Browsing by Author "Kyazze, Simon"

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    Determinants of underweight and overweight/ obesity among people with tuberculosis in Kampala, Uganda: A cross-sectional study
    (PLOS, 2026-02-13) Kyazze, Simon; Appeli, Saidi; Baluku, Joseph Baruch; Izudi, Jonathan
    Background Malnutrition significantly contributes to mortality among people with tuberculosis (TB). However, evidence on factors associated with the specific forms of malnutrition, specifically underweight and overweight/obesity, beyond clinical determinants, remains limited in many settings. We investigated the prevalence and determinants of underweight and overweight/obesity among people with pulmonary TB across five health facilities in Kampala, Uganda. Methods This analytic cross-sectional study involved people with pulmonary TB, either clinically diagnosed or bacteriologically confirmed, aged ≥18 years sampled across five health facilities in Kampala, Uganda. Nutritional status was assessed using body mass index (BMI, kg/m²) and categorized as underweight (<18.5), normal weight (18.5–24.9), and overweight/obese (≥25.0). To identify factors independently associated with nutritional status, normal weight was considered as the reference category in a multinomial logistic regression analysis, adjusting for multiple covariates and clustering at the health facility level. The measure of association was the adjusted relative risk ratios (aRRR) and the corresponding 95% confidence intervals (CI). Results Of the 818 participants studied, 417 (51.0%) had normal weight, 302 (36.9%) were underweight, and 99 (12.1%) were overweight or obese. Adjusted analysis showed that being underweight was associated with household food insecurity (aRRR 2.04, 95% CI: 1.48–2.80) while being overweight or obese was associated with self-employment (aRRR 2.26, 95% CI: 1.35–3.79) and being newly diagnosed with TB (aRRR 2.10, 95% CI: 1.30–3.41). Conclusion This study, conducted among people with pulmonary TB in an urban setting in Uganda, showed that underweight and overweight/obesity are prevalent. Furthermore, the study showed that food insecurity is associated with being underweight, while being overweight or obese is associated with being self-employed or newly diagnosed with TB. Therefore, TB control programs need to regularly assess the nutritional status of people with TB to mitigate the effect of being underweight or overweight on treatment outcomes.
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    Tuberculosis-related stigma and associated factors among people with pulmonary tuberculosis predominantly co-infected with HIV in Kampala, Uganda: a cross-sectional study
    (Elsevier, 2026-03-18) Izudi, Jonathan; Kyazze, Simon; Bajunirwe, Francis
    Rationale Stigma has a profound effect on the well-being and treatment outcomes of people with tuberculosis (PWTB). Despite its negative effects, TB-related stigma remains underexplored in high-burden TB settings such as Uganda. Objective To examine the factors associated with tuberculosis (TB)-related stigma among people with drug-susceptible pulmonary TB aged ≥18 years in Kampala, Uganda. Methods We conducted a cross-sectional study across five primary health facilities. The primary exposure was psychological well-being and was assessed using the World Health Organization (WHO) Five Well-Being Index (WHO-5). Scores ranged from 0 to 20, with ≥15 indicating good psychological well-being, and <15 indicating poor psychological well-being. TB-related stigma was the primary outcome measured using the Van Rie Stigma Scale, ranging from 0 to 48. We applied Generalized Estimating Equations, adjusting for important covariates and clustering by health facility to determine associated factors. Beta coefficients (β) and 95% confidence intervals (CI) were reported. Results We analyzed data from 818 participants, with normally distributed TB-related stigma scores: 25.3 ± 6.45. Higher TB-related stigma scores were statistically significantly associated with poor psychological well-being (β = 0.86, 95% CI: 0.60–1.13) and being a male (β = 0.77, 95% CI: 0.53–1.00). Individuals aged ≥25 years showed a borderline statistically significant association with TB-related stigma (β = 0.83, 95% CI: 0.11–1.55). Conclusion This study showed that poor psychological well-being and being male are associated with higher TB-related stigma scores among PWTB in Kampala, Uganda. TB programs should integrate mental health and implement stigma-reduction strategies that address underlying causes.