A5073382005- Malaria Research and Control
- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- Mosquito-borne diseases and control
- Child Nutrition and Water Access
- Complement system in diseases
- Global Maternal and Child Health
- Sepsis Diagnosis and Treatment
- Blood donation and transfusion practices
- Parasites and Host Interactions
- Epilepsy research and treatment
- Neonatal Respiratory Health Research
- Poverty, Education, and Child Welfare
- Neonatal and fetal brain pathology
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Prenatal Screening and Diagnostics
- Liver Disease and Transplantation
- Blood transfusion and management
- Respiratory Support and Mechanisms
- Acute Kidney Injury Research
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Neuroinflammation and Neurodegeneration Mechanisms
- Global Health and Surgery
- Inflammation biomarkers and pathways
World Health Organization - Uganda
2020-2025
Makerere University
2016-2025
Aga Khan University Nairobi
2023-2025
Jinja Hospital
2019-2025
Infectious Diseases Research Collaboration
2025
Aga Khan University Hospital Nairobi
2025
Mulago Hospital
2015-2024
Aga Khan University
2023-2024
Nationwide Children's Hospital
2023
George Washington University
2023
The role of fluid resuscitation in the treatment children with shock and life-threatening infections who live resource-limited settings is not established.We randomly assigned severe febrile illness impaired perfusion to receive boluses 20 40 ml 5% albumin solution (albumin-bolus group) or 0.9% saline (saline-bolus per kilogram body weight no bolus (control at time admission a hospital Uganda, Kenya, Tanzania (stratum A); hypotension were one groups only B). All received appropriate...
Cerebral malaria affects >785000 African children every year. We previously documented an increased frequency of cognitive impairment in with cerebral 6 months after their initial episode. This study was conducted to determine the long-term effects on function these children.Children who were 5 12 years age and presented Mulago Hospital, Kampala, Uganda, (n = 44) or uncomplicated 54), along healthy, asymptomatic community 89), enrolled a prospective cohort cognition. Cognitive testing...
OBJECTIVE. This study was conducted to assess prospectively the frequency of cognitive deficits in children with cerebral malaria. METHODS. Cognitive testing areas working memory, attention, and learning performed for Ugandan 5 12 years age malaria (n = 44), uncomplicated 54), healthy community 89) at admission 3 6 months later. RESULTS. Six after discharge, 21.4% had deficits, compared 5.8% children. Deficits were seen memory (11.9% vs 2.3%) attention (16.7% 2.3%). Children a 3.7-fold...
Early rapid fluid resuscitation (boluses) in African children with severe febrileillnesses increases the 48-hour mortality by 3.3% compared controls (nobolus). We explored effect of boluses on all-cause byclinical presentation at enrolment, hemodynamic changes over first hour, andon different modes death, according to terminal clinical events. hypothesizethat may cause excess deaths from neurological or respiratory eventsrelating overload. Pre-defined syndromes (PS; acidosis...
Although millions of transfusions are given annually worldwide, the effect red blood cell (RBC) unit storage duration on oxygen delivery is uncertain.To determine if longer-storage RBC units not inferior to shorter-storage for tissue oxygenation as measured by reduction in lactate levels and improvement cerebral saturation among children with severe anemia.Randomized noninferiority trial 290 (aged 6-60 months), most malaria or sickle disease, presenting February 2013 through May 2015 a...
Background Limited tools exist to identify which individuals infected with Plasmodium falciparum are at risk of developing serious complications such as cerebral malaria (CM). The objective this study was assess serum biomarkers that differentiate between CM and non-CM, the long-term goal a clinically informative prognostic test for severe malaria. Methodology/Principal Findings Based on hypothesis endothelial activation blood-brain-barrier dysfunction contribute pathogenesis, we examined...
Cerebrospinal fluid (CSF) and serum levels of 12 cytokines or chemokines important in central nervous system (CNS) infections were measured 76 Ugandan children with cerebral malaria (CM) 8 control children. As compared children, had higher cerebrospinal interleukin (IL)-6, CXCL-8/IL-8, granulocyte-colony stimulating factor (G-CSF), tumor necrosis factor-alpha (TNF-alpha), IL-1 receptor antagonist. There was no correlation between cytokine for any except G-CSF. Elevated but not TNF-alpha on...
Cerebral malaria (CM) is associated with long-term neurocognitive impairment in children ≥5 years of age. No prospective studies to date have assessed CM <5 age, or severe malarial anemia (SMA), a form estimated affect as many 5 million annually.Children age presenting Mulago Hospital, Kampala, Uganda, (n = 80) SMA 86) were for overall cognitive ability, attention, and associative memory 1 week after discharge 6 12 months later. The z scores each domain computed based on 61 healthy community...
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.
Severe anaemia in children is a leading cause of hospital admission and major mortality sub-Saharan Africa, yet there are limited published data on blood transfusion this vulnerable group. We present from large controlled trial fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) the prevalence, clinical features, management presenting to hospitals three East African countries with serious febrile illness (predominantly malaria and/or sepsis) impaired peripheral...
Cerebral malaria (CM) and severe malarial anaemia (SMA) are associated with neuro-developmental impairment in African children, but long-term mental health disorders these children not well defined. A cohort of previously exposed to CM (n = 173) or SMA 99) had neurologic assessments performed screening for behaviour difficulties using the Strengths Difficulties Questionnaire (SDQ) a median 21 months after disease episode. These findings were compared concurrently recruited community (CC, n...
Acute kidney injury (AKI) is a recognized complication of pediatric severe malaria, but its long-term consequences are unknown.Ugandan children with cerebral malaria (CM, n = 260) and anemia (SMA, 219) or community (CC, 173) between 1.5 12 years age were enrolled in prospective cohort study. Kidney Disease: Improving Global Outcomes (KDIGO) criteria used to retrospectively define AKI chronic disease (CKD). Cognitive testing was conducted using the Mullen Scales Early Learning < 5 Kaufman...
The World Health Organization recommends not performing transfusions in African children hospitalized for uncomplicated severe anemia (hemoglobin level of 4 to 6 g per deciliter and no signs clinical severity). However, high mortality readmission rates suggest that less restrictive transfusion strategies might improve outcomes.In this factorial, open-label, randomized, controlled trial, we assigned Ugandan Malawian 2 months 12 years age with immediate 20 ml or 30 whole-blood equivalent...
Globally, 85% of acute kidney injury (AKI) cases occur in low-and-middle-income countries. There is limited information on persistent disease (acute [AKD]) following severe malaria-associated AKI.Between March 28, 2014, and April 18, 2017, 598 children with malaria 118 community were enrolled a two-site prospective cohort study Uganda followed up for 12 months. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria used to define AKI (primary exposure) AKD at 1-month follow-up...
After starting hydroxyurea treatment, Ugandan children with sickle cell anemia had 60% fewer severe or invasive infections, including malaria, bacteremia, respiratory tract and gastroenteritis, than before treatment (incidence rate ratio, 0.40 [95% confidence interval, 0.29-0.54]; P < .001).
Because antiretroviral treatment (ART) fails to improve neurocognitive impairment in children with HIV, we completed a pilot study evaluating the feasibility and cognitive benefit of computerized rehabilitation therapy (CCRT) Ugandan HIV.Sixty HIV (23 on ART) were randomly assigned 10 sessions Captain's Log CCRT (Sandford, 2007) training configured for attention memory skills or no intervention. Kaufman Assessment Battery Children (2nd ed., KABC-2; & Kaufman, 2004) performance at baseline...
Several interventions to improve cognition in at risk children have been suggested. Identification of key variables predicting is necessary guide these interventions. This study was conducted identify Ugandan and such interventions.A cohort 89 healthy (45 females) aged 5 12 years old were followed over 24 months had cognitive tests measuring visual spatial processing, memory, attention learning administered baseline, 6 months. Nutritional status, child's educational level, maternal...
Objective: Our earlier studies on Ugandan children surviving cerebral malaria showed cognitive deficits mainly in attention and memory. We now present the first study sub-Saharan Africa to investigate feasibility potential benefits of computerized rehabilitation training neuropsychological behavioral functioning malaria. Methods: A randomized trial which 65 admitted 45 months with were recruited at Mulago Hospital, Kampala, Uganda. For 8 weeks, 32 received weekly sessions using Captain's Log...
Mediational intervention for sensitizing caregivers (MISC) is a structured program enabling to enhance their child's cognitive and emotional development through daily interactions. The principal aim was evaluate if year-long MISC caregiver training produced greater improvement in child compared with control program.One hundred nineteen uninfected HIV-exposed preschool children were randomly assigned 1 of 2 treatment arms: biweekly alternating between home clinic year or health nutrition...
Nodding syndrome is a devastating neurological disorder of uncertain aetiology affecting children in Africa. There no diagnostic test, and risk factors symptoms that would allow early diagnosis are poorly documented. This study aimed to describe the clinical, electrophysiological brain imaging (MRI) features complications nodding Ugandan children.Case series.22 with brought Mulago National Referral Hospital for assessment.Clinical features, physical functional disabilities, EEG MRI findings...