Cohort Profile: The MUg Observational Cohort

Funk, Anna; Kanters, Steve; Nansubuga, Margaret; Mwehire, Daniel; Featherstone, Amber; Druyts, Eric; Odiit, Mary; Mills, Edward J.

doi:10.1093/ije/dys170

Cited by 12 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This disproportion can be attributed to the practice of HIV testing during pregnancy [36] and the poor health-seeking behaviour of males [22]. In line with the findings of other African and European studies [5,8,27,34,37], the prevalence of HBV in our cohort was higher among men (11.7% vs 6.8%), but their under-representation may have lowered the actual overall prevalence. Secondly, our sampling procedures were performed in the AIDS clinic, and our study population consisted of regularly attending outpatients in good clinical condition with a high rate of adherence to ART (87.3%), which they had been receiving for a median of six years.…”

Section: Plos Onesupporting

confidence: 83%

Hepatitis B and HIV coinfection in Northern Uganda: Is a decline in HBV prevalence on the horizon?

Ochola

Oreni

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

Background The available data concerning hepatitis B virus (HBV) infection in Uganda are limited, particularly in the case of people living with HIV/AIDS (PLWH). HBV is not routinely tested when starting antiretroviral therapy (ART). We aimed to determine the prevalence, the correlates of the risk of HBV infection, and the association with outcomes of ART among PLWH attending a busy HIV clinic in a referral hospital in Northern Uganda. Patients and methods From April to June 2016, a random sample of 1000 PLWH attending the outpatients’ clinic of St. Mary’s Hospital, Gulu, Uganda were systematically selected to undergo a rapid hepatitis B surface antigen (HBsAg) test after administering a questionnaire in this cross-sectional study. HIV care parameters were obtained from client files. Multivariate logistic regression and general linear model were used for the analysis. Results 950 of the 985 evaluable patients (77% females; mean age 42.8 years) were receiving ART. The overall prevalence of HBsAg was 7.9% (95% confidence interval [CI] 6.2–9.6%), and was significantly lower among the females (6.8% vs 11.7%; p = 0.020). The factors independently associated with higher HBV infection were having lived in an internally displaced persons’ camp (adjusted odds ratio [aOR] 1.76, 95% CI 1.03–2.98; p = 0.036) and having shared housing with HBV-infected people during childhood (aOR 3.30, 95% CI 1.49–7.32; p = 0.003). CD4+ T cell counts were significantly lower in HBV patients (p = 0.025), and co-infection was associated with a poorer CD4+ T cell response to ART (AOR 0.88; 95% CI 0.79–0.98; p = 0.030). Conclusions The observed prevalence of HBV among the PLWH may be underestimated or a signal of HBV decline in the region. The factors favouring horizontal HBV transmission identified suggest extending HBV screening and vaccine prophylaxis among PLWH.

show abstract

Section: Plos Onesupporting

confidence: 83%

Hepatitis B and HIV coinfection in Northern Uganda: Is a decline in HBV prevalence on the horizon?

Ochola

Oreni

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…All patient data for this study is from the Mildmay Uganda observational cohort (MUg) 14. Mildmay is a medical service organization providing ART and other healthcare services to the HIV-positive community in Uganda.…”

Section: Methodsmentioning

confidence: 99%

Increased mortality among HIV-positive men on antiretroviral therapy: survival differences between sexes explained by late initiation in Uganda

Kanters¹,

Nansubuga²,

Mwehire³

et al. 2013

HIV

View full text Add to dashboard Cite

BackgroundWe aimed to assess the relationship between gender and survival among adult patients newly enrolled on antiretroviral therapy (ART) in Uganda. We also specifically examined the role of antenatal services in favoring women’s access to HIV care.MethodsFrom an observational cohort study, we assessed survival and used logistic regression and differences in means to compare men and women who did not access care through antenatal services. Differences were assessed on measures of disease progression (WHO stage and CD4 count) and demographic (age, marital status, and education), behavioral (sexual activity, disclosure to partner, and testing), and clinical variables (hepatitis B and C, syphilis, malaria, and anemia). A mediational analysis that considered gender as the initial variable, time to death as the outcome, initial CD4 count as the mediator, and age as a covariate was performed using an accelerated failure time model with a Weibull distribution.ResultsBetween 2004 and 2011, a total of 4775 patients initiated ART, and after exclusions 4537 (93.2%) were included in analysis. Men initiating ART were more likely to have a WHO disease stage III or IV (odds ratio: 1.46, 95% confidence interval [CI]: 1.29–1.66), and lower CD4 cell counts compared to women (median baseline CD4 124 cells/mm3, interquartile range [IQR]: 43–205 versus 147 cells/mm3, IQR: 68–212, P-value < 0.0001). Men were at an increased risk of death compared to women (hazard ratio: 1.38, 95% CI: 1.03–1.83). Baseline CD4 cell counts accounted for 43% of the increased risk of death in men (95% CI: 22%–113%). Access to care via antenatal services did not explain differences in outcomes.ConclusionIn this cohort there is a marked increase in risk of mortality for men and approximately half of it can be attributed to their later engagement in care. More effort is required to engage men in care in a timely manner.

show abstract

“…15 Mildmay is a medical service organization providing ART and other health care services to the HIV-positive community in Uganda using a family-centered multidisciplinary approach to care. The organization opened in 1998 to provide specialized outpatient care for people living with HIV/AIDS and provide teaching and training centre for HIV/AIDS health care personnel.…”

Section: Data and Study Populationmentioning

confidence: 99%