Background: There is limited real-world data on trends and distribution of treatment outcomes of cervical lesions in cervical cancer care settings in Uganda. We conducted this study to describe trends and the distribution of treatment outcomes for Cervical Intraepithelial Neoplasia (CIN) among women treated at Mbarara Regional Referral Hospital (MRRH), Southwestern Uganda. Methods: We conducted a retrospective census of women treated for CIN at the cervical cancer clinic and gynecology ward of MRRH from January 2020 to July 2025. Data on age, district of residence, HIV status, HPV test results, treatment modality, year of treatment, and treatment outcomes were extracted from clinic registers and patient records and analyzed using Stata 17. Results: We retrieved records of 184 women who had been treated for CIN, and their mean age was43.3 (±14.8). The majority (150/184, 81.5%) of CIN cases were documented as cured while the while 34/184 (18.5%) had persistent lesions. More than half of cases with persistent lesions also had unknown HIV status. Persistent CIN was mostly observed among women who were either positive with single HPV16 genotype (7/34, 20.6%) or HPV18/45 plus Other hrHPV genotypes (22/34, 64.7%). Conclusion: An increasing trend in persistent cervical intraepithelial neoplasia was observed over the study period, particularly among women with unknown HIV status and those with HPV16 infection or mixed HPV18/45 and other high-risk HPV infections. These findings highlight the need to strengthen integration of cervical precancer care into HIV services, reinforce the screen-and-treat approach, and improve post-treatment follow-up and monitoring.

Persistent infection with High-Risk Human Papillomavirus (hrHPV) causes almost all cervical cancer cases, and the world is steadily moving towards primary HPV testing for cervical cancer screening. We determined the prevalence, distribution, and trends of hrHPV genotypes at Mbarara Regional Referral Hospital (MRRH), south western Uganda. In this retrospective study, we reviewed laboratory records at MRRH for a period of six years from January 2020 and July 2025. Data on age, district of residence, HIV status, HPV test result, HPV genotype and date of testing were collected and analyzed using STATA 17. Out of the 4,852 HPV test results we retrieved, the overall prevalence of hrHPV infection was 28.52

There is a need to assess the potential of blood-based biomarkers to detect treatment outcomes of cervical lesions. We determined the association between serum P16ink4A and FOXP3 concentrations and treatment outcomes of cervical lesions at a clinic in Southwestern Uganda. In this prospective cohort study, participants with cytologically and/or histologically confirmed cervical intraepithelial neoplasia (CIN) (n = 90) and cervical cancer (CC) (n = 90) were monitored for 12 months. After consent, clinical and demographic data were recorded, blood was collected, and serum P16ink4A and FOXP3 were measured (quantitative ELISA) at baseline and 12 months post-treatment. With multinomial logistic regression, we determined the association between treatment outcomes and serum P16ink4A and FOXP3 concentrations in STATA 17 using P-values of < 0.05 as statistically significant. Of the 180 participants initially enrolled, 62 returned for the 12-month follow-up assessment. At this time point, 47 participants presented with cleared lesions, 6 with persistent lesions, and 9 with progressed lesions. All participants exhibiting disease progression (n = 9) were CC cases, while 82.98

Cervical cancer prevention relies on timely treatment and follow-up of premalignant cervical lesions, yet loss to follow-up (LTFU) remains common in many low-resource settings. Depression may be associated with poor engagement in care, but evidence among women treated for premalignant lesions in Uganda is limited. We assessed the prevalence of depression and its association with LTFU among women treated for premalignant cervical lesions at Mbarara Regional Referral Hospital in Uganda. This was a retrospective cross-sectional study at the Cervical Cancer Clinic of Mbarara Regional Referral Hospital in southwestern Uganda. Women treated for premalignant cervical lesions between January 2017 and December 2022 with complete records and active telephone contacts were enrolled (n = 112). Follow-up status was defined by clinic attendance on the scheduled review date or within three months thereafter. Depressive symptoms were assessed during telephone interviews (May–June 2023) using the Patient Health Questionnaire-9 (PHQ-9), categorized as moderate/severe (≥ 10) versus no/mild (< 10). sociodemographic and treatment-related data were collected using a separate structured questionnaire/clinical record abstraction. Logistic regression was used to assess the association between depression and LTFU, adjusting for district of residence, marital status, education level, and employment status. Of 112 participants, 75.0

Background Dolutegravir (DTG)-based antiretroviral therapy (ART) has been associated with weight gain and obesity which are also linked to hepatocellular dysfunction. Despite these associations, the link between obesity indices and hepatocellular damage among people living with human immunodeficiency virus (PLWH) on DTG-based ART remains poorly understood. This study examined the association between obesity indices and elevated serum transaminases, markers of liver damage, among PLWH on DTG-based ART in Southwestern Uganda. Methods We conducted a cross-sectional study among 212 PLWH aged 18years and above who had been on DTG-based ART for ≥1 year at Municipal Health Centre IV, Southwestern Uganda. Data was collected using a semi-structured questionnaire. Anthropometric measurements were taken, and a blood sample collected from each participant for laboratory measurement of serum alanine and aspartate transaminase activity. Results Elevated serum transaminase activity was found in 12.7% (27/212, 95% confidence interval (CI): 8.9%-18.0%) of participants. Participants with elevated transaminases had significantly higher median waist-to-hip ratio (0.88 vs 0.83, P < 0.001) and waist circumference (WC) to body mass index (BMI) ratio (3.56 vs 3.42, P = 0.026) compared to those with normal activity. In multivariate analysis, only WC/BMI ratio remained significantly associated (aOR = 3.68; 95% CI: 1.11-12.16; P = 0.033) with elevated serum transaminase activity. At an optimal cut-off of 3.45; sensitivity = 78%, specificity = 52%), WC/BMI had significantly predictive power, (area under the curve= 0.651; 95% CI: 0.580-0.722) for elevated serum transaminase activity. Conclusion WC/BMI ratio is a potential predictor of elevated transaminases among PLWH on DTG-based ART in South western Uganda.

Background:Blood transfusions are essential in the supportive care of patients with hematological malignancies but carry a risk of adverse reactions. Data on the incidence of transfusion reactions remain scarce in Uganda. This study evaluated the incidence of hemolytic and serologic transfusion reactions among patients with hematological malignancies at Mbarara Regional Referral Hospital and the Uganda Cancer Institute in Uganda. Materials and Methods:This prospective cohort study enrolled hospitalized patients aged ≥2 years with hematological malignancies and a history of prior red blood cell (RBC) transfusions. Participants received additional transfusions and were monitored for up to 14 days. Blood samples were collected on day 0 (transfusion day), days 7, and 14 to assess hemoglobin (Hb) levels, lactate dehydrogenase (LDH), and perform direct and indirect antiglobulin tests. Participants' medical records were also reviewed for transfusion and pregnancy histories. Repeated Measures-Analysis of Variance was used to compare mean Hb and LDH levels over time points. Results:Of the 467 participants enrolled (median age: 36.4 years, interquartile range: 27.3-46.9), 382 completed the follow-up period. A progressive increase in mean Hb levels (g/dL) was observed: 6.6 (95% confidence interval [CI]: 6.1-8.9) on day 0, 7.5 (7.3-10.1) on day 7, and 8.9 (8.4-10.6) on day 14. No acute or delayed hemolytic reactions occurred. The incidence of delayed serologic transfusion reactions (DSTRs) was 0.86 in 100 (95% CI: 0.02-1.69), while the overall RBC alloantibody prevalence was 2.4% (95% CI: 0.98-3.74). The identified alloantibodies were directed against antigens in the Rh, Kell, Lewis, and MNS group systems. Conclusion:Despite a low incidence of DSTRs, a notable prevalence of RBC alloimmunization was observed among patients with hematological malignancies. These findings underscore the need to strengthen pre-transfusion antibody testing to prevent hemolytic complications and improve transfusion outcomes in this population.

BACKGROUND AND OBJECTIVES:Patients with haematological malignancies often require blood transfusion support. Multiple allogeneic blood transfusions may result in alloimmunization, complicating future transfusions. This study determined alloantibody prevalence, specificities and factors associated with the presence of red blood cell (RBC) alloantibodies among transfused patients with haematological malignancies at Mbarara Regional Referral Hospital (MRRH) and the Uganda Cancer Institute (UCI). MATERIALS AND METHODS:This was a cross-sectional study among patients with haematological malignancies who had been multiply transfused and were seeking cancer care at MRRH and the UCI, in Uganda. Patient plasma was screened for the presence of RBC alloantibodies using haemagglutination testing with a 3-cell commercial reagent RBC and antibody identification with 11-cell antibody panels. RESULTS:A total of 427 patients with a median age of 36 (inter-quartile range: 26-56 years) were investigated. Twenty-five participants (5.9%) possessed RBC alloantibodies whose specificities were as follows: anti-C, two; anti-D, four; anti-E, six; anti-K, four; and anti-c, anti-Fya, anti-Jka, anti-Lea and anti-M, one each. Four patients possessed pan-reactive antibodies. Patients with chronic cancer (adjusted odds ratio [AOR] = 2.62, 95% confidence interval [CI]: 1.16-7.21), leukaemia (AOR = 2.71, 95% CI: 1.81-4.03), human immunodeficiency virus (HIV) infection (AOR = 4.34, 95% CI: 1.69-5.11), antibiotic use (AOR = 5.08, 95% CI: 2.11-7.41) and a history of ≥5 transfusions were significantly associated with RBC alloimmunization (p ≤ 0.05). CONCLUSION:RBC alloimmunization prevalence was 5.9% and associated with clinical and transfusion-related factors. Alloantibodies to Rh, Kell, MNS, Duffy, Kidd and Lewis blood group systems were detected, underscoring the need for improved pre-transfusion testing in Uganda.

Background:Nephropathy screening is vital in type 2 diabetes mellitus (T2DM) management to prevent complications, yet uptake remains low in resource-limited settings like Southwestern Uganda. This study explored the barriers and facilitators influencing screening among T2DM patients and providers at the diabetic clinic of Mbarara Regional Referral Hospital. Methods:A qualitative cross-sectional study guided by a phenomenological approach to explore lived experiences around nephropathy screening was conducted. Fifteen adult T2DM patients in care for ≥12 months and five healthcare providers (doctors, nurses, and a laboratory technician) were purposively sampled. Semi-structured, in-depth interviews were conducted. Data were analyzed using an inductive approach. Socio-demographics; including age, sex, education, and employment were collected. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed using Dedoose (version 10.0.25). Study reporting adhered to the COREQ 32-item checklist. Results:Patients described diabetes as a burdensome and life-altering condition. Key barriers to nephropathy screening included financial constraints, lack of transport, limited awareness, and dissatisfaction with care. Despite these challenges, facilitators such as proactive provider encouragement, community outreach, and availability of free testing motivated screening uptake. Providers emphasized their critical role in educating patients and detecting nephropathy but reported systemic constraints, including staff shortages, equipment failures, limited knowledge on new disease trends and screening protocols. Both groups highlighted the need for routine integration of nephropathy screening into diabetes care and greater support from the health system. Conclusion:Nephropathy screening behaviors among T2DM patients are influenced by perceived disease severity, provider communication, and systemic barriers such as cost and infrastructure. While both patients and providers recognize the value of early detection, sustained screening is hindered by resource limitations and inconsistent implementation. Strengthening institutional capacity, integrating screening into routine care, and enhancing patient-provider engagement are essential to reducing the burden of diabetic nephropathy in the study setting.

The field of RNA research has experienced significant changes and is now at the forefront of contemporary drug development. This narrative overview explores the scientific developments and historical turning points in RNA research, emphasising the field’s critical significance in the development of novel therapeutics. Important discoveries like antisense oligonucleotides (ASOs), mRNA therapies, and RNA interference (RNAi) have created novel treatment options that can be targeted, such as the ground-breaking mRNA vaccinations against COVID-19. Advances in high-throughput sequencing, single-cell RNA sequencing, and epitranscriptomics have further unravelled the complexity of RNA biology, shedding light on the intricacies of gene regulation and cellular diversity. The integration of computational tools and bioinformatics has propelled the identification of RNA-based biomarkers and the development of RNA therapeutics. Despite significant progress, challenges such as RNA stability, delivery, and off-target effects persist, necessitating continuous innovation and ethical considerations. This review provides a critical insight into the current state and prospects of RNA research, emphasising its transformative potential in drug discovery. By examining the interplay between technological advancements and therapeutic applications, we underscore the promising horizon for RNA-based interventions in treating a myriad of diseases, marking a new era in precision medicine.

Background Urinary tract infections (UTIs) are among the most common bacterial infections globally, with Enterobacteriaceae, particularly Escherichia coli and Klebsiella pneumoniae, being the primary causative agents. The rising prevalence of antimicrobial resistance (AMR) in these pathogens has complicated treatment, posing a significant public health challenge. In resource-limited settings like Southwestern Uganda, limited surveillance data and inappropriate antimicrobial use exacerbate the AMR crisis. Understanding the antibiotic susceptibility profiles of uropathogenic Enterobacteriaceae is crucial to inform empirical treatment and guide local antimicrobial stewardship efforts. This study investigated the antimicrobial susceptibility patterns of Enterobacteriaceae isolated from UTI patients to commonly used antibiotics. Methods A hospital-based cross-sectional study was carried out in Bwizibwera Health Center IV and Rubaya Health Center III in rural Southwestern Uganda, targeting 455 individuals who were confirmed to have Enterobacteriaceae infections. These participants were drawn from a pool of 2,371 patients presenting with urinary tract infections (UTIs) at the two health centers. Identification of Enterobacteriaceae was performed using a range of biochemical tests, and antimicrobial susceptibility patterns were assessed using the Kirby-Bauer disk diffusion technique with specific antibiotics. The data were analyzed and summarized as frequencies and percentages, with results presented in tables and graphs. Results Out of the 2371 participants, 455 (19.2%, CI 17.6 - 20.8) tested positive for uropathogenic Enterobacteriaceae. Out of the 455, the majority were females (398/455, 87.5%). The mean age of the study participants was 41.6 (SD 19.7) years. Each of the 455 study participants had a single uropathogen. Organisms were highly resistant to tetracycline with a proportion of 89.5% (407/455) and least resistant to meropenem 76 out of 455 (16.7%) and ceftriaxone 79 out of 455 (17.9%). Multidrug resistance (MDR) was observed in 114 out of 455 (25.05%) of the organisms, whereas 10.77% (49/455) of the organisms exhibited pan-drug resistance (PDR). In addition, MDR was highest in isolates from females, and MDR and PDR were highest among individuals 60 years and above. Conclusion Our study revealed a high prevalence of Enterobacteriaceae uropathogens isolated in rural South Western Uganda predominantly affecting women. The organisms showed the highest resistance to tetracycline and varying degrees of antibiotic resistance (MDR, extensive drug resistance (XDR), and PDR), including carbapenem-resistant strains of E. coli, Klebsiella, and Enterobacter spp., posing a significant public health threat. These findings highlight the urgent need for revised antibiotic prescription practices, strengthened antibiotic stewardship, and continuous surveillance of uropathogen susceptibility patterns to guide effective empirical treatment strategies.

Introduction: Expression of P16ink4A and FOXP3 is correlated with the grades of cervical lesions. In this study, we determined the diagnostic accuracy of serum P16ink4A and FOXP3 concentrations for detection of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC) in a rural setting in Southwestern Uganda. Material and Methods: CIN and CC cases (93 each before treatment), and 93 controls were identified. Clinical and demographic data were documented before quantifying serum P16ink4A and FOXP3 concentrations using quantitative ELISA kits. Cases were confirmed by cytology and/or histology. We employed descriptive statistics, cross-tabulation, and receiver operating curves (ROC) using statistical software for data science (STATA) 17. p-values <0.05 were considered statistically significant. Results: Serum FOXP3 concentration of 0.0545 ng/mL < showed moderate sensitivity (32.22% and 57.78%) for detection of CIN and CC from healthy controls, respectively. It also showed a moderately high specificity of 68.89% for detection of both CIN and CC from healthy controls (AUC-0.6014 and 0.7679, respectively). Serum P16ink4A concentration of 0.946 ng/mL < showed moderate sensitivities (50.00% and 60.00%) and specificities (56.67% and 55.56%) for the detection of CIN and CC from healthy controls, respectively (AUC-0.6085 and 0.7592, respectively). A combination of elevated serum FOXP3 and P16ink4A showed very low sensitivities of 18.89% in detecting CIN from healthy controls and 33.33% for detecting CC from healthy controls. This combination showed high specificity of 83.33% in detecting both CIN and CC from healthy controls (AUC-0.5992 and 0.7642, respectively). Conclusion: Although serum P16ink4A and FOXP3 concentrations showed moderate accuracy, their combination was more specific than sensitive. This combination has a high potential to be applied for diagnosis rather than screening for cervical lesions, at least in the Ugandan population. Combinations of P16ink4A and FOXP3 with other biomarkers could improve diagnostic accuracies. Additionally, studies could be conducted to assess the performance of these biomarkers in the detection of cervical lesions in specific populations, say Human Immunodeficiency Virus (HIV)-positive and HIV-negative populations.

Point-of-care (POC) diagnostics have revolutionized disease detection by enabling rapid, on-site testing without the need for centralized laboratory infrastructure. This review presents recent advances in aptamer-functionalized nanoparticles (AFNs) as promising tools for enhancing POC diagnostics, particularly in infectious diseases and cancer. Aptamers, with their high specificity, stability, and modifiability, offer significant advantages over antibodies, while nanoparticles contribute multifunctionality, including signal amplification and targeting capabilities. AFNs have demonstrated up to a 2-10 times increase in detection sensitivity and significant reductions in diagnostic timeframes. We discuss various nanoparticle types, conjugation strategies, real-world applications, and highlight innovative developments such as AI-assisted aptamer design, wearable diagnostic devices, and green nanoparticle synthesis. Challenges related to stability, manufacturing scalability, regulatory hurdles, and clinical translation are critically examined. By merging aptamer precision with nanoparticle versatility, AFNs hold transformative potential to deliver rapid, affordable, and decentralized healthcare solutions, especially in resource-limited settings. Future interdisciplinary research and sustainable practices will be pivotal in translating AFN-based diagnostics from promising prototypes to global healthcare standards.

Objectives:Previous studies present conflicting evidence on the relationship between hepatocellular damage biomarkers and dementia risk. While elevated serum transaminases have been associated with mild cognitive impairment, other studies link lower transaminase levels and reduced high-density lipoprotein-cholesterol levels to increased risk of cognitive decline. This study investigated the association between serum transaminase-to-high-density lipoprotein-cholesterol ratios and probable dementia among people living with HIV on antiretroviral therapy. Methods:We conducted a secondary data analysis using a dataset from a cross-sectional study conducted among 377 people living with HIV on dolutegravir-based antiretroviral therapy in southwestern Uganda. Probable dementia was screened using the brief Community Screening Instrument for Dementia and defined as a Community Screening Instrument for Dementia cognitive score ⩽4. Serum alanine aminotransferase/high-density lipoprotein-cholesterol and aspartate aminotransferase/high-density lipoprotein-cholesterol ratios were calculated from the respective serum transaminases and high-density lipoprotein-cholesterol divided into tertiles. We used logistic regression to assess the association between the independent variables and probable dementia. Results:The median age of the study participants was 44 years (interquartile range: 30-59), with 56.2% being female. The median total cholesterol/high-density lipoprotein-cholesterol levels were significantly higher in participants with probable dementia compared to those without (3.86 versus 3.22, p = 0.03). Aspartate aminotransferase/high-density lipoprotein-cholesterol and alanine aminotransferase/high-density lipoprotein-cholesterol levels were also higher among participants with probable dementia compared to those without, although the differences did not reach statistical significance. In the fully adjusted model, compared to participants in the first tertile of aspartate aminotransferase/high-density lipoprotein-cholesterol ratio, the odds of probable dementia were higher in the second tertile (adjusted odds ratio: 1.71; 95% confidence interval: 0.62-4.74; p = 0.301) and significantly elevated in the third tertile (adjusted odds ratio: 4.48; 95% confidence interval: 1.15-17.46; p = 0.031). Conclusions:The findings suggest that an elevated aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is significantly associated with probable dementia among people living with HIV on dolutegravir-based antiretroviral therapy. A high aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is potentially associated with cognitive decline in this population.

There is a pressing need to discover novel anti-tuberculosis agents to combat emerging drug-resistant strains. Cryptolepis sanguinolenta, Lantana camara, and Zanthoxylum leprieurii have been identified as potential sources of anti-tuberculosis (TB) drug candidates. Previous studies have examined the metabolites and metabolic pathways in mycobacterial strains affected by methanolic extracts of these plants, but the specific active compounds responsible for the antimycobacterial activity, the effect on affected metabolites and metabolic pathways of mycobacterial cell cultures, remain unclear. Untargeted metabolic fingerprinting may help identify the active compounds. The objective of this study was to model the antimycobacterial activity of methanolic extracts of C. sanguinolenta, L. camara, and Z. leprieurii as a function of their UHPLC-MS fingerprints and determine whether specific peaks (compounds) in the fingerprints contributed significantly to the activity. In this study, fingerprints of 18 methanolic extracts from C. sanguinolenta roots, L. camara leaves, and Z. leprieurii stem barks were obtained with ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). The minimal inhibitory concentrations (MICs) of these extracts against a pan-sensitive M. tuberculosis strain were determined using a resazurin-based microdilution assay. Fingerprints were processed and analyzed using regions of interest-multivariate curve resolution (ROIMCR). Partial least squares (PLS) regression was employed to model the MICs. Potential active compounds, including cryptolepine (from C. sanguinolenta), verbascoside (from L. camara), and isofagaridine (from Z. leprieurii), were identified as antimycobacterial compounds. These compounds likely influence mycobacterial metabolic processes, including cell wall synthesis, protein production, nucleotide metabolism, and energy generation. Further investigations are required to validate our findings.

BackgroundLoss to follow-up (LTFU) in individuals undergoing cervical cancer treatment is a major challenge in many low resource settings. We describe development of a customized and tailored mHealth intervention for reducing LTFU among patients undergoing cervical cancer treatment at Mbarara Regional Referral Hospital (MRRH).MethodsWe interviewed all health care providers (HCPs) at the cervical cancer clinic of MRRH, between April and May 2023. Transcripts were subsequently derived, reviewed and coded to generate themes and categories using inductive content analytic approach. Four medical experts used this data to develop relevant SMS content, which was incorporated into an app.ResultsHCPs had owned a phone for 13.8 ≤ years, had worked at the clinic for 5 ≤ years, and used text messages regularly. Qualitative data revealed that the main challenge to re-engagement was absence of a reminder mechanism between HCPs and patients. HCPs preferred text and or audio mode of messaging to improve health care responsiveness to LTFUs, awareness, continuity of care, and health service uptake among the majority illiterate population; though with potential constraints of costs and workload. Identified key messaging content included; the importance of attending scheduled follow-ups, follow up visit date and clinic customization and tailoring the message to the intended recipient. SMS content was uploaded onto the cc-follow-up app platform and customized according to preferred language, day, frequency and time of delivery.ConclusionTailoring an mHealth messaging intervention could help re-engage and reduce LTFU through improved information sharing, awareness, responsiveness, care engagement and medical compliance. A pilot study is required for our intervention in South Western Uganda.

Aptamers, single-stranded nucleic acids that bind to specific targets with high affinity and specificity, hold significant promise in various biomedical and biotechnological applications.The traditional method of aptamer selection, SELEX (Systematic Evolution of Ligands by EXponential Enrichment) takes a lot of work and time. Recent advancements in computational methods have revolutionized aptamer design, offering efficient and effective alternatives. This review examines recent advances in non-SELEX and de novo aptamer design methods, such as Making Aptamers without SELEX (MAWS), AptaLoop, AptaDiff, RNAGEN, RaptGen, Apta-MCTS, UltraSelex, and Torkamanian-Afshar model. These computer methods utilize bioinformatics, machine learning, and molecular modelling to generate high-affinity aptamers, eliminating the need for multiple selection steps in vitro or in vivo. We provide a comprehensive analysis of each method’s performance, including binding affinity, specificity, and stability, and discuss their practical applications in diagnostics, therapeutics, and environmental monitoring. Furthermore, we highlight the strengths and limitations of computational methods against the traditional one. The potential challenges, future directions, and emerging .technologies were also presented. This review underscores the transformative impact of computational aptamer design on research and industry, paving the way for rapid and cost-effective development of aptamer-based technologies.

Schistosomiasis is a parasitic disease that is endemic in tropical and subtropical areas. Its diagnosis is crucial for effective treatment and control, particularly in resource-limited settings where the disease burden is high. Various diagnostic methods are available. However, these methods are associated with low accuracy, efficiency or accessibility. This review summarizes the published literature on the diagnostics of schistosomiasis based on the techniques of microscopy, serology, molecular, antigen-based and aptamer-based assays. The limitations of each technique were summarized to encourage future research. Furthermore, we highlight the need for point-of-care diagnostics that are sensitive, specific, and easy to use in resource-limited settings may address the challenges associated with commonly used diagnostic techniques. The review concludes that further research and development are needed to improve the diagnosis of schistosomiasis and enable effective treatment and control of this debilitating disease.

Introduction: There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda. Methods: In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level. Results: The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, p : 0.0253), use of intrauterine devices (OR: 6.284, p : 0.039), and any family history of cervical cancer (OR: 4.144, p : 0.049) were significantly associated with cervical intraepithelial lesions. Conclusion: The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.

BACKGROUND:Cervical cancer continues to threaten women's health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings. METHODS:A descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators. RESULTS:We conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling. CONCLUSIONS:Our study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling.