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Article ; Online: COVID-19 vaccines and a perspective on Africa.

Mantovani, Alberto / Rescigno, Maria / Forni, Guido / Tognon, Francesca / Putoto, Giovanni / Ictho, Jerry / Lochoro, Peter

Trends in immunology

2023 Volume 44, Issue 3, Page(s) 172–187

Abstract: Vaccines have dramatically changed the COVID-19 pandemic. Over 30 vaccines that were developed on four main platforms are currently being used globally, but a deep dissection of the immunological mechanisms by which they operate is limited to only a few ... ...

Abstract	Vaccines have dramatically changed the COVID-19 pandemic. Over 30 vaccines that were developed on four main platforms are currently being used globally, but a deep dissection of the immunological mechanisms by which they operate is limited to only a few of them. Here, we review the evidence describing specific aspects of the modes of action of COVID-19 vaccines; these include innate immunity, trained innate immunity, and mucosal responses. We also discuss the use of COVID-19 vaccines in the African continent which is ridden with inequality in its access to vaccines and vaccine-related immunological research. We argue that strengthening immunology research in Africa should inform on fundamental aspects of vaccination, including the relevance of genetics, trained innate immunity, and microbiome diversity.
MeSH term(s)	Humans ; COVID-19 Vaccines ; COVID-19 ; Pandemics/prevention & control ; Vaccines ; Immunity, Innate ; Vaccination
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2023-01-11
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2036831-8
ISSN	1471-4981 ; 1471-4906
ISSN (online)	1471-4981
ISSN	1471-4906
DOI	10.1016/j.it.2023.01.005
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Article ; Online: Reply to: "Back rubs versus foot flicks - Query still persists for our babies".

Cavallin, Francesco / Lochoro, Peter / Ictho, Jerry / Nsubuga, John Bosco / Trevisanuto, Daniele

Resuscitation

2021 Volume 168, Page(s) 246–247

Language	English
Publishing date	2021-10-05
Publishing country	Ireland
Document type	Letter ; Comment
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2021.09.029
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Article ; Online: Corrigendum to "Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: A randomized controlled trial". [Resuscitation 167 (2021) 137-143].

Cavallin, Francesco / Lochoro, Peter / Ictho, Jerry / Nsubuga, John Bosco / Ameo, Jesca / Putoto, Giovanni / Trevisanuto, Daniele

Resuscitation

2021 Volume 169, Page(s) 314

Language	English
Publishing date	2021-10-25
Publishing country	Ireland
Document type	Published Erratum
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2021.10.017
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Article ; Online: Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: A randomized controlled trial.

Cavallin, Francesco / Lochoro, Peter / Ictho, Jerry / Nsubuga, John Bosco / Ameo, Jesca / Putoto, Giovanni / Trevisanuto, Daniele

Resuscitation

2021 Volume 167, Page(s) 137–143

Abstract: Background: Approximately 15% of infants require stimulation in low-resource settings, but data on effectiveness of different stimulation approaches are limited. We aimed to compare two recommended approaches of stimulation (back rubs vs. foot flicks) ... ...

Abstract	Background: Approximately 15% of infants require stimulation in low-resource settings, but data on effectiveness of different stimulation approaches are limited. We aimed to compare two recommended approaches of stimulation (back rubs vs. foot flicks) in reducing the need for face-mask ventilation in newly born infants who were not crying immediately after birth in a low-resource setting. Methods: A single center, open-label, randomized, superiority trial was conducted at St. Kizito Hospital in Matany (Uganda) between November 2019 and May 2020. Newly born infants with expected birthweight > 1500 grams who were not crying immediately after birth were randomly assigned to stimulation using back rubs or foot flicks. The primary outcome measure was the success rate of the stimulation, defined as the achievement of an effective crying preventing the need for face-mask ventilation. Results: Success of stimulation was achieved in 76/93 neonates (82%) using back rubs and 68/93 neonates (73%) using foot flicks (risk ratio 1.12, 95% confidence interval 0.96-1.31). No procedure-associated complications arose during the study. Time to first cry was not statistically different between the two arms (mean difference -11 seconds, 95% confidence interval -39 to 18). Conclusions: In newly born infants who were not crying immediately after birth, this trial did not provide a conclusive message in favor of back rubs or foot flicks. Nonetheless, we could not exclude a possible benefit of back rubs in avoiding the need for positive pressure ventilation and, possibly, further advanced resuscitative maneuvers. Clinical trials registration: clinicalTrial.gov: NCT04056091.
MeSH term(s)	Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Masks ; Positive-Pressure Respiration ; Respiration ; Resuscitation
Language	English
Publishing date	2021-08-23
Publishing country	Ireland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2021.08.028
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Article ; Online: Cardiac Tuberculosis: A Case Series from Ethiopia, Italy, and Uganda and a Literature Review.

The American journal of tropical medicine and hygiene

2024 Volume 110, Issue 4, Page(s) 795–804

Abstract: Extrapulmonary tuberculosis (TB) is estimated to account for up to 20% of active cases of TB disease, but its prevalence is difficult to ascertain because of the difficulty of diagnosis. Involvement of the heart is uncommon, with constrictive ... ...

Abstract	Extrapulmonary tuberculosis (TB) is estimated to account for up to 20% of active cases of TB disease, but its prevalence is difficult to ascertain because of the difficulty of diagnosis. Involvement of the heart is uncommon, with constrictive pericarditis being the most common cardiac manifestation. Diagnostic research for cardiac disease is frequently lacking, resulting in a high mortality rate. In addition to direct cardiac involvement, instances of cardiac events during antitubercular therapy are described. This case series describes five cases of TB affecting the heart (cardiac TB) from Italy and high-burden, low-income countries (Ethiopia and Uganda), including a case of Loeffler syndrome manifesting as myocarditis in a patient receiving antitubercular therapy. Our study emphasizes how cardiac TB, rare but important in high-burden areas, is a leading cause of pericardial effusion or pericarditis. Timely diagnosis and a comprehensive approach, including imaging and microbiological tools, are crucial. Implementing high-sensitivity methods and investigating alternative samples, such as detection of tuberculosis lipoarabinomannan or use of the GeneXpert assay with stool, is recommended in TB control programs.
MeSH term(s)	Humans ; Ethiopia/epidemiology ; Uganda ; Antitubercular Agents/therapeutic use ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/complications ; Pericardial Effusion/diagnosis ; Pericardial Effusion/drug therapy ; Pericardial Effusion/etiology ; Mycobacterium tuberculosis
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Review ; Case Reports ; Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.23-0505
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Article ; Online: Incidence and burden of long COVID in Africa: a systematic review and meta-analysis.

Frallonardo, Luisa / Segala, Francesco Vladimiro / Chhaganlal, Kajal D / Yelshazly, Mohmaoud / Novara, Roberta / Cotugno, Sergio / Guido, Giacomo / Papagni, Roberta / Colpani, Agnese / De Vito, Andrea / Barbagallo, Mario / Madeddu, Giordano / Babudieri, Sergio / Lochoro, Peter / Ictho, Jerry / Putoto, Giovanni / Veronese, Nicola / Saracino, Annalisa / Di Gennaro, Francesco

Scientific reports

2023 Volume 13, Issue 1, Page(s) 21482

Abstract: Long COVID, also known as "post-acute sequelae of COVID-19," affects at least 65 million individuals worldwide with a wide spectrum of symptoms that may last weeks, months, or permanently. Its epidemiology and burden in Africa are unclear. This meta- ... ...

Abstract	Long COVID, also known as "post-acute sequelae of COVID-19," affects at least 65 million individuals worldwide with a wide spectrum of symptoms that may last weeks, months, or permanently. Its epidemiology and burden in Africa are unclear. This meta-analysis examines long-term COVID-19 effects in the WHO African Region. A systematic search in several databases was carried out up to 12 February 2023 including observational studies from African countries reporting the cumulative incidence of long COVID signs and symptoms. Only studies conducted in African countries were included. Several sensitivity and meta-regression analyses were performed. Among 1547 papers initially screened, 25 were included, consisting of 29,213 participants. The incidence of any long COVID symptomatology was 48.6% (95% CI 37.4-59.8) as psychiatric conditions were the most frequent, particularly post-traumatic stress disorder reaching a cumulative incidence of 25% (95% CI 21.1-30.4). Higher age (p = 0.027) and hospitalization (p = 0.05) were associated with a higher frequency of long COVID. Long COVID poses a significant burden in Africa, particularly concerning psychiatric conditions. The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients. High-quality studies addressing this condition in African setting are urgently needed.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Post-Acute COVID-19 Syndrome ; Incidence ; Mental Disorders/epidemiology ; Africa/epidemiology
Language	English
Publishing date	2023-12-06
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-48258-3
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Article: Neurocysticercosis in Low- and Middle-Income Countries, a Diagnostic Challenge from Oyam District, Uganda.

Segala, Francesco Vladimiro / De Vita, Elda / Amone, James / Ongaro, Daniel / Nassali, Ritah / Oceng, Bonny / Okori, Samuel / Putoto, Giovanni / Lochoro, Peter / Ictho, Jerry / Fantoni, Massimo / Saracino, Annalisa / Di Gennaro, Francesco

Infectious disease reports

2022 Volume 14, Issue 4, Page(s) 505–508

Abstract: Background: In countries where : Methods: Here, we report the case of a 73-year-old woman admitted in a rural hospital in Northern Uganda, who presented with seizures and a progressive inability to walk. She was then diagnosed with NCC after a brain ... ...

Abstract	Background: In countries where Methods: Here, we report the case of a 73-year-old woman admitted in a rural hospital in Northern Uganda, who presented with seizures and a progressive inability to walk. She was then diagnosed with NCC after a brain CT scan. Conclusions: This case study represents a rare example of the detection of NCC in a rural district hospital, thus suggesting the potential feasibility of a CT-scan guided diagnostic approach in low resource settings.
Language	English
Publishing date	2022-07-01
Publishing country	Switzerland
Document type	Case Reports
ISSN	2036-7430
ISSN	2036-7430
DOI	10.3390/idr14040054
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Article ; Online: Subacute Cardiac Tamponade Due to Tuberculous Pericarditis Diagnosed by Urine Lipoarabinomannan Assay in a Immunocompetent Patient in Oyam District, Uganda: A Case Report.

De Vita, Elda / Segala, Francesco Vladimiro / Amone, James / Samuel, Kabuga / Marotta, Claudia / Putoto, Giovanni / Nassali, Ritah / Lochoro, Peter / Bavaro, Davide Fiore / Ictho, Jerry / Okori, Samuel / Di Gennaro, Francesco / Saracino, Annalisa

International journal of environmental research and public health

2022 Volume 19, Issue 22

Abstract: Background: Uganda ranks among the countries with the highest burden of TB the world and tuberculous pericarditis (TBP) affects up to 2% of people diagnosed with pulmonary tuberculosis worldwide. In Africa, it represents the most common cause of ... ...

Abstract	Background: Uganda ranks among the countries with the highest burden of TB the world and tuberculous pericarditis (TBP) affects up to 2% of people diagnosed with pulmonary tuberculosis worldwide. In Africa, it represents the most common cause of pericardial disease. Here, we present the case of a 21-year-old male patient who was diagnosed of cardiac tamponade due to tuberculous pericarditis with a positive urine LF-LAM. Case report: We report a case of a 21-year-old male living in Oyam district, Uganda, who presented to the emergency department with difficulty in breathing, easy fatigability, general body weakness, and abdominal pain. A chest X-ray showed the presence of right pleural effusion and massive cardiomegaly. Thus, percutaneous pericardiocentesis was performed immediately and pericardial fluid resulted negative both for gram staining and real-time PCR test Xpert MTB/RIF. The following day's urine LF-LAM test resulted positive, and antitubercular therapy started with gradual improvement. During the follow-up visits, the patient remained asymptomatic, reporting good compliance to the antitubercular therapy. Conclusion: Our case highlights the potential usefulness of a LF-LAM-based diagnostic approach, suggesting that, in low-resource settings, this test might be used as part of routine diagnostic workup in patients with pericardial disease or suspected extra-pulmonary tuberculosis.
MeSH term(s)	Male ; Humans ; Young Adult ; Adult ; Pericarditis, Tuberculous/complications ; Pericarditis, Tuberculous/diagnosis ; Cardiac Tamponade/etiology ; Uganda ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/complications ; Antitubercular Agents
Chemical Substances	lipoarabinomannan ; Antitubercular Agents
Language	English
Publishing date	2022-11-17
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph192215143
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Article ; Online: Quality of healthcare for children with severe acute malnutrition in a refugee setting: cross-sectional study in West Nile Region, Uganda.

Lazzerini, Marzia / Wanzira, Humphrey / Lochoro, Peter / Ndunguste, Amos / Ictho, Jerry / Katungi, Ambrose / Mariani, Ilaria / Putoto, Giovanni

BMJ open

2020 Volume 10, Issue 6, Page(s) e034738

Abstract: Objectives: 5.0 million annual deaths in low-income and middle-income countries are due to poor quality of care (QOC). We evaluated the QOC provided to malnourished children in West Nile Region in Uganda.: Design: Cross-sectional study.: Setting: ... ...

Abstract	Objectives: 5.0 million annual deaths in low-income and middle-income countries are due to poor quality of care (QOC). We evaluated the QOC provided to malnourished children in West Nile Region in Uganda. Design: Cross-sectional study. Setting: West Nile Region, an area hosting over one million refugees. Participants: Among 148 facilities providing nutritional services, 30 randomly selected facilities (20%) and the records of 1467 children with severe acute malnutrition (100% of those attending the 30 facilities during last year) were assessed. Outcomes: The national Nutrition Service Delivery Assessment (NSDA) tool was used to assess capacity areas related to QOC. Case management, data quality and health outcomes were assessed from official health records. Multivariate analysis was performed to explore factors significantly associated with better cure rates. Results: Of 305 NSDA scores allocated to 30 participating centres, 201 (65.9%) were 'good' or 'excellent'. However, 20 (66.7%) facilities had 'poor' 'quality improvement mechanisms' and 13 (43.3%) had 'poor' 'human resources'. Overall data quality in official records was poor, while recorded quality of case management was overall fair. Average cure rate was significantly lower than international Sphere standards (50.4% vs 75% p<0.001) with a higher default rate (23.2% vs 15% p<0.001). Large heterogeneity among facilities was detected for all indicators. Refugee-hosting and non-refugee-hosting facilities had a similar cure rate (47.1% vs 52.1%) though transfer rates were higher for those hosting refugees (21.5% vs 1.9%, p<0.001) despite better 'equipment and supplies'. 'Good/excellent' 'equipment' and 'store management' were significantly associated with better cure rates in outpatient therapeutic centres (+55.9, p<0.001; +65.4, p=0.041, respectively) in multivariate analysis. Conclusions: Though most NSDA capacity areas were rated good or excellent, health outcomes of malnourished children in West Nile Region, both in refugee-hosting and non-refugee-hosting facilities, are significantly below international standards. Effective and sustainable approaches to improve malnourished child health outcomes are needed.
MeSH term(s)	Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Quality of Health Care ; Refugees ; Severe Acute Malnutrition/epidemiology ; Severe Acute Malnutrition/therapy ; Uganda/epidemiology
Language	English
Publishing date	2020-06-11
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-034738
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Article ; Online: Capacity assessment for provision of quality sexual reproductive health and HIV-integrated services in Karamoja, Uganda.

Marotta, Claudia / Lochoro, Peter / Pizzol, Damiano / Putoto, Giovanni / Mazzucco, Walter / Saracino, Annalisa / Monno, Laura / Di Gennaro, Francesco / Ictho, Jerry

African health sciences

2020 Volume 20, Issue 3, Page(s) 1053–1065

Abstract: Introduction: Sexual and reproductive health (SRH) and Human Immunodeficiency Virus (HIV) are crucial global health issues. Uganda continues to sustain a huge burden of HIV and AIDS.: Methods: A cross-sectional health facility-based assessment was ... ...

Abstract	Introduction: Sexual and reproductive health (SRH) and Human Immunodeficiency Virus (HIV) are crucial global health issues. Uganda continues to sustain a huge burden of HIV and AIDS. Methods: A cross-sectional health facility-based assessment was performed in November and December 2016 in Karamoja Region, northern Uganda. All the 126 health facilities (HFs) in Karamoja, including 5 hospitals and 121 Health Centers (HCs), covering 51 sub-counties of the 7 districts were assessed. We assessed the capacity of a) leadership and governance, b) human resource, c) service delivery, d) SRH and HIV service integration and e) users satisfaction and perceptions. Results: 64% of the established health staffing positions were filled leaving an absolute gap of 704 units in terms of human resources. As for service delivery capacity, on 5 domains assessed, the best performing was basic hygiene and safety measures in which 33% HCs scored "excellent", followed by the presence of basic equipment. The level of integration of SRH/HIV services was 55.56%. Conclusion: HFs in Karamoja have capacity gaps in a number of health system building blocks. Many of these gaps can be addressed through improved planning. To invest in improvements for these services would have a great gain for Uganda.
MeSH term(s)	Adolescent ; Adult ; Capacity Building ; Cross-Sectional Studies ; Delivery of Health Care, Integrated/organization & administration ; Delivery of Health Care, Integrated/statistics & numerical data ; Female ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Health Facilities ; Humans ; Middle Aged ; Reproductive Health ; Reproductive Health Services/organization & administration ; Reproductive Health Services/statistics & numerical data ; Sexual Health ; Socioeconomic Factors ; Surveys and Questionnaires ; Uganda/epidemiology ; Young Adult
Language	English
Publishing date	2020-12-15
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2240308-5
ISSN	1729-0503 ; 1680-6905
ISSN (online)	1729-0503
ISSN	1680-6905
DOI	10.4314/ahs.v20i3.8
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