NRU :: Browsing by Author "Namale, Alice"

Browsing by Author "Namale, Alice"

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A Descriptive Epidemiological Study on Stroke in Kampala, Uganda: A Hospital based Study
(African Journal of Neurological Sciences, 2012) Nakibuuka, Jane; Nyakoojo, Abwooli; Namale, Alice; Blondin, Nicholas A.; Ddumba, Edward
Basic stroke features are hardly known in sub-Saharan countries, and no data are available in Uganda. Objective To characterize patients presenting with clinical stroke to Mulago Hospital. Design Descriptive epidemiological study. Setting Mulago National referral Hospital in Kampala, Uganda. Participants Patients presenting with clinical stroke from 1st July to 30th November 2006. Patients with confirmed stroke had comprehensive assessments for stroke risk factors. Results Among 139 patients presenting with clinical stroke, 127 had a non-contrast head CT scan and 12 died prior to scan. Eighty five patients were confirmed to have stroke while 42 had non stroke lesions. Among patients with confirmed stroke, 77.6% had ischemic stroke while 22.4% had hemorrhagic stroke. The mean age for all stroke patients was 62.2 ± 16.2 yrs and 51.8% were men. The incidence of both ischemic and hemorrhagic stroke increased with age. Atherosclerotic stroke was the most common ischemic stroke etiology, observed in 43.5% patients with ischemic stroke, while intraparenchymal hemorrhage was the most common hemorrhagic stroke etiology, observed in 78.9% of patients with hemorrhagic stroke. Hypertension was the commonest risk factor with more than 50% of all stroke patients reporting a history of hypertension, and more than half found to have blood pressure greater than 140/90 mm Hg. Physical inactivity and hypercholesterolemia were encountered in more than 36% and 30% of patients with ischemic and haemorrhagic strokes respectively. Conclusions Hypertension was the main risk factor for both Ischemic and hemorrhagic strokes in this study. This study provides important primary data on stroke in an African population and emphasizes the relevance of CT scan in stroke diagnosis.
Drug Tolerance in Mycobacterium tuberculosis
(Antimicrobial agents and chemotherapy, 1999) Wallis, Robert S.; Patil, Shripad; Cheon, Seon-Hee; Edmonds, Kay; Phillips, Manijeh; Perkins, Mark D.; Joloba, Moses; Namale, Alice; Johnson, John L.; Teixeira, Lucileia; Dietze, Reynaldo; Siddiqi, Salman; Mugerwa, Roy D.; Eisenach, Kathleen; Ellner, Jerrold J.
Although Mycobacterium tuberculosis is eradicated rapidly during therapy in some patients with pulmonary tuberculosis, it can persist for many months in others. This study examined the relationship between mycobacterial drug tolerance (delayed killing in vitro), persistence, and relapse. It was performed with 39 fully drug-susceptible isolates from a prospective trial of standard short-course antituberculous therapy with sputum smear-positive, human immunodeficiency virus-uninfected subjects with pulmonary tuberculosis in Brazil and Uganda. The rate of killing in vitro was determined by monitoring the growth index (GI) in BACTEC 12B medium after addition of drug to established cultures and was measured as the number of days required for 99% sterilization. Drugs differed significantly in bactericidal activity, in the following order from greatest to least, rifampin > isoniazid-ethambutol > ethambutol (P < 0.001). Isolates from subjects who had relapses (n 5 2) or in whom persistence was prolonged (n 5 1) were significantly more tolerant of isoniazidethambutol and rifampin than isolates from other subjects (P < 0.01).
HIV drug resistance among adults initiating antiretroviral therapy in Uganda
(Journal of Antimicrobial Chemotherapy, 2021) Watera, Christine; Ssemwanga, Deogratius; Namayanja, Grace; Asio, Juliet; Lutalo, Tom; Namale, Alice; Sanyu, Grace; Ssewanyana, Isaac; Gonzalez-Salazar, Jesus Fidel; Nazziwa, Jamirah; Nanyonjo, Maria; Raizes, Elliot; Kabuga, Usher; Mwangi, Christina; Kirungi, Wilford; Musinguzi, Joshua; Mugagga, Kaggwa; Katongole Mbidde, Edward; Kaleebu, Pontiano
WHO revised their HIV drug resistance (HIVDR) monitoring strategy in 2014, enabling countries to generate nationally representative HIVDR prevalence estimates from surveys conducted using this methodology. In 2016, we adopted this strategy in Uganda and conducted an HIVDR survey among adults initiating or reinitiating ART. Methods: A cross-sectional survey of adults aged 18 years initiating or reinitiating ART was conducted at 23 sites using a two-stage cluster design sampling method. Participants provided written informed consent prior to enrolment. Whole blood collected in EDTA vacutainer tubes was used for preparation of dried blood spot (DBS) specimens or plasma. Samples were shipped from the sites to the Central Public Health Laboratory (CPHL) for temporary storage before transfer to the Uganda Virus Research Institute (UVRI) for genotyping. Prevalence of HIVDR among adults initiating or reinitiating ART was determined.
Human Nutrition and Metabolism Severity of Human Immunodeﬁciency Virus Infection Is Associated with Decreased Phase Angle, Fat Mass and Body Cell Mass in Adults with Pulmonary Tuberculosis Infection in Uganda
(Journal of Nutrition, 2001) Shah, Snehal; Whalen, Christopher; Kotler, Donald P.; Mayanja, Harriet; Namale, Alice; Melikian, George; Mugerwa, Roy; Semba, Richard D.
Although coinfection with tuberculosis and human immunodeﬁciency virus (HIV) is emerging as a major problem in many developing countries, nutritional status has not been well characterized in adults with tuberculosis and HIV infection. We compared nutritional status between 261 HIV-positive and 278 HIV-negative adults with pulmonary tuberculosis in Kampala, Uganda, using anthropometry and bioelectrical impedance analysis. Among 163 HIV-positive and 199 HIV-negative men, intracellular water–to–extracellular water (ICW:ECW) ratio was 1.48 6 0.26 and 1.59 6 0.48 (P 5 0.006) and phase angle was 5.42 6 1.05 and 5.76 6 1.30 (P 5 0.009), respectively. Among 98 HIV-positive and 79 HIV-negative women, ICW:ECW was 1.19 6 0.16 and 1.23 6 0.15 (P 5 0.11) and phase angle was 5.35 6 1.27 and 5.43 6 0.93 (P 5 0.61), respectively. There were no signiﬁcant differences in BMI, body cell mass, fat mass or fat-free mass between HIV-positive and HIV-negative adults. Among HIV-positive subjects, BMI, ICW:ECW, body cell mass, fat mass and phase angle were signiﬁcantly lower among those with CD41 lymphocytes # 200 cells/ m L compared with those who had .200 cells/ m L. In sub- Saharan Africa, coinfection with pulmonary tuberculosis and HIV is associated with smaller body cell mass and intracellular water, but not fat-free mass, and by large differences in ICW:ECW and phase angle
Induction of the Antigen 85 Complex of Mycobacterium tuberculosis in Sputum: A Determinant of Outcome in Pulmonary Tuberculosis Treatment
(The Journal of infectious diseases, 1998) Wallis, Robert S.; Perkins, Mark; Phillips, Manijeh; Joloba, Moses; Demchuk, Barbara; Namale, Alice; Johnson, John L.; Williams, Donna; Wolski, Kathy; Dietze, Reynaldo; Mugerwa, Roy D.; Eisenach, Kathleen; Ellner, Jerrold J.
Sputum quantitative culture, acid-fast smear, days-to-positive by BACTEC, and Mycobacterium tuberculosis antigen 85 complex were monitored during therapy in 42 patients with pulmonary tuberculosis (TB). By BACTEC, 4 patients were persistently positive on days 90–180, and treatment ultimately failed in 2 of these. Antigen 85 expression increased in subjects in whom disease persisted (persisters) from days 0 to 14 when the difference between persisters and nonpersisters was statistically significant (P .002). Only antigen 85 complex values at day 14 suggested TB persistence at or after day 90. All subjects with day 14 antigen 85 complex values 60 pg/mL responded rapidly to treatment and were cured. Of those with values 60 pg/mL, in 33% TB persisted at or after day 90 and treatment failed in 17%. Biologic factors expressed early in therapy, not related to compliance or resistance, may exert a substantial influence on outcome. The antigen 85 complex is critical in cell wall biosynthesis and is induced by isoniazid in vitro. Its induction may represent an adaptive transition to a persistent state during therapy
The new female condom (FC2) in Uganda: perceptions and experiences of users and their sexual partners
(African Journal of AIDS Research, 2011) Wanyenze, Rhoda K.; Atuyambe, Lynn; Kibirige, Vista; Mbabazi, Sarah; Tumwesigye, Nazarius M.; Djurhuus, Kara; Namale, Alice
The new version of the female condom (FC2) was introduced in Uganda in October 2009, following an unsuccessful female condom programme begun in 1998. The failure of the earlier programme was partly attributed to low acceptance of the first type of female condom (FC1). We evaluated the acceptability of FC2 and the experiences of users and their sexual partners. This was a qualitative cross-sectional evaluation. We conducted 16 in-depth interviews with FC2 users (8 women and 8 male partners). We also conducted eight focus group discussions with women who used FC2, and 22 key informant interviews with service providers. All the female users appreciated FC2 as a tool to empower them to avoid sexually transmitted infections (STIs) and unwanted pregnancies. They liked FC2 because it has no smell, is not noisy, and does not rupture easily. The men also liked FC2 because of its soft texture and lubrication. Some women found FC2 insertion cumbersome, while others feared that it would slip in on itself during sex. Concurrent use of male condoms with FC2 and the reuse of FC2 were also mentioned. Providers reported a high demand for FC2; their main challenges were inadequate supplies and distribution mechanisms. This evaluation shows generally high acceptance of FC2. The experiences of users and their partners were largely positive, although some fears and incorrect practices arose. FC2 should be added to the existing HIV/STI-prevention and family-planning options in Uganda and other countries, with sufficient training and support to ensure correct use.
Provider-initiated HIV testing for paediatric inpatients and their caretakers is feasible and acceptable
(Tropical Medicine & International Health, 2019) Wanyenze, Rhoda K.; Nawavvu, Cecilia; Ouma, Joseph; Namale, Alice; Colebunders, Robert; Kamya, Moses R.
Early diagnosis of HIV-infected children remains a major challenge in Africa. Children who are hospitalised represent an opportunity for HIV diagnosis and appropriate treatment. We introduced HIV Counselling and Testing (HCT) for hospitalised children and their caretakers in Mulago teaching hospital in Uganda to assess its feasibility. methods We analysed routine program data for children and caretakers who were tested between February 2005 and February 2008 to assess the proportion of children and caretakers who were HIV- infected. We also assessed the level of immune suppression (CD4 percentage) in a subset of HIV infected children tested between January 2007 and December 2007. results Caretakers agreed to HIV testing for 8990 (92.8%) of the 9687 children who were offered HIV testing. Among the caretakers, 89.8% agreed to be tested. At the time of hospitalization, 41.3% of the caretakers had previously tested for HIV. Although 313 parents (mothers and fathers) reported that they had previously tested HIV positive, only 113 (36.3%) of these had tested their children prior to hospitalization. Overall HIV prevalence among caretakers was 16.7%. HIV prevalence among children was 12.4%, highest on the nutrition ward (30.8%). Of those children who underwent CD4 counts, 56.4% had a CD4 percentage of <20%. conclusion HCT for hospitalized children and their caretakers identiﬁed a signiﬁcant number of HIV infected children and caretakers. More than half of the children had advanced HIV disease. More intensive efforts are needed to ensure earlier diagnosis and linkage to care for HIV infected children.
Research article Sero-prevalence and risk factors for hepatitis B virus infection among health care workers in a tertiary hospital in Uganda
(BMC infectious diseases, 2010) Ziraba, Abdhalah K.; Bwogi, Josephine; Namale, Alice; Wainaina, Caroline W.; Mayanja-Kizza, Harriet
Hepatitis B virus (HBV) infection is a global public health challenge. Prevalence of current hepatitis B virus infection in the general population in Uganda is about 10%. Health care workers (HCW) have an extra risk of getting infected from their workplace and yet they are not routinely vaccinated against HBV infection. This study aimed at estimating prevalence of hepatitis B virus infection and associated risk factors among health care workers in a tertiary hospital in Uganda. Methods: Data were obtained from a cross sectional survey conducted in Mulago, a national referral and teaching hospital in Uganda among health care workers in 2003. A proportionate to size random sample was drawn per health care worker category. A structured questionnaire was used to collect data on socio-demographic characteristics and risk factors. ELISA was used to test sera for HBsAg, anti-HBs and total anti-HBc. Descriptive and logistic regression models were used for analysis.

Browsing by Author "Namale, Alice"

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