Browsing by Author "Nsubuga, Rebecca N."

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    Costs and effects of different ART scale-up options in Uganda
    (MRC/UVRI Research Unit on AIDS., 2016) McCreesh, Nicky; Andrianakis, Loannis; Nsubuga, Rebecca N.; Hayes, Richard; White, Richard G.; London School of Hygiene and Tropical Medicine, MRC/UVRI Research Unit on AIDS.
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    The General Population Cohort in Rural South Western Uganda: A Platform for Communicable and Non-Communicable Disease Studies
    (International journal of epidemiology, 2013) Asiki, Gershim; Murphy, Georgina; Miiro, Jessica Nakiyingi; Seeley, Janet; Nsubuga, Rebecca N.; Karabarinde, Alex; Waswa, Laban; Biraro, Sam; Kasamba, Ivan; Pomilla, Cristina; Maher, Dermot; Young, Elizabeth H; Kamali, Anatoli; Sandhu, Manjinder S
    The General Population Cohort (GPC) was set up in 1989 to examine trends in HIV prevalence and incidence, and their determinants in rural south-western Uganda. Recently, the research questions have included the epidemiology and genetics of communicable and non-communicable diseases (NCDs) to address the limited data on the burden and risk factors for NCDs in sub-Saharan Africa. The cohort comprises all residents (52% aged ≥13years, men and women in equal proportions) within one-half of a rural sub-county, residing in scattered houses, and largely farmers of three major ethnic groups. Data collected through annual surveys include; mapping for spatial analysis and participant location; census for individual socio-demographic and household socioeconomic status assessment; and a medical survey for health, lifestyle and biophysical and blood measurements to ascertain disease outcomes and risk factors for selected participants. This cohort offers a rich platform to investigate the interplay between communicable diseases and NCDs. There is robust infrastructure for data management, sample processing and storage, and diverse expertise in epidemiology, social and basic sciences. For any data access enquiries you may contact the director, MRC/UVRI, Uganda Research Unit on AIDS by email to mrc@mrcuganda.org or the corresponding author.
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    Practice and prospects of indigenous homestead based approaches to prevention of malaria; a case study of a high malaria transmission area in Uganda
    (Scientific Research and Essays, 2010) Waako, Paul J.; Nsubuga, Rebecca N.; Sebulime, Peregrine; Tabuti, John R.S.
    Environmental sanitation and indigenous practices based on homestead characteristics have not been emphasized in national malaria control strategies. This study explored homestead characteristics, housing attributes, indigenous practices and knowledge of malaria in a rural high malaria transmission community in Uganda. Structured interviews and direct observations of housing attribute and homestead characteristics were carried out in 100 randomly selected homesteads in Kaliro District, Uganda. Plants believed to be mosquito repellants were observed in a number of homesteads and most respondents correctly described malaria symptoms. Almost all homesteads (99%) had large crops grown around them and were close to kraals (within 50 m, 88%). A number of homesteads were in easy reach of un-protected water springs (49%), 32% had material that could harbour mosquitoes (e.g. tins or ditches). The community had good knowledge of malaria and its prevention. Homesteads had modifications aimed at reducing malaria transmission. Despite this knowledge, the environment of most homesteads was conducive for the survival and faster multiplication of malaria vectors and this collaborates with the high prevalence of malaria found in the study area. There is need to develop and pilot interventions focusing on modifications of homestead characteristics and housing attributes for sustainable control of malaria.
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    Profile of T Cell Recognition of HIV Type 1 Consensus Group M Gag and Nef Peptides in a Clade A1- and D-Infected Ugandan Population
    (AIDS research and human retroviruses, 2012) Serwanga, Jennifer; Mugaba, Susan; Pimego, Edward; Nanteza, Bridget; Lyagoba, Fred; Nakubulwa, Susan; Heath, Laura; Nsubuga, Rebecca N.; Ndembi, Nicaise; Gotch, Frances; Kaleebu, Pontiano
    Reagents for evaluating non-clade B HIV-specific T cell responses are uncommon. Peptides based on highly conserved HIV-1 consensus group M sequences that are phylogenetically closer to most circulating strains may provide potential alternative reagents in populations with diverse infections, and may be relevant for vaccine design. Recognition of such reagents in clade A1-and D-infected populations has not been previously evaluated. Interferon (IFN)-c ELISpot assay was used to evaluate T cell recognition of Gag and Nef peptides based on consensus group M sequences in 50 treatment-naive adults predominantly infected with HIV-1 clades A1 and D. Gag-induced T cell responses were correlated with gag sequence diversity. Infecting clades were determined from gag sequences for 45 of the 50 subjects as 40% clade A1 (18/45), 45% clade D (20/45), 2% clade C (1/45), 2% A1/C recombinant (1/45), 2% A1/D (1/45), 7% CRF10_CD (3/45), and 2% U (unclassifiable) (1/45). The mean genetic divergence and diversity of clade A and D gag region compared to group M consensus sequences at synonymous and nonsynonymous nucleotide and amino acid levels were not always significant. Gag peptides were targeted at significantly higher frequency [88% (44/50)] than Nef [64% (32/50)]; p = 0.014, although their mean IFN-c magnitudes were comparable ([3703 (95% CI 2567–4839)] vs. [2120 (95% CI 478–3762)]), respectively. Measurable virus-induced IFN-c responses were detected in 96% (48/50) individuals, primarily targeting the more conserved Gag p24 and Nef central core regions. Use of these reagents to screen for HIV-specific IFN-c responses may mitigate the challenge of viral diversity; although this targeting is apparently biased toward a few highly conserved epitopes.
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    Rates Of HIV-1 Virological Suppression And Patterns Of Acquired Drug Resistance Among Fisherfolk On First-Line Antiretroviral Therapy In Uganda
    (Journal of Antimicrobial Chemotherapy, 2019) Omooja, Jonah; Nannyonjo, Maria; Sanyu, Grace; Nabirye, Stella E.; Nassolo, Faridah; Lunkuse, Sandra; Kapaata, Anne; Segujja, Farouk; Kateete, David Patrick; Ssebaggala, Eric; Bbosa, Nicholas; Aling, Emmanuel; Nsubuga, Rebecca N.; Kaleebu, Pontiano; Ssemwanga, Deogratius
    We examined virological outcomes, patterns of acquired HIV drug resistance (ADR), correlates of virological failure (VF) and acquired drug resistance among fisherfolk on first-line ART.We enrolled 1169 adults on ART for a median duration of 6, 12, 24, 36 and ≥48 months and used a pooled VL testing approach to identify VF (VL ≥1000 copies/mL). We performed genotyping among VF cases and determined correlates of VF and ADR by logistic regression.The overall virological suppression rate was 91.7% and ADR was detected in 71/97 (73.2%) VF cases. The most prevalent mutations were M184V/I (53.6%) for NRTIs and K103N (39.2%) for NNRTIs. Thymidine analogue mutations were detected in 21.6% of VF cases while PI mutations were absent. A zidovudine-based ART regimen, duration on ART (≥24 months) and secondary/higher education level were significantly associated with VF. A nevirapine-based regimen [adjusted OR (aOR): 1.87; 95% CI: 0.03–0.54)] and VL ≥10000 copies/mL (aOR: 3.48; 95% CI: 1.37–8.85) were ADR correlates. The pooling strategies for VL testing with a negative predictive value (NPV) of ≥95.2% saved US $20320 (43.5%) in VL testing costs.We observed high virological suppression rates among these highly mobile fisherfolk; however, there was widespread ADR among those with VF at the first VL testing prior to intensive adherence counselling. Timely treatment switching and adherence support is recommended for better treatment outcomes. Adoption of pooled VL testing could be cost effective, particularly in resource-limited settings.