Background Malaria is one of the leading causes of morbidity and mortality among children under 5 years of age in Uganda. Although Karamoja sub-region has the highest prevalence of malaria, and one of the highest case fatality rates in children under 5 years, information on malaria case management for the sub-region is scarce. The study evaluated the malaria diagnostic and treatment practices, as well as the factors associated with inappropriate care for children under 5 years of age presenting with fever in two public hospitals within the sub-region. Methods A cross-sectional study was conducted amongst 857 children under 5 years of age who presented with fever at Abim and Kaabong general hospitals between February and March 2020. A questionnaire was administered to the primary caregiver during exit/bedside interviews to collect socio-demographic information. The participant clinical notes were reviewed to capture information on laboratory tests conducted, diagnosis given, and treatment prescribed. In addition, a health facility assessment was conducted and information on healthcare workers was collected. The healthcare worker and facility data was linked to the participant’s hospital visit. Main outcome measures were malaria diagnostic and treatment practices. Results Of the 857 children enrolled, 820 (95.7%) had a malaria diagnostic test done and 623 (76.0%) tested positive for malaria. All test positive children received anti-malarial treatment, however, only 424/623 (68.1%) received the recommended anti-malarial drug and 376/424 (88.7%) received the right dose of the treatment. Inappropriate diagnosis/treatment was in 321 (37.5%) of the enrolled participants. Factors associated with inappropriate diagnosis/treatment included: lack of recommended anti-malarials on the day of the visit (Prevalence Ratio [PR] = 2.1, 95% confidence interval [CI] 1.8–2.4), hospital where care was sought (PR = 0.4, 95% CI 0.3–0.5), being managed by a recently supervised health worker (PR = 0.5, 95% CI 0.2–0.9), and health worker cadre (PR = 0.8, 95% CI 0.7–0.9). Conclusion The prevalence of inappropriate malaria diagnosis and treatment in the Karamoja sub-region was high with approximately one in every three children receiving inappropriate care. This was majorly influenced by health system factors, which if improved upon may reduce malaria-related mortalities in the sub-region a vital step in meeting the country’s target of zero deaths from malaria by 2030.

Background: Atherogenic Index of Plasma (AIP) is a reliable predictor of coronary artery disease. There is paucity of data on AIP and its correlates among patients with type 2 diabetes (T2D) in Uganda. Objective: To assess the profile of AIP and its cardiovascular risk factor correlates among patients with T2D in Uganda. Methods: This was a cross-sectional study conducted in 8 health facilities with established T2D clinics in Central-Uganda. The study enrolled 500 patients aged 40 to 79 years. Data was collected on socio-demographic characteristics, lipid profile and glycated haemoglobin (HbA1c). The AIP was derived using log (triglycerides/high-density cholesterol) and further categorised as low cardiovascular disease (CVD) risk if the AIP was <0.1, intermediate risk (0.1-0.24) and high risk (≥0.24). Cardiovascular risk factors were defined according to international guidelines. Stata version 14 was used to analyse data, Pearson correlation analyses were conducted. Statistical significance was set at p<0.05. Results: There were 389(77.4%) females with a mean age of 55.07±8. 979 years. Low-risk was found in 43.6%, intermediate risk in 20.2% and high risk in 36.2% of the participants. AIP significantly correlated with waist circumference (r=0.1095, p<0.0147), waist-hip ratio (r=0.1926, p<0.001), Casteri Risk Index I (r=0.506, r=<0.001), Casteri Risk Index II (r=0.246, p<0.001) and atherogenic coefficient (r=0.186, p<0.001). Insignificant correlation was observed between AIP and fasting blood sugar (r=0.017, p=0.7042), HBA1C (r=0.0108, p=0.8099) and diabetes duration (r=0.0445, p=0.32) Conclusions: AIP is significantly elevated and correlated with cardiovascular risk factors in patients with T2D. In clinical management, this may be a useful tool in risk stratifying patients with T2D. Keywords: Atherogenic index of plasma; Type 2 diabetes; cardiovascular risk factors; Uganda.

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Aim: The aim of this study was to determine the prevalence of abnormal atherogenic cardiovascular indices, Ankle brachial index and their correlation with the predicted 10-year atherosclerotic cardiovascular disease risk (ASCVD) among type 2 diabetes patients in Central Uganda. Methodology: Five hundred patients aged 40-79 were consecutively selected.  Socio-demographic data was collected with a pre-tested questionnaire. Physical and laboratory measurements were performed. Atherogenic cardiovascular indices such as Atherogenic Index of Plasma (AIP), Atherogenic Coefficient and Casteri Risk Index I& II were determined. Ankle Brachial Index (ABI) was measured. We used the revised Pooled Cohorts Risk Equations to quantify the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. The proportions and percentages of atherogenic cardiovascular indices, ABI and 10-year ASCVD risk were determined. Pearson chi-square correlation analyses were performed to determine correlation. Statistical significance was set at P<0.05. Results: The prevalence of elevated AIP was 56.45%, Casteri Risk Index I 68.4%, Casteri Risk Index II 32.6 and Atherogenic Coefficient 64.8%. Low ABI of<0.9 was found among 25.4% while 0.6% had an ABI>1.3.Atherogenic cardiovascular indices significantly correlated with 10 year ASCVD risk with Casteri Risk Index I (r=0.185, P<0.001), Casteri Risk Index II (r=0.127, P=0.004), Atherogenic Coefficient r=0.186, P<0.001). AIP was positively but not significantly correlated with ASCVD risk (r=0.053, P=0.241). ABI negatively correlated with the ASCVD risk (r=-0.225, P<0.001).  Conclusion: Prevalence of abnormal atherogenic cardiovascular indices and ABI was high. They correlated with the ASCVD risk. Atherogenic cardiovascular indices and ABI can be used to screen and manage ASCVD in our setting.