Browsing by Author "Kitonsa, Peter James"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Is distance associated with tuberculosis treatment outcomes? A retrospective cohort study in Kampala, Uganda
    (BMC infectious diseases, 2020) Robsky, Katherine O.; Hughes, Seamus; Kityamuwesi, Alex; Kendall, Emily A.; Kitonsa, Peter James; Dowdy, David W.; Katamba, Achilles
    Challenges accessing nearby health facilities may be a barrier to initiating and completing tuberculosis (TB) treatment. We aimed to evaluate whether distance from residence to health facility chosen for treatment is associated with TB treatment outcomes. Methods: We conducted a retrospective cohort study of all patients initiating TB treatment at six health facilities in Kampala from 2014 to 2016. We investigated associations between distance to treating facility and unfavorable TB treatment outcomes (death, loss to follow up, or treatment failure) using multivariable Poisson regression. Results: Unfavorable treatment outcomes occurred in 20% (339/1691) of TB patients. The adjusted relative risk (aRR) for unfavorable treatment outcomes (compared to treatment success) was 0.87 (95% confidence interval [CI] 0.70, 1.07) for patients living ≥2 km from the facility compared to those living closer. When we separately compared each type of unfavorable treatment outcome to favorable outcomes, those living ≥2 km from the facility had increased risk of death (aRR 1.42 [95%CI 0.99, 2.03]) but decreased risk for loss to follow-up (aRR 0.57 [95%CI 0.41, 0.78]) than those living within 2 km. Conclusions: Distance from home residence to TB treatment facility is associated with increased risk of death but decreased risk of loss to follow up. Those who seek care further from home may have advanced disease, but once enrolled may be more likely to remain in treatment.
  • Thumbnail Image
    Item
    Low prevalence of diabetes mellitus among tuberculosis patients and their community in urban Uganda
    (The official journal of the International Union against Tuberculosis and Lung Disease, 2021) Kamoga, Caleb Erisa; Robsky, Katherine O.; Kitonsa, Peter James; Nalutaaya, Annet; Isooba, David; Nakasolya, Olga; Mukiibi1, James; Dowdy, David; Kendall, Emily A.; Katamba, Achilles
    Globally, epidemics of diabetes mellitus (DM) and tuberculosis (TB) are increasingly linked.1,2 Diabetes is associated with TB infection and with a two-to-four-fold increase in the risk of active disease;3 active TB may also increase the risk of diabetes.4 In sub- Saharan Africa, where the prevalence of diabetes in the general population is lower than in other regions,5 the prevalence of diabetes among patients with TB has been estimated at 9%.6 However, many studies that contributed to that estimate, including one in Uganda,7 evaluated only hospitalized TB patients and may not be representative of the region’s TB epidemic as a whole. There are few data from sub-Saharan African settings on the prevalence of DM among non-hospitalized TB patients or people with TB who have not yet sought treatment. Therefore, the extent to which diabetes detection or management should be integrated with TB care in this region remains unclear.