Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda.

RATIONALE: Detailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited. OBJECTIVE: We determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda. MEASUREMENTS: As of the 16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive care, mechanical ventilation or death during hospitalisation. MAIN RESULTS: The median age was 34.2 years; 67.9% were male; and 14.6% were <18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever (21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue (7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and 7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of >130/90 mm Hg, and 27.8% had BP of >140/90 mm Hg. Laboratory derangements were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical recovery was shorter among patients who received HCQ, but this difference did not reach statistical significance. CONCLUSION: Most of the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory not similar to other countries. Outcomes did not differ by HCQ treatment status in line with other concluded studies on the benefit of using HCQ in the treatment of COVID-19.

Health-seeking behavior for malaria among child and adult headed households in Rakai district, Uganda.

BACKGROUND: The number of orphans in Rakai district, Uganda is estimated to be 34,902 (OCBO, 2000) which translates into 28% of children under the age of 18 years. Young people who have been orphaned and as a result became heads of households must look after themselves and their siblings. These children are likely to be faced with several health problems and have to take crucial life decisions without parental/adult guidance. OBJECTIVES: This study was conducted in order to understand how child-headed households, Rakai district in Uganda recognize malaria, their health-seeking behavior when malaria is suspected and reasons for the type of behavior compared to the adult-headed households. METHODS: A comparative cross-sectional study was conducted in 300 households in Rakai district, Uganda, in which 8/23 (35%) of sub-counties and 150 child-headed households were included. The closest neighborhood adult-headed household to each child-headed household was selected for comparison. Individual interview was carried out with the respondents using semi-structure questionnaire. Key informant interview and focus group discussions were also conducted. RESULTS: The main findings were that the respondents in child-headed households had less knowledge on signs and symptoms of simple and severe malaria compared to adult heads of households. Respondents in child-headed households were less likely to seek health care from health facilities (OR=0.59, CI=0.36-0.97, p-value=0.028). There was no significant difference in the time lag before taking first action in the two types of households (OR=0.72, CI=0.42-1.22, p-value=0.194). The respondents in child-headed households were six times (OR=5.70,CI=2.75-11.91, p-value<0.001) more likely to use local herb for treatment of malaria than the adult heads households. Major reasons stated by the respondents for choosing where health care is sought included distance to source of health care, cheap or free treatment, availability of drugs, and quick services to patients. CONCLUSION: The respondents in child-headed households had less knowledge on signs and symptoms of simple and severe malaria and receive too little or late health care from health professionals compared to the adult heads of households probably due to lack of knowledge and money. Information Communication and Education programs should be designed and target the child-headed households and supply home packs.