ArticleFrontiers in immunology2026
Graduate-level medical doctors in Uganda have limited awareness of warning, specific signs, and immunological investigations of primary immunodeficiencies.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Primary Immunodeficiencies are inborn errors of immunity (IEIs) characterized by impaired immune function, resulting in recurrent infections, inflammation, autoimmunity, atopy, and malignancies. Although significant advances in diagnosis have been made in high-income countries, IEIs remain underdiagnosed in resource-limited settings like Uganda, where infectious diseases dominate clinical attention. Recognizing IEIs requires strong foundational knowledge of immune system functions, clinical manifestations, and relevant immunological investigations. This study assessed Ugandan doctors' knowledge in these areas. Method: A cross-sectional quantitative study was conducted among 114 doctors pursuing Master's degrees in Pediatrics, Internal Medicine, Immunology, and Clinical Microbiology at Makerere University. A 42-item questionnaire assessed knowledge across four domains: immune cell functions and clinical manifestations of IEIs-related defects, warning signs in adults and children, specific IEIs signs, and relevant immunological investigations. Responses were "True" (correct) or "Not sure" (incorrect/uncertain), and proportions of correct answers were calculated. Results: Respondents were mostly female (56.16%). Knowledge of immune cell functions and related clinical manifestations was high, with 77-97% correct responses. Awareness of key warning signs varied; while many recognized poor growth (76%) and family history (72%) as potential indicators, most scored low (13-44%) on other warning signs and specific IEIs features. Knowledge of immunological investigations was low: over 90% reported no experience with essential immunological tests, even basic investigations, such as CBC interpretation for IEIs screening were reported by only 6%. Conclusion: Ugandan doctors show strong foundational immunology knowledge but limited awareness of warning and specific IEIs signs, and almost no experience with diagnostic immunological tests.
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