Browsing by Author "Downing, Robert"
Now showing 1 - 9 of 9
Results Per Page
Sort Options
Item Evaluation of HIV-1 Rapid Tests and Identification of alternative Testing Algorithms for Use in Uganda(BMC Infectious Diseases, 2018) Kaleebu, Pontiano; Kitandwe, Paul Kato; Lutalo, Tom; Kigozi, Aminah; Watera, Christine; Nanteza, Mary Bridget; Musinguzi, Joshua; Opio, Alex; Downing, Robert; Mbidde, Edward KatongoleThe World Health Organization recommends that countries conduct two phase evaluations of HIV rapid tests (RTs) in order to come up with the best algorithms. In this report, we present the first ever such evaluation in Uganda, involving both blood and oral based RTs. The role of weak positive (WP) bands on the accuracy of the individual RT and on the algorithms was also investigated.Item Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey(African health sciences, 2009) Bwogi, Josephine; Braka, Fiona; Makumbi, Issa; Mishra, Vinod; Bakamutumaho, Barnabas; Nanyunja, Miriam; Opio, Alex; Downing, Robert; Biryahwaho, Benon; Lewis, Rosamund F.Infant immunization against hepatitis B began in Uganda in 2002. Objective: To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3% (95% CI: 51.0-53.6) of adults, and HBsAg in 10.3% (9.5-11.1). By 15-19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, occupation, number of sex partners, and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children.Item Human Herpesvirus Type 8 Variants Circulating In Europe, Africa And North America In Classic, Endemic And Epidemic Kaposi's Sarcoma Lesions During Pre-AIDS and AIDS Era(Virology, 2010) Tornesello, Maria Lina; Biryahwaho, Benon; Downing, Robert; Hatzakis, Angelo; Alessi, Elvio; Cusini, Marco; Ruocco, Vincenzo; Mbidde, Edward Katongole; Loquercio, Giovanna; Buonaguro, Luigi; Buonaguro, Franco M.Human herpesvirus-8 (HHV-8) variants have been found heterogeneously distributed among human populations living in diverse geographic regions, but their differential pathogenicity in Kaposi's sarcoma development remains controversial. In the present study, HHV-8 variant distribution has been analyzed in classic, iatrogenic, endemic as well as epidemic Kaposi's sarcoma (KS) during pre-AIDS and AIDS period (1971–2008) in countries with different KS incidence rate. DNA samples from cutaneous KS lesions of 68 patients living in Africa (n = 23, Cameroon, Kenya and Uganda), Europe (n = 34, Greece and Italy) and North America (n = 11) have been subjected to PCR amplification of HHV-8 ORF 26, T0.7, K1 and K14.1/15, followed by direct nucleotide sequencing and phylogenetic analysis. Among the 23 African samples, the majority of HHV-8 ORF 26 variants clustered with the subtype R (n = 12) and B (n = 5). Conversely, the viral sequences obtained from 45 European and North European tumors belonged mainly to subtype A/C (n = 36). In general, HHV-8 and K1 variant clustering paralleled that of ORF 26 and T0.7. Genotyping of the K14.1/15 loci revealed a large predominance of P subtype in all tumors. In conclusion, comparison of the HHV-8 sequences from classic or endemic versus AIDS-associated KS showed a strong linkage of the HHV-8 variants with specific populations, which has not changed during AIDS epidemic.Item Human Herpesvirus Type 8 Variants In Kaposi’s Sarcoma Before And After AIDS Era(BioMed Central, 2010) Tornesello, Maria Lina; Biryahwaho, Benon; Downing, Robert; Hatzakis, Angelo; Alessi, Elvio; Cusini, Marco; Ruocco, Vincenzo; Loquercio, Giovanna; Mbidde, Edward Katongole; Buonaguro, Luigi; Buonaguro, Franco M.Human herpesvirus 8 (HHV- 8) variants have been found heterogeneously distributed among human populations living in diverse geographic regions, but their differential pathogenicity in Kaposi's sarcoma (KS) development remains controversial. The aim of the present study was to analyze variations of HHV-8 genomes in tumor biopsies collected before and in the course of HIV epidemic (1971 - 2008), from patients with classic, iatrogenic, endemic as well as epidemic KS living in Africa, Europe, and North America.Item Isolation of Genetically Diverse Marburg Viruses from Egyptian Fruit Bats(PLoS pathogens, 2009) Towner, Jonathan S.; Amman, Brian R.; Sealy, Tara K.; Carroll, Serena A. Reeder; Comer, James A.; Kemp, Alan; Swanepoel, Robert; Paddock, Christopher D.; Balinandi, Stephen; Khristova, Marina L.; Formenty, Pierre B. H.; Albarino, Cesar G.; Miller, David M.; Reed, Zachary D.; Kayiwa, John T.; Mills, James N.; Cannon, Deborah L.; Greer, Patricia W.; Byaruhanga, Emmanuel; Farnon, Eileen C.; Atimnedi, Patrick; Okware, Samuel; Mbidde, Edward Katongole; Downing, Robert; Tappero, Jordan W.; Zaki, Sherif R.; Ksiazek, Thomas G.; Nichol, Stuart T.; Rollin, Pierre E.In July and September 2007, miners working in Kitaka Cave, Uganda, were diagnosed with Marburg hemorrhagic fever. The likely source of infection in the cave was Egyptian fruit bats (Rousettus aegyptiacus) based on detection of Marburg virus RNA in 31/611 (5.1%) bats, virus-specific antibody in bat sera, and isolation of genetically diverse virus from bat tissues. The virus isolates were collected nine months apart, demonstrating long-term virus circulation. The bat colony was estimated to be over 100,000 animals using mark and re-capture methods, predicting the presence of over 5,000 virus-infected bats. The genetically diverse virus genome sequences from bats and miners closely matched. These data indicate common Egyptian fruit bats can represent a major natural reservoir and source of Marburg virus with potential for spillover into humans.Item Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018(Emerging Infectious Diseases, 2020) Kisaakye, Esther; Riolexus Ario, Alex; Bainomugisha, Kenneth; Cossaboom, Caitlin M. Ping Zhu; Lowe, David; Bulage, Lilian; Kadobera, Daniel; Sekamatte, Musa; Lubwama, Bernard; Tumusiime, Dan; Tusiime, Patrick; Downing, Robert; Buule, Joshua; Lutwama, Julius; Salzer, Johanna S.; Matkovic, Eduard; Joy Gary, Jana Ritter,; Zhu, Bao-PingOn April 20, 2018, the Kween District Health Office in Kween District, Uganda reported 7 suspected cases of human anthrax. A team from the Uganda Ministry of Health and partners investigated and identified 49 cases, 3 confirmed and 46 suspected; no deaths were reported. Multiple exposures from handling the carcass of a cow that had died suddenly were significantly associated with cutaneous anthrax, whereas eating meat from that cow was associated with gastrointestinal anthrax. Eating undercooked meat was significantly associated with gastrointestinal anthrax, but boiling the meat for >60 minutes was protective. We recommended providing postexposure antimicrobial prophylaxis for all exposed persons, vaccinating healthy livestock in the area, educating farmers to safely dispose of animal carcasses, and avoiding handling or eating meat from livestock that died of unknown causes.Item Proportion of Deaths and Clinical Features in Bundibugyo Ebola Virus Infection, Uganda(Emerging infectious diseases, 2010) MacNeil, Adam; Farnon, Eileen C.; Wamala, Joseph; Okware, Sam; Cannon, Deborah L.; Reed, Zachary; Towner, Jonathan S.; Tappero, Jordan W.; Lutwama, Julius; Ksiazek, Thomas G.; Rollin, Pierre E.; Downing, Robert; Nichol, Stuart T.Ebola hemorrhagic fever (EHF) is a severe disease caused by several species of Ebolavirus (EBOV), in the family Filoviridae. Before 2007, four species of EBOV had been identifi ed; 2 of these, Zaire ebolavirus and Sudan ebolavirus, have caused large human outbreaks in Africa, with proportion of deaths ≈80%–90% and 50%, respectively (1–5). Large outbreaks are associated with person-to-person transmission after the virus is introduced into humans from a zoonotic reservoir. Data suggest that this reservoir may be fruit bats (6,7). During outbreaks of EHF, the virus is commonly transmitted through direct contact with infected persons or their bodily fl uids (8–11). The onset of EHF is associated with nonspecifi c signs and symptoms, including fever, myalgias, headache, abdominal pain, nausea, vomiting, and diarrhea; at later stages of disease, overt hemorrhage has been reported in ≈45% of cases (12). Bundibugyo District is located in western Uganda, which borders the Democratic Republic of Congo. After reports of a mysterious illness in Bundibugyo District, the presence of a novel, fi fth EBOV virus species, Bundibugyo ebolavirus (BEBOV), was identifi ed in diagnostic samples submitted to the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA, in November 2007 (13). In response to detection of EBOV, an international outbreak response was initiated. In this report, we summarize fi ndings of laboratory-confi rmed cases of BEBOV infection.Item Risk Factors Associated with HIV Infection in Uganda(Journal of Infectious Diseases, 1998) Berkley, Seth F.; Widy-Wirski, Roslaw; Okware, Samuel I.; Downing, Robert; Linnan, Michael J.; White, Karen E.; Sempala, SylvesterRisk factor data were collected in 1,328 inpatients and outpatients in 1987in 15hospitals throughout Uganda; 42010 were positive for HIV antibodies by ELISA. Seropositivity was associated with urban residence, sexually transmitted diseases (STD), number of sex partners, and sex for payment or with a person with an AIDS-like illness. Homosexuality and intravenous drug abuse, recognized risk factors in western countries, were not seen as risk factors. By multivariate analysis, urban residence and sex for payment were not independently associated with infection. Among females, number of sex partners, sex with a person with an AIDS-like illness, and numbers of episodes of STDs were significantly associated with seropositivity. In males, similar associations were seen, although number of reported sex partners was not independently associated with infection. These findings support the view that heterosexual contact is the predominant mode of transmission in Uganda and suggest that the main risk factors relate to high-risk heterosexual behavior.Item Shifts in Geographic Distribution and Antimicrobial Resistance during a Prolonged Typhoid Fever Outbreak — Bundibugyo and Kasese Districts, Uganda, 2009–2011(PLoS Negl Trop Dis, 2014) Spalding Walters, Maroya; Routh, Janell; Mikoleit, Matthew; Kadivane, Samuel; Ouma, Caroline; Mubiru, Denis; Mbusa, Ben; Murangi, Amos; Ejoku, Emmanuel; Rwantangle, Absalom; Kule, , Uziah; Lule, John; Garrett, Nancy; Halpin, Jessica; Maxwell, Nikki; Kagirita, Atek; Mulabya, Fred; Makumbi, Issa; Freeman, Molly; Joyce, Kevin; Hill, Vince; Downing, Robert; Mintz, EricSalmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese District, Uganda, a typhoid fever outbreak notable for a high IP rate began in 2008. We report that this outbreak continued through 2011, when it spread to the neighboring district of Bundibugyo. Methodology/Principal Findings: A suspected typhoid fever case was defined as IP or symptoms of fever, abdominal pain, and $1 of the following: gastrointestinal disruptions, body weakness, joint pain, headache, clinically suspected IP, or nonresponsiveness to antimalarial medications. Cases were identified retrospectively via medical record reviews and prospectively through laboratory-enhanced case finding. Among Kasese residents, 709 cases were identified from August 1, 2009–December 31, 2011; of these, 149 were identified during the prospective period beginning November 1, 2011. Among Bundibugyo residents, 333 cases were identified from January 1–December 31, 2011, including 128 cases identified during the prospective period beginning October 28, 2011. IP was reported for 507 (82%) and 59 (20%) of Kasese and Bundibugyo cases, respectively. Blood and stool cultures performed for 154 patients during the prospective period yielded isolates from 24 (16%) patients. Three pulsed-field gel electrophoresis pattern combinations, including one observed in a Kasese isolate in 2009, were shared among Kasese and Bundibugyo isolates. Antimicrobial susceptibility was assessed for 18 isolates; among these 15 (83%) were multidrug-resistant (MDR), compared to 5% of 2009 isolates. Conclusions/Significance: Molecular and epidemiological evidence suggest that during a prolonged outbreak, typhoid spread from Kasese to Bundibugyo. MDR strains became prevalent. Lasting interventions, such as typhoid vaccination and improvements in drinking water infrastructure, should be considered to minimize the risk of prolonged outbreaks in the future.