Browsing by Author "Kayima, James"

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    Community Knowledge and Attitudes of Epilepsy in Rural and Urban Mukono District, Uganda; A Cross Sectional Study
    (Epilepsy & Behavior, 2016) Kaddumukasa, Mark; Kakooza, Angelina; Kayima, James; Kaddumukasa, Martin N.; Ddumba, Edward; Mugenyi, Levi; Furlan, Anthony; Lhatoo, Samden; Sajatovic, Martha; Katabira, Elly
    The lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care of patients with epilepsy within the community. The purpose of this study was to determine the knowledge of and attitude towards epilepsy and its treatment by community dwellers in Uganda.A cross sectional population survey was conducted in urban and rural Mukono district, central Uganda. Adult respondents through multistage stratified sampling were interviewed about selected aspects of epilepsy knowledge, attitudes, and perception using a pretested structured questionnaire.Ninety-one percent of the study respondents had heard or read about epilepsy or knew someone who had epilepsy and had seen someone having a seizure. Thirty-seven percent of the respondents did not know the cause of epilepsy, while 29% cited genetic causes. About seventeen percent of the subjects believed that epilepsy is contagious. Only 5.6% (21/377) of the respondents would take a patient with epilepsy to hospital for treatment.Adults in Mukono are very acquainted with epilepsy but have many erroneous beliefs about the condition. Negative attitudes are pervasive within communities in Uganda. The national epilepsy awareness programs need to clarify the purported modes of transmission of epilepsy, available treatment options, and care offered during epileptic seizures during community sensitizations in our settings.
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    Determinants of hypertension in a young adult Ugandan population in epidemiological transition—the MEPI-CVD survey
    (BMC public health, 2015) Kayima, James; Nankabirwa, Joaniter; Sinabulya, Isaac; Nakibuuka, Jane; Zhu, Xiaofeng; Rahman, Mahboob; Longenecker, Christopher T.; Katamba, Achilles; Mayanja-Kizza, Harriet; Kamya, Moses R.
    High blood pressure is the principal risk factor for stroke, heart failure and kidney failure in the young population in Africa. Control of hypertension is associated with a larger reduction in morbidity and mortality in younger populations compared with the elderly; however, blood pressure control efforts in the young are hampered by scarcity of data on prevalence and factors influencing awareness, treatment and control of hypertension. We aimed to describe the prevalence of prehypertension and hypertension among young adults in a peri-urban district of Uganda and the factors associated with occurrence of hypertension in this population. Methods: This cross-sectional study was conducted between August, 2012 and May 2013 in Wakiso district, a suburban district that that encircles Kampala, Uganda’s capital city. We collected data on socio-demographic characteristics and hypertension status using a modified STEPs questionnaire from 3685 subjects aged 18–40 years selected by multistage cluster sampling. Blood pressure and anthropometric measurements were performed using standardized protocols. Fasting blood sugar and HIV status were determined using a venous blood sample. Association between hypertension status and various biosocial factors was assessed using logistic regression. Results: The overall prevalence of hypertension was 15 % (95 % CI 14.2 – 19.6) and 40 % were pre-hypertensive. Among the 553 hypertensive participants, 76 (13.7 %) were aware of their diagnosis and all these participants had initiated therapy with target blood pressure control attained in 20 % of treated subjects. Hypertension was significantly associated with the older age-group, male sex and obesity. There was a significantly lower prevalence of hypertension among participants with HIV OR 0.6 (95 % CI 0.4–0.8, P = 0.007). Conclusion: There is a high prevalence of high blood pressure in this young periurban population of Uganda with sub-optimal diagnosis and control. There is previously undocumented high rate of treatment, a unique finding that may be exploited to drive efforts to control hypertension. Specific programs for early diagnosis and treatment of hypertension among the young should be developed to improve control of hypertension. The relationship between HIV infection and blood pressure requires further clarification by longitudinal studies.
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    Global Medical Education Partnerships to Expand Specialty Expertise: A Case Report on Building Neurology Clinical and Research Capacity
    (Human resources for health, 2014) Kaddumukasa, Mark; Katabira, Elly; Salata, Robert A.; Costa, Marco A.; Ddumba, Edward; Furlan, Anthony; Mwesige, Angelina Kakooza; Kamya, Moses R.; Kayima, James; Longenecker, Chris T.; Kizza, Harriet Mayanja; Mondo, Charles; Moore, Shirley; Pundik, Svetlana; Sewankambo, Nelson; Simon, Daniel I.; Smyth, Kathleen A.; Sajatovic, Martha
    Neurological disorders are a common cause of morbidity and mortality in sub-Saharan African, but resources for their management are scarce. Collaborations between training institutions in developed and resource-limited countries can be a successful model for supporting specialty medical education and increasing clinical and research capacity.This report describes a US National Institutes of Health (NIH) funded Medical Education Partnership Initiative (MEPI) to enhance expertise in neurology, developed between Makerere University College of Health Sciences in Kampala, Uganda, and Case Western Reserve University School of Medicine in Cleveland, OH, USA.This collaborative model is based on a successful medical education and research model that has been developed over the past two decades. The Ugandan and US teams have accumulated knowledge and 'lessons learned' that facilitate specialty expertise in neurological conditions, which are widespread and associated with substantial disability in resource-limited countries. Strengths of the model include a focus on community health care settings and a strong research component. Key elements include strong local leadership; use of remote technology, templates to standardize performance; shared exchanges; mechanisms to optimize sustainability and of dissemination activities that expand impact of the original initiative. Efficient collaborations are further enhanced by external and institutional support, and can be sequentially refined.Models such as the Makerere University College of Health Sciences - Case Western Reserve University partnership may help other groups initiate collaborative education programmes and establish successful partnerships that may provide the opportunity to expand to other chronic diseases. A benefit of collaboration is that learning is two-directional, and interaction with other international medical education collaborators is likely to be of benefit to the larger global health community.
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    Hypertension awareness, treatment and control in Africa: a systematic review
    (BMC Cardiovascular Disorders, 2013) Kayima, James; Wanyenze, Rhoda K.; Katamba, Achilles; Leontsini, Elli; Nuwaha, Fred
    Inadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. Methods: The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. Results: Thirty eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. Conclusion: There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.
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    Safety and efficacy of hydroxychloroquine for treatment of non‑severe COVID‑19 among adults in Uganda: a randomized open label phase II clinical trial
    (BMC Infectious Diseases, 2021) Byakika‑Kibwika, Pauline; Sekaggya‑Wiltshire, Christine; Semakula, Jerome Roy; Nakibuuka, Jane; Musaazi, Joseph; Kayima, James; Sendagire, Cornelius; Meya, David; Kirenga, Bruce; Nanzigu, Sarah; Kwizera, Arthur; Nakwagala, Fred; Kisuule, Ivan; Wayengera, Misaki; Mwebesa, Henry G.; Kamya, Moses R.; Bazeyo, William
    Several repurposed drugs such as hydroxychloroquine (HCQ) have been investigated for treatment of COVID-19, but none was confirmed to be efficacious. While in vitro studies have demonstrated antiviral properties of HCQ, data from clinical trials were conflicting regarding its benefit for COVID-19 treatment. Drugs that limit viral replication may be beneficial in the earlier course of the disease thus slowing progression to severe and critical illness. Design: We conducted a randomized open label Phase II clinical trial from October–December 2020. Methods: Patients diagnosed with COVID-19 using RT-PCR were included in the study if they were 18 years and above and had a diagnosis of COVID-19 made in the last 3 days. Patients were randomized in blocks, to receive either HCQ 400 mg twice a day for the first day followed by 200 mg twice daily for the next 4 days plus standard of care (SOC) treatment or SOC treatment alone. SARS COV-2 viral load (CT values) from RT-PCR testing of samples collected using nasal/orapharyngeal swabs was performed at baseline, day 2, 4, 6, 8 and 10. The primary outcome was median time from randomization to SARS COV-2 viral clearance by day 6.