Browsing by Author "Baluku, Joseph Baruch"

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    Diagnostic Accuracy of Clinical Diagnostic Scoring Systems for Childhood Tuberculosis: A Systematic Review and Meta-analysis
    (Oxford University Press, 2023-12-11) Kakinda, Michael; Olum, Ronald; Baluku, Joseph Baruch; Bongomin, Felix
    Background. Diagnosis of childhood tuberculosis (TB) poses several challenges. Therefore, point-based scoring systems and diagnostic algorithms have been developed to improve the diagnostic yields in this population. However, there are no updated systematic reviews of the existing childhood TB scoring systems and algorithms. Hence, we systematically reviewed the diagnostic accuracy of the childhood TB diagnostic scoring systems and algorithms. Methods. We systematically searched PubMed, CINAHL, Embase, Scopus, and Google Scholar databases for relevant articles published until 30 March 2023. QUADAS-2 was used to assess their study quality. Diagnostic accuracy measures (ie, sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) were pooled using a random-effects model. Results. We included 15 eligible studies, with a total of 7327 study participants aged <15 years, with 10 evaluations of childhood TB diagnostic scoring systems and algorithms. Among these algorithms and scoring systems, only 3 were evaluated more than once. These were the Keith Edwards scoring system with 5 studies (sensitivity, 81.9%; specificity, 81.2%), Kenneth Jones criteria with 3 studies (sensitivity, 80.1%; specificity, 45.7%), and the Ministry of Health–Brazil algorithm with 3 studies (sensitivity, 79.9%; specificity, 73.2%). Conclusions. We recommend using the Keith Edwards scoring system because of its high sensitivity and specificity. Further research is necessary to assess the effectiveness of scoring systems and algorithms in identifying TB in children with HIV and malnutrition.
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    Invasive Fungal Diseases in Africa:
    (MDPI, 2022-11-22) Bongomin, Felix; Ekeng, Bassey E.; Kibone, Winnie; Nsenga, Lauryn; Olum, Ronald; Itam-Eyo, Asa; Ngouanom Kuate, Marius Paulin; Pebolo, Francis Pebalo; Davies, Adeyinka A; Manga, Musa; Ocansey, Bright; Kwizera, Richard; Baluku, Joseph Baruch
    Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.
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    Self-Reported Hypertension and Associated Factors Among Adults in Butambala District, Central Uganda: A Community-Based Prevalence Study
    (Integrated Blood Pressure Control, 2023-11-08) Male Kato, Alex; Kibone, Winnie; Okot, Jerom; Bongomin, Felix; Baluku, Joseph Baruch
    Background: The prevalence of hypertension (HTN) differs among regions and income groups, showing a substantial increase in low- and middle-income countries. The development of hypertension is modulated by modifiable lifestyle factors, and uncontrolled hypertension poses a risk for the onset of cardiovascular diseases. Objective: To determine the community-level point-prevalence and factors associated with self-reported HTN among adults in Butambala district, central Uganda. Methods: A community-based cross-sectional study was conducted among adults aged ≥18 years in Budde subcounty, central Uganda. Data on sociodemographic characteristics and behavior were collected using a semistructured questionnaire. Self-reported HTN was assessed using a single question: “Do you have high blood pressure?” Bivariate and multivariate logistic regression analyses were performed to identify predictors of self-reported HTN. Results: A total of 565 participants (53.5% female) with a median age of 38 years (IQR: 26–52) were included in the study. The prevalence of self-reported hypertension was 18.9%. Factors independently associated with HTN were age 60 years or older (aOR: 2.9, 95% CI: 1.64–5.23, p<0.001), female sex (aOR: 3.3, 95% CI: 2.3–6.3, p<0.001), being widowed (aOR: 10.4, 95% CI: 1.25–87.14, p=0.03), secondary (aOR: 0.4, 95% CI: 0.20–0.85, p=0.016) and tertiary (aOR: 0.2, 95% CI: 0.09–0.64, p=0.005) education,unemployment (aOR: 3.0, 95% CI: 1.11–7.96, p=0.03), tobacco use (aOR: 2.9, 95% CI: 1.83–4.53, p<0.001), having had at least one blood pressure measurement during antenatal visit (aOR: 4.7, 95% CI: 1.97–11.33, p<0.001) or medical checkup (aOR: 10.7, 95% CI: 6.06–18. Conclusion: We observed a high prevalence of self-reported HTN affecting approximately one in five participants. More efforts are required to enhance routine screening, health education, and accessibility to HTN services in rural areas, with a particular emphasis on implementing HTN prevention and control strategies to effectively reduce the prevalence of HTN