Predictors of never testing for HIV among sexually active individuals aged 15-56 years in Rwanda.

Human Immunodeficiency Virus (HIV) testing services are known as the primary step in preventing the spread of HIV. However, access to these crucial services varies across regions within continents due to disparities in healthcare infrastructure, resources, and awareness. Approximately one in every five people living with HIV (PLWH) encounters obstacles in accessing HIV testing, notably in Eastern and Southern Africa, where geographical, resource, awareness, and infrastructure limitations prevail. Consequently, HIV remains a significant public health concern in these regions, necessitating expanded testing efforts to combat the HIV/AIDS disaster. Despite these challenges, there is a lack of scientific evidence on the prevalence of HIV testing and its determining factors in Rwanda. This study determined the prevalence of never being tested for HIV and its associated factors among sexually active individuals aged 15-56 who participated in the Rwanda AIDS Indicators and HIV Incidence Survey (RAIHIS). This cross-sectional study enrolled 1846 participants. The variables were extracted from the RAIHIS dataset and statistically analyzed using STATA software version 13. Bivariate and multivariate logistic regression models were employed to identify predictors of never having undergone HIV testing, with a 95% confidence interval and a 5% statistical significance level applied. The prevalence of non-testing for HIV was 17.37%. Being aged 15-30 years (aOR 2.57, 95%CI 1.49-4.43, p < 0.001) and male (aOR 2.44, 95%CI 1.77-3.36, p < 0.001) was associated with an increase in the odds of never testing for HIV. Further, those from urban area were less likely than those living in rural areas to have never tested for HIV (aOR 0.31; 95% CI 0.38-0.67; p < 0.001). Participants who were not aware of HIV test facilitates were more likely to have never undergone HIV testing (aOR 1.75; 95% CI 1.25-2.47; p = 0.031) than their counterparts. While the prevalence of HIV non-testing remains modest, the significance of youth, male gender, lack of awareness, and rural residence as influential factors prompts a call for inventive strategies to tackle the reasons behind never having undergone HIV testing. Further exploration using mixed methodologies is advocated to better comprehend socio-cultural impacts and causation relating to these identified factors.

Availability and affordability of anticancer medicines at cancer treating hospitals in Rwanda.

BACKGROUND: Availability and accessibility of anti-cancer medicines is the pillar of cancer management, and it is one of the main concerns in low-income countries including Rwanda. The objective of this study was to assess the availability and affordability of anticancer medicines at cancer-treating hospitals in Rwanda. METHODOLOGY: A descriptive cross-sectional study was conducted at 5 cancer-treating hospitals in Rwanda. Quantitative data were collected from stock cards and software that manage medicines and included the availability of anti-cancer medicines at the time of data collection, their stock status within the last two years, and the selling price. RESULTS: The study found the availability of anti-cancer medicines at 41% in public hospitals at the time of data collection, and 45% within the last two years. We found the availability of anti-cancer medicines at 45% in private hospitals at the time of data collection, and 61% within the last two years. 80% of anti-cancer medicines in private hospitals were unaffordable while 20% were affordable. The public hospital that had most of the anti-cancer medicines in the public sector provided free services to the patients, and no cost was applied to the anti-cancer medicines. CONCLUSION: The availability of anti-cancer medicines in cancer-treating hospitals is low in Rwanda, and most of them are unaffordable. There is a need to design strategies that can increase the availability and affordability of anti-cancer medicines, for the patients to get recommended cancer treatment options.

Colonization of patients hospitalized at orthopedic department of tertiary hospital in Uganda with extended-spectrum beta-lactamase-producing enterobacterales.

BACKGROUND: Beta-lactamase production remains the most contributing factor to beta-lactam resistance. Extended-Spectrum Beta-Lactamase-Producing Enterobacterales (ESBL-PE) are associated with risk factors both in hospital and community settings. OBJECTIVES: To assess the incidence and risk factors for intestinal carriage of ESBL-PE among patients admitted to orthopedic ward of Mulago National Referral Hospital, and to analyze the acquisition of ESBL-PE during hospital stay and associated factors. METHODS: We screened 172 patients aged 18 years old and above who got admitted to the orthopedic ward of Mulago National Referral Hospital between May to July 2017. Stool samples or rectal swabs were collected at admission, every 3 days until fourteen days and screened for ESBL-PE. Data on demographic status, antibiotic use, admission and travel, length of hospital stay, hygiene practices and drinking boiled water were analyzed by logistic regression and cox regression model. RESULTS: At admission, 61% of patients showed intestinal ESBL-PE carriage. Co- resistance was common but no Carbapenem resistance was detected. Of the ESBL-PE negative, 49% were colonized during hospitalization. On admission, prior antibiotic use was significantly associated with carriage, but none was associated with acquisition during hospitalization at p-value < 0.05. CONCLUSION: Carriage of ESBL-PE on admissions and acquisition at orthopedic ward of Mulago Hospital were high, and dissemination into the community are of substantial concern. We suggested refinement of empirical treatment based on risk stratification, and enhanced infection control measures that target health care workers, patients and attendants.

Relationship between sperm quality and male reproductive hormones among male partners with fertility complications: attending CHUB

Background Infertility remains a highly prevalent global condition in the second decade of the new millennium. Reproductive hormones determine sperm quality as they initiate and maintain spermatogenesis. Hormonal imbalance can cause abnormal sperm quality that can be treated by hormonal replacement therapy. Objective To assess the relationship between sperm quality and male reproductive hormones among male partners with fertility complications attending CHUB. Methods The study was a descriptive cross-sectional, and a convenient sampling strategy was used to recruit subjects at CHUB. Sixty-two male subjects with fertility complications provided both semen and blood sample to analyze sperm quality and reproductive hormones. Descriptive statistics were used to analyze data. Results Both FSH and LH showed a strong negative correlation with sperm count which is more profound with FSH (r= -0.722) than LH (r= -0.545). Testosterone showed a strong positive correlation with sperm count (r= 0.712). FSH and LH showed a negative correlation with sperm motility which is more profound in FSH (r= - 0.312) than LH (r= -0.302). Testosterone also showed a positive correlation with sperm motility (r= 0.360). Conclusion Our study found a correlation between sperm quality and male reproductive hormones. We further suggest other studies to investigate predictive power of male reproductive hormones.