BackgroundAlthough fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on the burden of HIV and service utilization, particularly among the youth. We assessed the HIV prevalence and utilization of HIV prevention and treatment services among youth in Kasensero fishing community and the neighboring communities.MethodData were derived from the Rakai Community Cohort Study (RCCS) surveys conducted between 2013 and 2014. The RCCS is a population-based household survey that collects data annually from individuals aged 15–49 years, resident in 48 communities in Rakai and neighboring districts in Uganda. For this analysis, socio-demographic, behavioral and HIV-related data were obtained for 792 individuals aged 15–24 years. We used logistic regression to conduct bivariate and multivariable analysis to determine the factors that are independently associated with HIV-positive status and their corresponding 95% confidence intervals. Data were analyzed using STATA version 13.ResultsOverall HIV prevalence was 19.7% (n = 155); higher in Kasensero (n = 141; 25.1%) and Gwanda (n = 8; 11%) than in Kyebe (n = 6; 3.9%), p < 0.001 and among females (n = 112; 26.0%) than males (n = 43; 12.0%), p < 0.001. Uptake of HIV testing was high in both HIV-positive (n = 136; 89.5%) and HIV-negative youth (n = 435; 92%). Consistent condom use was virtually non-existent in HIV-positive youth (n = 1; 0.6%) compared to HIV-negative youth (n = 20; 4.2%). Only 22.4% (n = 34) of the HIV-positive youth were receiving antiretroviral therapy (ART) in 2013–2014; higher in the HIV-positive females (n = 31; 28.4%) than HIV-positive males (n = 03; 6.7%). Slightly more than half of males (n = 134; 53.8%) reported that they were circumcised; the proportion of circumcised youth was higher among HIV-negative males (n = 122; 58%) than HIV-positive males (n = 12; 27.9%). Factors significantly associated with HIV-positive status included living in Kasensero landing site (adjusted Odds Ratio [aOR] = 5.0; 95%CI: 2.22–13.01) and reporting one (aOR = 5.0; 95%CI: 1.33–15.80) or 2+ sexual partners in the past 12 months (aOR = 11.0; 95% CI; 3.04–36.72).ConclusionThe prevalence of HIV is high especially among young females and in landing site communities than in the peripheral communities. Uptake of HIV prevention and treatment services is very low. There is an urgent need for youth-friendly services in these communities.

BackgroundOn 6 February 2015, Kampala city authorities alerted the Ugandan Ministry of Health of a “strange disease” that killed one person and sickened dozens. We conducted an epidemiologic investigation to identify the nature of the disease, mode of transmission, and risk factors to inform timely and effective control measures.MethodsWe defined a suspected case as onset of fever (≥37.5 °C) for more than 3 days with abdominal pain, headache, negative malaria test or failed anti-malaria treatment, and at least 2 of the following: diarrhea, nausea or vomiting, constipation, fatigue. A probable case was defined as a suspected case with a positive TUBEX® TF test. A confirmed case had blood culture yielding Salmonella Typhi. We conducted a case-control study to compare exposures of 33 suspected case-patients and 78 controls, and tested water and juice samples.ResultsFrom 17 February–12 June, we identified 10,230 suspected, 1038 probable, and 51 confirmed cases. Approximately 22.58% (7/31) of case-patients and 2.56% (2/78) of controls drank water sold in small plastic bags (ORM-H = 8.90; 95%CI = 1.60–49.00); 54.54% (18/33) of case-patients and 19.23% (15/78) of controls consumed locally-made drinks (ORM-H = 4.60; 95%CI: 1.90–11.00). All isolates were susceptible to ciprofloxacin and ceftriaxone. Water and juice samples exhibited evidence of fecal contamination.ConclusionContaminated water and street-vended beverages were likely vehicles of this outbreak. At our recommendation authorities closed unsafe water sources and supplied safe water to affected areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-4002-0) contains supplementary material, which is available to authorized users.

Across Borders field events in Kanungu and Kisoro districts-Uganda, March 2019 Date Type (no. of participants) District Target group Event location Mar 15 Key informant interview (1) Kisoro Border screening volunteer Nteko, unofficial POE Mar 18 Focus group discussion (8) Kisoro Transport personnel (motorcycle taxi drivers) Bunagana, official POE Mar 18 Key informant interview (1) Kisoro Security personnel Bunagana, official POE Mar 19 Key informant interview (1) Kisoro Health care worker Nyakabande refugee transit camp Mar 19 Focus group discussion (4) Kisoro Health care workers Kisoro Hospital Mar 20 Key informant interview (1) Kanungu Security personnel Kanungu district health office Mar 21 Key informant interview (1) Kanungu District health personnel Kanungu district health office Mar 21 Focus group discussion (10) Kanungu Community leaders Butogota (also called Kyeshero), official POE Mar 22 Focus group discussion (8) Kanungu Traders Ishasha, official POE Mar 23 Focus group discussion (8) Kanungu Health care workers Bwindi Community Hospital Mar 25 Focus group discussion (8) Kanungu Military personnel at the border point Kayonza Tea Factory Mar 25 Key informant interview (1) Kanungu Health care worker Matanda refugee transit center Abbreviation: POE = point of entry.

BackgroundOn 18 August 2015, Kyegegwa District reported eight deaths during a measles outbreak to the Uganda Ministry of Health (MoH). We investigated this death cluster to verify the cause, identify risk factors, and inform public health interventions.MethodsWe defined a probable measles case as onset of fever and generalised rash in a Kyegegwa District resident from 1 February – 15 September 2015, plus ≥1 of the following: coryza, conjunctivitis, and cough. A confirmed measles case was a probable case with measles-specific IgM positivity. A measles death was a death of a probable or confirmed case-person. We conducted an active case-finding to identify measles patients who survived or died. In a case-control study, we compared risk factors between 16 measles patients who died (cases) and 48 who survived (controls), matched by age (±4 years) and village of residence.ResultsWe identified 94 probable measles cases, 10 (11%) were confirmed by positive measles-specific IgM. Of the 64 probable measles patients aged <5 years, 16 died (case-fatality rate = 25%). In the case-control study, no history of vaccination against measles was found in 94% (15/16) among the case-persons (i.e., measles patients who died) and 54% (26/48) among the controls (i.e., measles patients who survived) (ORM-H = 12; 95% CI = 1.6–104), while 56% (9/16) of case-persons and 67% (17/48) of controls (ORM-H = 2.3; 95% CI =0.74–7.4) did not receive vitamin A supplementation during illness. 63% (10/16) among the case-persons and 6.3% (3/48) of the controls (ORM-H = 33; 95% CI = 6.8–159) were not treated for measles illness at a health facility (a proxy for more appropriate treatment), while 38% (6/16) of the case-persons and 25% (12/48) of the controls (ORM-H = 2.5; 95% CI = 0.67–9.1) were malnourished.ConclusionLack of vaccination and no treatment in a health facility increased the risk for measles deaths. The one-dose measles vaccination currently in the national vaccination schedule had a protective effect against measles death. We recommended enhancing measles vaccination and adherence to measles treatment guidelines.