Makerere University

About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Public health. The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.

Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study

Abstract: The rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP. We used 3298 women of reproductive ages 15–49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson’s chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period. More than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1–2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47). Increasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.

Stepped wedge randomised controlled trials: systematic review of studies published between 2010 and 2014

Abstract: In a stepped wedge, cluster randomised trial, clusters receive the intervention at different time points, and the order in which they received it is randomised. Previous systematic reviews of stepped wedge trials have documented a steady rise in their use between 1987 and 2010, which was attributed to the design’s perceived logistical and analytical advantages. However, the interventions included in these systematic reviews were often poorly reported and did not adequately describe the analysis and/or methodology used. Since 2010, a number of additional stepped wedge trials have been published. This article aims to update previous systematic reviews, and consider what interventions were tested and the rationale given for using a stepped wedge design. We searched PubMed, PsychINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Web of Science, the Cochrane Library and the Current Controlled Trials Register for articles published between January 2010 and May 2014. We considered stepped wedge randomised controlled trials in all fields of research. We independently extracted data from retrieved articles and reviewed them. Interventions were then coded using the functions specified by the Behaviour Change Wheel, and for behaviour change techniques using a validated taxonomy. Our review identified 37 stepped wedge trials, reported in 10 articles presenting trial results, one conference abstract, 21 protocol or study design articles and five trial registrations. These were mostly conducted in developed countries (n = 30), and within healthcare organisations (n = 28). A total of 33 of the interventions were educationally based, with the most commonly used behaviour change techniques being ‘instruction on how to perform a behaviour’ (n = 32) and ‘persuasive source’ (n = 25). Authors gave a wide range of reasons for the use of the stepped wedge trial design, including ethical considerations, logistical, financial and methodological. The adequacy of reporting varied across studies: many did not provide sufficient detail regarding the methodology or calculation of the required sample size. The popularity of stepped wedge trials has increased since 2010, predominantly in high-income countries. However, there is a need for further guidance on their reporting and analysis.

The Rakai Project counselling programme experience.

Abstract: During the initial survey (April 1999-January 2000) of an ongoing Community HIV Epidemiological Research (CHER) study, adults aged 15-49 years in 56 study communities were enrolled into the study Knowledge, Attitude, Behaviour, Practice questionnaires were administered and blood was obtained from 776% HIV testing was performed using two different enzyme immunosorbent assays with Western blot confirmation of discordant results and first time positives All those who gave blood had free and unlimited access to voluntary counselling and testing (VCT), and were free to participate as individuals or couples HIV results were provided in people's homes by trained and certified project resident counsellors Ninety per cent of those who were bled requested their HIV results, while 646% of those who requested their HIV results received them The proportion of people receiving HIV results has almost doubled in the last 6 years (1994-2000) from about 35% in 1994/1995 to 65% in 1999/2000 These data indicate high proportions of acceptance and receipt of VCT in this rural population-based cohort, suggesting that home delivery of VCT could offer a unique opportunity for people in the rural areas to access counselling and testing services, given adequate resources

Concise gene signature for point-of-care classification of tuberculosis.

Abstract: There is an urgent need for new tools to combat the ongoing tuberculosis (TB) pandemic. Gene expression profiles based on blood signatures have proved useful in identifying genes that enable classification of TB patients, but have thus far been complex. Using real‐time PCR analysis, we evaluated the expression profiles from a large panel of genes in TB patients and healthy individuals in an Indian cohort. Classification models were built and validated for their capacity to discriminate samples from TB patients and controls within this cohort and on external independent gene expression datasets. A combination of only four genes distinguished TB patients from healthy individuals in both cross‐validations and on separate validation datasets with very high accuracy. An external validation on two distinct cohorts using a real‐time PCR setting confirmed the predictive power of this 4‐gene tool reaching sensitivity scores of 88% with a specificity of around 75%. Moreover, this gene signature demonstrated good classification power in HIV + populations and also between TB and several other pulmonary diseases. Here we present proof of concept that our 4‐gene signature and the top classifier genes from our models provide excellent candidates for the development of molecular point‐of‐care TB diagnosis in endemic areas.

HIV-1 viral subtype differences in the rate of CD4+ T-cell decline among HIV seroincident antiretroviral naive persons in Rakai District, Uganda.

Abstract: Background—Data on the effect of HIV-1 viral subtype on CD4 + T-cell decline are limited. Methods—We assessed the rate of CD4 + T-cell decline per year among 312 HIV seroincident persons infected with different HIV-1 subtypes. Rates of CD4 + decline by HIV-1 subtype were determined by linear mixed effects models, using an unstructured convariance structure. Results—A total of 59.6% had D, 15.7% A, 18.9% recombinant viruses (R), and 5.8% multiple subtypes (M). For all subtypes combined, the overall rate of CD4 + T-cell decline was −34.5 [95% confidence interval (CI), −47.1, −22.0] cells/μL per yr, adjusted for age, sex, baseline CD4 + counts, and viral load. Compared with subtype A, the adjusted rate of CD4 cell loss was −73.7/μL/yr (95% CI, −113.5, −33.8, P < 0.001) for subtype D, −43.2/μL/yr (95% CI, −90.2, 3.8, P = 0.072) for recombinants, and −63.9/μL/yr (95% CI, −132.3, 4.4, P = 0.067) for infection with multiple HIV subtypes. Square-root transformation of CD4 + cell counts did not change the results. Conclusions—Infection with subtype D is associated with significantly faster rates of CD4 + Tcell loss than subtype A. This may explain the more rapid disease progression for subtype D compared with subtype A.