Background: Screening for sickle cell traits before marriage or producing children is one of the outstanding preventive measures for sickle cell disease (SCD).The disease is a collection of inherited blood disorders that impact millions globally, with a predominant 75% occurrence in the sub-Saharan region. With increasing burden of SCD on the continent amidst a cost effective prevention method, no study has systematically reviewed or presented meta-analytic uptake or practice of premarital sickle cell trait screening. Methods: This review systematically explored the uptake or practice of premarital genotype screening in Africa. We searched PubMed and Scopus databases for African studies on premarital screening for sickle cell traits. Results: Our results indicate that the pooled uptake of premarital sickle cell trait screening in Africa is 47.82% (95% CI: [46.53–49.11]; I²: 98.95% [98.74–99.13]). Our review observed, a significant relationship between the awareness of sickle cell disease and the uptake of genotype screening; F(1, 13) = 12.04, p = 0.004). The model explained approximately 48.08% of the variation in genotype screening (R² = 0.4808) and predicted a 0.729 increase in the likelihood of genotype screening uptake for every unit rise in sickle cell disease awareness (β = 0.729, p = 0.004). Additionally, Pearson correlation (r = 0.6934) indicated a moderately strong positive correlation between the two variables. Conclusion: With over 75% of the global burden of sickle cell disease domiciled in Africa, the continent cannot overlook the cost of hemoglobinopathies. The uptake of sickle cell traits screening is suboptimal across the continent. To achieve the mandate of sustainable development goal number (3); to end preventable deaths of newborns and children under 5 years of age by 2030, there is need to intensify campaigns on premarital genetic screening through education and other health promotion tools.

In Uganda, many people self-medicate and the practice raises important questions about access to healthcare, patient choices, and the increasing prevalence of antimicrobial resistance. This systematic review and meta-analysis investigated the prevalence and factors associated with self-medication in Uganda. We searched Scopus, PubMed, and Embase databases, WHO AFRO, UNIPH registries, and Google Scholar search engine from inception to November 2024 using the algorithm “Self-Medication” AND “Uganda”. Twenty-two eligible studies were included while adhering to the preferred reporting items for systematic reviews and meta-analysis (PRISMA). A total of 9113 participants were represented across different demographics and regions of Uganda. Our analysis revealed a 55.63% (95%CI [40.40; 70.66] pooled prevalence of self-medication in Uganda. Antibiotics are the commonly self-medicated drugs and ease of access to medications, perceived cost effectiveness, long hospital waiting time, home storage of drugs (leftovers), and perceptions of minor illnesses were key contributors to self-medication behaviour. At least 1 in 2 Ugandans self-medicate and antibiotics constitute the dominant self-medicated drugs compounding the situation in an era of antimicrobial resistance. Awareness campaigns on the dangers of self-medication will be timely.

Globally, large proportions of Candida species are becoming a major threat to human health as they are developing resistance to most available antifungal drugs. The recent adoption of nanoparticles as an intervening strategy against resistant microbes has proven efficient. Besides their antifungal activities, several studies have reported the anticandida properties of nanoparticles fabricated from plant materials. In this systematic review, available data from the literature on the anticandida potentials of nanoparticles biosynthesized from tea leaf (Camellia sinensis) extracts were compiled and analyzed. A total of 30 studies were generated from a literature search in three electronic databases i.e. Scopus, PubMed, and Embase, in accordance to the PRISMA guidelines. The retrieved studies were filtered based on inclusion and exclusion criteria. We included nine (9) eligible articles that highlighted the antifungal efficacy of nanoparticles mediated from tea leaf extract against Candida species. From the selected articles, the antifungal effect of synthesized NPs against C. albicans, C. tropicalis, C. glabrata, C. dubliniensis, and C. parapsilosis was reported and expressed by the zone of inhibition (ZOI) diameter and the minimum inhibitory concentration (MIC). The studies analysis showed the potency of plant extract-mediated NPs against Candida species, regardless of the heterogeneity of results that was spotted in the diameter of ZOI presented from one study to another.

Background: Diabetes mellitus is increasing in Africa, and diabetes-related amputations exacerbated by diabetic foot infection are also prevalent with Staphylococcus aureus and Pseudomonas aeruginosa two priority pathogens playing key roles. Understanding the local epidemiology and antimicrobial resistance profiles of these dominant pathogens is crucial for appropriate antibiotic therapy. Main body of This systematic review and meta-analysis aim to contribute valuable insights that can guide the management of diabetic foot ulcer-related infections in Africa by comprehensively analyzing the available literature on the prevalence and antimicrobial resistance profiles of Staphylococcus aureus and Pseudomonas aeruginosa in infected diabetic foot ulcers across Africa. We conducted a continent-based literature search utilizing PubMed and Scopus databases on June 11th, 2023, to identify studies conducted in Africa among persons with diabetic foot ulcers that reported isolating bacteria from the foot ulcers. The main concepts related to this research, “diabetic foot ulcers”, “diabetic foot infections”, “bacteria” and “Africa” were expanded with their synonyms and combined using Boolean operators (AND, OR) to formulate the final search query. The selection and inclusion of studies followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Our review revealed that approximately 4124 bacteria have been isolated from diabetic foot ulcers across 13 African countries. Staphylococcus aureus is the dominant species with a random effect pooled prevalence of 19.9% (95%CI: [16.19–23.84%]; I² = 88.56% [82.26–92.62%]) followed by Pseudomonas aeruginosa with 11.8% (95%CI: [8.67–15.23%]; I² = 89.95% [84.67–93.41%]). Methicillin-resistant Staphylococcus aureus (MRSA) pooled 12.9% (95%CI: [3.99–25.89%]; I² = 95.47% [93.68–96.75%]). Multidrug-resistant S.aureus and P. aeruginosa pooled prevalence is 26.4% (95%CI: [17.84–36.06%]; I² = 71.16% [49.34–83.58%]) and 41.8% (95%CI: [27.38–56.91%]; I² = 78.48% [60.80–88.18%]), respectively. Short conclusion: Staphylococcus aureus dominates diabetic foot ulcer (DFU) isolates in Africa contrary to the prevailing assertion about Pseudomonas aeruginosa. However, multidrug resistance among both species is high emphasizing the need for antimicrobial stewardship and utilization of other wound management protocols such as topical silver sulfadiazine (SSD) for the duo.

Background: Diabetes is a growing health concern globally. Poorly managed diabetes may result in diabetic foot ulcers (DFU), which can become a source of chronic infection known as diabetic foot infections. The increasing trend of diabetes in Uganda speaks to the potential for diabetic foot ulcers which may eventually become infected and their attendant impact on the quality of life of diabetic patients. This review assesses the microbial diversity of DFUs in Uganda, aiming to guide treatment and identify research gaps. Main Body of the Abstract: We searched PubMed, Scopus and Embase for studies conducted in Uganda that reported isolating microorganisms from diabetic foot ulcers. Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA), we included two eligible studies that reported isolating 122 bacteria spread across eleven (11) species using swab samples and conventional culture methods. Significant isolates included World Health Organization priority pathogens including: Enterobacter specie, Staphylococcus aureus, Klebsiella pneumoniae, and Acinetobacter specie. Methicillin resistant Staphylococcus aureus (MRSA) constituted 33.3% of Staphylococci species and 26% of all bacterial isolates while extended-spectrum beta-lactamase producing Escherichia coli and Klebsiella specie constituted 14.29% of total microbial isolates. Most bacteria showed susceptibility to Imipenem, Vancomycin, Ciprofloxacin, and Clindamycin, but resistance to Cotrimoxazole and Ampicillin was noted. Short Conclusion: We conclude that data on the microbiology of DFUs in Uganda is scarce; however, the bioburden of DFUs in the country is similar to those in other parts of the world, and MRSA poses a challenge to antibiotic therapy. Consequently, the continued use of swab samples and conventional culture and sensitivity methods may limit the isolation, identification, and presentation of other important isolates. We recommend characterization of bacterial isolates to better understand their genetic makeup, and the development of a national guideline for managing diabetic foot infections.

Background: The concerning frequency of K. pneumoniae in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR-K. pneumoniae in the Kitagata hot spring, Southwestern Uganda. Methods: A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes viz. bla_TEM, bla_CTX-M and bla_KPC. Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis. Results: K. pneumoniae accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored bla_TEM gene alone and both bla_TEM and bla_CTX genes, followed by bla_KPC alone (33.3%), with 25% harboring all three resistance genes. During the dry season, K. pneumoniae had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR-K. pneumoniae significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either bla_TEM alone or bla_TEM+KPC+CTX genes. Conclusion: Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR-K. pneumoniae harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.