Browsing by Author "Joloba, M. L."

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    Evaluation of Suspected Tuberculous Pleurisy: Clinical and Diagnostic findings in HIV-1-Positive and HIV-negative Adults in Uganda
    (The international journal of tuberculosis and lung disease, 2001) Luzze, H.; Elliott, A. M.; Joloba, M. L.; Odida, M.; Nakiyingi, J.; Mugerwa, R. D.; Okwera, A.
    To compare clinical and radiographic presentation, and diagnostic methods, in adults with tuberculous pleurisy who are negative and positive for the human immunodeficiency virus (HIV). Adults with suspected pleural tuberculosis were screened by clinical examination, thoracocentesis and closed pleural biopsy. Biopsy material was cultured on Middlebrook 7H-10 solid medium and in BACTEC 12B radiometric vials. Pleural fluid was cultured using Löwenstein-Jensen slants, BACTEC and Kirchner liquid medium. Of 156 individuals enrolled, 142 had tuberculosis, of whom 80% were HIV-positive. Among those with tuberculosis, HIV-positive patients had a more severe and longer illness. The size of effusions was similar in HIV-positive and HIV-negative patients. A higher proportion of HIV-positive patients had parenchymal infiltrates but this difference was not statistically significant. Pleural fluid lymphocytosis was present in all HIV-negative and 97% of the HIV-positive patients. HIV-positive patients had lower pleural fluid lymphocyte counts. Pleural fluid cultures were more often positive in HIV-positive patients. BACTEC and Kirchner liquid media gave higher yields than solid media. HIV-positive patients with tuberculous pleurisy had a more severe illness than HIV-negative patients. Mycobacterial cultures from HIV-positive patients were more often positive, suggesting more mycobacterial extension from the lungs into the pleural space. Liquid culture media were superior to solid media with regard to diagnostic yield and time until diagnosis.
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    Polymorphisms in TICAM2 and IL1B are associated with TB
    (Genes & Immunity, 2015) Hall, N. B.; Igo Jr., R. P.; Malone, L. L.; Truitt, B.; Schnell, A.; Tao, L.; Okware, B.; Nsereko, M.; Chervenak, K.; Lancioni, C.; Hawn, T. R.; Mayanja-Kizza, H.; Joloba, M. L.; Boom, W. H.; Stein, C. M.
    Human genetic susceptibility for tuberculosis (TB) has been demonstrated by several studies, but few have examined the multiple innate and adaptive immunity genes comprehensively, age-specific effects and/or resistance to Mycobacterium tuberculosis (Mtb) infection (resistors (RSTRs)). We hypothesized that RSTRs, defined by a persistently negative tuberculin skin test, may have different genetic influences than Mtb disease. We examined 29 candidate genes in pathways that mediate immune responses to Mtb in subjects in a household contact study in Kampala, Uganda. We genotyped 546 haplotype-tagging single-nucleotide polymorphisms (SNPs) in 835 individuals from 481 families; 28.7% had TB, 10.5% were RSTRs, and the remaining 60.8% had latent Mtb infection. Among our most significant findings were SNPs in TICAM2 (P = 3.6 × 10− 6) and IL1B (P = 4.3 × 10− 5) associated with TB. Multiple SNPs in IL4 and TOLLIP were associated with TB (Po0.05). Age–genotype interaction analysis revealed SNPs in IL18 and TLR6 that were suggestively associated with TB in children aged ⩽10 years (P = 2.9 × 10− 3). By contrast, RSTR was associated with SNPs in NOD2, SLC6A3 and TLR4 (nominal Po0.05); these genes were not associated with TB, suggesting distinct genetic influences. We report the first association between TICAM2 polymorphisms and TB and between IL18 and pediatric TB.