Browsing by Author "Ntabadde, Kauthrah"

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    Gender diferences among patients with drug resistant tuberculosis and HIV co-infection in Uganda: a countrywide retrospective cohort study
    (Springer, 2021-10-18) Baruch Baluku, Joseph; Mukasa, David; Bongomin, Felix; Stadelmann, Anna; Nuwagira, Edwin; Haller, Sabine; Ntabadde, Kauthrah; Turyahabwe, Stavia
    Background: Gender diferences among patients with drug resistant tuberculosis (DRTB) and HIV co-infection could afect treatment outcomes. We compared characteristics and treatment outcomes of DRTB/HIV co-infected men and women in Uganda. Methods: We conducted a retrospective chart review of patients with DRTB from 16 treatment sites in Uganda. Eligible patients were aged≥18 years, had confrmed DRTB, HIV co-infection and a treatment outcome registered between 2013 and 2019. We compared socio-demographic and clinical characteristics and tuberculosis treatment outcomes between men and women. Potential predictors of mortality were determined by cox proportional hazard regression analysis that controlled for gender. Statistical signifcance was set at p<0.05. Results: Of 666 DRTB/HIV co-infected patients, 401 (60.2%) were men. The median (IQR) age of men and women was 37.0 (13.0) and 34.0 (13.0) years respectively (p<0.001). Men were signifcantly more likely to be on tenofovir-based antiretroviral therapy (ART), high-dose isoniazid-containing DRTB regimen and to have history of cigarette or alcohol use. They were also more likely to have multi-drug resistant TB, isoniazid and streptomycin resistance and had higher creatinine, aspartate and gamma-glutamyl aminotransferase and total bilirubin levels. Conversely, women were more likely to be unemployed, unmarried, receive treatment from the national referral hospital and to have anemia, a capreomycin-containing DRTB regimen and zidovudine-based ART. Treatment success was observed among 437 (65.6%) and did not difer between the genders. However, mortality was higher among men than women (25.7% vs. 18.5%, p=0.030) and men had a shorter mean (standard error) survival time (16.8 (0.42) vs. 19.0 (0.46) months), Log Rank test (p=0.046). Predictors of mortality, after adjusting for gender, were cigarette smoking (aHR=4.87, 95% CI 1.28–18.58, p=0.020), an increase in alanine aminotransferase levels (aHR=1.05, 95% CI 1.02–1.07, p<0.001), and his tory of ART default (aHR=3.86, 95% CI 1.31–11.37, p=0.014) while a higher baseline CD4 count was associated with lower mortality (aHR=0.94, 95% CI 0.89–0.99, p=0.013 for every 10 cells/mm3 increment). Conclusion: Mortality was higher among men than women with DRTB/HIV co-infection which could be explained by several sociodemographic and clinical differences.
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    Prevalence of anaemia and associated factors among people with pulmonary tuberculosis in Uganda
    (Epidemiology and Infection, 2022-01-08) Baruch Baluku, Joseph; Mayinja, Ernest; Mugabe, Pallen; Ntabadde, Kauthrah; Olum, Ronald; Bongomin, Felix
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    Prevalence of Intestinal Helminth Coinfection in Drug-Resistant Tuberculosis in Uganda
    (Oxford University Press, 2022-10-08) Baruch Baluku, Joseph; Nakazibwe, Bridget; Wasswa, Amir; Naloka, Joshua; Ntambi, Samuel; Waiswa, Damalie; Okwir, Mark; Nabwana, Martin; Bongomin, Felix; Katuramu, Richard; Nuwagira, Edwin; Ntabadde, Kauthrah; Katongole, Paul; Senyimba, Catherine; Andia-Biraro, Irene
    Background. Although a third of people with tuberculosis (TB) are estimated to be coinfected with helminths, the prevalence is largely unknown among people with drug-resistant TB (DR-TB). We determined the prevalence of helminth coinfection among people with DR-TB in Uganda. Methods. In a multicenter, cross-sectional study, eligible Ugandan adults with confirmed DR-TB were consecutively enrolled between July to December 2021 at 4 treatment centers. Sociodemographic data were collected using a questionnaire. Participants underwent anthropometric and blood pressure measurements, and blood samples were evaluated for random blood glucose, glycated hemoglobin, nonfasting lipid profile, human immunodeficiency virus (HIV) infection, and a complete blood count. Fresh stool samples were evaluated for adult worms, eggs, and larvae using direct microscopy after Kato-Katz concentration techniques. Results. Of 212 participants, 156 (73.6%) were male, 118 (55.7%) had HIV, and 3 (2.8%) had malaria coinfection. The prevalence of intestinal helminth coinfection was 4.7% (10/212) (95% confidence interval, 2.6%–8.6%). The frequency of helminth infections was Ancylostoma duodenale (n=4), Schistosoma mansoni (n=2), Enterobius vermicularis (n=2), Ascaris lumbricoides (n=1), and Trichuris trichiura (n=1). Conclusions. The prevalence of helminth coinfection was low among people with DR-TB. More studies are needed to determine the clinical relevance of helminth/DR-TB coinfection.