Browsing by Author "Mubangizi, Ivan"

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    Cardiovascular risk factors among people with drug-resistant tuberculosis in Uganda
    (BMC Cardiovascular Disorders, 2022) Baruch Baluku, Joseph; Nabwana, Martin; Nalunjogi, Joanitah; Muttamba, Winters; Mubangizi, Ivan; Nakiyingi, Lydia; Ssengooba, Willy; Olum, Ronald; Bongomin, Felix; Andia-Biraro, Irene; Worodria, William
    Tuberculosis (TB) and its risk factors are independently associated with cardiovascular disease (CVD). We determined the prevalence and associations of CVD risk factors among people with drug-resistant tuberculosis (DRTB) in Uganda. Methods In this cross-sectional study, we enrolled people with microbiologically confirmed DRTB at four treatment sites in Uganda between July to December 2021. The studied CVD risk factors were any history of cigarette smoking, diabetes mellitus (DM) hypertension, high body mass index (BMI), central obesity and dyslipidaemia. We used modified Poisson regression models with robust standard errors to determine factors independently associated with each of dyslipidaemia, hypertension, and central obesity. Results Among 212 participants, 118 (55.7%) had HIV. Overall, 196 (92.5%, 95% confidence interval (CI) 88.0-95.3) had ≥ 1 CVD risk factor. The prevalence; 95% CI of individual CVD risk factors was: dyslipidaemia (62.5%; 55.4–69.1), hypertension (40.6%; 33.8–47.9), central obesity (39.3%; 32.9–46.1), smoking (36.3%; 30.1–43.1), high BMI (8.0%; 5.0–12.8) and DM (6.5%; 3.7–11.1). Dyslipidaemia was associated with an increase in glycated haemoglobin (adjusted prevalence ratio (aPR) 1.14, 95%CI 1.06–1.22). Hypertension was associated with rural residence (aPR 1.89, 95% CI 1.14– 3.14) and previous history of smoking (aPR 0.46, 95% CI 0.21–0.98). Central obesity was associated with increasing age (aPR 1.02, 95%CI 1.00–1.03), and elevated diastolic blood pressure (aPR 1.03 95%CI 1.00–1.06). Conclusion There is a high prevalence of CVD risk factors among people with DRTB in Uganda, of which dyslipidaemia is the commonest. We recommend integrated services for identification and management of CVD risk factors in DRTB.
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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.