Browsing by Author "Biraro, Samuel"

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    Efect of COVID‑19 pandemic on inpatient service utilization and patient outcomes in Uganda
    (Scientifc Reports, 2023) Andia‑Biraro, Irene; Baruch Baluku, Joseph; Olum, Ronald; Bongomin, Felix; Kyazze, Andrew Peter; Ninsiima, Sandra; Ssekamatte, Phillip; Kibirige, Davis; Biraro, Samuel; Seremba, Emmanuel; Kabugo, Charles
    COVID-19 has had devastating efects on health systems but reports from sub-Saharan Africa are few. We compared inpatient admissions, diagnostic tests performed, clinical characteristics and inpatient mortality before and during the COVID-19 pandemic at an urban tertiary facility in Uganda. We conducted a retrospective chart review of patients admitted at Kiruddu National Referral Hospital in Uganda between January–July 2019 (before the pandemic) and January–July 2020 (during the pandemic). Of 3749 inpatients, 2014 (53.7%) were female, and 1582 (42.2%) had HIV. There was a 6.1% decline in admissions from 1932 in 2019 to 1817 in 2020. There were signifcantly fewer diagnostic tests performed in 2020 for malaria, tuberculosis, and diabetes. Overall, 649 (17.3%) patients died. Patients admitted during the COVID-19 pandemic (adjusted odds ratio [aOR] 1.2, 95% confdence interval [CI] 1.04–1.5, p= 0.018), patients aged≥ 60 years (aOR 1.6, 95% CI 1.2–2.1, p= 0.001), HIV co-infected (aOR 1.5, 95% CI 1.2–1.9, p < 0.001), and those admitted as referrals (aOR 1.5, 95% CI 1.2–1.9, p < 0.001) had higher odds of dying. The COVID-19 pandemic disrupted inpatient service utilization and was associated with inpatient mortality. Policy makers need to build resilience in health systems in Africa to cope with future pandemics.
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    Performance and cost-effectiveness of a pooled testing strategy for SARS-CoV-2 using real-time polymerase chain reaction in Uganda
    (International Journal of Infectious Diseases, 2021-10-21) Bogerea, Naghib; Bongominb, Felix; Katende, Andrew; Ssebambuliddee, Kenneth; Ssengooba, Willy; Ssenfuka, Henry; Kigozi, Edgar; Biraro, Samuel; Kateete, David P.; Andia-Biraro, Irene
    Real-time polymerase chain reaction (RT-PCR) remains the gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study tested the performance of a pooled testing strategy for RT-PCR and its cost-effectiveness. In total, 1280 leftover respiratory samples collected be tween 19 April and 6 May 2021 were tested in 128 pools of 10 samples each, out of which 16 pools were positive. The positivity rate of the unpooled samples was 1.9% (24/1280). After parallel testing using the individual and pooled testing strategies, positive agreement was 100% and negative agree ment was 99.8%. The overall median cycle threshold (Ct) value of the unpooled samples was 29.8 (in terquartile range 22.3–34.3). Pools that remained positive when compared with the results of individ ual samples had lower median Ct values compared with those that turned out to be negative (28.8 versus 34.8; P=0.0.035). Pooled testing reduced the cost >4-fold. Pooled testing may be a more cost effective approach to diagnose SARS-CoV-2 in resource-limited settings without compromising diagnostic performance.