Browsing by Author "Bagenda, Charles Nkubi"

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    A qualitative study of knowledge, experiences, and healthcare needs of people living with lymphedema in Kamwenge District, rural Uganda
    (Springer Nature, 2025-10-27) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Musinguzi, Benson; Agaba, Bosco Bekita; Muyambi, Raul; Asiimwe, Gerevasio Kalemire; Zamarano, Henry; Birungi, Caroline; Bagenda, Charles Nkubi; Bajunirwe, Francis; Bazira, Joel; Itabangi, Herbert; Byarugaba, Frederick; Mulogo, Edgar Mugema
    Background Lymphedema is a long-term, disabling condition caused by dysfunction of the lymphatic system, yet it continues to receive little attention in low-resource settings. In rural areas such as Kamwenge District, Uganda, those affected endure ongoing physical symptoms including swelling, pain, and reduced mobility alongside significant emotional and social challenges. Stigma, cultural misunderstandings, and poor access to timely diagnosis and effective care further hinder their well-being. While global neglected tropical disease (NTD) programs have made progress, many vulnerable communities remain overlooked. This qualitative study explored the lived experiences of lymphedema patients and caregivers in Kamwenge, focusing on local beliefs, knowledge gaps, and healthcare barriers to inform context-specific and stigma-sensitive interventions. Methods A community-based qualitative study design was employed. Data were collected through five focus group discussions (FGDs) involving lymphedema patients and caregivers, and seven key informant interviews (KIIs) with local health officials, community leaders, and religious figures. Participants were purposively sampled from Rukunyu Hospital and surrounding communities to capture diverse perspectives. Data were transcribed, translated, and analysed using Braun and Clarke’s thematic analysis approach. Results Seven key themes emerged: (1) patients’ daily struggles with pain, dependence, and economic hardship; (2) stigma leading to social exclusion; (3) gaps in knowledge and culturally influenced misconceptions about causes and treatment; (4) gender-specific vulnerabilities such as abandonment and psychological distress; (5) weak healthcare infrastructure and limited access; (6) reliance on informal coping strategies including herbal remedies, faith, and peer support; and (7) institutional deficiencies alongside community-driven recommendations for improved care and prevention. Despite some health education efforts, misinformation and stigma remain widespread, and affected individuals are often excluded from social support programs. Conclusion Lymphedema in Kamwenge District is a complex issue intersecting health, social stigma, and systemic weaknesses. Urgent, community-focused interventions are critical to closing knowledge gaps, enhancing healthcare services, reducing stigma, and integrating lymphedema management into national health policies.
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    Association of high serum aspartate transaminase to high density lipoproteincholesterol ratio with probable dementia among people living with HIV on antiretroviral therapy in Southwestern Uganda
    (Sage, 2025-08-11) Bagenda, Charles Nkubi; Mudondo, Hope; Ssemwanga, Elastus; Nzaramba, Daniel; Ssedyabane, Frank; Ojuko, Samuel; Musinguzi, Benson; Akiteng, Winnie; Agaba, Bosco Bekiita; Osuwat, Lawrence Obado; Maling, Samuel; Rugera, Simon Peter; Tusubira, Deusdedit
    Objectives: Previous studies present conflicting evidence on the relationship between hepatocellular damage biomarkers and dementia risk. While elevated serum transaminases have been associated with mild cognitive impairment, other studies link lower transaminase levels and reduced high-density lipoprotein-cholesterol levels to increased risk of cognitive decline. This study investigated the association between serum transaminase-to-high-density lipoprotein-cholesterol ratios and probable dementia among people living with HIV on antiretroviral therapy. Methods: We conducted a secondary data analysis using a dataset from a cross-sectional study conducted among 377 people living with HIV on dolutegravir-based antiretroviral therapy in southwestern Uganda. Probable dementia was screened using the brief Community Screening Instrument for Dementia and defined as a Community Screening Instrument for Dementia cognitive score ⩽4. Serum alanine aminotransferase/high-density lipoprotein-cholesterol and aspartate aminotransferase/high-density lipoprotein-cholesterol ratios were calculated from the respective serum transaminases and high-density lipoprotein-cholesterol divided into tertiles. We used logistic regression to assess the association between the independent variables and probable dementia. Results: The median age of the study participants was 44 years (interquartile range: 30–59), with 56.2% being female. The median total cholesterol/high-density lipoprotein-cholesterol levels were significantly higher in participants with probable dementia compared to those without (3.86 versus 3.22, p = 0.03). Aspartate aminotransferase/high-density lipoprotein-cholesterol and alanine aminotransferase/high-density lipoprotein-cholesterol levels were also higher among participants with probable dementia compared to those without, although the differences did not reach statistical significance. In the fully adjusted model, compared to participants in the first tertile of aspartate aminotransferase/high-density lipoprotein-cholesterol ratio, the odds of probable dementia were higher in the second tertile (adjusted odds ratio: 1.71; 95% confidence interval: 0.62–4.74; p = 0.301) and significantly elevated in the third tertile (adjusted odds ratio: 4.48; 95% confidence interval: 1.15–17.46; p = 0.031). Conclusions: The findings suggest that an elevated aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is significantly associated with probable dementia among people living with HIV on dolutegravir-based antiretroviral therapy. A high aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is potentially associated with cognitive decline in this population.
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    Dyslipidemia and associated factors among people living with HIV on dolutegravir-based antiretroviral therapy in central Uganda
    (SAGE Publications, 2025-10-23) Timbigamba, Flavia; Bagenda, Charles Nkubi; Sembogga, Hendry; Wasswa, Timothy; Bazibu, Faizo; Ssali, Joseph; Ssemwanga, Elastus; Mugisa, Michael Junior; Nuwagaba, Edwin; Ojuko, Samuel; Nantongo, Carol; Wafwoyo, Jesca Akoth; Musinguzi, Benson; Akiteng, Winnie; Osuwat, Lawrence Obado
    Introduction Dolutegravir (DTG)-based antiretroviral therapy (ART) use has been associated with excessive weight gain, increasing the risk of dyslipidemias such as hypercholesterolemia. We assessed the prevalence of, and associated factors with dyslipidemia among adults on DTG-based ART. Materials and methods We conducted a cross-sectional study among 281 systematically sampled adults on DTG-based ART for ≥ 6 months at Kira Health Centre IV, Wakiso District, Central Uganda. Data were collected through structured questionnaires, medical record reviews, anthropometric measurements, and laboratory biomarker analysis. Logistic regression was used to determine associated factors, and the predictive performance of obesity indices was evaluated using receiver operating characteristic (ROC) curve analysis. Results The prevalence of dyslipidemia was 44.1% 95% CI: 38.4%–50.0%. Low high-density lipoprotein (HDL) cholesterol was the most common abnormality, affecting 39.9% of participants, followed by elevated total cholesterol at 5.7% [95% CI: 3.51–9.11] and elevated low-density lipoprotein (LDL) cholesterol at 5.0%. High waist circumference (WC) was significantly associated with dyslipidemia; (aPR: 1.93, 95% CI: 1.15–3.24, p = .013), and demonstrated a significant ability to predict dyslipidemia with area under the curve (AUC) of 0.577 [95% CI: 0.511–0.644]. The AUC for WC in predicting hypercholesterolemia, elevated LDL-C, and low HDL-C were 0.702 (95% CI: 0.547–0.857), 0.729(95% CI: 0.590–0.867), and 0.548 (95% CI: 0.481–0.616) respectively. Conclusion Dyslipidemia is prevalent among adults on DTG-based ART, and is potentially associated with high WC.
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    Prevalence of malaria among individuals living with lymphedema in Kamwenge District, Western Uganda
    (Springer Nature, 2025-10-02) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Musinguzi, Benson; Muzafaru, Twinomujuni; Zamarano, Henry; Bagenda, Charles Nkubi; Mulogo, Edgar; Byarugaba, Frederick; Herbert, Itabangi
    Lymphedema, also known as elephantiasis, is a long-term and often debilitating condition characterized by the progressive swelling of limbs due to poor lymphatic drainage. While lymphatic filariasis, a mosquito-borne disease, is a common infectious cause globally, non-infectious forms such as podoconiosis resulting from prolonged exposure to mineral-rich soils are also prevalent in many low-resource, endemic regions. In areas where both malaria and lymphedema occur, malaria may further affect individuals already suffering from chronic swelling. In Kamwenge District, Western Uganda, lymphedema is a recognized public health concern, yet the contributing factors remain poorly understood. This lack of clarity complicates effective diagnosis, treatment, and disease control. This study aimed to assess the presence of malaria among individuals living with lymphedema in this setting. A cross-sectional study was conducted among 154 individuals with clinically confirmed lymphedema, recruited through purposive sampling from Rukunyu Hospital and surrounding communities. Data collection involved structured interviews, physical examinations, and venous blood sampling. Malaria infection was determined through microscopic examination of blood smears. Of the 154 participants, 71.4% were female, with an average age of 54.7 years. Plasmodium falciparum was detected in 3.3% (n=5) of the individuals. The majority (96.8%) had bilateral lower limb lymphedema and resided in rural areas, primarily engaged in subsistence farming. The presence of malaria among individuals with lymphedema highlights the need for integrated healthcare approaches in areas where multiple parasitic diseases are endemic. Although malaria was detected in a small portion of participants, its occurrence alongside lymphedema underscores the importance of continued disease surveillance, targeted interventions, and community education to support affected populations.
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    Total cholesterol/high-density lipoprotein cholesterol ratio is a significant predictor of metabolic syndrome among people on dolutegravir-based antiretroviral therapy: A cross-sectional study in southwestern Uganda
    (Sage, 2025-08-29) Bagenda, Charles Nkubi; Nantongo, Carol; Ssemwanga, Elastus; Mugisa, Michael Junior; Ojuko, Samuel; Sempijja, Fred; Nzaramba, Daniel; Kiconco, Ritah; Ssedyabane, Frank; Musinguzi, Benson; Akiteng, Winnie; Tusubira, Deusdedit; Osuwat, Lawrence Obado; Rugera, Simon Peter
    Objective: The total cholesterol/high-density lipoprotein cholesterol ratio is a predictor of nonalcoholic fatty liver disease—a hepatic manifestation of metabolic syndrome. This study investigated the association between total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome among people living with human immunodeficiency virus on dolutegravir-based antiretroviral therapy in southwestern Uganda. Methods: We conducted a secondary analysis of data obtained from a cross-sectional study of 377 adults who had been on dolutegravir-based antiretroviral therapy for at least 1 year at Ruhoko Health Centre IV, southwestern Uganda. Results: The median total cholesterol/high-density lipoprotein cholesterol ratio was significantly higher in individuals with metabolic syndrome (3.92) than in those without (2.96, p < 0.001). A statistically significant association was observed between high total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome (adjusted odds ratios: 2.06, 95% confidence interval: 1.08–3.91, p 1⁄4 0.028). The total cholesterol/high-density lipoprotein cholesterol ratio at an optimal cutoff of 3.30 had a significant ability (area under the curve 1⁄4 0.696, 95% confidence interval: 0.642–0.750) to differentiate participants with metabolic syndrome from those without at a sensitivity of 73% and specificity of 60%. Conclusion: The total cholesterol/high-density lipoprotein cholesterol ratio is a significant pre-dictor of metabolic syndrome and serves as a potential blood-based biomarker.