Browsing by Author "Kiwanuka, N."

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    Distinct T-Cell Responses When BCG Vaccination Is Delayed From Birth to 6 Weeks of Age in Ugandan Infants
    (The Journal of infectious diseases, 2014) Lutwama, F.; Kagina, B. M.; Waiswa, F.; Kirimunda, S.; Kiwanuka, N.
    In Uganda, the tuberculosis vaccine BCG is administered on the first day of life. Infants delivered at home receive BCG vaccine at their first healthcare facility visit at 6 weeks of age. Our aim was to determine the effect of this delay in BCG vaccination on the induced immune response. We assessed CD4+ and CD8+ T-cell responses with a 12-hour whole-blood intracellular cytokine/cytotoxic marker assay, and with a 6-day proliferation assay. We enrolled 92 infants: 50 had received BCG vaccine at birth and 42 at 6 weeks of age. Birth vaccination was associated with (1) greater induction of CD4+ and CD8+ T cells expressing either interferon γ (IFN-γ) alone or IFN-γ together with perforin and (2) induction of proliferating cells that had greater capacity to produce IFN-γ, tumor necrosis factor α (TNF-α), and interleukin 2 together, compared with delayed vaccination. Distinct patterns of T-cell induction occurred when BCG vaccine was given at birth and at 6 weeks of age. We propose that this diversity might impact protection against tuberculosis. Our results differ from those of studies of delayed BCG vaccination in South Africa and the Gambia, suggesting that geographical and population heterogeneity may affect the BCG vaccine–induced T-cell response.
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    Estimates of the Gross Domestic Product Loss due to Violence in Uganda
    (Injury Prevention, 2010) Nakitto, M.; Wandera, B.; Cannoodt, L.; Kiwanuka, N.; Lett, R.
    There is lack of information on economic cost of violent related injuries in Uganda. The study estimates both direct and indirect costs incurred as a result of interpersonal and self directed violent injuries. Data were collected from four hospitals and two health centres (September 2008 to November 2009) using a standardised form while medico-legal data were collected from Government chemist and Police surgeon. Estimating cost parameters were derived from a WHO Manual. Statistical analyses were done using Stata 10. Intentional injuries accounted for 20.7% of all injuries. Self-inflicted accounted for 30.3%, while interpersonal 69.7%. Violent injuries were frequent in homes; with causes: stabbing (31.1%) and poisoning (8.5%). Proportion of intentional injuries in homes was significantly higher than of unintentional injuries, 46.9% versus 23.7% (p<0.001). Direct total costs for self-directed injuries were $16 971 while per self-directed injury was $132.6. Indirect total costs for self-directed injuries were $506 443, while per self-directed injury was $3957. Direct medical costs for interpersonal injuries were $44 469, while $155 per interpersonal injury. Indirect costs for interpersonal injuries were $1 519 329, while $5312 per interpersonal injury. Direct costs due to violent injuries accounted for 0.04% of GDP while indirect costs accounted for 5.14% of GDP. Economic cost of violent injuries in Uganda is substantive and could be saved for more pressing priorities if a preventive strategy is implemented.