Current Organisation

Mulago Hospital, Kampala, Uganda

Current Job Title

Senior Consultant (Internal Medicine) & Head, Division of Respiratory Medicine

Biography

Publications

Project Title

Management of Lower Respiratory Tract Infections in Sub-Saharan Africa, a Pragmatic Approach (LoRTISA study)

EDCTP Project Call

Senior Fellowship (SF)

Host Organisation

Project Objectives

To determine the aetiology and predictors of treatment outcome in patients hospitalized with CAP in a high HIV burden setting.

Study Design

cross-sectional study

Project Summary

Lower respiratory tract infections are a leading cause of morbidity and mortality globally and the second highest cause of disability-adjusted life years after HIV in sub-Saharan Africa. Traditional diagnostic tests for community acquired pneumonia, which include sputum microscopy and culture, blood cultures, and serology, have low sensitivity. Novel molecular tests such as the multiplex PCR tests and next generation sequencing which can detect a large array of pathogens, are rapid and have high sensitivity for diagnosis of aetiology of CAP. Our working hypothesis is that adding nucleic acid testing for viruses and other hard to detect pathogens will improve microbiological identification of pathogens by at least 20%. Several severity-of-illness scores have been developed to identify whether individuals hospitalized with CAP are at high risk of dying during or immediately after hospitalization. Few of these scores have been validated in low-income settings because they need laboratory parameters that may not be readily accessible. Using simpler severity scores that depend less on laboratory results would be beneficial for low-income settings. The use of blood biomarkers has emerged as adjuncts to microbiology tests for diagnosis and for prognostic assessment. The study objectives are to determine the aetiology and resistance patterns of clinically diagnosed CAP among hospitalized individuals using a comprehensive microbiological approach; and will determine whether clinical features or biomarkers predict treatment outcomes (early treatment failure, mortality) of patients hospitalized with CAP in a high HIV burden setting.

Results & Outcomes

Project Title

Short- and long-term clinical and immunological outcomes of patients with HIV/TB coinfections on ART

EDCTP Project Call

Senior Fellowship (SF)

Host Organisation

Project Objectives

To study short-term effects of TB and ART treatment (the incidence, predictors and clinical characteristics of TB-IRIS, side effects of the therapy, causes of early mortality) and long term effects of ART after completing TB treatment (clinical events such as infections, late-onset IRIS, adverse effects of therapy or immunological and virological events such as changes in CD4 counts, CD4 %; viral load, viral resistance). Also to study possible factors influencing these outcomes such as adherence and factors affecting them, TB relapse and mycobacteriological factors, immunological defects and social factors that are associated with a recurrent TB episode and causes of mortality

Study Design

A cohort study to compare the effectiveness of early versus delayed antiretroviral therapy on prevention of mortality HIV-TB co-infected patients in a programmatic setting

Results & Outcomes