{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:36:01Z","timestamp":1781274961365,"version":"3.54.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1U2RTW010672-01"],"award-info":[{"award-number":["1U2RTW010672-01"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009771"],"award-info":[{"award-number":["D43TW009771"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Antimicrob Resist Infect Control"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Uganda remains one of the countries with the highest burden of TB\/HIV. Drug-resistant\u00a0TB remains a substantial\u00a0challenge\u00a0to TB\u00a0control\u00a0globally and requires new strategic effective control approaches. Drug resistance usually develops due to inadequate management of TB patients including improper treatment regimens and failure to complete the treatment course which may be due to an unstable supply or a lack of access to treatment, as well as patient noncompliance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Two sputa samples were collected from Xpert MTB\/RIF\u00ae assay-diagnosed multi-drug resistant tuberculosis (MDR-TB) patient at Lira regional referral hospital in northern Uganda between 2020 and 2021 for comprehensive routine mycobacterial species identification and drug susceptibility testing using culture-based methods. Detection of drug resistance-conferring genes was subsequently performed using whole-genome sequencing with Illumina MiSeq platform at the TB Supranational Reference Laboratory in Uganda.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In both isolates, extensively drug-resistant TB (XDR-TB) was identified including resistance to Isoniazid\u00a0(<jats:italic>katG<\/jats:italic> p.Ser315Thr), Rifampicin (<jats:italic>rpoB<\/jats:italic> p.Ser450Leu), Moxifloxacin (<jats:italic>gyrA<\/jats:italic> p.Asp94Gly), Bedaquiline (<jats:italic>Rv0678<\/jats:italic> Glu49fs), Clofazimine (<jats:italic>Rv0678<\/jats:italic> Glu49fs), Linezolid (<jats:italic>rplC<\/jats:italic> Cys154Arg), and Ethionamide (<jats:italic>ethA<\/jats:italic> c.477del). Further analysis of these two high quality genomes revealed that this 32\u00a0years-old patient was infected with the Latin American Mediterranean TB strain (LAM).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first identification of extensively drug-resistant <jats:italic>Mycobacterium tuberculosis<\/jats:italic> clinical isolates with bedaquiline, linezolid and clofazimine resistance from Uganda. These acquired resistances were because of non-adherence as seen in the patient\u2019s clinical history. Our study also strongly highlights the importance of combating DR-TB in Africa through implementing next generation sequencing that can test resistance to all drugs while providing a faster turnaround time. This can facilitate timely clinical decisions in managing MDR-TB patients with non-adherence or lost to follow-up.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13756-022-01101-2","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T12:06:56Z","timestamp":1652357216000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["First report of whole-genome analysis of an extensively drug-resistant Mycobacterium tuberculosis clinical isolate with bedaquiline, linezolid and clofazimine resistance from Uganda"],"prefix":"10.1186","volume":"11","author":[{"given":"Jupiter Marina","family":"Kabahita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Kabugo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Kakooza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isa","family":"Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ocung","family":"Guido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Byabajungu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanitah","family":"Namutebi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Magdalene","family":"Namaganda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pius","family":"Lutaaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Otim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick Elishama","family":"Kakembo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kanyerezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Nabisubi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Sserwadda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George William","family":"Kasule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasfah","family":"Nakato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Musisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Oola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses L.","family":"Joloba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8445-9414","authenticated-orcid":false,"given":"Gerald","family":"Mboowa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"1101_CR1","unstructured":"who_globalhbcliststb_2021\u20132025_backgrounddocument.pdf [Internet]. [cited 2021 Jul 23]. Available from: https:\/\/cdn.who.int\/media\/docs\/default-source\/hq-tuberculosis\/who_globalhbcliststb_2021-2025_backgrounddocument.pdf?sfvrsn=f6b854c2_9."},{"key":"1101_CR2","unstructured":"National strategic plan for tuberculosis and leprosy control 2020\/21 \u2013 2024\/25 [Internet]. Ministry of Health | Government of Uganda. [cited 2021 Jul 23]. Available from: https:\/\/www.health.go.ug\/cause\/national-strategic-plan-for-tuberculosis-and-leprosy-control-2020-21-2024-25\/."},{"issue":"1","key":"1101_CR3","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s13756-021-00947-2","volume":"10","author":"G Bahizi","year":"2021","unstructured":"Bahizi G, Majwala RK, Kisaka S, Nyombi A, Musisi K, Kwesiga B, et al. Epidemiological profile of patients with rifampicin-resistant tuberculosis: an analysis of the Uganda National Tuberculosis Reference Laboratory Surveillance Data, 2014\u20132018. Antimicrob Resist Infect Control. 2021;10(1):76.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"6","key":"1101_CR4","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1111\/jam.14478","volume":"128","author":"R Singh","year":"2020","unstructured":"Singh R, Dwivedi SP, Gaharwar US, Meena R, Rajamani P, Prasad T. Recent updates on drug resistance in Mycobacterium tuberculosis. J Appl Microbiol. 2020;128(6):1547\u201367.","journal-title":"J Appl Microbiol"},{"key":"1101_CR5","doi-asserted-by":"publisher","first-page":"779","DOI":"10.2217\/fmb-2019-0309","volume":"15","author":"L Guglielmetti","year":"2020","unstructured":"Guglielmetti L, Chiesi S, Eimer J, Dominguez J, Masini T, Varaine F, et al. Bedaquiline and delamanid for drug-resistant tuberculosis: a clinician\u2019s perspective. Future Microbiol. 2020;15:779\u201399.","journal-title":"Future Microbiol"},{"key":"1101_CR6","unstructured":"Meeting report of the WHO expert consultation on the definition of extensively drug-resistant tuberculosis [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/www.who.int\/publications-detail-redirect\/meeting-report-of-the-who-expert-consultation-on-the-definition-of-extensively-drug-resistant-tuberculosis."},{"issue":"8","key":"1101_CR7","doi-asserted-by":"publisher","first-page":"2377","DOI":"10.1093\/jac\/dkz206","volume":"74","author":"S Wasserman","year":"2019","unstructured":"Wasserman S, Louw G, Ramangoaela L, Barber G, Hayes C, Omar SV, et al. Linezolid resistance in patients with drug-resistant TB and treatment failure in South Africa. J Antimicrob Chemother. 2019;74(8):2377\u201384.","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"1101_CR8","doi-asserted-by":"publisher","first-page":"e02141","DOI":"10.1128\/AAC.02141-18","volume":"63","author":"N Ismail","year":"2019","unstructured":"Ismail N, Peters RPH, Ismail NA, Omar SV. Clofazimine exposure in vitro selects efflux pump mutants and bedaquiline resistance. Antimicrob Agents Chemother. 2019;63(3):e02141-e2218.","journal-title":"Antimicrob Agents Chemother"},{"issue":"3","key":"1101_CR9","first-page":"684","volume":"72","author":"C Villellas","year":"2017","unstructured":"Villellas C, Coeck N, Meehan CJ, Lounis N, de Jong B, Rigouts L, et al. Unexpected high prevalence of resistance-associated Rv0678 variants in MDR-TB patients without documented prior use of clofazimine or bedaquiline. J Antimicrob Chemother. 2017;72(3):684\u201390.","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"1101_CR10","doi-asserted-by":"publisher","first-page":"e02530","DOI":"10.1128\/AAC.02530-18","volume":"63","author":"H Ghajavand","year":"2019","unstructured":"Ghajavand H, Kargarpour Kamakoli M, Khanipour S, Pourazar Dizaji S, Masoumi M, Rahimi Jamnani F, et al. High prevalence of bedaquiline resistance in treatment-naive tuberculosis patients and verapamil effectiveness. Antimicrob Agents Chemother. 2019;63(3):e02530-e2618.","journal-title":"Antimicrob Agents Chemother"},{"issue":"102","key":"1101_CR11","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.ijid.2020.10.081","volume":"1","author":"Y Liu","year":"2021","unstructured":"Liu Y, Gao J, Du J, Shu W, Wang L, Wang Y, et al. Acquisition of clofazimine resistance following bedaquiline treatment for multidrug-resistant tuberculosis. Int J Infect Dis. 2021;1(102):392\u20136.","journal-title":"Int J Infect Dis"},{"key":"1101_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.655653\/full","author":"J Du","year":"2021","unstructured":"Du J, Gao J, Yu Y, Li Q, Bai G, Shu W, et al. Low rate of acquired linezolid resistance in multidrug-resistant tuberculosis treated with bedaquiline-linezolid combination. Front Microbiol. 2021. https:\/\/doi.org\/10.3389\/fmicb.2021.655653\/full.","journal-title":"Front Microbiol"},{"issue":"74","key":"1101_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cimid.2020.101574","volume":"1","author":"JL Khawbung","year":"2021","unstructured":"Khawbung JL, Nath D, Chakraborty S. Drug resistant tuberculosis: a review. Comp Immunol Microbiol Infect Dis. 2021;1(74): 101574.","journal-title":"Comp Immunol Microbiol Infect Dis"},{"issue":"4","key":"1101_CR14","doi-asserted-by":"publisher","first-page":"e165","DOI":"10.1016\/S2666-5247(20)30031-8","volume":"1","author":"C Nimmo","year":"2020","unstructured":"Nimmo C, Millard J, van Dorp L, Brien K, Moodley S, Wolf A, et al. Population-level emergence of bedaquiline and clofazimine resistance-associated variants among patients with drug-resistant tuberculosis in southern Africa: a phenotypic and phylogenetic analysis. Lancet Microbe. 2020;1(4):e165\u201374.","journal-title":"Lancet Microbe"},{"key":"1101_CR15","unstructured":"Organization WH. Global tuberculosis report 2018 [Internet]. World Health Organization; 2018 [cited 2021 Jul 25]. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/274453."},{"issue":"5","key":"1101_CR16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198091","volume":"13","author":"E Kigozi","year":"2018","unstructured":"Kigozi E, Kasule GW, Musisi K, Lukoye D, Kyobe S, Katabazi FA, et al. Prevalence and patterns of rifampicin and isoniazid resistance conferring mutations in Mycobacterium tuberculosis isolates from Uganda. PLoS ONE. 2018;13(5): e0198091.","journal-title":"PLoS ONE"},{"key":"1101_CR17","unstructured":"nextera-xt-library-prep-reference-guide-15031942-05.pdf [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/support.illumina.com\/content\/dam\/illumina-support\/documents\/documentation\/chemistry_documentation\/samplepreps_nextera\/nextera-xt\/nextera-xt-library-prep-reference-guide-15031942-05.pdf."},{"key":"1101_CR18","unstructured":"Babraham bioinformatics: FastQC a quality control tool for high throughput sequence data [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/www.bioinformatics.babraham.ac.uk\/projects\/fastqc\/"},{"key":"1101_CR19","unstructured":"MultiQC [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/multiqc.info\/."},{"key":"1101_CR20","unstructured":"Release TBProfiler v3.0.4 jodyphelan\/TBProfiler [Internet]. GitHub. [cited 2021 Jul 25]. Available from: https:\/\/github.com\/jodyphelan\/TBProfiler\/releases\/tag\/v3.0.4."},{"issue":"14","key":"1101_CR21","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1093\/bioinformatics\/btp324","volume":"25","author":"H Li","year":"2009","unstructured":"Li H, Durbin R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics. 2009;25(14):1754\u201360.","journal-title":"Bioinformatics"},{"issue":"16","key":"1101_CR22","doi-asserted-by":"publisher","first-page":"2078","DOI":"10.1093\/bioinformatics\/btp352","volume":"25","author":"H Li","year":"2009","unstructured":"Li H, Handsaker B, Wysoker A, Fennell T, Ruan J, Homer N, et al. The sequence alignment\/map format and SAMtools. Bioinformatics. 2009;25(16):2078\u20139.","journal-title":"Bioinformatics"},{"key":"1101_CR23","unstructured":"Garrison E, Marth G. Haplotype-based variant detection from short-read sequencing. 2012 Jul 20 [cited 2021 Jul 25]; Available from: http:\/\/arxiv.org\/abs\/1207.3907"},{"issue":"2","key":"1101_CR24","doi-asserted-by":"publisher","first-page":"80","DOI":"10.4161\/fly.19695","volume":"6","author":"P Cingolani","year":"2012","unstructured":"Cingolani P, Platts A, Wang LL, Coon M, Nguyen T, Wang L, et al. A program for annotating and predicting the effects of single nucleotide polymorphisms, SnpEff. Fly. 2012;6(2):80\u201392.","journal-title":"Fly"},{"key":"1101_CR25","unstructured":"Seemann T. tseemann\/snippy [Internet]. 2021 [cited 2021 Jul 25]. Available from: https:\/\/github.com\/tseemann\/snippy"},{"key":"1101_CR26","unstructured":"Release Version 3.0.0 sanger-pathogens\/gubbins [Internet]. GitHub. [cited 2021 Jul 25]. Available from: https:\/\/github.com\/sanger-pathogens\/gubbins\/releases\/tag\/v3.0.0"},{"key":"1101_CR27","unstructured":"SNP-sites [Internet]. snp-sites. [cited 2021 Jul 25]. Available from: http:\/\/sanger-pathogens.github.io\/snp-sites\/"},{"issue":"3","key":"1101_CR28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009490","volume":"5","author":"MN Price","year":"2010","unstructured":"Price MN, Dehal PS, Arkin AP. FastTree 2: Approximately maximum-likelihood trees for large alignments. PLoS ONE. 2010;5(3): e9490.","journal-title":"PLoS ONE"},{"issue":"Web Server issu","key":"1101_CR29","doi-asserted-by":"publisher","first-page":"W242","DOI":"10.1093\/nar\/gkw290","volume":"44","author":"I Letunic","year":"2016","unstructured":"Letunic I, Bork P. Interactive tree of life (iTOL) v3: an online tool for the display and annotation of phylogenetic and other trees. Nucleic Acids Res. 2016;44(Web Server issue):W242\u20135.","journal-title":"Nucleic Acids Res"},{"key":"1101_CR30","unstructured":"Malinga LA. Characterization of efflux pumps genes involved in second-line drug resistance of tuberculosis. 178."},{"key":"1101_CR31","unstructured":"Tuberculosis [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/www.theglobalfund.org\/en\/tuberculosis\/"},{"key":"1101_CR32","unstructured":"TB Online: TB infections hit 90,000 a year in Uganda, overtake HIV rates [Internet]. [cited 2021 Jul 25]. Available from: https:\/\/www.tbonline.info\/posts\/2019\/3\/20\/tb-infections-hit-90000-year-uganda-overtake-hiv-r\/."},{"issue":"2014","key":"1101_CR33","volume":"28","author":"N Alvarez","year":"2014","unstructured":"Alvarez N, Zapata E, Mej\u00eda GI, Realpe T, Araque P, Pel\u00e1ez C, et al. The structural modeling of the interaction between levofloxacin and the mycobacterium tuberculosis gyrase catalytic site sheds light on the mechanisms of fluoroquinolones resistant tuberculosis in Colombian clinical isolates. Biomed Res Int. 2014;28(2014): e367268.","journal-title":"Biomed Res Int"},{"issue":"12","key":"1101_CR34","doi-asserted-by":"publisher","first-page":"3799","DOI":"10.1128\/AAC.47.12.3799-3805.2003","volume":"47","author":"GP Morlock","year":"2003","unstructured":"Morlock GP, Metchock B, Sikes D, Crawford JT, Cooksey RC. ethA, inhA, and katG loci of ethionamide-resistant clinical mycobacterium tuberculosis Isolates. Antimicrob Agents Chemother. 2003;47(12):3799\u2013805.","journal-title":"Antimicrob Agents Chemother"},{"issue":"6","key":"1101_CR35","first-page":"e00239","volume":"61","author":"J Xu","year":"2017","unstructured":"Xu J, Wang B, Hu M, Huo F, Guo S, Jing W, et al. Primary clofazimine and bedaquiline resistance among isolates from patients with multidrug-resistant tuberculosis. Antimicrob Agents Chemother. 2017;61(6):e00239-e317.","journal-title":"Antimicrob Agents Chemother"},{"issue":"9","key":"1101_CR36","doi-asserted-by":"publisher","first-page":"2507","DOI":"10.1093\/jac\/dkv150","volume":"70","author":"S Zhang","year":"2015","unstructured":"Zhang S, Chen J, Cui P, Shi W, Zhang W, Zhang Y. Identification of novel mutations associated with clofazimine resistance in Mycobacterium tuberculosis. J Antimicrob Chemother. 2015;70(9):2507\u201310.","journal-title":"J Antimicrob Chemother"},{"issue":"5","key":"1101_CR37","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1128\/AAC.06227-11","volume":"56","author":"P Beckert","year":"2012","unstructured":"Beckert P, Hillemann D, Kohl TA, Kalinowski J, Richter E, Niemann S, et al. rplC T460C identified as a dominant mutation in linezolid-resistant mycobacterium tuberculosis strains. Antimicrob Agents Chemother. 2012;56(5):2743\u20135.","journal-title":"Antimicrob Agents Chemother"},{"key":"1101_CR38","unstructured":"NTLP. Uganda National guidelines for the programmatic management of drug-resistant tuberculosis, 2nd ed. 2016. 1\u2013232."}],"container-title":["Antimicrobial Resistance &amp; Infection Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13756-022-01101-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13756-022-01101-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13756-022-01101-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T12:28:17Z","timestamp":1652358497000},"score":1,"resource":{"primary":{"URL":"https:\/\/aricjournal.biomedcentral.com\/articles\/10.1186\/s13756-022-01101-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,12]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1101"],"URL":"https:\/\/doi.org\/10.1186\/s13756-022-01101-2","relation":{},"ISSN":["2047-2994"],"issn-type":[{"value":"2047-2994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,12]]},"assertion":[{"value":"2 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The project was approved by the Makerere University School of Biomedical Sciences Research and Ethics Committee (SBSREC) on July 19, 2021.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The participant has consented to the submission of the short report to the journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"68"}}