Browsing by Author "Nambasa, Victoria"

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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.
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    Implementation of a peer support intervention to promote the detection, reporting and management of adverse drug reactions in people living with HIV in Uganda: a protocol for a quasi-experimental study
    (BMJ Open, 2022) Kiguba, Ronald; Byomire, Helen; Byomire Ndagije, Helen; Nambasa, Victoria; Katureebe, Cordelia; Zakumumpa, Henry; Nanyonga, Stella Maris; Nambi Ssanyu, Jacquellyn; Tregunno, Phil; Harrison, Kendal; Merle, Corinne S.; Raguenaud, Marie-Eve; Kitutu, Freddy Eric
    Patients have contributed <1% of spontaneous adverse drug reaction (ADR) reports in Uganda’s pharmacovigilance database. Peer support combined with mobile technologies could empower people living with HIV (PLHIV) to report ADRs and improve ADR management through linkage to care. We seek to test the feasibility and effect of a peer support intervention on ADR reporting by PLHIV receiving combination antiretroviral therapy (cART) in Uganda; identify barriers and facilitators to the intervention; and characterise ADR reporting and
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    Prescription of Levofloxacin and Moxifloxacin in Select Hospitals in Uganda: A Pilot Study to Assess Guideline Concordance
    (Antibiotics, 2020) Nambasa, Victoria; Ndagije, Helen B.; Serwanga, Allan; Manirakiza, Leonard; Atuhaire, Joanitah; Nakitto, Diana; Kiguba, Ronald; Figueras, Albert
    In Uganda, national tuberculosis (TB) treatment guidelines were revised to include the newer generation fluoroquinolones among the second-line treatment options for multidrug-resistant TB. This study was designed to analyze if the prescription of these quinolones is compliant with country recommendations. Methods: This was an observational retrospective study of consumption data for 2017 and 2018 across four selected regional referral hospitals. The sources of consumption data were hospital pharmacy stock cards and the dispensing register. The medical files of patients who had been prescribed fluoroquinolones were also assessed to study compliance with the Uganda Clinical Guidelines and the British National Formulary (BNF). Results: None of the 371 levofloxacin prescriptions analyzed complied with the Uganda Clinical Guidelines, although 250 (67.3%) were prescribed for indications included in the BNF. According to WHO prescription indicators, only 220 (59.3%) prescriptions were appropriate. Conclusion: The prescription of levofloxacin and moxifloxacin increased in the hospitals studied, but in a high proportion of cases, they were not compliant with country recommendations. The findings call for the strengthening of national antimicrobial stewardship programs.