Browsing by Author "Musinguzi, Benson"
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Item Assessment of biosafety and biorisk management practices among medical laboratory students in two institutions in Uganda(Elsevier, 2022-09-07) Padde, John Roberts; Akiteng, Winnie; Edema, William; Atiku, Saad Mahjub; Tibyangye, Julius; Tekakwo, Job; Andruga, Cosmas; Hope, Derick; Musinguzi, Benson; Gesa, Jean Brenda; Amadile, Lawrence; Agondua, RobertMedical laboratory workers handle clinical specimens, which are a threat of exposure to infectious agents. Notably, medical laboratory science students report for internships with only theoretical knowledge of biosafety and biorisk management practices, predisposing them to a higher risk of laboratory hazards. In this study, we assessed the influence of entry-level students' adherence to practices and attitudes towards biosafety and biorisk management during the Internship. An online survey tool was used to explore the practices and attitudes towards laboratory biosafety and risk management. Of the 96 students, 60 (62.5%) anonymous responses were received, and of these, 60.3% were direct entrants, and 32.8% were diploma entrants. Most (91.7%) of the students attended hospital internships, with 60.2% in Biosafety Level (BSL)-2 laboratories and 70.2% rotating in all the core areas of laboratory medicine. The 8.3% who did not attend any internship were under the direct entry category. Exposure to biohazards was not significantly associated with laboratory safety level and student entry category (P> 0.05). Recommended laboratory biosafety practices were not significantly associated with the safety level of the laboratory and student entry category (P> 0.05). Poor attitudes towards certain laboratory biosafety practices were not significantly associated with the biosafety level of the training laboratory (P> 0.05), whereas training (P = 0.021) and clean-up procedures (P = 0.048) were associated with laboratory safety levels, respectively. The direct entrants had no access to BSL-3 laboratories, and this category of students had a negative attitude towards internship attendance. Therefore, there is a need to create a multi-channel full range laboratory biosafety and biorisk management teaching reforms based on practical application, real case studies, and laboratory simulation to be incorporated into the curriculum to benefit the direct entrant.Item Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda(Springer Nature, 2021-11-04) Zamarano, Henry; Musinguzi, Benson; Kabajulizi, Immaculate; Manirakiza, Godfrey; Guti, Walker; Muhwezi, Ivan; Ayan, Ahmed Hussein; Baweera, Agnes; Kabahinda, Boaz; Itabangi, Herbert; Bazira, Joel; Kabanda, TaseeraNeonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths.The objective of the study was to determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital. We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P < 0.05. Stata (version 14) used for statistical analysis. Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation.Item Distribution and antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with HIV in the era of universal test and treat policy in Uganda(Sage Publishing, 2024-04-30) Musinguzi, Benson; Turyamuhika, Laban; Mwesigwa, Alex; Nalumaga, Pauline Petra; Kabajulizi, Immaculate; Njovu, Israel Kiiza; Mwebesa, Edson; Luggya, Tonny; Ocheng, Francis; Kateete, David Patrick; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, BeatriceDespite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts. A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate Candida species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of Candida isolates to six antifungal drugs was determined using VITEK® (Marcy-l’Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto. The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which Candida albicans comprised of 20 (57.1%) while C. tropicalis and C. glabrata comprised 4 (11.4%) each. C. parapsilosis, C. dubliniensis and C. krusei accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like C. albicans showed 20% (4/20), C. glabrata 50% (2/4) and C. krusei 50% (1/2) resistance to fluconazole. Additionally, C. krusei showed 50% resistance to flucytosine. The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. C. albicans was the most frequently isolated oropharyngeal Candida species. C. glabrata and C. krusei exhibited the highest AFR among the non-albicans Candida species. The highest resistance was demonstrated to fluconazole.Item Distribution of Candida species isolated from people living with human immunodeficiency virus with oropharyngeal and oral candidiasis in Africa in the era of universal test and treat policy: a systematic review and meta‑analysis(Springer Nature, 2024-11-27) Musinguzi, Benson; Obuku, Ekwaro A.; Mwesigwa, Alex; Migisha, Richard; Kinengyere, Alison Annet; Ndagire, Regina; Baguma, Andrew; Okek, Erick Jacob; Olum, Ronald; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, BeatriceBackground: The introduction of antiretroviral therapy (ART) and the implementation of the human immunodeficiency virus (HIV) universal test and treat (UTT) policy have led to a decline in the incidence of opportunistic infections. However, oropharyngeal and oral candidiasis remain prevalent and continue to pose challenges among people living with human immunodeficiency virus (PLHIV) in Africa, indicating the need for a better understanding of the distribution of Candida species responsible for these infections. This systematic review and meta-analysis aimed to determine the distribution of Candida species isolated from PLHIV with oropharyngeal and oral candidiasis in Africa in the era of UTT policy. Methods: The review followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A comprehensive search was conducted to identify eligible studies to be included in the meta-analysis and analysed using a random effects model in STATA version 17. The risk of bias was assessed using the Joanna Briggs Institute quality assessment tool. Results: Fourteen studies with 4281 participants were included in the review. Overall, 2095 Candida isolates were reported, 78.7% (1650/2095) of which were C. albicans, 19.6% (410/2095), non-albicans Candida (NAC), and 1.7% (35/2095) could not be identified to the Candida specific species level. The most prevalent NAC species were C. glabrata (26.3%), followed by C. tropicalis (24.9%), C. krusei (15.6%), C. parapsilosis (11%), and C. dubliniensis (6.3%). The pooled prevalence of oropharyngeal and oral candidiasis was 48% (95% CI 34–62%). The prevalence of oropharyngeal candidiasis was higher in the pre-UTT era, at 56% (95% CI 40–72%, p < 0.001), than in the post-UTT era, at 34% (95% CI 10–67%, p < 0.001). The risk of bias assessment revealed that 71.4% (10/14) of the included studies had a low risk of bias and that 28.6% (4/14) had a moderate risk of bias. Conclusions: While C. albicans remain, the predominant species causing oropharyngeal and oral candidiasis among PLHIV in Africa, NAC species also contribute significantly to the infection burden. Despite ART and UTT policies, oropharyngeal candidiasis remains prevalent, emphasizing the need for targeted interventions.Item Extracellular hydrolytic enzyme activities and biofilm formation in Candida species isolated from people living with human immunodeficiency virus with oropharyngeal candidiasis at HIV/AIDS clinics in Uganda(Elsevier, 2024-12-14) Musinguzi, Benson; Akampurira, Andrew; Derick, Hope; Turyamuhika, Laban; Mwesigwa, Alex; Mwebesa, Edson; Mwesigye, Vicent; Kabajulizi, Immaculate; Sekulima, Tahalu; Ocheng, Francis; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, BeatriceBackground: Commensal oral Candida species can become opportunistic and transition to pathogenic causes of oropharyngeal candidiasis (OPC) in individuals with impaired immunity through ecological cues and the expression of extracellular hydrolytic enzyme activities and biofilm formation. Objective: We evaluated phospholipase, proteinase, hemolysin, esterase, and coagulase enzymatic activities and biofilm formation in Candida species isolated from people living with human immunodeficiency virus (PLHIV) with OPC. Methods: Thirty-five Candida isolates from PLHIV with OPC were retrieved from a sample repository and evaluated for phospholipase activity using the egg yolk agar method, proteinase activity using the bovine serum albumin agar method, hemolysin activity using the blood agar plate method, esterase activity using the Tween 80 opacity test medium method, coagulase activity using the classical tube method, and biofilm formation using the microtiter plate assay method in vitro. Results: A total of 35 Candida isolates obtained from PLHIV with OPC were included in this study, and phospholipase and proteinase activities were detected in 33/35 (94.3 %) and 31/35 (88.6 %) Candida isolates, respectively. Up to 25/35 (71.4 %) of the Candida isolates exhibited biofilm formation, whereas esterase activity was demonstrated in 23/35 (65.7 %) of the Candida isolates. Fewer isolates (21/35, 60 %) produced hemolysin, and coagulase production was the least common virulence activity detected in 18/35 (51.4 %) of the Candida isolates. Conclusion: Phospholipase and proteinase activities were the strongest in oropharyngeal Candida species.Item Functioning and control of phagocytosis(IntechOpen, 2023-04-24) Turyamuhika, Laban; Agaba, Bosco; Asiimwe, Moses; Musinguzi, Benson; Okek, ErickPhagocytosis is a very complex and versatile process that contributes to immunity through a series of events that is it’s sometimes referred to the Come and Eat me process. Due to the recognition ingestion and digestion then destruction. It’s also central to tissue homeostasis and remodeling by clearing dead cells. This ability of phagocytes to perform such diverse functions rests in large part on their vast repertoire of receptors. In this book chapter we looked at the processes used by phagocyte to perform there phagocytosis function. This is made possible by the binding of opsonins on the microbes like the C3b of the complement. This works as a chemo attractant to the phagocytes to come and initiate the process of eating. On recognition this microbe or dead cell interacts with the phagocyte with the help of a very big repertoire of receptors the microbe is engulfed with in the phagosome. As microbes interact with the phagocyte receptors a cascade of signaling events downstream that then activate phagocytosis. This membrane and cytoskeleton remodulation lead to the formation of pseudopods that cover the entire microbe forming a phagocytic cup which closes a few minutes to take up the microbe completely. The signal cascade is most known for the Fc receptor activities. Crosslinking of the Fc receptor on the surface of phagocyte activate phagocytosis and any other effector functions such as activation of the oxidative burst, degranulation, antibody dependent cell mediated cytotoxicity and activation of genes for cytokine/chemokine production that are beneficial in microbe destruction and initiation of inflammation. This starts once the interaction of phagocytes receptors and their ligands on the target microbes takes place appropriately. The phagocyte receptors will then aggregate to activate a series of pathways that regulate actin cytoskeleton which helps in the formation of a new vesicle which comes out of the membrane to enclose the microbe. In here a number of processes and stages take place all aimed at killing and denaturing the particle. They include early phagosome, intermediate phagosome, phagolysosome formation and the late phagosome all these participate in eliminating the phagocytized microbe. However with all the above phagocytic efficiency, some pathogens evade phagocytosis using different means and presence of certain capacities that facilitate evasion examples of organisms that evade phagocytosis include Mycobacterium tuberculosis, Listeria monocytogens Escherichia coli etc. all these use different means in evasion. Therefore the concept and science of Phagocytes used to be studied more to explore more pharmaceutical products based on the evasion mechanisms.Item Increasing postgraduate medical mycology research dissertations at Uganda's higher institution of learning(Elsevier, 2025-01) Achan, Beatrice; Musinguzi, Benson; Itabangi, Herbert; Sande, Obondo James; Meya, David B.Objectives Postgraduate medical mycology research may also be affected by funding. This study reports the positive impact of funding on postgraduate medical mycology research at Makerere University, Uganda. Methods This retrospective study was conducted on postgraduate medical microbiology dissertation topics from 2023 to 2024 using data collected between September and November 2024. Results A total of N = 60 postgraduate medical microbiology dissertations were analyzed for medical mycology topics, of which a total of 18 (30%) focused on medical mycology. The percentage of dissertations centered on medical mycology increased from 16% (four of 25) in 2023 to 40% (14 of 35) in 2024. Cryptococcal meningitis is the most studied fungal disease (35.7%) (five) in 2024. Notably, molecular-based polymerase chain reaction (50%, two) and semi-automated culture (35.7%, five) were the most commonly used laboratory methods in 2023 and 2024. There were 75% (four) and 71.4% (14) timely completions of the postgraduate students, and the Makerere University Fungal Group was formed to promote the “buddy system of learning” among the postgraduate medical mycology students. Conclusion There has been an increase in medical mycology research among postgraduate medical microbiology students at Makerere University, Uganda, which is attributable to increased funding.Item Investigating metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections: protocol for a laboratory-based cross-sectional study(JMIR Publications, 2023-04-09) Njovu, Israel Kiiza; Nalumaga, Pauline Petra; Ampaire, Lucas; Nuwagira, Edwin; Mwesigye, James; Musinguzi, Benson; Kassaza, Kennedy; Taseera, Kabanda; Mukasa, James Kiguli; Bazira, Joel; Iramiot, Jacob Stanley; Baguma, Andrew; Bongomin, Felix; Kwizera, Richard; Achan, Beatrice; Cox, Michael J; King, Jason S; May, Robin; Ballou, Elizabeth R; Itabangi, HerbertBackground: Fungal-bacterial cocolonization and coinfections pose an emerging challenge among patients suspected of having pulmonary tuberculosis (PTB); however, the underlying pathogenic mechanisms and microbiome interactions are poorly understood. Understanding how environmental microbes, such as fungi and bacteria, coevolve and develop traits to evade host immune responses and resist treatment is critical to controlling opportunistic pulmonary fungal coinfections. In this project, we propose to study the coexistence of fungal and bacterial microbial communities during chronic pulmonary diseases, with a keen interest in underpinning fungal etiological evolution and the predominating interactions that may exist between fungi and bacteria. Objective: This is a protocol for a study aimed at investigating the metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections through determining and characterizing the burden, etiological profiles, microbial communities, and interactions established between fungi and bacteria as implicated among patients with presumptive PTB. Methods: This will be a laboratory-based cross-sectional study, with a sample size of 406 participants. From each participant, 2 sputa samples (one on-spot and one early morning) will be collected. These samples will then be analyzed for both fungal and bacterial etiology using conventional metabolic and molecular (intergenic transcribed spacer and 16S ribosomal DNA–based polymerase chain reaction) approaches. We will also attempt to design a genome-scale metabolic model for pulmonary microbial communities to analyze the composition of the entire microbiome (ie, fungi and bacteria) and investigate host-microbial interactions under different patient conditions. This analysis will be based on the interplays of genes (identified by metagenomics) and inferred from amplicon data and metabolites (identified by metabolomics) by analyzing the full data set and using specific computational tools. We will also collect baseline data, including demographic and clinical history, using a patient-reported questionnaire. Altogether, this approach will contribute to a diagnostic-based observational study. The primary outcome will be the overall fungal and bacterial diagnostic profile of the study participants. Other diagnostic factors associated with the etiological profile, such as incidence and prevalence, will also be analyzed using univariate and multivariate schemes. Odds ratios with 95% CIs will be presented with a statistical significance set at P<.05. Results: The study has been approved by the Mbarara University Research Ethic Committee (MUREC1/7-07/09/20) and the Uganda National Council of Science and Technology (HS1233ES). Following careful scrutiny, the protocol was designed to enable patient enrollment, which began in March 2022 at Mbarara University Teaching Hospital. Data collection is ongoing and is expected to be completed by August 2023, and manuscripts will be submitted for publication thereafter. Conclusions: Through this protocol, we will explore the metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections among patients with presumptive PTB. Establishing key fungal-bacterial cross-kingdom synergistic relationships is crucial for instituting fungal bacterial coinfecting etiology.Item Laboratory diagnosis of candidiasis(IntechOpen, 2022-08-04) Musinguzi, Benson; Sande, Obondo J.; Mboowa, Gerald; Baguma, Andrew; Itabangi, Herbert; Achan, BeatriceThe burden of Candidiasis continues to increase and so does the Candida species. Although Candida species are closely similar phenotypically, they differ from each other in terms of epidemiology, genetic characteristics, antifungal susceptibility and virulence profile. Therefore, reliable and accurate laboratory methods for identification of Candida species can determine the Candidiasis burden and enable the administration of the most appropriate antifungal drug therapy to reduce fungal mortality rates. Conventional and biochemical methods are often used in identification of Candida species. However, these techniques are specific and sensitive enough in detecting the non albicans candida (NAC) species. Molecular techniques have improved the laboratory diagnosis and management of Candidiasis due to improved sensitivity and specificity threshold. This chapter provides an overview of different laboratory methods for diagnosis of Candidiasis.Item Plasmodium falciparum genetic diversity and multiplicity of infection among asymptomatic and symptomatic malaria-infected individuals in Uganda(Springer Nature, 2024-11-14) Mwesigwa, Alex; Ocan, Moses; Cummings, Bryan; Musinguzi, Benson; Kiyaga, Shahid; Kiwuwa, Steven M.; Okoboi, Stephen; Castelnuovo, Barbara; Bikaitwoha, Everd Maniple; Kalyango, Joan N.; Karamagi, Charles; Nankabirwa, Joaniter I.; Nsobya, Samuel L.; Byakika-Kibwika, PaulineBackground: Plasmodium falciparum (P. falciparum) remains a significant public health challenge globally, especially in sub-Saharan Africa (SSA), where it accounts for 99% of all malaria infections. The outcomes of P. falciparum infection vary, ranging from asymptomatic to severe, and are associated with factors such as host immunity, parasite genetic diversity, and multiplicity of infection (MOI). Using seven neutral microsatellite markers, the current study investigated P. falciparum genetic diversity and MOI in both asymptomatic and symptomatic malaria individuals in Uganda. Methods: This cross-sectional study analyzed 225 P. falciparum isolates from both asymptomatic and symptomatic malaria patients, ranging in age from 6 months to ≥ 18 years. P. falciparum genetic diversity, MOI, and multi-locus linkage disequilibrium (LD) were assessed through genotyping of seven neutral microsatellite markers: Poly-α, TA1, TA109, PfPK2, 2490, C2M34–313, and C3M69–383. Genetic data analysis was performed using appropriate genetic analysis software. Results: P. falciparum infections exhibited high genetic diversity in both asymptomatic and symptomatic individuals. The mean expected heterozygosity (He) ranged from 0.79 in symptomatic uncomplicated malaria cases to 0.81 in asymptomatic individuals. There was no significant difference (p = 0.33) in MOI between individuals with asymptomatic and symptomatic infections, with the mean MOI ranging from 1.92 in symptomatic complicated cases to 2.10 in asymptomatic individuals. Polyclonal infections were prevalent, varying from 58.5% in symptomatic complicated malaria to 63% in symptomatic uncomplicated malaria cases. A significant linkage disequilibrium (LD) was observed between asymptomatic and symptomatic uncomplicated/complicated infections (p < 0.01). Genetic differentiation was low, with FST values ranging from 0.0034 to 0.0105 among P. falciparum parasite populations in asymptomatic and symptomatic uncomplicated/complicated infections. Conclusion: There is a high level of P. falciparum genetic diversity and MOI among both symptomatic and asymptomatic individuals in Uganda. Asymptomatic carriers harbor a diverse range of parasites, which poses challenges for malaria control and necessitates targeted interventions to develop effective strategies.Item Plasmodium falciparum genetic diversity and multiplicity of infection based on msp-1, msp-2, glurp and microsatellite genetic markers in sub-Saharan Africa: a systematic review and meta-analysis(Springer Nature, 2024-04-08) Mwesigwa, Alex; Ocan, Moses; Musinguzi, Benson; Nante, Rachel Wangi; Nankabirwa, Joaniter I.; Kiwuwa, Steven M.; Kinengyere, Alison Annet; Castelnuovo, Barbara; Karamagi, Charles; Obuku, Ekwaro A.; Nsobya, Samuel L.; Mbulaiteye, Sam M.; Byakika-Kibwika, PaulineIn sub-Saharan Africa (SSA), Plasmodium falciparum causes most of the malaria cases. Despite its crucial roles in disease severity and drug resistance, comprehensive data on Plasmodium falciparum genetic diversity and multiplicity of infection (MOI) are sparse in SSA. This study summarizes available information on genetic diversity and MOI, focusing on key markers (msp-1, msp-2, glurp, and microsatellites). The systematic review aimed to evaluate their influence on malaria transmission dynamics and offer insights for enhancing malaria control measures in SSA. The review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Two reviewers conducted article screening, assessed the risk of bias (RoB), and performed data abstraction. Meta-analysis was performed using the random-effects model in STATA version 17. The review included 52 articles: 39 cross-sectional studies and 13 Randomized Controlled Trial (RCT)/cohort studies, involving 11,640 genotyped parasite isolates from 23 SSA countries. The overall pooled mean expected heterozygosity was 0.65 (95% CI: 0.51–0.78). Regionally, values varied: East (0.58), Central (0.84), Southern (0.74), and West Africa (0.69). Overall pooled allele frequencies of msp-1 alleles K1, MAD20, and RO33 were 61%, 44%, and 40%, respectively, while msp-2 I/C 3D7 and FC27 alleles were 61% and 55%. Central Africa reported higher frequencies (K1: 74%, MAD20: 51%, RO33: 48%) than East Africa (K1: 46%, MAD20: 42%, RO33: 31%). For msp-2, East Africa had 60% and 55% for I/C 3D7 and FC27 alleles, while West Africa had 62% and 50%, respectively. The pooled allele frequency for glurp was 66%. The overall pooled mean MOI was 2.09 (95% CI: 1.88–2.30), with regional variations: East (2.05), Central (2.37), Southern (2.16), and West Africa (1.96). The overall prevalence of polyclonal Plasmodium falciparum infections was 63% (95% CI: 56–70), with regional prevalences as follows: East (62%), West (61%), Central (65%), and South Africa (71%)Item Sero-antigen prevalence of lymphatic filariasis and risk factors of podoconiosis in Busiriba sub-county, Kamwenge district, Southwestern Uganda, August–September 2018(Springer Nature, 2024-05-17) Mwesigye, Vicent; Musinguzi, Benson; Okongo, Benson; Mucunguzi, William; Kakaire, Michael Nyende; Migisha, RichardGiven the neglected nature of filariasis, especially in Uganda where data are scarce, this cross-sectional study aimed to determine the sero-antigen prevalence of lymphatic filariasis and risk factors associated with non-lymphatic filariasis (podoconiosis) in Busiriba Sub-county, Kamwenge District, Uganda, during August–September 2018, to inform targeted elimination efforts. We enrolled 101 participants, among whom 35 (34.7%) had podoconiosis. The sero-antigen prevalence of lymphatic filariasis was 1.0%. Older age and walking barefoot were associated with increased podoconiosis risk. Specifically, individuals aged 25–49 years with had 7.38 times higher odds of podoconiosis (adjusted odds ratio [aOR] = 7.38, 95% CI: 1.36–40.13) compared to those under 25 years, while those aged ≥ 50 years had even higher odds (aOR = 8.49, 95%CI: 1.44–50.15). Additionally, individuals who reported walking barefoot had 14 times higher odds of podoconiosis (aOR = 14.08; 95% CI: 2.49–79.50).Item Status of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara University Teaching Hospital in Southwestern Uganda(SAGE Publications, 2021-08-31) Njovu, Israel Kiiza; Musinguzi, Benson; Mwesigye, James; Kassaza, Kennedy; Turigurwa, Joseph; Nuwagira, Edwin; Bazira, Joel; Kabanda, Taseera; Mpeirwe, Moses; Ampaire, Lucas; Mutekanga, Andrew; Kiguli, James; Achan, Beatrice; Itabangi, HerbertPulmonary mycoses are important diseases of the respiratory tract caused by pulmonary fungal pathogens. These pathogens are responsible for significant morbidity and mortality rates worldwide; however, less attention has been paid to them. In this study we determined the prevalence of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara Regional Referral Hospital. This was a hospital based cross sectional survey. Sputum samples were collected from each study participant. For each sample, the following tests were performed: Sabouraud dextrose agar for fungal culture, GeneXpert for Mycobacteria tuberculosis (MTB) and potassium hydroxide for fungal screening. Filamentous fungal growth and yeasts were further examined with lactophenol cotton blue staining and germ tube respectively. Out of 113 study participants, 80 (70.7%) had pulmonary fungal pathogens whilst those with pulmonary tuberculosis numbered five (4.4%). Candida albicans [21 (22.58%)] and Aspergillus species [16 (17.20%)] were the pathogens most identified among others. Two (1.7%) TB GeneXpert positive participants had fungal pathogens isolated from their sputum samples. We established a prevalence of 57 (71.3%) for pulmonary fungal pathogen (PFP) isolates, three (60.0%) for MTB in HIV positive patients and 18 (22.5%) for PFP, and zero (0.0%) for MTB in HIV negative patients. On the other hand, two (100%) HIV positive patients had both PFP isolates and MTB.Our findings highlight the diversity of neglected pulmonary fungal pathogens whose known medical importance in causing pulmonary mycoses cannot be overemphasised. Therefore this presents a need for routine diagnosis for pulmonary mycoses among TB suspects and set-up of antimicrobial profile for pulmonary fungal isolates to support clinical management of these cases.Item Temporal changes in Plasmodium falciparum genetic diversity and multiplicity of infection across three areas of varying malaria transmission intensities in Uganda(Springer Nature, 2023-12-30) Mwesigwa, Alex; Kiwuwa, Steven M.; Musinguzi, Benson; Kawalya, Hakiim; Katumba, James Davis; Baguma, Andrew; Mutuku, Irene M.; Adebayo, Ismail Abiola; Nsobya, Samuel L.; Byakika‑Kibwika, Pauline; Kalyango, Joan N.; Karamagi, Charles; Nankabirwa, Joaniter I.Background: Malaria is a significant public health challenge in Uganda, with Plasmodium falciparum (P. falciparum) responsible for most of malaria infections. The high genetic diversity and multiplicity of infection (MOI) associated with P. falciparum complicate treatment and prevention efforts. This study investigated temporal changes in P. falciparum genetic diversity and MOI across three sites with varying malaria transmission intensities. Understanding these changes is essential for informing effective malaria control strategies for the different malaria transmission settings. Methods: A total of 220 P. falciparum-positive dried blood spot (DBS) filter paper samples from participants in a study conducted during 2011–2012 and 2015–2016 were analyzed. Genotyping utilized seven polymorphic markers: Poly-α, TA1, TA109, PfPK2, 2490, C2M34–313, and C3M69–383. Genetic diversity metrics, including the number of alleles and expected heterozygosity, were calculated using GENALEX and ARLEQUIN software. MOI was assessed by counting distinct genotypes. Multi-locus linkage disequilibrium (LD) and genetic differentiation were evaluated using the standardized index of association (IAS) and Wright’s fixation index (FST), respectively. Statistical comparisons weremade using the Kruskal–Wallis test, and temporal trends were analyzed using the Jonckheere–Terpstra test, with statistical significance set at p < 0.05. Results: Of the 220 samples, 180 were successfully amplified. The majority of participants were males (50.6%) and children aged 5–11 years (46.7%). Genetic diversity remained high, with mean expected heterozygosity (He) showing a slight decrease over time (range: 0.73–0.82). Polyclonal infections exceeded 50% at all sites, and mean MOI ranged from 1.7 to 2.2, with a significant reduction in Tororo (from 2.2 to 2.0, p = 0.03). Linkage disequilibrium showed a slight increase, with Kanungu exhibiting the lowest IA S in 2011–2012 (0.0085) and Jinja the highest (0.0239) in 2015–2016. Overall genetic differentiation remained low, with slight increases in pairwise FST values over time, notably between Jinja and Tororo (from 0.0145 to 0.0353).