Browsing by Author "Jonathan Izudi"

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Adverse events associated with AstraZeneca COVID-19 vaccine among adults in Greater Kampala, Uganda: a cross-sectional study
(African Health Sciences, 2024-07-11) Allan Komakech; Jonathan Izudi; John Kamulegeya; reda L. Aceng; James Acaye; Edirisa Juniour Nsubuga; Petranilla Nakamya; Daniel Kadobera; Lilian Bulage; Benon Kwesiga; Alex R Ario
Background: Uganda started AstraZeneca COVID-19 vaccination in March 2021 but information about adverse events is lim- ited. We assessed adverse events following AstraZeneca vaccination among adults in Greater Kampala, Uganda. Methods: In this cross-sectional study, we systematically sampled persons who had received ≥1 dose of the AstraZeneca vac- cine and collected data between March and April 2021 through telephone interviews. We defined adverse events as any untoward medical occurrence after vaccination and serious adverse events as any event leading to hospitalization, persistent disability >28 days, death, or congenital anomaly. Results: Of 374 participants aged 20-85 years, the prevalence of adverse events was 76.5%. Common adverse events included injection site redness and hadache; no serious adverse event was reported. Participants aged 20–29 years (Adjusted odds ratio (AOR) 4.58; 95% confidence interval (CI): 1.92–10.95), 30-39 years (AOR 3.69; 95% CI: 1.81–7.51) and 40-49 years (AOR 2.78; 95% CI 1.26–4.90) were more likely to develop adverse events compared to those aged ≥50 years. Conclusion: Adverse events are prevalent, largely among those aged <50 years; serious adverse events are rare. Persons aged <50 years should be targeted for surveillance of adverse events alongside appropriate health education and counselling. Keywords: Adverse events; assessment; COVID-19; Greater Kampala; Uganda
Africa should research the long-term sequelae of mpox.
(The Lancent Global Health., 2024-10) Allan Komakech; Brian Ngongheh Ajong; ∙ Danny Kalala; Nora Efire; Cris Kacita; Emmanuel Hasivirwe Vakaniaki; Jonathan Izudi; Laurens Liesenborghs; Nicaise Ndembii
In July, 2022, WHO declared mpox—a viral zoonotic illness—a public health emergency of international concern, due to the rising number of cases and its spread to many countries outside Africa.1 By May, 2023, reported cases of mpox had reduced in regions outside Africa, leading to the lifting of the emergency declaration. In August, 2023, the WHO Director-called upon state parties to develop national mpox plans that incorporated lessons learned, to strengthen laboratory-based surveillance, to enhance community protection through risk communication, and to comprehensively support research for prevention and control.2 However, mpox remains a critical public health problem in Africa, where it was first identified among humans in 1970, in the Democratic Republic of the Congo (DR Congo).3
Malnutrition and unsuccessful tuberculosis treatment among people with multi-drug resistant tuberculosis in Uganda: A retrospective analysis
(Elsevier, 2024-12) Samuel Engoru; Francis Bajunirwe; Jonathan Izudi
Rationale: Multi-drug-resistant tuberculosis (MDR-TB) poses a significant public health challenge to the control and successful eradication of TB globally. Suboptimal treatment outcomes are common among persons with MDR-TB necessitating a need to understand the contextual factors. Objective: We determined the factors associated with unsuccessful TB treatment among persons with MDR-TB at a large TB Unit in Central Uganda. Methods: We retrospectively reviewed medical records for all persons with MDR-TB at Mubende Regional Referral Hospital MDR-TB Clinic in Central Uganda. The patients were treated with either second-line, modified second-line, or individualized anti-TB regimens and completed treatment between January 2012 and October 2023. The primary outcome was unsuccessful TB treatment defined as death, treatment failure, or loss to follow- up and measured as a binary outcome. We used a multivariable binary logistic regression analysis to determine the factors independently associated with unsuccessful TB treatment at a 5 % statistical significance level. We reported the adjusted odds ratio (aOR) and the 95 % confidence interval (CI). Measurements and results: We analyzed data from 98 persons with MDR-TB who were aged 15–78 years (mean 36.4 ± 15.4 years). Of these, 40 (40.8 %) were cured, 25 (25.5 %) completed TB treatment, 1 (1.0 %) had treatment failure, 13 (13.3 %) died, and 19 (19.4 %) were lost to follow-up. Overall, 33 (33.7 %) participants had unsuccessful TB treatment which was associated with older age for a 1-year increase in age (aOR 1.05, 95 % CI 1.01–1.09), malnutrition—mid-upper arm circumference of <12.5 cm (aOR 2.99, 95 % CI 1.16–7.98), and previous TB treatment (aOR 0.28, 95 % CI 0.10–0.77). Conclusion: Unsuccessful TB treatment is high among persons with MDR-TB at this TB Unit. It is more likely as age advances and when persons with MDR-TB have malnutrition, but less likely when they have been previously treated for TB. Therefore, interventions to improve treatment outcomes may be beneficial for persons with MDR- TB who are older, malnourished, and those newly diagnosed with the disease. For example, routine nutritional assessment and counseling, including nutritional support for malnourished persons with MDR-TB may be needed to optimize their TB treatment success.
Malnutrition is a risk factor for tuberculosis disease among household contacts: A case-control study in Uganda
(Elsevier, 2024-08) Jonathan Izudi; Samuel Engoru; Francis Bajunirwe
Objective: Household contacts (HHCs) of persons with tuberculosis (TB) including rifampicin-resistant or multi- drug-resistant TB (RR/MDR-TB) are at risk for TB infection. We investigated whether index patient-level clinical and socio-demographic factors of persons with MDR-TB are associated with TB disease among their HHCs in Uganda. Methods: We designed an unmatched case-control study. Cases were HHCs of persons with MDR-TB that had TB disease while controls were a random sample of HHCs of persons with MDR-TB that had no TB disease. The case- to-control ratio was 1:3. We identified the factors that significantly differed between the cases and controls in a multivariable binary logistic regression analysis and reported the odds ratio (OR) and 95% confidence interval (CI). Results: We found similar demographic and clinical characteristics among the 11 cases and 33 controls. In a multivariable analysis, malnutrition was significantly associated with being a case than a control (adjusted OR 5.01; 95% CI 1.18-24.83). Conclusion: Therefore, TB Control Programs should focus on identifying malnutrition among persons with MDR- TB and providing nutritional counseling and support to improve recovery, and potentially reduce household TB transmission and optimize treatment success. Additionally, rapid screening for TB and preventive therapy should be prioritized to reduce transmission
Sudan virus disease super-spreading, Uganda, 2022
(BMC Infectious Diseases, 2024-05-23) Allan Komakech; Shannon Whitmer; Jonathan Izudi; Charles Kizito; Mackline Ninsiima; Sherry R. Ahirirwe; Zainah Kabami; Alex R. Ario; Daniel Kadobera; Benon Kwesiga; Samuel Gidudu; Richard Migisha; Issa Makumbi; Daniel Eurien; Joshua Kayiwa; Lilian Bulage; Doreen N. Gonahasa; Irene Kyamwine; Paul E. Okello; Hildah T. Nansikombi; Immaculate Atuhaire; Alice Asio; Sarah Elayeete; Edirisa J. Nsubuga; Veronica Masanja; Stella M. Migamba; Patience Mwine; Petranilla Nakamya; Rose Nampeera; Andrew Kwiringira; Rebecca Akunzirwe; Helen Nelly Naiga; Saudah K. Namubiru; Brian Agaba; Jane Frances Zalwango; Marie Gorreti Zalwango; Patrick King; Brenda Nakafeero Simbwa; Robert Zavuga; Mercy Wendy Wanyana; Thomas Kiggundu; Lawrence Oonyu; Alex Ndyabakira; Mariam Komugisha; Brian Kibwika; Innocent Ssemanda; Yasin Nuwamanya; Adams Kamukama; Dorothy Aanyu; Dominic Kizza; Sophia Mulei; Stephen Balinandi; Luke Nyakarahuka; Jimmy Baluku; Jackson Kyondo; Alex Tumusiime; Dativa Aliddeki; Ben Masiira; Esther Muwanguzi; Ivan Kimuli; Daniel Bulwadda; Herbert Isabirye; Deborah Aujo; Arthur Kasambula; Solome Okware; Emmanuel Ochien; Innocent Komakech; Charles Okot; Mary Choi3; Caitlin M. Cossaboom; Carrie Eggers; John D. Klena; Modupe O. Osinubi; Katrin S. Sadigh; Mary C. Worrell; Amy L. Boore; Trevor Shoemaker; Joel M. Montgomery; Susan N. Nabadda; Michael Mwanga; Allan N. Muruta; Julie R. Harris
Background On 20 September 2022, Uganda declared its fifth Sudan virus disease (SVD) outbreak, culminating in 142 confirmed and 22 probable cases. The reproductive rate (R) of this outbreak was 1.25. We described persons who were exposed to the virus, became infected, and they led to the infection of an unusually high number of cases during the outbreak. Methods In this descriptive cross-sectional study, we defined a super-spreader person (SSP) as any person with real-time polymerase chain reaction (RT-PCR) confirmed SVD linked to the infection of ≥ 13 other persons (10-fold the outbreak R). We reviewed illness narratives for SSPs collected through interviews. Whole-genome sequencing was used to support epidemiologic linkages between cases. Results Two SSPs (Patient A, a 33-year-old male, and Patient B, a 26-year-old male) were identified, and linked to the infection of one probable and 50 confirmed secondary cases. Both SSPs lived in the same parish and were likely infected by a single ill healthcare worker in early October while receiving healthcare. Both sought treatment at multiple health facilities, but neither was ever isolated at an Ebola Treatment Unit (ETU). In total, 18 secondary cases (17 confirmed, one probable), including three deaths (17%), were linked to Patient A; 33 secondary cases (all confirmed), including 14 (42%) deaths, were linked to Patient B. Secondary cases linked to Patient A included family members, neighbours, and contacts at health facilities, including healthcare workers. Those linked to Patient B included healthcare workers, friends, and family members who interacted with him throughout his illness, prayed over him while he was nearing death, or exhumed his body. Intensive community engagement and awareness-building were initiated based on narratives collected about patients A and B; 49 (96%) of the secondary cases were isolated in an ETU, a median of three days after onset. Only nine tertiary cases were linked to the 51 secondary cases. Sequencing suggested plausible direct transmission from the SSPs to 37 of 39 secondary cases with sequence data. Conclusion Extended time in the community while ill, social interactions, cross-district travel for treatment, and religious practices contributed to SVD super-spreading. Intensive community engagement and awareness may have reduced the number of tertiary infections. Intensive follow-up of contacts of case-patients may help reduce the impact of super-spreading events.