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Endocarditis Caused By Candida (Candidozyma) Auris, Farah Ebrahim, Mzee Ngunga, Abdulaziz Abeid, Hilda Nasibwa, Newnex Mongare, Rodney Adam

Internal Medicine, East Africa

Candida (Candidozyma) auris has emerged as a hospital-acquired pathogen and was first reported in East Asia in 2009. Infective endocarditis due to C. auris has been rarely reported, while other Candida species account for < 2% of infective endocarditis (IE) cases. Herein we report three cases of endocarditis caused by C. auris , including a native aortic valve, a native tricuspid valve, and a prosthetic valve. Each of these cases had been in healthcare settings months to years earlier that were the likely sources of their infec- tions. These cases suggest the possibility for indolent but life-threatening infections from C. auris . ©2026 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Institute For Global Health And Development : Issue 14 - April-June 2026, Institute For Global Health And Development

IGHD Newsletters

• Honours & Recognition
• Research & Publications
• In the Media
• Events & Convenings
• Training, Projects & Field Work
• People & Milestones
• Research Highlights & Knowledge Contributions
• Publications from IGHD
• Stay Connected

Precision And Papers (Research Newsletter) Jan-Jun 2026, Department Of Surgery

Department of Surgery Archives

• Message from Vice-chair Research
•  Meet the Research Team
• Grants
• Faculty Spotlight
• Conferences/ Talks/ Presentations
• Building Our Research Registries
• ERC Submissions
• Publications

A Misplaced Pocket Of Air: Intramural Gastric Air Most Consistent With Gastric Emphysema, Priyanka Panwar, Lavender Otom, Subo Marsa, Gerald Odong, Steven Idet, Irene Muchiri, Hussein Abdulsamad, John Odhiambo, Christopher Opio, Amos Mwasamwaja, Saleem Abdulkarim

Internal Medicine, East Africa

Background Gastric emphysema (GE), or gastric pneumatosis, is a rare, noninfectious cause of intramural gastric air that must be distinguished from emphysematous gastritis (EG), a highly lethal infectious entity. Despite similar radiographic appearances, these conditions differ substantially in etiology, clinical course, management, and prognosis.

Cases We report three hemodynamically stable patients with CT-confirmed intramural gastric air most consistent with GE. Two had associated portal venous gas. The cases occurred in distinct clinical contexts: infectious gastroenteritis with retching, transient midgut volvulus with obstructive gastric overdistension, and alcohol-related upper gastrointestinal bleeding with forceful vomiting and a Mallory–Weiss tear. Although early EG could …

Paediatrics & Child Health | Newsletter Vol 8 Issue 1, Department Of Paediatrics & Child Health

Department of Paediatrics & Child Health Archives

• I write to you in unsettled times...
• Service | Clinics and Nursing
• World Autism Awareness Day 2025 — Understanding Autism: Myths, Challenges & Strategies
• Research | Conferences, Field Sites, Studies and Dissemination Strategies
• MoU with SHINE
• Three honours at the 23rd Annual
• Protecting infant gut health in early life
• Academics | PG, UG, CME
• The Science Behind a Paediatrician’s Quick Diagnosis
• Making Immunology Simple for Clinical Practice
• Achievements
• Behind the Systems That Build Great Doctors
• 15,000+ physical therapists. 1,440+ posters. One team from Pakistan.
• Awards and recognitions
• After hours
• Ramzan Iftar Dinner
• Alumni reunion
• PRISMA appreciation night
• In the media …

Community-Based Tuberculosis Screening With Computer-Aided Detection Technology Alone And In Combination With Point-Of-Care C-Reactive Protein Testing: A Paired Screen-Positive Trial, Klaus Reither, Fiona Vanobberghen, Anna Verjans, Harsh Harkare, Bart Jacobs, Alastair Heerden, Shriya Misra, Fabrizio Tedios, Curdin Brugger, Alfred Keter

Population Health, East Africa

Background Active tuberculosis case-finding in communities is crucial for early disease detection and disruption of transmission; however, it is complex and costly. A thorough analysis of tuberculosis screening strategies is essential, particularly because the health systems affected often have limited resources. We aimed to compare two community screening approaches in terms of tuberculosis case yield and cost.

Methods This pragmatic community trial, with a paired screen-positive design (ie, within-person comparison), was conducted in the Butha-Buthe District in Lesotho and the uMgungundlovu District in South Africa. All household members aged at least 18 years were eligible to participate, except those who …

Spatially Dissecting Drivers Of Inter-And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

Hiding In Plain Sight: A Case Of Intestinal Tuberculosis Masquerading As Benign Lower Gi Bleeding, Lavender Otom, Priyanka Panwar, Gerald Odong, Fatma Kassim, Patricia Okiro, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

Background Intestinal tuberculosis (TB) represents the most common form of abdominal TB, often affecting the ileocaecal region. Lower gastrointestinal bleeding is an uncommon presentation and may create significant diagnostic uncertainty, particularly in immunocompromised patients and in settings where inflammatory bowel disease is also encountered.

Case Presentation A woman in her sixties from Africa presented with recurrent diarrhoea and intermittent haematochezia over a 6-month period. Initial endoscopic evaluation was nondiagnostic. Cross-sectional imaging later demonstrated multifocal bowel involvement affecting both the small and large bowel, including ileocaecal and rectoanal disease, with associated abdominopelvic lymphadenopathy. Histopathology from repeat colonoscopy biopsy showed caseating granulomas …

Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise

General Surgery, East Africa

Sub-Saharan Africa (SSA) remains significantly underrepresented in global cancer clinical trials, despite having the largest population of individuals of African descent, an essential demographic for ensuring diversity in clinical research. This study, developed from the 2024 African Organization for Research and Training in Cancer (AORTIC)-ASCO stakeholder meeting, addresses the critical need to involve SSA in cancer trials to improve global trial diversity and patient outcomes. Although globalization of trials has shifted research sites to regions like Eastern Europe and Asia, < 1% occur in Africa. This report highlights emerging solutions such as regional alliances, decentralized trial models, capacity-building initiatives, and public-private partnerships. The role of AORTIC and its Clinical Trial Special Interest Group in advancing training, infrastructure development, and international collaboration is discussed, with notable clinical trial networks, such as HypoAfrica, ARETTA, African Research Group for Oncology, and regional consortia, illustrating growing momentum and capability. This study advocates for a coordinated strategy to integrate SSA into global trials, ensuring more inclusive, effective, and equitable cancer treatment outcomes.

New-Onset Cognitive Impairment After Delirium Among Hospitalised Older Ghanaians: A Pilot Study, John-Paul Omuojine, Richard Dei-Asamoa, Caleb Otu-Ansah, Gertrude Aboah, Belinda Opoku, George Amponsah, Stella Afeti, Leah Ratner, Ruth Owusu-Antwi, Cyprian Mostert

Population Health, East Africa

Background Delirium is a potentially modifiable risk factor for dementia. However, post-delirium cognition has hardly been studied in Africa, where the burden of both disorders is rising disproportionately.

Objective We estimated the incidence of new-onset cognitive impairment (NCI) 6 months after hospitalisation with non-stroke delirium among older Ghanaians.

Methods This was a prospective observational pilot study conducted among 60 previously cognitively unimpaired (retrospective proxy assessment) adults aged ≥60 years, hospitalised with non-stroke prevalent delirium in a Tertiary Hospital. Delirium was confirmed and rated using the Confusion Assessment Method (CAM) and Severity Scale (CAM-S) within 24–72 hours of admission and reassessed …

Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

A Rare Manifestation Of Mycobacterium Kansasii As A Cutaneous Infection: A Case Report, Wandera Carey, Antony Kimani, Zamanali Khakhar, Dheer Kalaiya, Alok Iyer, Sayed Karar

Internal Medicine, East Africa

Nontuberculous mycobacteria (NTM) are environmental organisms increasingly recognized as opportunistic pathogens, particularly in immunocompromised individuals. Mycobacterium kansasii, a slow-growing photochromogen (Runyon group I), is primarily associated with pulmonary disease; however, extrapulmonary and cutaneous manifestations are uncommon and often underdiagnosed. Given the rising incidence of NTM infections, cutaneous disease should be considered in the differential diagnosis of skin lesions, especially in immunocompromised patients. Early microbiological confirmation is crucial for appropriate therapy, as M. kansasii is intrinsically resistant to pyrazinamide. Herein, we present a case of pathologically confirmed cutaneous M. kansasii infection occurring in isolation, illustrating the diagnostic challenges and therapeutic outcomes.

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

Low-Abundance And Fragmentary Helicobacter Pylori Dna Detected In Phenotypically Negative Gastric Biopsies Using Targeted Sequencing, Fabien Mbaya-Tshibangu, Alain Cimuanga-Mukanya, Evariste Tshibangu-Kabamba, Nadine Kayiba-Kalenda, Tressy Kalenga-Ngomba, Patrick Ngoma-Kisoko, Gunturu Revathi, Junko Akada, Benoît Mbiya-Mukinayi, Augustin Tshibaka Kabongo

Pathology, East Africa

Accurate detection and monitoring of antimicrobial resistance (AMR) in Helicobacter pylori mainly rely on phenotypic methods and culture, which can sometimes fail when bacterial load is low or after recent treatment. We investigated whether gastric biopsies classified as H. pylori-negative by standard diagnostic techniques still contain detectable bacterial DNA, including regions linked to AMR, and assessed whether selected DNA fragments can mediate allelic exchange in vitro. Gastric biopsies from 46 dyspeptic patients in the Democratic Republic of the Congo (including 23 phenotypically positive and 23 phenotypically negative individuals) were analyzed using long-read amplicon sequencing of seven resistance-associated loci, selective whole-genome …

Prevalence Of Plasmodium Ovale And Plasmodium Malariae Mixed Infections And Associated Mortality In Children With Severe Falciparum Malaria, Giselle Lima-Cooper, Dibyadyuti Datta, Caitlin Bond, Kagan Mellencamp, Ruth Namazzi, Mahesh Gupta, Andrea Conroy, Robert Opoka, Chandy John

Paediatrics and Child Health, East Africa

The prevalence and clinical significance of mixed Plasmodium infections in children with severe Plasmodium falciparum (P. falciparum) malaria are not well characterized. In a cohort of 440 Ugandan children hospitalized with severe malaria who were diagnosed with Plasmodium species via microscopy, nested polymerase chain reaction (nPCR) testing was used to detect P. falciparum, Plasmodium ovale (P. ovale), Plasmodium malariae (P. malariae), and Plasmodium vivax (P. vivax) infections and assess their association with adverse clinical outcomes during hospitalization. Using nPCR testing, the Plasmodium 18S small-subunit ribosomal RNA gene was detected in 440 children. Plasmodium falciparum mono-infection was identified in 329 (74.8%) …

Modeling Of Aggregate Losses Of Metastatic Cancer Using Katz Family (A, B, 0) Distributions, Cynthia M. Mwau, Howard Omukami

Institute for Educational Development, East Africa

The incidence of metastatic cancer over the years has gradually increased. This can be due to delayed quality treatment, attributed to insufficient funds. Models that can more accurately price cancer insurance policies incorporating its metastatic nature would enable insurance firms to develop affordable and profitable cancer insurance policies. Effectively marketed and reasonably priced insurance policies can enhance the uptake of cancer specific insurance, thereby alleviating the financial strain linked to cancer treatment. To capture the impact of metastatic cancer on overall cancerrelated losses, we construct Katz recursive models grounded in the Katz family of distributions, specifically the (a, b, 0) …

Disseminated Tuberculosis Presenting With A Nodo-Colonic Fistula In A Newly Diagnosed Hiv-Positive Patient: A Case Report From Tanzania, Samina Somji, Salim Surani, Joshua Ngimbwa, Tevin Kahwa, Frank Swai, Fatema Tayabali, Bishoy Rofaeil

Population Health, East Africa

We present the case of a 35-year-old male with no known comorbidities who presented with chronic gastrointestinal (GI) and constitutional symptoms and was empirically treated with several antibiotics during multiple clinic visits at different health facilities. The laboratory test sent included a stool GeneXpert, which was positive for Mycobacterium tuberculosis (MTB). CT imaging revealed multiple necrotic abdominal and retroperitoneal lymph nodes, hypoenhancing splenic lesions, a nodo-colonic fistula between the necrotic retroperitoneal lymph nodes and the adjacent colon, and a mild left-sided pleural effusion. Colonoscopy demonstrated caseating discharge from the fistulous tract 40 cm from the anal verge, and histology showed …

Global Trends In Bioterrorism And Biosecurity Research Publications (1997–2025): A Scopus Bibliometric Analysis, Festus Mulakoli, Samuel Gesaka, John Mbataru

School of Nursing & Midwifery, East Africa

Introduction: Bioterrorism and biosecurity preparedness are critical pillars of global public health protection and resilience of health systems worldwide. Although this field has grown over the past few decades, there remains limited clarity on how research efforts have evolved and where critical gaps persist, particularly regarding global collaboration and emerging biological threats. To address this, we conducted a bibliometric analysis to map publication trends, influential contributors, and collaboration networks in bioterrorism and biosecurity from 1997 to 2025. This study analyzed global research output, collaboration, and thematic evolution in bioterrorism and biosecurity and identified gaps relevant to preparedness and policy. …

A Qualitative Socioecological Exploration Of Community Health Promoters’ Barriers And Facilitators In Cardiovascular Disease Prevention In Kenya, Emily Muchina, Maureen Akolo, Rose Maina

School of Nursing & Midwifery, East Africa

Background:

Cardiovascular diseases (CVDs) remain a growing public health challenge in low- and middle-income countries, where there is an upsurge of risk factors. Community health promoters (CHPs) have the potential to play a crucial role in CVD prevention and care to underserved communities in Kenya. However, there are limited studies on their experiences, which are likely shaped by multilevel barriers and facilitators across the individual CHP, the community, relationships with primary health systems, and societal-level policies and structures. This study explored the barriers and facilitators shaping CHPs’ experiences in mitigating CVD in Kenya.

Methods:

A qualitative descriptive study was conducted …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …

A Review Of Yellow Fever: Epidemiology, Pathogenesis, Clinical Manifestations, Treatment, Prevention, And Prognosis, Farah Ebrahim, Samina Somji, Reena Shah, Salim Surani

Internal Medicine, East Africa

Yellow fever is a mosquito-borne viral illness caused by the yellow fever virus (YFV), a member of the Flaviviridae family. Despite the availability of an effective live-attenuated vaccine, the disease remains endemic in regions of Africa and South America. Transmission occurs primarily via an infected mosquito called Aedes aegypti, with distinct urban, sylvatic, and intermediate transmission cycles. Clinically, infection ranges from mild febrile illness to severe disease, which is characterized by jaundice, hemorrhage, and multiorgan failure. Pathogenesis involves viral replication in hepatocytes, immune-mediated injury, and dysregulated inflammatory responses, leading to characteristic hepatic mid-zone necrosis. Diagnosis relies on molecular detection …

Prevalence Of Undiagnosed Dyspepsia, Associated Factors, And Its Relationship With Quality Of Life Among Undergraduate Health Program Students At Makerere University In Uganda, Shamim Nabidda, Christine Atuhurra Kabahinda, David Wagaba, Samuel Okellodepartment Of Clinical Epidemiology And Biostatistics, School Of Medicine, College Of Health Sciences, Makerere University, Kampala, Uganda, Derrick Mugisha, Evan Atwebembeire, Happy Unith, Lule Daniel, Andrew Marvin Kanyike, Ibrahim Edrisa Mutebi, Mark Kaddu Mukasa, Joan N. Kalyango

School of Nursing & Midwifery, East Africa

Introduction:  Dyspepsia affects 6.9% of people globally and significantly impairs quality of life, yet it often remains undiagnosed. Undiagnosed dyspepsia (UD) affects up to one-third of patients and is prevalent among students due to stress, irregular eating, and self-medication. In Uganda, limited access to endoscopy results in many cases being undiagnosed, yet recent data among health program students remains scarce.

Objective:  To determine the prevalence of UD, associated factors, and its relationship with QoL among undergraduate health program students at Makerere University.

Methods:  This was a cross-sectional study involving 378 undergraduate health program students from Makerere University between March and …

The 'Golden Hour': A Geospatial Analysis Of Travel Time To Public Emergency Departments In Kenya, Tushara Surapaneni, Nancy Kinyua, Benjamin Wachira

Emergency Medicine, East Africa

Introduction In Kenya and many other low- and middle-income countries, prehospital care systems are underdeveloped or entirely non-existent, leaving emergency departments (EDs) as the primary point of care for medical emergencies. The aim of this cross-sectional observational study was to use a geographic information system (GIS) to comprehensively analyse access to public EDs in Kenya within 1-hour and 2-hour travel times.

Methods Using open-source GIS software, population, land cover, elevation and road network data were analysed to create maps of 1-hour and 2-hour travel time catchment areas around public EDs in Kenya. Travel time analysis was calculated using AccessMod with …

Age-Specific Concentrations And Seroprevalence Of Antibodies Against Salmonella Enteritidis (O:9) And Salmonella Typhimurium (O:4,5) Across Three Sites In Kenya., Esther Muthumbi, Sean Elias, Alfred Mwanzu, Agnes Mutiso, Perpetual Wanjiku, Cecilia Mbae, Godfrey Bigogo, Jennifer Verani, Stefan Flasche, Samuel Kariuki

Population Health, East Africa

Background Seroprevalence studies can indicate the age distribution of first infection with nontyphoidal Salmonella and estimate the rate of infection by age.

Method We collected 1254 paired samples of serum and stool from healthy children and adults in Kilifi, Nairobi, and Siaya counties in Kenya, areas of low, medium, and high incidence of invasive nontyphoidal Salmonella disease, respectively. We quantified the age- and site-specific geometric mean concentrations (GMCs) of IgG and IgA antibodies against S Enteritidis O-antigen (O:9, serogroup D) and S Typhimurium O-antigen (O:4,5, serogroup B) using an in-house standardized enzyme-linked immunosorbent assay. Serum concentrations were estimated against a …

Institute For Global Health And Development : Issue 13 - March 2026, Institute For Global Health And Development

IGHD Newsletters

• Dr Jai Das Receives AKU Award For Excellence In Research
•  
• Cochrane Review On Umbilical Cord Antiseptics Highlights Impact On Newborn Survival
• Strong Representation And Awards At The 27th National Health Sciences Research Symposium
• Dr Bhavita Kumari Represents Ighd At International Public Health Conference
• IGHD Contributes To National Polio Strategy Discussions At Eoc Meetings
• IGHD Hosts HEC Delegation For Strategic Discussion On Collaborations In Nutrition, Climate Change Courses And Women In Science
• Podcast Panel Explores Gender Equity In Science And Technology
• IGHD Showcases Shapes Research At Heatnexus International Convening
• CERL and NRL Visit By AKU Dean Of Medicine
• Field Visit To …

Prevalence And Factors Associated With Delayed Surgery Among Children With Wilms Tumor At Mulago Hospital: A Mixed-Method Study, Lule Daniel, Shamim Nabidda, Abraham Muhwezi, Ronald Naitala, Anne Akullo, Enid Kawala Kagoya, Ruth Namazzi, Nasser Kakembo, Joan N. Kalyango

School of Nursing & Midwifery, East Africa

Introduction:  Wilms tumor (WT) is a highly treatable form of childhood cancer, with five-year survival rates greater than 90% in high-income countries. In low- and middle-income countries, survival is still low. Delayed surgery is one of the leading factors for poor survival, as it leads to tumor complications, making subsequent treatment more complex. However, there is a paucity of information in Uganda on the prevalence and factors associated with delayed surgery. This study aimed to determine the prevalence and factors associated with delayed surgery, and to explore the barriers and facilitators of timely surgery among children with WT at …

Variation In Antiviral Immunity And Inflammation Pathways Precedes Hiv-1 Infection In A High-Risk African Cohort, Mwikali Kioko, Shaban Mwangi, Lynn Fwambah, Amin Hassan, Jason Blackard, Philip Bejon, Eduard Sanders, Thumbi Ndung’U, Eunice Nduati, Abdirahman Abdi

Institute for Human Development, East Africa

BACKGROUND. Susceptibility to HIV-1 infection varies between individuals, but the biological determinants of acquisition risk remain poorly defined.

METHODS. We conducted a case-control study nested within a high-risk cohort in Kenya. We compared the plasma extracellular RNA collected before HIV-1 acquisition with that from matched uninfected individuals acting as controls to identify immunological processes linked to infection risk.

RESULTS. Individuals who later acquired HIV-1 exhibited upregulation of immune processes that facilitate viral infection, including T cell suppression and type II IFN and Th2 immune responses. In contrast, processes associated with antiviral defence and tissue repair, such as …

Patient, Family And Clinician Priorities For Critical Care Research In Asia And Africa: A James Lind Alliance Priority Setting Partnership Using Modified Delphi And Nominal Group Techniques, Ccaa Priority Setting Partnership Steering Group, Teddy Abonyo, Sumaiya Arfin, Diptesh Aryal, Abi Beane, Martina Borellini, Arjen Dondorp, Emma Donley, Punam Gautam, Tiffany Gooden

Anaesthesiology, East Africa

Background This James Lind Alliance (JLA) Priority Setting Partnership aimed to identify and prioritise unanswered questions important to adult patients, their families and health professionals with lived experience of critical care across Asia and Africa.

Methods Modified Delphi techniques were used to generate suggestions using an online survey. Following verification, literature review and content analysis, these suggestions were iteratively codified into emergent topics. Topics were presented in a second online survey for ranking, prior to an online workshop where nominal group technique was used to identify top priority questions across stakeholder groups. Surveys were disseminated using snowballing techniques.

Findings The …

“Now That The Baby Is Out, I Can Be Vaccinated”: A Qualitative Study On Covid-19 Vaccine Hesitancy In Pregnant Women In Kilifi, Kenya, Angela Koech, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Richmond Mdindi, Peter Mwangome, Rachel Craik, Marianne Vidler, Mai-Lei Kinshella, Marleen Temmerman

Centre of Excellence in Women and Child Health

COVID-19 vaccines are safe and effective in pregnancy, but vaccine hesitancy limits uptake and effectiveness. This study explored COVID-19 vaccine hesitancy in pregnancy in Kilifi, coastal Kenya, to elicit reasons for vaccine hesitancy and acceptance, and to compile misconceptions around vaccination in pregnancy. Twenty-three in-depth interviews were conducted with pregnant women, mothers who had given birth in the previous 2 years and health workers (community health promoters, nurses, and supervisors). Data were analyzed using thematic template analysis based on the Vaccine Hesitancy Determinants Matrix. Concern about vaccine safety for the unborn baby was a major driver of hesitancy. Many pregnant …