Browsing by Author "Zalwango, Sarah."

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    Validation of a Pictorial Survey Tool to Measure Time Use in an African Urban Setting
    (Sage publication, 2019) Schwartz, Lauren M.; Mutanga, Jane; Kakaire, Robert; Davis-Olwell, Paula; Handel, Andreas; Sekandi, Juliet; Halloran, Elizabeth M.; Kiwanuka, Noah.; Zalwango, Sarah.; Whalen, Christopher C.
    Disease often depends on how a host interacts with his or her environment. This interaction is important for respiratory infectious diseases, where built environments may promote transmission. To learn about time use, or the amount of time people spend in a day doing various activities,in sub-Saharan Africa may be difficult because of low literacy and different cultural perceptions of time. We developed a culturally appropriate survey tool to measure time use called the mweso game. Method: Three cross sectional studies were performed among adults in Kampala, Uganda, to evaluate criterion and construct validity and to assess reliability of the mweso game. The mweso game was compared to actual elapsed time, a detailed 24-hr recall survey, and between three different recall periods. In all analyses, the mean number of beads, or hours, was calculated; Pearson correlation coefficients and Cronbach’s a were estimated. Results: Criterion validity for the use of beads to measure time was fair; mean values tended to be accurate, but there was variability in estimates of time across participants. When comparing the mweso game to the 24-hr recall survey, construct validity was very good. For most of the settings, the difference between measurements was less than one hour; there was good to excellent correlation for most settings. Reliability and internal consistency were best for time use at home and work. Conclusions: We have developed the mweso game as an instrument to measure time use in the context of low literacy and different cultural perceptions of time. The mweso game was valid and reliable, especially for measuring time use at home and work. With further validation, it may prove useful in measuring time use and in studying its relation to transmission of respiratory infectious diseases.
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    Whole Blood Interferon-Gamma Responses to Mycobacterium tuberculosis Antigens in Young Household Contacts of Persons with Tuberculosis in Uganda
    (Plos one, 2008) Lewinsohn, Deborah A.; Zalwango, Sarah.; Stein, Catherine M.; Mayanja-Kizza, Harriet.; Okwera, Alphonse.; Boom, Henry W.; Mugerwa, Roy D.; Whalen, Christopher C.
    Background: Due to immunologic immaturity, IFN-c-producing T cell responses may be decreased in young children compared to adults, thus we hypothesized that IFN-c responses to mycobacterial antigens in household contacts exposed to Mycobacterium tuberculosis (Mtb) would be impaired in young children relative to adults. The objective of this study was to compare whole blood IFN-c production in response to mycobacterial antigens between children and adults in Uganda. Methodology/Principal Findings: We studied household contacts of persons with culture-positive pulmonary tuberculosis (TB) enrolled in a cohort study conducted in Kampala, Uganda. Whole blood IFN-c production in response to Mtb culturefiltrate antigens was measured by ELISA and compared between infants (,2 years old, n = 80), young children (2 ,5 years old, n = 216), older children (5 ,15 years old, n = 443) and adults ($15 years old, n = 528). We evaluated the relationship between IFN-c responses and the tuberculin skin test (TST), and between IFN-c responses and epidemiologic factors that reflect exposure to Mtb, and the effect of prior BCG vaccination on IFN-c responses. Young household contacts demonstrated robust IFN-c responses comparable to those of adults that were associated with TST and known risk factors for infection. There was no effect of prior BCG immunization on the IFN-c response. Conclusions/Significance: Young children in a TB endemic setting can mount robust IFN-c responses generally comparable to those of adults, and as in adults, these responses correlated with the TST and known epidemiologic risk factors forMtb infection.