Browsing by Author "Welburn, Susan Christina"
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Item Bee Venom—A Potential Complementary Medicine Candidate for SARS-CoV-2 Infections(Frontiers in public health, 2020) Kasozi, Keneth Iceland; Alqarni, Mohammed; Zirintunda, Gerald; Ssempijja, Fred; Musinguzi, Simon Peter; Matama, Kevin; Mbiydzenyuy, Ngala Elvis; Welburn, Susan ChristinaSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 directly interacts with angiotensin-converting enzyme 2 (ACE-2) receptors in the human body. Complementary therapies that impact on expression of IgE and IgG antibodies, including administration of bee venom (BV), have efficacy in the management of arthritis, and Parkinson's disease. A recent epidemiological study in China showed that local beekeepers have a level of immunity against SARS-CoV-2 with and without previous exposure to virus. BV anti-inflammatory properties are associated with melittin and phospholipase A2 (PLA2), both of which show activity against enveloped and non-enveloped viruses, including H1N1 and HIV, with activity mediated through antagonist activity against interleukin-6 (IL-6), IL-8, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). Melittin is associated with the underexpression of proinflammatory cytokines, including nuclear factor-kappa B (NF-κB), extracellular signal-regulated kinases (ERK1/2), and protein kinase Akt. BV therapy also involves group III secretory phospholipase A2 in the management of respiratory and neurological diseases. BV activation of the cellular and humoral immune systems should be explored for the application of complementary medicine for the management of SARS-CoV-2 infections. BV “vaccination” is used to immunize against cytomegalovirus and can suppress metastases through the PLA2 and phosphatidylinositol-(3,4)-bisphosphate pathways. That BV shows efficacy for HIV and H1NI offers opportunity as a candidate for complementary therapy for protection against SARS-CoV-2.Item COVID-19-Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low-Income Earners of Western Uganda(Frontiers in public health, 2021) Lemuel, Ann Monima; Alghamdi, Saad; Archibong, Victor; Kasozi, Keneth Iceland; Ssebuufu, Robinson; Kabanyoro, Annet; Swase, Dominic Terkimbi; Ssempijja, Fred; Ayuba, John Tabakwot; Matama, Kevin; Kembabazi, Stellamaris; Kairania, Emmanuel; Batiha, Gaber El-Saber; Welburn, Susan ChristinaThe study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda. This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively. The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r2 = 47.4% and 6.4%, respectively) had a negative correlation with awareness of mental health care. In addition, no formal education had a positive correlation with anger and depression (r2 = 1.9% and 0.3%, respectively). Singleness in this study had a negative correlation with awareness of mental health care, anger, and depression (r2 = 1.9, 0.8, and 0.3%, respectively), and a positive correlation with anxiety (r2 = 3.9%). It is evident that education and relationship status influenced awareness on mental health care and mental health state among low-income earners in Western Uganda during the first COVID-19 lockdown. Therefore, policymakers should strengthen social transformation through the proper engagement of low-income earners in this COVID-19 era.Item Effects of b-Blockers on the Sympathetic and Cytokines Storms in Covid-19(Frontiers in Immunology, 2021) Al-kuraishy, Hayder M.; Al-Gareeb, Ali Ismail; Kasozi, Keneth Iceland; Zirintunda, Gerald; Welburn, Susan Christina; Batiha, Gaber El-SaberSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a causative virus in the development of coronavirus disease 2019 (Covid-19) pandemic. Respiratory manifestations of SARS-CoV-2 infection such as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) leads to hypoxia, oxidative stress, and sympatho-activation and in severe cases leads to sympathetic storm (SS). On the other hand, an exaggerated immune response to the SARS-CoV-2 invasion may lead to uncontrolled release of pro-inflammatory cytokine development of cytokine storm (CS). In Covid-19, there are interactive interactions between CS and SS in the development of multi-organ failure (MOF). Interestingly, cutting the bridge between CS and SS by anti-inflammatory and anti-adrenergic agents may mitigate complications that are induced by SARS-CoV-2 infection in severely affected Covid-19 patients. The potential mechanisms of SS in Covid-19 are through different pathways such as hypoxia, which activate the central sympathetic center through carotid bodies chemosensory input and induced pro-inflammatory cytokines, which cross the blood-brain barrier and activation of the sympathetic center. β2-receptors signaling pathway play a crucial role in the production of pro-inflammatory cytokines, macrophage activation, and B-cells for the production of antibodies with inflammation exacerbation. β-blockers have anti-inflammatory effects through reduction release of pro-inflammatory cytokines with inhibition of NF-κB. In conclusion, β-blockers interrupt this interaction through inhibition of several mediators of CS and SS with prevention development of neural-cytokine loop in SARS-CoV-2 infection. Evidence from this study triggers an idea for future prospective studies to confirm the potential role of β-blockers in the management of Covid-19.Item Embracing One Health offers practical strategies in management of COVID-19 for Africa(The Pan African Medical Journal, 2020) Kasozi, Keneth Iceland; Mujinya, Regan; Bogere, Paul; Ekou, Justine; Zirintunda, Gerald; Ahimbisibwe, Salaviriuse; Matama, Kevin; Ninsiima, Herbert Izo; Ayikobua, Emmanuel Tiyo; Ssimbwa, Godfrey; Musinguzi, Simon Peter; Muyinda, Robert; Ssempijja, Fred; Matovu, Henry; MacLeod, Ewan; Anderson, Neil Euan; Welburn, Susan ChristinaThe coronavirus, COVID-19 outbreak has now affected over 60% of African countries in less than two months , gaining a foothold through major economic and transport hubs on the African continent including Egypt, Algeria, Nigeria, South Africa and Kenya. Travel restrictions imposed against citizens from countries with major outbreaks including China, USA and those in Europe were too late . African Union member states as of early April 2020 are reporting 6,470 cases and 241 deaths from COVID-19 reporting growth as “close to exponential”. Africa Centers for Disease Control and Prevention acknowledges the virus is an existential threat to African countries and that with local transmission now underway many would pass the 10,000-infection mark by the end of April. While the impact of wearing of face masks for control of COVID-19 remains controversial, it is inarguable that respiratory transmission needs to be prevented. Currently, there is a global shortage of masks and personal protective equipment (PPE) and distribution is being rationed in developed countries to retain this for workers in the health system, showing that developing countries in Africa are bound to suffer more should the pandemic be mismanaged at these early stages. In addition, health systems in developing countries, already crippled from years of underinvestment will be compromised unless practical and realistic prevention strategies are put in place. China, Italy, France, UK and USA, all with sophisticated health systems, have found COVID-19 challenging. Infection is increasing across the African subcontinent and health systems will struggle as the pandemic sweeps into and across Africa.Item Epidemiology of Trypanosomiasis in Wildlife—Implications for Humans at the Wildlife Interface in Africa(Frontiers in Veterinary Science, 2021) Kasozi, Keneth Iceland; Zirintunda, Gerald; Ssempijja, Fred; Buyinza, Bridget; Matama, Kevin; Nakimbugwe, Helen N.; Onanyang, David; Bogere, Paul; Ochieng, Juma John; Matovu, Wycliff; Nalumenya, David Paul; Batiha, Gaber El-Saber; Osuwat, Lawrence Obado; Omadang, Leonard; Welburn, Susan ChristinaWhile both human and animal trypanosomiasis continue to present as major human and animal public health constraints globally, detailed analyses of trypanosome wildlife reservoir hosts remain sparse. African animal trypanosomiasis (AAT) affects both livestock and wildlife carrying a significant risk of spillover and cross-transmission of species and strains between populations. Increased human activity together with pressure on land resources is increasing wildlife–livestock–human infections. Increasing proximity between human settlements and grazing lands to wildlife reserves and game parks only serves to exacerbate zoonotic risk. Communities living and maintaining livestock on the fringes of wildlife-rich ecosystems require to have in place methods of vector control for prevention of AAT transmission and for the treatment of their livestock. Major Trypanosoma spp. include Trypanosoma brucei rhodesiense, Trypanosoma brucei gambiense, and Trypanosoma cruzi, pathogenic for humans, and Trypanosoma vivax, Trypanosoma congolense, Trypanosoma evansi, Trypanosoma brucei brucei, Trypanosoma dionisii, Trypanosoma thomasbancrofti, Trypanosma elephantis, Trypanosoma vegrandis, Trypanosoma copemani, Trypanosoma irwini, Trypanosoma copemani, Trypanosoma gilletti, Trypanosoma theileri, Trypanosoma godfreyi, Trypansoma simiae, and Trypanosoma (Megatrypanum) pestanai. Wildlife hosts for the trypansomatidae include subfamilies of Bovinae, Suidae, Pantherinae, Equidae, Alcephinae, Cercopithecinae, Crocodilinae, Pteropodidae, Peramelidae, Sigmodontidae, and Meliphagidae. Wildlife species are generally considered tolerant to trypanosome infection following centuries of coexistence of vectors and wildlife hosts. Tolerance is influenced by age, sex, species, and physiological condition and parasite challenge. Cyclic transmission through Glossina species occurs for T. congolense, T. simiae, T. vivax, T. brucei, and T. b. rhodesiense, T. b. gambiense, and within Reduviid bugs for T. cruzi. T. evansi is mechanically transmitted, and T. vixax is also commonly transmitted by biting flies including tsetse. Wildlife animal species serve as long-term reservoirs of infection, but the delicate acquired balance between trypanotolerance and trypanosome challenge can be disrupted by an increase in challenge and/or the introduction of new more virulent species into the ecosystem. There is a need to protect wildlife, animal, and human populations from the infectious consequences of encroachment to preserve and protect these populations. In this review, we explore the ecology and epidemiology of Trypanosoma spp. in wildlife.Item Molecular Epidemiology of Anaplasmosis in Small Ruminants along a Human-Livestock-Wildlife Interface in Uganda(Heliyon, 2021) Kasozi, Keneth Iceland; Welburn, Susan Christina; Nalumenya, David Paul; Namayanja, Monica; Matama, Kevin; Zalwango, Kelly Katenta; Matovu, Wycliff; Zirintunda, Gerald; Ekou, Justine; Kembabazi, Stellamaris; Mugasa, Claire Mack; Kitibwa, Annah; Tayebwa, Dickson Stuart; Musinguzi, Simon Peter; Mahero, Michael; Ssengendo, Ibrahim; Nanteza, Anne; Matovu, Enock; MacLeod, Ewan ThomasInformation as regards the epidemiology of the Anaplasmataceae in small ruminants in several low- and middle-income countries is scarce. In this study a total of 712 DNA samples collected from small ruminants were analyzed for Anaplasmataceae and Anaplasma ovis using the 16S rRNA and MSP4 genes respectively. Infection risk was assessed by location, sex and age of the animals and qGIS® was used to construct spatial maps. The prevalence of Anaplasmataceae spp was 89.1% (95% CI: 77.5–95.9) and 79.1% (95% CI: 75.9–82.1) in ovines and caprines respectively (RR = 1.1, 95% CI: 1.0–1.3); higher than those previously reported in other eastern African countries. The prevalence of A. ovis was 26.1% and 25.4% for both ovines and caprines respectively with ovines showing significantly higher levels of infection than caprines (P < 0.05). The risk of Anaplasma ovis infections was not affected by age (OR = 1.2, 95% CI: 0.9–1.7) or sex (OR = 1.1, 95% CI: 0.6–2.0). Small ruminants located at the forest edge (<0.3 km) showed higher A. ovis prevalence than those found inland with infections present in the midland regions associated with increased agricultural activity. Anaplasma ovis remains a major challenge for small ruminant husbandry in Uganda and infections are under-reported. Policy efforts to prioritize management of Anaplasmataceae for small ruminant health would promote livestock productivity in vulnerable communities, improving livelihoods and ecosystem health.Item The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections(Life, 2021) Moubarak, Mohamed; Kasozi, Keneth Iceland; Matama, Kevin; Kairania, Emmanuel; Musenero, Monica; Welburn, Susan Christina; Batiha, Gaber El-SaberNovel therapies for the treatment of COVID-19 are continuing to emerge as the SARS-Cov-2 pandemic progresses. PCR remains the standard benchmark for initial diagnosis of COVID-19 infection, while advances in immunological profiling are guiding clinical treatment. The SARS-Cov-2 virus has undergone multiple mutations since its emergence in 2019, resulting in changes in virulence that have impacted on disease severity globally. The emergence of more virulent variants of SARS-Cov-2 remains challenging for effective disease control during this pandemic. Major variants identified to date include B.1.1.7, B.1.351; P.1; B.1.617.2; B.1.427; P.2; P.3; B.1.525; and C.37. Globally, large unvaccinated populations increase the risk of more and more variants arising. With successive waves of COVID-19 emerging, strategies that mitigate against community transmission need to be implemented, including increased vaccination coverage. For treatment, convalescent plasma therapy, successfully deployed during recent Ebola outbreaks and for H1N1 influenza, can increase survival rates and improve host responses to viral challenge. Convalescent plasma is rich with cytokines (IL-1β, IL-2, IL-6, IL-17, and IL-8), CCL2, and TNFα, neutralizing antibodies, and clotting factors essential for the management of SARS-CoV-2 infection. Clinical trials can inform and guide treatment policy, leading to mainstream adoption of convalescent therapy. This review examines the limited number of clinical trials published, to date that have deployed this therapy and explores clinical trials in progress for the treatment of COVID-19.Item Systematic Review and Meta-Analysis on Knowledge Attitude and Practices on African Animal Trypanocide Resistance(Tropical Medicine and Infectious Disease, 2022) Kasozi, Keneth Iceland; MacLeod, Ewan Thomas; Waiswa, Charles; Mahero, Michael; Ntulume, Ibrahim; Welburn, Susan ChristinaAfrican trypanocide resistance is an emerging public health emergency whose control requires a revisit on farmer’s knowledge, attitudes, and practices in developing countries. African animal trypanocide resistance (AATr) is rife in an environment where drug use and policy decisions are disjointed. The objective of the study was to identify community factors responsible for the development of AATr. This was important since diminazene aceturate (DA), isometamidium chloride (ISM), and homidium bromide (HB) have existed for over 30 years and no new drugs have been provided to farmers. Methods: An electronic keyword search across 12 databases was conducted using a search criterion from 1806 to June 2022. This generated a total of 24 publications, but after removing duplicates, review articles, and nonrelated articles, a total of eight papers were included in the analysis by following the PRISMA checklist. A meta-analysis was conducted on the data extracted and the risk ratio and inverse variance at 95% confidence interval were calculated using RevMan®. Results: All the eight articles in the study showed that DA was the most preferred trypanocide in both West and Eastern Africa. Poor farmer knowledge of AATr and limited drug options were major drivers for trypanocide resistance. In addition, farmer treatments, use of untrained personnel, poor administration, poor dosing, and preparation of trypanocides were major drivers for the development of AATr and similarities were identified in DA and ISM practices (P = 0.13). Conclusions: AATr is spread in developing countries due to a lack of community knowledge, attitudes, and drug-use practices. This situation could be reversed through interdisciplinary collaborations in endemic communities by promoting effective treatments and responsible drug handling.Item University Lecturers and Students Could Help in Community Education about SARS-CoV-2 Infection in Uganda(Health services insights, 2020) Echoru, Isaac; Kasozi, Keneth Iceland; Usman, Ibe Michael; Mutuku, Irene Mukenya; Ssebuufu, Robinson; Ajambo, Patricia Decanar; Ssempijja, Fred; Mujinya, Regan; Matama, Kevin; Musoke, Grace Henry; Ayikobua, Emmanuel Tiyo; Ninsiima, Herbert Izo; Dare, Samuel Sunday; Eze, Ejike Daniel; Bukenya, Edmund Eriya; Nambatya, Grace Keyune; MacLeod, Ewan; Welburn, Susan ChristinaThe World Health Organization has placed a lot of attention on vulnerable communities of Africa due to their chronically weak health care systems. Recent findings from Uganda show that medical staff members have sufficient knowledge but poor attitudes toward coronavirus disease 2019 (COVID-19) pandemic.The aim of this study was to determine the knowledge, attitudes, and preparedness/practices of lecturers and students in the fight against COVID-19.This was a descriptive cross-sectional study of 103 lecturers and students both men and women of age group 18 to 69 years in western Uganda. Data were obtained through a pretested questionnaire availed online.Knowledge on COVID-19 symptoms was highest in this order: fever > dry cough > difficulty breathing > fatigue > headache with no significant differences between lecturers and students. Knowledge of participants on transmission of COVID-19 was highest in the order of cough drops > contaminated surfaces > person-to-person contact > asymptomatic persons > airborne > zoonotic with no significant differences among lecturers and students. Lecturers and students were all willing to continue using personal protective equipment like masks, and personal practices such as covering the mouth while sneezing and coughing, no handshaking, and washing of hands with no significant differences in the responses. The positive attitudes that COVID-19 could kill, anyone can get COVID-19, and willing to abide by the set regulations against the pandemic showed personal concerns and desired efforts against COVID-19.The study identifies lecturers and students as potential stakeholders in the fight against community transmission of COVID-19.Item An Update on African Trypanocide Pharmaceutics and Resistance(Frontiers in Veterinary Science, 2022) Kasozi, Keneth Iceland; MacLeod, Ewan Thomas; Ntulume, Ibrahim; Welburn, Susan ChristinaAfrican trypanosomiasis is associated with Trypanosoma evansi, T. vivax, T. congolense, and T. brucei pathogens in African animal trypanosomiasis (AAT) while T. b gambiense and T. b rhodesiense are responsible for chronic and acute human African trypanosomiasis (HAT), respectively. Suramin sodium suppresses ATP generation during the glycolytic pathway and is ineffective against T. vivax and T. congolense infections. Resistance to suramin is associated with pathogen altered transport proteins. Melarsoprol binds irreversibly with pyruvate kinase protein sulfhydryl groups and neutralizes enzymes which interrupts the trypanosome ATP generation. Melarsoprol resistance is associated with the adenine-adenosine transporter, P2, due to point mutations within this transporter. Eflornithine is used in combination with nifurtimox. Resistance to eflornithine is caused by the deletion or mutation of TbAAT6 gene which encodes the transmembrane amino acid transporter that delivers eflornithine into the cell, thus loss of transporter protein results in eflornithine resistance. Nifurtimox alone is regarded as a poor trypanocide, however, it is effective in melarsoprol-resistant gHAT patients. Resistance is associated with loss of a single copy of the genes encoding for nitroreductase enzymes. Fexinidazole is recommended for first-stage and non-severe second-stage illnesses in gHAT and resistance is associated with trypanosome bacterial nitroreductases which reduce fexinidazole. In AAT, quinapyramine sulfate interferes with DNA synthesis and suppression of cytoplasmic ribosomal activity in the mitochondria. Quinapyramine sulfate resistance is due to variations in the potential of the parasite's mitochondrial membrane. Pentamidines create cross-links between two adenines at 4–5 pairs apart in adenine-thymine-rich portions of Trypanosoma DNA. It also suppresses type II topoisomerase in the mitochondria of Trypanosoma parasites. Pentamidine resistance is due to loss of mitochondria transport proteins P2 and HAPT1. Diamidines are most effective against Trypanosome brucei group and act via the P2/TbAT1 transporters. Diminazene aceturate resistance is due to mutations that alter the activity of P2, TeDR40 (T. b. evansi). Isometamidium chloride is primarily employed in the early stages of trypanosomiasis and resistance is associated with diminazene resistance. Phenanthridine (homidium bromide, also known as ethidium bromide) acts by a breakdown of the kinetoplast network and homidium resistance is comparable to isometamidium. In humans, the development of resistance and adverse side effects against monotherapies has led to the adoption of nifurtimox-eflornithine combination therapy. Current efforts to develop new prodrug combinations of nifurtimox and eflornithine and nitroimidazole fexinidazole as well as benzoxaborole SCYX-7158 (AN5568) for HAT are in progress while little comparable progress has been done for the development of novel therapies to address trypanocide resistance in AAT.