Publications, Standards and Data

The use of antiretroviral therapy (ART) in the management of HIV/AIDS has greatly increased the life expectancy of people living with HIV. However, longer life spans have been accompanied by a growing burden of non-communicable diseases (NCDs). This study assessed healthcare satisfaction and the prevalence of diabetes and hypertension among older adults living with HIV (50 years and above) at Mbale Regional Referral Hospital in Eastern Uganda.

Methods

A cross-sectional study was conducted at Mbale Regional Referral Hospital (MRRH) involving 400 HIV-positive patients aged more than 50 years on ART. The sociodemographic information, ART history, and comorbidities were obtained. Bivariate and multivariable logistic regression analyses were performed to identify predictors of comorbidities.

Results

The prevalence of DM and HTN were 28.3% and 27.1%, respectively. Participants aged ≥64 years had significantly higher odds of HTN (AOR: 2.25; 95% CI: 1.27–3.19; p = 0.029). Changing ART regimens three or more times was associated with HTN (AOR: 2.55; 95% CI: 1.08–4.73; p = 0.015). Living 6–10 km from a health facility increased the odds of DM (AOR: 5.46; 95% CI: 1.12–26.54; p = 0.044). Overall, 91% of the participants reported satisfaction with the healthcare received.

Conclusion

DM and HTN are highly prevalent among older adults living with HIV in Eastern Uganda and are associated with advanced age, ART regimen changes, and healthcare access challenges. The integration of NCD screening and management into HIV care are key for improving long-term outcomes in this population.

Access to essential medicines is a critical indicator of a country’s commitment to public health, yet significant barriers persist in sub-Saharan Africa. In Eastern Uganda, most studies have focused on pharmaceutical supply chain-related factors that limit access to essential medicines, while community and patient-related factors, which are also major contributors, have been largely neglected.

Objective: To assess the extent and determinants of access to essential medicines at the community level in Eastern Uganda, using a multidimensional WHO-aligned framework.

Methodology: This was a household-based, cross-sectional survey conducted in the rural and urban communitiesof the Kibuku, Kapchorwa, and Mbale districts of Eastern Uganda, between February and April 2025. The household representatives were selected using multi-stage sampling. Access to essential medicines was defined using the five-point tool, comprising; availability, affordability, acceptability, accessibility, and accommodation/adequacy. Full access necessitated accomplishing all five criteria for the most recent episode of acute illness. Descriptive statistics were conducted to summarize participant characteristics, and bivariate and multivariable logistic regression to identify independent predictors of medicine access.

Results: Only 8.55% of households reported access to essential medicines. Key challenges included frequent medicine stock-outs (72.52%) and high costs (68.92%). Participants engaged in informal employment were significantly less likely to access medicines (aOR: 0.24, 95% CI: 0.10–0.57, p = 0.001), as were those seeking care at public hospitals (aOR: 0.30, 95% CI: 0.11–0.86, p = 0.026) and households with a member living with a chronic disease(aOR: 0.37, 95% CI: 0.17–0.85, p = 0.019). Nearly half (44.03%) of the households had medicines stored at home including analgesics (39.6%), Antimalarials (20.6%), and Antibiotics (20.1%).

The continued reemergence of Ebola virus epidemics remains a global health concern, largely due to limited therapeutic interventions. This study is aimed at identifying and characterizing antiviral peptides as potential lead candidates against the Sudan Ebola virus. We retrieved antiviral peptides from the AVPdb and designed novel peptides from them using support vector machine, RF, and discriminant analysis algorithms. The toxicity and allergenicity predictions were performed using ToxinPred, ADMETLab 3.0, Allertop, and AllergenFP web servers, respectively. The 3D structures of selected peptides were modeled using PEP-FOLD and I-TASSER and validated using ProSA and PROCHECK web servers. The best peptide models were docked against the Sudan Ebola virus VP-40 protein using HDOCK and ClusPro. Molecular dynamics (MD) simulations were then carried out in GROMACS 2024.2. Out of 170 designed motifs, 30 exhibited antiviral potential with antiviral scores ranging from 0.506 to 1.000. Among the predicted antiviral peptides, five demonstrated favorable stability, nontoxicity, and nonallergenic properties. PEP-FOLD produced more stable peptide structures than I-TASSER, with over 84.6% of their amino acids in the most favorable region. Binding energies ranged from −252.39 to −145.83 kcal/mol (HDOCK) and from −887.7 to −538.7 units (ClusPro). The MD simulations confirmed high stability, with motif A10_M showing the strongest binding and structural compactness. Five peptides show strong potential as therapeutic leads against Sudan Ebola virus; however, further experimental validation is recommended.

The emergence of artemisinin resistance and limited antimalarial drug access in Uganda has increased reliance on herbal medicines as complementary and alternative therapies. Indigenous use of Albizia coriaria, Zanthoxylum chalybeum, Entada abyssinica, Maytenus senegalensis, and Kigelia Africana for malaria treatment is widespread but scientific evidence of their efficacy and safety was limited.

Aim of the study

This study aimed to validate the traditional antimalarial use of the five medicinal plants by evaluating their phytochemical composition, acute toxicity, and in vitro antiplasmodial activity against chloroquine-sensitive (3D7), chloroquine-resistant (Dd2) and clinical P. falciparum isolates.

Materials and methods

Phytochemical screening and quantification was conducted on 70 % hydroethanolic extracts from dried plant samples using UV–Vis spectrophotometry. The acute oral toxicity testing was conducted in Wistar albino rats using OECD 423 limit dose test. The antiplasmodial efficacy was evaluated using a 72-h SYBR Green assay on Plasmodium falciparum laboratory strains (3D7, Dd2) and clinical isolates.

Results

Alkaloids, flavonoids, tannins, and terpenoids were present in all the plant samples in varying quantities. Z. chalybeum was the most potent extract (IC50 0.81–1.28 μg/ml), followed by A. coriaria and E. abyssinica (IC50 10–50 μg/ml). M. senegalensis showed weak activity while K. africana was largely inactive (IC50 > 100 μg/ml). A. coriaria and M. senegalensis showed moderate acute toxicity (LD50 < 2000 mg/kg), while the other extracts showed no severe signs of acute toxicity in Wistar albino rats (LD50 > 2000 mg/kg).

Conclusion

Zanthoxylum chalybeum, Albizia coriaria and Entada abyssinica demonstrated promising antiplasmodial activity that supports their traditional use in management of malaria. However, more efficacy studies using in vivo models, sub-chronic and chronic toxicity studies particularly on A. coriaria and advanced phytochemical profiling are needed to delineate their therapeutic potential before being prioritized for development of standardized herbal remedies and novel antimalarial drugs.

Currently, highly active antiretroviral therapy is unable to cure HIV/AIDS because of HIV latency. This study aimed at documenting medicinal plants used in the management of HIV/AIDS in Eastern Uganda so as to identify phytochemicals with HIV latency reversing potential. An ethnobotanical survey was conducted across eight districts in Eastern Uganda. Traditional medicine practitioners were interviewed using semi-structured questionnaires. Qualitative and quantitative phytochemical tests were respectively, performed to determine the presence and quantity of phytochemicals in frequently mentioned plant species. Data were analysed and presented using descriptive statistics and Informant Consensus Factor (ICF). Twenty-one plant species from fourteen plant families were reported to be used in the management of HIV/AIDS. Six plant species with the highest frequency of mention were: Zanthoxylum chalybeum, Gymnosporia senegalensis, Warbugia ugandensis, Leonatis nepetifolia, Croton macrostachyus and Rhoicissus tridentata. Qualitative phytochemical analysis of all the six most frequently mentioned plant species revealed the presence of flavonoids, tannins, terpenoids, alkaloids and phenolics. Quantitative analysis revealed the highest content of flavonoids in L. nepetifolia (20.4 mg/g of dry extract) while the lowest content was determined in C. macrostachyus (7.1 mg/g of dry extract). On the other hand, the highest content of tannins was observed in L. nepetifolia. (199.9 mg/g of dry extract) while the lowest content was found in R. tridentata. (42.6 mg/g of dry extract). Medicinal plants used by traditional medicine practitioners in Eastern Uganda to manage HIV/AIDS are rich in phytochemicals including flavonoids and tannins. Further studies to evaluate the HIV-1 latency reversing ability of these phytochemicals are recommended to discover novel molecules against HIV/AIDS.

Albizia coriaria (Fabaceae) crude extracts are key ingredients of several licensed and unlicensed herbal products in East Africa. However, there is limited and often contradicting information regarding its toxicity. We therefore evaluated the acute and subacute toxicity of the ethanolic stem bark extract of A. coriaria in mature healthy Wistar albino rats following Lorke's method and OECD guidelines 407. The LD50 of the ethanolic stem bark extract of A. coriaria was 2000 mg/kg. The acute toxicity signs observed included piloerection, hyperventilation, lethargy, and loss of righting reflex. There was a significant increase in aspartate aminotransferase, alkaline phosphatase, red blood cells and haemoglobin in rats after 28 days at the dose of 500 mg/kg. Histological analyses revealed multifocal random parenchymal necrosis and scattered periportal mononuclear inflammatory cells infiltration in the liver, interstitial nephritis in the kidney and multifocal lymphoid accumulation in the peribronchiolar and perivascular lung tissue at 500 mg/kg. The ethanolic stem bark of A. coriaria was therefore moderately toxic to the rats when administered in a single high oral dose within 24 h. The extract caused a dose dependent toxicity with significant damage to the kidney, liver and lung tissues at a dose of 500 mg/kg after 28 days. Herbal medicines containing A. coriaria extracts should be consumed cautiously due to likelihood of toxicity particularly at higher doses greater than 500 mg/kg.

Diabetes mellitus (DM) is a collection of metabolic disorder that is characterized by chronic hyperglycemia. Recent studies have demonstrated the crucial involvement of oxidative stress (OS) and inflammatory reactions in the development of DM. Curcumin (CUR), a natural compound derived from turmeric, exerts beneficial effects on diabetes mellitus through its interaction with the nuclear factor kappa B (NF-κB) pathway. Research indicates that CUR targets inflammatory mediators in diabetes, including tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6), by modulating the NF-κB signaling pathway. By reducing the expression of these inflammatory factors, CUR demonstrates protective effects in DM by improving pancreatic β-cells function, normalizing inflammatory cytokines, reducing OS and enhancing insulin sensitivity. The findings reveal that CUR administration effectively lowered blood glucose elevation, reinstated diminished serum insulin levels, and enhanced body weight in Streptozotocin -induced diabetic rats. CUR exerts its beneficial effects in management of diabetic complications through regulation of signaling pathways, such as calcium-calmodulin (CaM)-dependent protein kinase II (CaMKII), peroxisome proliferator-activated receptor gamma (PPAR-γ), NF-κB, and transforming growth factor β1 (TGFB1). Moreover, CUR reversed the heightened expression of inflammatory cytokines (TNF-α, Interleukin-1 beta (IL-1β), IL-6) and chemokines like MCP-1 in diabetic specimens, vindicating its anti-inflammatory potency in counteracting hyperglycemia-induced alterations. CUR diminishes OS, avert structural kidney damage linked to diabetic nephropathy, and suppress NF-κB activity. Furthermore, CUR exhibited a protective effect against diabetic cardiomyopathy, lung injury, and diabetic gastroparesis. Conclusively, the study posits that CUR could potentially offer therapeutic benefits in relieving diabetic complications through its influence on the NF-κB pathway.

Aloe-emodin (AE) has drawn interest due to its potential activity against type II diabetes mellitus (T2DM). However, the mechanisms underlying its antidiabetic activity are not well explored. Using network pharmacology, molecular docking and molecular dynamics simulation studies, we investigated its molecular mechanisms in the management of T2DM. Potential target genes of AE were predicted using the Swiss Target Prediction (http://www.swisstargetprediction.ch/) database. The GeneCards, OMIM and DisGeNET databases were used to compile a comprehensive list of genes associated with T2DM. A compound-disease-target network was constructed, and protein-protein interaction networks were analysed to identify hub genes. Finally, molecular docking and interaction analysis between AE and the identified proteins were performed using AutoDock tools. Investigation of AE targets and genes associated with T2DM identified 32 overlapping genes. Gene ontology studies revealed that AE may exert its anti-diabetic effects by modulating glucose metabolism and enhancing cellular response to glucose. Furthermore, KEGG pathway analysis suggested that AE influences these processes by targeting pathways related to apoptosis, insulin resistance, and T2DM signaling. The core target proteins identified were TNF, ALB, TP53, PPARG, BCL2, CASP3, and EGFR. AE interaction with each of these proteins exhibited a binding energy of > - 5 kcal/mol, with TNF showing the lowest binding energy (- 7.75 kcal/mol). Molecular dynamics simulation further validated the molecular docking results with TNF and EGFR exhibiting a strong affinity for AE and forming stable interactions. AE exerts its antidiabetic activity through multiple mechanisms, with the most significant being the amelioration of pancreatic β-cell apoptosis by binding to and inhibiting the actions of TNFα. Further cellular and molecular studies are needed to validate these findings.

Polyscias fulva is traditionally used in Uganda for the management of Uterine fibroids (UF). However, there is paucity of data regarding its efficacy, biological targets and potential mechanisms of action hence prompting scientific validation process through insilico and invivo approaches. In this study, we utilized network pharmacology, molecular docking, molecular dynamic simulations and invivo assays to investigate the drug likeliness, pharmacokinetics and efficacy of Polyscias fulva against Uterine fibroids.

Four Polyscias fulva bioactive compounds; pinoresinol, lichexanthone, methyl atarate, β-sitosterol exhibited drug likeness properties with moderate safety profiles. Forty-eight (48) uterine fibroid targets were identified as potential targets for the eleven Polyscias fulva compounds. Protein-protein interaction (PPI) analysis revealed four key targets (HIF1A, ESR1, EGFR, and CASP3). The KEGG pathway and GO enrichment analyses revealed that these key targets play significant roles in regulating the positive regulation of cyclin-dependent protein serine/threonine kinase activity, positive regulation of nitric-oxide synthase activity and positive regulation of transcription, DNA-templated. β-sitosterol demonstrated the strongest binding affinity with the four targets, showing particularly strong affinities for EGFR (−9.75 kcal/mol) and HIF1A (−9.21 kcal/mol). Molecular dynamics (MD) simulations revealed high stability in these protein-ligand complexes, with CASP3 displaying the lowest deviation and most consistent RMSD (0.14 nm) of the protein, followed by EGFR (0.25), HIF1A (0.29), and ESR1 (0.79). In-vivo evaluation on female Wistar rats with Polyscias fulva ethanolic extract showed an ameliorative effect of the extracts against monosodium glutamate-induced (MSG) UF. Treated animals exhibited a decrease in serum proteins, cholesterol, estrogen, and progesterone levels (P < 0.05) and the extract preserved uterine tissue histoachitecture as compared to controls. In conclusion, Polyscias fulva demonstrates potential ameliorative activity against UF with promising pharmacokinetic properties and safety profiles.

Uterine fibroids affect a substantial proportion of women in their reproductive age. Despite their effectiveness, surgical options such as hysterectomy are invasive, costly, and associated with recurrences. Pharmacological treatments are non-curative, only alleviate symptoms, and associated with adverse effects. Polyscias fulva (Araliaceae) is traditionally used to manage uterine fibroids in East Africa. In this study we synthesized Polyscias fulva silver nanoparticles (PFAgNPs), evaluated their toxicity and activity against monosodium glutamate (MSG)-induced uterine fibroids in Wistar albino rats. The UV-visible spectroscopy showed maximal absorbance at 425 nm with adequate stability at varying temperatures, pH and storage conditions. Dynamic light scattering (DLS) analysis revealed an average hydrodynamic size of 107.4 d.nm, polydispersity index of 0.264, and zeta potential of -18.3 mV. X-ray diffraction (XRD) confirmed the crystalline nature of PFAgNPs with an average size of 25 nm while scanning electron microscopy (SEM) showed a spherical shape with an average size of 35 nm. The PFAgNPs caused lethargy, hyperventilation, and hyperactivity at a dose of 300 mg/kg BW, whereas 2000 mg/kg caused severe toxicity, resulting in death in acute toxicity testing. The no observed adverse effect level was 50 mg/kgBW, the lowest observed adverse effect level was 100 mg/kgBW, and median lethal dose (LD50) was 1000 mg/kg. The PFAgNPs significantly decreased (P < 0.05) serum proteins, cholesterol, estrogen and progesterone alongside preservation of the histoarchitecture of the uterus. Further research is needed to investigate the clinical safety of PFAgNPs in managing uterine fibroids.