Background: Coronavirus disease-2019 (COVID-19) is an emerging public health problem threatening the life of over 2.4 million people globally. The present study sought to determine knowledge, attitude and practices (KAP) of health care workers (HCWs) toward COVID-19 in Makerere University Teaching Hospitals (MUTHs) in Uganda. Methods: An online cross sectional, descriptive study was undertaken through WhatsApp Messenger among HCWs in four MUTHs. HCWs aged 18 years and above constituted the study population. KAP toward COVID-19 was assessed by using a pre-validated questionnaire. Bloom's cut-off of 80% was used to determine sufficient knowledge (≥80%), positive attitude (≥4), and good practice (≥2.4). All analyses were performed using STATA 15.1 and GraphPad Prism 8.3. Results: Of the 581 HCWs approached, 136 (23%) responded. A vast majority of the participants were male (n = 87, n = 64%), with a median age of 32 (range: 20–66) years. Eighty-four (62%) were medical doctors and 125 (92%) had at least a bachelor's degree. Overall, 69% (n = 94) had sufficient knowledge, 21% (n = 29) had positive attitude, and 74% (n = 101) had good practices toward COVID-19. Factors associated with knowledge were age >40 years (aOR: 0.3; 95% CI: 0.1–1.0; p = 0.047) and news media (aOR: 4.8; 95% CI: 1.4–17.0; p = 0.015). Factors associated with good practices were age 40 years or more (aOR: 48.4; 95% CI: 3.1–742.9; p = 0.005) and holding a diploma (aOR: 18.4; 95% CI: 1–322.9; p = 0.046). Conclusions: Continued professional education is advised among HCWs in Uganda to improve knowledge of HCWs hence averting negative attitudes and promoting positive preventive and therapeutic practices. We recommend follow up studies involving teaching and non-teaching hospitals across the country.

Given the dearth need for healthcare workers in the control of the ongoing COVID-19 pandemic, e-learning has been adopted in many settings to hasten the continuation of medical training. However, there is a paucity of data in low resource settings on the plausibility of online learning platforms to support medical education. We aimed to assess the awareness, attitudes, preferences, and challenges to e-learning among Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Nursing (B.NUR) students at Makerere University, Uganda. An online cross-sectional study was conducted between July and August 2020. Current MBChB and B.NUR students aged 18 years or older constituted the study population. Using Google forms, a web-based questionnaire was administered through the Makerere University mailing list and WhatsApp messenger. The questionnaire was developed using validated questions from previously published studies. Overall, 221 participants responded (response rate = 61%). Of the 214 valid responses, 195 (92.1%) were Ugandans, 123 (57.5% were male, and 165 (77.1%) were pursuing the MB ChB program. The median age was 23 (18 to 40) years. Ownership of computers, smartphones, and email addresses were at 131 (61.2%), 203 (94.9%), and 208 (97.2%), respectively. However, only 57 (26.6%) respondents had access to high or very high quality internet access. Awareness and self-reported usage of e-learning (MUELE) platforms were high among 206 (96.3%) and 177 (82.7%) respondents, respectively. However, over 50% lacked skills in using the Makerere University e-learning (MUELE) platform. About half (n = 104, 49%) of the students believed that e-learning reduces the quality of knowledge attained and is not an efficient method of teaching. Monthly income (P = .006), internet connectivity quality (P < .001), computer ownership (P = .015) and frequency of usage of academic websites or applications (P = .006) significantly affected attitudes towards e-learning. Moreover, internet costs and poor internet connectivity were the most important barriers to e-learning reported by 199 (93%) and 179 (84%) students, respectively. Sensitization and training of students and faculty on e-learning and use of existing learning platforms are important to improve the attitude and use of e-learning. Blended online and use of offline downloadable learning materials would overcome the challenges related to the variable quality of internet access in the country.

Background: The coronavirus disease (COVID-19) pandemic is a global public health concern affecting over 5 million people and posing a great burden on health care systems worldwide. Objective: The aim of this study is to determine the knowledge, attitude, and practices of medical students in Uganda on the COVID-19 pandemic. Methods: We conducted an online, descriptive cross-sectional study in mid-April 2020, using WhatsApp Messenger. Medical students in 9 of the 10 medical schools in Uganda were approached through convenience sampling. Bloom’s cut-off of 80% was used to determine good knowledge (≥12 out of 15), positive attitude (≥20 out of 25), and good practice (≥12 out of 15). Results: The data of 741 first- to fifth-year medical students, consisting of 468 (63%) males with a mean age of 24 (SD 4) years, were analyzed. The majority (n=626, 84%) were pursuing Bachelor of Medicine and Bachelor of Surgery degrees. Overall, 671 (91%) had good knowledge, 550 (74%) had a positive attitude, and 426 (57%) had good practices. Knowledge was associated with the 4th year of study (adjusted odds ratio [aOR] 4.1, 95% CI 1.6-10.3; P<.001). Attitude was associated with the female sex (aOR 0.7, 95% CI 0.5-1; P=.04) and TV or radio shows (aOR 1.1, 95% CI 0.6-2.1; P=.01). Practices were associated with the ≥24 years age category (aOR 1.5, 95% CI 1.1-2.1; P=.02) and online courses (aOR 1.8, 95% CI 1.1-3.2; P=.03). In total, 592 (80%) medical students were willing to participate in frontline care if called upon. Conclusions: Medical students in Uganda have sufficient knowledge of COVID-19 and will be a large reservoir for health care response when the need arises.

Immunization is an important strategy for controlling the COVID-19 pandemic. COVID-19 vaccination was recently launched in Uganda, with prioritization to healthcare workers and high-risk individuals. In this study, we aimed to determine the acceptability of COVID-19 vaccine among persons at high risk of COVID-19 morbidity and mortality in Uganda. Between 29 March and 14 April 2021, we conducted a cross-sectional survey consecutively recruiting persons at high risk of severe COVID-19 (diabetes mellitus, HIV and cardiovascular disease) attending Kiruddu National Referral Hospital outpatient clinics. A trained research nurse administered a semi-structured questionnaire assessing demographics, COVID-19 vaccine related attitudes and acceptability. Descriptive statistics, bivariate and multivariable analyses were performed using STATA 16. A total of 317 participants with a mean age 51.5 ± 14.1 years were recruited. Of this, 184 (60.5%) were female. Overall, 216 (70.1%) participants were willing to accept the COVID-19 vaccine. The odds of willingness to accept COVID-19 vaccination were four times greater if a participant was male compared with if a participant was female [adjusted odds ratio (AOR): 4.1, 95% confidence interval (CI): 1.8–9.4, p = 0.00]. Participants who agreed (AOR: 0.04, 95% CI: 0.01–0.38, p = 0.003) or strongly agreed (AOR: 0.04, 95% CI: 0.01–0.59, p = 0.005) that they have some immunity against COVID-19 were also significantly less likely to accept the vaccine. Participants who had a history of vaccination hesitancy for their children were also significantly less likely to accept the COVID-19 vaccine (AOR: 0.1, 95% CI: 0.01–0.58, p = 0.016). The willingness to receive a COVID-19 vaccine in this group of high-risk individuals was comparable to the global COVID-19 vaccine acceptance rate. Increased sensitization, myth busting and utilization of opinion leaders to encourage vaccine acceptability is recommended.

Background: Depression affects about a third of medical students worldwide. There is paucity of data on depression among medical students in Uganda. The purpose of this study was to establish the prevalence and factors associated with depression among medical students at Makerere University College of Health Science (MakCHS), Uganda. Methods: A cross-sectional study was conducted among students pursuing a Bachelor of Medicine and Surgery at MakCHS in May and July 2019. Students were enrolled by consecutive sampling, both online using Google Forms and in person for those unable to access internet. The self-reported Patient Health Questionnaire 9 (PHQ9) was administered to assess depression, defined as a PHQ9 score ≥ 10. Microsoft Excel 2016 and Stata 16 were used for data analysis. Results: Overall, 331 valid responses (mean age 23.1± 3.3 years) were submitted (response rate 93.8%). In a majority of participants, the prevalence of depression was 21.5% (n=71) of which 64.1% had moderate depression (n=50). On bivariate analysis, year of study, worrying about academic performance, and lectures were significantly associated with depression. On multivariate analysis, worrying about academic performance (aOR 2.52, 95% CI 1.50– 4.22; P< 0.001) and lectures (aOR 1.89, 95% CI 1.11– 3.22; P=0.018) were significantly associated with depression. Conclusion: Depression affects a significant number of medical students at MakCHS. About one in five medical students have depression. Year of study and academic performance were significantly associated with depression. Efforts aimed at identification and evaluation of students at risk, administering appropriate interventions, and follow-up of affected students are vital. Analytical studies aimed at establishing the causative factors and the effects of depression on medical students are recommended.

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.