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    Access to the World Health Organization-recommended essential diagnostics for invasive fungal infections in critical care and cancer patients in Africa: A diagnostic survey
    (Journal of Infection and Public Health, 2023-08-16) Tufa, Tafese Beyene; Bongomin, Felix; Fathallah, Akila; Luísa S.M., Ana; Hashad f, Rola; Soussi Abdallaoui g, Maha; Ahmed Nail h, Abdelsalam; Adetona Fayemiwo, Samuel; Penney, Richard O.S.; Orefuwa, Emma; Denning, David W.
    Background: Invasive fungal infections (IFIs) contribute to significant morbidity and mortality among patients with haemato-oncological conditions, seriously ill hospitalised patients and those in intensive care (ICU). We surveyed for the World Health Organization-recommended essential diagnostic tests for IFIs in these risk groups in Africa. Methods: The Global Action For Fungal Infections (GAFFI) evaluated the different levels of access to both diagnostics for IFIs for populations in Africa, with the aim of building a comparative dataset and a publicly available interactive map. Data was collected through a validated questionnaire administered to a country leader in relevant topics (i.e., HIV, laboratory coordination) and/or Ministry of Health representatives and followed up with 2 rounds of validation by video calls, and later confirmation by email of findings. Results: Initial data was collected from 48 African countries covering 99.65 % of the population.Conventional diagnostics such as blood cultures, direct microscopy and histopathology were often used for diagnosis of IFIs in more than half of the facilities. Bronchoscopy was rarely done or not done in 20 countries (population 649 million). In over 40 African countries (population > 850 million), Aspergillus antigen testing was never performed in either the public or private sectors. Computed tomography (CT) imaging is routinely used in 27 (56 %) of countries in the public sector and 21 44 %) in the private sector. However, magnetic resonance imaging remains relatively uncommon in most African countries. Conclusions: There are critical gaps in the availability of essential diagnostics for IFIs in Africa, particularly Aspergillus antigen testing and modern medical imaging modalities. Early diagnosis and commencement of targeted therapy of IFIs are critical for optimal outcomes from complex cancer therapies
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    Long COVID in Uganda: Electrographic findings among patients at risk
    (Wiley, 2023-03-13) Semulimi, Andrew Weil; Batte, Charles; Iraguha, Daniel; Okwir, Pamela Apio; Atuhaire, Hope; Lipoto, Chelsea; Muwonge, Tonny; Namirembe, Norah; Lubega, Grace Biyinzika; Ainembabazi, Provia; Mukisa, John; Bongomin, Felix; Ssinabulya, Isaac; Okello, Emmy
    Background: COVID-19 has a significant cardiovascular involvement. An electrocardiographic (ECG) abnormalities among people at a risk of Long COVID in Uganda was investigated. Methods: A cross-sectional study was conducted from February to June 2022 at the post COVID-19 clinic in Mulago National Specialized Hospital, Kampala. A standard resting ECG was performed on individuals at least 2 months following acute COVID-19, with a negative SARS-CoV-2 reverse-transcription polymerase chain reaction. Socio-demographic and clinical characteristics as well as vital signs were recorded for all study participants. Results: Of the 244 study participants, 117 (47.9%) were female. The median age of all the participants was 33.0 (interquartile range: 26.0–43.5) years. Twenty-five (10.2%) participants had a history of smoking, whereas 117 (48%) had a history of alcohol intake. In total, 46 (18.9%) had abnormal ECG findings (95% Confidence Interval [CI]: 14.39–24.29), and nonspecific T-wave inversion (n = 16, 34%) was the most frequent ECG abnormality. The proportion of participants with ECG abnormalities was 48% lower among females (adjusted prevalence ratio [aPR]: 0.52, 95% CI: 0.28–0.96, p value <0.05) and twofold greater for those with a history of smoking (aPR: 2.03, 95% CI: 1.096–3.776, p value <0.05). Conclusion: One in five Ugandans who were checked at the clinic at a risk of Long COVID showed ECG abnormalities. ECG screening is suggested to be integrated into the follow-up care of those at a risk of Long COVID
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    Invasive Fungal Diseases in Africa:
    (MDPI, 2022-11-22) Bongomin, Felix; Ekeng, Bassey E.; Kibone, Winnie; Nsenga, Lauryn; Olum, Ronald; Itam-Eyo, Asa; Ngouanom Kuate, Marius Paulin; Pebolo, Francis Pebalo; Davies, Adeyinka A; Manga, Musa; Ocansey, Bright; Kwizera, Richard; Baluku, Joseph Baruch
    Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.
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    Prevalence of Use of Herbal Medicines for the Treatment of Sickle Cell Disease in Africa: a Systematic Review and Meta-analysis
    (Elsevier, 2023-08-11) Awora, S.; Bongomin, F.; Kaggwa, M.M.; Pebalo, F.P.; Musoke, D.
    Introduction: Several herbal medicines have been reported to ameliorate sickle cell disease (SCD) complications in many African communities. However, no comprehensive review has evaluated the use of herbal remedies for treating SCD crises. Therefore, this study aimed to determine the prevalence of the use of herbal medicines for the treatment of SCD in Africa. Methods: Following registration of the review protocol with PROSPERO (CRD42022346755), searched PubMed, Embase, Africa Journal Online, and Web of Science databases using the keywords ‘herbal medicine,’ ‘SCD,’ and ‘Africa’ on 1st August 2022 for peer-reviewed articles without language restriction. We included articles that reported the prevalence of herbal medicine use for SCD treatment in Africa and excluded qualitative studies, letters to editors, case reports, and editorials. All included papers were assessed using the modified Newcastle Ottawa quality assessment scale for observational studies. We used the random-effect model to calculate the pooled prevalence of herbal medicine use for SCD treatment with STATA 17.0. Results: Overall, 142 research articles were identified. Of this, three cross-sectional studies involving 702 chil dren with SCD from Uganda (n = 1) and Nigeria (n = 2) met the eligibility criteria and were included. Four hundred thirty-four individuals from the included studies used herbal medicines for the management of SCD. The prevalence of current herbal medicine use in individual studies ranged from 36.4% to 78.0%, with a pooled prevalence of 59% (95% confidence interval: 35.0–82.0, I 2 = 97.68%, P < 0.001). Conclusions: Almost three in five persons with SCD in Africa use herbal remedies as a form of treatment. However, there is limited data detailing the magnitude of the prevalence of use of herbal medicines for the treatment of SCD across different regions. Therefore, further studies are encouraged to explore the prevalence of use of herbal remedies for the management of SCD in Africa.