Browsing by Author "Kabanda, Joseph"

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    Cryptococcal Antigenemia in Human Immunodeficiency Virus Antiretroviral Therapy–Experienced Ugandans With Virologic Failure
    (Clinical infectious diseases, 2020) Mpoza, Edward; Radha, Rajasingham; Tugume, Lillian; Joshua, Rhein; Nabaggala, Maria Sarah; Ssewanyana, Isaac; Nyegenye, Wilson; Kushemererwa, Grace Esther; Mulema, Vivienne; Kalamya, Julius; Kiyaga, Charles; Kabanda, Joseph; Ssali, Mina; Boulware, David R.; Meya, David B.
    Detectable serum or plasma cryptococcal antigen (CrAg) precedes symptomatic cryptococcal meningitis. The World Health Organization recommends CrAg screening for human immunodeficiency virus–positive persons with CD4 count <100 cells/μL initiating antiretroviral therapy (ART). However, an increasing proportion of patients with cryptococcosis are now ART experienced. Whether CrAg screening is cost-effective in those with virologic failure is unknown. Methods We retrospectively performed nationwide plasma CrAg testing among ART-experienced Ugandan adults with virologic failure (≥1000 copies/mL) using leftover plasma after viral load testing during September 2017–January 2018. For those who were CrAg positive, we obtained ART history, meningitis occurrence, and 6-month survival via medical records review. Results Among 1186 subjects with virologic failure, 35 (3.0%) were CrAg positive with median ART duration of 41 months (interquartile range, 10–84 months). Among 25 subjects with 6-month outcomes, 16 (64%) survived, 7 (28%) died, and 2 (8%) were lost. One survivor had suffered cryptococcal meningitis 2 years prior. Two others developed cryptococcal meningitis and survived. Five survivors were known to have received fluconazole. Thus, meningitis-free survival at 6 months was 61% (14/23). Overall, 91% (32/35) of CrAg-positive persons had viral load ≥5000 copies/mL compared with 64% (735/1151) of CrAg-negative persons (odds ratio, 6.0 [95% confidence interval, 1.8–19.8]; P = .001). CrAg prevalence was 4.2% (32/768) among those with viral loads ≥5000 copies/mL and 0.7% (3/419) among those with viral loads <5000 copies/mL. Conclusions In addition to the CD4 threshold of <100 cells/μL, reflexive CrAg screening should be considered in persons failing ART in Uganda with viral loads ≥5000 copies/mL.
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    Poor immunological recovery among severely immunosuppressed antiretroviral therapy-naïve Ugandans
    (HIV/AIDS – Research and Palliative Care, 2013) Nanzigu, Sarah; Kiguba, Ronald; Kabanda, Joseph; Mukonzo, Jackson K .; Waako, Paul; Kityo, Cissy; Makumbi, Fred
    With access to antiretroviral therapy (ART) expanding in resource-limited settings, assessing factors related to clinical, immunological, and virological outcomes of ART is of great importance. Even though ART is loosely referred to as a lifelong treatment, clinical, immunological and virological outcome measures differ among patients on highly active ART (HAART), with differences reported within and across cohorts.1–6 Mortality is among the ART-outcome variables that have been studied extensively, and rates of up to 30% have been reported during the first year of treatment in some sub-Saharan settings
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    The current educational interventions for teaching and learning evidence-based practice knowledge, skills, attitudes, and behaviours: a systematic review among undergraduate healthcare students in developing countries
    (Cogent Education, 2025) Nalweyiso, Dorothy Irene; Mbabazi, Johnson; Josette, Bettany Saltikov; Kabanda, Joseph; Jeff, Breckon; Nnyanzi, Lawrence Achilles; Kawooya, Michael Grace; Mubuuke, Aloysius Gonzaga; Kinengyere, Alison Annet; Katherine, Sanderson
    This study aims to evaluate the current educational interventions designed to teach evidence-based practice (EBP) knowledge, skills, attitudes, and behaviours among undergraduate healthcare students in developing countries. A systematic review of quantitative primary research studies was conducted. From an initial set of 942 studies, 848 were screened based on their titles and abstracts, and 11 full-text articles were assessed. After applying exclusion criteria, eight studies were included in the review. These studies were identified through a comprehensive search of electronic databases, including CINAHL, MEDLINE, EMBASE, PUBMED, and ERIC. Two independent reviewers screened, appraised, and extracted data, utilizing the McMaster appraisal tools to assess methodological quality. A best-evidence synthesis approach was applied to summarize the findings in accordance with PRISMA guidelines. The review identified eight studies, 87.5% of which were conducted in Asian countries. The majority (62.5%) of these studies employed survey designs, and 75% incorporated blended teaching methods to deliver EBP content. A notable finding was the absence of EBP-focused interventions for healthcare students in sub-Saharan Africa. There is a significant gap in research regarding educational interventions for teaching EBP to undergraduate healthcare students in developing countries. The findings suggest a need for more targeted research and interventions, particularly in regions like sub-Saharan Africa.