Browsing by Author "Asiki, Gershim"

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    Adverse Pregnancy Outcomes in Rural Uganda (1996–2013): Trends and Associated Factors from Serial Cross Sectional Surveys
    (BMC pregnancy and childbirth, 2015) Asiki, Gershim; Baisley, Kathy; Newton, Rob; Marion, Lena; Seeley, Janet; Kamali, Anatoli; Smedman, Lars
    Community based evidence on pregnancy outcomes in rural Africa is lacking yet it is needed to guide maternal and child health interventions. We estimated and compared adverse pregnancy outcomes and associated factors in rural south-western Uganda using two survey methods.Within a general population cohort, between 1996 and 2013, women aged 15–49 years were interviewed on their pregnancy outcome in the past 12 months (method 1). During 2012–13, women in the same cohort were interviewed on their lifetime experience of pregnancy outcomes (method 2). Adverse pregnancy outcome was defined as abortions or stillbirths. We used random effects logistic regression for method 1 and negative binomial regression with robust clustered standard errors for method 2 to explore factors associated with adverse outcome.One third of women reported an adverse pregnancy outcome; 10.8 % (abortion = 8.4 %, stillbirth = 2.4 %) by method 1 and 8.5 % (abortion = 7.2 %, stillbirth = 1.3 %) by method 2. Abortion rates were similar (10.8 vs 10.5) per 1000 women and stillbirth rates differed (26.2 vs 13.8) per 1000 births by methods 1 and 2 respectively. Abortion risk increased with age of mother, non-attendance of antenatal care and proximity to the road. Lifetime stillbirth risk increased with age. Abortion and stillbirth risk reduced with increasing parity.Both methods had a high level of agreement in estimating abortion rate but were markedly below national estimates. Stillbirth rate estimated by method 1 was double that estimated by method 2 but method 1 estimate was more consistent with the national estimates.Strategies to improve prospective community level data collection to reduce reporting biases are needed to guide maternal health interventions.
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    Adverse pregnancy outcomes in rural Uganda (1996–2013): trends and associated factors from serial cross sectional surveys
    (BMC pregnancy and childbirth, 2015) Asiki, Gershim; Baisley, Kathy; Newton, Rob; Marions, Lena; Seeley, Janet; Kamali, Anatoli; Smedman, Lars
    Community based evidence on pregnancy outcomes in rural Africa is lacking yet it is needed to guide maternal and child health interventions. We estimated and compared adverse pregnancy outcomes and associated factors in rural south-western Uganda using two survey methods. Methods Within a general population cohort, between 1996 and 2013, women aged 15–49 years were interviewed on their pregnancy outcome in the past 12 months (method 1). During 2012–13, women in the same cohort were interviewed on their lifetime experience of pregnancy outcomes (method 2). Adverse pregnancy outcome was defined as abortions or stillbirths. We used random effects logistic regression for method 1 and negative binomial regression with robust clustered standard errors for method 2 to explore factors associated with adverse outcome. Results One third of women reported an adverse pregnancy outcome; 10.8 % (abortion = 8.4 %, stillbirth = 2.4 %) by method 1 and 8.5 % (abortion = 7.2 %, stillbirth = 1.3 %) by method 2. Abortion rates were similar (10.8 vs 10.5) per 1000 women and stillbirth rates differed (26.2 vs 13.8) per 1000 births by methods 1 and 2 respectively. Abortion risk increased with age of mother, non-attendance of antenatal care and proximity to the road. Lifetime stillbirth risk increased with age. Abortion and stillbirth risk reduced with increasing parity. Discussion Both methods had a high level of agreement in estimating abortion rate but were markedly below national estimates. Stillbirth rate estimated by method 1 was double that estimated by method 2 but method 1 estimate was more consistent with the national estimates. Conclusion Strategies to improve prospective community level data collection to reduce reporting biases are needed to guide maternal health interventions.
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    The General Population Cohort in Rural South Western Uganda: A Platform for Communicable and Non-Communicable Disease Studies
    (International journal of epidemiology, 2013) Asiki, Gershim; Murphy, Georgina; Miiro, Jessica Nakiyingi; Seeley, Janet; Nsubuga, Rebecca N.; Karabarinde, Alex; Waswa, Laban; Biraro, Sam; Kasamba, Ivan; Pomilla, Cristina; Maher, Dermot; Young, Elizabeth H; Kamali, Anatoli; Sandhu, Manjinder S
    The General Population Cohort (GPC) was set up in 1989 to examine trends in HIV prevalence and incidence, and their determinants in rural south-western Uganda. Recently, the research questions have included the epidemiology and genetics of communicable and non-communicable diseases (NCDs) to address the limited data on the burden and risk factors for NCDs in sub-Saharan Africa. The cohort comprises all residents (52% aged ≥13years, men and women in equal proportions) within one-half of a rural sub-county, residing in scattered houses, and largely farmers of three major ethnic groups. Data collected through annual surveys include; mapping for spatial analysis and participant location; census for individual socio-demographic and household socioeconomic status assessment; and a medical survey for health, lifestyle and biophysical and blood measurements to ascertain disease outcomes and risk factors for selected participants. This cohort offers a rich platform to investigate the interplay between communicable diseases and NCDs. There is robust infrastructure for data management, sample processing and storage, and diverse expertise in epidemiology, social and basic sciences. For any data access enquiries you may contact the director, MRC/UVRI, Uganda Research Unit on AIDS by email to mrc@mrcuganda.org or the corresponding author.
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    Longitudinal evaluation of aflatoxin exposure in two cohorts in south-western Uganda
    (Food Additives & Contaminants: Part A, 2015) Kang, Min-Su; Nkurunziza, Peter; Muwanika, Richard; Qian, Guoqing; Tang, Lili; Songa, Xiao; Xue, Kathy; Nkwata, Allan; Ssempebwa, John; Lutalo, Tom; Asiki, Gershim; Serwadda, David; Seeley, Janet; Kaleebu, Pontiano; Nalugoda, Fred; Newton, Robert; William, Jonathan H.; Wang, Jia-Sheng
    Aflatoxins (AF) are a group of mycotoxins. AF exposure causes acute and chronic adverse health effects such as aflatoxicosis and hepatocellular carcinoma in human populations, especially in the developing world. In this study, AF exposure was evaluated using archived serum samples from human immunodeficiency virus (HIV)-seronegative participants from two cohort studies in south-western Uganda. AFB1–lysine (AFB-Lys) adduct levels were determined via HPLC fluorescence in a total of 713 serum samples from the General Population Cohort (GPC), covering eight time periods between 1989 and 2010. Overall, 90% (642/713) of the samples were positive for AFB-Lys and the median level was 1.58 pg mg−1 albumin (range = 0.40–168 pg mg−1 albumin). AFB-Lys adduct levels were also measured in a total of 374 serum samples from the Rakai Community Cohort Study (RCCS), across four time periods between 1999 and 2003. The averaged detection rate was 92.5% (346/374) and the median level was 1.18 pg mg−1 albumin (range = 0.40–122.5 pg mg−1 albumin). In the GPC study there were no statistically significant differences between demographic parameters, such as age, sex and level of education, and levels of serum AFB-Lys adduct. In the RCCS study, longitudinal analysis using generalised estimating equations revealed significant differences between the adduct levels and residential areas (p = 0.05) and occupations (p = 0.02). This study indicates that AF exposure in people in two populations in south-western Uganda is persistent and has not significantly changed over time. Data from one study, but not the other, indicated that agriculture workers and rural area residents had more AF exposure than those non-agricultural workers and non-rural area residents. These results suggest the need for further study of AF-induced human adverse health effects, especially the predominant diseases in the region.
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    Participation in Clinical Research Could Modify Background Risk for Trial Outcome Measures
    (AIDS Research and Human Retroviruses, 2014) Abaasa, Andrew M.; Asiki, Gershim; Levin, Jonathan; Bahemuka, Ubaldo; Ruzagira, Eugene; Kibengo, Freddie M.; Mulondo, Jerry; Ndibazza, Juliet; Price, Matthew A.; Fast, Pat; Kamali, Anatoli
    Data on HIV incidence and retention are needed to inform study design of efficacy trials. However, the selection criteria and interventions during an actual clinical trial could reduce HIV incidence and thus affect the statistical power. We investigated the effect of inclusion and participation in a simulated vaccine efficacy trial (SiVET) on HIV and pregnancy incidence in a fisherfolk cohort in SW Uganda.
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    Prevalence and correlates of HIV infection among adolescents and young people living in fishing populations along Lake Victoria Fishing Communities in Uganda
    (Pan African Medical Journal, 2020) Nanyonjo, Gertrude; Asiki, Gershim; Ssetaala, Ali; Nakaweesa, Teddy; Wambuzi, Mathias; Nanvubya, Annet; Mpendo, Juliet; Okech, Brenda; Kato Kitandwe, Paul; Nielsen, Leslie; Nalutaaya, Annet; Welsh, Sabrina; Ssentalo Bagaya, Bernard; Chinyenze, Kundai; Fast, Pat; Price, Matt; Kiwanuka, Noah
    fishing communities in Uganda are key populations for HIV, with persistently higher prevalence and incidence than the general population. Methods: between March and August 2014, a cross sectional survey was conducted in 10 fishing communities of Lake Victoria in Uganda. Data was collected on socio-behavioural characteristics using interviewer administered questionnaires and venous blood collected for HIV testing. Prevalent HIV infections among adolescents and young people aged 13 to 24 years was estimated and the factors associated with those infections determined using multi variable logistic regression modelling. Results: HIV prevalence was 10.8% among the 630 (96.5%) who provided a blood sample. Females were 3.5 times as likely to have HIV infection as males (aOR=3.52, 95% CI: 1.34-9.22). Young people aged 20-24 years were twice as likely to be HIV infected as those aged 13-19 years (aOR=1.77, 95% CI: 0.05-2.10), participants without formal education or those who had studied up to primary level were more likely to be HIV infected than those who had post primary education ((aOR=2.45, 95% CI: 1.19-5.07) or (5.29 (1.35-20.71) respectively). Reporting more than one sexual partner in the past 6 months was associated with HIV prevalent infection than those reporting no sexual partners (aOR=6.44, 95% CI: 1.27-32.83). Conclusion: adolescents and young people aged 13-24 years in fishing communities around Lake Victoria, Uganda, have a high HIV prevalence, with females having a three-fold higher level than males. These findings highlight the need to improve HIV prevention among young females living in these fishing communities.
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    The general population cohort in rural southwestern Uganda: a platform for communicable and non-communicable disease studies
    (International journal of epidemiology, 2013) Asiki, Gershim; Georgina, Murphy; Nakiyingi-Miiro, Jessica; Janet, Seeley; Nsubuga, Rebecca N.; Karabarinde, Alex; Waswa, Laban; Biraro, Sam; Kasamba, Ivan; Cristina, Pomilla; Dermot, Maher; Elizabeth, H. Young; Kamali, Anatoli; Manjinder, S. Sandhu
    The General Population Cohort (GPC) was set up in 1989 to examine trends in HIV prevalence and incidence, and their determinants in rural south-western Uganda. Recently, the research questions have included the epidemiology and genetics of communicable and non-communicable diseases (NCDs) to address the limited data on the burden and risk factors for NCDs in sub-Saharan Africa. The cohort comprises all residents (52% aged ≥13years, men and women in equal proportions) within one-half of a rural sub-county, residing in scattered houses, and largely farmers of three major ethnic groups. Data collected through annual surveys include; mapping for spatial analysis and participant location; census for individual socio-demographic and household socioeconomic status assessment; and a medical survey for health, lifestyle and biophysical and blood measurements to ascertain disease outcomes and risk factors for selected participants. This cohort offers a rich platform to investigate the interplay between communicable diseases and NCDs. There is robust infrastructure for data management, sample processing and storage, and diverse expertise in epidemiology, social and basic sciences. For any data access enquiries you may contact the director, MRC/UVRI, Uganda Research Unit on AIDS by email to mrc@mrcuganda.org or the corresponding author.
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    Trends of Reported HIV Sexual Risk Behaviour and HIV Incidence among Fisherfolk in Uganda Receiving Clinic-based Routine HIV Counseling and Testing
    (AIDS Research and Human Retroviruses, 2014) Mushabe Bahemuka, Ubaldo; Abaasa, Andrew; Ruzagira, Eugene; Mukasa Kibengo, Freddie; Ndibazza, Juliet; Asiki, Gershim; Mulondo, Jerry; Andrew Price, Matthew; Fast, Patricia; Kamali, Anatoli
    HIV counseling and testing (HCT) has been shown to reduce HIV risk behavior and is central to HIV prevention programs. We investigated risk behavior and HIV incidence trends in a fisherfolk cohort on Lake Victoria, Uganda. HIV negative volunteers aged 18–49 years, at high risk of HIV infection and willing to undergo HCT were enrolled. At every quarterly visit, they received HCT. Condoms and STI treatment were also provided. Risk behavior data on alcohol consumption before sex, multiple or new sex partners, condom use and exchange of gifts for sex in the past 3 months were collected at baseline and every 6 months for 2 years. We fitted multilevel logistic regression models to investigate the trends.