Publications - Uganda

Community-based interventions to improve and sustain antiretroviral therapy adherence, retention in HIV care and clinical outcomes in low- and middle-income countries for achieving the UNAIDS 90-90-90 targets

Post Date: 
2016-07-30
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Countries: 
Publication: 
Current HIV/AIDS Reports
Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically...

Association of medical male circumcision and antiretroviral therapy scale-up with community HIV incidence in Rakai, Uganda

Post Date: 
2016-07-12
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Publication: 
JAMA
Importance Medical male circumcision (MMC) and antiretroviral therapy (ART) are proven HIV prevention interventions, but there are limited data on the population-level effect of scale-up of these interventions in sub-Saharan Africa. Such evaluation is important for planning and resource allocation...

Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial

Post Date: 
2016-03-19
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Publication: 
The Lancet
Background: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical...

Effectiveness of peer support on care engagement and preventive care intervention utilization among pre-antiretroviral therapy, HIV-infected adults in Rakai, Uganda: a randomized trial

Post Date: 
2015-08-14
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Publication: 
AIDS and Behavior
442 pre-ART, HIV-infected adults were randomized to peer support consisting of structured home visits to promote clinic attendance and preventive care intervention use or standard of care. At baseline, 62 % reported previously visiting an HIV clinic, 45 % reported taking cotrimoxazole...

Impact of patient-selected care buddies on adherence to HIV care, disease progression and conduct of daily life among pre-antiretroviral HIV-infected patients in Rakai, Uganda: a randomized controlled trial

Post Date: 
2015-06-01
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Publication: 
Journal of Acquired Immune Deficiency Syndromes
Background: Data are limited on effects of household or community support persons ("care buddies") on enrollment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression, and conduct of daily life among...

Durable suppression of HIV-1 after virologic monitoring-based antiretroviral adherence counseling in Rakai, Uganda

Post Date: 
2015-05-26
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Publication: 
PLOS One
Objectives: HIV viral load is recommended for monitoring antiretroviral treatment and identifying treatment failure. We assessed the durability of viral suppression after viral load-triggered adherence counseling among patients with HIV viremia 6 months after ART initiation. ...

Predictors and outcomes of mycobacteremia among HIV-infected smear- negative presumptive tuberculosis patients in Uganda

Post Date: 
2015-02-15
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Publication: 
BMC Infectious Diseases
Background : Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB...

Is CD4 monitoring needed among Ugandan clients achieving a virologic and immunologic response to treatment?

Post Date: 
2014-11-15
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Countries: 
Publication: 
AIDS Patient Care and STDs
It is unclear whether ongoing CD4 monitoring is needed following immunologic and virologic response to antiretroviral therapy (ART). We investigated the proportion of clients who achieved a virologic and immunologic response and then had a subsequent CD4 count <200 cells/μL despite...

Diagnostic accuracy of a rapid urine lipoarabinomannan test for tuberculosis in HIV-infected adults

Post Date: 
2014-07-01
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Countries: 
Publication: 
Journal of Acquired Immune Deficiency Syndromes
Objective : In settings of high HIV prevalence, tuberculosis control and patient management are hindered by lack of accurate, rapid tuberculosis diagnostic tests that can be performed at point-of-care. The Determine TB LAM Ag (TB LAM) test is a lateral flow immunochromatographic test for...

Optimisation of the Medical Education Partnership Initiative to address African health-care challenges

Post Date: 
2014-06-25
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Publication: 
The Lancet Global Health
The Medical Education Partnership Initiative (MEPI) is an innovative and potentially transformative 5-year programme, established by the US Government in 2010, to increase the number of doctors to meet crucial human resource needs in sub-Saharan Africa.1 MEPI allows African institutions that...

Comparative performance of urinary lipoarabinomannan assays and Xpert MTB/RIF in HIV-infected individuals

Post Date: 
2014-06-01
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Countries: 
Publication: 
AIDS
Background : Xpert MTB/RIF ('Xpert') and urinary lipoarabinomannan (LAM) assays offer rapid tuberculosis (TB) diagnosis, but have suboptimal sensitivity when used individually in HIV-positive patients. The yield of these tests used in combination for the diagnosis of active TB among HIV-...

Socioeconomic determinants of mortality in HIV: evidence from a clinical cohort in Uganda

Post Date: 
2014-05-15
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Countries: 
Publication: 
Journal of Acquired Immune Deficiency Syndromes
Objective: To delineate the association between baseline socioeconomic status (SES) indicators and mortality and lost to follow-up (LTFU) in a cohort of HIV-infected individuals enrolled in antiretroviral therapy (ART) in urban Uganda. Design: Retrospective...

A consortium approach to competency-based undergraduate medical education in Uganda: process, opportunities and challenges

Post Date: 
2014-05-15
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Countries: 
Publication: 
Education for Health
Background: Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health...

Field evaluation of PIMA point-of-care CD4 testing in Rakai, Uganda

Post Date: 
2014-03-10
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Publication: 
PLOS One
Objective: To assess the accuracy of PIMA Point-of-Care (POC) CD4 testing in rural Rakai, Uganda. Methods: 903 HIV positive persons attending field clinics provided a venous blood sample assessed on site using PIMA analyzers per manufacturer's specifications. The...

The role of viral introductions in sustaining community-based HIV epidemics in rural Uganda: evidence from spatial clustering, phylogenics, and egocentric transmission models

Post Date: 
2014-03-04
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Countries: 
Publication: 
PLOS One
Background: It is often assumed that local sexual networks play a dominant role in HIV spread in sub-Saharan Africa. The aim of this study was to determine the extent to which continued HIV transmission in rural communities—home to two-thirds of the African population—is driven by intra-...

Cost-effectiveness of novel algorithms for rapid diagnosis of tuberculosis in HIV-infected individuals in Uganda

Post Date: 
2013-11-28
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Countries: 
Publication: 
AIDS
Objective : Xpert MTB/RIF ('Xpert') and urinary lateral-flow lipoarabinomannan (LF-LAM) assays offer rapid tuberculosis (TB) diagnosis. This study evaluated the cost-effectiveness of novel diagnostic algorithms utilizing combinations of Xpert and LF-LAM for the detection of active TB among...

A qualitative study of barriers to enrollment into free HIV care: perspectives of never-in-care HIV-positive patients and providers in Rakai, Uganda

Post Date: 
2013-07-23
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Publication: 
BioMed Research International
Background: Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5%) of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never...

Cost-utility of lateral-flow urine lipoarabinomannan for tuberculosis diagnosis in HIV-infected African adults

Post Date: 
2013-04-15
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Countries: 
Publication: 
International Journal of Tuberculosis and Lung Disease
Setting : In-patient hospitals in South Africa and Uganda. Objective : To evaluate the cost-effectiveness of a lateral-flow urine lipoarabinomannan (LAM) test when added to existing strategies for tuberculosis (TB) diagnosis in human immunodeficiency virus infected adults (...

Household-based HIV counseling and testing as a platform for referral to HIV care and medical male circumcision in Uganda: a pilot evaluation

Post Date: 
2012-12-13
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Publication: 
PLOS One
Background: Combination HIV prevention initiatives incorporate evidence-based, biomedical and behavioral interventions appropriate and acceptable to specific populations, aiming to significantly reduce population-level HIV incidence. Knowledge of HIV serostatus is key to linkages to HIV care...

Pooled individual data analysis of five randomized trials of infant nevirapine prophylaxis to prevent breast-milk HIV-1 transmission

Post Date: 
2012-10-19
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Publication: 
Clinical Infectious Diseases
Background: In resource-limited settings, mothers infected with human immunodeficiency virus type 1 (HIV-1) face a difficult choice: breastfeed their infants but risk transmitting HIV-1 or not breastfeed their infants and risk the infants dying of other infectious diseases or...

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