge, some knowledge and good knowledge. Ordered probit regression models were used to analyze the associations of independent factors with PrEP knowledge levels. Results: Participants had a mean age of 29±7.6 years. Ofthese, 257 (51.7%) reported having sex with women, 157 (31.6%) with men and 83 (16.7%) with both men and women. Self-reported HIV-positive status was 6.4% in fisherfolk, 11.8% in MSM and 27.3% in FSW. PrEP awareness stood at 62.4% overall, with the highest awareness in FSW (73.6%) and the lowest in fisherfolk (54.1%). Willingness to use PrEP was high across all groups (77.7%), although it was lower among FSW (66.9%). Multivariate probit analysis highlighted key independent factors associated with PrEP knowledge among fisherfolks and HIV-related concerns (Adj. Coeff = 0.54, 95% CI: 0.11, 0.97) and lack of PrEP awareness (Adj. Coeff = -0.99, 95% CI:-1.28, -0.70); among MSM, lack of PrEP awareness (Adj. Coeff = -1.74, 95% CI:-2.38, -1.10); and in FSW, tertiary education (Adj. Coeff = 1.53, 95% CI: 0.07, 2.99) and marital status (Adj. Coeff = 0.57, 95% CI=0.09, 1.05). MEshighlighted the influence of these independent factors at each knowledge level. Conclusions and Recommendations: Despite the high willingness to use PrEP, significant knowledge gaps exist, particularly concerning dosage and use duration, which are influenced by factors such as HIV concern and educational attainment. Tailored educational initiatives may bridge these gaps and enhance willingness to use PrEP.

Background HIV status disclosure among sexual partners is vital in HIV management. Community health workers (CHW) support HIV disclosure among adults living with HIV (ALHIV) in sexual relationships with disclosure difficulties. However, experiences and challenges of using CHW-led disclosure support mechanism were not documented. This study explored experiences and challenges involved in using CHW-led disclosure support mechanism among ALHIV in heterosexual relationships in the rural Uganda. Methods This was a phenomenological qualitative study involving in-depth interviews among CHWs and ALHIV with HIV disclosure difficulties to sexual partners in greater Luwero region, Uganda. We conducted 27 interviews among purposively selected CHWs and participants who had participated in the CHW-led disclosure support mechanism. Interviews were conducted until saturation was reached; and analysis was done using inductive and deductive content analysis in Atlas. Results All respondents viewed HIV disclosure as an important strategy in HIV management. Provision of adequate counseling and support to those intending to disclose was instrumental for successful disclosure. However, fear of the negative disclosure outcomes was viewed as a barrier to disclosure. The CHWs were viewed as having an added advantage in supporting disclosure as opposed to the routine disclosure counseling. However, HIV disclosure using CHW-led support mechanism would be limited by possible bleach of client’s confidentiality. Therefore, respondents thought that appropriate selection of CHWs would improve their trust in the community. Additionally, providing CHWs with adequate training and facilitation during the disclosure support mechanism was viewed to improve their work. Conclusion Community health workers were viewed as being more supportive in HIV disclosure among ALHIV with disclosure difficulties to sexual partners compared to routine facility based disclosure counseling. Therefore, near location CHW-led disclosure mechanism was acceptable and useful in supporting HIV disclosure among HIV-affected sexual partners in rural settings.

Background HIV disclosure is vital in HIV management. Community Health Workers (CHW) were reported to support partner disclosure among HIV affected heterosexual partners with disclosure difficulties. However, time to disclosure attributed to use of CHW led disclosure support mechanism was not documented. This study compared the incidence of sexual partner disclosure among adults living with HIV (ALHIV) with CHW support and those without in the greater Luwero region, Uganda. Methods We conducted a quasi-experimental study with two arms allocated by geographically determined clusters and adjusted for between-group differences; among ALHIV in the greater Luwero region of Uganda who had never disclosed to their current primary sexual partners. We allocated study clusters to either a CHW-led intervention or control arm. In both arms, we consecutively recruited participants; those in the intervention arm received CHW disclosure support in addition to routine care. The overall follow-up was six months, and the primary outcome was disclosure to the partner. We used survival analysis with proportional hazard ratios to determine the time to partner disclosure in both arms. Results A total of 245 participants were enrolled, and 230 (93.9%) completed the study; of these, 112 (48.7%) were in the intervention and 118 (51.3%) in the control arm. The mean age was 31 ± 8 years with a range of 18 to 55 years; the majority were females, 176 (76.5%). The cumulative incidence of disclosure was higher in the intervention arm, 8.76 [95% CI: 7.20–10.67] per 1,000 person-days versus 5.15 [95%CI: 4.85–6.48] per 1,000 person-days in the control arm, log-rank test, X2 = 12.93, P < 0.001. Male gender, aHR = 1.82, tertiary education, aHR = 1.51, and relationship duration of > six months, aHR = 1.19 predicted disclosure. Prior disclosure to a relative, aHR = 0.55, and having more than one sexual partner in the past three months, aHR = 0.74, predicted non-disclosure. Conclusion CHW-led support mechanism increased the rate of sexual partner disclosure among ALHIV with disclosure difficulties. Therefore, to achieve the global targets of ending HIV, near location CHW-led disclosure support mechanism may be used to hasten HIV disclosure in rural settings.

Abstract Introduction: Health seeking behavior (HSB) is simply an action or inaction of an individual towards their health. For various, at times justifiable reasons, HSB is generally low among healthcare workers in Ugandans. However, this situation could have changed during the covid 19 pandemic era. We set out to assess for determinants of HSB among Healthcare Workers (HWs) in Public and Private Facilities in the Covid-19 hit Kampala capital city of Uganda. Methods: This was a Cross-sectional study with an explanatory-sequential mixed methods design in which we consecutively recruited HWs from the selected health facilities during the study period and met eligibility criteria. A questionnaire was administered using the Open Data Toolkit system and data was later exported into STATA 17/MP for analysis. We summarized it in tables, graphs, mean and SD. Determinants of HSB were assessed using a modified Poison regression method with clustered robust standard errors. Qualitative data from focus group discussions was analyzed using Atlas.ti 9 using the inductive content analysis method. Results: We recruited 579 HWs. The mean and standard deviation of their age was 35±7 years. Majority were females 322 (55.6%). Most of the participants (n=240, 41.5%) worked in government hospitals. Majority 80.5% [95%CI 77.0-83.6] had undergone a medical check-up in the past 12 months. The factors that positively influenced HSB were having a Diploma aPR =0.86 [95%CI: 0.79-0.93], P<0.001, being widowed aPR =1.17 [95%CI: 1.12-1.22], P<0.001, having 10+ years of working experience aPR = 1.07 [95%CI: 1.01-1.13], P= 0.028, having a chronic illness aPR =1.10 [95%CI: 1.03-1.17], P=0.004, having a family doctor aPR=1.12 [95%CI: 1.04-1.21], P=0.004. From the focus group discussions, participants described routine medical check-up as being advantageous, however, sighted barriers to good HSB such as; fear of the unknown, mistrust among colleagues with their confidentiality and busy schedules. The suggested facilitators of good HSB included; good hospital policies, waiver money for medical checkups and treatment, increase salaries, having CMEs, and increased awareness about good HSB practices. Conclusions: Although not the desirable, commendable HSB was exhibited by HWs during the Covid-19 era a norm that must be replicated years after.

Introduction: Acute kidney injury (AKI) is a common and life-threatening complication of major trauma. Recognition is often delayed and management is frequently sub-optimal. We determined the incidence, risk factors and immediate outcomes of AKI in patients with major trauma at Mulago National Referral Hospital. Methods: This was a prospective study. We recruited adult patients with ISS of > 16. The KDIGO criteria was used to stage AKI. Serum creatinine was measured at baseline, 24, 48, 72 hours and on discharge from the study. Participants were followed up for seven days if not yet discharged. Bivariate and multivariate analysis was done using modified Poisson regression with robust standard errors. Results: 224 patients were recruited. The incidence was 67/1000 persons per day. The risk factors were male sex, delayed presentation, hypoglycemia at admission, RR=1.62 (95%CI 1.24-2.12) and non-operative management RR=1.39 (95%CI 1.02-1.89). Out of the 62 patients that died, 34 (54.8%) had AKI. The overall mortality rate was 39.5 patients per thousand per day. Conclusion: There was a high incidence of AKI among patients with major trauma. Efforts to reduce morbidity and mortality should be prioritized.

Awareness of HIV serostatus helps individuals calibrate behaviour or link to care. Globally, young people (15-24years) contribute over 30% of new HIV infections. Despite progress in enhancing access to HIV services, HIV testing among young people in Uganda is below target. We determined the prevalence and factors influencing HIV testing among young people in a peri-urban district with the highest proportion of young people. We conducted a nested explanatory sequential mixed-methods study from March to May 2019 in Wakiso district. We used stratified cluster random sampling to select 397 rural and 253 urban young people from eight parishes. We collected data using questionnaires and subsequently conducted in-depth interviews with 16 purposively selected survey participants. The prevalence of testing for HIV was 80.2%. Young people related their decisions about HIV testing to self-evaluation of their risk and perceived ability to manage the consequences of a positive result. Participants reported high levels of support for HIV testing from peers, partners, and family members. They perceived health facilities as confusing, distant, expensive, and staffed by judgmental, older health workers as barriers. They felt that mobile testing points solved some of these problems, but introduced less privacy and greater confidentiality concerns. The prevalence of HIV testing among young people in Wakiso district was low compared to the UNAIDS 2030 target but among the highest in sub-Saharan Africa. Community-based programs resolve many concerns about testing at health facilities. However, there is a need to make these programs more comfortable and private.

Background: HIV disclosure is a critical component of HIV prevention and treatment programs. Community Health Workers (CHW) play an important role in HIV disclosure counseling among HIV-affected heterosexual partners. However, time to disclosure attributed to the use of CHW in the disclosure process remains undocumented. This study assessed the effect of CHW-facilitated counseling on time to partner disclosure among Adults living with HIV (ALHIV) in the greater Luwero region, Uganda Methods: We conducted a two-arm cluster, non-randomized controlled trial. HIV care facilities in the greater Luwero region were allocated to either the intervention or control arm. Eligible participants were ALHIV in heterosexual partnerships who had never disclosed to their current partners. In the control arm, participants received routine regular facility-based counseling. In the intervention arm, alongside usual care, participants received CHW-facilitated disclosure counseling. Data were collected at baseline, 3 and 6 months with the primary outcome of disclosure. Survival analysis with proportional hazard ratios was used to determine the time to disclosure in both arms. Results: A total of 245 participants were enrolled, of whom complete data were available for 230 (93.9%). Of these, 112 (48.7%) were in the intervention arm and 118 (51.3%) were in the control arm. Mean ± SD age was 31±8 years with a range of 18 to 55 years. More participants were females 176 (76.5%). The cumulative incidence of disclosure was higher in the intervention arm 8.76 [95% CI: 7.20-10.67] per 1,000 person-time versus 5.15 [95%CI: 4.85-6.48] per 1,000 person-time in the control arm, log-rank test, X 2 = 12.93, P<0.001. Male gender, aHR =1.82 [95% CI: 1.26-2.65], tertiary education, aHR = 1.51 [95% CI: 1.43-1.60] and relationship duration of >6 months, aHR = 1.19 [95% CI: 1.16-1.22] predicted disclosure. Prior disclosure to a relative, aHR = 0.55 [95% CI: 0.39-0.78] and having >1 sexual partner in the past 3 months, aHR = 0.74 [95% CI: 0.60-0.92] predicted non-disclosure Conclusion: CHW-led counseling increased the rate of partner HIV disclosure among ALHIV in heterosexual partnerships. Therefore, CHW-facilitated counseling may be used to quicken disclosure, reduce stigma and improve HIV treatment outcomes among ALHIV with disclosure difficulties.

Background:Uganda's population, though, largely characterized by young people, has seen the number of people aged 60 and over grow from 686,000 twenty years ago, to 1,433,596 in 2014. Effective caring for the well-being of this population requires strategic and deliberate planning that involves Quality Of Life (QoL) assessments. QoL assessments among the elderly are important in evaluating the efficacy of strategies, such as health interventions, welfare programs, health care and well-being of the elderly. However, elderly in Uganda face several challenges, ranging from loneliness, poor housing, lack of social and financial support and poor health. These may negatively affect older persons' quality of life and consequently their perceptions and attitudes towards aging.Methods:The study was carried out in 2019 in the communities of Nansana and Busukuma town councils in Wakiso district, Uganda. The participants were 380 people 60 years and older. To establish the association between perceptions of ageing and QoL, this study utilized a locally adapted version of the Older Person's Quality of Life Questionnaire (OPQOL) and the Brief Ageing Perceptions Questionnaire (B-APQ). The OPQOL assesses three domains of QoL: Health QoL (HQoL); Social economic QoL (SQoL); and Psychosocial QoL (PQoL). The B-APQ assesses perceptions about physical age, participation in social activities, and perceptions about ability to regulate emotions as one ages. Pearson's Chi-square tests were used to characterize the relationship between the perceptions and quality of life.Results:The majority of the respondents, 61% (95%CI 56.7-64.8), had negative perceptions towards ageing. Eighty six percent had poor HQoL, 90% poor SQoL and 83% poor PQoL. There was a significant association between good HQoL and positive perception about participation in social activities (X2 = 7.3670, P = 0.007) as well as with positive perception on regulation of emotions (X2 = 18.1803, P<0.001). There was a significant association between good SQoL and positive perception about participation in social activities (X2 = 5.3472, P = 0.021), as well with positive perception on regulation of emotions (X2 = 10.5128, P<0.001). A significant association between good PQoL and positive perception on regulation of emotions (X2 = 9.2414, P= 0.002).Conclusion:Positive perceptions of ageing are associated with good QoL. Directly addressing perceptions of ageing could be a low cost and effective strategy to improve the QoL of older persons in SSA.

Abstract Background The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence. Objective To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV. Methods We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP. Key results We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5–85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31–3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03–1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39–2.81, P < 0.001). In focus group discussions, participants described pill burden, side-effects and drug safety as potential barriers to PrEP use. Conclusions and recommendations Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also increase means of awareness of PrEP as an HIV preventive strategy .

Many implementation efforts experience interruptions, especially in settings with developing health systems. Approaches for evaluating interruptions are needed to inform re-implementation strategies. We sought to devise an approach for evaluating interruptions by exploring the sustainability of a programme that implemented diabetes mellitus (DM) screening within tuberculosis clinics in Uganda in 2017. In 2019, we conducted nine interviews with clinic staff and observed clinic visits to determine their views and practices on providing integrated care. We mapped themes to a social ecological model with three levels derived from the Consolidated Framework for Implementation Research (CFIR): outer setting (i.e. community), inner setting (i.e. clinic), and individuals (i.e. clinicians). Respondents explained that DM screening ceased due to disruptions in the national supply chain for glucose test strips, which had cascading effects on clinics and clinicians. Lack of screening supplies in clinics limited clinicians' opportunities to perform DM screening, which contributed to diminished self-efficacy. However, culture, compatibility and clinicians' beliefs about DM screening sustained throughout the interruption. We propose an approach for evaluating interruptions using the CFIR and social ecological model; other programmes can adapt this approach to identify cascading effects of interruptions and target them for re-implementation.

Background: The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence. Objective: To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV. Methods: We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP. Key results: We enrolled 283 participants with a mean age of 31±8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6%, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P= 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P=0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P<0.001). In focus group discussions, participants described pill burden, side-effects, drug safety, and accessibility as potential barriers to PrEP use. Conclusions and recommendations: Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also address issues of access to drugs.

Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three [3] months at the pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71% (95%CI 61.1–79.6) and 56% (95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) p = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

INTRODUCTION:Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies globally. Living with a stoma has potential to impair the patient's quality of life, often with associated negative psychological effects.OBJECTIVE:To evaluate the quality of life among intestinal stoma patients under Mulago National Referral Hospital (MNRH), with emphasis on psychological effects and effects on family-social interactions.METHODOLOGY:A cross-sectional study carried out at surgical outpatient clinics of MNRH between January and June 2018. Data was collected using Stoma-QOL questionnaire, PHQ-9 and GAD-7 from 51 participants who had lived with intestinal stomas for at least a month.RESULTS:Of the 51 participants, male: female ratio was 4:1 and aged 18-84 years (mean age 44.04+18.47 years). 76.5% had colostomy; 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+ 17.04. Only about a quarter (24%) of participants had Stoma-QOL scores >70 (best). Most patients exhibited negative psychological effects (anxiety-100%, concerns about changed body image - 96.1% and depression - 88.4%).CONCLUSION:Most participants had low levels of stoma-related quality of life, suffered negative psychological effects and exhibited limited social interactions. This calls for efforts to support Stoma patients adapt beter life.

INTRODUCTION:the study aimed to determine the prevalence of emotional, behavioral, developmental and psychosis related disorders among children and adolescents with active epilepsy aged 5 to 18 years in southwestern Uganda.METHODS:we conducted a cross sectional study at one big urban hospital, two rural health centers and one rural special needs school. The disorders were assessed using an adapted parent version of the Child and Adolescent Symptom Inventory-5 (CASI-5).RESULTS:one hundred and sixty-one participants were assessed, and 93 (57.8%) had at least one psychiatric disorder. Developmental disorders were the most prevalent at 39.8% (95%CI 32.11 - 47.39), followed by emotional disorders, 30.4% (95%CI 23.25-37.62), behavioral disorders, 7.5% (95%CI 3.35-11.55) and psychosis related disorders, 6.2% (95%CI 2.44 - 9.98). Thirty-nine participants (24.2%) had at least two psychiatric disorders. Developmental disorders were associated with younger age (aOR=0.86, p=0.001) and having epilepsy-related physical injuries and deformities (aOR=2.36, p=0.036). Emotional disorders (aOR=1.13, p=0.007) and psychosis related disorders (aOR=1.44, p=0.007) were associated with increasing age, whereas a family history of epilepsy was protective (aOR=0.22, p=0.042).CONCLUSION:psychiatric disorders were highly prevalent among children and adolescents with epilepsy in southwestern Uganda; highlighting the need to integrate screening and management of these disorders into routine epilepsy care.