A5004747457- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- Child Nutrition and Water Access
- Prenatal Screening and Diagnostics
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Bone and Joint Diseases
- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- Blood donation and transfusion practices
- HIV Research and Treatment
- Malaria Research and Control
- Childhood Cancer Survivors' Quality of Life
- Blood groups and transfusion
- Advances in Oncology and Radiotherapy
- Digital Imaging for Blood Diseases
- Pituitary Gland Disorders and Treatments
- Acute Myeloid Leukemia Research
- Acute Lymphoblastic Leukemia research
- Hemophilia Treatment and Research
- Cerebral Palsy and Movement Disorders
- Infant Development and Preterm Care
- Neonatal Respiratory Health Research
- Autopsy Techniques and Outcomes
- Hepatitis C virus research
- Pregnancy and preeclampsia studies
Makerere University
2016-2025
Mulago Hospital
2011-2024
Baylor College of Medicine Children’s Foundation
2023
Carol Davila University of Medicine and Pharmacy
2023
Hydroxyurea has proven safety, feasibility, and efficacy in children with sickle cell anemia sub-Saharan Africa, studies showing a reduced incidence of vaso-occlusive events mortality. Dosing standards remain undetermined, however, whether escalation to the maximum tolerated dose confers clinical benefits that outweigh treatment-related toxic effects is unknown.
Co-trimoxazole (fixed-dose trimethoprim-sulfamethoxazole) prophylaxis administered before antiretroviral therapy (ART) reduces morbidity in children infected with the human immunodeficiency virus (HIV). We investigated whether and adolescents receiving long-term ART sub-Saharan Africa could discontinue co-trimoxazole.We conducted a randomized, noninferiority trial of stopping versus continuing daily open-label co-trimoxazole Uganda Zimbabwe. Eligible participants were older than 3 years age,...
Introduction The neurocognitive functions in Ugandan children aged 1–12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings identify risk factors for disease-associated impairment. Methods This cross-sectional study of the SCA ( N = 242) and 127) used age- linguistically appropriate standardized tests cognition, executive function, attention ages 1–4 5–12. Test scores converted locally derived age-normalized z -scores. group underwent a stroke examination prior...
Abstract Introduction Transcranial doppler ultrasound (TCD) screening for primary stroke prevention in children with sickle cell anemia (SCA) was established higher-resource regions, targeting interventions highest velocity (“abnormal”). We sought to identify additional risk factors Uganda. Methods conducted a 30-month open-label single-arm Ugandan hydroxyurea trial, dose-escalated maximum tolerated dose, aimed test brain protection aged 3-9 years SCA. Study procedures included history,...
ABSTRACT Introduction Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub‐Saharan Africa (SSA) may be at risk of disease‐associated difficulties. Limited data exist on this topic among school‐age children the region. We aimed to assess academic a sample SCA Uganda compared unaffected controls. Methods This cross‐sectional study was conducted Kampala, Uganda. Participants were...
ABSTRACT Introduction Transcranial Doppler ultrasound (TCD) screening for primary stroke prevention in children with sickle cell anemia (SCA) was established higher‐resource regions, targeting interventions highest velocity (“abnormal”). We sought to identify additional risk factors Uganda. Methods conducted a 30‐month open‐label single‐arm Ugandan hydroxyurea trial, dose‐escalated maximum‐tolerated dose, aimed test brain protection aged 3–9 years SCA. Study procedures included history,...
The bioequivalence of formulations is usually evaluated in healthy adult volunteers. In our study 19 HIV–1–infected Ugandan children (1.8–4 years age, weight 12 to <15 kg) receiving zidovudine, lamivudine, and abacavir solutions twice a day for ≥24 weeks, the use scored tablets allowed comparison plasma pharmacokinetics oral vs. tablets. Samples were collected 0, 1, 2, 4, 6, 8, h after each child's last morning dose solution before changing Combivir (coformulated zidovudine + lamivudine)...
Background: Sickle cell anemia (SCA), one of most prevalent monogenic diseases worldwide, is caused by a glutamic acid to valine substitution on the beta globin protein hemoglobin, which leads hemolytic anemia. Hydroxyurea, only disease-modifying therapy approved Food and Drug Administration for SCA, has proven be viable therapeutic option SCA patients in resource-rich settings, given clinical improvements experienced while taking medication its once-daily oral dosing. Significant studies...
Mineral bone disorders (MBD) are common in sickle cell anemia (SCA). Frequent vaso-occlusive crises (VOC) further impact MBD children with SCA. We evaluated the prevalence of markers SCA-related (sMBD) hospitalized and assessed relationship between sMBD individual mineral abnormalities kidney disease.We prospectively recruited 185 SCA a VOC. Serum measures metabolism (calcium, phosphate, parathyroid hormone, 25-hydroxy vitamin D, FGF23, osteopontin) were measured at enrollment. The primary...
Abstract Background Children with sickle cell anemia (SCA) are highly susceptible to stroke and other manifestations of pediatric cerebral vasculopathy. Detailed evaluations in sub-Saharan Africa limited. Methods We aimed establish the frequency types brain injury a cross-sectional study at large SCA clinic Kampala, Uganda randomly selected sample 265 patients HbSS ages 1–12 years. Brain was defined as one or more abnormality on standardized testing: neurocognitive impairment using an...
The disease burden of sickle cell anemia (SCA) in sub-Saharan African (SSA) countries is substantial, with many children dying without an established diagnosis or proper treatment. global SCA increasing each year, making therapeutic intervention a high priority. Hydroxyurea the only disease-modifying therapy proven feasibility and efficacy suitable for SSA; however, no one has quantified health economic implications its use. Therefore, from perspective care provider, we estimated incremental...
Treatment of HIV-1 infected Ugandan children with antiretroviral therapy (ART) is increasing, but few prospective long-term studies evaluating the treatment process have been reported. In this study, we sought to determine prospectively how consistent monitoring RNA levels affects ART process.One hundred eight initiating were enrolled into study. These had comprehensive laboratory monitoring, including level determination and genotype analysis (where appropriate), CD4% plus absolute counts...
Children with sickle cell anemia (SCA) in Sub-Saharan Africa are at high risk of cerebrovascular injury (SCVI). Hydroxyurea, a commonly used disease-modifying therapy, may prevent or decrease SCVI for reduced incident stroke, stroke and potentially cognitive dysfunction. We aim to test the impact daily hydroxyurea therapy on these outcomes Ugandan children SCA. hypothesize that over 36 months will prevent, stabilize improve complications The BRAIN SAFE II study is an open-label, single-arm...
Background: Antiretroviral therapy (ART) adherence is critical for successful HIV treatment outcomes. Once-daily dosing could improve adherence. Plasma concentrations of once-daily vs twice-daily abacavir + lamivudine are bioequivalent in children, but no randomized trial has compared virological Methods: Children taking lamivudine-containing first-line regimens twice daily more than 36 weeks the ARROW (NCT02028676, ISRCTN24791884) were to continue move (open-label). Co-primary outcomes...
Sickle Cell Disease (SCD) is the leading genetic disease in sub-Saharan Africa and therefore remains a global public health threat. Use of complementary alternative medicines (CAM) most especially herbal medicine (HM) chronic diseases such as sickle cell has widely been reported where advanced technologies are greatly lacking. Despite large presence Uganda, extent to which used management children with not documented. This study purposed determine prevalence use associated factors among...
Cerebrovascular injury frequently occurs in children with sickle cell anaemia (SCA). Limited access to magnetic resonance imaging and angiography (MRI-MRA) sub-Saharan Africa impedes detection of clinically unapparent cerebrovascular injury. Blood-based brain biomarkers cerebral infarcts have been identified non-SCA adults. Using plasma samples from a well-characterized cross-sectional sample Ugandan SCA, we explored relationships between biomarker levels MRI-detected transcranial Doppler...
Pulmonary cryptococcosis is rare in immunocompetent individuals. Limited data exist regarding its occurrence children, especially developing countries. This case report describes an 8-year-old HIV-negative child with pulmonary cryptococco- sis, previously diagnosed and treated for tuberculosis twice without improvement. Fine needle aspiration biopsy confirmed the diagnosis of serum cryptococcal antigen test was positive. The improved on am- photericin fluconazole treatment. Despite limited...
Children with cerebral palsy (CP) frequently experience chronic pain. The burden and severity of such pain is often underestimated in relation to their other impairments. Recognition awareness this among children CP constitute the cornerstone for caretakers clinicians improve quality life those children. This study aimed determine prevalence CP, factors associated.A cross-sectional aged 2-12 years, attending rehabilitation clinic Pediatric Neurology Clinic at Mulago Hospital, Uganda from...