Browsing by Author "Katumba, Kenneth R."
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Item Acceptability and Predictors of Uptake of Anti-Retroviral Pre-Exposure Prophylaxis (Prep) among Fishing Communities in Uganda: A Cross-Sectional Discrete Choice Experiment Survey(AIDS and behavior, 2019) Kuteesa, Monica O.; Quaife, Mathew; Biraro, Sam; Katumba, Kenneth R.; Seeley, Janet; Kamali, Anatoli; Nakanjako, DamalieWe used a discrete choice experiment to assess the acceptability and potential uptake of HIV pre-exposure prophylaxis (PrEP) among 713 HIV-negative members of fishing communities in Uganda. Participants were asked to choose between oral pill, injection, implant, condoms, vaginal ring (women), and men circumcision. Product attributes were HIV prevention effectiveness, sexually transmitted infection (STI) prevention, contraception, waiting time, and secrecy of use. Data were analysed using mixed multinomial logit and latent class models. HIV prevention effectiveness was viewed as the most important attribute. Both genders preferred oral PrEP. Women least preferred the vaginal ring and men the implant. Condom use was predicted to decrease by one third among men, and not to change amongst women. Oral PrEP and other new prevention technologies are acceptable among fishing communities and may have substantial demand. Future work should explore utility of multiple product technologies that combine contraception with HIV and other STI prevention.Item Application of sero- epidemiology data to inform interventions for HBV in Africa: should diagnosis and treatment replace catch-up vaccination?(Global Health, 2018) McNaughton, Anna L.; Lourenço, José; Armand Bester, Phillip; Mokaya, Jolynne; Lumley, Sheila F.; Forde, Donall; Maponga, Tongai G.; Katumba, Kenneth R.; Goedhals, Dominique; Gupta, Sunetra; Seeley, Janet; Newton, Robert; Ocama, Ponsiano; Matthews, Philippa C.International goals for hepatitis B virus (HBV) infection set ambitious targets for elimination by 2030. In populations with a high prevalence of infection, catch-up HBV vaccination of adults is sometimes deployed. An alternative approach of ‘test and treat’ could be applied as a population intervention for HBV. Methods: We used a systematic approach to determine the relationship between prevalence of HBV infection (HBsAg) and exposure (anti-HBc) in Africa. We applied a mathematical model to compare the impact of catch-up vaccination with a ‘test and treat’ strategy in a high prevalence setting. Findings: There is a strong relationship between the prevalence of HBsAg and anti- HBc (p<0·0001) across Africa, but the pattern differs between regions. Our data can be interactively visualised at https://hbv-geo.shinyapps.io/oxafricahbv/. In settings with high prevalence of infection, catch-up vaccination may have a transient effect. However, this intervention does not contribute to a sustained decline in prevalence, because a high proportion of adults are either already infected or immune as a result of prior exposure. In contrast, diagnosing and treating infection has a marked impact on reducing prevalence, equivalent to that of neonatal vaccination. Interpretation: We have developed a high-resolution picture of HBV epidemiology across Africa. In combination with robust neonatal vaccination programmes, testing and treating infection is likely to be of more benefit than catch-up vaccination. This alternative not only benefits the infected individual, but also has impact on transmission, thus contributing to sustained reductions in population prevalence.