Browsing by Author "Kyazze, Andrew Peter"

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    Anemia in Ugandan pregnant women: a cross-sectional, systematic review and meta-analysis study
    (Tropical medicine and health, 2021-02-19) Bongomin, Felix; Olum, Ronald; Kyazze, Andrew Peter; Ninsiima, Sandra; Nattabi, Gloria; Nakyagaba, Lourita; Nabakka, Winnie; Kukunda, Rebecca; Ssekamatte, Phillip; Kibirige, Davis; Cose, Stephen; Nakimuli, Annettee; Baruch Baluku, Joseph; Andia-Biraro, Irene
    Background: Anemia in pregnancy represents a global public health concern due to wide ranging maternal and neonatal adverse outcomes in all peripartum periods. We estimated the prevalence and factors associated with anemia in pregnancy at a national obstetrics and gynecology referral hospital in Uganda and in addition performed a systematic review and meta-analysis of the overall burden of anemia in pregnancy in Uganda. Methods: We conducted a cross-sectional study among 263 pregnant women attending the antenatal care clinic of Kawempe National Referral Hospital, Kampala, Uganda, in September 2020. Anemia in pregnancy was defined as a hemoglobin level of < 11.0 g/dl and microcytosis as a mean corpuscular volume (MCV) of < 76 fL. We also performed a systematic review (PROSPERO Registration ID: CRD42020213001) and meta-analysis of studies indexed on MEDLINE, Embase, African Journal Online, ClinicalTrials.gov, ICTRP, and the Cochrane Library of systematic review between 1 January 2000 and 31 September 2020 reporting on the prevalence of anemia in pregnancy in Uganda. Results: The prevalence of anemia was 14.1% (n= 37) (95%CI 10.4–18.8), of whom 21 (56.8%) had microcytic anemia. All cases of anemia occurred in the second or third trimester of pregnancy and none were severe. However, women with anemia had significantly lower MCV (75.1 vs. 80.2 fL, p<0.0001) and anthropometric measurements, such as weight (63.3 vs. 68.9kg; p=0.008), body mass index (25.2 vs. 27.3, p=0.013), hip (98.5 vs. 103.8 cm, p=0.002), and waist (91.1 vs. 95.1 cm, p=0.027) circumferences and mean systolic blood pressure (BP) (118 vs 125 mmHg, p=0.014). Additionally, most had BP within the normal range (59.5% vs. 34.1%, p=0.023). The comparison meta-analysis of pooled data from 17 published studies of anemia in pregnancy in Uganda, which had a total of 14,410 pregnant mothers, revealed a prevalence of 30% (95% CI 23–37). Conclusions: Despite our study having a lower prevalence compared to other studies in Uganda, these findings further confirm that anemia in pregnancy is still of public health significance and is likely to have nutritional causes, requiring targeted interventions. A larger study would be necessary to demonstrate potential use of basic clinical parameters such as weight or blood pressure as screening predictors for anemia in pregnancy.
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    Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review
    (Scientific Reports, 2023-11-11) Kibirige, Davis; Andia‑Biraro, Irene; Kyazze, Andrew Peter; Olum, Ronald; Bongomin, Felix; Mwanje Nakavuma, Rose; Ssekamatte, Phillip; Emoru, Reagan; Nalubega, Goretti; Chamba, Nyasatu; Kilonzo, Kajiru; Naftal Laizer, Sweetness; Elauteri Mrema, Lucy; Olomi, Willyhelmina; Minja, Lilian Tina; Ntinginya, Nyanda Elias; Sabi, Issa; Hill, Philip C.; te Brake, Lindsey; van Crevel, Reinout; Sharples, Katrina; Critchley, Julia
    Diabetes mellitus (DM) increases the risk of developing tuberculosis infection (TBI). However, the evidence on the burden and phenotypic characteristics of TBI in African patients with DM is limited. This study aimed to determine the prevalence and characterisation of TBI in native African patients living with DM. We searched PubMed, EMBASE, and African Journals Online for original studies reporting information on the prevalence and characteristics of TBI in adult Africans with DM. A forest plot was used to describe the pooled prevalence estimate of TBI and the corresponding 95% confdence intervals (CI). Six studies conducted in four African countries involving 721 participants with DM were included in this systematic review. The pooled prevalence estimate of TBI was 40% (95% CI 20–60%, I 2 = 98.52%, p< 0.001). Age ≥ 40 years and glycated haemoglobin levels independently predicted TBI positivity in patients with DM in three studies. Africans with DM have a high prevalence of TBI, especially those who are older or with poorly controlled diabetes. This justifes the need for studies to explore how to screen and manage TBI to avert the progression to active TB disease.
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    Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review
    (Springer Nature, 2023) Kibirige, Davis; Biraro, IreneAndia; Kyazze, Andrew Peter; Olum, Ronald; Bongomin, Felix; Nakavuma, Rose Mwanje; Ssekamatte, Phillip; Emoru, Reagan; Nalubega, Goretti; Chamba, Nyasatu; Kilonzo, Kajiru; Laizer, Sweetness Naftal; Mrema, Lucy Elauteri; Olomi, Willyhelmina; Minja, LilianTina; Ntinginya, Nyanda Elias; Sabi, Issa; Hill, Philip C.; Brake, Lindsey te; Crevel, Reinout van; Sharples, Katrina; Critchley, Julia
    Diabetes mellitus (DM) increases the risk of developing tuberculosis infection (TBI). However, the evidence on the burden and phenotypic characteristics of TBI in African patients with DM is limited. This study aimed to determine the prevalence and characterisation of TBI in native African patients living with DM. We searched PubMed, EMBASE, and African Journals Online for original studies reporting information on the prevalence and characteristics of TBI in adult Africans with DM. A forest plot was used to describe the pooled prevalence estimate of TBI and the corresponding 95% confdence intervals (CI). Six studies conducted in four African countries involving 721 participants with DM were included in this systematic review. The pooled prevalence estimate of TBI was 40% (95% CI 20–60%, I 2 = 98.52%, p< 0.001). Age ≥ 40 years and glycated haemoglobin levels independently predicted TBI positivity in patients with DM in three studies. Africans with DM have a high prevalence of TBI, especially those who are older or with poorly controlled diabetes. This justifes the need for studies to explore how to screen and manage TBI to avert the progression to active TB disease
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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.