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1
Reid, Andrew, and Ceri Z. Ashley. "A context for the Luzira Head." Antiquity 82, no. 315 (March 1, 2008): 99–112. http://dx.doi.org/10.1017/s0003598x00096472.
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The Luzira head, a pottery figure discovered in a Ugandan prison compound in 1929, has remained curiously anonymous ever since. New archaeological work on the northern shores of (Lake) Victoria Nyanza has defined a formative period of political centralisation at the end of the first millennium AD. The authors show that this period of early to late Iron Age transition is where this remarkable object and related figurative material belongs. This has implications both for the formation of kingdoms in Uganda and for the story of African art more generally.
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Bebell, Lisa M., Mark J. Siedner, Nicholas Musinguzi, Yap Boum, Bosco M. Bwana, Winnie Muyindike, Peter W. Hunt, Jeffrey N. Martin, and David R. Bangsberg. "Trends in one-year cumulative incidence of death between 2005 and 2013 among patients initiating antiretroviral therapy in Uganda." International Journal of STD & AIDS 28, no. 8 (September 20, 2016): 800–807. http://dx.doi.org/10.1177/0956462416671431.
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Recent ecological data demonstrate improving outcomes for HIV-infected people in sub-Saharan Africa. Recently, Uganda has experienced a resurgence in HIV incidence and prevalence, but trends in HIV-related deaths have not been well described. Data were collected through the Uganda AIDS Rural Treatment Outcomes (UARTO) Study, an observational longitudinal cohort of Ugandan adults initiating antiretroviral therapy (ART) between 2005 and 2013. We calculated cumulative incidence of death within one year of ART initiation, and fit Poisson models with robust variance estimators to estimate the effect enrollment period on one-year risk of death and loss to follow-up. Of 760 persons in UARTO who started ART, 30 deaths occurred within one year of ART initiation (cumulative incidence 3.9%, 95% confidence interval [CI] 2.7–5.6%). Risk of death was highest for those starting ART in 2005 (13.0%, 95% CI 6.0–24.0%), decreased in 2006–2007 to 4% (95% CI 2.0–6.0%), and did not change thereafter ( P = 0.61). These results were robust to adjustment for age, sex, CD4 cell count, viral load, asset wealth, baseline depression, and body mass index. Here, we demonstrate that one-year cumulative incidence of death was high just after free ART rollout, decreased the following year, and remained low thereafter. Once established, ART programs in President’s Emergency Fund for AIDS Relief-supported countries can maintain high quality care.
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Watera, Christine, Deogratius Ssemwanga, Grace Namayanja, Juliet Asio, Tom Lutalo, Alice Namale, Grace Sanyu, et al. "HIV drug resistance among adults initiating antiretroviral therapy in Uganda." Journal of Antimicrobial Chemotherapy 76, no. 9 (May 15, 2021): 2407–14. http://dx.doi.org/10.1093/jac/dkab159.
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Abstract Background WHO revised their HIV drug resistance (HIVDR) monitoring strategy in 2014, enabling countries to generate nationally representative HIVDR prevalence estimates from surveys conducted using this methodology. In 2016, we adopted this strategy in Uganda and conducted an HIVDR survey among adults initiating or reinitiating ART. Methods A cross-sectional survey of adults aged ≥18 years initiating or reinitiating ART was conducted at 23 sites using a two-stage cluster design sampling method. Participants provided written informed consent prior to enrolment. Whole blood collected in EDTA vacutainer tubes was used for preparation of dried blood spot (DBS) specimens or plasma. Samples were shipped from the sites to the Central Public Health Laboratory (CPHL) for temporary storage before transfer to the Uganda Virus Research Institute (UVRI) for genotyping. Prevalence of HIVDR among adults initiating or reinitiating ART was determined. Results Specimens from 491 participants (median age 32 years and 61.5% female) were collected between August and December 2016. Specimens from 351 participants were successfully genotyped. Forty-nine had drug resistance mutations, yielding an overall weighted HIVDR prevalence of 18.2% with the highest noted for NNRTIs at 14.1%. Conclusions We observed a high HIVDR prevalence for NNRTIs among adults prior to initiating or reinitiating ART in Uganda. This is above WHO’s recommended threshold of 10% when countries should consider changing from NNRTI- to dolutegravir-based first-line regimens. This recommendation was adopted in the revised Ugandan ART guidelines. Dolutegravir-containing ART regimens are preferred for first- and second-line ART regimens.
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Dirajlal-Fargo, Sahera, Abdus Sattar, Lingpeng Shan, Emily Bowman, Rashida Nazzinda, Victor Musiime, Nicholas Funderburg, and Grace A. McComsey,. "2528. Inflammation and Plasma Selenium and Chromium in Ugandan Children Living with HIV." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S879. http://dx.doi.org/10.1093/ofid/ofz360.2206.
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Abstract Background Selenium deficiency has been reported to be associated with HIV disease progression and chromium deficiency with insulin resistance and hyperlipidemia. Here, we assessed selenium and chromium status in a cohort of Ugandan HIV+, HIV exposed uninfected (HEU) and HIV negative (HIV−) children and their associations with markers of systemic inflammation, immune activation, and gut integrity. Methods This is a cross-sectional study in HIV+, HEU and HIV unexposed uninfected (HIV-) children aged 2–10 years old enrolled in Uganda. HIV+ children were on stable ART with undetectable viral load. We measured plasma concentrations of selenium and chromium as well as markers of systemic inflammation, monocyte activation, gut integrity and insulin resistance (HOMA-IR). Results Among HIV+ children (n = 57), 93% had viral load ≤ 20 copies/mL, mean CD4 was 34% and 77% were receiving a non-nucleotide reserve transcriptase regimen. Mean age of all participants was 7 years and 55% were girls. Mean selenium concentrations were higher in the HIV+ group (106 µg/L) compared with the HEU (84 µg/L) and HIV− (98 µg/L) groups (p . Mean chromium concentrations were 1 µg/L; 1 HIV+ child and 6 HEU children had chromium levels > 1 µg/L (p. Conclusion In this cohort of HIV+ children on ART in Uganda, plasma selenium and chromium concentrations appear sufficient. Higher plasma selenium concentrations were associated with lower systemic inflammation and higher gut integrity markers. Although our findings do not support the use of selenium supplementation broadly for HIV-infected children in Uganda, further studies are warranted to assess the role of selenium supplements in attenuating heightened inflammation. Disclosures All authors: No reported disclosures.
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Fitzgerald, Felicity C., Edouard Lhomme, Kathryn Harris, Julia Kenny, Ronan Doyle, Cissy Kityo, Liam P. Shaw, et al. "Microbial Translocation Does Not Drive Immune Activation in Ugandan Children Infected With HIV." Journal of Infectious Diseases 219, no. 1 (August 11, 2018): 89–100. http://dx.doi.org/10.1093/infdis/jiy495.
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Abstract Objective Immune activation is associated with morbidity and mortality during human immunodeficiency virus (HIV) infection, despite receipt of antiretroviral therapy (ART). We investigated whether microbial translocation drives immune activation in HIV-infected Ugandan children. Methods Nineteen markers of immune activation and inflammation were measured over 96 weeks in HIV-infected Ugandan children in the CHAPAS-3 Trial and HIV-uninfected age-matched controls. Microbial translocation was assessed using molecular techniques, including next-generation sequencing. Results Of 249 children included, 142 were infected with HIV; of these, 120 were ART naive, with a median age of 2.8 years (interquartile range [IQR], 1.7–4.0 years) and a median baseline CD4+ T-cell percentage of 20% (IQR, 14%–24%), and 22 were ART experienced, with a median age of 6.5 years (IQR, 5.9–9.2 years) and a median baseline CD4+ T-cell percentage of 35% (IQR, 31%–39%). The control group comprised 107 children without HIV infection. The median increase in the CD4+ T-cell percentage was 17 percentage points (IQR, 12–22 percentage points) at week 96 among ART-naive children, and the viral load was <100 copies/mL in 76% of ART-naive children and 91% of ART-experienced children. Immune activation decreased with ART use. Children could be divided on the basis of immune activation markers into the following 3 clusters: in cluster 1, the majority of children were HIV uninfected; cluster 2 comprised a mix of HIV-uninfected children and HIV-infected ART-naive or ART-experienced children; and in cluster 3, the majority were ART naive. Immune activation was low in cluster 1, decreased in cluster 3, and persisted in cluster 2. Blood microbial DNA levels were negative or very low across groups, with no difference between clusters except for Enterobacteriaceae organisms (the level was higher in cluster 1; P < .0001). Conclusion Immune activation decreased with ART use, with marker clustering indicating different activation patterns according to HIV and ART status. Levels of bacterial DNA in blood were low regardless of HIV status, ART status, and immune activation status. Microbial translocation did not drive immune activation in this setting. Clinical Trials Registration ISRCTN69078957.
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Musumari, Patou Masika, Teeranee Techasrivichien, Kriengkrai Srithanaviboonchai, Rhoda K. Wanyenze, Joseph K. B. Matovu, Hemant Poudyal, S. Pilar Suguimoto, et al. "HIV epidemic in fishing communities in Uganda: A scoping review." PLOS ONE 16, no. 4 (April 1, 2021): e0249465. http://dx.doi.org/10.1371/journal.pone.0249465.
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Background Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. In Uganda, literature on HIV in fishing communities has grown extensively since the first country’s documented case of HIV in a fishing community in 1985. The current study describes the status of the HIV burden, prevention, and treatment in Ugandan fishing communities. Method This scoping review was conducted based on the York Framework outlined by Arksey and O’Malley. We searched the PubMed, Embase, and Web of Science databases to identify relevant quantitative and qualitative studies on HIV incidence, HIV prevalence, HIV-related risk factors, HIV testing, antiretroviral therapy coverage and adherence, and interventions to improve treatment outcomes and reduce HIV risk factors. Results & conclusion We identified 52 papers and 2 reports. Thirty-four were quantitative, 17 qualitative, and 3 had a mixed-methods design. Eleven studies reported on the prevalence of HIV and 8 on HIV incidence; 9 studies documented factors associated with HIV incidence or HIV positive status; 10 studies reported on HIV testing coverage and/or associated factors; 7 reported on antiretroviral therapy coverage/adherence/outcomes; and 1 study reported on the impact of combination HIV interventions in fishing communities. This scoping review revealed a significant lack of evidence in terms of what works in HIV prevention and for improving adherence to ART, in contrast to the relatively large amount of evidence from observational quantitative and qualitative studies on HIV prevalence, incidence and related risk factors in Ugandan fishing communities. Intervention studies are urgently needed to fill the current evidence gaps in HIV prevention and ART adherence.
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Owachi, Darius, Godwin Anguzu, Joanita Kigozi, Janneke Cox, Barbara Castelnuovo, Fred Semitala, and David Meya. "Virologic suppression and associated factors in HIV infected Ugandan female sex workers: a cross-sectional study." African Health Sciences 21, no. 2 (August 2, 2021): 603–13. http://dx.doi.org/10.4314/ahs.v21i2.15.
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Introduction: Key populations have disproportionately higher HIV prevalence rates than the general population.
Objective: To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP).
Methods: Clinical records of CSW and GPs who initiated ART between December 2014 to December 2016 from seven urban clinics were analyzed to determine virologic suppression (viral load < 1000 copies/ml) and associated factors.
Results: We identified 218 CSW and 182 female GPs. CSW had median age of 28 (IQR 25-31) vs 31 (IQR 26-37); median baseline CD4 446 (IQR 308-696) vs 352 (IQR 164–493) cells/microL; and optimal ART adherence levels at 70.6% vs 92.8% respectively, compared to GP. Virologic suppression in CSW and GPs was 85.7% and 89.6% respectively, P=0.28. Overall virologic suppression in CSW was 55% while Retention in care after 6 months of ART was 77.5%. Immediate ART initiation (<2weeks) and tuberculosis independently predicted virologic suppression in CSW with adjusted odds ratios 0.07 (95% C.I. 0.01-0.55, P=0.01) and 0.09 (95% C.I. 0.01-0.96, P=0.046) respectively.
Conclusion: Virologic suppression in both groups is similar, however, intensified follow-up is needed to improve treatment outcomes.
Keywoeds: HIV infected Ugandans; female sex workers.
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Mpoza, Edward, Radha Rajasingham, Lillian Tugume, Joshua Rhein, Maria Sarah Nabaggala, Isaac Ssewanyana, Wilson Nyegenye, et al. "Cryptococcal Antigenemia in Human Immunodeficiency Virus Antiretroviral Therapy–Experienced Ugandans With Virologic Failure." Clinical Infectious Diseases 71, no. 7 (November 3, 2019): 1726–31. http://dx.doi.org/10.1093/cid/ciz1069.
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Abstract Background Detectable serum or plasma cryptococcal antigen (CrAg) precedes symptomatic cryptococcal meningitis. The World Health Organization recommends CrAg screening for human immunodeficiency virus–positive persons with CD4 count <100 cells/μL initiating antiretroviral therapy (ART). However, an increasing proportion of patients with cryptococcosis are now ART experienced. Whether CrAg screening is cost-effective in those with virologic failure is unknown. Methods We retrospectively performed nationwide plasma CrAg testing among ART-experienced Ugandan adults with virologic failure (≥1000 copies/mL) using leftover plasma after viral load testing during September 2017–January 2018. For those who were CrAg positive, we obtained ART history, meningitis occurrence, and 6-month survival via medical records review. Results Among 1186 subjects with virologic failure, 35 (3.0%) were CrAg positive with median ART duration of 41 months (interquartile range, 10–84 months). Among 25 subjects with 6-month outcomes, 16 (64%) survived, 7 (28%) died, and 2 (8%) were lost. One survivor had suffered cryptococcal meningitis 2 years prior. Two others developed cryptococcal meningitis and survived. Five survivors were known to have received fluconazole. Thus, meningitis-free survival at 6 months was 61% (14/23). Overall, 91% (32/35) of CrAg-positive persons had viral load ≥5000 copies/mL compared with 64% (735/1151) of CrAg-negative persons (odds ratio, 6.0 [95% confidence interval, 1.8–19.8]; P = .001). CrAg prevalence was 4.2% (32/768) among those with viral loads ≥5000 copies/mL and 0.7% (3/419) among those with viral loads <5000 copies/mL. Conclusions In addition to the CD4 threshold of <100 cells/μL, reflexive CrAg screening should be considered in persons failing ART in Uganda with viral loads ≥5000 copies/mL.
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Huibers, M. H. W., C. Kityo, R. S. Boerma, E. Kaudha, K. C. E. Sigaloff, S. N. Balinda, S. Bertagnolio, et al. "Long-term virological outcomes, failure and acquired resistance in a large cohort of Ugandan children." Journal of Antimicrobial Chemotherapy 74, no. 10 (July 9, 2019): 3035–43. http://dx.doi.org/10.1093/jac/dkz266.
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Abstract Objectives To evaluate long-term virological failure (VF) and drug resistance among HIV-infected Ugandan children on first-line ART. Methods In a multicentre prospective cohort study, viral load (VL) and drug resistance mutations (DRMs) were investigated at baseline and 6 monthly intervals in children (age ≤ 12 years). VF (two consecutive VLs >1000 copies/mL or death after 6 months of ART) was defined as early VF (0–24 months of ART) or late VF (25–48 months of ART). An active regimen was defined as partially active if the genotypic susceptibility score (GSS) was <3. Results Between 2010 and 2011, 316 children were enrolled. Viral suppression was achieved in 75.8%, 71.5%, 72.6% and 69.2% at 12, 24, 36 and 48 months. VF occurred in 111/286 (38.8%), of which 67.6% was early and 32.4% late VF. Early VF was associated with a partially active regimen at baseline (OR 6.0, 95% CI 1.9–18.5), poor adherence (OR 3.1, 95% CI 1.3–7.4) and immunodeficiency (OR 3.3, 95% CI 1.1–10.2). Late VF was associated with age >3 years (OR 2.5, 95% CI 1.0–6.6) and WHO stage 3/4 (OR 4.2, 95% CI 1.4–13.4). Acquired DRMs were detected in 27.0% before 24 months, versus 14.4% after 24 months (P < 0.001). A total of 92.2% of the children with early VF, versus 56.2% with late VF, had a partially active regimen (P < 0.001). Conclusions VF rates were high, occurred predominantly in the first 24 months and appeared to increase again in year four. Risk factors and patterns of early VF/DRMs were different from those of late VF/DRMs. Virological control may improve by close monitoring and prompt switching to second-line therapy in the first 24 months. Late VF may be prevented by early start of ART.
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Soeria‐Atmadja, Sandra, Pauline Amuge, Sarah Nanzigu, Dickson Bbuye, Johanna Rubin, Jaran Eriksen, Adeodata Kekitiinwa, Celestino Obua, Lars L. Gustafsson, and Lars Navér. "Pretreatment HIV drug resistance predicts accumulation of new mutations in ART‐naïve Ugandan children." Acta Paediatrica 109, no. 12 (May 26, 2020): 2706–16. http://dx.doi.org/10.1111/apa.15320.
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Castellano, Carlos Garrido. "Institutionalism, Public Sphere, and Artistic Agency: A Conversation on 32° East Ugandan Art Trust." Critical Interventions 11, no. 2 (May 4, 2017): 116–31. http://dx.doi.org/10.1080/19301944.2017.1363501.
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Namakoola, I., K. Wakeham, R. Parkes-Ratanshi, J. Levin, T. Mugagga, C. Seymour, J. Kissa, A. Kamali, and D. G. Lalloo. "Use of nail and oral pigmentation to determine ART eligibility among HIV-infected Ugandan adults." Tropical Medicine & International Health 15, no. 2 (February 2010): 259–62. http://dx.doi.org/10.1111/j.1365-3156.2009.02448.x.
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Namwase, Sylvie. "Securing legal reforms to the use of force in the context of police militarisation in Uganda: The role of public interest litigation and structural interdict." African Human Rights Law Journal 21, no. 2 (December 31, 2021): 1–27. http://dx.doi.org/10.17159/1996-2096/2021/v21n2a48.
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This article argues that the failure by the Ugandan government to put in place clear regulations governing the use of force and firearms by the police and armed security forces, particularly during joint police and military operations, as part of arrest and crowd control operations, threatens to violate the right to life, the right to freedom from inhumane treatment, the right to assemble and the right to a remedy under the Ugandan Constitution. It argues that the constitutional, statutory law and case law framework in Uganda can facilitate public interest litigation in order to secure the adoption by the Ugandan government of comprehensive and internationally-accepted standards on the use of force and firearms by police and armed security forces. The article draws on a recent progressive decision of the High Court in James Muhindo & 3 Others v Attorney-General, and the Human Rights Enforcement Act of 2019 to expound on the proactive potential of article 50 of Uganda's Constitution to deliver expedited institutional and human rights-oriented reforms and to afford the courts oversight functions in the implementation of these reforms through structural interdict. These aspects of the public interest litigation framework in Uganda offer a pathway to civilian-led reform in a highly state-controlled, politicised and militarised police and security sector over which Ugandans otherwise have no civilian oversight. Thus, the article explores the potential of public interest litigation as an empowering tool in competing approaches to state formation in transitional contexts and positions public interest litigation as a transformative response to militarisation in a fragile state.
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Byakika-Kibwika, Pauline, Mohammed Lamorde, Peter Lwabi, Wilson B. Nyakoojo, Violet Okaba-Kayom, Harriet Mayanja-Kizza, Marta Boffito, et al. "Cardiac Conduction Safety during Coadministration of Artemether-Lumefantrine and Lopinavir/Ritonavir in HIV-Infected Ugandan Adults." Chemotherapy Research and Practice 2011 (April 7, 2011): 1–4. http://dx.doi.org/10.1155/2011/393976.
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Background. We aimed to assess cardiac conduction safety of coadministration of the CYP3A4 inhibitor lopinavir/ritonavir (LPV/r) and the CYP3A4 substrate artemether-lumefantrine (AL) in HIV-positive Ugandans. Methods. Open-label safety study of HIV-positive adults administered single-dose AL (80/400 mg) alone or with LPV/r (400/100 mg). Cardiac function was monitored using continuous electrocardiograph (ECG). Results. Thirty-two patients were enrolled; 16 taking LPV/r -based ART and 16 ART naïve. All took single dose AL. No serious adverse events were observed. ECG parameters in milliseconds remained within normal limits. QTc measurements did not change significantly over 72 hours although were higher in LPV/r arm at 24 (424 versus 406; P=.02) and 72 hours (424 versus 408; P=.004) after AL intake. Conclusion. Coadministration of single dose of AL with LPV/r was safe; however, safety of six-dose AL regimen with LPV/r should be investigated.
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Nolan, David J., Rebecca Rose, Rongzhen Zhang, Alan Leong, Gary B. Fogel, Larissa L. S. Scholte, Jeffrey M. Bethony, Paige Bracci, Susanna L. Lamers, and Michael S. McGrath. "The Persistence of HIV Diversity, Transcription, and Nef Protein in Kaposi’s Sarcoma Tumors during Antiretroviral Therapy." Viruses 14, no. 12 (December 13, 2022): 2774. http://dx.doi.org/10.3390/v14122774.
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Epidemic Kaposi’s sarcoma (KS), defined by co-infection with Human Herpes Virus 8 (HHV-8) and the Human Immunodeficiency Virus (HIV), is a major cause of mortality in sub-Saharan Africa. Antiretroviral therapy (ART) significantly reduces the risk of developing KS, and for those with KS, tumors frequently resolve with ART alone. However, for unknown reasons, a significant number of KS cases do not resolve and can progress to death. To explore how HIV responds to ART in the KS tumor microenvironment, we sequenced HIV env-nef found in DNA and RNA isolated from plasma, peripheral blood mononuclear cells, and tumor biopsies, before and after ART, in four Ugandan study participants who had unresponsive or progressive KS after 180–250 days of ART. We performed immunohistochemistry experiments to detect viral proteins in matched formalin-fixed tumor biopsies. Our sequencing results showed that HIV diversity and RNA expression in KS tumors are maintained after ART, despite undetectable plasma viral loads. The presence of spliced HIV transcripts in KS tumors after ART was consistent with a transcriptionally active viral reservoir. Immunohistochemistry staining found colocalization of HIV Nef protein and tissue-resident macrophages in the KS tumors. Overall, our results demonstrated that even after ART reduced plasma HIV viral load to undetectable levels and restored immune function, HIV in KS tumors continues to be transcriptionally and translationally active, which could influence tumor maintenance and progression.
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Jain, Raghav, Amara E. Ezeamama, Alla Sikorskii, William Yakah, Sarah Zalwango, Philippa Musoke, Michael J. Boivin, and Jenifer I. Fenton. "Serum n-6 Fatty Acids are Positively Associated with Growth in 6-to-10-Year Old Ugandan Children Regardless of HIV Status—A Cross-Sectional Study." Nutrients 11, no. 6 (June 4, 2019): 1268. http://dx.doi.org/10.3390/nu11061268.
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Fatty acids (FAs) are crucial in child growth and development. In Uganda, antiretroviral therapy (ART) has drastically reduced perinatal human immunodeficiency virus (HIV) infection of infants, however, the interplay of FAs, ART, and HIV in relation to child growth is not well understood. To investigate this, serum was collected from 240 children between 6–10 years old in Uganda and analyzed for FAs using gas-chromatography mass-spectrometry. HIV status and anthropometric measurements were taken, and relationships with FAs were assessed. No significant differences in growth parameters or serum FAs were found between HIV uninfected children with and without exposure to ART. HIV positive children had significantly lower height-for-age-z-scores (HAZ) than uninfected children (p < 0.001). HIV-positive children had higher arachidonic acid than uninfected children (p = 0.003). Total omega-6 FAs were significantly associated with HAZ regardless of HIV status (p = 0.035). Mean total omega-3 FAs (2.90%) were low in this population compared to other cohorts in Africa. These results provide reference serum FA values for 6–10-year-old children in Uganda and may be used to inform lipid supplementation programs to promote child growth. Future studies should investigate the relationships between child growth trajectories in relation to HIV status and serum FAs.
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Dirajlal-Fargo, Sahera, Vanessa El-Kamari, Lukasz Weiner, Lingpeng Shan, Abdus Sattar, Manjusha Kulkarni, Nicholas Funderburg, et al. "Altered Intestinal Permeability and Fungal Translocation in Ugandan Children With Human Immunodeficiency Virus." Clinical Infectious Diseases 70, no. 11 (July 1, 2019): 2413–22. http://dx.doi.org/10.1093/cid/ciz561.
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Abstract Background Children with perinatally acquired human immunodeficiency virus (HIV; PHIVs) face a lifelong cumulative exposure to HIV and antiretroviral therapy (ART). The relationship between gut integrity, microbial translocation, and inflammation in PHIV is poorly understood. Methods This is a cross-sectional study in 57 PHIVs, 59 HIV-exposed but uninfected children, and 56 HIV-unexposed and -uninfected children aged 2–10 years old in Uganda. PHIVs were on stable ART with HIV-1 RNA <400 copies/mL. We measured markers of systemic inflammation, monocyte activation, and gut integrity. Kruskal-Wallis tests were used to compare markers by group and the Spearman correlation was used to assess correlations between biomarkers. Results The mean age of all participants was 7 years and 55% were girls. Among PHIVs, the mean CD4 % was 34%, 93% had a viral load ≤20 copies/mL, and 79% were on a nonnucleoside reverse transcriptase inhibitor regimen. Soluble cluster of differentiation 14 (sCD14), beta-D-glucan (BDG), and zonulin were higher in the PHIV group (P ≤ .01). Intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide binding protein (LBP) did not differ between groups (P > .05). Among PHIVs who were breastfed, levels of sCD163 and interleukin 6 (IL6) were higher than levels in PHIV who were not breastfed (P < .05). Additionally, in PHIVs with a history of breastfeeding, sCD14, BDG, LBP, zonulin, and I-FABP correlated with several markers of systemic inflammation, including high-sensitivity C-reactive protein, IL6, d-dimer, and systemic tumor necrosis factor receptors I and II (P ≤ .05). Conclusions Despite viral suppression, PHIVs have evidence of altered gut permeability and fungal translocation. Intestinal damage and the resultant bacterial and fungal translocations in PHIVs may play a role in the persistent inflammation that leads to many end-organ diseases in adults. Despite viral suppression, children with perinatally acquired human immunodeficiency virus (HIV) in Uganda have evidence of alterations in intestinal permeability and fungal translocation, compared to HIV-exposed but uninfected and HIV-unexposed children, which may play a role in HIV-associated chronic inflammation.
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Seremba, Emmanuel, Victor Ssempijja, Sarah Kalibbala, Ronald Gray, Maria Wawer, Fred Nalugoda, Corey Casper, et al. "Antiretroviral Therapy is Highly Effective Against Incident Hepatitis B Disease Acquisition Among HIV-Infected Adults in Rakai, Uganda." Journal of Global Oncology 2, no. 3_suppl (June 2016): 62s—63s. http://dx.doi.org/10.1200/jgo.2016.004044.
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Abstract 30 Background and objective: Co-infection with Hepatitis B (HBV) and HIV is common in sub-Saharan Africa (SSA) and accelerates progression of liver disease to cirrhosis, hepatocellular carcinoma (HCC) and other complications. About 60% of HCC in Africa is attributed to HBV. In Uganda, 80% of HCC patients have HBV and 20% have HIV/HBV coinfection. HCC is the 4th commonest cancer among Ugandan males and the 6th commonest in females. It is almost always a fatal malignancy in SSA. Prevention of HBV is best achieved through vaccination. Vaccination of HIV-infected adults for HBV is standard of care in developed countries but not in SSA where HBV is believed to be acquired in childhood and where there is lack of HBV incidence data. We investigated the incidence and risk factors associated with HBV among HIV-infected adults in Rakai, Uganda. Methods: We screened stored sera from 944 HIV infected adults enrolled in the Rakai Community Cohort Study between September 2003 and March 2015 for evidence of HBV exposure using the anti-HBc marker. Serum from participants who tested anti-HBc negative (497) at the baseline round was tested over 3-7 consecutive survey rounds for either anti-HBc or HBsAg sero-conversion. The time of HBV incidence was defined as the median date between the last anti-Hbc or HBsAg negative sample and the first positive anti-HBc or HBsAg serum sample. Almost all ART treatment regimens contained at least one HBV active medication. Exact poisson incidence methods were used to estimate the incidence of HBV with 95% confidence intervals while the Cox proportional regression methods were used to estimate adjusted hazard ratios of ART use and other confounders. Results: Thirty nine infections occurred (8 positive for both HBsAg and anti-HBc, 3 for HBsAg only, and 28 for anti-HBc only) over 3,342 person-years (pys), incidence 1.17/100 person-years. HBV incidence was significantly lower with ART use: 0.48 /100 person-years with ART use and 2.34/100 person-years without ART (p<0.001) and with HIVRNA suppression: 0.6/100pys with HIVRNA ≤400 copies/mL 6.0/100pys with >400copies/mL (p<0.001). It also decreased significantly with age: 2.60/100 pys if aged 15-29 years, 1.32/100 pys if aged 30-39 years and 0.48/100 pys if aged 40-50 years (p<0.001). The adjusted hazard ratios of HBV incidence significantly differed by ART use: non ART use versus ART use, aHR=0.24 (95% CI, 0.1-0.5), lamivudine (3TC) use: no ART versus 3TC-based ART, aHR= 0.24(0.1-0.5), p=<0.001), HIVRNA suppression ≤400 versus >400copies/mL, aHR= 6.4(2.2-19.0) and by age: 40-50 years versus 15-29 years, aHR= 3.66 (1.3-10.2); 40-50 years versus 30-39 years, aHR=2.18(0.9-5.4). No new HBV infections occurred among participants on a tenofovir-based regimen and there was no statistical significant differences by gender, occupation, marital status or number of sex partners, duration on ART or baseline CD4 count. Conclusion: The protective effects of HBV-active ART medications underscores additional benefits of earlier initiation of ART. Ongoing HBV transmission demonstrated by this study represents an opportunity for vaccine preventive strategies which could ultimately significantly reduce the burden of HCC in SSA. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Emmanuel Seremba No relationship to disclose Victor Ssempijja No relationship to disclose Sarah Kalibbala No relationship to disclose Ronald Gray No relationship to disclose Maria Wawer No relationship to disclose Fred Nalugoda No relationship to disclose Corey Casper Consulting or Advisory Role: Temptime Corporation, GlaxoSmithKline Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: GlaxoSmithKline, TempTime Warren T. Phipps No relationship to disclose Ponsiano Ocama No relationship to disclose David L. Thomas No relationship to disclose Steven J. Reynolds No relationship to disclose
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Nachega, Jean B., Brian Mutamba, David Basangwa, Hoang Nguyen, David W. Dowdy, Edward J. Mills, Elly Katabira, and Ethel Nakimuli-Mpungu. "Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults." Tropical Medicine & International Health 18, no. 1 (November 8, 2012): 53–57. http://dx.doi.org/10.1111/tmi.12019.
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Kajubi, P., Anne R. Katahoire, David Kyaddondo, and Susan R. Whyte. "COMMUNICATION IN THE CONTEXT OF FAMILY CAREGIVING: AN EXPLORATORY STUDY OF UGANDAN CHILDREN ON ANTIRETROVIRAL THERAPY." Journal of Biosocial Science 48, no. 5 (October 28, 2015): 672–93. http://dx.doi.org/10.1017/s0021932015000371.
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SummaryIt is important to consider the complexities of family dynamics when deciding when and how to communicate with HIV-infected children about their illness and treatment. Previous research has focused on providers’ and caregivers’ perspectives on whether, when and how to disclose HIV/AIDS diagnosis and treatment to HIV-infected children. From the perspective of HIV-infected children, communication does not mean just giving information about illness and treatment, but also encompasses emotional and material care. This paper places communication within the broader framework of caregiving in family situations. This exploratory study was conducted in Jinja district, Uganda, between November 2011 and December 2012. Through participant observation and in-depth interviews, communication by, and with, HIV-infected children in the context of family situations was explored from the perspectives of 29 HIV-infected children aged 8–17 years on antiretroviral therapy (ART) using content thematic analysis. Children’s communication with caregivers about their illness and treatment varied depending on whom they were living with and the nature of caregiving. Although a mother’s care was considered best, children described others who cared ‘like a mother’. For some, caregiving was distributed among several relatives and non-relatives, while others felt they had hardly anyone to care for them. Caregiving from the children’s perspective involved emotional support, expressed verbally and explicitly in messages of concern, encouragement conveyed in reminders to take medicines, attention when sick and confidential conversations about the challenges of having HIV and taking ART. Caregiving was also communicated implicitly in acts of provision of food/drinks to take with medicines, counting pills to confirm they had taken the medicines and accompanying children to treatment centres. Children’s communication about their health and medicines and the care they received was to a large extent shaped by the nature of their relatedness to their caregivers, the extent to which caregiving was dispersed among several people and who else in the household was infected with HIV and on medication.
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Kyarimpa, A. "Delivering Cost-Effective Cervical Cancer Screening Package to Women Living With Human Immunodeficiency Virus By Reproductive Health Uganda." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 146s. http://dx.doi.org/10.1200/jgo.18.77200.
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Background and context: Uganda has one of the highest cervical cancer incidences in the world. Over 80% late diagnosis compounds the challenge. It is evident that women living with human immunodeficiency virus (HIV) have a higher prevalence of precancer lesions and have limited access to cervical cancer knowledge and relevant services especially women living with HIV, who are poor and marginalized. This results in a gap for first-line defense to cervical cancer. To bridge the gap and deliver services, Reproductive Health Uganda (RHU) introduced cost-effective “see and treat”, single visit approach (SVA), using combined visual inspection with acetic acid (VIA) and cryotherapy. Aim: To promote single visit approach in cervical cancer screening program in selected HIV clinics and assess the feasibility. Strategy: • Collaborate with HIV clinics, which enroll and provide counseling and services to women living with HIV • Integrate SVA into the current services package in HIV clinics and outreaches to break geographic barriers • Train RHU and public health clinic staff to perform VIA and cryotherapy if needed • Enable SVA in public antiretroviral therapy (ART) clinics through partnerships • Awareness creation through group health education and individual counseling Program: The project implemented in three high HIV prevalence rate districts targeted women 25-49 years of age. Partnered with public ART clinics and arranged training to ensure midwives and nurses in RHU and public health facilities are able to carry out VIA and cryotherapy if needed. Announcements and appointment posters were pinned up on the facility notice board providing details of dates and service package. RHU used this opportunity to promote contraception and STIs management. Health education and counseling session were conducted. Trained peer support mothers mobilized women seek cervical cancer screening when doing HIV follow-up. Quarterly support supervision, QOC assessments and DQAs were conducted to ensure quality and reliability of results and reports. Outcomes: Acceptability of cervical cancer screening was high. The project increased general awareness among rural community members, where cancer is generally stigmatized and associated with a lot of myths. Knowledge, skills and competencies of 54 midwives to screen for and treat with cryotherapy was built. 23,713 women were screened, with average VIA positivity rate 8%-11% across project districts. 98% of cryotherapy-eligible women treated during the same visit. Referral to Ugandan cancer institute was established to ensure timely cancer therapy. Integration and acceptability of family planning increased among women attending ART clinics. What was learned: With appropriate demand creation, acceptability of SVA was good among women attending the ART clinics, SVA is cost-effective and feasible. Integration of SRH package of services helps leverage resources. Strategic partnerships are critical in strengthening public–private partnership in services provision.
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Singh, Simran. "The Ugandan hip-hop image: the uses of activism and excess in fragile sites." Popular Music 39, no. 3-4 (December 2020): 420–38. http://dx.doi.org/10.1017/s0261143020000446.
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AbstractThis article discusses the characteristics of image in Ugandan hip-hop with a particular focus on representations of activism and excess. Locating Uganda as a fragile site on the basis of widespread political, social and economic marginalisation, this examination considers members of Uganda's first generation of hip-hop artists, to argue that both activism and excess act in singular response to these circumstances. Finding articulation in strivings for economic freedom and social justice, the Ugandan hip-hop image reveals negotiations of histories of colonialism and of contemporary neoliberal capitalism: in doing so, it raises intersections of race and gender, informed by hip-hop's significance as a multi-billion-dollar global industry. This cross-disciplinary inquiry combines ethnomusicology with media, cultural and visual studies in dialogue with political economy.
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Mujuzi, Jamil Ddamulira. "Reconciling Customary Law and Cultural Practices with Human Rights in Uganda." Obiter 41, no. 2 (October 1, 2020): 239–56. http://dx.doi.org/10.17159/obiter.v41i2.9148.
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Customary law has been part of Ugandan law for many years. Section 2 of the Local Council Courts Act, 2006 defines “customary law” to mean “the rules of conduct established by custom and long usage having the force of law and not forming part of the common law nor formally enacted in any legislation”. Ugandan courts have explained the relationship between customary law and other laws. In 1995, Uganda adopted a constitution that includes, among other things, a bill of rights that prohibits discriminatory and degrading laws and customs. This was informed during the making of the Constitution by the arguments of many Ugandans that discriminatory and degrading customary practices and laws should be abolished by the Constitution. In this article, the author illustrates the steps that have been taken by the drafters of the Constitution, Parliament (through legislation) and courts to outlaw discriminatory and degrading cultural practices. The author recommends ways in which some of these measures could be strengthened.
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Serwanga, Jennifer, Susan Mugaba, Auma Betty, Edward Pimego, Sarah Walker, Paula Munderi, Charles Gilks, Frances Gotch, Heiner Grosskurth, and Pontiano Kaleebu. "CD8+T-Cell Responses before and after Structured Treatment Interruption in Ugandan Adults Who Initiated ART with CD4+T Cells <200 Cell/μL: The DART Trial STI Substudy." AIDS Research and Treatment 2011 (2011): 1–10. http://dx.doi.org/10.1155/2011/875028.
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Objective. To better understand attributes of ART-associated HIV-induced T-cell responses that might be therapeutically harnessed.Methods. CD8+T-cell responses were evaluated in some HIV-1 chronically infected participants of the fixed duration STI substudy of the DART trial. Magnitudes, breadths, and functionality of IFN-γ and Perforin responses were compared in STI (n=42) and continuous treatment (CT) (n=46) before and after a single STI cycle when the DART STI trial was stopped early due to inferior clinical outcome in STI participants.Results. STI and CT had comparable magnitudes and breadths of monofunctional CD8+IFNγ+and CD8+Perforin+responses. However, STI was associated with significant decline in breadth of bi-functional (CD8+IFNγ+Perforin+) responses;P=.02, Mann-Whitney test.Conclusions. STI in individuals initiated onto ART at <200 CD4+T-cell counts/μl significantly reduced occurrence of bifunctional CD8+IFNγ+/Perforin+responses. These data add to others that found no evidence to support STI as a strategy to improve HIV-specific immunity during ART.
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Wanyama, Jane N., Maria S. Nabaggala, Bonnie Wandera, Agnes N. Kiragga, Barbara Castelnuovo, Ivan K. Mambule, Josephine Nakajubi, et al. "Significant rates of risky sexual behaviours among HIV-infected patients failing first-line ART: A sub-study of the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial." International Journal of STD & AIDS 29, no. 3 (August 17, 2017): 287–97. http://dx.doi.org/10.1177/0956462417724707.
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There are limited data on the prevalence of risky sexual behaviours in individuals failing first-line antiretroviral therapy (ART) and changes in sexual behaviour after switch to second-line ART. We undertook a sexual behaviour sub-study of Ugandan adults enrolled in the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial. A standardized questionnaire was used to collect sexual behaviour data and, in particular, risky sexual behaviours (defined as additional sexual partners to main sexual partner, inconsistent use of condoms, non-disclosure to sexual partners, and exchange of money for sex). Of the 79 participants enrolled in the sub-study, 62% were female, median age (IQR) was 37 (32–42) years, median CD4 cell count (IQR) was 79 (50–153) cells/µl, and median HIV viral load log was 4.9 copies/ml (IQR: 4.5–5.3) at enrolment. The majority were in long-term stable relationships; 69.6% had a main sexual partner and 87.3% of these had been sexually active in the preceding six months. At enrolment, around 20% reported other sexual partners, but this was higher among men than women (36% versus 6.7 %, p < 0.001). In 50% there was inconsistent condom use with their main sexual partner and a similar proportion with other sexual partners, both at baseline and follow-up. Forty-three per cent of participants had not disclosed their HIV status to their main sexual partner (73% with other sexual partners) at enrolment, which was similar in men and women. Overall, there was no significant change in these sexual behaviours over the 96 weeks following switch to second-line ART, but rate of non-disclosure of HIV status declined significantly (43.6% versus 19.6%, p <0.05). Among persons failing first-line ART, risky sexual behaviours were prevalent, which has implications for potential onward transmission of drug-resistant virus. There is need to intensify sexual risk reduction counselling and promotion of partner testing and disclosure, especially at diagnosis of treatment failure and following switch to second- or third-line ART.
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Kiweewa, Flavia M., Deo Wabwire, Jessica Nakibuuka, Mike Mubiru, Danstan Bagenda, Phillippa Musoke, Mary G. Fowler, and Gretchen Antelman. "Noninferiority of a Task-Shifting HIV Care and Treatment Model Using Peer Counselors and Nurses Among Ugandan Women Initiated on ART." JAIDS Journal of Acquired Immune Deficiency Syndromes 63, no. 4 (August 2013): e125-e132. http://dx.doi.org/10.1097/qai.0b013e3182987ce6.
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Juška, Žygimantas. "The Significance of the EU Trust Fund for Africa on the Ugandan Refugee-Hosting Model." African Review 47, no. 1 (May 4, 2020): 247–66. http://dx.doi.org/10.1163/1821889x-12340018.
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Abstract Uganda’s refugee policy is perceived by the international community to be among the most progressive in the world. It is grounded on the 2006 Refugees Act and its implementation is reinforced by three frameworks: the STA, integrated in the National Development Plan II, as well as two international approaches – CRRF and ReHope – supported by the United Nations and the World Bank. However, the sustainability of the Uganda’s refugee-hosting model is completely dependent on effective financial support from donors, which has been lacking. Indeed, the EU Trust Fund for Africa has been the primary financial tool to facilitate Uganda’s refugee policy. First, this article examines the three main frameworks of the Ugandan policy on refugees: the CRRF, ReHope and STA. Second, it scrutinises three EU projects in Uganda and discusses their relationship with the CRRF, ReHope and STA. Finally, this paper analyses the importance of the EU projects on the refugee policy in the National Development Plan III (2020–2025).
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Kamateeka, Moreen, L. Barlow-Mosha, M. Mubiru, M. Lutajumwa, P. Mudiope, and P. M. Musoke. "Immunologic and Virologic Responses to Nevirapine Based Antiretroviral Therapy (ART) Among HIV-tuberculosis Co-infected Ugandan Children on Rifampicin Based Anti-tubercular Treatment." HIV/AIDS Research and Treatment - Open Journal 2, no. 1 (April 21, 2015): 27–36. http://dx.doi.org/10.17140/hartoj-2-104.
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Beckerman, Michael, Jessica Schwartz, Roland Huntford, Roger Buckton, Michael Cwach, Kevin C. Karnes, Timothy J. Cooley, Bret Werb, Petra Gelbart, and Jeffrey A. Summit. "AUDITORY SNAPSHOTS FROM THE EDGES OF EUROPE." Transactions of the Royal Historical Society 22 (December 2012): 199–221. http://dx.doi.org/10.1017/s0080440112000126.
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ABSTRACTThis article presents thirty ‘auditory snapshots’ from a wide variety of geographical locations and contexts in order to elaborate several points. First, we believe that the study of history cannot be separated from the study of sound, whether in the form of ‘soundscapes’ or pieces of music. Second, we find that considerations of edges, into which we fold such things as provinces, peripheries and frontiers, can be greatly enriched by looking at a broad range of musical phenomena, from the liturgy of Ugandan Jews to reggae-infused Polish mountain songs and from the sounds of Mozart's Black contemporary Saint-Georges to Silent Night on the Southern Seas. Finally, drawing on certain ideas from James C. Scott's The Art of Not Being Governed, we argue that paradoxically, in music, the middle often has unusual properties. In other words, musical structure mimics the ongoing battle between those in positions of authority and those who wish to evade that authority. Beginnings and endings, then, tend to be sites of power and convention, while middles attempt to subvert it. While culturally and geographically we may contrast centres and peripheries, in music the centre is often the edge.
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Bajunirwe, Francis, Flora Tumwebaze, Denis Akakimpa, Cissy Kityo, Peter Mugyenyi, and George Abongomera. "Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts." BioMed Research International 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/9619684.
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Background. UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods. We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions. In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target.
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Kendrick, Maureen, Elizabeth Namazzi, Ava Becker-Zayas, and Esther Nancy Tibwamulala. "Closing the HIV and AIDS “Information Gap” Between Children and Parents: An Exploration of Makerspaces in a Ugandan Primary School." Education Sciences 10, no. 8 (July 23, 2020): 193. http://dx.doi.org/10.3390/educsci10080193.
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In this study, we address the research question: “How might child-created billboards about HIV and AIDS help facilitate more open discussions between parents and children?" The premise of our study is that there may be considerable potential for using multimodal forms of representation in makerspaces with young children to create more open dialogue with parents about culturally sensitive information. Drawing on multimodal literacies and visual methodologies, we designed a makerspace in a grade 5 classroom (with students aged 9–10) in a Ugandan residential primary school. Our makerspace included soliciting students’ knowledge about HIV and AIDS as part of a class discussion focused on billboards in the local community and providing art materials for students to explore their understandings of HIV and AIDS through the creation of billboards as public service announcements. Parents were engaged in the work as audience members during a public exhibition at the school. Data sources include the billboards as artifacts, observations within the makerspace, and interviews with parents and children following the public exhibition. The findings show that, for parents and children, the billboards enhanced communication; new understandings about HIV and AIDS were gained; and real-life concerns about HIV and AIDS were made more visible. Although these more open conversations may depend to some degree on family relationships more broadly, we see great potential for makerspaces to serve as a starting point for closing the HIV and AIDS information gap between children and parents.
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Ghadrshenas, Matine J., Rachel A. Bender Ignacio, Daniel H. Low, Warren Phipps, Jackson Orem, Ann Duerr, and Corey Casper. "Documentation of HIV Testing and Treatment Status Among Patients Presenting for Cancer Care in Uganda." Journal of Global Oncology 2, no. 3_suppl (June 2016): 58s. http://dx.doi.org/10.1200/jgo.2016.003756.
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Abstract 23 HIV increases the incidence and mortality of cancer; knowledge of HIV status and treatment is essential for management of patients with HIV-associated malignancies (HIVAM). In Uganda, where the prevalence of HIV infection is 7.4%, the incidence of AIDS-defining cancers (ADCs) is high, and non-AIDS defining cancers (NADCs) are increasingly common. We investigated how often cancer providers documented HIV status and clinical parameters of HIV infection among patients at the Uganda Cancer Institute (UCI). Medical records of patients aged ≥18 who registered at the UCI June - September 2015 were abstracted for demographics and cancer and HIV parameters. We calculated binomial proportions and used χ2 tests to evaluate factors associated with HIV. Among 1,130 patients in this analysis, 71% of charts documented HIV status. Of those documenting HIV status, 32% were HIV+, and 58% of HIV+ individuals had an ADC. The documented HIV prevalence in NADCs was 21%. Women were more likely to lack HIV results (RR 1.32, p=0.009); 36% of women lacked results, including 40% with cervical cancer. HIV+ patients were younger than HIV-negative patients (median age 41 vs. 49, p<0.001). 62% of HIV-infected patients had a CD4 count recorded; CD4 counts were lower among persons with ADC (median 270 cells/ml, IQR 80-460) compared with NADC (median 370, IQR 215-564), p=0.006. There was no difference in the proportion of HIV patients with ADCs and NADCs receiving ART (both 86%, p=0.45). HIV prevalence was 4.5 times higher in Ugandan cancer patients with documented status than in the general population. Though the majority of cancer patients had HIV testing performed, gaps remained in documenting HIV status, even among cancers considered AIDS-defining in HIV. This study highlights opportunities to educate cancer clinicians in Africa on the burden of HIV in cancer patients and opportunities to coordinate management of both cancer and HIV. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Matine J. Ghadrshenas No relationship to disclose Rachel A. Bender Ignacio No relationship to disclose Daniel H. Low No relationship to disclose Warren Phipps No relationship to disclose Jackson Orem No relationship to disclose Ann Duerr No relationship to disclose Corey Casper Leadership: Temptime Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, GlaxoSmithKline
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Dirajlal-Fargo, Sahera, Abdus Sattar, Victor Musiime, Cissy Kityo, Reuben N. Robbins, Anthony F. Santoro, Christopher Ferraris, Yoelvis Garcia-Mesa, Grace A. McComsey, and Dennis Kolson. "80. Heme Oxygenase-1 Gene promoter and associations with inflammation and subclinical vascular disease in Ugandan adolescents with and without HIV." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S52. http://dx.doi.org/10.1093/ofid/ofab466.080.
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Abstract Background Heme oxygenase-1 (HO-1) is a cytoprotective enzyme with potent anti-inflammatory, and anti-oxidant effects. The HO-1 response is modulated by functional polymorphisms (a dinucleotide (GT)n repeat length variation) in the HO-1 gene promoter region which have been associated with cardiovascular disease (CVD) susceptibility in adults. HO-1 polymorphisms and their associations with markers of inflammation and CVD in Ugandan adolescents with (HIV+) and without HIV (HIV-) have not been investigated. Methods We included 177 children (92 HIV+, 85 HIV-) enrolled in an ongoing observational cohort study at the Joint Clinical Research Center, Kampala, Uganda. All HIV+ participants were on ART. HO-1 (GT)n allele genotypes were determined by PCR of the (GT)n repeat region followed by fragment size determination on a capillary sequencer in DNA extracted from blood samples. Allele designations were assigned by number of (GT)n repeats: S < 27, M 27-34, or L > 34 repeats. We measured mean common carotid artery intima-media thickness (IMT) as a marker of CVD, markers of systemic inflammation (hsCRP, IL6, sTNFRI), monocyte activation (sCD14 and sCD163), and T-cell activation (expression of CD38 and HLA-DR on CD4+ and CD8+) , oxidized lipids, markers of gut integrity and fungal translocation (BDG). Results Median age (IQR) was 13 (11, 14), 44% were females, 86% had viral load < 20 copies/mL. 19% had a short allele genotype, 37% had a medium allele genotype and 44% had a long allele genotype (Figure). The shortest and longest allele length correlated with lower IMT in HIV- only (r=-0.36 and -0.30, respectively, p≤ 0.01 for both). Among biomarkers, only the medium allele correlated with oxidized lipids in HIV+ and with hsCRP and BDG in HIV- (p≤ 0.05). After adjusting for age, sex, and BMI, the presence of a long allele was associated with lower IMT. This was no longer significant after adjusting for markers of inflammation or oxidized lipids (Table). Heme Oxygenase-1 genotype allele length frequency in Ugandan cohort of HIV+ and HIV- youth 1: Models are adjusted for age (years), sex (male vs female), BMI (kg/m2) and HIV status (positive vs negative) 2: Models are adjusted for age (years), sex (male vs female), BMI (kg/m2), sCD14 (pg/mL) and HIV status (positive vs negative) 3: Models are adjusted for age (years), sex (male vs female), BMI (kg/m2), high sensitivity C reactive protein (ng/mL) and HIV status (positive vs negative) 4: Models are adjusted for age (years), sex (male vs female), BMI (kg/m2), oxidized lipids and HIV status (positive vs negative) Conclusion These findings underscore the potential of the HO pathways in modulating future risk for CVD in adolescents through inflammation. HIV status in this setting, likely influences the associations with the genotype with the risk of CVD. Further studies to validate our findings in this population are required. Disclosures Grace A. McComsey, MD, Gilead (Consultant, Advisor or Review Panel member)Janssen (Consultant, Advisor or Review Panel member)Merck (Consultant, Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member)Redhill (Research Grant or Support)Roche (Grant/Research Support)Tetraphase, Astellas (Research Grant or Support)Theratechnologies (Consultant)Vanda (Grant/Research Support)ViiV/GSK (Scientific Research Study Investigator, Advisor or Review Panel member)
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Crane, Johanna T. "Dreaming partnership, enabling inequality: administrative infrastructure in global health science." Africa 90, no. 1 (January 2020): 188–208. http://dx.doi.org/10.1017/s0001972019001001.
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AbstractThis article examines the fiscal and administrative infrastructures underpinning global health research partnerships between the US and Uganda, and the power dynamics they entail. Science studies scholars and anthropologists have argued for the importance of studying so-called ‘boring things’ – standards, bureaucracies, routinization, codes and databases, for example – as a way to bring to the surface the assumptions and power relations that often lie embedded within them. This article focuses on fiscal administration as an understudied ethnographic object within the anthropology of global health. The first part of the article is a case study of the fiscal administration of a US–Uganda research partnership. The second part describes the institutionalization of some of the administrative norms and practices used by this partnership within the ‘global health enabling systems’ employed by US universities working in Uganda and elsewhere in Africa. I analyse a case study and ‘enabling systems’ to show how these administrative strategies create parallel infrastructures that avoid direct partnership with Ugandan public institutions and may facilitate the outsourcing of legal and financial risks inherent in international partnerships to Ugandan collaborators. In this way, these strategies act to disable rather than enable (or build) Ugandan research and institutional capacity, and have profound implications for African institutions as well as for the dream of ‘real partnership’ in global health.
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Awadu, Jorem Emmillian, Alla Sikorskii, Sarah Zalwango, Audrey Coventry, Bruno Giordani, and Amara E. Ezeamama. "Developmental Disorder Probability Scores at 6–18 Years Old in Relation to In-Utero/Peripartum Antiretroviral Drug Exposure among Ugandan Children." International Journal of Environmental Research and Public Health 19, no. 6 (March 21, 2022): 3725. http://dx.doi.org/10.3390/ijerph19063725.
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(1) We examined the hypothesis that in utero/peripartum antiretroviral (IPA) exposure may affect the likelihood of developmental disorders—i.e., attention deficit and hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and functional impairment (FI). (2) Children and their primary caregivers were enrolled and followed for 12 months. The sample included 250 children perinatally HIV-infected (CPHIV), 250 children HIV-exposed and uninfected (CHEU) of women living with HIV, and 250 children HIV unexposed and uninfected (CHUU) at 6–18 years of age. CHEU’s IPA exposure -type was established via medical records and categorized as no IPA, single-dose nevirapine with/without zidovudine (SdNVP ± AZT), SdNVP + AZT + Lamivudine (3TC), or combination ART (cART). Developmental disorders were assessed at months 0, 6, and 12 per caregiver response to standardized questions from the third edition of Behavioral Assessment System for Children. Multivariable repeated measures linear regression models estimated standardized mean differences (SMDs) with 95% confidence intervals (95% CI) according to the IPA exposure type relative to CHUU with adjustment for the dyad’s sociodemographic and psychosocial factors. (3) Relative to the CHUU, outcomes were similar for CPHIV/CHEU with cART, SdNVP ± AZT, and no anti-retroviral drug exposure in the peripartum period. For CHEU relative to CHUU, SdNVP + AZT + 3TC exposure was associated with lower resiliency (SMD = −0.26, 95% CI: −0.49, −0.51), and elevated scores on ADHD (SMD = 0.41, 95% CI: 0.12, 0.70), ASD (SMD = 0.40, 95% CI: 0.19, 0.61), and EBD (SMD = 0.32, 95% CI: 0.08, 0.56) probability and functional impairment (SMD = 0.39, 95% CI: 0.18, 0.61) index scores. With the exception of ADHD, the adverse association between SdNVP + AZT + 3TC and outcomes were replicated for CPHIV vs. CHUU. (4) The results provided reassuring evidence that cART exposure in the peripartum period is unlikely to be adversely associated with developmental disorder probability scores in late childhood and adolescent years. However, the peripartum SdNVP + AZT + 3TC exposure associated elevation in developmental disorder probability and functional limitation at 6–18 years of life is a concern.
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Hundle, Anneeth Kaur. "Postcolonial Patriarchal Nativism, Domestic Violence and Transnational Feminist Research in Contemporary Uganda." Feminist Review 121, no. 1 (March 2019): 37–52. http://dx.doi.org/10.1177/0141778918818835.
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This article examines the development of a multidimensional, transnational feminist research approach from and within Uganda in relation to a high-profile case of domestic violence and femicide of a middle-class, upper-caste Indian migrant woman in Kampala in 1998. It explores indigenous Ugandan public and Ugandan Asian/Indian community interpretations and the dynamics of cross-racial feminist mobilisation and protest that emerged in response to the Joshi-Sharma domestic violence case. In doing so, it advocates for a transnational feminist research approach from and within Uganda and the Global South that works against the grain of nationalist and nativist biases in existing feminist scholarly trends. This approach lays bare power inequalities and internal tensions within and across racialised African and Asian communities, and thus avoids the romanticisation of cross-racial feminist African-Asian solidarities.
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Heffron, Renee, Timothy R. Muwonge, Katherine K. Thomas, Florence Nambi, Lylianne Nakabugo, Joseph Kibuuka, Dorothy Thomas, et al. "PrEP uptake and HIV viral suppression when PrEP is integrated into Ugandan ART clinics for HIV-negative members of HIV-serodifferent couples: A stepped wedge cluster randomized trial." eClinicalMedicine 52 (October 2022): 101611. http://dx.doi.org/10.1016/j.eclinm.2022.101611.
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Kapoor, Shailendra. "RE: Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults by JM Nachegaet al. (2013),TMIH18, pp 53-57." Tropical Medicine & International Health 19, no. 1 (December 17, 2013): 131–32. http://dx.doi.org/10.1111/tmi.12243.
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Nakimuli-Mpungu, Ethel, David W. Dowdy, and Jean B. Nachega. "RE: Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults by JM Nachegaet al. (2013),TMIH18, pp 53-57." Tropical Medicine & International Health 19, no. 1 (December 17, 2013): 133–34. http://dx.doi.org/10.1111/tmi.12244.
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Beckmann, Gitte. "Sign language as a technology: existential and instrumental perspectives of Ugandan Sign Language." Africa 92, no. 4 (August 2022): 430–48. http://dx.doi.org/10.1017/s0001972022000432.
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AbstractThe introduction of Ugandan Sign Language in Acholi, northern Uganda, was part of a growing internationally linked disability movement in the country and was set within the framework of development policy and human rights-based approaches. In this context, Ugandan Sign Language appeared as a technology of development. But how did the appropriation of Ugandan Sign Language change deaf people’s lives, their being-in-the-world, in Acholi? In using the theoretical approach of existential and instrumental perspectives on technologies by Martin Heidegger, this article analyses the complex transitions following the appropriation of Ugandan Sign Language on international, national and local levels. The disability movement – including Ugandan Sign Language projects – reached Acholi during the time of war between the Lord’s Resistance Army and Ugandan national forces. Displacement brought scattered deaf people together in towns and camps, where Ugandan Sign Language was introduced through workshops and institutions including churches. This created new forms of communication and possibilities of sociality. After the war, gender differences emerged, as many deaf women returned to rural homes where they had few opportunities to communicate with other sign language users.
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Leopold, Mark. "Legacies of Slavery in North-West Uganda: The Story of the ‘one-Elevens’." Africa 76, no. 2 (May 2006): 180–99. http://dx.doi.org/10.3366/afr.2006.76.2.180.
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AbstractThis article outlines the history of a people known as ‘Nubi’ or ‘Nubians’, northern Ugandan Muslims who were closely associated with Idi Amin's rule, and a group to which he himself belonged. They were supposed to be the descendants of former slave soldiers from southern Sudan, who in the late 1880s at the time of the Mahdi's Islamic uprising came into what is now Uganda under the command of a German officer named Emin Pasha. In reality, the identity became an elective one, open to Muslim males from the northern Uganda/southern Sudan borderlands, as well as descendants of the original soldiers. These soldiers, taken on by Frederick Lugard of the Imperial British East Africa Company, formed the core of the forces used to carve out much of Britain's East African Empire. From the days of Emin Pasha to those of Idi Amin, some Nubi men were identified by a marking of three vertical lines on the face – the ‘One-Elevens’. Although since Amin's overthrow many Muslims from the north of the country prefer to identify themselves as members of local Ugandan ethnic groups rather than as ‘Nubis’, aspects of Nubi identity live on among Ugandan rebel groups, as well as in cyberspace.
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Mwaka, Erisa Sabakaki, Ian Guyton Munabi, Barbara Castelnuovo, Arvind Kaimal, William Kasozi, Andrew Kambugu, Philippa Musoke, and Elly Katabira. "Low bone mass in people living with HIV on long-term anti-retroviral therapy: A single center study in Uganda." PLOS ONE 16, no. 2 (February 5, 2021): e0246389. http://dx.doi.org/10.1371/journal.pone.0246389.
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Background This study set out to determine the prevalence of low bone mass following long-term exposure to antiretroviral therapy in Ugandan people living with HIV. Methods A cross-sectional study was conducted among 199 people living with HIV that had been on anti-retroviral therapy for at least 10 years. All participants had dual X-ray absorptiometry to determine their bone mineral density. The data collected included antiretroviral drug history and behavioral risk data Descriptive statistics were used to summarize the data. Inferential statistics were analyzed using multilevel binomial longitudinal Markov chain Monte Carlo mixed multivariate regression modelling using the rstanarm package. Results One hundred ninety nine adults were enrolled with equal representation of males and females. The mean age was 39.5 (SD 8.5) years. Mean durations on anti-retroviral treatment was 12.1 (SD 1.44) years, CD4 cell count was 563.9 cells/mm3. 178 (89.5%) had viral suppression with <50 viral copies/ml. There were 4 (2.0%) and 36 (18%) participants with low bone mass of the hip and lumbar spine respectively. Each unit increase in body mass index was associated with a significant reduction in the odds for low bone mineral density of the hip and lumbar spine. The duration on and exposure to the various antiretroviral medications had no significant effect on the participant’s odds for developing low bone mass. All the coefficients of the variables in a multivariable model for either hip or lumbar spine bone mass were not significant. Conclusion These results provide additional evidence that patients on long term ART achieve bone mass stabilization. Maintaining adequate body weight is important in maintaining good bone health in people on antiretroviral therapy.
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Mujuzi, Jamil Ddamulira. "Hearsay evidence in Uganda: Understanding its meaning, admissibility and probative value." International Journal of Evidence & Proof 24, no. 4 (September 22, 2020): 418–39. http://dx.doi.org/10.1177/1365712720960241.
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In Uganda legislation requires witnesses to adduce direct evidence in court. However, this may not be possible in all cases and the law provides for circumstances in which hearsay may be admissible. The Evidence Act is the main piece of legislation which governs the issue evidence. In this article, the author relied on 539 cases in which the Ugandan High Court, Court of Appeal and Supreme Court have dealt with hearsay evidence to establish the principles which these courts have developed on this issue. This case law shows, inter alia, that there are three major issues that Ugandan courts are still grappling with when it comes to hearsay evidence: the definition of hearsay; the admissibility of hearsay (exceptions to the hearsay rule) and the probative value of hearsay evidence. The author suggests ways in which courts can handle these issues.
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Boardman, Jed, and Emilio Ovuga. "Rebuilding psychiatry in Uganda." Psychiatric Bulletin 21, no. 10 (October 1997): 649–55. http://dx.doi.org/10.1192/pb.21.10.649.
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Psychiatry in Uganda has a fine pedigree. Academic psychiatry was established in the late 1960s when the Makerere University Department of Psychiatry was founded. Academic medicine and psychiatry suffered during the Amin regime but, like the country as a whole, these have begun to rebuild themselves over the past 10 years. Problems still remain including poor facilities, lack of resources, and a need to revise the Mental Treatment Act and standards of treatment. The high prevalence of AIDS and post-traumatic stress disorder place added burdens on Ugandan psychiatry.
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Hjelmeland, Heidi, Birthe Loa Knizek, Eugene Kinyanda, Seggane Musisi, Hilmar Nordvik, and Kyrre Svarva. "Suicidal Behavior as Communication in a Cultural Context." Crisis 29, no. 3 (May 2008): 137–44. http://dx.doi.org/10.1027/0227-5910.29.3.137.
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In this study, we attempt to even out some of the imbalance in suicide research caused by the fact that most such research has been conducted in the Western part of the world with the corresponding common disregard of the potential problems in generalizing findings to different cultural settings. Our point of departure was to look at suicidal behavior as communication and our main purpose was to investigate whether Qvortrups semiotic four-factor model, which has been empirically supported in the West, would be applicable in an African context, exemplified by Uganda. Interviews of patients admitted to hospital following an act of nonfatal suicidal behavior were conducted in Uganda and Norway and the data were compared. The results showed that the four-factor structure found in the West was not applicable in the Ugandan context, but that two by two of these factors were collapsed into a two-factor model in Uganda: One factor regarding the external dialog and one factor regarding the internal dialog. Some differences and some similarities were found between Norway and Uganda when suicidal behavior was considered as a communicative act. The results are discussed in terms of the differences in the psychological characteristics of the suicidal persons in the two countries, as well as the different cultural settings of the study.
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Apuuli, Kasaija Phillip. "Uganda’s decision ‘In the Matter of an Arrest Warrant and the Surrender to the International Criminal Court (ICC) of Omar Hassan Ahmed al-Bashir’: Explanation, issues and consequences." African Yearbook on International Humanitarian Law 2021 (2021): 150–73. http://dx.doi.org/10.47348/ayih/2021/a6.
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On 19 December 2019, High Court Justice Peter Adonyo issued a warrant of arrest for former Sudan President Omar al-Bashir should he ever set foot in Uganda or in a territory controlled by Uganda. He also held that by failing to arrest and surrender al-Bashir on two occasions in 2016 and 2017, in fulfilment of the warrants of arrest issued by the International Criminal Court (ICC) in 2009 and 2010, Uganda had breached its own International Criminal Court Act (2010), the Rome Statute (1998) and United Nations Security Council Resolution 1593 (2005). This contribution discusses the judgment by considering the context of Uganda’s failure to meet its legal obligations with regard to the ICC’s arrest warrants against al-Bashir. It then discusses the future of Uganda’s arrest warrant against al-Bashir, and the court’s clarification of the superiority of United Nations (UN) decisions over those of the African Union (AU).
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Yakah, William, Jenifer I. Fenton, Alla Sikorskii, Sarah K. Zalwango, Robert Tuke, Philippa Musoke, Michael J. Boivin, Bruno Giordani, and Amara E. Ezeamama. "Serum Vitamin D is Differentially Associated with Socioemotional Adjustment in Early School-Aged Ugandan Children According to Perinatal HIV Status and In Utero/Peripartum Antiretroviral Exposure History." Nutrients 11, no. 7 (July 12, 2019): 1570. http://dx.doi.org/10.3390/nu11071570.
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An impact of vitamin D in neurocognitive function has been theorized but it remains unknown whether vitamin-D insufficiency (VDI) is associated with worse socio-emotional adjustment (SEA) in vulnerable early school-aged children. This study examines the thesis that deficits in SEA are related to VDI using longitudinal data from 254 children that are perinatally HIV-infected (PHIV), exposed-uninfected (HEU), or unexposed-uninfected (HUU). In utero/peripartum antiretroviral (IPA) exposure was established per medical record documentation of biological mother’s ART regimen in pregnancy. Four caregiver-reported age- and sex-standardized measures of SEA were obtained at months 0, 6, and 12 for dependent children aged 6–10 years: externalizing problems (EPC), internalizing problems (IPC), behavioral symptoms index (BSI), and adaptive skills index (ASI). VDI was highly prevalent (74%, n = 188), and its association with change in SEA measures over 12 months varied by HIV-status (VDI*HIV, all p-values < 0.03). There was further variation in relationship of vitamin-D to SEA by IPA among PHIV (for ASI, BSI, and EPC, vitamin-D*IPA, p-value ≤ 0.01) and HEU (for BSI and EPC, vitamin-D*IPA, p-value ≤ 0.04). Among HUU, BSI (β = −0.32, 95% CI: −0.50, −0.13), IPC (β = −0.28, 95% CI: −0.47, −0.09), and EPC (β = −0.20, 95% CI: −0.37, −0.02) all declined moderately per quartile increment in VD. Among PHIV, on the one hand higher vitamin D predicted ASI gains (moderate vs. low VD, β = 0.52, p = 0.002), but this protective association was absent for BSI, EPC, and IPC (β = 0.36–0.77, p < 0.05). In absence of IPA-exposure, increasing vitamin-D predicted declines in BSI and EPC (moderate vs. low Vitamin D, β = −0.56 to −0.71, p ≤ 0.02) among HEU. However, given IPA exposure among HEU, higher VDI predicted moderate elevation in BSI (β = 0.39, 95% CI: 0.00, 0.78) and IPC (β = 0.48, 95% CI: 0.05, 0.92). Interaction between VD and IPA exposure for SEA outcomes among HEU and PHIV children warrants further investigation. The vitamin-D associated SEA improvement among HUU and HEU without IPA exposure suggests vitamin-D supplementation may remediate behavioral and adaptive deficits in this groups.
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Edmondson, Laura. "Antihomosexual Acts on Trial: The Poetics of Justice in Uganda." TDR/The Drama Review 63, no. 2 (June 2019): 6–33. http://dx.doi.org/10.1162/dram_a_00833.
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Reading across artistic, political, and legal expressions of LGBT activism in and from Uganda reveals an aesthetics of silence. These moments of silence serve as a strategy of deferral that enables Ugandans on both sides of the Anti-Homosexuality Bill controversy to refuse humanitarian savior narratives, affirm the legitimacy of the postcolonial state, and point the way toward an East African grammar of justice.
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Mujuzi, Jamil Ddamulira. "The Trial of Civilians Before Courts Martial in Uganda: Analysing the Jurisprudence of Ugandan Courts in the Light of the Drafting History of Articles 129(1)(d) and 120(a) of the Constitution." Potchefstroom Electronic Law Journal 25 (April 5, 2022): 1–32. http://dx.doi.org/10.17159/1727-3781/2022/v25ia12023.
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Unlike in the constitutions of other African countries such as Botswana and Lesotho, where the relationship between the High Court and courts martial is stipulated, the Ugandan Constitution 1995 (the Constitution) does not deal with this relationship. The Constitution is also silent on the question of whether courts martial have jurisdiction over civilians. The Uganda Peoples' Defence Forces Act (the UPDF Act) creates different types of courts martial with varying jurisdictions (section 197). The Act also provides (section 119) for the circumstance in which the General Court Martial has jurisdiction over civilians and appeals against the decisions of the General Court Martial lie to the Court Martial Appeal Court, which is the final appellate court except in cases where the offender is sentenced to death or life imprisonment. According to Regulation 20(2) of the UPDF (Court Martial Appeal Court) Regulations, in case an offender is sentenced to death or life imprisonment and his/her sentence is upheld by the Court Martial Appeal Court, he/she has a right to appeal to the Court of Appeal. Since 2003, Ugandan courts have grappled with the issues of whether courts martial are courts of judicature within the meaning of article 129(1) of the Constitution or organs of the UPDF and, therefore, part of the Executive under article 210 of the Constitution and whether courts martial have jurisdiction over civilians. Judges of the Supreme Court Constitutional Court and Court of Appeal have often disagreed on these issues. In this article the author relies on the drafting history of Articles 129 and 210 to argue that courts have erred by holding that courts martial are not courts of judicature under article 129(d) of the Constitution; and that courts martial are subordinate to the High Court. The author also relies on the drafting history of the Constitution and on international human rights law to argue that courts martial in Uganda should not have jurisdiction over civilians because they lack the necessary independence and impartiality and were established for the single purpose of enforcing military discipline.
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Scott, Kirsten, Jonathan A. Butler, Karen Spurgin, and Prabhuraj D. Venkatraman. "Restorative fashion: Collaborative research, benign design and the healing powers of the mutuba tree." Journal of Applied Arts & Health 13, no. 3 (December 1, 2022): 357–72. http://dx.doi.org/10.1386/jaah_00116_1.
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The potential of a radically Indigenous and endangered textile to improve human well-being and environmental health is the subject of an ongoing cross-disciplinary and multi-faceted research project between the United Kingdom and Uganda. This article presents the researchers’ findings to date on Ugandan barkcloth, produced from the mutuba tree and part of the Intangible Cultural Heritage of Humanity. Methods included fieldwork in Uganda, natural dye experiments, testing a biodesign strategy, textile laboratory testing and scientific laboratory testing of the unique antimicrobial properties of barkcloth. Although beginning with artistic, practice-based research, the group uncovers important knowledge that may provide significant medical science benefits. They identify the central role of the mutuba tree in restorative and agroforestry systems; create natural dyes that may confer barkcloth’s properties to other materials. Thus demonstrating barkcloth production as a truly slow fashion textile and well-making system that promotes the well-being of people and planet in multiple ways.