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Purpose: Evidence supporting secondary stroke in sub-Saharan Africa is scarce. This study describes the incidence of stroke recurrence and associated risk factors in sub-Saharan Africa. Methods and Materials: Scientific databases were systematically searched from January 2000 to December 2022 for population-based observational studies, case-control or cohort studies of recurrent stroke involving adults aged 18 years and above in sub-Saharan Africa (SSA). We assessed the quality of the eligible studies using the Critical Appraisal Skills Program (CASP) checklist for observational studies. Results: Six studies met the inclusion criteria and were included in this study. Stroke recurrence rates in SSA ranged from 9.4% to 25%. Majority of the studies were conducted from Western Africa and showed that stroke recurrence rates are high within sub-Saharan Africa ranging from 2% to 25%. The known stroke risk factors such as hypertension, chronic alcohol consumption, etc., remained the leading causes of stroke recurrence. The studies reported a higher mortality rate ranging from 20.5 − 23% among those with recurrent strokes compared to primary strokes. Conclusion: This systematic review is an update and summary of the available literature on stroke recurrence within sub-Saharan Africa. Further studies are warranted to assess the outcomes and burden of stroke recurrence in SSA. [ABSTRACT FROM AUTHOR]

Purpose: There is a documented association between cervical cancer and metabolic syndrome. In this study, we determined the association between lipids, insulin-like growth factor binding protein-3 (IGFBP-3) and treatment outcomes for cervical lesions at Mbarara Regional Referral Hospital (MRRH) in south western Uganda. Patients and Methods: In this prospective cohort study, we recruited 94 cases and 94 controls at the cervical cancer clinic of MRRH, and followed them for 12 months. Cases were confirmed with cytology and/or histology. With consent, we collected demographic data and measured lipids and IGFBP-3 both at baseline and after 12 months. The lipid profile was measured using a Cobas 6000 Chemistry Analyzer, whereas IGFBP-3 was measured using a MAGLUMI fully automated chemiluminescence immunoassay analyzer. Abnormal values for lipids were defined using WHO recommended cut-offs. IGFBP-3 concentrations were divided into two categories of low concentration (< 3.29 μg/mL) and raised concentration (≥ 3.29 μg/mL). Statistical analyses were conducted in STATA version 17 using logistic regression analysis. A p-value of < 0.05 was taken to be statistically significant. Results: The average (mean ± SD) age of our participants was 38.7± 8.2 years for controls and 34.5± 7.8 years for cases. The average serum IGFBP-3 concentration was 3.769± 1.098 μg/mL among cases with cleared lesions and 3.505± 0.979 μg/mL among cases whose lesions persisted. A serum IGFBP-3 concentration of less than 3.291 μg/mL was likely to be associated with clearance of cervical lesions (AOR 1.65, p=0.67), although this was not statistically significant. A serum triglyceride concentration of 35– 135 mg/dL was also likely to be associated with clearance of cervical lesions (AOR 2.41, p=0.46), although this was also not statistically significant. Conclusion: Although not statistically significant, reduced serum concentrations of IGFBP-3 and triglyceride may be associated with clearance of cervical lesions. Lipid management may be of benefit in the treatment of cervical lesions. [ABSTRACT FROM AUTHOR]

The study set out to perform a systematic literature review of evidence-based interventions that target the reduction of secondary stroke risk in Africa. The review analyzed longitudinal intervention studies conducted in Sub-Saharan Africa, focusing on adult participants who had suffered a prior stroke. It encompassed publications and peer-reviewed papers sourced from reputable databases, including PubMed, Ovid, Cochrane, and Web of Science. Three randomized clinical trial (RCT) studies were included with sample sizes ranging from 16 to 400 participants, mean age ranged between 50 and 66 years, with 64.5% male participants. All studies applied multidisciplinary team interventions of enhanced patient follow-up involving care givers, nurse educators, physicians, and social workers. Interventions ranged from comprehensive patient education, tracking of medication adherence and enforcing healthy lifestyle behaviors (regular exercise, regular BP checks, and dietary changes). We found a decrease in Systolic Blood Pressure over time in 2 of 3 treatment groups, an improvement in medical adherence in all treatment groups, and a decrease in cholesterol levels in 1 treatment group. Evidence-based interventions involving multidisciplinary teams and comprehensive patient education were found to demonstrate promising results in reducing secondary stroke risk in Africa, leading to significant improvements in medical adherence and reductions in systolic blood pressure in the majority of treatment groups. However, more research is required to confirm the influence of these interventions on cholesterol levels and to establish their lasting advantages in preventing strokes among African communities. [ABSTRACT FROM AUTHOR]

Background: Globally, about 1.8 million adolescents between the ages of 10 and 19 were living with HIV by close of 2021, of these, about 1.5 million were living in sub-Saharan Africa. This study explored the influence of mass media campaigns in promoting adherence to antiretroviral therapies among adolescents living with HIV in southwestern Uganda. Methods: We conducted a phenomenological qualitative study design that was adopted to explore the role of mass media campaigns on adherence to antiretroviral therapy among adolescents at the adolescents' HIV clinic Mbarara Regional Referral Hospital. The FGDs were conducted in Runyankole-Rukiga, and they were transcribed verbatim and later translated to English. Data were analyzed using thematic analysis. Results: We conducted 7 Focus Group Discussions with adolescents living with HIV aged 10– 19 years and 5 key informants' interviews with the health care providers. Results from the analysis were grouped into three broad themes: awareness of mass media HIV campaigns promoting adherence to ART, influence of mass media campaigns on adherence to antiretroviral therapy, and preferred mass media mode of delivery by adolescents' living with HIV. Participants preferred broadcast media channels and messages that featured success stories of people living with HIV. Conclusion: HIV mass media campaigns influence adherence to antiretroviral therapy among people living with HIV. It is recommended that HIV-related media campaign designers consider the unique needs of adolescents while designing and airing out various media campaigns. This will influence their positive living and thus lead to their increased health life expectancy. [ABSTRACT FROM AUTHOR]

The study set out to determine the seizure control and factors associated with poor seizure control among children with confirmed epilepsy who had been attending the paediatrics epilepsy clinic at MRRH for at least 6 months. Jane Namusisi, SP 1 sp Mark Kaddumukasa, SP 2 sp Martha Sajatovic, SP 3 sp Peter Kalubi SP 1 sp SP 1 sp Department of Pediatrics and Child Health, Mbarara University of Science and Technology (MUST), Mbarara, Uganda; SP 2 sp Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; SP 3 sp Neurological and Behavioral Outcomes Center, University Hospital Case Medical Center, Case Western Reserve University, Cleveland, OH, USA Correspondence: Mark Kaddumukasa, Email [email protected] View the original paper by Dr Namusisi and colleagues This is in response to the Letter to the Editor Dear editor The authors thank Selvi A. Mangundap for the keen interest in our study. Poor Seizure Control Among Children Attending a Tertiary 8 Hospital in South Western Uganda - A Retrospective Study [Response to Letter]. [Extracted from the article]

Introduction: The development of a strong professional identity is influenced by the motivation behind enrolling in a nursing or midwifery programme. Professional identity is a driving force that sustains the commitment of nurses and midwives to nursing/midwifery and their dedication to the well‑being of those they serve. This study evaluated Ugandan students' reasons for enrolling in nursing and midwifery programmes. Furthermore, we investigated the nurse/midwifery practices that support professional identity creation in recent graduates and undergraduate nursing/midwifery students. Methods: A mixed‑method research approach was employed amongst nursing/midwifery students of Makerere University and Mbarara University of Science and Technology and recent nursing/midwifery graduates from Mulago National and Mbarara Regional referral hospitals. We collected quantitative data from 173 participants, and for qualitative data, we conducted six focus group discussions among recent graduates and students of nursing/midwifery. We used descriptive statistics and thematic analysis to analyse the quantitative and qualitative data. Results: Nearly all - 95.4% (165/173) - of the participants were motivated to undertake nursing/midwifery as their programme of study, and 94.2% (163/173) participants identified as nurses/midwives, all with an average score above 3. They also strongly agreed that they took up the programmes because they wanted to learn new things [111/173 (64.2%)] and considered nurses' groups important [68.8% (119/173)]. Participants proposed measures to promote the formation of professional identity among students and graduates, including the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and embedding of ethical principles, recognition and motivation, mentorship, leadership, career guidance and the inclusion of men and challenging of gender stereotypes. Conclusion: Participants were motivated to work in nursing. The ways to promote professional identity included the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and instillation of ethical principles, recognition and motivation, mentorship, leadership, career guidance and male inclusiveness and the challenging of gender stereotypes. Nursing and midwifery leadership needs to provide guidance, mentorship and empowerment; challenge gender stereotypes in nursing/midwifery practice; and give support while advocating for ethical practice., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)