Browsing by Author "Babigumira, Joseph"

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    Finding the best examples of healthcare quality improvement in Sub-Saharan Africa
    (BMJ Quality & Safety, 2010) Liu, Constance; Babigumira, Joseph; Chiunda, Allan; Katamba, Achilles; Litvak, Ilya; Miller, Lakisha; Namagembe, Imelda; Sekandi, Juliet; Seicean, Andrea; Seicean, Sinziana; Neuhauser, Duncan
    The purpose of this study was to summarise the current state of healthcare quality improvement literature focusing on sub-Saharan Africa. Methods Conventional methods of searching the literature were quickly found to be inadequate or inappropriate, given the different needs of practitioners in sub-Saharan Africa, and the inaccessibility of the literature. Results The group derived a core list of what were deemed exemplary quality improvement articles, based on consensus and a search into the “grey” literature of quality improvement. Conclusions Quality improvment articles from sub- Saharan Africa are difficult to find, and suffer from a lack of centrality and organisation of literature. Efforts to address this are critical to fostering the growth of quality improvement literature in developing country settings.
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    Supervised Versus Unsupervised Intake Of Six-Dose Artemether-Lumefantrine For Treatment Of Acute, Uncomplicated Plasmodium Falciparum Malaria In Mbarara, Uganda: A Randomised Trial
    (The Lancet, 2005) Piola, Patrice; Fogg, Carole; Bajunirwe, Francis; Biraro, Samuel; Grandesso, Francesco; Ruzagira, Eugene; Babigumira, Joseph; Kigozi, Isaac; Kiguli, James; Kyomuhendo, Juliet; Ferradini, Laurent; Taylor, Walter; Checchi, Francesco; Guthmann, Jean-Paul
    The six-dose regimen of artemether-lumefantrine is effective and is among combination therapies prioritised to replace antimalarials that no longer work in Africa. However, its effectiveness has not been assessed in the field, and could be compromised by poor adherence, incorrect timing of doses, and insufficient intake of fatty foods with every dose. Our aim, therefore, was to assess the effectiveness of artemether-lumefantrine prescribed under routine outpatient conditions, compared with its efficacy when given under supervision to inpatients with acute uncomplicated falciparum malaria.We did a randomised trial to compare the efficacy, safety, and pharmacokinetics of artemether-lumefantrine when given in a supervised (all doses observed with fatty-food intake; n=313) or unsupervised (first dose supervised followed by outpatient treatment with nutritional advice; n=644) setting to patients of all ages (weight >10 kg) with acute, uncomplicated falciparum malaria in Mbarara, Uganda. Our primary endpoint was 28 day, PCR-adjusted, parasitological cure rate. Analysis was by intention to treat and evaluability analysis.38 patients were lost to follow-up and one withdrew consent. Day-28 cure rates were 97·7% (296 of 303) and 98·0% (603 of 615) in the supervised and unsupervised groups, respectively. We recorded 15 non-severe, drug-related adverse events, all of which resolved.Artemether-lumefantrine has a high cure rate irrespective of whether given under supervision with food or under conditions of routine clinic practice. If used as first-line treatment, artemether-lumefantrine could make a substantial contribution to malaria control in Africa, though cost is an issue.