Browsing by Author "Babirye, D."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Multicomponent Strategy with Decentralized Molecular Testing for Tuberculosis
    (New England Journal of Medicine, 2021) Cattamanchi, A.; Reza, T.F.; Nalugwa, T.; Adams, K.; Nantale, M.; Oyuku, D.; Nabwire, S.; Babirye, D.; Turyahabwe, S.; Tucker, A.; Sohn, H.; Ferguson, O.; Thompson, R.; Shete, P.B.; Handley, M.A.; Ackerman, S.; Joloba, M.; Moore, D.A.J.; Davis, J.L.; Dowdy, D.W.; Fielding, K.; Katamba, A.
    Effective strategies are needed to facilitate the prompt diagnosis and treatment of tuberculosis in countries with a high burden of the disease. METHODS We conducted a cluster-randomized trial in which Ugandan community health centers were assigned to a multicomponent diagnostic strategy (on-site molecular testing for tuberculosis, guided restructuring of clinic workflows, and monthly feedback of quality metrics) or routine care (on-site sputum-smear microscopy and referral-based molecular testing). The primary outcome was the number of adults treated for confirmed tuberculosis within 14 days after presenting to the health center for evaluation during the 16-month intervention period. Secondary outcomes included completion of tuberculosis testing, same-day diagnosis, and sameday treatment. Outcomes were also assessed on the basis of proportions. RESULTS A total of 20 health centers underwent randomization, with 10 assigned to each group. Of 10,644 eligible adults (median age, 40 years) whose data were evaluated, 60.1% were women and 43.8% had human immunodeficiency virus infection. The intervention strategy led to a greater number of patients being treated for confirmed tuberculosis within 14 days after presentation (342 patients across 10 intervention health centers vs. 220 across 10 control health centers; adjusted rate ratio, 1.56; 95% confidence interval [CI], 1.21 to 2.01). More patients at intervention centers than at control centers completed tuberculosis testing (adjusted rate ratio, 1.85; 95% CI, 1.21 to 2.82), received a same-day diagnosis (adjusted rate ratio, 1.89; 95% CI, 1.39 to 2.56), and received same-day treatment for confirmed tuberculosis (adjusted rate ratio, 2.38; 95% CI, 1.57 to 3.61). Among 706 patients with confirmed tuberculosis, a higher proportion in the intervention group than in the control group were treated on the same day (adjusted rate ratio, 2.29; 95% CI, 1.23 to 4.25) or within 14 days after presentation (adjusted rate ratio, 1.22; 95% CI, 1.06 to 1.40). CONCLUSIONS A multicomponent diagnostic strategy that included on-site molecular testing plus implementation supports to address barriers to delivery of high-quality tuberculosis evaluation services led to greater numbers of patients being tested, receiving a diagnosis, and being treated for confirmed tuberculosis. (Funded by the National Heart, Lung, and Blood Institute; XPEL-TB ClinicalTrials.gov number, NCT03044158.)
  • Thumbnail Image
    Item
    Patterns of usage and preferences of users for tuberculosis related text messages and voice calls in Uganda
    (The International Journal of Tuberculosis and Lung Disease, 2018) Ggita, J. M.; Ojok, C.; Meyer, A. J.; Farr, K.; Shete, P. B.; Ochom, E.; Turimumahoro, P.; Babirye, D.; Mark, D.; Dowdy, D.; Ackerman, S.; Armstrong-Hough, M.; Nalugwa, T.; Ayakaka, I.; Moore, D.; Haberer, J. E.; Cattamanchi, A.; Katamba, A.; Davis, J. L.
    Little information exists about mobile phone usage or preferences for tuberculosis (TB) related health communications in Uganda. METHODS : We surveyed household contacts of TB patients in urban Kampala, Uganda, and clinic patients in rural central Uganda. Questions addressed mobile phone access, usage, and preferences for TB-related communications. We collected qualitative data about messaging preferences. RESULT S : We enrolled 145 contacts and 203 clinic attendees. Most contacts (58%) and clinic attendees (75%) owned a mobile phone, while 42% of contacts and 10% of clinic attendees shared one; 94% of contacts and clinic attendees knew how to receive a short messaging service (SMS) message, but only 59% of contacts aged745 years (vs. 96% of contacts aged ,45 years, P¼0.0001) did so. All contacts and 99% of clinic attendees were willing and capable of receiving personal- health communications by SMS. Among contacts, 55% preferred detailed messages disclosing test results, while 45% preferred simple messages requesting a clinic visit to disclose results. CONCLUS IONS : Most urban household TB contacts and rural clinic attendees reported having access to a mobile phone and willingness to receive TB-related personal-health communications by voice call or SMS. However, frequent phone sharing and variable messaging abilities and preferences suggest a need to tailor the design and monitoring of mHealth interventions to target recipients.