Browsing by Author "Ssebagala, Darix"

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    Prevalence Of Protective Tetanus Antibodies And Immunological Response Following Tetanus Toxoid Vaccination Among Men Seeking Medical Circumcision Services In Uganda
    (PloS one, 2018) Makumbi, Fredrick; Byabagambi, John; Muwanika, Richard; Kigozi, Godfrey; Gray, Ronald; Galukande, Moses; Bagaya, Bernard; Ssebagala, Darix; Karamagi, Esther; Rahimzai, Mirwais; Kaggwa, Mugagga; Watya, Stephen; Mbonye, Anthony K.; Aceng, Jane Ruth; Musinguzi, Joshua; Kiggundu, Valerian; Njeuhmeli, Emmanuel; Nanteza, Barbara
    Tetanus infection associated with men who had male circumcision has been reported in East Africa, suggesting a need for tetanus toxoid-containing vaccines (TTCV).To determine the prevalence of tetanus toxoid antibodies following vaccination among men seeking circumcision. We enrolled 620 consenting men who completed a questionnaire and received TTCV at enrollment (day 0) prior to circumcision on day 28. Blood samples were obtained at day 0 from all enrollees and on days 14, 28 and 42 from a random sample of 237 participants. Tetanus toxoid (TT) IgG antibody levels were assayed using EUROIMMUN. Analyses included prevalence of TT antibodies at enrollment and used a mixed effects model to determine the immunological response.Mean age was 21.4 years, 65.2% had knowledge of tetanus, 56.6% knew how tetanus was contracted, 22.8% reported ever receipt of TTCV, and 16.8% had current/recently healed wounds. Insufficient tetanus immunity was 57.1% at enrollment, 7.2% at day 14, 3.8% at day 28, and 0% at day 42. Antibody concentration was 0.44IU/ml (CI 0.35–0.53) on day 0, 3.86IU/ml (CI 3.60–4.11) on day 14, 4.05IU/ml (CI 3.81–4.29) on day 28, and 4.48IU/ml (CI 4.28–4.68) on day 42. TT antibodies increased by 0.24IU/ml (CI 0.23, 0.26) between days 0 and 14 and by 0.023IU/ml (CI 0.015, 0.031) between days 14 and 42 days. Immunological response was poorer in HIV-infected clients and men aged 35+ years.Insufficient immunity was common prior to TTCV, and a protective immunological response was achieved by day 14. Circumcision may safely be provided 14 days after vaccination in HIV-uninfected men aged less than 35 years.
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    Survival of Infants Born to HIV-Positive Mothers, by Feeding Modality, in Rakai, Uganda
    (PLoS ONE, 2008) Kagaayi, Joseph; Gray, Ronald H.; Brahmbhatt, Heena; Kigozi, Godfrey; Nalugoda, Fred; Wabwire-Mangen, Fred; Serwadda, David; Sewankambo, Nelson; Ddungu, Veronica; Ssebagala, Darix; Sekasanvu, Joseph; Kigozi, Grace; Makumbi, Fredrick; Kiwanuka, Noah; Lutalo, Tom; Reynolds, Steven J.; Wawer, Maria J.
    Data comparing survival of formula-fed to breast-fed infants in programmatic settings are limited. We compared mortality and HIV-free of breast and formula-fed infants born to HIV-positive mothers in a program in rural, Rakai District Uganda. One hundred eighty two infants born to HIV-positive mothers were followed at one, six and twelve months postpartum. Mothers were given infant-feeding counseling and allowed to make informed choices as to whether to formula-feed or breast-feed. Eligible mothers and infants received antiretroviral therapy (ART) if indicated. Mothers and their newborns received prophylaxis for prevention of mother-to-child HIV transmission (pMTCT) if they were not receiving ART. Infant HIV infection was detected by PCR (Roche Amplicor 1.5) during the follow-up visits. Kaplan Meier time-to-event methods were used to compare mortality and HIV-free survival. The adjusted hazard ratio (Adjusted HR) of infant HIV-free survival was estimated by Cox regression. Seventy-five infants (41%) were formula-fed while 107 (59%) were breast-fed. Exclusive breast-feeding was practiced by only 25% of breast-feeding women at one month postpartum. The cumulative 12-month probability of infant mortality was 18% (95% CI = 11%–29%) among the formula-fed compared to 3% (95% CI = 1%–9%) among the breast-fed infants (unadjusted hazard ratio (HR) = 6.1(95% CI = 1.7–21.4, P-value,0.01). There were no statistically significant differentials in HIV-free survival by feeding choice (86% in the formula-fed compared to 96% in breast-fed group (Adjusted RH = 2.8[95%CI = 0.67–11.7, P-value = 0.16]