Browsing by Author "Byaruhanga, Aggrey"

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    Death after cure: Mortality among pulmonary tuberculosis survivors in rural Uganda Joseph Baruch Baluku Brenda Namanda Sharon Namiiro Aggrey Byaruhang
    (Elsevier Ltd, 2024-07) Baluku, Joseph Baruch; Namanda, Brenda; Namiiro, Sharon; Rwabwera, Diana Karungi; Mwesigwa, Gloria; Namaara, Catherine; Twinomugisha, Bright; Nyirazihawe, Isabella; Nuwagira, Edwin; Kansiime, Grace; Kizito, Enock; Nabukenya-Mudiope, Mary G; Sekadde, Moorine Penninah; Bongomin, Felix; Senfuka, Joshua; Olum, Ronald; Byaruhanga, Aggrey; Munabi, Ian; Kiguli, Sarah
    Objectives: To determine the incidence of mortality and its predictors among pulmonary tuberculosis (PTB) survivors treated at a rural Ugandan tertiary hospital. Methods: We conducted a retrospective chart review of data between 2013 and 2023. We included all people that met the World Health Organisation's definition of tuberculosis cure and traced them or their next of kin to determine vital status (alive/deceased). We estimated the cumulative incidence of mortality per 1000 population, crude all-cause mortality rate per 1000 person-years, and median years of potential life lost for deceased individuals. Using Cox proportional hazard models, we investigated predictors of mortality. Results: Of 334 PTB survivors enrolled, 38 (11.4%) had died. The cumulative incidence of all-cause mortality was 113.7 per 1000 population, and the crude all-cause mortality rate was 28.5 per 1000 person-years. The median years of potential life lost for deceased individuals was 23.8 years (IQR: 9.6-32.8). Hospitalization (adjusted hazard ratio (aHR): 4.3, 95% CI: 1.1-16.6) and unemployment (aHR: 7.04, 95% CI: 1.5-31.6) at TB treatment initiation predicted mortality. Conclusion: PTB survivors experience post high mortality rates after TB cure. Survivors who were hospitalized and unemployed at treatment initiation were more likely to die after cure. Social protection measures and long-term follow-up of previously hospitalized patients could improve the long-term survival of TB survivors.
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    Risk factors for human anthrax outbreak in Kiruhura District, Southwestern Uganda: a population-based case control study
    (PAMJ - One Health, 2021) Migisha, Richard; Mbatidde, Irene; Agaba, David C.; Turyakira, Eleanor; Tumwine, Gabriel; Byaruhanga, Aggrey; Siya, Aggrey; Ruzaaza, Gad N.; Kirunda, Halid
    Introduction: in 2018, Uganda experienced recurrent outbreaks of anthrax in both humans and livestock. We aimed to determine risk factors for human anthrax outbreak among residents of Kazo County, Kiruhura District, south-western Uganda. Methods: we conducted an unmatched case control study during March-April 2019. We defined a case as having had anthrax infection reported to be diagnosed by a healthcare worker in a resident of Kazo County between May 1st, 2018 and June 1st, 2018. A control was a resident in the nearest neighboring household who had not been diagnosed with anthrax between May 1st and June 1st and who had no symptoms suggestive of anthrax in May 2018. We obtained participants' sociodemographic, clinical and exposure characteristics using a structured questionnaire. We performed logistic regression to identify risk factors for human anthrax. Results: we recruited 101 participants (28 cases and 73 controls) with median age of 34 (IQR; 26-47) years; most (61.4%) were female. The overall attack rate was 1.9%, while the most common clinical manifestations were ulcers (96.4%) and fever (96.4%). The risk factors for contracting human anthrax were: slaughtering of anthrax infected animals (aOR=5.74; 95%CI: 1.39-23.8), consuming of anthrax infected meat (aOR=6.4; 95%CI: 1.53- 6.7) and being male (aOR=12.8; 95%CI: 3.31-49.1).
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    Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID‑19 pandemic, Uganda
    (BMC psychology, 2021) Migisha, Richard; Riolexus, Alex A.; Kwesiga, Benon; Bulage, Lilian; Kadobera, Daniel; Kabwama, Steven N.; Katana, Elizabeth; Ndyabakira, Alex; Wadunde, Ignatius; Byaruhanga, Aggrey; Amanya, Geofrey; Harris, Julie R.; Fitzmaurice, Arthur G.
    Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda. Methods: We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress. Results: Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress. Conclusions: Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID- 19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize