Browsing by Author "Kasamba, Ivan"

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    Evaluating the glycemic effects of Dolutegravir and its predictors among people living with HIV in Uganda: A prospective cohort study.
    (Open Forum Infectious Diseases, 2024-10) Ankunda, Collins; Agolor, Curthbert; Karamagi, Yvonne; Nakubulwa, Susan; Namasambi, Sharon; Kasamba, Ivan; Christopher, Semei Mukama; Kukundakwe, Patience; Odiit, Mary; Mubangizi, Ivan; Emunyu, Jude; Kesi, Diana Nakitto; Nambasa, Victoria; Ndagije, Helen Byomire; Mukasa, Barbara
    Abstract Introduction Dolutegravir (DTG), a key component of the recommended HIV treatment regimens in Uganda, has been associated with hyperglycemia. We evaluated its influence on hyperglycemia risk to create a hyperglycemia risk stratification tool for patient monitoring. Methods We conducted a prospective cohort study at three sites with 628 HIV patients on Tenofovir Disoproxyl Fumarate, Lamivudine, and Dolutegravir (TLD). Participants included both Nucleoside reverse transcriptase inhibitors-experienced (exposed) and ART-naïve (non-exposed) groups. Follow-ups occurred every six months with Random Blood Sugar(RBS)every three months. Participants with RBS ≥ 7 mmol/L were classified as hyperglycemic and underwent HbA1c testing, confirming diabetes with a 6.5% cut-off. Results The study found a hyperglycemia incidence rate of 24.5 cases per 100 person-years (95% CI: 19.3-31.1) and a diabetes incidence rate of 5.8 cases per 100 person-years (95% CI: 3.6-9.3). Hyperglycemia incidence was slightly lower in non-exposed (20.8 cases per 100 person-years) vs. exposed groups (25.2 cases per 100 person-years). Multivariable analysis indicated a trend towards lower hyperglycemia risk in non-exposed (adjusted HR = 0.78, 95% CI: 0.37-1.66, p = 0.52) and substantially lower diabetes incidence (adjusted HR = 0.34, 95% CI: 0.04-2.82, p = 0.32). Significant factors for hyperglycemia included age (p < 0.001), study site (p < 0.001), and DTG-based ART duration (p = 0.02). Conclusion Our study showed an increased incidence of hyperglycemia with age, study site, and duration of DTG exposure in HIV patients on TLD. We suggest integrated screening and care for hyperglycemia and diabetes in HIV services, especially when initiating DTG regimens.
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    The General Population Cohort in Rural South Western Uganda: A Platform for Communicable and Non-Communicable Disease Studies
    (International journal of epidemiology, 2013) Asiki, Gershim; Murphy, Georgina; Miiro, Jessica Nakiyingi; Seeley, Janet; Nsubuga, Rebecca N.; Karabarinde, Alex; Waswa, Laban; Biraro, Sam; Kasamba, Ivan; Pomilla, Cristina; Maher, Dermot; Young, Elizabeth H; Kamali, Anatoli; Sandhu, Manjinder S
    The General Population Cohort (GPC) was set up in 1989 to examine trends in HIV prevalence and incidence, and their determinants in rural south-western Uganda. Recently, the research questions have included the epidemiology and genetics of communicable and non-communicable diseases (NCDs) to address the limited data on the burden and risk factors for NCDs in sub-Saharan Africa. The cohort comprises all residents (52% aged ≥13years, men and women in equal proportions) within one-half of a rural sub-county, residing in scattered houses, and largely farmers of three major ethnic groups. Data collected through annual surveys include; mapping for spatial analysis and participant location; census for individual socio-demographic and household socioeconomic status assessment; and a medical survey for health, lifestyle and biophysical and blood measurements to ascertain disease outcomes and risk factors for selected participants. This cohort offers a rich platform to investigate the interplay between communicable diseases and NCDs. There is robust infrastructure for data management, sample processing and storage, and diverse expertise in epidemiology, social and basic sciences. For any data access enquiries you may contact the director, MRC/UVRI, Uganda Research Unit on AIDS by email to mrc@mrcuganda.org or the corresponding author.