Browsing by Author "Wandera, Bonnie"

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    Increased malaria parasitaemia among adults living with HIV who have discontinued cotrimoxazole prophylaxis in Kitgum district, Uganda
    (PLoS ONE, 2020) Orishaba, Philip; Kalyango, Joan N.; Byakika-Kibwika, Pauline; Arinaitwe, Emmanuel; Wandera, Bonnie; Katairo, Thomas; Muzeyi, Wani; Tendo Nansikombi, Hildah; Nakato, Alice; Mutabazi, Tobius; Kamya, Moses R.; Dorsey, Grant; Nankabirwa, Joaniter I.
    Although WHO recommends cotrimoxazole (CTX) discontinuation among HIV patients who have undergone immune recovery and are living in areas of low prevalence of malaria, some countries including Uganda recommend CTX discontinuation despite having a high malaria burden. We estimated the prevalence and factors associated with malaria parasitaemia among adults living with HIV attending hospital outpatient clinic before and after discontinuation of CTX prophylaxis.
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    Prevalence and determinants of minimum dietary diversity for women of reproductive age in Uganda
    (BioMed Central Ltd, 2024-03) Kimuli, Derrick; Nakaggwa, Florence; Namuwenge, Norah; Nsubuga, Rebecca N; Kasule, Kenneth; Nyakwezi, Sheila; Odong, Jimmy; Isabirye, Paul; Sevume, Solome; Mubiru, Norbert; Mwehire, Daniel; Matovu, Fatuma; Wandera, Bonnie; Amuron, Barbara; Bukenya, Daraus
    BACKGROUNDGlobally, over a billion women of reproductive age (WRA) suffer from some kind of undernutrition micronutrient deficiencies, and/or anemia as a result of inadequate dietary diversity. This leads to poor maternal and child health outcomes, however, there is limited research on population level research on minimum dietary diversity for women (MDD-W). This study assessed the prevalence and predictors of MDD-W among WRA in Uganda.METHODSThis study was a secondary analysis of data from the lot quality assurance sampling (LQAS) survey conducted across 55 Ugandan districts between May and September 2022. Women of various ages were interviewed across 5 study subgroups that this study used to construct its study population (WRA). Descriptive analyses, tests for outcome differences, and multilevel mixed-effects logistic regression were conducted at a 5% statistical significance level using STATA version 17. The results were reported using Adjusted Odds Ratios (aOR) as the measure of the outcome.RESULTSThe study analyzed responses from 29,802 WRA with a mean age of 27.8 (± 6.8) years. Only 8.8% (95% CI 8.5-9.3) achieved the MDD-W, the least proportion was observed in the South-Central region (3.13%). In the adjusted analysis, WRA who were older than 25 years (aOR 1.1, 95% CI 1.1-1.3, p < 0.001), had secondary education (aOR = 1.4, 95% CI 1.1-1.7, p = 0.003) or above (aOR = 1.7, 95% CI 1.3-2.2, p < 0.001), and used modern contraceptives (aOR = 1.1, 95% CI 1.0-1.3, p = 0.01) were more likely to achieve the MDD-W. Conversely, WRA who travelled longer distances to the nearest household water source (aOR = 0.8, 95% CI 0.7-0.9, p = 0.002) and those residing in larger households (aOR = 0.9, 95% CI 0.8-1.0, p = 0.019) were less likely to achieve the MDD-W.CONCLUSIONA low proportion of WRA met the MDD-W. Age, education level, household sizes and use of modern contraception were predictors of MDD-W among WRA in Uganda. MDD-W-related program efforts in Uganda should strengthen multisectoral collaboration with prioritization of younger women, education, household sizes and access to safe water sources.
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    Sexual Behaviors over a 3-Year Period among Individuals with Advanced HIV/AIDS Receiving Antiretroviral Therapy in an Urban HIV Clinic in Kampala, Uganda
    (Journal of acquired immune deficiency syndromes, 2011) Wandera, Bonnie; Kamya, Moses R.; Castelnuovo, Barbara; Kiragga, Agnes; Kambugu, Andrew; Wanyama, Jane N.; Easterbrook, Philippa; Sethi, Ajay K.
    Few studies have prospectively examined sexual behaviors of HIV-infected person on antiretroviral therapy (ART) in Sub-Saharan Africa.From 2004 to 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semi-annually for three years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over three-years after initiating ART.559 adults contributed 2,594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. Majority (63.4%) of married individuals were unaware of their partner’s HIV status. Female gender (PR=2.97; 95% CI: 1.85, 4.79), being married (PR=1.48; 95% CI: 1.06, 2.06), and reporting unprotected sex prior to ART (PR=1.68; 95% CI: 1.16, 2.42) were among factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load >1,500 copies/ml, representing periods of greater HIV transmission risk.Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women.
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    Significant rates of risky sexual behaviours among HIV-infected patients failing first-line ART: A sub-study of the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial
    (International journal of STD & AIDS, 2018) Wanyama, Jane N.; Nabaggala, Maria S.; Wandera, Bonnie; Kiragga, Agnes N.; Castelnuovo, Barbara; Mambule, Ivan K.; Nakajubi, Josephine; Kambugu, Andrew D.; Paton, Nicholas I.; Colebunders, Robert; Wanyenze, Rhoda K.; Easterbrook, Philippa
    There are limited data on the prevalence of risky sexual behaviours in individuals failing first-line antiretroviral therapy (ART) and changes in sexual behaviour after switch to second-line ART. We undertook a sexual behaviour sub-study of Ugandan adults enrolled in the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial. A standardized questionnaire was used to collect sexual behaviour data and, in particular, risky sexual behaviours (defined as additional sexual partners to main sexual partner, inconsistent use of condoms, non-disclosure to sexual partners, and exchange of money for sex). Of the 79 participants enrolled in the sub-study, 62% were female, median age (IQR) was 37 (32–42) years, median CD4 cell count (IQR) was 79 (50–153) cells/ml, and median HIV viral load log was 4.9 copies/ml (IQR: 4.5–5.3) at enrolment. The majority were in long-term stable relationships; 69.6% had a main sexual partner and 87.3% of these had been sexually active in the preceding six months. At enrolment, around 20% reported other sexual partners, but this was higher among men than women (36% versus 6.7 %, p<0.001). In 50% there was inconsistent condom use with their main sexual partner and a similar proportion with other sexual partners, both at baseline and follow-up. Forty-three per cent of participants had not disclosed their HIV status to their main sexual partner (73% with other sexual partners) at enrolment, which was similar in men and women. Overall, there was no significant change in these sexual behaviours over the 96 weeks following switch to second-line ART, but rate of non-disclosure of HIV status declined significantly (43.6% versus 19.6%, p<0.05). Among persons failing first-line ART, risky sexual behaviours were prevalent, which has implications for potential onward transmission of drug-resistant virus. There is need to intensify sexual risk reduction counselling and promotion of partner testing and disclosure, especially at diagnosis of treatment failure and following switch to second- or third-line ART.