Infectious Diseases Institute (IDI)

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Browsing Infectious Diseases Institute (IDI) by Author "Aanyu-Tukamuhebwa, Hellen"
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    The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project
    (Elsevier, 2024) Kirenga, Bruce J. ; Chakaya, Jeremiah ; Yimer, Getnet ; Nyale, George ; Haile, Tewodros ; Muttamba, Winters ; Mugenyi, Levicatus ; Katagira, Winceslaus ; Worodria, William ; Aanyu-Tukamuhebwa, Hellen ; Lugogo, Njira ; Joloba, Moses ; Mersha, Tesfaye B. ; Bekele, Amsalu ; Fred Makumbi, Fred ; Mekasha, Amha ; Green, Cynthia L. ; de Jong, Corina ; Kamya, Moses ; van der Molen, Thys
    Background: Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. Objective: We sought to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethiopia. Methods: Using the American Thoracic Society/European Respiratory Society case definition of severe asthma, we analyzed for the prevalence of severe asthma (requiring Global Initiative for Asthma [GINA] steps 4-5 asthma medications for the previous year to achieve control) and severe refractory asthma (remains uncontrolled despite treatment with GINA steps 4-5 asthma medications) in a cohort of 1086 asthma patients who had been in care for 12 months and had received all GINA-recommended medications. Asthma control was assessed by the asthma control questionnaire (ACQ). Results: Overall, the prevalence of severe asthma and severe refractory asthma was 25.6% (95% confidence interval [CI], 23.1-28.3) and 4.6% (95% CI, 3.5-6.0), respectively. Patients with severe asthma were (nonsevere vs severe vs severe refractory) older (39, 42, 45 years, P = .011), had high skin prick test reactivity (67.1%, 76.0%, 76.0%, P = .004), had lower forced expiratory volume in 1 second percentage (81%, 61%, 55.5%, P < .001), had lower quality of life score (129, 127 vs 121, P < .001), and had higher activity impairment (10%, 30%, 50%, P < .001). Factors independently associated with severe asthma were hypertension comorbidity; adjusted odds ratio 2.21 (1.10-4.47), P = .027, high bronchial hyperresponsiveness questionnaire score; adjusted odds ratio 2.16 (1.01-4.61), P = .047 and higher ACQ score at baseline 2.80 (1.55-5.08), P = .001. Conclusion: The prevalence of severe asthma in Africa is high and is associated with high morbidity and poor quality of life.
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    Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda
    (BMJ, 2020) Kirenga, Bruce ; Muttamba, Winters ; Kayongo, Alex ; Nsereko, Christopher ; Siddharthan, Trishul ; Lusiba, John ; Mugenyi, Levicatus ; Byanyima, Rosemary K. ; Worodria, William ; Nakwagala, Fred ; Nantanda, Rebecca ; Kimuli, Ivan ; Katagira, Winceslaus ; Sentalo Bagaya, Bernard ; Nasinghe, Emmanuel ; Aanyu-Tukamuhebwa, Hellen ; Amuge, Beatrice ; Sekibira, Rogers ; Buregyeya, Esther ; Kiwanuka, Noah ; Muwanga, Moses ; Kalungi, Samuel ; Lutaakome Joloba, Moses ; Kateete, David Patrick ; Byarugaba, Baterana ; Kamya, Moses R. ; Mwebesa, Henry ; Bazeyo, William
    Rationale: Detailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited. Objective: We determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda. Measurements: As of the 16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive care, mechanical ventilation or death during hospitalisation. Main results: The median age was 34.2 years; 67.9% were male; and 14.6% were <18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever (21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue (7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and 7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of >130/90 mm Hg, and 27.8% had BP of >140/90 mm Hg. Laboratory derangements were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical recovery was shorter among patients who received HCQ, but this difference did not reach statistical significance. Conclusion: Most of the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory not similar to other countries. Outcomes did not differ by HCQ treatment status in line with other concluded studies on the benefit of using HCQ in the treatment of COVID-19