Browsing by Author "Nanzigu, Sarah"

Now showing 1 - 7 of 7
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    Antibiotic use among children under five years with diarrhea in rural communities of Gulu, northern Uganda: a cross-sectional study
    (BMC Public Health, 2021) Lanyero, Hindum; Ocan, Moses; Obua, Celestino; Stålsby Lundborg, Cecilia; Nanzigu, Sarah; Katureebe, Agaba; Kalyango, Joan N.; Eriksen, Jaran
    Diarrhea is the second leading cause of mortality in children under 5 years of age globally, and the risk of death increases with practices such as restriction of fluid intake and inappropriate use of antibiotics. We determined the prevalence of antibiotic use in managing diarrhea in children under 5 years of age in rural communities of Gulu district, northern Uganda. Method: A cross-sectional study among children under 5 years with diarrhea, from households selected using multistage sampling. A researcher administered questionnaire was used to obtain data from caregivers of these children. Results: Of the 856 children recruited, 318 (37.1%, 318/856) had experienced diarrhea, where 263 (82.7%, 263/318) had diarrhea with acute respiratory infections (ARIs), and 55 (17.3%, 55/318) had diarrhea without ARIs. The majority (89.6%, 285/318) of the children had non-bloody diarrhea. A high proportion (82.8%) of the children with non-bloody diarrhea also had ARIs. Bloody diarrhea was reported for 33 (10.4%) children including those with ARIs, and only 6 of these (18.2%) children had bloody diarrhea without ARIs. Of the 318 children with diarrhea, over half (52%, CI: 46–57) were administered antibiotics. Of the 55 children who had diarrhea without ARIs, over a third (38%, CI: 26–51) were administered antibiotics. Similarly, of the 263 children with diarrhea and ARIs, 54% (CI: 48–60) were treated with antibiotics. The determinants of antibiotic use included; children living in peri-urban settings (AOR: 3.41, CI: 1.65–7.08, P = 0.001), getting treatment from health facility (AOR: 1.76, CI: 1.06–2.93, P = 0.029), and having diarrhea with ARIs (AOR: 3.09, CI: 1.49–6.42, P = 0.003). Conclusion: Antibiotic use is common among children under 5 years with diarrhea in rural communities of northern Uganda.
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    Antiretroviral concentration measurements as an additional tool to manage virologic failure in resource limited settings: a case control study
    (AIDS research and therapy, 2019) Buzibye, Allan; Musaazi, Joseph; Braun, Amrei von; Nanzigu, Sarah; Sekaggya‑Wiltshire, Christine; Kambugu, Andrew; Fehr, Jan; Lamorde, Mohammed; Gutteck, Ursula; Muller, Daniel; Sowinski, Stefanie; Reynolds, Steven J.; Castelnuovo, Barbara
    Several studies demonstrate a correlation between sub-therapeutic concentrations of antiretroviral drugs and virologic failure. We examined the sensitivity, specificity and predictive values of sub-therapeutic drug levels in predicting viralogic failure. Methods: This was a case control study with cases being samples of participants with virologic failure, and controls samples of participants with virologic suppression. We analyzed samples obtained from participants that had been on antiretroviral treatment (ART) for at least 6 months. Virologic failure was defined as HIV-RNA viral load ≥ 1000 copies/ ml. Sub-therapeutic drug levels were defined according to published reference cutoffs. The diagnostic validity of drug levels for virologic failure was assessed using plasma viral loads as a gold standard. Results: Sub-therapeutic ART concentrations explained only 38.2% of virologic failure with a probability of experiencing virologic failure of 0.66 in a patient with low drug levels versus 0.25 for participants with measurements within or above the normal range. Approximately 90% of participants with ART concentrations above the lower clinical cut off did not have virologic failure. Conclusions: These results support prior indication for therapeutic drug monitoring in cases of suspected virologic failure.
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    CD4-T-Lymphocyte Reference Ranges in Uganda and Its Influencing Factors
    (Laboratory Medicine, 2011) Nanzigu, Sarah; Waako, Paul; Petzold, Max; Kiwanuka, Gertrude; Dungu, Henry; Makumbi, Fred; Gustafsson, Lars L.; Eriksen, Jaran
    Given the importance of CD4-T-lymphocyte monitoring in HIV/ART management, we established CD4/CD8 reference ranges in Uganda and studied factors associated with CD4/CD8 in a normal population. Blood samples for 206 HIV seronegative healthy volunteers from the Mbarara and Kampala districts in Uganda were analyzed using the PanLeucogating protocol.
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    Poor immunological recovery among severely immunosuppressed antiretroviral therapy-naïve Ugandans
    (HIV/AIDS – Research and Palliative Care, 2013) Nanzigu, Sarah; Kiguba, Ronald; Kabanda, Joseph; Mukonzo, Jackson K .; Waako, Paul; Kityo, Cissy; Makumbi, Fred
    With access to antiretroviral therapy (ART) expanding in resource-limited settings, assessing factors related to clinical, immunological, and virological outcomes of ART is of great importance. Even though ART is loosely referred to as a lifelong treatment, clinical, immunological and virological outcome measures differ among patients on highly active ART (HAART), with differences reported within and across cohorts.1–6 Mortality is among the ART-outcome variables that have been studied extensively, and rates of up to 30% have been reported during the first year of treatment in some sub-Saharan settings
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    Safety and efficacy of hydroxychloroquine for treatment of non‑severe COVID‑19 among adults in Uganda: a randomized open label phase II clinical trial
    (BMC Infectious Diseases, 2021) Byakika‑Kibwika, Pauline; Sekaggya‑Wiltshire, Christine; Semakula, Jerome Roy; Nakibuuka, Jane; Musaazi, Joseph; Kayima, James; Sendagire, Cornelius; Meya, David; Kirenga, Bruce; Nanzigu, Sarah; Kwizera, Arthur; Nakwagala, Fred; Kisuule, Ivan; Wayengera, Misaki; Mwebesa, Henry G.; Kamya, Moses R.; Bazeyo, William
    Several repurposed drugs such as hydroxychloroquine (HCQ) have been investigated for treatment of COVID-19, but none was confirmed to be efficacious. While in vitro studies have demonstrated antiviral properties of HCQ, data from clinical trials were conflicting regarding its benefit for COVID-19 treatment. Drugs that limit viral replication may be beneficial in the earlier course of the disease thus slowing progression to severe and critical illness. Design: We conducted a randomized open label Phase II clinical trial from October–December 2020. Methods: Patients diagnosed with COVID-19 using RT-PCR were included in the study if they were 18 years and above and had a diagnosis of COVID-19 made in the last 3 days. Patients were randomized in blocks, to receive either HCQ 400 mg twice a day for the first day followed by 200 mg twice daily for the next 4 days plus standard of care (SOC) treatment or SOC treatment alone. SARS COV-2 viral load (CT values) from RT-PCR testing of samples collected using nasal/orapharyngeal swabs was performed at baseline, day 2, 4, 6, 8 and 10. The primary outcome was median time from randomization to SARS COV-2 viral clearance by day 6.
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    Use of antibacterials in the management of symptoms of acute respiratory tract infections among children under five years in Gulu, northern Uganda: Prevalence and determinants
    (PLoS ONE, 2020) Lanyero, Hindum; Eriksen, Jaran; Obua, Celestino; Stålsby Lundborg, Cecilia; Nanzigu, Sarah; Katureebe, Agaba; Kalyango, Joan N.; Ocan, Moses
    Inappropriate use of antibacterials is a major public health challenge as it can promote emergence of resistance, wastage of financial resources, morbidity and mortality. In this study, we determined the prevalence and factors associated with antibacterial use in managing symptoms of acute respiratory tract infections (ARIs) in households in rural communities of Gulu district, northern Uganda. A cross-sectional study was conducted among households selected using multi-stage sampling. Data were collected through interviews with care-givers of children under five years, using a structured interviewer administered questionnaire. Out of the 856 children who had symptoms of ARIs, 515 (60.2%; CI: 54.5%-65.6%) were treated with antibacterials. The most commonly used antibacterials were amoxicillin (55.2%, n = 358), cotrimoxazole (15.4%, n = 100) and metronidazole (11.4%, n = 74). The determinants of antibacterial use included; getting treatment from a health facility (AOR: 1.85, CI: 1.34–2.56, P < 0.001), households located in peri-urban area (AOR: 2.54, CI: 1.34–4.84, P = 0.005), and a child having cough (AOR: 7.02, CI: 4.36–11.31, P < 0.001). The prevalence of antibacterial use among children under five years with symptoms of ARIs is high in communities of Gulu district, northern Uganda. Getting treatment from a health facility, if a household was located in a peri-urban area and having a cough are positive predictors of antibacterial use. There is need for targeted education on appropriate antibacterial use in rural communities and hospital settings where over prescription is most likely especially in treating symptoms of ARIs among children under five years.
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    Validity of caregivers’ reports on prior use of antibacterials in children under five years presenting to health facilities in Gulu, northern Uganda
    (PLoS ONE, 2021) Lanyero, Hindum; Ocan, Moses; Obua, Celestino; Stålsby Lundborg, Cecilia; Agaba, Katureebe; Kalyango, Joan N.; Eriksen, Jaran; Nanzigu, Sarah
    Given the frequent initiation of antibacterial treatment at home by caregivers of children under five years in low-income countries, there is a need to find out whether caregivers’ reports of prior antibacterial intake by their children before being brought to the healthcare facility are accurate. The aim of this study was to describe and validate caregivers’ reported use of antibacterials by their children prior to seeking care at the healthcare facility. Methods A cross sectional study was conducted among children under five years seeking care at healthcare facilities in Gulu district, northern Uganda. Using a researcher administered questionnaire, data were obtained from caregivers regarding reported prior antibacterial intake in their children. These reports were validated by comparing them to common antibacterial agents detected in blood and urine samples from the children using liquid chromatography with tandem mass spectrometry (LC-MS/MS) methods.