A5043234794- Tuberculosis Research and Epidemiology
- Pneumonia and Respiratory Infections
- Pneumocystis jirovecii pneumonia detection and treatment
- Health Policy Implementation Science
- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- Mobile Health and mHealth Applications
- ICT in Developing Communities
- HIV/AIDS Impact and Responses
- Mental Health and Patient Involvement
- Health Literacy and Information Accessibility
- Community Health and Development
- HIV, Drug Use, Sexual Risk
- Antibiotic Use and Resistance
- Behavioral Health and Interventions
- Primary Care and Health Outcomes
- Biosimilars and Bioanalytical Methods
- Pharmacological Effects and Toxicity Studies
- School Health and Nursing Education
- Hematological disorders and diagnostics
- Mycobacterium research and diagnosis
- Clinical Reasoning and Diagnostic Skills
- Digital Mental Health Interventions
- Healthcare Systems and Reforms
- HIV-related health complications and treatments
Makerere University
2016-2025
Uganda Virus Research Institute
2022-2023
Yale University
2017
Infectious Diseases Research Collaboration
2015
MUJHU Research Collaboration
2014
Studies of the quality tuberculosis (TB) diagnostic evaluation patients in high burden countries have generally shown poor adherence to international or national guidelines. Health worker perspectives on barriers improving TB are critical for developing clinic-level interventions improve guideline implementation.We conducted structured, in-depth interviews with staff at six district-level health centers Uganda elicit their perceptions regarding evaluation. Interviews were transcribed, coded...
Background. The effect of Xpert MTB/RIF (Xpert) scale-up on patient outcomes in low-income settings with a high tuberculosis (TB) burden has not been established. We sought to characterize the effectiveness as implemented across different levels healthcare system Uganda. Methods. reviewed laboratory records from 2012 2014 at 18 health facilities throughout In 8 facilities, had onsite since 2012, and 10 sites was available an offsite referral test another facility. describe testing volumes by...
<sec><title>BACKGROUND</title>Stigma is a barrier to care for people affected by TB and HIV in Uganda, where these conditions remain endemic. While scales have been adapted validated measure stigma among TB-affected households there need that the experiences of persons with (PWTB).</sec><sec><title>METHODS</title>We Van Rie 12-item individual perspectives scale 10-item use Uganda through cross-cultural discussions multidisciplinary research team four cognitive interviews community health...
Six district-level government health centers in rural Uganda and the surrounding communities.To determine pathways to care associated costs for patients with chronic cough referred tuberculosis (TB) evaluation Uganda.We conducted a cross-sectional study, surveying 64 presenting undergoing first-time sputum at clinics. We also surveyed random sample of 114 individuals communities. collected information on previous visits as well current visit.Eighty per cent clinic had previously sought their...
Setting Seven public tuberculosis (TB) units in Kampala, Uganda, where Uganda's national TB program recently introduced household contact investigation, as recommended by 2012 guidelines from WHO. Objective To apply a cascade analysis to implementation of investigation programmatic setting. Design Prospective, multi-center observational study. Methods We constructed for describe the proportions of: 1) index patient households recruited; 2) visited; 3) contacts screened TB; and 4) completing...
Abstract Background Communities of Practice (CoPs) offer an accessible strategy for healthcare workers to improve the quality care through knowledge sharing. However, not enough is known about which components CoPs are core facilitating behavior change. Therefore, we carried out a qualitative study address these important gaps in literature on and inform planning interventional CoPs. Methods We organized community health (CHWs) from two tuberculosis (TB) clinics Kampala, Uganda, into CoP...
Home sputum collection could facilitate prompt evaluation and diagnosis of tuberculosis (TB) among contacts patients with active TB. We analyzed barriers to home-based as part an enhanced intervention for household TB contact investigation in Kampala, Uganda.We conducted a convergent mixed-methods study describe the outcomes home 91 examine their context through 19 nested interviews two focus group discussions lay health workers (LHWs).LHWs collected from 35 (39%) contacts. Contacts...
Background Tuberculosis (TB) remains under-diagnosed in many countries, part due to poor evaluation practices at health facilities. Theory-informed strategies are needed improve implementation of TB guidelines. We aimed evaluate the impact performance feedback and same-day smear microscopy on quality 6 centers rural Uganda. Methods tested components a multi-faceted intervention adherence International Standards for Care (ISTC): microscopy. The were selected based qualitative assessment...
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,...
The objective of this prospective cross-sectional study, conducted at a national referral hospital in Kampala, Uganda, was to determine diagnostic performance serum C-reactive protein (CRP) as triage test for tuberculosis (TB) among HIV-seronegative inpatients. We calculated the sensitivity, specificity, positive and negative likelihood ratios, predictive values CRP enzyme-linked immunosorbent assay (ELISA) (Eurolyser) comparison that reference standard Mycobacterium culture on two sputum...
Abstract Background Implementation science offers a systematic approach to adapting innovations and delivery strategies new contexts but has yet be widely applied in low- middle-income countries. The Fogarty Center for Global Health Studies is sponsoring special series, “Global Science Case Studies,” address this gap. Methods We developed case study series describing our lessons learned while conducting prospective, multi-modal design, implement, evaluate an implementation strategy TB...
Improving childhood tuberculosis (TB) evaluation and care is a global priority, but data on performance at community health centers in TB endemic regions are sparse.
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...
Introduction Mobile health (mHealth) applications may improve timely access to services and patient-provider communication, but the upfront costs of implementation be prohibitive, especially in resource-limited settings. Methods We measured developing implementing an mHealth-facilitated, home-based strategy for tuberculosis (TB) contact investigation Kampala, Uganda, between February 2014 July 2017. compared routine involving community workers (CHWs) screening referring household contacts...
Percentages rounded to the nearest
The most common method for detection of drug resistant (DR) TB in resource-limited settings (RLSs) is indirect susceptibility testing on Lowenstein-Jensen medium (LJ) which very time consuming with results available only after 2–3 months. Effective therapy DR therefore markedly delayed and patients can transmit strains. Rapid accurate tests suitable RLSs the diagnosis are thus highly needed. In this study we compared two direct techniques - Nitrate Reductase Assay (NRA) Microscopic...
Setting Seven public tuberculosis (TB) units in Kampala, Uganda, where Uganda’s national TB program recently introduced household contact investigation, as recommended by 2012 guidelines from WHO. Objective To apply a cascade analysis to implementation of investigation programmatic setting. Design Prospective, multi-center observational study. Methods We constructed for describe the proportions of: 1) index patient households recruited; 2) visited; 3) contacts screened TB; and 4) completing...
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...
Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda.
Abstract Introduction Strong epidemiological links between human immunodeficiency virus (HIV) and tuberculosis (TB) may make household TB contact investigation an efficient strategy for HIV screening finding individuals in serodifferent partnerships at risk of linking them to prevention services. We aimed compare the proportions couples TB-affected households general population Kampala, Uganda. Methods included data from a cross-sectional trial counselling testing (HCT) context home-based...
Understanding the geographic distribution and factors associated with delayed TB diagnosis may help target interventions to reduce delays improve patient outcomes.
Since 2012, the World Health Organization has recommended household contact investigation as an evidence-based intervention to find and treat individuals with active tuberculosis (TB), most common infectious cause of death worldwide after COVID-19. Unfortunately, uptake this recommendation been suboptimal in low- middle-income countries, where majority affected reside, little is known about how effectively deliver service. Therefore, we undertook a systematic process design novel,...
Abstract Background Tuberculosis (TB) is among the leading causes of infectious death worldwide. Contact investigation an evidence-based, World Health Organisation-endorsed intervention for timely TB diagnosis, treatment, and prevention but has not been widely effectively implemented. Methods We are conducting a stepped-wedge, cluster-randomised, hybrid Type III implementation-effectiveness trial comparing user-centred to standard strategy implementing contact in 12 healthcare facilities...