Browsing by Author "Musewa, Angella"

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Detection of Erysipelothrix rhusiopathiae in naturally infected pigs in Kamuli District, Uganda
    (Revue d’élevage et de médecine vétérinaire des pays tropicaux, 2018) Musewa, Angella; Roesel, Kristina; Grace, Delia; Dione, Michel; Erume, Joseph
    Swine erysipelas is an economically significant disease affecting all stages of pork production. The biggest losses may occur in growers-finishers because of sudden death or acute septicemia. Survivors often suffer from chronic lameness, arthritis and endocarditis leading to poor body growth. The causative agent is the ubiquitous bacterium Erysipelothrix (E.) rhusiopathiae, which is also able to enter the skin of people handling infected animals and meat and cause infection. In order to show the presence of E. rhusiopathiae in pigs, serum samples from 426 randomly selected pigs were collected in four subcounties (Bugulumbya, Butansi, Kitayunjwa and Namwendwa) in Kamuli District in Uganda, as part of a multipathogen survey conducted by the International Livestock Research Institute in 2013. Subsequently, 100 samples of fresh pork were collected from all 67-pork slaughterhouses operating in the same subcounties for isolation and bacterial culture. Overall, 308/460 (67%) of the pig sera carried antibodies against E. rhusiopathiae and 45/100 (45%) of the fresh pork samples were contaminated with E. rhusiopathiae. This is the first ever report of E. rhusiopathiae in pigs and pork in Uganda.
  • Thumbnail Image
    Item
    Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda
    (PLoS ONE, 2017) Nangendo, Joanita; Obuku, Ekwaro A.; Kawooya, Ismael; Mukisa, John; Nalutaaya, Annet; Musewa, Angella; Semitala, Fred C.; Karamagi, Charles A.; Kalyango, Joan N.
    The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% of people living with HIV are unaware of their status. The current HIV testing policy which is strictly blood-based poses several challenges including: a need for high level laboratory skills, stringent waste disposal needs, and painful sample collection. It is envisaged that introduction of a rapid, painless HIV oral fluid test as a potential alternative is likely to increase the number of people testing. The aim of this study was to determine the diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending Kisenyi Health Centre IV in Kampala. Methods and findings We conducted a cross-sectional study among 440 adults recruited consecutively at Kisenyi Health Centre IV from January to March 2016. The diagnostic accuracy of the HIV oral test was assessed by comparing to the national HIV serial testing algorithm. We also assessed for acceptability among patients and health care workers (HCWs) by triangulating responses from a structured questionnaire, three focus group discussions and seven key informant interviews. Acceptability was defined as willingness to take the test at the time of the study and intention for future use of the test if it was availed. The prevalence of HIV infection among study participants was 14.8%. The HIV oral fluid test was highly accurate with sensitivity of 100% (95% CI; 94.5±100.0), specificity of 100% (95% CI; 99.0±100.0), positive predictive value (PPV) of 100% (95% CI; 94.5±100.0) and negative predictive value (NPV) of 100% (95% CI; 99.0±100.0). Acceptability of HIV oral testing was also high at 87.0% (95% CI; 83.6±89.9). Participants preferred HIV oral testing because it was: pain free (91%, n = 399) and did not require blood draw (82%, n = 360). Conclusion The HIV oral fluid test has high diagnostic accuracy and acceptability. HIV oral testing is a suitable addition to the national HIV testing strategies with the potential of increasing access to HIV testing services in Uganda.
  • Thumbnail Image
    Item
    Measurement error of mean sac diameter and crown-rump length among pregnant women at Mulago hospital, Uganda
    (BMC Pregnancy and Childbirth, 2018) Ali, Sam; Kusaba Byanyima, Rosemary; Ononge, Sam; Ictho, Jerry; Nyamwiza, Jean; Loro, Emmanuel Lako Ernesto; Mukisa, John; Musewa, Angella; Nalutaaya, Annet; Ssenyonga, Ronald; Kawooya, Ismael; Temper, Benjamin; Katamba, Achilles; Kalyango, Joan; Karamagi, Charles
    Ultrasonography is essential in the prenatal diagnosis and care for the pregnant mothers. However, the measurements obtained often contain a small percentage of unavoidable error that may have serious clinical implications if substantial. We therefore evaluated the level of intra and inter-observer error in measuring mean sac diameter (MSD) and crown-rump length (CRL) in women between 6 and 10 weeks’ gestation at Mulago hospital. Methods: This was a cross-sectional study conducted from January to March 2016. We enrolled 56 women with an intrauterine single viable embryo. The women were scanned using a transvaginal (TVS) technique by two observers who were blinded of each other’s measurements. Each observer measured the CRL twice and the MSD once for each woman. Intra-class correlation coefficients (ICCs), 95% limits of agreement (LOA) and technical error of measurement (TEM) were used for analysis. Results: Intra-observer ICCs for CRL measurements were 0.995 and 0.993 while inter-observer ICCs were 0.988 for CRL and 0.955 for MSD measurements. Intra-observer 95% LOA for CRL were ± 2.04 mm and ± 1.66 mm. Inter-observer LOA were ± 2.35 mm for CRL and ± 4.87 mm for MSD. The intra-observer relative TEM for CRL were 4.62% and 3.70% whereas inter-observer relative TEM were 5.88% and 5.93% for CRL and MSD respectively. Conclusions: Intra- and inter-observer error of CRL and MSD measurements among pregnant women at Mulago hospital were acceptable. This implies that at Mulago hospital, the error in pregnancy dating is within acceptable margins of ±3 days in first trimester, and the CRL and MSD cut offs of ≥7 mm and≥ 25 mm respectively are fit for diagnosis of miscarriage on TVS. These findings should be extrapolated to the whole country with caution. Sonographers can achieve acceptable and comparable diagnostic accuracy levels of MSD and CLR measurements with proper training and adherence to practice guidelines.
  • Thumbnail Image
    Item
    Prevalence and factors associated with safe male circumcision among Makerere University undergraduate students, Kampala - Uganda
    (Research Square, 2019) Nyamwiza, Jean; Mukisa, John; Ictho, Jerry; Ssenyonga, Ronald; Nalutaaya, Annet; Kawooya, Ismael; Benjamin, Temper; Nagendo, Joanita; Musewa, Angella; Ali, Sam; Lako Ernesto Loro, Emmanuel; Agaba, Bekiita Bosco; Kiwuwa, Mpungu Steven; Kalyango, Joan N.; Karamagi, Charles
    Background Safe male circumcision (SMC) is currently recognized as a preventive strategy in reducing the risk of HIV; however, the prevalence of circumcised men in Uganda is still quite low at 26%. This study aimed to determine the prevalence and factors associated with SMC and among Makerere University undergraduate students, in Kampala Uganda. Methods We conducted a cross-sectional study among 602 participants selected using multistage probability sampling strategy. Pretested semi-structured questionnaires and focus group discussions were used to collect data. Quantitative data were analyzed with Stata 12.0, the prevalence ratio and p-values were calculated. Possible interactions and confounding variables were assessed with the Poisson regression model while qualitative data was analyzed with content analysis. Results The overall prevalence of safe male circumcision among male undergraduates was 58.3% (95% CI: 54.37 – 62.24). Factors associated with SMC prevalence included: safety of SMC procedure (Prevalence Ratio (PR) = 1.13, 95% Confidence Interval (CI): 1.03 – 1.25) and friendly health workers (PR = 0.78, 95% CI: 0.74 – 0.83). The perceived benefits of SMC included hygiene (86.5%, n = 521), reduced risk of HIV transmission (4.5%, n = 26) and reduced risk of penile cancer (45.7%, n = 275) while, the perceived barrier was pain (10.1%, n = 61). The students perceived that SMC recipient’s first sexual partner post-procedure should not be his girlfriend. Most participants in all the focus group discussions perceived SMC increases sexual pleasure. Conclusion The overall self-reported SMC success rate among participants was high, along with the safety of SMC services and friendly health workers as important factors among male students. There is a need for continuous sensitization campaigns and communication strategies to address beliefs about SMC, some related misconceptions, and barriers so as to increase its prevalence.
  • Thumbnail Image
    Item
    Sporadic outbreaks of crimean-congo haemorrhagic fever in Uganda, July 2018- January 2019
    (PLoS neglected tropical diseases, 2019) Mirembe, Bernadette Basuta; Musewa, Angella; Kadobera, Daniel; Kisaakye, Esther; Birungi, Doreen; Eurien, Daniel; Nyakarahuka, Luke; Balinandi, Stephen; Tumusiime, Alex; Kyondo, Jackson; Mbula Mulei, Sophia; Baluku, Jimmy; Kwesiga, Benon; Ndugwa Kabwama, Steven; Zhu, Bao-Ping; Harris, Julie R.; Lutwama, Julius Julian; Alex, Riolexus Ario
    Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne, zoonotic viral disease that causes haemorrhagic symptoms. Despite having eight confirmed outbreaks between 2013 and 2017, all within Uganda’s ‘cattle corridor’, no targeted tick control programs exist in Uganda to prevent disease. During a seven-month-period from July 2018-January 2019, the Ministry of Health confirmed multiple independent CCHF outbreaks. We investigated to identify risk factors and recommend interventions to prevent future outbreaks. We defined a confirmed case as sudden onset of fever (�37.5 ̊C) with �4 of the following signs and symptoms: anorexia, vomiting, diarrhea, headache, abdominal pain, joint pain, or sudden unexplained bleeding in a resident of the affected districts who tested positive for Crimean-Congo haemorrhagic fever virus (CCHFv) by RT-PCR from 1 July 2018–30 January 2019. We reviewed medical records and performed active case-finding. We conducted a case-control study and compared exposures of case-patients with age-, sex-, and sub-county-matched control-persons (1:4). We identified 14 confirmed cases (64% males) with five deaths (case-fatality rate: 36%) from 11 districts in the western and central region. Of these, eight (73%) case patients resided in Uganda’s ‘cattle corridor’. One outbreak involved two case-patients and the remainder involved one. All case-patients had fever and 93% had unexplained bleeding. Case-patients were aged 6–36 years, with persons aged 20–44 years more affected (AR: 7.2/1,000,000) than persons �19 years (2.0/1,000,000), p = 0.015. Most (93%) case-patients had contact with livestock �2 weeks before symptom onset. Twelve (86%) lived <1 km from grazing fields compared with 27 (48%) controls (OR M-H = 18, 95% CI = 3.2-1) and 10 (71%) of 14 case-patients found ticks attached to their bodies �2 weeks before symptom onset, compared to 15 (27%) of 56 control-persons (OR M-H = 9.3, 95%CI = 1.9–46). CCHF outbreaks occurred sporadically during 2018–2019, both within and outside the ‘cattle corridor’ districts of Uganda. Most cases were associated with tick exposure. The Ministry of Health should partner with the Ministry of Agriculture, Animal Industry, and Fisheries to develop joint nationwide tick control programs and strategies with shared responsibilities through a One Health approach.