@article{huerga2023novel,

title = {Novel FujiLAM assay to detect tuberculosis in HIV-positive ambulatory patients in four African countries: a diagnostic accuracy study},

author = {Helena Huerga and Mathieu Bastard and Alex Vicent Lubega and Milcah Akinyi and Natalia Tamayo Antabak and Liesbet Ohler and Winnie Muyindike and Ivan Mugisha Taremwa and Rosanna Stewart and Claire Bossard and others},

year  = {2023},

date = {2023-01-01},

journal = {The Lancet Global Health},

volume = {11},

number = {1},

pages = {e126--e135},

publisher = {Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ryckman2023ending,

title = {Ending tuberculosis in a post-COVID-19 world: a person-centred, equity-oriented approach},

author = {Theresa Ryckman and Katherine Robsky and Lucia Cilloni and Stella Zawedde-Muyanja and Ramya Ananthakrishnan and Emily A Kendall and Sourya Shrestha and Stavia Turyahabwe and Achilles Katamba and David W Dowdy},

year  = {2023},

date = {2023-01-01},

journal = {The Lancet Infectious Diseases},

volume = {23},

number = {2},

pages = {e59--e66},

publisher = {Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{bahr2023recurrence,

title = {Recurrence of symptoms following cryptococcal meningitis: characterizing a diagnostic conundrum with multiple etiologies},

author = {Nathan C Bahr and Caleb P Skipper and Kathy Huppler-Hullsiek and Kenneth Ssebambulidde and Bozena M Morawski and Nicole W Engen and Edwin Nuwagira and Carson M Quinn and Prashanth S Ramachandran and Emily E Evans and others},

year  = {2023},

date = {2023-01-01},

journal = {Clinical Infectious Diseases},

volume = {76},

number = {6},

pages = {1080--1087},

publisher = {Oxford University Press US},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{bulterys2023him,

title = {“Him Leaving Me--That is My Fear Now”: A Mixed Methods Analysis of Relationship Dissolution Between Ugandan Pregnant and Postpartum Women Living with HIV and Their Male Partners},

author = {Michelle A Bulterys and Andrew Mujugira and Agnes Nakyanzi and Monique A Wyatt and Brenda Kamusiime and Vicent Kasiita and Grace Nalukwago Kakoola and Alisaati Nalumansi and Collins Twesigye and Emily E Pisarski and others},

year  = {2023},

date = {2023-01-01},

journal = {AIDS and Behavior},

volume = {27},

number = {6},

pages = {1776--1792},

publisher = {Springer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{mwebaza2023prevalence,

title = {Prevalence of neuropsychiatric adverse events and associated factors among adult patients on dolutegravir attending Mulago ISS clinic},

author = {Joyce Mwebaza and David Meya and Victor Musiime and Caroline Birungi},

year  = {2023},

date = {2023-01-01},

journal = {HIV medicine},

volume = {24},

number = {4},

pages = {491--501},

publisher = {Wiley Online Library},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Méndez-Sánchez2022,

title = {Global multi-stakeholder endorsement of the MAFLD definition},

author = {Nahum Méndez-Sánchez and Elisabetta Bugianesi and Robert G Gish and Frank Lammert and Herbert Tilg and Mindie H Nguyen and Shiv K Sarin

and Núria Fabrellas and Shira Zelber-Sagi and Jian-Gao Fan and Gamal Shiha and Giovanni Targher and Ming-Hua Zheng and Wah-Kheong Chan

Shlomo Vinker and Takumi Kawaguchi and Laurent Castera and Yusuf Yilmaz and Marko Korenjak and C Wendy Spearman and Mehmet Ungan and Melissa Palmer and Mortada El-Shabrawi and Hans-Juergen Gruss and Jean-François Dufour and Anil Dhawan and Heiner Wedemeyer and Jacob George and Luca Valenti and Yasser Fouad and Manuel Romero‐Gomez and Mohammed Eslam and the Global multi-stakeholder consensus on the redefinition of fatty liver disease.

},

url = {https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00062-0/fulltext#%20},

doi = {https://doi.org/10.1016/S2468-1253(22)00062-0},

year  = {2022},

date = {2022-05-01},

journal = {The Lancet; Gastroentology & Hepatology},

volume = {7},

number = {5},

pages = {388-390},

abstract = {Comprising over 1000 signatories representative of multiple stakeholders, including hepatologists, internists, diabetologists, endocrinologists, paediatricians, primary-care providers, nephrologists, cardiologists, pathologists, patient advocates, nurses, nutritionists, and pharmaceutical experts from over 134 countries, we—the undersigned—endorse both the name metabolic (dysfunction)-associated fatty liver disease (MAFLD) as an overarching term and its definition for fatty liver diseases associated with metabolic dysregulation. 1, 2, 3 We advocate for this change because it more accurately reflects the underlying pathogenesis of the disease than does the previously used term, non-alcoholic fatty liver disease (NAFLD). Furthermore, we believe that this designation will enhance our ability to advance the science of fatty liver disease and to improve patient care. 4, 5

This open letter represents the voices of individuals and multiple stakeholders across the global liver health community; it is not intended to devalue any other initiative, but to complement and inform them.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Cresswell2022,

title = {Implementation of long-acting antiretroviral therapy in low-income and middle-income countries. },

author = { Fiona V. Cresswell and Mohammed Lamorde },

url = {https://www.ingentaconnect.com/content/wk/coh/2022/00000017/00000003/art00004},

doi = {https://doi.org/10.1097/COH.0000000000000732},

year  = {2022},

date = {2022-05-01},

journal = {Current Opinion in HIV and AIDS},

volume = {17},

number = {3},

pages = {127-134},

abstract = { Purpose of review



With oral antiretroviral therapy, HIV has become a manageable chronic illness. However, UNAIDS targets for virologic suppression have not yet been attained in many low-income and middle-income countries (LMICs). Long-acting drug formulations hold promise to improve treatment outcomes. In this rapidly evolving area of research, we aim to review recent literature on the treatment of HIV with long-acting agents and identify implementation considerations for LMICs.



Recent findings



Randomized controlled trials have shown that monthly long-acting injectable cabotegravir (CAB) and rilpivirine (RPV) is noninferior to oral ART, and 2-monthly CAB/RPV is noninferior to monthly injections. However, few people from LMICs were included. A modelling study predicts that in sub-Saharan Africa, injectable CAB/RPV is best targeted to those with poor adherence (HIV viral load >1000 copies/ml) in whom cost-effectiveness is greatest and risk of contributing to further resistance is no greater than continuation of oral ART. Other promising agents, such as lenacapavir are under investigation and may prove particularly useful in heavily treatment-experienced adults.



Summary



Long-acting regimens are a promising advance in HIV treatment. By extending the dosing interval, increasing convenience and being discreet these regimens may reduce HIV treatment challenges. However, there are multiple implementation considerations in LMICs including the need for exclusion of hepatitis B, cold chain, oral bridging in case of missed dosing and switching during tuberculosis therapy. Efficacy and safety data are also awaited for settings without routine access to baseline resistance testing or regular viral load monitoring and for special populations, such as pregnancy, children and the elderly. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lofgren2022,

title = {Can COVID-19 changes reduce stigma in African HIV clinics?},

author = {Sarah M Lofgren and Joanita Kigozi and Nakita G Natala and Sharon Tsui and Anita Arinda and Vanessa Akinyange and Raymond Sebuliba and David R Boulware and Barbara Castelnuovo},

url = {https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00045-5/fulltext},

doi = {https://doi.org/10.1016/S2352-3018(22)00045-5},

year  = {2022},

date = {2022-05-01},

journal = {The Lancet HIV},

volume = {9},

number = {5},

pages = {e304-e305},

abstract = {There is an extensive body of literature showing that HIV stigma is a barrier to HIV care at every level of the care cascade.1

HIV stigma reduces HIV testing, disclosure, engagement in treatment, adherence to medication, and retention in care.2

Stigma is also related to poor social support and increased depression, both of which worsen health outcomes.1

HIV stigma interventions that have been proposed and completed globally show small, targeted changes in stigma; however, overall, the efficacy of stigma interventions is disappointing,3, 4 perhaps because interventions are often designed by those outside the communities served. Thus, although further work on stigma interventions is vital, particularly those that have been initiated locally with the involvement of community members, perhaps in order to improve HIV care the focus should be shifted to clinic systems.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Melendez2022,

title = {Retrospective Analysis of Ugandan Men with Urethritis Reveals Mycoplasma genitalium and Associated Macrolide Resistance},

author = {Johan H. Melendez, Justin Hardick, Annet Onzia, Tong Yu, Peter Kyambadde, Rosalind Parkes-Ratanshi, Edith Nakku-Joloba, Agnes Kiragga, Yukari C. Manabe, Matthew M. Hamill},

doi = {https://doi.org/10.1128/spectrum.02304-21},

year  = {2022},

date = {2022-04-27},

journal = {Microbiology Spectrum},

volume = {10},

number = {2},

pages = {e0230421},

abstract = {The rising rates of antimicrobial resistance (AMR) in Mycoplasma genitalium globally and the association of this sexually transmitted infection (STI) with cervicitis, urethritis, and HIV are potentially of great public health concern. Data on the epidemiology of M. genitalium in men in sub-Saharan Africa are limited. We sought to determine the prevalence of M. genitalium and macrolide resistance in men with urethritis in Kampala, Uganda. Self-collected penile-meatal swabs and/or urine samples from men with symptomatic urethritis (n = 250) were retrospectively analyzed for the presence of M. genitalium and macrolide resistance markers with the Aptima M. genitalium and ResistancePlus M. genitalium assays. Additionally, demographic and STI coinfection data were used to investigate associations with M. genitalium infection. M. genitalium was detected in 12.8% (32/250) of individuals; 40.6% (n = 13) had M. genitalium monoinfection. Mutations associated with macrolide resistance were detected in 10.7% (3/28) of participants. Coinfection with Neisseria gonorrhoeae was common (41.0%), but M. genitalium was more prevalent in participants without N. gonorrhoeae coinfection (P = 0.001). M. genitalium is common in Ugandan men with urethritis both as a monoinfection and as a coinfection with other curable STIs. Macrolide resistance was present and warrants further research on treatment outcomes and the association between untreated M. genitalium and subsequent morbidity.



IMPORTANCE Mycoplasma genitalium is a common sexually transmitted infection associated with urethritis in men. Little is known about M. genitalium infection in men with urethritis in Uganda. We report that 12% of participants in this study were positive for M. genitalium and that resistance to azithromycin, a macrolide antibiotic, is present. Furthermore, we show that either self-collected penile-meatal swabs or urine can be used for detection of M. genitalium.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{V2022d,

title = {The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge? },

author = {Lazarus Jeffrey V and Mark Henry E and Villota-Rivas Marcela and Palayew Adam and Carrieri Patrizia and Colombo Massimo and Ekstedt Mattisia and Esmat Gamal and George Jacob and Marchesini Gilio and Novak Katja and Ocama Ponsiano and Ratziu Vlad and Razavi Homie and Romero-Gómez Manuel and Silva Marcelo, Spearman C. Wendy and Tacke Frank and Tsochatzis Emmanuel A and Yilmaz Yusuf and Younossi Zobair M. and Wong Vincent W.-S and Zelber-Sagi Shira and Cortez-Pinto Helena and Anstee Quentin M. and NAFLD policy review collaborators. },

url = {https://pubmed.ncbi.nlm.nih.gov/34895743/},

year  = {2022},

date = {2022-04-20},

volume = {76},

number = {4},

pages = {771-780},

abstract = {Background & Aims

Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas.



Methods

We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied.



Results

The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guidelines were present in only 32 countries.



Conclusions

Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels.



Lay summary

Around a third of the countries scored a zero on the NAFLD policy preparedness index, with no country scoring over 50/100. Although NAFLD is a pressing public health problem, a comprehensive public health response is lacking in all 102 countries. Policies and strategies to address NAFLD at the national and global levels are urgently needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{NI2022d,

title = {Efficacy and safety of dolutegravir or darunavir in combination with lamivudine plus either zidovudine or tenofovir for second-line treatment of HIV infection (NADIA): week 96 results from a prospective, multicentre, open-label, factorial, randomised, non-inferiority trial},

author = {Nicholas I Paton and Joseph Musaazi and Cissy Kityo and Stephen Walimbwa and Anne Hoppe and Apolo Balyegisawa and Jesca Asienzo and Arvind Kaimal and Grace Mirembe and Abbas Lugemwa and Gilbert Ategeka and Margaret Borok and Henry Mugerwa and Abraham Siika and Eva Laker A Odongpiny and Barbara Castelnuovo and Agnes Kiragga and Andrew Kambugu and NADIA Trial Team},

url = {https://pubmed.ncbi.nlm.nih.gov/35460601/},

doi = {10.1016/S2352-3018(22)00092-3.},

year  = {2022},

date = {2022-04-20},

journal = {Lancet HIV.},

volume = {9},

number = {6},

pages = {e381-e393},

abstract = {Background: WHO guidelines recommend dolutegravir plus two nucleoside reverse transcriptase inhibitors (NRTIs) for second-line HIV therapy, with NRTI switching from first-line tenofovir to zidovudine. We aimed to examine whether dolutegravir is non-inferior to darunavir, the best-in-class protease inhibitor drug, and whether maintaining tenofovir in second-line therapy is non-inferior to switching to zidovudine.



Methods: In this prospective, multicentre, open-label, factorial, randomised, non-inferiority trial (NADIA), participants with confirmed HIV first-line treatment failure (HIV-1 RNA ≥1000 copies per mL) were recruited at seven clinical sites in Kenya, Uganda, and Zimbabwe. Following a 2 × 2 factorial design and stratified by site and screening HIV-1 RNA concentration, participants were randomly assigned (1:1:1:1) to receive a 96-week regimen containing either dolutegravir (50 mg once daily) or ritonavir-boosted darunavir (800 mg of darunavir plus 100 mg of ritonavir once daily) in combination with either tenofovir (300 mg once daily) plus lamivudine (300 mg once daily) or zidovudine (300 mg twice daily) plus lamivudine (150 mg twice daily). The NRTI drugs allocated by randomisation were administered orally in fixed-dose combination pills; other drugs were administered orally as separate pills. The previously reported primary outcome was the proportion of participants with a plasma HIV-1 RNA concentration of less than 400 copies per mL at 48 weeks. Here, we report the main secondary outcome: the proportion of participants with a plasma HIV-1 RNA concentration of less than 400 copies per mL at 96 weeks (non-inferiority margin 12%). We analysed this outcome and safety outcomes in the intention-to-treat population, which excluded only those who were randomly assigned in error and withdrawn before receiving trial drugs. This study was registered at ClinicalTrials.gov, NCT03988452, and is complete.



Findings: Between July 30 and Dec 18, 2019, we screened 783 patients and enrolled 465. One participant was randomly assigned in error and immediately withdrawn. The remaining 464 participants were randomly assigned to receive either dolutegravir (n=235) or ritonavir-boosted darunavir (n=229) and to receive lamivudine plus either tenofovir (n=233) or zidovudine (n=231). At week 96, 211 (90%) of 235 participants in the dolutegravir group and 199 (87%) of 229 participants in the darunavir group had HIV-1 RNA less than 400 copies per mL (percentage point difference 2·9, 95% CI -3·0 to 8·7), indicating non-inferiority. Nine (4%) participants (all in the dolutegravir group) developed dolutegravir resistance; no participants developed darunavir resistance (p=0·0023). In the other randomised comparison, 214 (92%) of 233 patients in the tenofovir group and 196 (85%) of 231 patients in the zidovudine group had HIV-1 RNA less than 400 copies per mL (percentage point difference 7·0, 95% CI 1·2 to 12·8), showing non-inferiority and indicating the superiority of tenofovir (p=0·019). The proportions of participants with any grade 3-4 adverse event were similar between the dolutegravir (26 [11%]) and darunavir (28 [12%]) groups and between the tenofovir (22 [9%]) and zidovudine (32 [14%]) groups. There were no deaths related to study medication.



Interpretation: Dolutegravir-based and darunavir-based regimens maintain good viral suppression during 96 weeks; dolutegravir is non-inferior to darunavir but is at greater risk of resistance in second-line therapy. Tenofovir should be continued in second-line therapy, rather than being switched to zidovudine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nankya-Mutyoba2022,

title = {A training for health care workers to integrate hepatitis B care and treatment into routine HIV care in a high HBV burden, poorly resourced region of Uganda: the ‘2for1’ project},

author = {Joan Nankya-Mutyoba, David Ejalu, Claude Wandera, Rachel Beyagira, Jacinto Amandua, Emmanuel Seremba, Kaggwa Mugagga, Andrew Kambugu, Alex Muganzi, Philippa Easterbrook & Ponsiano Ocama },

doi = {https://doi.org/10.1186/s12909-022-03329-3},

year  = {2022},

date = {2022-04-20},

journal = {BMC Medical Education volume},

volume = {22},

number = {297},

abstract = {Introduction



The “2for1” project is a demonstration project to examine the feasibility and effectiveness of HBV care integrated into an HIV clinic and service. An initial phase in implementation of this project was the development of a specific training program. Our objective was to describe key features of this integrated training curriculum and evaluation of its impact in the initial cohort of health care workers (HCWs).



Methods



A training curriculum was designed by experts through literature review and expert opinion. Key distinctive features of this training program (compared to standard HBV training provided in the Government program) were; (i) Comparison of commonalities between HIV and HBV (ii) Available clinic- and community-level infrastructure, and the need to strengthen HBV care through integration (iii) Planning and coordination of sustained service integration. The training was aided by a power-point guided presentation, question and answer session and discussion, facilitated by physicians and hepatologists with expertise in viral hepatitis. Assessment approach used a self-administered questionnaire among a cohort of HCWs from 2 health facilities to answer questions on demographic information, knowledge and attitudes related to HBV and its prevention, before and after the training. Knowledge scores were generated and compared using paired t- tests.



Results



A training curriculum was developed and delivered to a cohort of 44 HCWs including medical and nursing staff from the two project sites. Of the 44 participants, 20 (45.5%) were male, average age (SD) was 34.3 (8.3) with an age range of 22–58 years. More than half (24, 54.5%) had been in service for fewer than 5 years. Mean correct knowledge scores increased across three knowledge domains (HBV epidemiology and transmission, natural history and treatment) post-intervention. However, knowledge related to diagnosis and prevention of HBV did not change.



Conclusion



A structured HBV education intervention conducted as part of an HIV/HBV care integration training for health care workers yielded improved knowledge on HBV and identified aspects that require further training. This approach may be replicated in other settings, as a public health strategy to heighten HBV elimination efforts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Buyego2022,

title = {Feasibility of Virtual Reality based Training for Optimising COVID-19 Case Handling in Uganda},

author = {Paul Buyego and Elizabeth Katwesigye, Grace Kebirungi, Mike Nsubuga, and Shirley Nakyejwe, Phillip Cruz, Meghan McCarthy, and Darrell Hurt, Andrew Kambugu, Joseph Walter Arinaitwe, and Umaru Ssekabira, Daudi Jjingo, Daudi Jjingo},

doi = { doi: 10.21203/rs.3.rs-882147/v1},

year  = {2022},

date = {2022-04-13},

journal = {Research Square},

volume = {22},

number = {1:274},

pages = {21},

abstract = {Background



Epidemics and pandemics are causing high morbidity and mortality on a still-evolving scale exemplified by the COVID-19 pandemic. Infection prevention and control (IPC) training for frontline health workers is thus essential. However, classroom or hospital ward based training portends an infection risk due to the in-person interaction of participants. We explored the use of Virtual Reality (VR) simulations for frontline health worker training since it trains participants without exposing them to infections that would arise from in-person training. It does away with the requirement for expensive Personal Protective Equipment (PPE) that has been in acute shortage and improves learning, retention and recall. This represents the first attempt in deploying VR-based pedagogy in a Ugandan medical education context.



Methods



We used animated VR-based simulations of bedside and ward-based training scenarios for frontline health workers. The training covered the wearing and stripping of PPE, case management of COVID-19 infected individuals and hand hygiene. It used VR headsets and Graphics Processing Units (GPUs) to actualize an immersive experience, via a hybrid of VR renditions and 360degrees videos. We then compared the level of knowledge acquisition between individuals trained using this method to comparable cohorts previously trained in a classroom setting. That evaluation was supplemented by a qualitative assessment based on feedback from participants about their experience.



Results



The effort resulted into a well-designed COVID-19 IPC VR curriculum, equivalent VR content and a pioneer cohort of trained frontline health workers. The formalized comparison with classroom-trained cohorts showed relatively better outcomes by way of skills acquired, speed of learning and rates of information retention (P-value =4.0e-09) - suggesting the effectiveness and feasibility of VR as a medium of medical training. Additionally, in the qualitative assessment 90% of the participants rated the method as very good, 58.1% strongly agreed that the activities met the course objectives, and 97.7 % strongly indicated willingness to refer the course to colleagues.



Conclusion



VR-based COVID-19 IPC training is feasible, effective and achieves enhanced learning while protecting participants from infections within a pandemic context in Uganda. It is a delivery medium transferable to the contexts of other highly infectious diseases.



Keywords: 

Virtual Reality, COVID-19, Personal Protective Equipment, Medical Education, Pandemics},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ravicz2022,

title = {Using Intervention Mapping methodology to design an HIV linkage intervention in a refugee settlement in rural Uganda},

author = {Miranda Ravicz, Bernadette Muhongayire, Stella Kamagaju, Robin E. Klabbers, Zikama Faustin, Andrew Kambugu, Ingrid Bassett & Kelli O’Laughlin},

doi = {https://doi.org/10.1080/09540121.2021.1900532},

year  = {2022},

date = {2022-04-01},

journal = {AIDS, Care},

volume = {34},

number = {4},

pages = {446-458},

abstract = {Nearly 80 million people have been forcibly displaced by persecution, violence, and disaster. Displaced populations, including refugees, face health challenges such as resource shortages, food and housing insecurity, violence, and disrupted social support. People living with HIV in refugee settings have decreased engagement with HIV services compared to non-refugee populations, and interventions are needed to enhance linkage to care. However, designing health interventions in humanitarian settings is challenging. We used Intervention Mapping (IM), a six-step method for developing theory- and evidence-based health interventions, to design a program to increase linkage to HIV care for refugees and Ugandan nationals in Nakivale Refugee Settlement in Uganda. We engaged a diverse group of stakeholders (N = 14) in Nakivale, including community members and humanitarian actors, in an interactive workshop focusing on IM steps 1–4. We developed a chronic care program that would integrate HIV care with services for hypertension and diabetes at accessible community sites, thereby decreasing stigma around HIV treatment and improving access to care. IM provided an inclusive, efficient method for integrating community members and program implementers in the intervention planning process, and can be used as a method-driven approach to intervention design in humanitarian settings.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lazarus2022,

title = {The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?},

author = {Lazarus JV, Mark HE, Villota-Rivas M, Palayew A, Carrieri P, Colombo M, Ekstedt M, Esmat G, George J, Marchesini G, Novak K, Ocama P, Ratziu V, Razavi H, Romero-Gómez M, Silva M, Spearman CW, Tacke F, Tsochatzis EA, Yilmaz Y, Younossi ZM, Wong VW, Zelber-Sagi S, Cortez-Pinto H, Anstee QM; NAFLD policy review collaborators},

doi = {https://doi.org/10.1016/j.jhep.2021.10.025},

year  = {2022},

date = {2022-04-01},

journal = {Journal of Hepatology},

volume = {76},

number = {4},

pages = {771-780},

abstract = {Background & Aims



Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas.



Methods



We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied.



Results



The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guidelines were present in only 32 countries.



Conclusions



Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels.



Lay summary



Around a third of the countries scored a zero on the NAFLD policy preparedness index, with no country scoring over 50/100. Although NAFLD is a pressing public health problem, a comprehensive public health response is lacking in all 102 countries. Policies and strategies to address NAFLD at the national and global levels are urgently needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mohamed2022,

title = {Fungal CNS Infections in Africa: The Neuroimmunology of Cryptococcal Meningitis},

author = {Sally H. Mohamed, Tinashe K. Nyazika, Kenneth Ssebambulidde, Michail S. Lionakis, David B. Meya and Rebecca A. Drummondcorresponding author },

doi = {doi: 10.3389/fimmu.2022.804674},

year  = {2022},

date = {2022-04-01},

journal = {Front Immunol},

volume = {13},

pages = {804674. },

abstract = {Cryptococcal meningitis (CM) is the leading cause of central nervous system (CNS) fungal infections in humans, with the majority of cases reported from the African continent. This is partly due to the high burden of HIV infection in the region and reduced access to standard-of-care including optimal sterilising antifungal drug treatments. As such, CM is responsible for 10-15% of all HIV-related mortality, with a large proportion being preventable. Immunity to the causative agent of CM, Cryptococcus neoformans, is only partially understood. IFNγ producing CD4+ T-cells are required for the activation of myeloid cells, especially macrophages, to enable fungal killing and clearance. However, macrophages may also act as a reservoir of the fungal yeast cells, shielding them from host immune detection thus promoting latent infection or persistent chronic inflammation. In this chapter, we review the epidemiology and pathogenesis of CNS fungal infections in Africa, with a major focus on CM, and the antifungal immune pathways operating to protect against C. neoformans infection. We also highlight the areas of research and policy that require prioritisation to help reduce the burden of CNS fungal diseases in Africa.



Keywords: 

microglia, cryptococcal meningitis, fungal infection, astrocyte, HAART},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Srishyla2022,

title = {Determinants of cryptococcal antigen (CrAg) screening uptake in Kampala, Uganda: An assessment of health center characteristics},

author = {Diksha Srishyla, Gabriel Saemisch, Fred Turya, Elizabeth Nalintya, Samuel Jjunju, Enock Kagimu, Morris K Rutakingirwa, Caleb P Skipper, David R Boulware, David B Meya, Radha Rajasingham},

doi = {https://doi.org/10.1093/mmy/myac013},

year  = {2022},

date = {2022-04-01},

journal = {Medical Mycology},

volume = {60},

number = {4},

pages = {myac013},

abstract = {Abstract



Cryptococcal antigen (CrAg) screening and pre-emptive antifungal therapy for people with CD4 cell counts <100 cells/μl are recommended by the World Health Organization and several national HIV guidelines. We sought to evaluate CrAg screening program implementation across Uganda, in relation to health center level and distance from the capital. We conducted a cross-sectional study of 22 health centers across southern Uganda from April to June 2019. We reviewed laboratory records regarding number of CD4 cell count tests performed, proportion of outpatients with CD4 counts <200 cells/μl, and number of CrAg screening tests performed. We administered surveys to health center staff to understand barriers to advanced HIV care. We observed no significant difference in health center level and performance of CrAg screening; with each subsequent health center level, there was 1.17-fold (95% CI: 0.92–1.41) higher odds of CrAg screening performed per level. CrAg screening uptake was not associated with distance from the capital city (odds ratio = 0.96, 95% CI: 0.89–1.04). Qualitative data from surveys indicated that limitations to uptake of CrAg screening were secondary to dysfunctional CD4 machines, lack of provider awareness of CrAg screening guidelines, and inadequate/intermittent supply of CrAg tests. There were no significant associations between CrAg screening uptake and level of health center or distance of health center from the capital city. We identified systemic barriers to CrAg screening related to inadequate CD4 testing, insufficient knowledge regarding national screening guidelines, and irregular laboratory testing supplies.



Lay summary



The objective of this study was to evaluate cryptococcal antigen (CrAg) screening program implementation in Uganda, by type of healthcare center and by distance from the capital city. CrAg screening uptake was not associated with distance from the capital city, or the type of healthcare center.



Key Terms

Cryptococcal screening, advanced HIV disease, cryptococcal meningitis, implementation science



Topic:



hiv antifungal agents cryptococcal meningitis cd4 count determination procedure health status laboratory techniques and procedures outpatients uganda world health organization cryptococcus guidelines hiv infections cryptococcal polysaccharide test screening test hiv guidelines implementation },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wagner2022,

title = {Social network-based group intervention to promote HIV prevention in Uganda: study protocol for a cluster randomized controlled trial of Game Changers},

author = {Glenn J. Wagner, Laura M. Bogart, Harold D. Green, Erik D. Storholm, David J. Klein, Ryan K. McBain, Richard Serunkuuma, Kuraish Mubiru, Joseph K. B. Matovu & Stephen Okoboi },

doi = {https://doi.org/10.1186/s13063-022-06186-z},

year  = {2022},

date = {2022-03-28},

journal = {Trials},

volume = {23},

number = {233},

abstract = {Introduction



Innovative strategies are needed to disseminate HIV prevention messages across communities efficiently, as well as reduce HIV stigma while promoting HIV prevention. This randomized controlled trial will evaluate the efficacy of a social network-based group intervention, Game Changers, which trains persons living with HIV (PLWH) to encourage members of their social network to use HIV protective behaviors



Methods



PLWH in HIV care for at least 1 year will be randomly assigned to receive the 8-session group advocacy training intervention or no-intervention control group. Each enrolled PLWH (index participant) will be asked to recruit up to four social network members (alter participant). Assessments will be administered at baseline and months 6, 12, and 18 to both index and alter participants. The primary outcomes are HIV testing and condom use among alter participants; secondary outcomes are engagement in HIV prevention advocacy and internalized HIV stigma among index participants. Repeated-measures multivariable regression analyses will be conducted to compare outcomes between the intervention and control arms, in addition to a cost-effectiveness evaluation.



Discussion



This social network-based approach to HIV prevention is particularly timely in the era of biomedical interventions, which require widespread penetration of effective HIV prevention and care messaging into communities. Positioning PLWH as central to the solution for controlling (vs. causing) the HIV epidemic has the potential to reduce HIV stigma and improve prevention outcomes at the individual and network levels.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Jarvis2022,

title = {Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis.},

author = {Joseph N. Jarvis, David S. Lawrence, David B. Meya, Enock Kagimu, John Kasibante, Edward Mpoza, Morris K. Rutakingirwa, Kenneth Ssebambulidde, Lillian Tugume, Joshua Rhein, David R. Boulware, Henry C. Mwandumba, Melanie Moyo, Henry Mzinganjira, Cecilia Kanyama, Mina C. Hosseinipour, Chimwemwe Chawinga, Graeme Meintjes, Charlotte Schutz, Kyla Comins, Achita Singh, Conrad Muzoora, Samuel Jjunju, Edwin Nuwagira, Mosepele Mosepele, Tshepo Leeme, Keatlaretse Siamisang, Chiratidzo E. Ndhlovu, Admire Hlupeni, Constantine Mutata, Erik van Widenfelt, Tao Chen, Duolao Wang, William Hope, Timothée Boyer-Chammard, Angela Loyse, Síle F. Molloy, Nabila Youssouf, Olivier Lortholary, David G. Lalloo, Shabbar Jaffar and Thomas S. Harrison, M.D. for the Ambition Study Group},

doi = {DOI: 10.1056/NEJMoa2111904},

year  = {2022},

date = {2022-03-24},

journal = {The New England Journal of Medicine},

volume = {386},

number = {12},

pages = {1109-1120},

abstract = {Background

Cryptococcal meningitis is a leading cause of human immunodeficiency virus (HIV)–related death in sub-Saharan Africa. Whether a treatment regimen that includes a single high dose of liposomal amphotericin B would be efficacious is not known.



Methods



In this phase 3 randomized, controlled, noninferiority trial conducted in five African countries, we assigned HIV-positive adults with cryptococcal meningitis in a 1:1 ratio to receive either a single high dose of liposomal amphotericin B (10 mg per kilogram of body weight) on day 1 plus 14 days of flucytosine (100 mg per kilogram per day) and fluconazole (1200 mg per day) or the current World Health Organization–recommended treatment, which includes amphotericin B deoxycholate (1 mg per kilogram per day) plus flucytosine (100 mg per kilogram per day) for 7 days, followed by fluconazole (1200 mg per day) for 7 days (control). The primary end point was death from any cause at 10 weeks; the trial was powered to show noninferiority at a 10-percentage-point margin.



Results



A total of 844 participants underwent randomization; 814 were included in the intention-to-treat population. At 10 weeks, deaths were reported in 101 participants (24.8%; 95% confidence interval [CI], 20.7 to 29.3) in the liposomal amphotericin B group and 117 (28.7%; 95% CI, 24.4 to 33.4) in the control group (difference, −3.9 percentage points); the upper boundary of the one-sided 95% confidence interval was 1.2 percentage points (within the noninferiority margin; P<0.001 for noninferiority). Fungal clearance from cerebrospinal fluid was −0.40 log10 colony-forming units (CFU) per milliliter per day in the liposomal amphotericin B group and −0.42 log10 CFU per milliliter per day in the control group. Fewer participants had grade 3 or 4 adverse events in the liposomal amphotericin B group than in the control group (50.0% vs. 62.3%).



Conclusions



Single-dose liposomal amphotericin B combined with flucytosine and fluconazole was noninferior to the WHO-recommended treatment for HIV-associated cryptococcal meningitis and was associated with fewer adverse events. (Funded by the European and Developing Countries Clinical Trials Partnership and others; Ambition ISRCTN number, ISRCTN72509687. opens in new tab.)},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Link2022,

title = {Delays in Cryptococcal Meningitis Diagnosis and Care: A Mixed Methods Study in Rural Uganda},

author = {Abigail Link, Mark Okwir, Betty Nabongo, David Meya, Sarah Iribarren, Paul Bohjanen and Danuta Kasprzyk},

doi = {doi: 10.5334/aogh.3524},

year  = {2022},

date = {2022-03-18},

journal = {Annals of Global Health.},

volume = {88},

number = {1},

pages = {22},

abstract = {Background:



Cryptococcal meningitis (CM) remains a major cause of mortality for HIV-infected persons in sub-Saharan Africa, despite widespread access to antiretroviral therapy. Delays in CM diagnosis and treatment contribute to high mortality, with patients often arriving “too late” for treatment to be effective. Little is known about patient-related delays and their experiences with CM.



Objectives:



This study seeks to identify the factors related to delays in diagnosis and care among patients with cryptococcal meningitis.



Methods:



A convergent mixed-methods approach was used to understand delays related to diagnosis and treatment of CM among patients admitted to Lira Regional Referral Hospital in rural northern Uganda. We collected data from February to March 2020 using surveys followed by semi-structured interviews from 20 CM patients who survived hospitalization and 20 family members of deceased patients during February 2017–November 2019. Interviews were audio-recorded, transcribed, and thematically coded for analysis.



Findings:



Delays to CM care were related to 1) self-medication, 2) lack of CM education, 3) seeking treatment multiple times at health centers with 4) missed/misdiagnosis, and 5) cultural factors. Among patients who died, 70% sought care ≥3 times, while those who survived, 35% of sought care ≥3 times before CM diagnosis. Only 10% of patients and 40% of family members knew what caused CM, indicating a lack of knowledge.



Conclusions:



Patients sought medical care for CM symptoms, but several factors contributed to CM diagnosis and care delays. Many of these factors relate to a lack of CM education and knowledge among patients and providers. A CM awareness campaign for the general public, targeted education for HIV patients, and continuing medical education for healthcare providers can decrease delays and improve outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Enock2022,

title = {Evaluation of the initial 12 months of a routine cryptococcal antigen screening program in reduction of HIV-associated cryptococcal meningitis in Uganda},

author = {Kagimu Enock, Kiwanuka Julius, Bridget C. Griffith, Derrick Bary Abila, Morris K. Rutakingirwa, John Kasibante, Kiiza Tadeo Kandole, Richard Kwizera, Aggrey Semeere & David B. Meya },

doi = {https://doi.org/10.1186/s12913-022-07624-z},

year  = {2022},

date = {2022-03-04},

journal = {BMC Health Services Research},

volume = {22},

pages = {301},

abstract = {Background



Asymptomatic Cryptococcal Antigenemia (CrAg) patients develop meningitis within a month of testing positive. Pre-emptive antifungal therapy can prevent progression to Cryptococcal meningitis (CM). In April 2016, a national CrAg screening program was initiated in 206 high-volume health facilities that provide antiretroviral therapy in Uganda. We report the evaluation of the CrAg screening cascade focusing on linkage to care, fluconazole therapy for 10 weeks and 6 months follow up, and ART initiation in a subset of facilities.



Methods



We conducted a retrospective, cross-sectional survey of patients with CD4 < 100 at seven urban and seven rural facilities after 1 year of program implementation. We quantified the number of patients who transitioned through the steps of the CrAg screening cascade over six-months follow-up. We defined cascade completion as a pre-emptive fluconazole prescription for the first 10 weeks. We conducted semi-structured interviews with lab personnel and clinic staff to assess functionality of the CrAg screening program. Data was collected using REDCap.



Results



We evaluated 359 patient records between April 2016 to March 2017; the majority (358/359, 99.7%) were from government owned health facilities and just over half (193/359, 53.8%) had a median baseline CD4 cell count of < 50 cell/μL. Overall, CrAg screening had been performed in 255/359 (71.0, 95% CI, 66.0–75.7) of patients’ records reviewed, with a higher proportion among urban facilities (170/209 (81.3, 95% CI, 75.4–86.4)) than rural facilities (85/150 (56.7, 95% CI, 48.3–64.7)). Among those who were CrAg screened, 56/255 (22.0, 95% CI, 17.0–27.5%) had cryptococcal antigenemia, of whom 47/56 (83.9, 95% CI, 71.7–92.4%) were initiated on pre-emptive therapy with fluconazole and 8/47 (17.0, 95% CI, 7.6–30.8%) of these were still receiving antifungal therapy at 6 months follow up. At least one CNS symptom was present in 70% (39/56) of those with antigenemia. In patients who had started ART, almost 40% initiated ART prior to CrAg screening. Inadequacy of equipment/supplies was reported by 15/26 (58%) of personnel as a program barrier, while 13/26 (50%) reported a need for training about CM and CrAg screening.



Conclusion



There was a critical gap in the follow-up of patients after initiation on fluconazole therapy. ART had been initiated in almost 40% of patients prior to CrAg screening.. Higher antigenemia patients presenting with CNS symptoms could be related to late presentation. There is need to address these gaps after a more thorough evaluation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mulindwa2022,

title = {Association between integrase strand transfer inhibitor (INSTIs) use with insulin resistance and incident diabetes mellitus in persons living with HIV: A systematic review and meta-analysis protocol},

author = {Frank Mulindwa, Habiba Kamal, Barbara Castelnuovo, Robert C. Bollinger, Jean-Marc Schwarz, Nele Brussealers},

doi = {https://doi.org/10.1371/journal.pone.0264792},

year  = {2022},

date = {2022-03-02},

journal = {PLOS ONE},

volume = {17},

number = {3},

abstract = {Introduction



Poeple living with HIV have higher prevalence of diabetes mellitus and metabolic perturbations compared to non-HIV populations. Diabetes and metabolic syndrome co-morbidities add significant burden to HIV care. Currently, WHO recommends integrase strand transfer inhibitors (INSTIs) as the first or second line therapy in people with HIV due to overall good tolerability and safety profile. However, whether INSTI use increases the risk of incident diabetes (with or without metabolic syndrome) compared to other anti-retroviral therapies (ART) is controversial. In this systematic review and meta-analysis, we aim to examine this risk in HIV-positive populations receiving INSTIs compared to other ART regimens (not containing INSTIs).



Methods and analysis



The study will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. This protocol adheres to the Standard Protocol Items for reporting systematic reviews and meta-analyses checklist. Eligibility criteria will be original peer-reviewed published articles and conference abstracts with no language or geographical restriction; that report the ocurrence of diabetes mellitus as a discrete outcome or part of metabolic syndrome, in adult PLWHIV receiving INSTIs compared to other ART regimens. PubMed/ Medline, Web of Science, Embase and Cochrane Database of Systematic Reviews will be searched from 1st- January-2000 to 31st—January-2022. Per our a priori, screening, inclusion and data extraction will be conducted separately by two investigators, and a senior researcher will be consulted in case of disagreement. The quality of included studies will be assessed by the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies and the revised Cochrane risk-of-bias tool (ROB2) for randomized controlled trials. The quantitative synthesis of the study outcomes will be explored in different subgroups and sensitivity analyses. Meta regression will also be performed to further test the predictors of the outcome.



Ethics and dissemination



Ethical approval is waived as the study is a review of published litterature. The analyses will be presented in conferences and published as a scientific article.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yang2022,

title = {Developing the EQ-5D-5L Value Set for Uganda Using the ‘Lite’ Protocol},

author = {Fan Yang, Kenneth R. Katumba, Bram Roudijk, Zhihao Yang, Paul Revill, Susan Griffin, Perez N. Ochanda, Mohammed Lamorde, Giulia Greco, Janet Seeley & Mark Sculpher },

doi = {https://doi.org/10.1007/s40273-021-01101-x},

year  = {2022},

date = {2022-03-01},

journal = {PharmacoEconomics},

volume = {40},

number = {3},

pages = {309–321},

abstract = {Objective



A ‘lite’ version of the EQ-5D-5L valuation protocol, which requires a smaller sample by collecting more data from each participant, was proposed and used to develop an EQ-5D-5L value set for Uganda.



Methods



Adult respondents from the general Ugandan population were quota sampled based on age and sex. Eligible participants were asked to complete 20 composite time trade-off tasks in the tablet-assisted personal interviews using the offline EuroQol Portable Valuation Technology software under routine quality control. No discrete choice experiment task was administered.



The composite time trade-off data were modelled using four additive and two multiplicative regression models. Model performance was evaluated based on face validity, prediction accuracy in cross-validation and in predicting mild health states. The final value set was generated using the best-performing model.



Results



A representative sample (N = 545) participated in this study. Responses to composite time trade-off tasks from 492 participants were included in the primary analysis. All models showed face validity and generated comparable prediction accuracy. The Tobit model with constrained intercepts and corrected for heteroscedasticity was considered the preferred model for the value set on the basis of better performance. The value set ranges from − 1.116 (state 55555) to 1 (state 11111) with ‘pain/discomfort’ as the most important dimension.



Conclusions



This is the first EQ-5D-5L valuation study using a ‘lite’ protocol involving composite time trade-off data only. Our results suggest its feasibility in resource-constrained settings. The established EQ-5D-5L value set for Uganda is expected to be used for economic evaluations and decision making in Uganda and the East Africa region.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nsubuga2022,

title = {Complete sputum smear monitoring among adults with pulmonary tuberculosis in central Uganda: evidence from a retrospective cohort study},

author = {Ronald Nsubuga, Norbert Adrawa, Stephen Okoboi, Alimah Komuhangi & Jonathan Izudi},

doi = {https://doi.org/10.1186/s12879-022-07178-9},

year  = {2022},

date = {2022-02-25},

journal = {BMC Infectious Diseases },

volume = {22},

number = {1},

pages = {191},

abstract = {Background



People with bacteriologically confirmed pulmonary tuberculosis require sputum smear monitoring at 2, 5, and 6 months to establish treatment outcomes. However, there is limited information about sputum smear monitoring in Uganda, similar to other developing countries. We examined factors associated with complete sputum smear monitoring among persons with bacteriologically confirmed pulmonary TB aged ≥ 15 years in central Uganda.



Methods



We retrospectively reviewed and abstracted data for persons with bacteriologically confirmed pulmonary TB initiated on treatment between January 2017 and December 2019 across 11 large TB units in Masaka district in central Uganda. Complete sputum smear monitoring was measured as the receipt of three sputum smear microscopy tests at 2, 5, and 6 months of TB treatment. The data were summarized descriptively and the differences in the outcome with independent variables were examined using tests of statistical significance, namely the Chi-square or Fisher’s exact test and the student’s t-test. The factors independently associated with the outcome were established using the modified Poisson regression analysis with robust standard errors, reported as adjusted risk ratio (aRR) along with the 95% confidence interval (CI).



Results



A total of 416 participants were enrolled, with a mean age of 37.3 ± 12.9 years. Of the participants, 290 (69.7) were males, 269 (64.7) were rural residents, and 128 (30.8%) had complete sputum smear monitoring. Urban residence (aRR, 1.45; 95% CI 1.12–1.90) and treatment under the community-based directly observed therapy short-course strategy (DOTS) (aRR, 1.91; 95% CI 1.25–2.92) were associated with a higher likelihood of complete sputum smear monitoring while TB and human immunodeficiency virus (TB/HIV) comorbidity (aRR 0.45, 95% CI 0.30–0.68) was associated with a lower likelihood of complete sputum smear monitoring.



Conclusions



We found a low magnitude of complete sputum smear monitoring among persons with bacteriologically confirmed pulmonary TB aged ≥ 15 years in central Uganda. Strategies to enhance the performance of sputum smear monitoring should target rural health facilities, strengthen TB/HIV collaboration and the implementation of community-based DOTS.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rajasingham2022,

title = {Cost-effectiveness of single-dose AmBisome pre-emptive treatment for the prevention of cryptococcal meningitis in African low and middle-income countries},

author = {Radha Rajasingham, Elizabeth Nalintya, Dennis M Israelski, David B Meya, Bruce A Larson, David R Boulware},

doi = { https://doi.org/10.1093/mmy/myab078},

year  = {2022},

date = {2022-02-01},

journal = {Medical Mycology},

volume = {60},

number = {2},

pages = {myab078},

abstract = {Abstract



Cryptococcal antigen (CrAg) screening is recommended for patients with advanced HIV to reduce AIDS-related mortality. For asymptomatic CrAg-positive persons, fluconazole pre-emptive therapy is standard, despite a ∼25% failure rate. Single-dose liposomal amphotericin B (AmBisome) is non-inferior to standard treatment for cryptococcal meningitis. We evaluate the threshold of efficacy necessary for AmBisome + fluconazole to be cost-effective as pre-emptive therapy for CrAg-positive persons.



We created a decision analytic model to evaluate CrAg screening and treatment in HIV-infected persons with CD4 < 100 cells/μL. Costs were estimated for screening, pre-emptive therapy, and hospitalization for an example low-income country (Uganda) and middle-income country (South Africa). We used a discounted price range of AmBisome® at $16.25 to $40 per 50 mg vial for both Uganda and South Africa. We estimated AmBisome efficacy from 75 to 95%. Parameter assumptions were based on prospective CrAg screening studies and clinical trials in Africa. Disability adjusted life years (DALYs) were calculated using the age-specific life expectancy in Uganda, per WHO Global Health Observatory data. We modeled the theoretical efficacy of adjunctive AmBisome to determine cost per DALY averted.



In South Africa, at $16.25 per vial cost and a minimum efficacy of 85%, adjunctive AmBisome is cost-saving compared to fluconazole monotherapy. Compared to fluconazole pre-emptive therapy in Uganda, AmBisome + fluconazole would cost $475, $220, or $136 per DALY averted if meningitis-free survival efficacy was 80, 85, or 90% at $24 per vial cost.



Investing in AmBisome may be cost-effective in low-income settings compared to using fluconazole pre-emptive therapy alone, if efficacy is 85% or greater. AmBisome pre-emptive therapy appears more cost-efficient in middle-income settings where hospitalization costs for meningitis, and GDP per capita are higher.



Lay Summary



We evaluate the efficacy necessary for AmBisome + fluconazole to be cost-effective to prevent cryptococcal meningitis. We found that if AmBisome pre-emptive therapy has an efficacy of 85% or greater, it is likely to be cost-effective in low-income settings.



Topic:

meningitis amphotericin b cryptococcal meningitis cost effectiveness fluconazole income south africa uganda disability-adjusted life years vial single-dose regimen prevention 

},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Okwir2022,

title = {High Burden of Cryptococcal Meningitis Among Antiretroviral Therapy–Experienced Human Immunodeficiency Virus–Infected Patients in Northern Uganda in the Era of “Test and Treat”: Implications for Cryptococcal Screening Programs },

author = {Mark Okwir, Abigail Link, Joshua Rhein, John Stephen Obbo, James Okello, Betty Nabongo, Jimmy Alal, David Meya, Paul R Bohjanen},

doi = {https://doi.org/10.1093/ofid/ofac004},

year  = {2022},

date = {2022-02-01},

journal = {Open Forum Infectious Diseases},

volume = {9},

number = {2},

pages = {ofac004},

abstract = {Background



The impact of the “test and treat” program for human immunodeficiency virus (HIV) treatment in rural areas of Uganda on cryptococcal antigen (CrAg) screening or cryptococcal meningitis (CM) is poorly understood.



Methods



We retrospectively evaluated clinical factors in 212 HIV-infected patients diagnosed with CM from February of 2017 to November of 2019 at Lira Regional Referral Hospital in northern Uganda.



Results



Among 212 patients diagnosed with CM, 58.5% were male. Median age was 35 years; CD4 count and HIV viral load (VL) were 86 cells/μL and 9463 copies/mL, respectively. Only 10% of patients had a previous history of CM. We found that 190 of 209 (90.9%) patients were ART experienced and 19 (9.1%) were ART naive. Overall, 90 of 212 (42.5%) patients died while hospitalized (median time to death, 14 days). Increased risk of death was associated with altered mental status (hazard ratio [HR], 6.6 [95% confidence interval {CI}, 2.411–18.219]; P ≤ .0001) and seizures (HR, 5.23 [95% CI, 1.245–21.991]; P = .024).



Conclusions



Current guidelines recommend CrAg screening based on low CD4 counts for ART-naive patients and VL or clinical failure for ART-experienced patients. Using current guidelines for CrAg screening, some ART-experienced patients miss CrAg screening in resource-limited settings, when CD4 or VL tests are unavailable. We found that the majority of HIV-infected patients with CM were ART experienced (90.9%) at presentation. The high burden of CM in ART-experienced patients supports a need for improved CrAg screening of ART-exposed patients.



Key Terms

antiretroviral therapy, cryptococcal meningitis outcomes, screening



Topic:



hiv seizures cryptococcal meningitis cd4 count determination procedure uganda cryptococcus guidelines mortality hiv infections anti-retroviral agents 



},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wagner2022b,

title = {Association of Condom Use Advocacy with Perceived Condom Use Among Social Network Members: The Mediating Role of Advocates’ Internalized HIV Stigma and Own Condom Use},

author = {Glenn J. Wagner, Laura M. Bogart, David J. Klein, Harold D. Green, Joan Nampiima, Andrew Kambugu & Joseph K. B. Matovu },

doi = {https://doi.org/10.1007/s10461-022-03601-z},

year  = {2022},

date = {2022-01-29},

journal = {AIDS and Behavior},

volume = {26},

pages = {2485–2493},

abstract = {We examined the association of HIV prevention advocacy with social network members (alters) on alter condom use behavior, and factors that may mediate and moderate this relationship, among people living with HIV (PLWH) in Uganda. Ninety PLWH completed all assessments (baseline and 5- and 8-month follow-ups). Internalized HIV stigma, HIV disclosure self-efficacy, positive living behavior (i.e., condom use), and advocacy self-efficacy were examined as mediators (at 5-month follow-up) of the association between condom use advocacy and perceived alter condom use. Individual socio-demographic and social network characteristics at baseline were examined as moderators. Among alters who received condom use advocacy in the months prior to both baseline and 5-month follow-up, 69.9% (51/73) were perceived to mostly/always use condoms at either the 5- or 8-month follow-up, which was significantly higher than the 36.4% (235/645) of alters who received none or less advocacy. Participants’ internalized HIV stigma and consistent condom use mediated the association of advocacy and perceived consistent condom use among alters; the participant having any secondary education and the alter being male were associated with increased magnitude of the associations between advocacy and alter condom use. These findings highlight the importance of sustained advocacy to promote consistent condom use, and the value of anti-stigma and positive living interventions as mechanisms for enhancing effective advocacy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kafeero2022,

title = {Disproportionate Distribution of HBV Genotypes A and D and the Recombinant Genotype D/E in the High and Low HBV Endemic Regions of Uganda: A Wake-Up Call for Regional Specific HBV Management},

author = {Hussein Mukasa Kafeero, Dorothy Ndagire, Ponsiano Ocama, Charles Drago Kato, Eddie Wampande, Henry Kajumbula, David Kateete, Abdul Walusansa, Ali Kudamba, Kigozi Edgar, Fred Ashaba Katabazi, Maria Magdalene Namaganda, Jamilu E. Ssenku and Hakim Sendagire},

doi = {https://doi.org/10.1155/2022/3688547},

year  = {2022},

date = {2022-01-11},

journal = {International Journal of Hepatology},

volume = {2022},

number = {688547,},

pages = {15 Pages},

abstract = {Abstract



Background. Hepatitis B virus (HBV) is the leading cause of liver-related diseases. In Uganda, there is a regional disparity in the HBV burden. Our study was aimed at establishing the circulating genotypes in a low and a high endemic region to give plausible explanations for the differences in regional burden and guide the future management of the disease. Methods. A total of 200 HBsAg-seropositive subjects were recruited into the study by convenience sampling. The HBsAg Rapid Test Strip (Healgen Scientific Limited Liability Company, Houston, TX77047- USA) was used to screen for HBsAg while the Roche machine (Roche, Basel Switzerland/Abbot Technologies (USA)) was used to determine the viral load. The Chemistry Analyzer B120 (Mindray, China) was used for chemistry analysis. For HBV genotyping, total DNA was extracted from whole blood using the QIAamp® DNA extraction kit. Nested PCR amplification was performed using Platinum Taq DNA Polymerase (Invitrogen Corporation, USA) to amplify the 400 bp HBV polymerase gene. Purification of nested PCR products was performed using Purelink PCR product purification kit (Life Technologies, USA). Automated DNA sequencing was performed using BigDye Terminator v3.1 Cycle Sequencing Kit on 3130 Genetic Analyzer (Applied Biosystems, USA). The NCBI HBV genotyping tool (https://www.ncbi.nlm.nih.gov/projects/genotyping/formpage.cgi) was used for determination of genotype for each HBV sequence. Pearson’s chi-square, multinomial logistic regression, and Mann–Whitney

tests were used for the analysis. All the analyses were done using SPSS version 26.0 and MedCalc software version 19.1.3 at 95% CI. A was considered statistically significant. Results. Majority of our study subjects were female (64.5%), youth (51.0%), and married (62.0%). Overall, genotype A was the most prevalent (46%). Genotype D and the recombinant genotype D/E were proportionately more distributed in the high endemic (38.2%) and low endemic (36.5%) regions, respectively. Genotype D was significantly more prevalent in the high endemic region and among the elderly (). Genotype D was significantly associated with elevated viral load and direct bilirubin (). The recombinant genotype D/E was significantly associated with elevated viral load (). Similarly, genotype A was significantly associated with elevated AST and GGT, lowered viral load, and normal direct bilirubin levels (). Conclusion. There is disproportionate distribution of genotypes A and D and the recombinant genotype D/E in the low and high endemic regions of Uganda. This probably could explain the differences in endemicity of HBV in our country signifying the need for regional specific HBV management and control strategies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Romo2022,

title = {Disparities in Dolutegravir Uptake Affecting Females of Reproductive Age With HIV in Low- and Middle-Income Countries After Initial Concerns About Teratogenicity},

author = {Matthew L. Romo, Rena C. Patel, Jessie K. Edwards, John M. Humphrey, Beverly S. Musick, Caitlin Bernard, Mercy W. Maina, Ellen Brazier, Barbara Castelnuovo,Jeremy Penner, Katarzyna Wyka, Sandra Wagner Cardoso, Penh Sun Ly, Cordelia Kunzekwenyika, Claudia P. Cortés, Radoslaw Panczak, Elizabeth A. Kelvin, Kara K. Wools-Kaloustian and Denis Nash, on behalf of International epidemiology Databases to Evaluate AIDS (IeDEA)},

doi = {https://doi.org/10.7326/M21-3037},

year  = {2022},

date = {2022-01-03},

journal = {Annals of Internal Medicine},

volume = {175},

number = {1},

pages = {84-94},

abstract = {Background:



The transition to dolutegravir-containing antiretroviral therapy (ART) in low- and middle-income countries (LMICs) was complicated by an initial safety signal in May 2018 suggesting that exposure to dolutegravir at conception was possibly associated with infant neural tube defects. On the basis of additional evidence, in July 2019, the World Health Organization recommended dolutegravir for all adults and adolescents living with HIV.



Objective:



To describe dolutegravir uptake and disparities by sex and age group in LMICs.

Design:



Observational cohort study.



Setting:



87 sites that began using dolutegravir in 11 LMICs in the Asia-Pacific; Caribbean, Central and South America network for HIV epidemiology (CCASAnet); and sub-Saharan African regions of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.

Patients:



134 672 patients aged 16 years or older who received HIV care from January 2017 through March 2020.

Measurements:



Sex, age group, and dolutegravir uptake (that is, newly initiating ART with dolutegravir or switching to dolutegravir from another regimen).



Results:



Differences in dolutegravir uptake among females of reproductive age (16 to 49 years) emerged after the safety signal. By the end of follow-up, the cumulative incidence of dolutegravir uptake among females 16 to 49 years old was 29.4% (95% CI, 29.0% to 29.7%) compared with 57.7% (CI, 57.2% to 58.3%) among males 16 to 49 years old. This disparity was greater in countries that began implementing dolutegravir before the safety signal and initially had highly restrictive policies versus countries with a later rollout. Dolutegravir uptake was similar among females and males aged 50 years or older.



Limitation:



Follow-up was limited to 6 to 8 months after international guidelines recommended expanding access to dolutegravir.



Conclusion:



Substantial disparities in dolutegravir uptake affecting females of reproductive age through early 2020 are documented. Although this disparity was anticipated because of country-level restrictions on access, the results highlight its extent and initial persistence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Asiimwe2022,

title = {Stable warfarin dose prediction in sub-Saharan African patients: A machine-learning approach and external validation of a clinical dose–initiation algorithm},

author = {Innocent G. Asiimwe, Marc Blockman, Karen Cohen, Clint Cupido, Claire Hutchinson, Barry Jacobson, Mohammed Lamorde, Jennie Morgan, Johannes P. Mouton, Doreen Nakagaayi, Emmy Okello, Elise Schapkaitz, Christine Sekaggya-Wiltshire, Jerome R. Semakula, Catriona Waitt, Eunice J. Zhang, Andrea L. Jorgensen, Munir Pirmohamed},

doi = { https://doi.org/10.1002/psp4.12740},

year  = {2022},

date = {2022-01-02},

journal = {CPT: Pharmacometrics & System Pharmacology},

volume = {11},

number = {1},

pages = {20-29},

abstract = {Warfarin remains the most widely prescribed oral anticoagulant in sub-Saharan Africa. However, because of its narrow therapeutic index, dosing can be challenging. We have therefore (a) evaluated and compared the performance of 21 machine-learning techniques in predicting stable warfarin dose in sub-Saharan Black-African patients and (b) externally validated a previously developed Warfarin Anticoagulation in Patients in Sub-Saharan Africa (War-PATH) clinical dose–initiation algorithm. The development cohort included 364 patients recruited from eight outpatient clinics and hospital departments in Uganda and South Africa (June 2018–July 2019). Validation was conducted using an external validation cohort (270 patients recruited from August 2019 to March 2020 in 12 outpatient clinics and hospital departments). Based on the mean absolute error (MAE; mean of absolute differences between the actual and predicted doses), random forest regression (12.07 mg/week; 95% confidence interval [CI], 10.39–13.76) was the best performing machine-learning technique in the external validation cohort, whereas the worst performing technique was model trees (17.59 mg/week; 95% CI, 15.75–19.43). By comparison, the simple, commonly used regression technique (ordinary least squares) performed similarly to more complex supervised machine-learning techniques and achieved an MAE of 13.01 mg/week (95% CI, 11.45–14.58). In summary, we have demonstrated that simpler regression techniques perform similarly to more complex supervised machine-learning techniques. We have also externally validated our previously developed clinical dose–initiation algorithm, which is being prospectively tested for clinical utility.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{mulindwa2022associationb,

title = {Association between integrase strand transfer inhibitor (INSTIs) use with insulin resistance and incident diabetes mellitus in persons living with HIV: A systematic review and meta-analysis protocol},

author = {Frank Mulindwa and Habiba Kamal and Barbara Castelnuovo and Robert C Bollinger and Jean-Marc Schwarz and Nele Brussealers},

year  = {2022},

date = {2022-01-01},

journal = {PloS one},

volume = {17},

number = {3},

pages = {e0264792},

publisher = {Public Library of Science San Francisco, CA USA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{girardi2022contributionb,

title = {The contribution of late HIV diagnosis on the occurrence of HIV-associated tuberculosis},

author = {Enrico Girardi and Yanink Caro-Vega and Alessandro Cozzi-Lepri and Joseph Musaazi and Gabriela Carriquiry and Barbara Castelnuovo and Andrea Gori and Yukari C Manabe and José Eduardo Gotuzzo and Antonella D’arminio Monforte and others},

year  = {2022},

date = {2022-01-01},

journal = {AIDS},

volume = {36},

number = {14},

pages = {2005--2013},

publisher = {Wolters Kluwer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{lumu2022durabilityb,

title = {Durability of switched therapy after failure of WHO-recommended antiretroviral therapy regimens in a resource-limited setting},

author = {Ivan Lumu and Joseph Musaazi and Barbara Castelnuovo},

year  = {2022},

date = {2022-01-01},

journal = {AIDS},

volume = {36},

number = {13},

pages = {1791--1800},

publisher = {Wolters Kluwer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{lazarus2022multinationalb,

title = {A multinational Delphi consensus to end the COVID-19 public health threat},

author = {Jeffrey V Lazarus and Diana Romero and Christopher J Kopka and Salim Abdool Karim and Laith J Abu-Raddad and Gisele Almeida and Ricardo Baptista-Leite and Joshua A Barocas and Mauricio L Barreto and Yaneer Bar-Yam and others},

year  = {2022},

date = {2022-01-01},

journal = {Nature},

volume = {611},

number = {7935},

pages = {332--345},

publisher = {Nature Publishing Group UK London},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{babirye2022tracheobronchomegalyb,

title = {Tracheobronchomegaly (Mounier-Kuhn Syndrome) in a 43-Year-Old Male: A Case Report},

author = {Deborah Babirye and Jonathan Walubembe and Juliet Allen Babirye and Joseph Baruch Baluku and Pauline Byakika-Kibwika and Eva Nabawanuka},

year  = {2022},

date = {2022-01-01},

journal = {International Medical Case Reports Journal},

pages = {631--637},

publisher = {Taylor & Francis},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nakalema2022pharmacokineticsb,

title = {Pharmacokinetics of levonorgestrel and etonogestrel contraceptive implants over 48 weeks with rilpivirine-or darunavir-based antiretroviral therapy},

author = {Shadia Nakalema and Catherine A Chappell and Michelle Pham and Pauline Byakika-Kibwika and Julian Kaboggoza and Stephen I Walimbwa and Joseph Musaazi and Ritah Nakijoba and Leah Mbabazi and Isabella Kyohairwe and others},

year  = {2022},

date = {2022-01-01},

journal = {Journal of Antimicrobial Chemotherapy},

volume = {77},

number = {11},

pages = {3144--3152},

publisher = {Oxford University Press US},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{bongomin2022factorsb,

title = {Factors Associated with Medical Students’ Career Choices Regarding Internal Medicine in Uganda},

author = {Felix Bongomin and Ronald Olum and Jonathan Kajjimu and Andrew Marvin Kanyike and Linda Atulinda and Daphine Ninsiima and Nicholas Kisaakye Wamala and Pauline Byakika-Kibwika},

year  = {2022},

date = {2022-01-01},

journal = {Advances in Medical Education and Practice},

pages = {1293--1304},

publisher = {Taylor & Francis},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{wang2022postb,

title = {A post-mortem analysis of tenofovir, lamivudine, efavirenz and fluconazole penetration in female genital tissues},

author = {Fan Wang and Olivie C Namuju and Katelyn A Pastick and Kizito Abdusalaamu and Usha Mishra and Lindsey Collins and David R Boulware and Robert Lukande and David B Meya and Melanie R Nicol},

year  = {2022},

date = {2022-01-01},

journal = {Journal of Antimicrobial Chemotherapy},

volume = {77},

number = {11},

pages = {3180--3186},

publisher = {Oxford University Press US},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{kasibante2022distalb,

title = {Distal jejunal obstruction due to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection: A case report},

author = {John Kasibante and Enock Kagimu and Morris K Rutakingirwa and Samuel Jjunju and Lillian Tugume and David B Meya},

year  = {2022},

date = {2022-01-01},

journal = {Medical Mycology Case Reports},

volume = {38},

pages = {44--47},

publisher = {Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{lawrence2022acceptabilityb,

title = {The acceptability of the AMBITION-cm treatment regimen for HIV-associated cryptococcal meningitis: findings from a qualitative methods study of participants and researchers in Botswana and Uganda},

author = {David S Lawrence and Agnes Ssali and Neo Moshashane and Georgina Nabaggala and Lebogang Maphane and Thomas S Harrison and David B Meya and Joseph N Jarvis and Janet Seeley},

year  = {2022},

date = {2022-01-01},

journal = {PLoS neglected tropical diseases},

volume = {16},

number = {10},

pages = {e0010825},

publisher = {Public Library of Science San Francisco, CA USA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{lawrence2022costb,

title = {Cost-effectiveness of single, high-dose, liposomal amphotericin regimen for HIV-associated cryptococcal meningitis in five countries in sub-Saharan Africa: an economic analysis of the AMBITION-cm trial},

author = {David S Lawrence and Charles Muthoga and David B Meya and Lillian Tugume and Darlisha Williams and Radha Rajasingham and David R Boulware and Henry C Mwandumba and Melanie Moyo and Eltas N Dziwani and others},

year  = {2022},

date = {2022-01-01},

journal = {The Lancet Global Health},

volume = {10},

number = {12},

pages = {e1845--e1854},

publisher = {Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{heffron2022boneb,

title = {Bone mineral density, nutrient intake, and physical activity among young women from Uganda},

author = {Renee Heffron and Timothy R Muwonge and Jade Boyer and Flavia Matovu and Yasaman Zia and Monica Bagaya and Timothy Ssebuliba and Susan Morrison and Felix Bambia and Rogers Nsubuga and others},

year  = {2022},

date = {2022-01-01},

journal = {Archives of Osteoporosis},

volume = {17},

number = {1},

pages = {134},

publisher = {Springer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{baluku2022cardiovascularb,

title = {Cardiovascular risk factors among people with drug-resistant tuberculosis in Uganda},

author = {Joseph Baruch Baluku and Martin Nabwana and Joanitah Nalunjogi and Winters Muttamba and Ivan Mubangizi and Lydia Nakiyingi and Willy Ssengooba and Ronald Olum and Felix Bongomin and Irene Andia-Biraro and others},

year  = {2022},

date = {2022-01-01},

journal = {BMC Cardiovascular Disorders},

volume = {22},

number = {1},

pages = {1--10},

publisher = {BioMed Central},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{spearman2022hepatocellularb,

title = {Hepatocellular carcinoma: measures to improve the outlook in sub-Saharan Africa},

author = {Wendy C Spearman and Geoffrey Dusheiko and Eduard Jonas and Abdelmounem Abdo and Mary Afihene and Lina Cunha and Hailemichael Desalegn and Chris Kassianides and Leolin Katsidzira and Anna Kramvis and others},

year  = {2022},

date = {2022-01-01},

journal = {The Lancet Gastroenterology & Hepatology},

volume = {7},

number = {11},

pages = {1036--1048},

publisher = {Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{okello2022endoscopicb,

title = {Endoscopic esophageal stenting for advanced esophageal cancer in Lubaga Hospital, Kampala, Uganda},

author = {Michael Okello and Dave Darshit and Esther Patience Nabwire and Anna Ainembabazi Tinka and Sabrina Bakeera-Kitaka and Ponsiano Ocama},

year  = {2022},

date = {2022-01-01},

journal = {BMC Research Notes},

volume = {15},

number = {1},

pages = {1--6},

publisher = {BioMed Central},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{byanyima2022feasibilityb,

title = {Feasibility and sensitivity of saliva GeneXpert MTB/RIF Ultra for tuberculosis diagnosis in adults in Uganda},

author = {Patrick Byanyima and Sylvia Kaswabuli and Emmanuel Musisi and Catherine Nabakiibi and Josephine Zawedde and Ingvar Sanyu and Abdul Sessolo and Alfred Andama and William Worodria and Laurence Huang and others},

year  = {2022},

date = {2022-01-01},

journal = {Microbiology spectrum},

volume = {10},

number = {5},

pages = {e00860--22},

publisher = {Am Soc Microbiol},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{okoboi2022adherenceb,

title = {Adherence monitoring methods to measure virological failure in people living with HIV on long-term antiretroviral therapy in Uganda},

author = {Stephen Okoboi and Joseph Musaazi and Rachel King and Sheri A Lippman and Andrew Kambugu and Andrew Mujugira and Jonathan Izudi and Rosalind Parkes-Ratanshi and Agnes N Kiragga and Barbara Castelnuovo},

year  = {2022},

date = {2022-01-01},

journal = {PLOS Global Public Health},

volume = {2},

number = {12},

pages = {e0000569},

publisher = {Public Library of Science San Francisco, CA USA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{muhindo2022covidb,

title = {COVID-19 vaccine acceptability, and uptake among people living with HIV in Uganda},

author = {Richard Muhindo and Stephen Okoboi and Agnes Kiragga and Rachel King and Walter Joseph Arinaitwe and Barbara Castelnuovo},

year  = {2022},

date = {2022-01-01},

journal = {PloS one},

volume = {17},

number = {12},

pages = {e0278692},

publisher = {Public Library of Science San Francisco, CA USA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{kajubi2022perceptionsb,

title = {Perceptions and Attitudes Toward an Interactive Voice Response Tool (Call for Life Uganda) Providing Adherence Support and Health Information to HIV-Positive Ugandans: Qualitative Study},

author = {Phoebe Kajubi and Rosalind Parkes-Ratanshi and Adelline Twimukye and Agnes Bwanika Naggirinya and Maria Sarah Nabaggala and Agnes Kiragga and Barbara Castelnuovo and Rachel King},

year  = {2022},

date = {2022-01-01},

journal = {JMIR formative research},

volume = {6},

number = {12},

pages = {e36829},

publisher = {JMIR Publications Toronto, Canada},

keywords = {},

pubstate = {published},

tppubtype = {article}

}