Browsing by Author "Baliraine, Frederick N."

Now showing 1 - 6 of 6
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    Achieving measles control: lessons from the 2002–06 measles control strategy for Uganda
    (Health policy and planning, 2002) Mbabazi, William B.; Nanyunja, Miriam; Makumbi, Issa; Braka, Fiona; Baliraine, Frederick N.; Kisakye, Annet; Bwogi, Josephine; Mugyenyi, Possy; Kabwongera, Eva; Lewis, Rosamund F.
    The 2002–06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. Methods Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases.
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    Possible Interruption of Measles Virus Transmission, Uganda, 2006–2009
    (Emerging infectious diseases, 2011) Baliraine, Frederick N.; Bwogi, Josephine; Bukenya, Henry; Seguya, Ronald; Kabaliisa, Theopista; Kisakye, Annet; Mbabazi, William B.; Smith, Sheilagh B.
    To determine what measles virus genotype(s) circulated in Uganda after strategic interventions aimed at controlling/ eliminating measles, we examined samples obtained during 2006–2009 and found only genotype B3.1, which had not been previously detected. Kenya was the likely source, but other countries cannot be excluded.
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    Prolonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda
    (iseases, 2011) Baliraine, Frederick N.; Rosenthal, Philip J.
    We compared the prevalence of key pfmdr1 alleles between pretreatment Plasmodium falciparum parasite isolates and parasites that emerged after treatment of uncomplicated malaria in a longitudinal cohort of Ugandan children. The pfmdr1 86N, 184F, and 1246D alleles were selected after treatment with artemether-lumefantrine, but not after artesunate-amodiaquine or amodiaquine-sulfadoxine-pyrimethamine. Remarkably, selection persisted in infections presenting up to about 60 days after treatment with artemether-lumefantrine. Thus, parasites selected for decreased drug sensitivity can appear long after predicted exposure to antimalarial drugs. Continued surveillance of the clinical efficacy and in vitro activity of new combination therapies is warranted.
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    Quinine, an old anti-malarial drug in a Modern world: role in the treatment of Malaria
    (Malaria journal, 2011) Achan, Jane; Talisuna, Ambrose O.; Erhart, Annette; Yeka, Adoke; Tibenderana, James K.; Baliraine, Frederick N.; Rosenthal, Philip J.; D’Alessandro, Umberto;
    Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented.However, itscontinued use is challenged by its poor tolerability, poor compliance with complex dosing regimens,and the availability of more efficacious anti-malarial drugs. This article reviews the historical role of quinine,considers its current usage and provides insight into its appropriate future use in the treatment of malaria. In lightof recent research findings intravenous artesunate should be thefirst-line drug for severe malaria, with quinine asan alternative. The role of rectal quinine as pre-referral treatment for severe malaria has not been fully explored,but it remains a promising intervention. In pregnancy, quinine continues to play a critical role in the managementof malaria, especially in the first trimester, and it will remain a mainstay of treatment until safer alternatives becomeavailable. For uncomplicated malaria, artemisinin-based combination therapy (ACT) offers a better option thanquinine though the difficulty of maintaining a steady supply of ACT in resource-limited settings renders the rapidwithdrawal of quinine for uncomplicated malaria cases risky. The best approach would be to identify solutions toACT stock-outs, maintain quinine in case ofACT stock-outs, and evaluate strategies for improving quininetreatment outcomes by combining it with antibiotics. In HIV andTB infected populations, concerns about potentialinteractions between quinine and antiretroviral and antituberculosis drugs exist, andthese will need furtherresearch and pharmacovigilance.
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    Temporal Changes in Prevalence of Molecular Markers Mediating Antimalarial Drug Resistance in a High Malaria Transmission Setting in Uganda
    (The American journal of tropical medicine and hygiene, 2014) Mbogo, George W.; Nankoberanyi, Sheila; Tukwasibwe, Stephen; Baliraine, Frederick N.; Nsobya, Samuel L.; Conrad, Melissa D.; Arinaitwe, Emmanuel; Kamya, Moses; Tappero, Jordan; Staedke, Sarah G.; Dorsey, Grant
    Standard therapy for malaria in Uganda changed from chloroquine to chloroquine + sulfadoxine-pyrimethamine in 2000, and artemether-lumefantrine in 2004, although implementation of each change was slow. Plasmodium falciparum genetic polymorphisms are associated with alterations in drug sensitivity. We followed the prevalence of drug resistancemediating P. falciparum polymorphisms in 982 samples from Tororo, a region of high transmission intensity, collected from three successive treatment trials conducted during 2003–2012, excluding samples with known recent prior treatment. Considering transporter mutations, prevalence of the mutant pfcrt 76T, pfmdr1 86Y, and pfmdr1 1246Y alleles decreased over time. Considering antifolate mutations, the prevalence of pfdhfr 51I, 59R, and 108N, and pfdhps 437G and 540E were consistently high; pfdhfr 164L and pfdhps 581G were uncommon, but most prevalent during 2008–2010. Our data suggest sequential selective pressures as different treatments were implemented, and they highlight the importance of genetic surveillance as treatment policies change over time.
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    Whole genome analysis of selected human and animal rotaviruses identified in Uganda from 2012 to 2014 reveals complex genome reassortment events between human, bovine, caprine and porcine strains
    (PLoS ONE, 2017) Bwogi, Josephine; Jere, Khuzwayo C.; Karamagi, Charles; Byarugaba, Denis K.; Namuwulya, Prossy; Baliraine, Frederick N.; Desselberger, Ulrich; Iturriza-Gomara, Miren
    Rotaviruses of species A (RVA) are a common cause of diarrhoea in children and the young of various other mammals and birds worldwide. To investigate possible interspecies transmission of RVAs, whole genomes of 18 human and 6 domestic animal RVA strains identified in Uganda between 2012 and 2014 were sequenced using the Illumina HiSeq platform. The backbone of the human RVA strains had either a Wa- or a DS-1-like genetic constellation. One human strain was a Wa-like mono-reassortant containing a DS-1-like VP2 gene of possible animal origin. All eleven genes of one bovine RVA strain were closely related to those of human RVAs. One caprine strain had a mixed genotype backbone, suggesting that it emerged from multiple reassortment events involving different host species. The porcine RVA strains had mixed genotype backbones with possible multiple reassortant events with strains of human and bovine origin.Overall, whole genome characterisation of rotaviruses found in domestic animals in Uganda strongly suggested the presence of human-to animal RVA transmission, with concomitant circulation of multi-reassortant strains potentially derived from complex interspecies transmission events. However, whole genome data from the human RVA strains causing moderate and severe diarrhoea in under-fives in Uganda indicated that they were primarily transmitted from person-to-person.