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Quality of Sputum Specimen Samples Submitted for Culture and Drug Susceptibility Testing at the National Tuberculosis Reference Laboratory-Uganda, July-October 2013

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Journal of Tuberculosis Research 2015年第3期3卷 97-106页

作者： lilian bulage Joseph Imoko Bruce J. Kirenga Terry Lo Henry Byabajungu Keneth Musisi Moses Joloba Emily Bloss National Tuberculosis and Leprosy Programme Kampala Uganda National Tuberculosis Reference Laboratory Kampala Uganda World Health Organization Kampala Uganda Division of Pulmonary Medicine Department of Medicine Makerere University College of Health Sciences Kampala Uganda Centers for Disease Control and Prevention Atlanta USA

Setting: The Uganda National Tuberculosis Reference Laboratory (NTRL) in Kampala. Objective: The proportion of poor quality specimens received for drug susceptibility testing (DST) at the NTRL and factors contributing to poor specimen quality were assessed. Design: A cross-sectional study was conducted of sputum samples received at the NTRL from patients at high risk for multi-drug-resistant tuberculosis (MDR TB) during July-October 2013. Demographic, clinical, and bacte-riological data were abstracted from laboratory records. A poor quality sample failed to meet any one of four criteria: ≥3 milliliter (ml) volume, delivered within 72 hours, triple packaged, and non-salivary appearance. Results: Overall, 365 (64%) of 556 samples were of poor quality;89 (16%) were not triple packaged, 44 (8%) were <3 mls, 164 (30%) were not delivered on time, and 215 (39%) were salivary in appearance. Poor quality specimens were more likely to be collected during the eighth month of TB treatment (OR = 2.5, CI = 1.2 - 5.1), from the East or Northeast zones (OR = 2.2, CI = 1.1 - 4.8), and from patients who previously defaulted from treatment (OR = 1.9, CI = 1.1 - 3.2). Conclusion: The majority of sputum samples had poor quality. Additional efforts are needed to improve quality of samples collected at the end of treatment, from East and Northeast zones, and from patients who had previously defaulted.

关键词： Tuberculosis Sputum Specimen Quality Uganda

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A prolonged cholera outbreak caused by drinking contaminated stream water,Kyangwali refugee settlement,Hoima District,Western Uganda:2018

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Infectious Diseases of Poverty 2020年第6期9卷 107-108页

作者： Fred Monje Alex Riolexus Ario Angella Musewa Kenneth Bainomugisha Bernadette Basuta Mirembe Dativa Maria Aliddeki Daniel Eurien Godfrey Nsereko Carol Nanziri Esther Kisaakye Vivian Ntono Benon Kwesiga Daniel Kadobera lilian bulage Godfrey Bwire Patrick Tusiime Julie Harris Bao-Ping Zhu Uganda Public Health Fellowship Program KampalaUganda 不详

Background: On 23 February 2018,the Uganda Ministry of Health(MOH)declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement,Hoima District,bordering the Democratic Republic of Congo(DRC).We investigated to determine the outbreak scope and risk factors for transmission,and recommend evidence-based control ***:: We defined a suspected case as sudden onset of watery diarrhoea in any person aged≥2 years in Hoima District,1 February–9 May 2018.A confirmed case was a suspected case with Vibrio cholerae cultured from a stool *** found cases by active community search and record reviews at Cholera Treatment *** calculated case-fatality rates(CFR)and attack rates(AR)by sub-county and *** a case-control study,we compared exposure factors among case-and *** estimated the association between the exposures and outcome using Mantel-Haenszel *** conducted an environmental assessment in the refugee settlement,including testing samples of stream water,tank water,and spring water for presence of fecal *** tested suspected cholera cases using cholera rapid diagnostic test(RDT)kits followed by culture for ***: We identified 2122 case-patients and 44 deaths(CFR=2.1%).Case-patients originating from Demographic Republic of Congo were the most affected(AR=15/1000).The overall attack rate in Hoima District was 3.2/1000,with Kyangwali sub-county being the most affected(AR=13/1000).The outbreak lasted 4 months,which was a multiple *** assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for *** three water sources tested,only stream water was feacally-contaminated,yielding>100 CFU/100 *** 130 stool samples tested,124(95%)yielded *** by *** water was most strongly associated with illness(odds ratio[OR]=14.2,95%CI:1.5–133),although tank water also appeared to

关键词： Outbreak Cholera Refugees Uganda

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Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda

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World Journal of AIDS 2022年第2期12卷 43-54页

作者： lilian bulage Benedict Akimana Justine D. Namuli Seggane Musisi Josephine Birungi Micheal Etukoit Ramin Mojtabai Jean B. Nachega Edward J. Mills Etheldreda Nakimuli-Mpungu African Field Epidemiology Network Kampala Uganda Uganda Public Health Fellowship Program Kampala Uganda Ministry of Health Butabika National Referral Mental Hospital Kampala Uganda Department of Psychiatry College of Health Sciences Makerere University Kampala Uganda The AIDS Support Organization (TASO) Kampala Uganda Department of Mental Health Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Departments of Epidemiology Infectious Diseases and Microbiology Graduate School of Public Health University of Pittsburgh Pittsburgh USA Center for Infectious Disease Department of Medicine Faculty of Medicine and Health Sciences Stellenbosch University Cape Town South Africa Departments of International Health and Epidemiology Bloomberg’s School of Public Health Johns Hopkins University Baltimore USA Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton Canada

Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder;we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.

关键词： Depression Suicide Risk Anti-Retroviral Therapy Viral Suppression Uganda

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