29 results on '"Ssetaala, Ali"'
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2. Acceptability and applicability of biometric iris scanning for the identification and follow up of highly mobile research participants living in fishing communities along the shores of Lake Victoria in Kenya, Tanzania, and Uganda
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Okello, Elialilia, Ayieko, Philip, Kwena, Zachary, Nanyonjo, Gertrude, Bahemuka, Ubaldo, Price, Matt, Bukusi, Elizabeth, Hashim, Ramadhan, Nakamanya, Sarah, Okech, Brenda, Kuteesa, Monica, Oketch, Bertha, Ssetaala, Ali, Ruzagira, Eugene, Kidega, William, Fast, Patricia, Kibengo, Freddie, Grosskurth, Heiner, Seeley, Janet, and Kapiga, Saidi
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- 2023
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3. Social networks, mobility, and HIV risk among women in the fishing communities of Lake Victoria
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Nakamanya, Sarah, Okello, Elialilia S., Kwena, Zachary A., Nanyonjo, Gertrude, Bahemuka, Ubaldo M., Kibengo, Freddie M., Ssetaala, Ali, Bukusi, Elizabeth A., Kapiga, Saidi, Fast, Patricia E., and Seeley, Janet
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- 2022
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4. Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey
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Ssetaala, Ali, Ssempiira, Julius, Nanyonjo, Gertrude, Okech, Brenda, Chinyenze, Kundai, Bagaya, Bernard, Price, Matt A, Kiwanuka, Noah, and Degomme, Olivier
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- 2021
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5. Hepatitis B prevalence and incidence in the fishing communities of Lake Victoria, Uganda: a retrospective cohort study
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Kitandwe, Paul Kato, Muyanja, Enoch, Nakaweesa, Teddy, Nanvubya, Annet, Ssetaala, Ali, Mpendo, Juliet, Okech, Brenda, Bagaya, Bernard S., Kiwanuka, Noah, and Price, Matt A.
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- 2021
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6. Finding women in fishing communities around Lake Victoria: "Feasibility and acceptability of using phones and tracking devices".
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Nanyonjo, Gertrude, Kwena, Zachary, Nakamanya, Sarah, Okello, Elialilia, Oketch, Bertha, Bahemuka, Ubaldo M., Ssetaala, Ali, Okech, Brenda, Price, Matt A., Kapiga, Saidi, Fast, Pat, Bukusi, Elizabeth, and Seeley, Janet
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FISHING villages ,FISH communities ,SIM cards ,GPS receivers ,GLOBAL Positioning System - Abstract
Introduction: Women in fishing communities have both high HIV prevalence and incidence, hence they are a priority population for HIV prevention and treatment interventions. However, their mobility is likely to compromise the effectiveness of interventions. We assessed the acceptability, feasibility and of using phones and global positioning system (GPS) devices for tracking mobility, to inform future health research innovations. Methods: A mult-site formative qualitative study was conducted in six purposively selected Fishing Communities on the shores of Lake Victoria in Kenya, Tanzania, and Uganda. Participants were selected based on duration of stay in the community and frequency of movement. Sixty-four (64) women participated in the study (16 per fishing community). Twenty-four (24) participants were given a study phone; 24 were asked to use their own phones and 16 were provided with a portable GPS device to understand what is most preferred. Women were interviewed about their experiences and recommendations on carrying GPS devices or phones. Twenty four (24) Focus Group Discussions with 8–12 participants were conducted with community members to generate data on community perceptions regarding GPS devices and phones acceptability among women. Data were analyzed thematically and compared across sites/countries. Results: Women reported being willing to use tracking devices (both phones and GPS) because they are easy to carry. Their own phone was preferred compared to a study phone and GPS device because they were not required to carry an additional device, worry about losing it or be questioned about the extra device by their sexual partner. Women who carried GPS devices suggested more sensitization in communities to avoid domestic conflicts and public concern. Women suggested changing the GPS colour from white to a darker colour and, design to look like a commonly used object such as a telephone Subscriber Identity Module (SIM) card, a rosary/necklace or a ring for easy and safe storage. Conclusion: Women in the study communities were willing to have their movements tracked, embraced the use of phones and GPS devices for mobility tracking. Devices need to be redesigned to be more discrete, but they could be valuable tools to understanding movement patterns and inform design of interventions for these mobile populations. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey
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Ssetaala, Ali, Nabawanuka, Joan, Matovu, Gideon, Nakiragga, Nusula, Namugga, Judith, Nalubega, Phiona, Kaluuma, Henry Lutalo, Chinyenze, Kundai, Perehudoff, Katrina, Michielsen, Kristien, Bagaya, Bernard, Price, Matt, Kiwanuka, Noah, and Degomme, Olivier
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- 2020
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8. Protocol for a randomized clinical trial exploring the effect of antimicrobial agents on the penile microbiota, immunology and HIV susceptibility of Ugandan men
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Galiwango, Ronald M., Bagaya, Bernard, Mpendo, Juliet, Joag, Vineet, Okech, Brenda, Nanvubya, Annet, Ssetaala, Ali, Muwanga, Moses, and Kaul, Rupert
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- 2019
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9. Schistosoma mansoni infection alters the host pre-vaccination environment resulting in blunted Hepatitis B vaccination immune responses.
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Muir, Roshell, Metcalf, Talibah, Fourati, Slim, Bartsch, Yannic, Kyosiimire-Lugemwa, Jacqueline, Canderan, Glenda, Alter, Galit, Muyanja, Enoch, Okech, Brenda, Namatovu, Teddy, Namara, Irene, Namuniina, Annemarie, Ssetaala, Ali, Mpendo, Juliet, Nanvubya, Annet, Kitandwe, Paul Kato, Bagaya, Bernard S., Kiwanuka, Noah, Nassuna, Jacent, and Biribawa, Victoria Menya
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SCHISTOSOMA mansoni ,HEPATITIS B vaccines ,IMMUNE response ,IMMUNOLOGIC memory ,REGULATORY T cells ,PSYCHONEUROIMMUNOLOGY - Abstract
Schistosomiasis is a disease caused by parasitic flatworms of the Schistosoma spp., and is increasingly recognized to alter the immune system, and the potential to respond to vaccines. The impact of endemic infections on protective immunity is critical to inform vaccination strategies globally. We assessed the influence of Schistosoma mansoni worm burden on multiple host vaccine-related immune parameters in a Ugandan fishing cohort (n = 75) given three doses of a Hepatitis B (HepB) vaccine at baseline and multiple timepoints post-vaccination. We observed distinct differences in immune responses in instances of higher worm burden, compared to low worm burden or non-infected. Concentrations of pre-vaccination serum schistosome-specific circulating anodic antigen (CAA), linked to worm burden, showed a significant bimodal distribution associated with HepB titers, which was lower in individuals with higher CAA values at month 7 post-vaccination (M7). Comparative chemokine/cytokine responses revealed significant upregulation of CCL19, CXCL9 and CCL17 known to be involved in T cell activation and recruitment, in higher CAA individuals, and CCL17 correlated negatively with HepB titers at month 12 post-vaccination. We show that HepB-specific CD4
+ T cell memory responses correlated positively with HepB titers at M7. We further established that those participants with high CAA had significantly lower frequencies of circulating T follicular helper (cTfh) subpopulations pre- and post-vaccination, but higher regulatory T cells (Tregs) post-vaccination, suggesting changes in the immune microenvironment in high CAA could favor Treg recruitment and activation. Additionally, we found that changes in the levels of innate-related cytokines/chemokines CXCL10, IL-1β, and CCL26, involved in driving T helper responses, were associated with increasing CAA concentration. This study provides further insight on pre-vaccination host responses to Schistosoma worm burden which will support our understanding of vaccine responses altered by pathogenic host immune mechanisms and memory function and explain abrogated vaccine responses in communities with endemic infections. Author summary: Schistosomiasis drives host immune responses for optimal pathogen survival, potentially altering host responses to vaccine-related antigen. Chronic schistosomiasis and co-infection with hepatotropic viruses are common in countries where schistosomiasis is endemic. We explored the impact of Schistosoma mansoni (S. mansoni) worm burden on Hepatitis B (HepB) vaccination of individuals from a fishing community in Uganda. We demonstrate that higher schistosome-specific antigen (circulating anodic antigen, CAA) concentration pre-vaccination, is associated with lower HepB antibody titers post-vaccination at month 7. We show higher pre-vaccination levels of CCL17 in instances of high CAA that negatively associate with HepB antibody titers month 12 post-vaccination and coincided with lower frequencies of circulating T follicular helper cell populations (cTfh), proliferating antibody secreting cells (ASCs), and higher frequencies of regulatory T cells (Tregs). We also show that monocyte function is important in HepB vaccine responses, and high CAA is associated with alterations in the early innate cytokine/chemokine microenvironment. Our findings suggest that in individuals with high CAA and likely high worm burden, schistosomiasis can create an environment that is polarized against optimal host immune responses to the vaccine, which puts many endemic communities at risk for infection against HepB and other diseases that are preventable by vaccines. [ABSTRACT FROM AUTHOR]- Published
- 2023
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10. A randomized trial to assess retention rates using mobile phone reminders versus physical contact tracing in a potential HIV vaccine efficacy population of fishing communities around Lake Victoria, Uganda
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Kiwanuka, Noah, Mpendo, Juliet, Asiimwe, Stephen, Ssempiira, Julius, Nalutaaya, Annet, Nambuusi, Betty, Wambuzi, Mathias, Kabuubi, Brian, Namuniina, Annemarie, Oporia, Frederick, Nanvubya, Annet, and Ssetaala, Ali
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- 2018
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11. Improving access to maternal health services among rural hard-to-reach fishing communities in Uganda, the role of community health workers.
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Ssetaala, Ali, Ssempiira, Julius, Wambuzi, Mathias, Nanyonjo, Gertrude, Okech, Brenda, Chinyenze, Kundai, Bagaya, Bernard, Price, Matt A, Kiwanuka, Noah, and Degomme, Olivier
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MATERNAL health services ,HEALTH services accessibility ,CONFIDENCE intervals ,RURAL conditions ,RESEARCH methodology ,MEDICAL care ,RESEARCH funding ,PRENATAL care ,LOGISTIC regression analysis ,ODDS ratio ,DATA analysis software ,LONGITUDINAL method - Abstract
Objectives: To explore whether community health worker household-based maternal health visits improve antenatal care and skilled birth attendance among hard-to-reach fishing villages on Lake Victoria, Uganda. Methods: This quasi-experimental 18-month prospective study involved 486 consenting women aged 15–49 years, who were pregnant or had a pregnancy outcome in the past 6 months, from 6 island fishing communities. The community health worker household-based intervention (community health workers' household visits to provide counseling, blood pressure measurement, anemia, and HIV testing) involved 243 women from three fishing communities. Random effects logistic regression was used to determine the association between the community health worker intervention and antenatal care and skilled birth attendance among women who had at least 5 months of pregnancy or childbirth at follow-up. Results: Almost all women accepted the community health worker intervention (90.9% (221/243)). Hypertension was at 12.5% (27/216) among those who accepted blood pressure measurements, a third (33.3% (9/27)) were pregnant. HIV prevalence was 23.5% (52/221). Over a third (34.2% (69/202)) of women tested had anemia (hemoglobin levels less than 11 g/dL). The community health worker intervention was associated with attendance of first antenatal care visit within 20 weeks of pregnancy (adjusted odd ratio = 2.1 (95% confidence interval 0.6–7.6)), attendance of at least four antenatal care visits (adjusted odd ratio = 0.9 (95% confidence interval 0.4–2.0)), and skilled birth attendance (adjusted odd ratio = 0.5 (95% confidence interval 0.1–1.5)), though not statistically significant. Conclusion: Community health workers have a crucial role in improving early antenatal care attendance, early community-based diagnosis of anemia, hypertensive disorders, and HIV among women in these hard-to-reach fishing communities. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Understanding mobility and sexual risk behaviour among women in fishing communities of Lake Victoria in East Africa: a qualitative study.
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Kwena, Zachary, Nakamanya, Sarah, Nanyonjo, Gertrude, Okello, Elialilia, Fast, Pat, Ssetaala, Ali, Oketch, Bertha, Price, Matt, Kapiga, Saidi, Bukusi, Elizabeth, Seeley, Janet, the LVCHR, Grosskurth, Heiner, Kamali, Anatoli, Kaleebu, Pontiano, Kibengo, Freddie Mukasa, Kidega, William, De Bont, Jan, and LVCHR
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FISHING villages ,HIV prevention ,HIV infections ,WOMEN'S sexual behavior ,WOMEN - Abstract
Background: HIV-prevalence and incidence is high in many fishing communities around Lake Victoria in East Africa. In these settings, mobility among women is high and may contribute to increased risk of HIV infection and poor access to effective prevention and treatment services. Understanding the nature and patterns of this mobility is important for the design of interventions. We conducted an exploratory study to understand the nature and patterns of women's mobility to inform the design of HIV intervention trials in fishing communities of Lake Victoria.Methods: This was a cross-sectional formative qualitative study conducted in six purposively selected fishing communities in Kenya, Tanzania and Uganda. Potential participants were screened for eligibility on age (18+ years) and having stayed in the fishing community for more than 6 months. We collected data using introductory and focus group discussions, and in-depth interviews with key informants. Data focused on: history and patterns of mobility, migration in and out of fishing communities and the relationship between mobility and HIV infection. Since the interviews and discussions were not audio-recorded, detailed notes were taken and written up into full scripts for analysis. We conducted a thematic analysis using constant comparison analysis.Results: Participants reported that women in fishing communities were highly mobile for work-related activities. Overall, we categorized mobility as travels over long and short distances or periods depending on the kind of livelihood activity women were involved in. Participants reported that women often travelled to new places, away from familiar contacts and far from healthcare access. Some women were reported to engage in high risk sexual behaviour and disengaging from HIV care. However, participants reported that women often returned to the fishing communities they considered home, or followed a seasonal pattern of work, which would facilitate contact with service providers.Conclusion: Women exhibited circular and seasonal mobility patterns over varying distances and duration away from their home communities. These mobility patterns may limit women's access to trial/health services and put them at risk of HIV-infection. Interventions should be tailored to take into account mobility patterns of seasonal work observed in this study. [ABSTRACT FROM AUTHOR]- Published
- 2020
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13. Antenatal Care Practices Among Hard-to-Reach Fishing Communities on Lake Victoria: A Community-Based Cross-Sectional Survey.
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Ssetaala, Ali, Nabawanuka, Joan, Matovu, Gideon, Nakiragga, Nusula, Namugga, Judith, Nalubega, Phiona, Lutalo Kaluuma, Henry, Perehudoff, Katrina, Michielsen, Kristien, Bagaya, Bernard, Kiwanuka, Noah, and Degomme, Olivier
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- 2020
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14. High HIV-1 prevalence, risk behaviours, and willingness to participate in HIV vaccine trials in fishing communities on Lake Victoria, Uganda
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Kiwanuka, Noah, Ssetaala, Ali, Mpendo, Juliet, Wambuzi, Matthias, Nanvubya, Annet, Sigirenda, Simon, Nalutaaya, Annet, Kato, Paul, Nielsen, Leslie, Kaleebu, Pontiano, Nalusiba, Josephine, and Sewankambo, Nelson K.
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AIDS vaccines -- Research -- Usage ,Industry hiring ,Health - Abstract
Introduction: HIV epidemics in sub-Saharan Africa are generalized, but high-risk subgroups exist within these epidemics. A recent study among fisher-folk communities (FFC) in Uganda showed high HIV prevalence (28.8%) and incidence (4.9/100 person-years). However, those findings may not reflect population-wide HIV rates in FFC since the study population was selected for high-risk behaviour. Methods: Between September 2011 and March 2013, we conducted a community-based cohort study to determine the population representative HIV rates and willingness to participate (WTP) in hypothetical vaccine trials among FFC, Uganda. At baseline (September 2011-January 2012), a household enumeration census was done in eight fishing communities (one lakeshore and seven islands), after which a random sample of 2200 participants aged 18-49 years was selected from 5360 individuals. Interviewer-administered questionnaire data were collected on HIV risk behaviours and WTP, and venous blood was collected for HIV testing using rapid HIV tests with enzyme-linked immunosorbent assay (EIA) confirmation. Adjusted prevalence proportion ratios (adj.PPRs) of HIV prevalence were determined using log-binomial regression models. Results: Overall baseline HIV prevalence was 26.7% and was higher in women than men (32.6% vs. 20.8%, p B0.0001). Prevalence was lower among fishermen (22.4%) than housewives (32.1%), farmers (33.1%) and bar/lodge/restaurant workers (37%). The adj.PPR of HIV was higher among women than men (adj.PPR = 1.50, 95%; 1.20, 1.87) and participants aged 30-39 years (adj.PPR = 1.40, 95%; 1.10,1.79) and 40-49 years (adj.PPR = 1.41, 95%; 1.04,1.92) compared to those aged 18-24 years. Other factors associated with HIV prevalence included low education, previous marriage, polygamous marriage, alcohol and marijuana use before sex. WTP in hypothetical vaccine trials was 89.3% and was higher in men than women (91.2% vs. 87.3%, p= 0.004) and among island communities compared to lakeshore ones (90.4% vs. 85.8%, p= 0.004). Conclusions: The HIV prevalence in the general fisher-folk population in Uganda is similar to that observed in the 'high-risk' fisher folk. FFC have very high levels of willingness to participate in future HIV vaccine trials. Keywords: HIV-1; willingness to participate in HIV vaccine trials; fishing communities; Uganda., Introduction Globally, the HIV pandemic is most severe in East and Southern African countries, where the regional epidemics are generalized and stable or declining [1]. In generalized HIV epidemics, transmission [...]
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- 2013
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15. Field Performance of PIMA Point-of-Care Machine for CD4 Enumeration Under a Mobile HIV Counseling and Testing Program in Remote Fishing Communities of Lake Victoria, Uganda.
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Namuniina, Annemarie, Lutwama, Fredrick, Biribawa, Victoria Menya, Kizza, David, Kabuubi, Brian Roy, Kitandwe, Paul Kato, Mpendo, Juliet, Nanvubya, Annet, Ssempiira, Julius, Nalutaaya, Annet, Ssetaala, Ali, Welsh, Sabrina, Price, Matt A., Kiwanuka, Noah, and Bagaya, Bernard Ssentalo
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Uganda is among the most HIV/AIDS-afflicted countries, and many HIV-infected persons live in remote areas with poor access to health care. The success of HIV care programs relies in part on patient monitoring using CD4 T cell counts. We conducted an evaluation of the point-of-care PIMA test using BD FACSCount as a gold standard. One hundred fifty-one participants were enrolled, provided venous blood and samples tested at the point of care with the Alere PIMA™ CD4 Analyzer and the BD FACSCount in the UVRI-IAVI main laboratory. Correlation between the methods was assessed, as was the ability of the Pima Analyzer to predict values <200, <350, and ≥500 CD4 cells/mm
3 when compared with BD FACSCount as the gold standard. A near-perfect positive Pearson correlation coefficient (r = 0.948; p < .0001) between the two methods was observed. The Alere PIMA Analyzer had a mean bias of −32.5 cells/mm3 . The sensitivity and specificity, for PIMA to predict CD4 lymphocyte count less than 200 cells/mm3 , were 71.4% and 100%, respectively; less than 350 cells/mm3 were 84.6% and 94.6%, respectively; and at CD4 count less than 500 cells/mm3 were 94.4% and 100%. The Alere Pima Analyzer provides reliable CD4 cell count measurement and is suitable for monitoring and screening eligible HIV patients in hard-to-reach settings. [ABSTRACT FROM AUTHOR]- Published
- 2019
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16. Population attributable fraction of incident HIV infections associated with alcohol consumption in fishing communities around Lake Victoria, Uganda.
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Kiwanuka, Noah, Ssetaala, Ali, Ssekandi, Ismail, Nalutaaya, Annet, Kitandwe, Paul Kato, Ssempiira, Julius, Bagaya, Bernard Ssentalo, Balyegisawa, Apolo, Kaleebu, Pontiano, Hahn, Judith, Lindan, Christina, and Sewankambo, Nelson Kaulukusi
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HIV infections , *DISEASE incidence , *ALCOHOL drinking , *FISHING villages - Abstract
Background: Although the association between alcohol consumption and HIV risk is well documented, few studies have examined the magnitude of new HIV infections that could be prevented by controlling alcohol use. We report the population attributable fraction (PAF) of incident HIV infections due to alcohol consumption among the HIV high-risk population of fishing communities along Lake Victoria, Uganda. Methods: In a community-based cohort study, 1607 HIV sero-negative participants aged 18–49 years were enrolled from eight fishing communities along Lake Victoria, Uganda. At follow up 12 months later, 1288 (80.1%) were seen and interviewed. At baseline and follow-up visits, participants completed interviewer-administered questionnaires on alcohol consumption, demographics, and sexual risk behavior, and were tested for HIV infection. HIV incidence and adjusted incident rate ratios (adjusted IRRs) were estimated using Poisson regression models; the crude and adjusted PAFs of incident HIV infections associated with alcohol consumption were calculated using the Greenland and Drescher method for cohort studies. Results: Among the 1288 participants seen at follow up, 53.5% reported drinking alcohol of whom 24.4% drank occasionally (2 days a week or less) and 29.1% drank regularly (3–7 days a week). Forty eight incident HIV infections occurred giving an incidence rate of 3.39/100 person years at-risk (pyar) (95% CI, 2.55–4.49). Compared to non-drinkers, the adjusted IRR of HIV was 3.09 (1.13–8.46) among occasional drinkers and 5.34 (2.04–13.97) among regular drinkers. The overall adjusted PAF of incident HIV infections due alcohol was 64.1 (95% CI; 23.5–83.1); ranging from 52.3 (11.9–74.2) among Muslims to 71.2 (32.6–87.7) for participants who reported ≥ 2 sexual partners in the past 12 months. Conclusion: In fishing communities along Lake Victoria, Uganda, 64% of new HIV infections can be attributed to drinking alcohol. Interventions to reduce alcohol consumption should be integrated in HIV/AIDS prevention activities for populations in whom both HIV and alcohol consumption are highly prevalent. [ABSTRACT FROM AUTHOR]
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- 2017
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17. Factors associated with dropout in a long term observational cohort of fishing communities around lake Victoria, Uganda.
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Abaasa, Andrew, Asiki, Gershim, Mpendo, Juliet, Levin, Jonathan, Seeley, Janet, Nielsen, Leslie, Ssetaala, Ali, Nanvubya, Annet, De Bont, Jan, Kaleebu, Pontiano, and Kamali, Anatoli
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FISHING villages ,HIV ,HIV prevention ,CONFIDENCE intervals - Abstract
Background: Fishing communities are potentially suitable for Human immunodeficiency virus (HIV) efficacy trials due to their high risk profile. However, high mobility and attrition could decrease statistical power to detect the impact of a given intervention. We report dropout and associated factors in a fisher-folk observational cohort in Uganda. Methods: Human immunodeficiency virus-uninfected high-risk volunteers aged 13-49 years living in five fishing communities around Lake Victoria were enrolled and followed every 6 months for 18 months at clinics located within each community. Volunteers from two of the five communities had their follow-up periods extended to 30 months and were invited to attend clinics 10-40 km (km) away from their communities. Human immunodeficiency virus counseling and testing was provided, and data on sexual behaviour collected at all study visits. Study completion was defined as completion of 18 or 30 months or visits up to the date of sero-conversion and dropout as missing one or more visits. Discrete time survival models were fitted to find factors independently associated with dropout. Results: A total of 1000 volunteers (55 % men) were enrolled. Of these, 91.9 % completed 6 months, 85.2 % completed 12 months and 76.0 % completed 18 months of follow-up. In the two communities with additional follow-up, 76.9 % completed 30 months. In total 299 (29.9 %) volunteers missed at least one visit (dropped out). Dropout was independently associated with age (volunteers aged 13-24 being most likely to dropout), gender [men being more likely to dropout than women [adjusted hazard ratio (aHR) 1.4; 95 % confidence interval (CI) 1.1-1.8)], time spent in the fishing community (those who stayed <1 year being most likely to dropout), History of marijuana use (users being more likely to dropout than non-users [1.7; (1.2-2.5)], ethnicity (non-Baganda being more likely to dropout than Baganda [1.5; (1.2-1.9)], dropout varied between the five fishing communities, having a new sexual partner in the previous 3 months [1.3 (1.0-1.7)] and being away from home for ≥2 nights in the month preceding the interview [1.4 (1.1-1.8)]. Conclusion: Despite a substantial proportion dropping out, retention was sufficient to suggest that by incorporating retention strategies it will be possible to conduct HIV prevention efficacy trials in this community. [ABSTRACT FROM AUTHOR]
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- 2015
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18. Use of Modern Family Planning Methods in Fishing Communities of Lake Victoria, Uganda.
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Nanvubya, Annet, Ssempiira, Julius, Mpendo, Juliet, Ssetaala, Ali, Nalutaaya, Annet, Wambuzi, Mathias, Kitandwe, Paul, Bagaya, Bernard S., Welsh, Sabrina, Asiimwe, Stephen, Nielsen, Leslie, Makumbi, Fredrick, and Kiwanuka, Noah
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FAMILY planning ,FISHING villages ,HEALTH services accessibility ,PUBLIC health - Abstract
Introduction: Fishing communities (FCs) in Uganda have high HIV infection rates but poor access to health services including family planning (FP). Although FP is a cost-effective public health intervention, there is a paucity of data on knowledge and use of modern FP in FCs. This study determined knowledge and use of modern FP methods in FCs of Uganda. Methods: Data were accrued from a 12-month follow up of 1,688 HIV-uninfected individuals, 18–49 years from 8 FCs along Lake Victoria, between September 2011 and March 2013. Data on knowledge and use of modern FP were collected through a semi-structured questionnaire. Prevalence Risk Ratios with corresponding 95% CIs were used to determine factors associated with Modern FP knowledge and use. Results: The mean age was 31.4 years, with nearly half (48.8%) being females while more than half (58.6%) had attained up to primary education level. Knowledge of modern FP was high, 87.5% (1477/1688); significantly higher among females [adj. PRR = 4.84 (95% CI; 3.08, 7.61)], among older respondents (25–29 years) [adj. PRR = 1.83 (95% CI; 1.12, 2.99)] compared to younger ones (18–24 years) and among those conducting business [adj. PRR = 2.42(95% CI; 1.02, 5.74)] relative to those primarily in fishing. Just over a third (35.2%, 595/1688) reported use of at least one modern FP method. Use of modern FP methods was significantly higher among females [adj. PRR = 2.04 (95% CI; 1.56, 2.65, and among those reporting multiple sexual partnerships [adj. PRR = 2.12, 95% CI; 1.63, 2.76)]. Nonuse of modern methods was mostly due to desire for more children (30.6%), fear of side effects (12.2%) and partner refusal (5.2%). Conclusion: Despite their high knowledge of FP, FCs have low use of modern FP methods. Key barriers to use of modern FP methods were high fertility desires, fear of perceived side effects and partner refusal of methods. [ABSTRACT FROM AUTHOR]
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- 2015
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19. Schistosoma mansoni and HIV acquisition in fishing communities of Lake Victoria, Uganda: a nested case-control study.
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Ssetaala, Ali, Nakiyingi ‐ Miiro, Jessica, Asiki, Gershim, Kyakuwa, Nassim, Mpendo, Juliet, Van Dam, Govert J., Corstjens, Paul L., Pala, Pietro, Nielsen, Leslie, Bont, Jan De, Pantaleo, Giuseppe, Kiwanuka, Noah, Kaleebu, Pontiano, Kamali, Anatoli, Elliott, Alison M., and Nakiyingi-Miiro, Jessica
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SCHISTOSOMA mansoni , *ENDEMIC diseases , *HIV infections , *DISEASE susceptibility , *FISHING villages , *COHORT analysis - Abstract
Objective: It has been suggested that Schistosoma mansoni, which is endemic in African fishing communities, might increase susceptibility to human immunodeficiency virus (HIV) acquisition. If confirmed, this would be of great public health importance in these high HIV-risk communities. This study was undertaken to determine whether S. mansoni infection is a risk factor for HIV infection among the fishing communities of Lake Victoria, Uganda. We conducted a matched case-control study, nested within a prospective HIV incidence cohort, including 50 HIV seroconverters (cases) and 150 controls during 2009-2011.Methods: S. mansoni infection prior to HIV seroconversion was determined by measuring serum circulating anodic antigen (CAA) in stored serum. HIV testing was carried out using the Determine rapid test and infection confirmed by enzyme-linked immunosorbent assays.Results: About 49% of cases and 52% of controls had S. mansoni infection prior to HIV seroconversion (or at the time of a similar study visit, for controls): odds ratio, adjusting for ethnicity, religion, marital status, education, occupation, frequency of alcohol consumption in previous 3 months, number of sexual partners while drunk, duration of stay in the community, and history of schistosomiasis treatment in the past 2 years was 1.23 (95% CI 0.3-5.7) P = 0.79. S. mansoni infections were chronic (with little change in status between enrolment and HIV seroconversion), and there was no difference in median CAA concentration between cases and controls.Conclusions: These results do not support the hypothesis that S. mansoni infection promotes HIV acquisition. [ABSTRACT FROM AUTHOR]- Published
- 2015
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20. Schistosoma mansoni Infection in Ugandan Men Is Associated with Increased Abundance and Function of HIV Target Cells in Blood, but Not the Foreskin: A Cross-sectional Study.
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Prodger, Jessica L., Ssemaganda, Aloysious, Ssetaala, Ali, Kitandwe, Paul K., Muyanja, Enoch, Mpendo, Juliet, Nanvubya, Annet, Wambuzi, Mathias, Nielsen, Leslie, Kiwanuka, Noah, and Kaul, Rupert
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SCHISTOSOMA mansoni ,HIV infections ,T cells ,CELLULAR immunity ,CD4 antigen ,CHEMOKINE receptors - Abstract
Background Schistosoma mansoni infection has been associated with an increased HIV prevalence in humans and SHIV incidence in primate models. We hypothesized that immune activation from this gastrointestinal mucosa infection would increase highly HIV-susceptible CD4 T cell subsets in the blood and the foreskin through common mucosal homing. Methodology/Principal Findings Foreskin tissue and blood were obtained from 34 HIV- and malaria-uninfected Ugandan men who volunteered for elective circumcision, 12 of whom were definitively positive for S. mansoni eggs in stool and 12 definitively negative for both S. mansoni eggs and worm antigen. Tissue and blood T cell subsets were characterized by flow cytometry and immunohistochemistry (IHC). Th17 and Th1 cells from both the blood and foreskin expressed higher levels of CCR5 and were more activated than other CD4 T cell subsets. S. mansoni-infected men had a higher frequency of systemic Th1 cells (22.9 vs. 16.5% of blood CD4 T cells, p<0.05), Th17 cells (2.3 vs. 1.5%, p<0.05), and Th22 cells (0.5 vs. 0.3%, p<0.01) than uninfected men. Additionally, Th17 cells in the blood of S. mansoni-infected men demonstrated enhanced function (28.1 vs. 16.3% producing multiple cytokines, p = 0.046). However, these immune alterations were not observed in foreskin tissue. Conclusions/Significance S. mansoni infection was associated with an increased frequency of highly HIV-susceptible Th1, Th17 and Th22 cell subsets in the blood, but these T cell immune differences did not extend to the foreskin. S. mansoni induced changes in T cell immunology mediated through the common mucosal immune system are not likely to increase HIV susceptibility in the foreskin. [ABSTRACT FROM AUTHOR]
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- 2015
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21. Recruitment and retention of women in fishing communities in HIV prevention research.
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Ssetaala, Ali, Nakiyingi-Miiro, Jessica, Asiimwe, Stephen, Nanvubya, Annet, Mpendo, Juliet, Asiki, Gershim, Nielsen, Leslie, Kiwanuka, Noah, Seeley, Janet, Kamali, Anatoli, and Kaleebu, Pontiano
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HIV prevention , *FISHING villages , *WOMEN - Abstract
Introduction: Women in fishing communities in Uganda are more at risk and have higher rates of HIV infection. Socio-cultural gender norms, limited access to health information and services, economic disempowerment, sexual abuse and their biological susceptibility make women more at risk of infection. There is need to design interventions that cater for women’s vulnerability. We explore factors affecting recruitment and retention of women from fishing communities in HIV prevention research. Methods: An HIV incidence cohort screened 2074 volunteers (1057 men and 1017 women) aged 13-49 years from 5 fishing communities along Lake Victoria using demographic, medical history, risk behaviour assessment questionnaires.1000 HIV negative high risk volunteers were enrolled and followed every 6 months for 18 months. Factors associated with completion of study visits among women were analyzed using multivariable logistic regression. Results: Women constituted 1,017(49%) of those screened, and 449(45%) of those enrolled with a median (IQR) age of 27 (22-33) years. Main reasons for non-enrolment were HIV infection (33.9%) and reported low risk behaviour (37.5%). A total of 382 (74%) women and 332 (69%) men completed all follow up visits. Older women (>24 yrs) and those unemployed, who had lived in the community for 5 years or more, were more likely to complete all study visits. Conclusion: Women had better retention rates than men at 18 months. Strategies for recruiting and retaining younger women and those who have stayed for less than 5 years need to be developed for improved retention of women in fishing communities in HIV prevention and research Programs. [ABSTRACT FROM AUTHOR]
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- 2015
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22. Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission.
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Kamali, Anatoli, Price, Matt A., Lakhi, Shabir, Karita, Etienne, Inambao, Mubiana, Sanders, Eduard J., Anzala, Omu, Latka, Mary H., Bekker, Linda-Gail, Kaleebu, Pontiano, Asiki, Gershim, Ssetaala, Ali, Ruzagira, Eugene, Allen, Susan, Farmer, Paul, Hunter, Eric, Mutua, Gaudensia, Makkan, Heeran, Tichacek, Amanda, and Brill, Ilene K.
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HIV prevention ,CLINICAL trials ,DISEASE prevalence ,EPIDEMIOLOGY ,AIDS vaccines - Abstract
HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. [ABSTRACT FROM AUTHOR]
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- 2015
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23. High Incidence of HIV-1 Infection in a General Population of Fishing Communities around Lake Victoria, Uganda.
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Kiwanuka, Noah, Ssetaala, Ali, Nalutaaya, Annet, Mpendo, Juliet, Wambuzi, Matthias, Nanvubya, Annet, Sigirenda, Simon, Kitandwe, Paul Kato, Nielsen, Leslie Elizabeth, Balyegisawa, Apolo, Kaleebu, Pontiano, Nalusiba, Josephine, and Sewankambo, Nelson Kaulukusi
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HIV infections , *DISEASE incidence , *FISHING villages , *PUBLIC health , *MEDICAL microbiology , *BIOMETRY - Abstract
Background: High HIV-1 incidence rates were reported among persons in fisherfolk communities (FFC) in Uganda who were selected for high risk behaviour. We assessed the incidence of HIV-1 and associated risk factors in a general population FFC to determine population-wide HIV rates. Methods: A community-based cohort study was conducted among a random sample of 2191 participants aged 18–49 years. At baseline and 12 months post-baseline, data were collected on socio-demographic characteristics and risky behaviors (including number of partners, new partners, condom use, use of alcohol and illicit drug use). Venous blood was collected for HIV serological testing. HIV incidence was calculated per 100 person years at-risk (pyar) and adjusted incidence rate ratios (Adj.IRR) were estimated by multivariable Poisson regression. Results: Overall follow up at 12 months was 76.9% (1685/2191) and was significantly higher among HIV uninfected persons and those with at least 1 year duration of stay in community. Overall HIV-1 incidence was 3.39/100 pyar (95% CI: 2.55–4.49). Among the 25–29 years who drank alcohol, HIV incidence was 7.67/100pyar (95% CI;4.62–12.7) while it was 5.67/100pyar (95% CI;3.14–10.2) for 18–24 year olds who drank alcohol. The risk of HIV infection was higher among 25–29 years (adj.IRR = 3.36; 95% CI: 1.48–7.65) and 18–24 years (adj.IRR = 2.65; 95% CI: 1.05–6.70) relative to 30+ years. Compared to non-drinkers, HIV incidence increased by frequency of alcohol drinking - occasional drinkers (adj.IRR = 3.18; 95% CI: 1.18–8.57) and regular drinkers (adj.IRR = 4.93; 95% CI: 1.91–12.8). Conclusion: HIV-1 incidence in general fisherfolk population along L.Victoria, Uganda, is high and is mainly associated with young age and alcohol drinking. HIV prevention and control strategies are urgently needed in this population. [ABSTRACT FROM AUTHOR]
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- 2014
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24. Characterization of Neutrophil Subsets in Healthy Human Pregnancies.
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Ssemaganda, Aloysius, Kindinger, Lindsay, Bergin, Philip, Nielsen, Leslie, Mpendo, Juliet, Ssetaala, Ali, Kiwanuka, Noah, Munder, Markus, Teoh, Tiong Ghee, Kropf, Pascale, and Müller, Ingrid
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NEUTROPHILS ,ARGINASE ,ENZYME activation ,GRANULOCYTES ,MATERNAL health ,GENE expression ,IMMUNE system ,NATURAL immunity - Abstract
We have previously shown that in successful pregnancies increased arginase activity is a mechanism that contributes to the suppression of the maternal immune system. We identified the main type of arginase-expressing cells as a population of activated low-density granulocytes (LDGs) in peripheral blood mononuclear cells and in term placentae. In the present study, we analyzed the phenotype of LDGs and compared it to the phenotype of normal density granulocytes (NDGs) in maternal peripheral blood, placental biopsies and cord blood. Our data reveal that only LDGs but no NDGs could be detected in placental biopsies. Phenotypically, NDGs and LDGs from both maternal and cord blood expressed different levels of maturation, activation and degranulation markers. NDGs from the maternal and cord blood were phenotypically similar, while maternal, cord and placental LDGs showed different expression levels of CD66b. LDGs present in cord blood expressed higher levels of arginase compared to maternal and placental LDGs. In summary, our results show that in maternal and cord blood, two phenotypically different populations of neutrophils can be identified, whereas in term placentae, only activated neutrophils are present. [ABSTRACT FROM AUTHOR]
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- 2014
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25. Prevalence and correlates of HIV infection among adolescents and young people living in fishing populations along Lake Victoria Fishing Communities in Uganda.
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Nanyonjo, Gertrude, Asiki, Gershim, Ssetaala, Ali, Nakaweesa, Teddy, Wambuzi, Mathias, Nanvubya, Annet, Mpendo, Juliet, Okech, Brenda, Kitandwe, Paul Kato, Nielsen, Leslie, Nalutaaya, Annet, Welsh, Sabrina, Bagaya, Bernard Ssentalo, Chinyenze, Kundai, Fast, Pat, Price, Matt, and Kiwanuka, Noah
- Abstract
Introduction: fishing communities in Uganda are key populations for HIV, with persistently higher prevalence and incidence than the general population. Methods: between March and August 2014, a cross sectional survey was conducted in 10 fishing communities of Lake Victoria in Uganda. Data was collected on socio-behavioural characteristics using interviewer administered questionnaires and venous blood collected for HIV testing. Prevalent HIV infections among adolescents and young people aged 13 to 24 years was estimated and the factors associated with those infections determined using multi variable logistic regression modelling. Results: HIV prevalence was 10.8% among the 630 (96.5%) who provided a blood sample. Females were 3.5 times as likely to have HIV infection as males (aOR=3.52, 95% CI: 1.34-9.22). Young people aged 20-24 years were twice as likely to be HIV infected as those aged 13-19 years (aOR=1.77, 95% CI: 0.05-2.10), participants without formal education or those who had studied up to primary level were more likely to be HIV infected than those who had post primary education ((aOR=2.45, 95% CI: 1.19-5.07) or (5.29 (1.35-20.71) respectively). Reporting more than one sexual partner in the past 6 months was associated with HIV prevalent infection than those reporting no sexual partners (aOR=6.44, 95% CI: 1.27-32.83). Conclusion: adolescents and young people aged 13-24 years in fishing communities around Lake Victoria, Uganda, have a high HIV prevalence, with females having a three-fold higher level than males. These findings highlight-the need to improve HIV prevention among young females living in these fishing communities. [ABSTRACT FROM AUTHOR]
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- 2020
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26. Correction: Use of Modern Family Planning Methods in Fishing Communities of Lake Victoria, Uganda.
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Nanvubya, Annet, Ssempiira, Julius, Mpendo, Juliet, Ssetaala, Ali, Nalutaaya, Annet, Wambuzi, Mathias, Kitandwe, Paul, Bagaya, Bernard S., Welsh, Sabrina, Asiimwe, Stephen, Nielsen, Leslie, Makumbi, Fredrick, and Kiwanuka, Noah
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PUBLISHED errata ,BIOLOGICAL periodicals ,PERIODICAL publishing ,PERIODICAL articles ,PUBLISHING ,PUBLISHED articles ,PUBLICATIONS - Published
- 2015
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27. Knowledge and Use of Modern Family Planning Methods in Fishing Communities along Lake Victoria, Uganda.
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Mpendo, Juliet, Ssetaala, Ali, Ssempiira, Julius, Nalutaaya, Annet, Wambuzi, Mathias, Asiimwe, Steven, Nielsen, Leslie, Makumbi, Fredrick, and Kiwanuka, Noah
- Abstract
An abstract of the article "Knowledge and Use of Modern Family Planning Methods in Fishing Communities along Lake Victoria, Uganda" by Annet Nanvubya is presented.
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- 2014
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28. Assessment of Retention Rates Using Mobile Phones versus Physical Contact Tracing among Fishing Communities Along the Shores of Lake Victoria, Uganda.
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Nanvubya, Annet, Ssetaala, Ali, Ssempiira, Julius, Nalutaaya, Annet, Wambuzi, Matthias, Nielsen, Leslie, Asiimwe, Steven, and Kiwanuka, Noah
- Abstract
An abstract of the article "Assessment of Retention Rates Using Mobile Phones versus Physical Contact Tracing among Fishing Communities Along the Shores of Lake Victoria, Uganda" by Juliet Mpendo, Annet Nanvubya, Ali Ssetaala, and colleagues is presented.
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- 2014
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29. An assessment of fishing communities around Lake Victoria, Uganda, as potential populations for future HIV vaccine efficacy studies: an observational cohort study.
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Kiwanuka, Noah, Mpendo, Juliet, Nalutaaya, Annet, Wambuzi, Matthias, Nanvubya, Annet, Kitandwe, Paul K, Muyanja, Enoch, Ssempiira, Julius, Balyegisawa, Apolo, Ssetaala, Ali, and UVRI-IAVI Research Team
- Abstract
Background: An effective HIV vaccine is still elusive. Of the 9 HIV preventive vaccine efficacy trials conducted to-date, only one reported positive results of modest efficacy. More efficacy trials need to be conducted before one or more vaccines are eventually licensed. We assessed the suitability of fishing communities in Uganda for future HIV vaccine efficacy trials.Methods: A community-based cohort study was conducted among a random sample of 2191 participants aged 18-49 years. Data were collected on socio-demographic characteristics, HIV risky behaviors, and willingness to participate in future HIV vaccine trials (WTP). Venous blood was collected for HIV serological testing. Retention/follow rates and HIV incidence rates per 100 person years at-risk (pyar) were estimated. Adjusted prevalence proportion ratios (PPRs) of retention and odds ratios (ORs) of lack of WTP were estimated using log-binomial and logistic regression models respectively.Results: Overall retention rate was 76.9% (1685/2191), highest (89%) among participants who had spent 5+ years in the community and lowest (54.1%) among those with <1 year stay. Significant predictors of retention included tribe/ethnicity, baseline HIV negative status, and longer than 1 year stay in the community. Overall WTP was 89.1% (1953/2191). Lack of WTP was significantly higher among women than men [adj.OR = 1.51 (95% CI, 1.14- 2.00)] and among participants who had stayed in fishing communities for 10 or more years relative to those with less than one year [adj.OR = 1.78 (95% CI, 1.11 - 2.88)]. Overall HIV incidence rate per 100 pyar was 3.39 (95% CI; 2.55 - 4.49). Participants aged 25-29 years had highest incidence rates (4.61 - 7.67/100 pyar) and high retention rates between 78.5 and 83.1%. In a combined analysis of retention and incidence rates participants aged 30+ years had retention rates ~80% but low incidence rates (2.45 - 3.57 per 100 pyar) while those aged 25-29 years had the highest incidence rates (4.61 - 7.67/100 pyar) and retention rates 78.5 - 83.1%.Conclusions: There is high HIV incidence, retention and WTP among fishing communities around L. Victoria, Uganda which make these communities appropriate for future HIV prevention efficacy studies including vaccine trials. [ABSTRACT FROM AUTHOR]- Published
- 2014
- Full Text
- View/download PDF
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