Browsing by Author "Walusimbi, Bridgious"

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    Contrasting Impact of Rural, Versus Urban, Living on Glucose Metabolism and Blood Pressure in Uganda
    (Wellcome open research, 2020) Sanya, Richard E.; Biraro, Irene Andia; Nampijja, Margaret; Zziwa, Christopher; Nanyunja, Carol; Nsubuga, Denis; Kiwanuka, Samuel; Tumusiime, Josephine; Walusimbi, Bridgious; Cose, Stephen; Ocama, Ponsiano; Grencis, Richard K.; Elliott, Alison M.; Webb, Emily L.
    The burden of cardiometabolic diseases, including cardiovascular diseases and diabetes, is increasing in sub-Saharan Africa and this has been linked to urbanisation. Helminths, through their immunomodulatory properties, may protect against these disorders. We hypothesised that the rural environment protects against cardiometabolic diseases and that helminths may influence rural-urban disparity of cardiometabolic disease risk.We compared metabolic parameters of individuals aged ≥10 years living in rural, high-helminth-transmission and urban, lower-helminth-transmission settings in Uganda. Cross-sectional surveys were conducted in rural Lake Victoria island fishing communities and in urban sub-wards in Entebbe municipality. Helminth infection and outcomes, including insulin resistance (computed using the homeostatic model assessment of insulin resistance [HOMA-IR]), fasting blood glucose, fasting blood lipids, blood pressure, body mass index (BMI), waist and hip circumference, were assessed.We analysed 1,898 rural and 930 urban participants. Adjusting for BMI, exercise, smoking, alcohol intake, age and sex, urban residents had lower mean fasting glucose (adjusted mean difference [95%CI] 0.18 [-0.32, -0.05] p=0.01) and HOMA-IR (-0.26 [-0.40, -0.11] p=0.001) but higher blood pressure (systolic, 5.45 [3.75, 7.15] p<0.001; diastolic, 1.93 [0.57, 3.29] p=0.006). Current helminth infection did not explain the observed differences.In the Ugandan context, living in rural fishing communities may protect against hypertension but worsen glucose metabolism.
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    The Effect of Helminth Infections and Their Treatment on Metabolic Outcomes: Results of a Cluster-Randomized Trial
    (Clinical infectious diseases, 2020) Sanya, Richard E.; Webb, Emily L.; Zziwa, Christopher; Kizindo, Robert; Sewankambo, Moses; Tumusiime, Josephine; Nakazibwe, Esther; Oduru, Gloria; Niwagaba, Emmanuel; Nakawungu, Prossy Kabuubi; Kabagenyi, Joyce; Nassuuna, Jacent; Walusimbi, Bridgious; Andia-Biraro, Irene; Elliot, Alison M.
    Helminths may protect against cardiometabolic risk through effects on inflammation and metabolism; their treatment may be detrimental to metabolic outcomes. In a cluster-randomized trial in 26 Ugandan fishing communities we investigated effects of community-wide intensive (quarterly single-dose praziquantel, triple-dose albendazole) vs standard (annual single-dose praziquantel, biannual single-dose albendazole) anthelminthic treatment on metabolic outcomes, and observational associations between helminths and metabolic outcomes. The primary outcome, homeostatic model assessment of insulin resistance (HOMA-IR), and secondary outcomes (including blood pressure, fasting blood glucose, lipids) were assessed after 4 years' intervention among individuals aged ≥10 years. We analyzed 1898 participants. Intensive treatment had no effect on HOMA-IR (adjusted geometric mean ratio, 0.96 [95% confidence interval {CI}, .86–1.07]; P = .42) but resulted in higher mean low-density lipoprotein cholesterol (LDL-c) (2.86 vs 2.60 mmol/L; adjusted mean difference, 0.26 [95% CI, −.03 to .56]; P = .08). Lower LDL-c levels were associated with Schistosoma mansoni (2.37 vs 2.80 mmol/L; −0.25 [95% CI, −.49 to −.02]; P = .04) or Strongyloides (2.34 vs 2.69 mmol/L; −0.32 [95% CI, −.53 to −.12]; P = .003) infection. Schistosoma mansoni was associated with lower total cholesterol (4.24 vs 4.64 mmol/L; −0.25 [95% CI, −.44 to −.07]; P = .01) and moderate to heavy S. mansoni infection with lower triglycerides, LDL-c, and diastolic blood pressure. Helminth infections improve lipid profiles and may lower blood pressure. Studies to confirm causality and investigate mechanisms may contribute to understanding the epidemiological transition and suggest new approaches to prevent cardiometabolic disease.
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    Helminth driven gut inflammation and microbial translocation associate with altered vaccine responses in rural Uganda
    (npj Vaccines, 2025-03-26) Nassuuna, Jacent; Walusimbi, Bridgious; Natukunda, Agnes; Zirimenya, Ludoviko
    Vaccine responses are sometimes impaired in rural, low-income settings. Helminth-associated gut barrier dysfunction and microbial translocation (MT) may be implicated. We used samples from a trial of praziquantel treatment-effects on vaccine responses in Schistosoma mansoni (Sm)-endemic Ugandan islands, measuring intestinal fatty acid-binding protein 2 (I-FABP2), lipopolysaccharide-binding protein, anti-endotoxin core antibodies (EndoCab), soluble CD14 (sCD14) in plasma, and faecal lipocalin-2, occult blood (FOB), and calprotectin (fCAL), and evaluating their associations with baseline helminth infection, praziquantel treatment, and responses to BCG, yellow fever, typhoid, HPV, and tetanus-diphtheria vaccines. Sm associated positively with fCAL and FOB, hookworm with I-FABP2, and any helminth with EndoCab IgM, fCAL and FOB. Sm associated inversely with sCD14. Praziquantel treatment reduced all marker concentrations, significantly fCAL and FOB, implying that Sm-associated gut inflammation and MT is reversible. Associations of assessed markers with vaccine-specific responses were predominantly inverse. Interventions to improve gut barrier function may enhance vaccine responsiveness.
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    The effect of intensive praziquantel administration on vaccine-specific responses among schoolchildren in Ugandan schistosomiasis-endemic islands (POPVAC A): an open-label, randomised controlled trial
    (The Lancet Global Health, 2024-11-23) Nkurunungi, Gyaviira; Nassuuna, Jacent; Natukunda, Agnes; Walusimbi, Bridgious
    Vaccine responses differ between populations and are often impaired in rural and low-income settings. The reasons for this are not fully understood, but observational data suggest that the immunomodulating effects of parasitic helminths might contribute. We hypothesised that Schistosoma mansoni infection suppresses responses to unrelated vaccines, and that suppression could be reversed—at least in part—by intensive praziquantel administration.
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    Uganda Schistosomiasis Symposium 2023: understanding morbidity drivers and developing controlled human infection models for vaccine research
    (Trends in Parasitology, 2023) Egesa, Moses; Kiberu, Davis; Sanya, Richard E.; Alabi, Ayodele; Baluku, Joseph Baruch; Oguttu, David W.; Driciru, Emmanuella; Odongo, Matthew; Elliott, Alison M.; Walusimbi, Bridgious; Nkurunungi, Gyaviira
    Schistosomiasis impacts African populations most strongly. Despite Uganda’s leading role in the Schistosomiasis Control Initiative for mass drug administration (MDA), about half the population remains at risk and a quarter infected. Prevalence and intensity remain high, and morbidity severe, in northwest Uganda around Lake Albert and the Albert Nile. An effective vaccine could combat repeated infection following MDA, and controlled human infection (CHI) studies could enable such vaccine development. Therefore, the Uganda Schistosomiasis Multidisciplinary Research Center and CHI-in-Africa Network hosted a symposium in Uganda bringing together local and international partners to discuss research on the drivers of schistosomal morbidity and the development of CHI studies for helminth vaccine development in Africa. In this TrendsTalk, we invited 10 early- to mid-career researchers to summarise the symposium proceedings.