Jane Francis Ndyetukira
A5065915630- Fungal Infections and Studies
- Antifungal resistance and susceptibility
- Nail Diseases and Treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Cytomegalovirus and herpesvirus research
- Syphilis Diagnosis and Treatment
- HIV/AIDS Research and Interventions
- HIV/AIDS oral health manifestations
- Myasthenia Gravis and Thymoma
- Bacterial Infections and Vaccines
- Congenital Diaphragmatic Hernia Studies
- Whipple's Disease and Interleukins
- HIV Research and Treatment
- HIV-related health complications and treatments
- HIV, Drug Use, Sexual Risk
- HIV/AIDS drug development and treatment
- Adolescent Sexual and Reproductive Health
Makerere University
2018-2025
Infectious Diseases Institute
2018-2025
Botswana Harvard AIDS Institute Partnership
2024
London School of Hygiene & Tropical Medicine
2024
ABSTRACT Cryptococcal antigen screening is recommended among people living with AIDS when entering HIV care a CD4 count of <100 cells/μl, and preemptive fluconazole monotherapy treatment for those subclinical cryptococcal antigenemia. Yet, knowledge limited current antimicrobial resistance in Africa. We examined antifungal drug susceptibility 198 clinical isolates collected from Kampala, Uganda, between 2010 2014 using the CLSI broth microdilution assay. In comparison two previous studies...
Increased antiretroviral therapy (ART) availability has been associated with more patients developing cryptococcosis after ART initiation. Despite this changing epidemiology, data regarding cryptococcal meningitis in those already receiving are limited. We compared clinical presentations and outcomes among ART-naïve ART-experienced Ugandans.
Cryptococcal meningitis can occur in persons with less-apparent immunosuppression. We evaluated clinical characteristics and outcomes of HIV-related Cryptococcus presenting higher CD4 counts.We enrolled 736 participants from 2 prospective cohorts Uganda South Africa November 2010 to May 2017. compared <50, 50-99, or ≥100 cells/μL by characteristics, cerebrospinal fluid (CSF) parameters, 18-week survival.Among first episode cryptococcosis, 9% presented cells/μL. Participants more often...
Advanced HIV disease (AHD) is still a significant problem in Uganda despite the test-and-treat strategy and increased access to antiretroviral therapy (ART). Meningitis remains major cause of morbidity mortality people with AHD. counselling essential plays an important role managing persons AHD-related meningitis. We sought describe experiences challenges we faced during these individuals, highlighting strategies, gaps how can fill them. First, our experience Second, strategies used overcome...
Individuals with cryptococcal antigenemia are at high risk of developing meningitis if untreated. The progression and timing from asymptomatic infection to is unclear. We describe a subpopulation individuals neurologic symptomatic but negative cerebral spinal fluid (CSF) studies. evaluated 1201 human immunodeficiency virus–seropositive hospitalized suspected in Kampala Mbarara, Uganda. Baseline characteristics clinical outcomes participants neurologic–symptomatic CSF antigen (CrAg) were...
Abstract Background. Cerebrospinal fluid (CSF) cryptococcal glucuronoxylomannan antigen (CrAg) titers generally correlate with quantitative fungal culture burden; however, correlation is not precise. Some patients have higher CrAg lower burdens and vice versa. We hypothesized that the relative discordancy between titer burden reflects degree of shedding by Cryptococcus neoformans associated human immune responses. Methods. One hundred ninety immunodeficiency virus-infected individuals...
Introduction Health workers’ failure to adhere guidelines for screening, diagnosis and management of HIV-associated cryptococcal meningitis (CM) remains a significant public health concern. We aimed assess adherence the standards care HIV patients at risk CM per MoH stock supplies in period January June 2021 selected facilities (HFs) Uganda. Methods The study employed an observational cross-sectional design level workers clinical positive as Uganda, 2021in facilities. team used survey guide...
Abstract Background Sodium abnormalities are frequent in central nervous system infections and may be caused by cerebral salt wasting, syndrome of inappropriate antidiuretic hormone secretion, or medication adverse events. In cryptococcal meningitis (CM), the prevalence baseline hyponatremia whether adversely impacts survival is unknown. Methods We conducted a secondary analysis data from 2 randomized trials human immunodeficiency virus–infected adult Ugandans with CM. grouped serum sodium...
Background Nurses form a very important part of the health workforce in sub-Saharan Africa. Research nurses are critical to implementation clinical trials. The duties and responsibilities research nurse complex continue evolve as new practices guidelines formulated. Aims In this paper, we have highlighted major contributions HIV trials Africa from unique perspective Ugandan nurses. Methods requirements challenges two multi-site, randomised cryptococcal meningitis Uganda were assessed...
Abstract Background The EnACT trial was a phase 2 randomized clinical conducted in Uganda, which evaluated novel orally delivered lipid nanocrystal (LNC) amphotericin B combination with flucytosine for the treatment of cryptococcal meningitis. When (5FC) is used as monotherapy cryptococcosis, 5FC can induce resistant Cryptococcus mutants. Oral uses drug delivery mechanism, and we assessed whether resistance to develops during oral LNC–amphotericin therapy. Methods We enrolled Ugandans HIV...
Limited data exist on the antifungal activity of daily liposomal amphotericin B with flucytosine induction regimens for cryptococcal meningitis, which are recommended in high-income countries. Liposomal monotherapy at 3 mg/kg previously failed to meet noninferiority criteria compared deoxycholate its registrational clinical trial. We aimed compare quantitative and mortality between among persons human immunodeficiency virus (HIV)-related meningitis receiving adjunctive 100 mg/kg/day....
Cryptococcus is the commonest cause of adult meningitis in Africa, with 50%-70% experiencing increased intracranial pressure. Cerebral oximetry a noninvasive near-infrared spectroscopy technology to monitor percent regional cerebral tissue oxygenation (rSO2). We assessed if predicts mortality. performed within 14 days cryptococcal diagnosis on 121 Ugandans from April 2016 September 2017. evaluated baseline rSO2 association mortality by multivariable logistic regression and correlation other...
Amphotericin-induced phlebitis is a common infusion-related reaction in patients managed for cryptococcal meningitis. High-quality nursing care critical component to successful cryptococcosis treatment. We highlight the magnitude and main approaches management of amphotericin-induced challenges faced resource-limited settings.We prospectively determined incidence during clinical trials Kampala, Uganda from 2013 2018. relate practical strategies phlebitis.Overall, 696 participants were...
<ns3:p>Background In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with in research settings. However, liposomal (AmBisome) now available via efforts UNITAID. We sought describe our nursing experience using AmBisome within a clinical trial for meningitis. Methods single-dose 10mg/kg from perspective nurse Uganda. Second, we described process preparing and administering amphotericin....
Abstract Background Mortality among adults diagnosed with HIV-associated cryptococcal meningitis remains high (24%–40%). We hypothesized that nutritional state, as measured by mid–upper arm circumference (MUAC), is a potentially modifiable risk factor for mortality. Methods Ugandan hospitalized had MUAC measurements performed at baseline. compared baseline clinical and demographic variables investigated associations survival using Cox regression. Results Of 433 participants enrolled, 41%...
<ns3:p>Background In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with in research settings. However, liposomal (AmBisome) now available via efforts UNITAID. We sought describe our nursing experience using AmBisome within a clinical trial for meningitis. Methods single-dose 10mg/kg from perspective nurse Uganda. Second, we described process preparing and administering amphotericin....
Abstract Given extensive improvements in access to antiretroviral therapy (ART) over the past 12 years, HIV and cryptococcal meningitis landscapes have dramatically changed since 2010. We sought evaluate changes clinical presentation outcomes of people presenting with HIV-associated between 2010 2022 Uganda. analyzed three prospective cohorts HIV-infected Ugandans during 2010–2012, 2013–2017, 2018–2022. summarized baseline demographics, characteristics at presentation, 2-week 16-week...
<ns4:p>Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART people living with HIV. Despite this, advanced disease (CD4 less than 200 cells/mL) opportunistic infections remain a persistent challenge contribute significantly HIV-associated mortality, which equates 23,000 deaths Uganda 2018 alone. Our Meningitis Research Team based is committed...
<ns5:p>Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART all HIV-positive people. Despite this, advanced disease (CD4 less than 200 cells/mL) opportunistic infections remain a persistent challenge contribute significantly HIV-associated mortality, which equates 23,000 deaths Uganda 2018 alone. Our Meningitis Research Team based is committed...