Background The incidence of prostate cancer in Uganda is one of the highest recorded in Africa. Prostate cancer is the most common cancer among men in Uganda. Objective This study assessed the current knowledge, attitudes and practices of adult Ugandan men regarding prostate cancer. Subjects and Methods We conducted a descriptive cross-sectional study using interviewer administered questionnaires and focus group discussions among 545 adult men aged 18–71 years, residing in Kampala, the capital of Uganda. Quantitative data were analyzed with SPSS version 20. Qualitative data were collected using audio recorded focus group discussions, transcribed and analyzed by clustering into themes. Results The majority of the respondents (324, 59.4%) were aged 18–28 years, 295 (54.1%) had heard about prostate cancer and 250 (45.9%) had never heard about it. The commonest source of information about prostate cancer was the mass media. Only 12.5% of the respondents obtained information about prostate cancer from a health worker, 37.4% did not know the age group that prostate cancer affects and 50.2% could not identify any risk factor for prostate cancer. Participants in the focus group discussions confused prostate cancer with gonorrhea and had various misconceptions about the causes of prostate cancer. Only 10.3% of the respondents had good knowledge of the symptoms of prostate cancer and only 9% knew about serum prostate specific antigen (PSA) testing. Although 63.5% thought they were susceptible to prostate cancer, only 22.9% considered getting and only 3.5% had ever undergone a serum PSA test. Conclusion There was generally poor knowledge and several misconceptions regarding prostate cancer and screening in the study population. Community based health education programs about prostate cancer are greatly needed for this population.

BackgroundIn low income countries, many patients with breast cancer present with advanced disease which is majorly attributed to late presentation and this is associated with poor survival rates. The aim of this study was to determine the magnitude of patient delay and the factors that influence, delay in seeking health care in female breast cancer patients.MethodsA cross-sectional study was done between January and April 2014 at a tertiary breast unit. Female patients with breast cancer above the age of 18 years were interviewed. Ethical approval was obtained.ResultsIn total 162 patients were recruited, the mean patient delay in months was 22.6 (SD = 26.4), median delay was 13 months and range was 1–127 months. 139 (89 %) patients delayed by more than 3 months after noticing symptoms of breast anomaly. Patients with no social support from spouses and family were more likely to delay (OR = 7.1, 95 % CI 2.4–21.5, p = 0.001), those who perceived the symptoms as very serious were less likely to delay (OR = 0.2, 95 % CI 0.1–0.6, p = 0.007). There was a significant association between delayed presentation and advanced stage at presentation (p = 0.006).ConclusionMost women (89 %) with breast cancer delayed by more than 3 months to seek the first medical consultation after noticing symptoms. Patients who had no social support from their families were more likely to delay.

ObjectiveThe detection of urinary lipoarabinomannan (LAM), a mycobacterial cell wall component, is used to diagnose tuberculosis (TB). How LAM enters the urine is not known. To investigate if urinary LAM-positivity is the result of renal TB infection we correlated the outcomes of urinary LAM-antigen testing to renal histology in an autopsy cohort of hospitalized, Ugandan, HIV-infected adults.MethodsWe performed a complete autopsy, including renal sampling, in HIV-infected adults that died during hospitalization after written informed consent was obtained from the next of kin. Urine was collected postmortem through post-mortem catheterisation or by bladder puncture and tested for LAM with both a lateral flow assay (LFA) and an ELISA assay. Two pathologists assessed the kidney histology. We correlated the LAM-assay results and the histology findings.ResultsOf the 13/36 (36%) patients with a positive urinary LAM ELISA and/or LFA, 8/13 (62%) had renal TB. The remaining 5 LAM-positive patients had disseminated TB without renal involvement. Of the 23 LAM-negative patients, 3 had disseminated TB without renal involvement. The remaining LAM-negative patients had no TB infection and died mostly of fungal and bacterial infections. LAM LFA had a sensitivity of 81% and specificity of 100% to diagnose TB at any location, and the LAM ELISA a sensitivity of 63% and a specificity of 100%. 54% (7/13) LAM LFA-positive patients were not on anti-TB treatment at the time of death.ConclusionRenal TB infection explained LAM-positivity in the majority of patients. Patients with disseminated TB without renal involvement can also be diagnosed with LAM. This suggests that other mechanisms that lead to urinary LAM-positivity exist in a minority of patients.

Blind needle autopsy identified half of the major diagnosis. The addition of ultrasound guidance did not significantly improve the performance of needle autopsy. Needle autopsy is a valuable method to confirm causes of death in HIV-infected patients, especially for highly prevalent diseases like TB.