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The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa

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The African Critical Illness Outcome Study (ACIOS) is the largest study to date on critical illness in Africa, highlighting a significant burden of life-threatening conditions in hospitals across the continent. The study aimed to assess the prevalence, management, and outcomes of critically ill patients while identifying gaps in essential emergency and critical care (EECC).

Associate Professor Arthur Kwizera (College of Health Sciences, Makerere University) was a Co-Investigator and National Lead for Uganda in partnership with researchers from Europe and Africa.

A Research publication detailing the study was published in the Lancet and can be downloaded here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02846-0/fulltext

Key Findings

  • High Prevalence of Critical Illness: One in eight hospital inpatients (12.5%) in Africa are critically ill.
  • High Mortality Rate: Critically ill patients face a 21% seven-day mortality rate, significantly higher than the 2.7% mortality for non-critically ill patients.
  • Limited Access to Intensive Care: Nearly 70% of critically ill patients receive care in general hospital wards rather than intensive care units (ICUs) or high-dependency units.
  • Insufficient Emergency Care: Over 56% of critically ill patients do not receive essential emergency and critical care (EECC), including oxygen therapy, intravenous fluids, and airway management.

Significance
The study provides first-of-its-kind epidemiological data on critical illness across multiple African countries. The findings highlight severe gaps in emergency care infrastructure and resources, emphasizing the need for investment in low-cost, lifesaving interventions to reduce mortality. Addressing these gaps through EECC can save many lives without requiring high-cost ICU infrastructure.

Study Methodology
ACIOS was a multi-country prospective study, involving 20,000 patients from 180 hospitals in 22 African countries. Investigators assessed all adult inpatients (≥18 years) across different hospitals, identifying those with severely deranged vital signs. Patients were then followed up over seven days to determine their health outcomes. Additionally, the study collected hospital resource availability data to assess the readiness of facilities to provide critical care.

Funding and Collaboration
The study was funded by the National Institute for Health and Care Research (NIHR) Global Health Group in Perioperative and Critical Care (NIHR133850) with Professors Rupert Pearse and Bruce Biccard as PIs, and conducted in partnership with Makerere University (Uganda) led by Associate Professor Arthur Kwizera (as Co-PI and national lead), Busitema University (Uganda) led by Dr Adam Hewitt Smith, University of Cape Town (South Africa) led by Bruce Biccard, Muhimbili University of Health and Allied Sciences (Tanzania) Led by Dr Tim Baker, Queen Mary University of London (UK), the African Perioperative Research Group, and the EECC Network.

Policy Implications
The findings call for urgent action by health policymakers and hospital administrators to:

  • Strengthen emergency and critical care services in general hospital wards.
  • Improve the availability of essential life-saving interventions such as oxygen therapy and IV fluids.
  • Train healthcare workers in essential emergency and critical care (EECC) protocols to enhance patient outcomes.

Relevance to Uganda
Uganda, like many African countries, faces a severe shortage of ICU beds and critical care services. The study underscores the urgent need for investment in critical care infrastructure and workforce training to improve survival rates among critically ill patients.

Conclusion
The ACIOS study is a wake-up call for Africa’s healthcare systems, urging greater focus on low-cost, high-impact interventions that can significantly reduce mortality among critically ill patients. By prioritizing essential emergency and critical care, health systems can improve survival rates without requiring large investments in ICU infrastructure.

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Mak Editor

Health

Makerere Health Services Guidance on Ebola Virus Disease (EVD)

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How to protect yourself and your loved ones from Ebola. Ministry of Health, Kampala Uganda, East Africa.

The Democratic Republic of Congo (DRC) and Uganda recently reported an outbreak of Ebola Virus Disease (EVD), which is a serious and often deadly disease caused by a person being infected by the Ebola virus.

The virus spreads through direct contact with body fluids such as blood, saliva, faeces, vomit, urine, sweat or genital fluids from a person who is infected with EVD.

The symptoms of EVD usually develop after 8 – 10 days from contact with an infected person and may include fatigue, high fever, headache, sore throat, muscle and joint pains, vomiting and diarrhea and in severe cases, bleeding.

What should we do as the Makerere University community?

The Chief, Makerere Health Services, Prof. J.K. Byamugisha advises as follows:

  1. Avoid unnecessary contact such as shaking hands, hugging etc.
  2. Place alcohol disinfectants or hand washing equipment at all entry points within the University and ensure everyone is using them.
  3. Students should sit in single-person chairs while in class, avoiding contact with their neighbours.
  4. Do not sit too close to one another especially in frequently crowded places such as classrooms, library or any other waiting area.
  5. While at the University Hospital, wash hands a the gate, use alcohol disinfectant at the reception.
  6. All patients should have a maximum of one caretaker – others can check on them by calling.
  7. Avoid bringing luggage to the University Hospital.
  8. Target to do as instructed by the health worker.
  9. For further information and guidance on Ebola, please call Dr. Charles Basigara on Tel: 0702 966652 and Sr. Eunice Namubiru on Tel: 0779 950978 (Contact persons for the University Health Services)

Additionally, always look out for and ensure full compliance with Ministry of Health (MoH) Infection Prevention and Control measures such as the one below.

How to protect yourself and your loved ones from Ebola. Ministry of Health, Kampala Uganda, East Africa.
How to protect yourself and your loved ones from Ebola.

How to report suspected Ebola cases to Health Authorities. Ministry of Health, Kampala Uganda, East Africa.
How to report suspected Ebola cases to Health Authorities.

Please find attached detailed communications from Prof. Byamugisha and
the Permanent Secretary Ministry of Health.

Mak Editor

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Health

Call for Applications: Masters Support in Self-Management Intervention for Reducing Epilepsy Burden

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An aerial photo of the College of Health Sciences (CHS), Makerere University showing Left to Right: The Sir Albert Cook Memorial Library, School of Biomedical Sciences, Davies Lecture Theatre, School of Public Health, Mulago Specialised Women and Neonatal Hospital (MSWNH)-Background Left and Nakasero Hill-Background Right, Kampala Uganda, East Africa.

The Makerere University College of Health Sciences and Case Western Reserve University, partnering with Mbarara University of Science and Technology, are implementing a five-year project titled “Self-management Intervention for Reducing Epilepsy Burden Among Adult Ugandans with Epilepsy.”

The program is funded by the National Institute of Health (NIH) and the National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates interested in pursuing clinical and research careers in Epilepsy. We aim to grow epilepsy research capacity, including self-management approaches, in SSA.

The Project is soliciting applications for Master’s Research thesis support focusing on epilepsy-related research at Makerere University and Mbarara University, cohort 3, 2026/2027.

Selection criteria

  • Should be a Master’s student of the following courses: MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing, or a Master’s in the Basic Sciences (Physiology, Anatomy, Biochemistry, or any other related field).
  • Should have completed at least one year of their Master’s training in the courses listed above.
  • Demonstrated interest in Epilepsy and Neurological diseases, care and prevention, and commitment to develop and maintain a productive career, and devoted to Epilepsy, Clinical Practice, and Prevention.

Research Programs:

The following are the broad Epilepsy research priority areas (THEMES), and applicants are encouraged to develop research concepts in the areas of: Applicants are not limited to these themes; they can propose other areas.

  • The epidemiology of Epilepsy and associated risk factors.
  • Determining the factors affecting the quality of life, risk factors, and outcomes (mortality, morbidity) for Epilepsy, epilepsy genetics, and preventive measures among adults.
  • Epilepsy in childhood and its associated factors, preventative measures etc.
  • Epilepsy epidemiology and other Epilepsy related topics.
  • Epilepsy interventions and rehabilitation

In addition to a formal master’s program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis, and research management.

The review criteria for applicants will be as follows:

·      Relevance to program objectives

  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your mentoring plan, please include who the mentors are, what training they will provide, and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied by a detailed curriculum vitae, two recommendation letters from Professional referees or mentors, and a 2-page concept or an approved full proposal describing your project and addressing Self-Management Intervention for Reducing Epilepsy Burden Among Adults or an epilepsy-related problem.

For more information, inquiries, and additional advice on developing concepts, don’t hesitate to get in touch with the following:

Makerere University College of Health Sciences

Prof. Mark Kaddumukasa:  kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

A soft copy should be submitted to the Administrator of the Epilepsy Project. Email: smireb2@gmail.com; Closing date for the Receipt of applications is 5th July 2026.

Mak Editor

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Health

ALLSTAR Training Program: Applications Open for AI and Machine Learning Course in TB Research

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Officials pose for a group photo with participants in the specialized short course on Artificial Intelligence (AI) and Machine Learning (ML) focused on their application in tuberculosis (TB) research, held from June 23–27, 2025, ResilientAfrica Network (RAN), Kololo MakSPH Annex. Makerere University School of Public Health, Kampala Uganda, East Africa.

Makerere University School of Public Health (MakSPH), through the Department of Epidemiology and Biostatistics, in collaboration with the Global Health Institute at the University of Georgia, USA, is inviting applications for an intensive five-day short course on the Foundations and Applications of Artificial Intelligence (AI) and Machine Learning (ML) in Tuberculosis (TB) Research.

Date: June 22–26, 2026
Time: 2:00 PM – 6:00 PM (EAT)
Venue: ResilientAfrica Network (RAN), Kololo MakSPH Annex

The course is designed for Master’s and PhD students, research fellows, junior researchers, and professionals in public health, medicine, digital health, TB/HIV, biostatistics, bioinformatics, computer science, geography, nursing, and related fields.

Participants will gain hands-on exposure to AI/ML applications in TB and TB/HIV research, including Generative AI, LLMs, Computer Vision, GeoAI, ethical AI use, data management, and model deployment.

Limited scholarships are available.
Application deadline: June 1, 2026

Read more and apply here: https://sph.mak.ac.ug/anouncement/allstar-training-program-applications-open-for-ai-and-machine-learning-course-in-tb-research/

John Okeya

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