Browsing by Author "Opio, Denis"

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    The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study
    (BMC Infectious Diseases, 2021) Nakafeero Simbwa, Brenda; Katamba, Achilles; Katana, Elizabeth B.; Laker, Eva A. O.; Nabatanzi, Sandra; Sendaula, Emmanuel; Opio, Denis; Ictho, Jerry; Lochoro, Peter; Karamagi, Charles A.; Kalyango, Joan N.; Worodria, William
    Emergence of drug resistant tuberculosis (DR-TB) has aggravated the tuberculosis (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population in Karamoja, Uganda with a high-TB burden (3500 new cases annually) and sought to determine the prevalence, patterns, factors associated with DR-TB. Methods: We used mixed methods of data collection. We enrolled 6890 participants who were treated for tuberculosis in a programmatic setting between January 2015 and April 2018. A cross sectional study and a matched case control study with conditional logistic regression and robust standard errors respectively were used to the determine prevalence and factors associated with DR-TB. The qualitative methods included focus group discussions, in-depth interviews and key informant interviews. Results: The overall prevalence of DR-TB was 41/6890 (0.6%) with 4/64,197 (0.1%) among the new and 37/2693 (1.4%) among the previously treated TB patients respectively. The drug resistance patterns observed in the region were mainly rifampicin mono resistant (68.3%) and Multi Drug-Resistant Tuberculosis (31.7%). Factors independently associated with DR-TB were previous TB treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) and drug stock-outs aOR 0.027 (95%CI 0.002–0.364). The nomadic lifestyle, substance use, congested homesteads and poor health worker attitudes were a great challenge to effective treatment of TB. Conclusion: Despite having the highest national TB incidence, Karamoja still has a low DR-TB prevalence. Previous TB treatment and drug stock outs were associated with DR-TB. Regular supply of anti TB medications and health education may help to stem the burden of TB disease in this nomadic population.
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    Loss to follow-up and associated factors among adult people living with HIV at public health facilities in Wakiso district, Uganda: a retrospective cohort study
    (BMC health services research, 2019) Opio, Denis; Semitala, Fred C.; Kakeeto, Alex; Sendaula, Emmanuel; Okimat, Paul; Nakafeero, Brenda; Nankabirwa, Joaniter I.; Karamagi, Charles; Kalyango, Joan N.
    Loss to follow-up (LTFU) from care among people living with HIV (PLHIV) is thought to be more common in the public setting compared to the private health care. It is anticipated that the problem may become worse with the current “test and treat” policy in Uganda due to the likely increases in patient loads and its attendant pressure on health care providers to support patient counseling. This study determined the incidence and factors associated with LTFU from HIV care among adult PLHIV in public health facilities in Wakiso district, Uganda. Methods: This was a retrospective cohort study that involved the review of 646 records of patients initiated on antiretroviral therapy (ART) between January 1st, 2015 and December 31st, 2017 at 13 randomly selected public health facilities in Wakiso district. The cox proportional hazards regression was used to determine the factors associated with LTFU. The results were supported by sequential in-depth and key informant interviews to explore reasons for LTFU. Results: Of the 646 patients enrolled, 391 were female (60.5%), 282 were below 30 years (43.6%) and 207 were married (50.1%). A total of 216 patients (33.4%) had no documented outcomes and were considered LTFU. The incidence of LTFU was 21 per 1000 person months (95% confidence interval (CI): 18–25 per 1000 person months). Factors associated with LTFU included having normal weight compared to underweight (adjusted hazard ratio (aHR) 0.64, 95% CI: 0.45–0.90, p = 0.011), receiving HIV care from hospitals compared to lower level facilities (aHR 0.22, 95% CI: 0.12–0.41, p < 0.001), and no telephone contact compared to those with a telephone contact (aHR 2.16, 95% CI: 1.33–3.51, p = 0.002). Stigmatization and long waiting times were the prominent reasons for LTFU reported from the in-depth and key informant interviews. Conclusions: The incidence of LTFU in public health facilities in Uganda is quite high and is associated with being underweight, not having a telephone contact to receive reminders and receiving care at lower level facilities. Early diagnosis, routine use of patient address locator forms and improved quality of HIV care at lower level health facilities may reduce LTFU among PLHIV.
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    Prevalence and Factors Associated with transfusion-transmissible infections among blood donors in Arua regional blood bank, Uganda
    (Springer Nature B.V, 2024-09) Cwinyaai, Norman; Opio, Denis; Kajumbula, Henry; Zalwango, Jane F; Akunzirwe, Rebecca; Okello, Tom; Francis, Anguzu
    Background -Blood transfusion services play a very key role in modern health care service delivery. About 118.5 million blood donations were collected globally in 2022. However, about 1.6 million units of blood are destroyed annually due to transfusion-transmissible infections (TTIs). There is a very high risk of TTIs through donated blood to recipients if safe transfusion practices are not observed. This study determined the prevalence and factors associated with TTIs among blood donors in Arua regional blood bank, Uganda. Methods -This study was a retrospective cross-sectional design that involved a review of a random sample of 1370 blood donors registered between January 1st, 2018 and December 31st, 2019 at Arua regional blood bank, Uganda. Descriptive statistics were used to describe the characteristics of the blood donors. The binary logistic regression was used to determine the factors associated with TTIs. Results -The majority of the blood donors were male (80.1%), and the median donor age was 23 years (IQR=8 years). The overall prevalence of TTIs was found to be 13.8% (95%CI: 12.0-15.6%), with specific prevalences of 1.9% for HIV, 4.1% for HBV, 6.6% for HCV and 2.8% for treponema pallidum. Male sex (AOR=2.10, 95%CI: 1.32–3.36, p-value=0.002) and lapsed donor type compared to new donor type (AOR=0.34, 95%CI: 0.13–0.87, p-value=0.025) were found to be associated with TTIs. Conclusion -The prevalence of TTIs among blood donors of West Nile region, Uganda was found to be significantly high, which implies a high burden of TTIs in the general population. Hence, there is need to implement a more stringent donor screening process to ensure selection of risk-free donors, with extra emphasis on male and new blood donors. Additionally, sensitization of blood donors on risky behaviors and self-deferral will reduce the risk of donating infected blood to the recipients. Keywords -Blood donor, Voluntary donor, Transfusion-transmissible infections (TTIs), Seropositive blood donor