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Institution

Makerere University

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


Papers
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Journal ArticleDOI
01 Jul 1997-AIDS
TL;DR: Prevalence was not an adequate surrogate measure of incidence, limiting the utility of serial prevalence measures in assessing the dynamics of the HIV epidemic and in evaluating the impact of current preventive strategies.
Abstract: Findings are reported from a 2-year follow-up study of an open cohort of people aged 15-59 years living in a sample of 31 representative community clusters in rural Rakai district Uganda to measure whether trends in serial HIV-1 prevalence reflect trends in HIV incidence and to gain insight into the effects of HIV-1 incidence mortality mobility and compliance upon HIV-1 prevalence. In each year of study all consenting adults provided a serological sample and were interviewed; 2591 adults were enrolled at baseline. HIV prevalence among adults declined significantly between 1990 and 1992; from 23.4% in 1990 to 21.8% in 1991 and 20.9% in 1992. Declining prevalence was also observed in subgroups including young adults aged 15-24 years from 20.6% to 16.2% reproductive-age women from 27.1% to 23.5% and pregnant women from 25.4% to 20.0%. The decline in HIV prevalence among pregnant women however is not significant. HIV incidence did not change significantly among all adults aged 15-59 years nor in population subgroups. HIV-related mortality was 13.5/person-year of observation among those who were HIV-positive. Substantial numbers of HIV-infected individuals were also loss to emigration.

141 citations

Journal ArticleDOI
TL;DR: In this article, field surveys of plants and animals were combined with satellite remote sensing of broad vegetation types to map biodiversity and thereby help plan conservation in the Sango Bay area, some 30 by 100 kilometres bordering Lake Victoria in Uganda.

140 citations

Journal ArticleDOI
TL;DR: The effect of in utero tenofovir exposure by analyzing the pregnancy and infant outcomes of HIV-infected women enrolled in the DART trial is investigated.
Abstract: BACKGROUND: Few data have described long-term outcomes for infants born to HIV-infected African women taking antiretroviral therapy (ART) in pregnancy. This is particularly true for World Health Organization (WHO)-recommended tenofovir-containing first-line regimens, which are increasingly used and known to cause renal and bone toxicities; concerns have been raised about potential toxicity in babies due to in utero tenofovir exposure. METHODS AND FINDINGS: Pregnancy outcome and maternal/infant ART were collected in Ugandan/Zimbabwean HIV-infected women initiating ART during The Development of AntiRetroviral Therapy in Africa (DART) trial, which compared routine laboratory monitoring (CD4; toxicity) versus clinically driven monitoring. Women were followed 15 January 2003 to 28 September 2009. Infant feeding, clinical status, and biochemistry/haematology results were collected in a separate infant study. Effect of in utero ART exposure on infant growth was analysed using random effects models. 382 pregnancies occurred in 302/1,867 (16%) women (4.4/100 woman-years [95% CI 4.0-4.9]). 226/390 (58%) outcomes were live-births, 27 (7%) stillbirths (≥22 wk), and 137 (35%) terminations/miscarriages ( 0.4). Of 219 surviving infants, 182 (83%) enrolled in the follow-up study; median (interquartile range [IQR]) age at last visit was 25 (12-38) months. From mothers' ART, 62/9/111 infants had no/20%-89%/≥90% in utero tenofovir exposure; most were also zidovudine/lamivudine exposed. All 172 infants tested were HIV-negative (ten untested). Only 73/182(40%) infants were breast-fed for median 94 (IQR 75-212) days. Overall, 14 infants died at median (IQR) age 9 (3-23) months, giving 5% 12-month mortality; six of 14 were HIV-uninfected; eight untested infants died of respiratory infection (three), sepsis (two), burns (one), measles (one), unknown (one). During follow-up, no bone fractures were reported to have occurred; 12/368 creatinines and seven out of 305 phosphates were grade one (16) or two (three) in 14 children with no effect of in utero tenofovir (p>0.1). There was no evidence that in utero tenofovir affected growth after 2 years (p = 0.38). Attained height- and weight for age were similar to general (HIV-uninfected) Ugandan populations. Study limitations included relatively small size and lack of randomisation to maternal ART regimens. CONCLUSIONS: Overall 1-year 5% infant mortality was similar to the 2%-4% post-neonatal mortality observed in this region. No increase in congenital, renal, or growth abnormalities was observed with in utero tenofovir exposure. Although some infants died untested, absence of recorded HIV infection with combination ART in pregnancy is encouraging. Detailed safety of tenofovir for pre-exposure prophylaxis will need confirmation from longer term follow-up of larger numbers of exposed children. TRIAL REGISTRATION: www.controlled-trials.com ISRCTN13968779

140 citations

Journal ArticleDOI
TL;DR: As the intensity of malaria transmission declines in Africa through the scaling up of insecticide-treated nets and other vector control measures a focus of disease prevention among very young children becomes less appropriate.
Abstract: The understanding of the epidemiology of severe malaria in African children remains incomplete across the spectrum of Plasmodium falciparum transmission intensities through which communities might expect to transition, as intervention coverage expands. Paediatric admission data were assembled from 13 hospitals serving 17 communities between 1990 and 2007. Estimates of Plasmodium falciparum transmission intensity in these communities were assembled to be spatially and temporally congruent to the clinical admission data. The analysis focused on the relationships between community derived parasite prevalence and the age and clinical presentation of paediatric malaria in children aged 0–9 years admitted to hospital. As transmission intensity declined a greater proportion of malaria admissions were in older children. There was a strong linear relationship between increasing transmission intensity and the proportion of paediatric malaria admissions that were infants (R2 = 0.73, p < 0.001). Cerebral malaria was reported among 4% and severe malaria anaemia among 17% of all malaria admissions. At higher transmission intensity cerebral malaria was a less common presentation compared to lower transmission sites. There was no obvious relationship between the proportions of children with severe malaria anaemia and transmission intensity. As the intensity of malaria transmission declines in Africa through the scaling up of insecticide-treated nets and other vector control measures a focus of disease prevention among very young children becomes less appropriate. The understanding of the relationship between parasite exposure and patterns of disease risk should be used to adapt malaria control strategies in different epidemiological settings.

140 citations

Journal ArticleDOI
26 Jul 2007-BMJ
TL;DR: Weak positive bands on rapid tests for HIV should be confirmed by enzyme immunoassay and western blotting before disclosing the diagnosis, and programmes using rapid tests routinely should use standard serological assays for quality control.
Abstract: Objective To evaluate the limitations of rapid tests for HIV-1. Design Diagnostic test accuracy study. Setting Rural Rakai, Uganda. Participants 1517 males aged 15-49 screened for trials of circumcision for HIV prevention. Main outcome measures Sensitivity, specificity, negative predictive values, and positive predictive values of an algorithm using three rapid tests for HIV, compared with the results of enzyme immunoassay and western blotting as the optimal methods. Results Rapid test results were evaluated by enzyme immunoassay and western blotting. Sensitivity was 97.7%. Among 639 samples where the strength of positive bands was coded if the sample showed positivity for HIV, the algorithm had low specificity (94.1%) and a low positive predictive value (74.0%). Exclusion of 37 samples (5.8%) with a weak positive band improved the specificity (99.6%) and positive predictive value (97.7%). Conclusion Weak positive bands on rapid tests for HIV should be confirmed by enzyme immunoassay and western blotting before disclosing the diagnosis. Programmes using rapid tests routinely should use standard serological assays for quality control. Trial registration Clinical Trials NCT00425984.

139 citations


Authors

Showing all 7286 results

NameH-indexPapersCitations
Pete Smith1562464138819
Joy E Lawn10833055168
Philip J. Rosenthal10482439175
William M. Lee10146446052
David R. Bangsberg9746339251
Daniel O. Stram9544535983
Richard W. Wrangham9328829564
Colin A. Chapman9249128217
Ronald H. Gray9252934982
Donald Maxwell Parkin8725971469
Larry B. Goldstein8543436840
Paul Gepts7826319745
Maria J. Wawer7735727375
Robert M. Grant7643726835
Jerrold J. Ellner7634717893
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202343
202289
20211,200
20201,120
2019900
2018790