Forced displacement is high globally as populations are increasingly displaced by conflicts and disasters. Substance misuse is increasingly recognized as a major cause of morbidity and mortality in displaced populations. This study aimed to investigate the correlates of alcohol misuse among internally displaced adults in Northern Cross River, Nigeria. A cross-sectional study was conducted in Ogoja displacement settlements. Three-hundred and thirty-five displaced adults were selected using snowball sampling method. Alcohol dependence was measured using the interviewer-administered Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Data were analyzed using descriptive statistics, Chi-square, and multivariable logistic regression. The prevalence of alcohol misuse was 26.3%. The multivariate analysis revealed that male gender (AOR=7.28; p<0.001), farming occupation (AOR=4.44; p=0.003), discrimination (AOR=3.49; p=0.001), financial strains (AOR=0.12; p=0.002), overcrowded shelters (AOR=3.49; p=0.001), fear of reprisals (AOR=2.49; p=0.016), and concerns about health and safety (AOR=0.087; p<0.001) were significantly associated with alcohol dependence among IDPs in this study. These findings indicate that nearly three out of every ten displaced adults were alcohol-dependent as a result of traumatic events, life events, and deprivation of basic care. Protection, social, and psychological remedies are required to foster relief and reintegration efforts for internally displaced persons in Nigeria.

The role of the microbiome in COVID-19 outcomes remains an area of exploration. We comprehensively explored the gut microbiome of Ugandan COVID-19 patients and inferred potential implications. Stool and demographic data were collected from 100 COVID-19 confirmed cases at the covid isolation and treatment centers in Kampala during the first and second waves of the pandemic in Uganda (2020 and 2021, respectively). 16S rRNA sequencing was performed on the DNA extracted from stool, followed by bioinformatics analysis. Machine-learning techniques were used to determine microbes that were associated with disease severity. We observed differences in microbial composition between COVID-19 patients and healthy controls. Pathogenic bacteria such as Klebsiella oxytoca, Salmonella enterica and Serratia marcescens had an increased presence in COVID-19 disease states, especially severe cases. Additionally, there was an increase in opportunistic pathogens like Enterococcus species, along with a decrease in beneficial microbes, such as Alphaproteobacteria, when comparing mild and severe cases. Machine-learning identified age and microbes like Ruminococcaceae, Bacilli, Enterobacteriales, porphyromonadaceae and Prevotella copri as predictive of severity. The microbiome likely plays a role in the dynamics of SARS-CoV-2 infection in Ugandan patients. The shift in abundance of specific microbes can moderately predict severity of COVID-19 in this population. Not applicable.

To investigate the relationship between type 2 diabetes mellitus and postmenopausal women with fracture risk when using PPIs. We conducted an observational study to investigate the association between PPI use and an increased fracture risk in postmenopausal women and type 2 diabetes mellitus. We searched for epidemiological studies published between 2006 and 2023 in PubMed, Google Scholar, and other bibliographies of the retrieved papers. The pooled OR was obtained using the random-effects model, and a subgroup analysis was conducted. Eight studies, including six cohorts and two case-control studies, were conducted with 1.3 million participants. In these studies, 1,63,346 cases of fracture risk were identified. The pooled effect estimate of these studies was OR 1.61, with a 95% CI of 1.36-1.90. This indicates a significant correlation between Type 2 diabetes mellitus, post-menopausal women, and the risk of fractures. The OR for type 2 DM alone was 1.34 (95% CI 1.14-1.57), and for menopausal women alone, the OR was 2.15 (95% CI 1.36-1.90). Notably, there was no evidence of publication bias. This meta-analysis provides strong evidence that PPI use in type 2 DM and menopausal women is significantly associated with the risk of developing fractures.

The burden and clinical correlates of dementia are unknown in Uganda. We therefore determined the prevalence and factors associated with dementia among older persons in Northern Uganda. In a cross-sectional study, adults aged 60 years and above attending the medical outpatient clinic at a tertiary Hospital from March 2022 to April 2022 were enrolled. The prevalence of dementia was determined using the Intervention for Dementia in Elderly Africans (IDEA) and the Instrumental Activities of Daily Living (IADL) tool henceforth presented as IDEA-IADL. Factors of association were collected using a standardized questionnaire. A total of 271 eligible participants were enrolled into the study. Majority were age 60-69 years (153/271) and of male gender (165/271). The prevalence of dementia was 17.7% (48/271), severe dementia 7.4%, (20/271), moderate dementia 10.3%, (28/271). Factors independently associated with dementia were: participants aged between 80-89 years; (adjusted odds ratio (aOR): 9.7; 95% Confidence Interval (CI): 4.08-23.07, p< 0.001), family history of dementia (aOR: 3.4, 95CI: 1.62-7.04, p=0.001). history of depression (aOR: 2.7, 95CI: 1.40-5.02, p=0.003). Physical activity and cognitive exercise were associated protective factors with (aOR 0.1, 95CI: 0.03-0.24, p< 0.001) and (aOR 0.2, 95CI: 0.06-0.53, p<0.002) respectively. There burden of dementia among older persons in Northern Uganda is significant. Enhanced screening and early identification of dementia is recommended in this setting.

Tuberculosis control in Tasikmalaya relies on competent drug supervisors (DS) to ensure adherence, yet knowledge gaps remain. To assess factors influencing DS effectiveness in Tasikmalaya, Indonesia. A cross-sectional study of 121 DS was conducted. Data on sociodemographic factors, knowledge, attitudes, and practices were collected through validated questionnaires. Logistic regression was used to identify determinants of DS performance. Female and officially designated DS were significantly more effective in ensuring adherence compared to males and voluntary DS. Overall knowledge was inadequate among most DS (95.9%). Cadres performed better than family members in supervisory tasks. Improving DS capacity-especially family and male supervisors-through structured training and official designation can enhance TB treatment outcomes.

Prescribing processes for the elderly are complex and challenging due to advanced age-related physiologic changes, co-morbidities, and co-medications which increase the chances of medication errors. There are, however, limited studies on the magnitude and profiles of medication errors among elderly populations in low-resource settings such as Tanzania. To determine the prevalence and profiles of medication errors among elderly in-patients at Mwananyamala Regional Referral Hospital (MRRH) in Dar-es-Salaam in Tanzania. Medical data were analyzed of patients aged 65 years and above who were admitted to MRRH between March 2019 and February 2020 for any type of illness. Medication errors were systematically assessed using STOPP/START criteria. Of 298 patients' records analyzed, the majority were females (n=151, 50.7%). Each patient had at least 2 diseases with an average of 5 types of medicines per patient. Twenty-eight patients (9.40%) had at least one error while the majority (n=270, 90.60%) had no medication errors. Medication omission accounted for the majority of errors present (86, 28.86%). Medication errors were prevalent among elderly patients admitted at MRRH, with diverse profiles related to the errors. Further studies are warranted to devise and adopt strategies to mitigate medication errors in this population.

Snakebite envenoming is a neglected tropical disease and a major medical emergency in rural India. Medical officers play a key role in its management but often face systemic and operational barriers. To explore the challenges and barriers faced by medical officers in managing snakebite envenoming in rural Karnataka. A qualitative study using purposive sampling was conducted in selected Government healthcare centers (PHCs (Primary healthcare centre), CHCs (Community health centre), and THs (Taluk hospital) across Belagavi and Raichur districts of Karnataka. The interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Ethical clearance was obtained from the institutional ethics committees. Forty-eight medical officers (38 males and 10 females) participated in open-ended, face-to-face interviews conducted in English and 41.66% had 1-5 years of experience. Major barriers included delayed patient presentation due to reliance on traditional healers, poor awareness, shortages of antivenom (ASV), equipment, ICU facilities, inadequate training, staffing shortages, and persistent cultural misconceptions about snakebite. Strengthening infrastructure, ensuring ASV availability, enhancing training, and community education are crucial to improve outcomes and reduce mortality from snakebite envenoming in rural India.

The coronavirus disease of 2019 (COVID-19) pandemic left lasting effects in all sectors globally. Particularly among women of reproductive age, it has instilled difficulty of accessing healthcare, which has been linked to fear of being exposed to the virus at health facilities. However, most studies especially in East Africa have narrowed COVID-19 related research to qualitative reviews and descriptive analyses due to inadequacy of COVID-19 data. The purpose of this study was to determine the relationship between health facility visiting and healthcare access difficulty due to fear of COVID-19 at health facilities, while exploring both individual and contextual determinants. The current study applied a multilevel logistic mixed-effects regression model to account for both individual and contextual dimensions in the study. Overall, 30.0% of the women reported difficulty in accessing healthcare. Women who had visited a health facility in the past 4 weeks of the survey and had health insurance were associated with less healthcare access difficulty; (AOR= 0.73; 95% CI, 0.57-0.95) and (AOR= 0.74; 95% CI, 0.59-0.94) respectively. On the contrary, women who watched television, in households that had partially and completely lost household income due to the virus were associated with more difficulty; (AOR= 1.38; 95% CI, 1.10-1.74), (AOR= 2.09, 95% CI, 1.51-2.88) and (AOR= 2.40, 95% CI, 1.65-3.47) respectively. About 72% of the total variance in healthcare access difficulty was attributable to differences in enumeration areas (ICC= 0.72; 95% CI, 0.66-0.76), with less significant individual level contribution. Interventions that influence routine health facility visits can boost healthcare access among women. Enumeration area-specific interventions may be more effective.

Metabolic syndrome (MS) is an atherogenic risk factor influenced by both modifiable and non-modifiable risk factors, including race, hypertension, obesity, and age. This study evaluated the association between MS and arterial stiffness (AS) in individuals of African ancestry. Using WHO criteria, MS was assessed in 668 participants aged 18-70 years. Obesity was evaluated through body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). Blood pressure (BP) measurements included office BP, 24-hour ambulatory BP monitoring (ABPM), and daytime/nighttime BP. Arterial stiffness was assessed via pulse wave velocity (PWV). Blood samples were analyzed for triglycerides (TG), high-density lipoprotein (HDL), and fasting blood glucose. Statistical analysis was performed using SPSS and STATA. The prevalence of metabolic syndrome increased with age and was significantly higher in females. Participants with MS had a higher prevalence of hypertension and obesity. PWV was significantly associated with BP parameters and obesity indices (BMI, WC, WHR). Moreover, PWV was higher in individuals with MS compared to those without. Obesity and hypertension, key diagnostic components of MS, are independently associated with arterial stiffness. This underscores their role in driving target organ damage among individuals with MS in this African ancestry cohort.

Thyroid diseases vary geographically, with iodine deficiency being a major cause in Africa. These conditions range from congenital anomalies to acquired neoplastic and non-neoplastic lesions. To establish baseline data on the frequency and patterns of thyroid lesions diagnosed in a teaching hospital's histopathology department over an 11-year period (2012-2022). A retrospective descriptive study was conducted using slides and paraffin-embedded blocks of thyroidectomy specimens from January 2012 to December 2022. Clinical data including age, sex, and histological diagnosis were retrieved and analyzed using SPSS version 23.0. A total of 111 thyroid lesions (2.4% of all cases) were reviewed, with a female-to-male ratio of 5.5:1 and a mean age of 42.5 years (SD = 12.94). Hyperplastic lesions predominated (76.6%), comprising nodular hyperplasia (45.0%) and diffuse goitre (31.5%). Neoplasms accounted for 18.9%, including papillary carcinoma (7.2%) and follicular carcinoma (4.5%). Congenital and inflammatory lesions were least frequent. Neoplasms peaked in the fourth decade, with significant associations between age, gender, and lesion type (p < 0.001). Thyroid lesions showed strong female predominance. Non-neoplastic conditions were most common, with peak incidence between the fourth and sixth decades.