Pauline Byakika-Kibwika Ronald Ssenyonga Mohammed Lamorde Daniel Blessborn Joel Tarning

BMC Infectious Diseases

2019-12-01

Byakika-Kibwika P, Nyakato P, Lamorde M, Kiragga AN.

Malar J.

BACKGROUND:

Malaria control largely depends on availability of highly efficacious drugs, however, over the years, has been threatened by emergence of drug resistance. It is, therefore, important to monitor the impact of recurrent anti-malarial treatment on the long-term efficacy of anti-malarial regimens, especially in sub-Saharan African countries with high malaria transmission. Evaluation of parasite clearance following treatment of severe malaria with intravenous artesunate among patients in Eastern Uganda, was performed, as a contribution to monitoring anti-malarial effectiveness.

METHODS:

Parasite clearance data obtained from a clinical trial whose objective was to evaluate the 42-day parasitological treatment outcomes and safety following treatment of severe malaria with intravenous artesunate plus artemisinin-based combination therapy among patients attending Tororo District Hospital in Eastern Uganda, were analysed. Serial blood smears were performed at 0, 1, 2, 4, 6, 8, 10, 12, 16, 20, 24 h, followed by 6-hourly blood smears post start of treatment until 6 h post the first negative blood smear when parasite clearance was achieved. Study endpoints were; parasite clearance half-life (the time required for parasitaemia to decrease by 50% based on the linear portion of the parasite clearance slope) and parasite clearance time (time required for complete clearance of initial parasitaemia).

RESULTS:

One hundred and fifty participants with severe malaria were enrolled. All participants were treated with intravenous artesunate. All study participants tolerated artesunate well with rapid recovery from symptoms and ability to take oral mediation within 24 h. No immediate adverse events were recorded. The median (IQR) number of days to complete parasite clearance was of 2 (1-2). The median (IQR) time to clear 50% and 99% parasites was 4.8 (3.61-7.10) and 17.55 (14.66-20.66) h, respectively. The median estimated clearance rate constant per hour was 0.32. The median (IQR) slope half-life was 2.15 (1.64, 2.61) h.

CONCLUSION:

Parasite clearance following treatment with intravenous artesunate was rapid and adequate. This finding provides supportive evidence that resistance to artemisinins is unlikely to have emerged in this study area. Continuous monitoring of artemisinin effectiveness for malaria treatment should be established in high malaria transmission areas in sub-Saharan Africa where spread of resistance would be disastrous. Trial registration The study was registered with the Pan African Clinical Trial Registry (PACTR201110000321348). Registered 7th October 2011, http://www.pactr.org/ ).

2018-08-30

Denis Omali Allan Buzibye Richard Kwizera Pauline Byakika-Kibwika Rhoda Namakula Joshua Matovu Olive Mbabazi Emmanuel Mande Christine Sekaggya-Wiltshire Damalie Nakanjako Ursula Gutteck Keith McAdam Philippa Easterbrook Andrew Kambugu Jan Fehr Barbara Castelnuovo Yukari C. Manabe Mohammed Lamorde Daniel Mueller Concepta Merry

African Journal of Laboratory Medicine

2023-02-07

Bakesiima R1, Byakika-Kibwika P2, Tumwine JK3, Kalyango JN1, Nabaasa G1, Najjingo I1, Nabaggala GS1, Olweny F1, Karamagi C3.

BMJ Open.

OBJECTIVE:

To determine the prevalence and factors associated with dyslipidaemias in women using hormonal contraceptives.

DESIGN:

Cross-sectional study SETTING: Mulago Hospital, Kampala, Uganda PARTICIPANTS: Three hundred and eighty-four consenting women, aged 18-49 years, who had used hormonal contraceptives for at least 3 months prior to the study.

STUDY OUTCOME:

Dyslipidaemias (defined as derangements in lipid profile levels which included total cholesterol ≥200 mg/dL, high-density lipoprotein <40 mg/dL, triglyceride >150 mg/dL or low-density lipoprotein ≥160 mg/dL) for which the prevalence and associated factors were obtained.

RESULTS:

The prevalence of dyslipidaemias was 63.3% (95% CI: 58.4 to 68.1). Body mass index (BMI) (PR=1.33, 95% CI: 1.15 to 1.54, p<0.001) and use of antiretroviral therapy (ART) (PR=1.21, 95% CI: 1.03 to 1.42, p=0.020) were the factors significantly associated with dyslipidaemias.

CONCLUSION:

Dyslipidaemias were present in more than half the participants, and this puts them at risk for cardiovascular diseases. The high-risk groups were women with a BMI greater than 25 Kg/m² and those who were on ART. Therefore, lipid profiles should be assessed in women using hormonal contraceptives in order to manage them better.

2018-08-18

Antimicrob Agents Chemother.

Across sub-Saharan Africa, patients with HIV on antiretrovirals often get malaria and need cotreatment with artemisinin-containing therapies. We undertook two pharmacokinetic studies in healthy volunteers, using standard adult doses of artemether-lumefantrine or artesunate-amodiaquine given with 50 mg once daily dolutegravir (DTG) to investigate the drug-drug interaction between artemether-lumefantrine or artesunate-amodiaquine and dolutegravir. The dolutegravir/artemether-lumefantrine interaction was evaluated in a two-way crossover study and measured artemether, dihydroartemisinin, lumefantrine, and desbutyl-lumefantrine over 264 h. The dolutegravir/artesunate-amodiaquine interaction was investigated using a parallel study design due to long half-life of the amodiaquine metabolite, desethylamodiaquine and measured artesunate, amodiaquine, and desethylamodiaquine over 624 h. Noncompartmental analysis was performed, and geometric mean ratios and 90% confidence intervals were generated for evaluation of both interactions. Dolutegravir did not significantly change the maximum concentration in plasma, the time to maximum concentration, and the area under the concentration-time curve (AUC) for artemether, dihydroartemisinin, lumefantrine, and desbutyl-lumefantrine, nor did it significantly alter the AUC for artesunate, dihydroartemisinin, amodiaquine, and desethylamodiaquine. Coadministration of dolutegravir with artemether-lumefantrine resulted in a 37% decrease in DTG trough concentrations. Coadministration of dolutegravir with artesunate-amodiaquine resulted in 42 and 24% approximate decreases in the DTG trough concentrations and the AUC, respectively. The significant decreases in DTG trough concentrations with artemether-lumefantrine and artesunate-amodiaquine and dolutegravir exposure with artesunate-amodiaquine are unlikely to be of clinical significance since the DTG trough concentrations were above dolutegravir target concentrations of 300 ng/ml. Study drugs were well tolerated with no serious adverse events. Standard doses of artemether-lumefantrine and artesunate-amodiaquine should be used in patients receiving dolutegravir. (This study has been registered at ClinicalTrials.gov under identifier NCT02242799.).

Copyright © 2019

2019-08-29

Joseph Baruch Baluku Sylvia Nassozi Brian Gyagenda Margret Namanda Irene Andia-Biraro William Worodria Pauline Byakika-Kibwika

Journal of Tropical Medicine

2019-07-25

Deborah Babirye Jonathan Walubembe Juliet Allen Babirye Joseph Baruch Baluku Pauline Byakika-Kibwika Eva Nabawanuka

International Medical Case Reports Journal

2022-11-01

Mark Kizito Rejani Lalitha Henry Kajumbula Ronald Ssenyonga David Muyanja Pauline Byakika-Kibwika

Antibiotics

2021-09-26

Felix Bongomin Ronald Olum Jonathan Kajjimu Andrew Marvin Kanyike Linda Atulinda Daphine Ninsiima Nicholas Kisaakye Wamala Pauline Byakika-Kibwika

Advances in Medical Education and Practice

2022-10-01

Felix Bongomin Ronald Olum Lydia Nakiyingi Rejani Lalitha Isaac Ssinabulya Christine Sekaggya-Wiltshire Ponsiano Ocama Pauline Byakika-Kibwika

Advances in Medical Education and Practice

2021-03-01

Provia Ainembabazi Barbara Castelnuovo Stephen Okoboi Walter Joseph Arinaitwe Rosalind Parkes-Ratanshi Pauline Byakika-Kibwika

2020-09-25

Felix Bongomin Ronald Olum Lydia Nakiyingi Lalitha Rejani Isaac Ssinabulya Christine Sekaggya-Wiltshire Ponsiano Ocama Pauline Byakika-Kibwika

2020-12-18

Pauline Byakika-Kibwika Patience Nyakato Mohammed Lamorde Agnes N. Kiragga

Malaria Journal

2018-12-01

Provia Ainembabazi Barbara Castelnuovo Stephen Okoboi Walter Joseph Arinaitwe Rosalind Parkes-Ratanshi Pauline Byakika-Kibwika

BMC Medical Ethics

2021-12-01

Pauline Byakika-Kibwika Jane Achan Mohammed Lamorde Carine Karera-Gonahasa Agnes N. Kiragga Harriet Mayanja-Kizza Noah Kiwanuka Sam Nsobya Ambrose O. Talisuna Concepta Merry

BMC Infectious Diseases

2017-12-01

Geraldine Kauma Henry Ddungu Isaac Ssewanyana Sharon Nyesiga Naghib Bogere Teddy Namulema-Diiro Pauline Byakika-Kibwika Elizabeth Namukwaya Harriet Mayanja Kizza

JCO Global Oncology

2023-04-01