Browsing by Author "Birungi, Abraham"

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    A case of toxoplasmic encephalitis in a patient on cancer chemotherapy in Uganda
    (African Journals Online (AJOL), 2025-01-11) Mitala, Yekosani; Atwine, Raymond; Birungi, Abraham; Ambaru, Jacinta; Kuraishi, Baluku; Sekitene, Semei; Nuwagira, Edwin
    Background: Reactivation of central nervous system (CNS) toxoplasmosis can be caused by immunosuppression (ISS) of any kind. However, anti-cancer chemotherapy combined with human immunodeficiency virus (HIV) induced ISS results in an atypical presentation that is fatal. Case presentation: A 46 years old man with a well-controlled infection of the human immunodeficiency virus presented with generalized tonic-clonic seizures following the second dose of anti-cancer chemotherapy for esophageal cancer. His brain's computerized tomography (CT) scan showed enlarged ventricles with no space-occupying lesions. Cerebrospinal fluid (CSF) smears stained with hematoxylin and eosin (H&E) revealed numerous bradyzoites and tachyzoites consistent with central nervous system toxoplasmosis. Conclusion: With a double burden of cancer and Human immunodeficiency virus (HIV) infection in low-income countries, this case raises awareness about the atypical presentation of CNS toxoplasmosis reactivation among patients on cancer chemotherapy.
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    Association between HIV Serostatus and premalignant cervical lesions among women attending a cervical cancer screening clinic at a tertiary care facility in southwestern Uganda: a comparative cross-sectional study
    (BMC, 2024-04) Kirabira, Justus; Kayondo, Musa; Bawakanya, Stephen Mayanja; Nsubuga, Edirisa Juniour; Yarine, Fajardo; Namuli, Alexcer; Namugumya, Rita; Natulinda, Christine Hilda; Atwine, Raymond; Birungi, Abraham; Lugobe, Henry Mark; Tibaijuka, Leevan; Kisombo, Dean; Jjuuko, Mark; Agaba, David Collins; Saturday, Pascal; Atupele, Subira Mlangwa; Tumusiime, Matthew; Migisha, Richard; Kajabwangu, Rogers
    Abstract Background Uganda has approximately 1.2 million people aged 15–64 years living with human immunodeficiency virus (HIV). Previous studies have shown a higher prevalence of premalignant cervical lesions among HIV-positive women than among HIV-negative women. Additionally, HIV-infected women are more likely to have human papilloma virus (HPV) infection progress to cancer than women not infected with HIV. We determined the prevalence of premalignant cervical lesions and their association with HIV infection among women attending a cervical cancer screening clinic at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a comparative cross-sectional study of 210 women aged 22–65 years living with HIV and 210 women not living with HIV who were systematically enrolled from March 2022 to May 2022. Participants were subjected to a structured interviewer-administered questionnaire to obtain their demographic and clinical data. Additionally, Papanicolaou smears were obtained for microscopy to observe premalignant cervical lesions. Multivariate logistic regression was performed to determine the association between HIV status and premalignant cervical lesions. Results The overall prevalence of premalignant cervical lesions in the study population was 17% (n = 72; 95% C.I: 14.1–21.4), with 23% (n = 47; 95% C.I: 17.8–29.5) in women living with HIV and 12% (n = 25; 95% C.I: 8.2–17.1) in women not living with HIV (p < 0.003). The most common premalignant cervical lesions identified were low-grade squamous intraepithelial lesions (LSIL) in both women living with HIV (74.5%; n = 35) and women not living with HIV (80%; n = 20). HIV infection was significantly associated with premalignant lesions (aOR: 2.37, 95% CI: 1.27–4.42; p = 0.007). Conclusion Premalignant cervical lesions, particularly LSILs, were more common in HIV-positive women than in HIV-negative women, highlighting the need to strengthen the integration of cervical cancer prevention strategies into HIV care programs.