A5077929488- Tuberculosis Research and Epidemiology
- Pneumonia and Respiratory Infections
- Global Maternal and Child Health
- Mycobacterium research and diagnosis
- Healthcare Systems and Reforms
- Respiratory viral infections research
- Child Nutrition and Water Access
- Mobile Health and mHealth Applications
- ICT in Developing Communities
- HIV/AIDS Impact and Responses
- HIV/AIDS Research and Interventions
- Genetics, Bioinformatics, and Biomedical Research
- Health Literacy and Information Accessibility
- Health Policy Implementation Science
- Mosquito-borne diseases and control
- Digital Imaging for Blood Diseases
- Infectious Diseases and Tuberculosis
- Digital Mental Health Interventions
- Gas Sensing Nanomaterials and Sensors
- SARS-CoV-2 and COVID-19 Research
- Pneumocystis jirovecii pneumonia detection and treatment
- Biomedical Text Mining and Ontologies
- Ethics in Clinical Research
- Chronic Disease Management Strategies
- Advanced Chemical Sensor Technologies
World Health Organization - Uganda
2024-2025
Uganda Virus Research Institute
2020-2024
Makerere University
2006-2022
Yale University
2017
Infectious Diseases Research Collaboration
2015
Mulago Hospital
2015
University of California, San Francisco
2006
San Francisco General Hospital
2006
BackgroundNon-sputum-based triage tests for tuberculosis are a priority ending tuberculosis. We aimed to evaluate the diagnostic accuracy of late-prototype Xpert MTB Host Response (Xpert HR) blood-based assay.MethodsWe conducted prospective study among outpatients with presumed in outpatient clinics Viet Nam, India, Philippines, Uganda, and South Africa. Eligible participants were aged 18 years or older reported cough lasting at least 2 weeks. excluded those receiving treatment preceding 12...
Sputum-based testing is a barrier to increasing access molecular diagnostics for tuberculosis (TB). Many people with TB are unable produce sputum, and sputum processing increases assay complexity cost. Tongue swabs emerging as an alternative but performance limits uncertain.
BackgroundDecentralised molecular testing for tuberculosis could reduce missed diagnoses and losses to follow-up in high-burden settings. The aim of this study was evaluate the cost cost-effectiveness Xpert Performance Evaluation Linkage Tuberculosis Care (XPEL-TB) strategy, a multicomponent strategy including decentralised tuberculosis, Uganda.MethodsWe conducted costing analysis nested pragmatic cluster-randomised trial onsite (decentralised) versus hub-and-spoke (centralised) with MTB/RIF...
Abstract Background Social and structural determinants of health (SDoH) are associated with tuberculosis (TB) outcomes but often unaddressed in TB care programs. We sought to describe the mechanism by which SDoH impact completion diagnostic evaluation Uganda using an implementation science framework rooted behavioral theory. Methods Trained research staff interviewed 24 purposively sampled adults undergoing at six community centers between February-August 2019. Framework analysis was used...
Abstract Background Many high burden countries are scaling-up GeneXpert® MTB/RIF (Xpert) testing for tuberculosis (TB) using a hub-and-spoke model. However, the effect of scale up on reducing TB has been limited. We sought to characterize variation in implementation referral-based Xpert across Uganda, and identify health system factors that may enhance or prevent high-quality services. Methods conducted cross-sectional study triangulating quantitative qualitative data sources at 23 community...
Studies of malaria in well-defined cohorts offer important data about the epidemiology this complex disease, but few have been done urban African populations. To generate a sampling frame for longitudinal study incidence and treatment Kampala, Uganda, census, mapping survey project was conducted.All households geographically defined area were enumerated mapped. Probability used to recruit representative sample children collect baseline descriptive future studies.16,172 residents living 4931...
Effective strategies are needed to facilitate the prompt diagnosis and treatment of tuberculosis in countries with a high burden disease.We conducted cluster-randomized trial which Ugandan community health centers were assigned multicomponent diagnostic strategy (on-site molecular testing for tuberculosis, guided restructuring clinic workflows, monthly feedback quality metrics) or routine care sputum-smear microscopy referral-based testing). The primary outcome was number adults treated...
Abstract Background Recognizing new and improved diagnostics as a key step to reducing the global tuberculosis (TB) burden, World Health Organization (WHO) publishes target product profiles (TPPs) guide development of novel TB diagnostics; however, TPPs have not included preferences people undergoing testing. Understanding their is crucial for optimizing acceptability uptake diagnostic services. Design/methods We conducted discrete choice experiment (DCE) among adults with presumptive or...
To assess malaria-related prevention and treatment strategies in an urban parish of Kampala, Uganda, a questionnaire was administered to 339 randomly selected primary caregivers children 1-10 years age. Our study population relatively stable well educated, with better access health services than many Africa. Ownership insecticide-treated net (ITN) reported by 11% households predicted only greater household wealth (highest quartile versus lowest quartile: odds ratio [OR] 21.8; 95% confidence...
Little information exists about mobile phone usage or preferences for tuberculosis (TB) related health communications in Uganda.We surveyed household contacts of TB patients urban Kampala, Uganda, and clinic rural central Uganda. Questions addressed access, usage, TB-related communications. We collected qualitative data messaging preferences.We enrolled 145 203 attendees. Most (58%) attendees (75%) owned a phone, while 42% 10% shared one; 94% knew how to receive short service (SMS) message,...
Pre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by Short-Messaging-Service (SMS) increasingly being considered as a solution, but there limited information about its feasibility public health tool low resourced settings.We sought assess the of utilizing SMS technology deliver TB during routine diagnostic evaluation Uganda.We conducted single arm interventional pilot study at four community centers...
Globally, countries are increasingly prioritizing the reduction of health inequalities and provision universal coverage. While national benchmarking has become more common, such work at subnational levels is rare. The timely rigorous measurement local trends in key interventions outcomes vital to identifying areas progress detecting early signs stalled or declining system performance. Previous studies have yet provide a comprehensive assessment Uganda's maternal child (MCH) landscape level....
To assess the feasibility of a streamlined strategy for improving tuberculosis (TB) diagnostic evaluation and treatment initiation among patients with presumed TB.D E S I G N : Single-arm interventional pilot study at five primary care health centers streamlined, SIngle-saMPLE (SIMPLE) TB strategy: 1) examination two smear results from single spot sputum specimen using light-emitting diode fluorescence microscopy, 2) daily transportation smearnegative samples to Xpert w MTB/RIF testing...
Abstract Background Delays in diagnosis and treatment of tuberculosis (TB) remain common high-burden countries. To improve case detection, substantial investments have been made to scale-up Xpert MTB/RIF (Xpert), a cartridge-based nucleic acid amplification test that can detect TB within 2 hours, as replacement for sputum smear microscopy. However, the optimal strategy implementation testing remains unclear. Methods The Performance Evaluation Linkage Tuberculosis Care (XPEL-TB) trial uses an...
Many high-burden countries are scaling-up Xpert MTB/RIF using a hub-and-spoke model. We evaluated the quality of care for patients undergoing TB evaluation at microscopy centers (spokes) linked to testing sites (hubs) in Uganda.To characterize extent which were receiving accordance with international and national guidelines.We conducted prospective cohort study all adults presumptive pulmonary 24 health sites. Health center staff photographed registers, uploaded photos secure server...
Abstract Background Newer molecular testing platforms are now available for deployment at lower-level community health centers. There limited data on facility- and worker-level factors that would promote successful adoption of such rapid tuberculosis (TB) treatment initiation. Our study aimed to assess readiness implement onsite centers in Uganda, a high TB burden country sub-Saharan Africa. Methods To understand implementation readiness, we conducted qualitative assessment guided by the...
We assessed attitudes and perceptions willingness to accept (WTA) varying incentive structures for completing tuberculosis (TB) diagnostic evaluation among patients in Uganda.We surveyed 177 adult undergoing TB at 10 health centers between September 2018 March 2019. collected household sociodemographic information of incentives. regarding their complete exchange incentives ranging value from 500 Ugandan shillings (USh) 25 000USh (~$0.15-$6.75). compared associations WTA patient...
Background Mitigating financial barriers to tuberculosis (TB) diagnosis and treatment is a core priority of the global TB agenda. We evaluated impact cash transfer intervention on completion testing initiation in Uganda. Methods conducted pragmatic complete stepped wedge randomised trial one-time unconditional at 10 health centres between September 2019 March 2020. People referred for sputum-based were enrolled receive UGX 20 000 (∼USD 5.39) upon sputum submission. The primary outcome was...
Abstract Background The World Health Organization (WHO) recommends household contact investigation for tuberculosis (TB) in high-burden countries. However, contacts who complete evaluation TB during may have difficulty accessing their test results. Use of automated short-messaging services (SMS) to deliver results could improve status awareness and linkage care. We sought explore how experience delivered via SMS, these experiences influence follow-up intentions. Methods conducted...
Reliance on sputum-based testing is a key barrier to increasing access molecular diagnostics for tuberculosis (TB). Many people with TB are unable produce and sputum processing increases the complexity cost of assays. Tongue swabs emerging as an alternative sputum, but performance limits uncertain.