Browsing by Author "Nsubuga, Fred"

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    Factors associated with acute watery diarrhea among children aged 0–59 months in Obongi District, Uganda, April 2022: A case–control study
    (Elsevier Ltd, 2024-04) Juniour Nsubuga, Edirisa; Kirabo, Jireh; Kwiringira, Andrew; Andaku, Linus; Magona Nerima, Saharu; Nsubuga, Fred; Nakazzi, Rashida; Kwesiga, Benon; Bulage, Lilian; Kadobera, Daniel; Edward Okello, Paul; Riolexus Ario, Alex
    Abstract • Poor caregiver hand hygiene linked to acute watery diarrhea in children. • Source of water in a home was associated with acute watery diarrhea in children. • Rotavirus vaccination only, not enough to prevent acute watery diarrhea in children. • Educate communities on handwashing at critical times, using clean water & soap. • Stresses need for treated pipped/tap water in every household.
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    Factors Associated with Virological Nonsuppression among HIV-Positive Patients on Antiretroviral Therapy in Uganda, August 2014–July 2015
    (BMC infectious diseases, 2017) Bulage, Lilian; Ssewanyana, Isaac; Nankabirwa, Victoria; Nsubuga, Fred; Kihembo, Christine; Pande, Gerald; Ario, Alex R.; Matovu, Joseph K. B.; Wanyenze, Rhoda K.; Kiyaga, Charles
    Despite the growing number of people on antiretroviral therapy (ART), there is limited information about virological non suppression and its determinants among HIV-positive (HIV+) individuals enrolled in HIV care in many resource-limited settings. We estimated the proportion of virologically non-suppressed patients, and identified the factors associated with virological non suppression. Methods: We conducted a descriptive cross-sectional study using routinely collected program data from viral load (VL) samples collected across the country for testing at the Central Public Health Laboratories (CPHL) in Uganda. Data were generated between August 2014 and July 2015. We extracted data on socio-demographic, clinical and VL testing results. We defined virological non-suppression as having ≥1000 copies of viral RNA/ml of blood for plasma or ≥5000 copies of viral RNA/ml of blood for dry blood spots. We used logistic regression to identify factors associated with virological non-suppression. Results: The study was composed of 100,678 patients; of these, 94,766(94%) were for routine monitoring, 3492(4%) were suspected treatment failures while 1436(1%) were repeat testers after suspected failure. The overall proportion of non suppression was 11%. Patients on routine monitoring registered the lowest (10%) proportion of nonsuppressed patients. Virological non-suppression was higher among suspected treatment failures (29%) and repeat testers after suspected failure (50%). Repeat testers after suspected failure were six times more likely to have virological non-suppression (ORadj = 6.3, 95%CI = 5.5–7.2) when compared with suspected treatment failures (ORadj = 3.3, 95%CI = 3.0–3.6). The odds of virological non-suppression decreased with increasing age, with children aged 0–4 years (ORadj = 5.3, 95%CI = 4.6–6.1) and young adolescents (ORadj = 4.1, 95%CI = 3.7–4.6) registering the highest odds. Poor adherence (ORadj = 3.4, 95%CI = 2.9–3.9) and having active TB (ORadj = 1.9, 95%CI = 1.6–2.4) increased the odds of virological non-suppression. However, being on second/third line regimens (ORadj = 0.86, 95%CI = 0.78–0.95) protected patients against virological non-suppression. Conclusion: Young age, poor adherence and having active TB increased the odds of virological non-suppression while second/third line ART regimens were protective against non-suppression. We recommend close follow up and intensified targeted adherence support for repeat testers after suspected failure, children and adolescents.
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    Novel Oral Poliovirus Vaccine 2 Safety Evaluation during Nationwide Supplemental Immunization Activity, Uganda, 2022
    (Centers for Disease Control and Prevention, 2024-04) Tobolowsky, Farrell A; Nsubuga, Fred; Gilani, Zunera; Kisakye, Annet; Ndagije, Helen; Kyabayinze, Daniel; Gidudu, Jane F
    Abstract Given its enhanced genetic stability, novel oral poliovirus vaccine type 2 was deployed for type 2 poliovirus outbreak responses under World Health Organization Emergency Use Listing. We evaluated the safety profile of this vaccine. No safety signals were identified using a multipronged approach of passive and active surveillance.
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    Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015
    (PLoS ONE, 2017) Nsubuga, Fred; Ampaire, Immaculate; Kasasa, Simon; Luzze, Henry; Kisakye, Annet
    Disease surveillance is a critical component in the control and elimination of vaccine preventable diseases. The Uganda National Expanded Program on Immunization strives to have a sensitive surveillance system within the Integrated Disease Surveillance and Response (IDSR) framework. We analyzed measles surveillance data to determine the effectiveness of the measles case-based surveillance system and estimate its positive predictive value in order to inform policy and practice. Methods An IDSR alert was defined as ≥1 suspected measles case reported by a district in a week, through the electronic Health Management Information System. We defined an alert in the measles case-based surveillance system (CBS) as ≥1 suspected measles case with a blood sample collected for confirmation during the corresponding week in a particular district. Effectiveness of CBS was defined as having ≥80% of IDSR alerts with a blood sample collected for laboratory confirmation. Positive predictive value was defined as the proportion of measles case-patients who also had a positive measles serological result (IgM +). We reviewed case-based surveillance data with laboratory confirmation and measles surveillance data from the electronic Health Management Information System from 2012–2015. Results A total of 6,974 suspected measles case-persons were investigated by the measles case-based surveillance between 2012 and 2015. Of these, 943 (14%) were measles specific IgM positive. The median age of measles case-persons between 2013 and 2015 was 4.0 years. Between 2013 and 2015, 72% of the IDSR alerts reported in the electronic Health Management Information System, had blood samples collected for laboratory confirmation. This was however less than the WHO recommended standard of ≥80%. The PPV of CBS between 2013 and 2015 was 8.6%. Conclusion In conclusion, the effectiveness of measles case-based surveillance was sub-optimal, while the PPV showed that true measles cases have significantly reduced in Uganda. We recommended strengthening of case-based surveillance to ensure that all suspected measles cases have blood samples collected for laboratory confirmation to improve detection and ensure elimination by 2020.
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    Viruses associated with measles-like illnesses in Uganda
    (Journal of Infection, 2024) Namuwulya, Prossy; Shirin, Ashraf; Marc, Niebel; Ssekagiri, Alfred; Tushabe, Phionah; Kakooza, Proscovia; Lily, Tong; Bukenya, Henry; Hanna, Jerome; Chris, Davis; Birungi, Molly; Turyahabwe, Irene; Mugaga, Arnold; Eliku, James Peter; Aine, Francis; Nakabazzi, Lucy; Nsubuga, Fred; Katushabe, Edson; Kisakye, Annet; Ampeire, Immaculate; Nanteza, Ann; Kaleebu, Pontiano; Bakamutumaho, Barnabas; Nsamba, Peninah; Kazibwe, Anne; Ana, da Silva Filipe; Tweyongyere, Robert; Bwogi, Josephine; Thomson, Emma C.
    Objectives In this study, we investigated the causes of measles-like illnesses (MLI) in the Uganda national surveillance program in order to inform diagnostic assay selection and vaccination strategies. Methods We used metagenomic next-generation sequencing (M-NGS) on the Illumina platform to identify viruses associated with MLI (defined as fever and rash in the presence of either cough, coryza or conjunctivitis) in patient samples that had tested IgM negative for measles between 2010 and 2019. Results Viral genomes were identified in 87/271 (32%) of samples, of which 44/271 (16%) contained 12 known viral pathogens. Expected viruses included rubella, human parvovirus B19, Epstein Barr virus, human herpesvirus 6B, human cytomegalovirus, varicella zoster virus and measles virus (detected within the seronegative window-period of infection) and the blood-borne hepatitis B virus. We also detected Saffold virus, human parvovirus type 4, the human adenovirus C2 and vaccine-associated poliovirus type 1. Conclusions The study highlights the presence of undiagnosed viruses causing MLI in Uganda, including vaccine-preventable illnesses. NGS can be used to monitor common viral infections at a population level, especially in regions where such infections are prevalent, including low and middle income countries to guide vaccination policy and optimize diagnostic assays.