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Papers by caroline birungi

Research paper thumbnail of Vulnerability to risky sexual behavior among patients with severe mental illness in Uganda

Discover social science and health, Apr 8, 2024

Research paper thumbnail of Perceptions of risky sexual behaviour among individuals with severe mental illness in Uganda

To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental ... more To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental illness(SMI) in Uganda. Hypothesis Participants who perceive themselves as being at a high risk for RSB have a higher perception to RSB.

Research paper thumbnail of Factors contributing to vulnerability to risky sexual behaviour in severe mental illness in the Ugandan socio-cultural context

Research Square (Research Square), Apr 25, 2023

Research paper thumbnail of Substance use among HIV-infected adolescents in Uganda: rates and association with potential risks and outcome factors

AIDS Care, 2020

This article sets out to investigate alcohol and substance use (ASU) among adolescents living wit... more This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.

Research paper thumbnail of Physical and psychiatric comorbidity among patients with severe mental illness as seen in Uganda

medRxiv, 2020

This study established the prevalence of physical and psychiatric comorbidity and associated risk... more This study established the prevalence of physical and psychiatric comorbidity and associated risk factors among 1,201 out-patients with severe mental illness (SMI) attending Butabika and Masaka hospitals in Uganda. Participants completed an assessment battery; structured, standardized and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidity and risk factors. Prevalence of physical and psychiatric comorbidity was 13.1 %. Childhood sexual abuse (aOR 1.06, 95% CI 1.03 -1.10, P=0.001), sexual abuse in adulthood (aOR 2.22, 95% CI 1.60 - 3.08, P<0.001), childhood physical abuse (aOR 1.07, 95% CI 1.03 - 1.10, P<0.001) and physical abuse in adulthood (aOR 1.69, 95% CI 1.30 - 2.20, P<0.001) were associated with an increased risk of having comorbid psychiatric and physical disorders. Emerging healthcare models in U...

Research paper thumbnail of Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

European Archives of Psychiatry and Clinical Neuroscience, Aug 24, 2022

Research paper thumbnail of Prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago hospital, Kampala- Uganda: A cross sectional study

Journal of Psychosomatic Research, Oct 1, 2021

BACKGROUND Depression is a major cause of the global disease burden and globally affects 350-400 ... more BACKGROUND Depression is a major cause of the global disease burden and globally affects 350-400 million persons making it the largest contributor to years lived with disability. Among of patients with chronic physical illnesses like tuberculosis, depression affects up to 25-33% of individuals. There are limited studies on the comorbidity of depressive illness and tuberculosis in the Ugandan setting. Our aim was to determine the prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago Hospital, Uganda. METHODS This was a cross sectional study involving 308 consecutively sampled participants aged 18 years and above diagnosed with tuberculosis attending the tuberculosis clinic in Mulago Hospital, Uganda. Consecutive sampling was done for a sample size of 308 participants. Participants had the following instruments administered to them; the Socio-demographic questionnaire, the Mini Neuropsychiatric Interview (MINI) to diagnose depressive illness and the Patient Health Questionnaire- 9 to rate the severity of depression. Data was entered using Epi-Data. Descriptive, bivariate and multivariate analyses were done with the Statistical Package for Social Sciences (SPSS). RESULTS the prevalence of depressive illness was 23.7% (95% confidence interval 19.3-28.9). Depressive illness was independently associated with low education level (AOR = 0.39, 95%CI = 0.21-0.72, p = 0.003), being in the intensive phase of TB treatment (AOR = 2.34, 95%CI = (1.27-4.33), p = 0.007) and family history of depressive illness (AOR = 5.42, 95%CI = 2.02-14.54, p = 0.001). On the PHQ, 60.3% had moderate to severe depression. CONCLUSION Depressive illnesses should be screened and managed among patients with TB. RECOMMENDATION Depression should be routinely screened and managed among patients with Tuberculosis.

Research paper thumbnail of P1‐319: Feasibility of Using the Cognitive Assessment Tool Kit in Uganda

Alzheimers & Dementia, Jul 1, 2018

NFL to test for a potential mediation as per the Baron &amp;amp;amp; Kenny method. Results: T... more NFL to test for a potential mediation as per the Baron &amp;amp;amp; Kenny method. Results: There was a significant negative correlation between log transformed AHI and RAVLT trials 1-5 and RAVLT Long Delay Trial 7 (p &amp;amp;lt; 0.05) controlling for age, sex and education. The addition of NFL to the model did not change the association between OSA and RAVLT. Conclusions:OSAwas associated with lower memory performance in middle-aged adults. However, this effect was not mediated by NFL. Additional studies are needed to determine the neural correlates of cognitive dysfunction in OSA.

Research paper thumbnail of Prevalence of neuropsychiatric adverse events and associated factors among adult patients on dolutegravir attending Mulago <scp>ISS</scp> clinic

Hiv Medicine, Nov 6, 2022

Research paper thumbnail of P1‐319: Feasibility of Using the Cognitive Assessment Tool Kit in Uganda

Alzheimer's & Dementia, 2018

NFL to test for a potential mediation as per the Baron & Kenny method. Results: There was a s... more NFL to test for a potential mediation as per the Baron & Kenny method. Results: There was a significant negative correlation between log transformed AHI and RAVLT trials 1-5 and RAVLT Long Delay Trial 7 (p < 0.05) controlling for age, sex and education. The addition of NFL to the model did not change the association between OSA and RAVLT. Conclusions:OSAwas associated with lower memory performance in middle-aged adults. However, this effect was not mediated by NFL. Additional studies are needed to determine the neural correlates of cognitive dysfunction in OSA.

Research paper thumbnail of Prevalence and factors associated with depressive disorders in an HIV+ rural patient population in southern Uganda

Journal of Affective Disorders, 2011

ABSTRACT Depressive disorders are estimated to occur in nearly half of HIV-infected individuals w... more ABSTRACT Depressive disorders are estimated to occur in nearly half of HIV-infected individuals worldwide. To examine the prevalence and cardinal demographic, psychosocial and clinical features associated with having any depressive disorder, sub-clinical depression, current and lifetime depressive disorders among patients with human immunodeficiency virus (HIV) in southern Uganda. Five hundred HIV+ individuals were screened for depression using a 20 item self-reporting questionnaire (SRQ-20) and evaluated with the mini neuropsychiatric interview(MINI) that assessed current and lifetime depressive disorders. The prevalence estimates of any depressive disorder, subclinical depression, both current and lifetime major depression, and bipolar depression were 46.4%, 17.8%, 25% and 3.6% respectively. In comparison to non-depressed patients, those with sub-clinical depression were less likely to have high levels of self-efficacy, more likely to be using ART for less than one year, have advanced HIV disease and current alcohol use disorders (AUD&#39;s). Those with both current and lifetime depressive disorders were less likely to be 85% adherent to antiretroviral therapy (ART), have social support and high levels of self-efficacy, more likely to have tuberculosis and past manic episodes. Those with only lifetime depressive disorders were more likely to have current AUD&#39;s and past manic episodes. Information concerning exposures and outcomes was collected simultaneously, thus causal relationships are difficult to establish. Sub-clinical depression, major depression and bipolar depression are widespread among HIV patients receiving ART. Integration of mental health services into HIV Care is desperately needed.

Research paper thumbnail of Prevalence of neuropsychiatric adverse events and associated factors among adult patients on dolutegravir attending Mulago ISS clinic

Research paper thumbnail of The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study

International Journal of STD & AIDS

Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a... more Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case–control study to assess the risk of hyperglycemia associated with use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia while controls had no hyperglycemia as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis...

Research paper thumbnail of Prevalence and Factors Associated with Risky Sexual Behaviors among Patients with Severe Mental Illness in Uganda: A Descriptive Cross Sectional Study

Open Journal of Psychiatry

Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar... more Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric outpatient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months' periods was 24.2% (95% CI: 20.2%-28.7%). The factors that were independently significantly associated with RSB were: trauma related

Research paper thumbnail of The risk of hyperglycaemia associated with the use of dolutegravir among adults living with HIV in Kampala, Uganda: a case-control study

The Lancet Global Health, 2022

BACKGROUND Emerging evidence suggests a possible association between hyperglycaemia and use of do... more BACKGROUND Emerging evidence suggests a possible association between hyperglycaemia and use of dolutegravir, a preferred first-line antiretroviral agent in sub-Saharan Africa. Rigorous studies are needed to validate this association in the light of increasing dolutegravir use and burden of non-communicable diseases among people living with HIV. METHODS We conducted a case-control study in Kampala, Uganda to assess the risk of hyperglycaemia associated with dolutegravir-based antiretroviral therapy (ART). Cases were people living with HIV with hyperglycaemia and controls were people living with HIV without hyperglycaemia, confirmed by fasting plasma glucose and 2-hour oral glucose tolerance tests. Data were collected by interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on dolutegravir use before diagnosis of hyperglycaemia while controlling for potential confounders through multivariable logistic regression. FINDINGS A total 435 participants were included (204 cases, 231 controls). At bivariate analysis, significant differences in age, education, current body-mass index, hypertension as a comorbidity, previous ART regimen, and current ART regimen existed between cases and controls. Among the 204 cases, 54 (27%) had hyperglycaemic levels that were diagnostic of prediabetes, with 150 (74%) being diagnostic of diabetes. Of note, 75 (40%) participants previously treated with dolutegravir changed to other ART regimens after being diagnosed with hyperglycaemia. In multivariable analysis, patients with previous dolutegravir use had nearly 30-times greater odds of hyperglycaemia compared with those who had non-dolutegravir based regimens (adjusted odds ratio [aOR] 29·06 [95% CI 9·86-85·70]). The odds of hyperglycaemia also increased with age (56 years and older vs 18-35 years, aOR 7·53 [95% CI 2·65-21·38]), and hypertension (aOR 5·64 [2·60-12·21]). INTERPRETATION Our study shows a strong association between previous dolutegravir exposure and hyperglycaemia. Given the benefits of dolutegravir, its wide-scale roll-out in sub-Saharan Africa, and the growing burden of diabetes, systematic screening of hyperglycaemia before initiation of dolutegravir, routine glucose monitoring, and the consideration of alternate regimens for those at risk for diabetes are needed. FUNDING This research was supported by the US National Institutes of Health, Fogarty International Center and Global Health Equity Scholars (grant D43TW010540).

Research paper thumbnail of Prevalence of Relapse of Alcohol Use Disorder and the Association With Self-Efficacy and Perceived Social Support in Butabika Hospital

Background Alcohol use disorder (AUD) is a problem globally and Uganda has one of the highest per... more Background Alcohol use disorder (AUD) is a problem globally and Uganda has one of the highest per capita alcohol consumption rates in sub-Saharan Africa. Relapse is a distressing aspect in the treatment of AUD and it is mediated by self-efficacy and perceived social support besides other psychosocial factors. In Uganda, there is paucity of data regarding relapse of AUD and the association with self-efficacy and perceived social support hence the need to carry out this study. Objective To determine the prevalence of relapse of AUD and the association with self-efficacy and perceived social support at Butabika hospital. Methods A cross-sectional study design was used and 269 participants that received treatment for AUD at hospital in the period between 1st /01/2016 and 31st /12/2017 were consecutively recruited. Participants were assessed for relapse of AUD using the SCID-5 substance use disorder section. Data was collected using a socio-demographic questionnaire, the general self-eff...

Research paper thumbnail of The Risk of Hyperglycemia Associated with Use of Dolutegravir Among Adults Living with HIV in Kampala, Uganda: A Case-Control Study

SSRN Electronic Journal, 2021

Research paper thumbnail of A comparative study of the prevalence and clinical features associated with depression among HIV- positive and HIV- negative elderly patients in Mulago Hospital

The dissertation is submitted to the directorate of research and graduate training in partial ful... more The dissertation is submitted to the directorate of research and graduate training in partial fullfilment of the requirements for the award of the Degree of master of medicine in psychiatry of Makerere University.

Research paper thumbnail of A comparison of the prevalence and clinical features of depression in HIV-positive and HIV-negative elderly patients in Uganda

Background Depression is a leading contributor to the burden of disease worldwide, a serious co m... more Background Depression is a leading contributor to the burden of disease worldwide, a serious co morbidity and critical barrier to Human Immunodeficiency Virus (HIV) care and prevention especially in Sub- Saharan Africa. It is unclear if among elderly HIV/ Acquired Immune Deficiency Syndrome (AIDS) positive individuals the characteristics of the illness presents different as compared to elderly HIV/AIDS negative individuals. We thus set out to compare the prevalence and clinical features associated with depression among elderly HIV positive and elderly HIV negative patients in Mulago Hospital. Methods This was a comparative cross sectional study of HIV positive and HIV negative individuals aged ≥ 60 years. They were enrolled from the Assessment Centre and the AIDS clinic in Mulago Hospital. The Geriatric Depression Scale was used to screen for depression, any individual score of ≥10, had the diagnosis of depression confirmed using the Mini-International Neuropsychiatric Interview. Da...

Research paper thumbnail of Vulnerability to risky sexual behavior among patients with severe mental illness in Uganda

Discover social science and health, Apr 8, 2024

Research paper thumbnail of Perceptions of risky sexual behaviour among individuals with severe mental illness in Uganda

To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental ... more To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental illness(SMI) in Uganda. Hypothesis Participants who perceive themselves as being at a high risk for RSB have a higher perception to RSB.

Research paper thumbnail of Factors contributing to vulnerability to risky sexual behaviour in severe mental illness in the Ugandan socio-cultural context

Research Square (Research Square), Apr 25, 2023

Research paper thumbnail of Substance use among HIV-infected adolescents in Uganda: rates and association with potential risks and outcome factors

AIDS Care, 2020

This article sets out to investigate alcohol and substance use (ASU) among adolescents living wit... more This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.

Research paper thumbnail of Physical and psychiatric comorbidity among patients with severe mental illness as seen in Uganda

medRxiv, 2020

This study established the prevalence of physical and psychiatric comorbidity and associated risk... more This study established the prevalence of physical and psychiatric comorbidity and associated risk factors among 1,201 out-patients with severe mental illness (SMI) attending Butabika and Masaka hospitals in Uganda. Participants completed an assessment battery; structured, standardized and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidity and risk factors. Prevalence of physical and psychiatric comorbidity was 13.1 %. Childhood sexual abuse (aOR 1.06, 95% CI 1.03 -1.10, P=0.001), sexual abuse in adulthood (aOR 2.22, 95% CI 1.60 - 3.08, P<0.001), childhood physical abuse (aOR 1.07, 95% CI 1.03 - 1.10, P<0.001) and physical abuse in adulthood (aOR 1.69, 95% CI 1.30 - 2.20, P<0.001) were associated with an increased risk of having comorbid psychiatric and physical disorders. Emerging healthcare models in U...

Research paper thumbnail of Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

European Archives of Psychiatry and Clinical Neuroscience, Aug 24, 2022

Research paper thumbnail of Prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago hospital, Kampala- Uganda: A cross sectional study

Journal of Psychosomatic Research, Oct 1, 2021

BACKGROUND Depression is a major cause of the global disease burden and globally affects 350-400 ... more BACKGROUND Depression is a major cause of the global disease burden and globally affects 350-400 million persons making it the largest contributor to years lived with disability. Among of patients with chronic physical illnesses like tuberculosis, depression affects up to 25-33% of individuals. There are limited studies on the comorbidity of depressive illness and tuberculosis in the Ugandan setting. Our aim was to determine the prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago Hospital, Uganda. METHODS This was a cross sectional study involving 308 consecutively sampled participants aged 18 years and above diagnosed with tuberculosis attending the tuberculosis clinic in Mulago Hospital, Uganda. Consecutive sampling was done for a sample size of 308 participants. Participants had the following instruments administered to them; the Socio-demographic questionnaire, the Mini Neuropsychiatric Interview (MINI) to diagnose depressive illness and the Patient Health Questionnaire- 9 to rate the severity of depression. Data was entered using Epi-Data. Descriptive, bivariate and multivariate analyses were done with the Statistical Package for Social Sciences (SPSS). RESULTS the prevalence of depressive illness was 23.7% (95% confidence interval 19.3-28.9). Depressive illness was independently associated with low education level (AOR = 0.39, 95%CI = 0.21-0.72, p = 0.003), being in the intensive phase of TB treatment (AOR = 2.34, 95%CI = (1.27-4.33), p = 0.007) and family history of depressive illness (AOR = 5.42, 95%CI = 2.02-14.54, p = 0.001). On the PHQ, 60.3% had moderate to severe depression. CONCLUSION Depressive illnesses should be screened and managed among patients with TB. RECOMMENDATION Depression should be routinely screened and managed among patients with Tuberculosis.

Research paper thumbnail of P1‐319: Feasibility of Using the Cognitive Assessment Tool Kit in Uganda

Alzheimers & Dementia, Jul 1, 2018

NFL to test for a potential mediation as per the Baron &amp;amp;amp; Kenny method. Results: T... more NFL to test for a potential mediation as per the Baron &amp;amp;amp; Kenny method. Results: There was a significant negative correlation between log transformed AHI and RAVLT trials 1-5 and RAVLT Long Delay Trial 7 (p &amp;amp;lt; 0.05) controlling for age, sex and education. The addition of NFL to the model did not change the association between OSA and RAVLT. Conclusions:OSAwas associated with lower memory performance in middle-aged adults. However, this effect was not mediated by NFL. Additional studies are needed to determine the neural correlates of cognitive dysfunction in OSA.

Research paper thumbnail of Prevalence of neuropsychiatric adverse events and associated factors among adult patients on dolutegravir attending Mulago <scp>ISS</scp> clinic

Hiv Medicine, Nov 6, 2022

Research paper thumbnail of P1‐319: Feasibility of Using the Cognitive Assessment Tool Kit in Uganda

Alzheimer's & Dementia, 2018

NFL to test for a potential mediation as per the Baron & Kenny method. Results: There was a s... more NFL to test for a potential mediation as per the Baron & Kenny method. Results: There was a significant negative correlation between log transformed AHI and RAVLT trials 1-5 and RAVLT Long Delay Trial 7 (p < 0.05) controlling for age, sex and education. The addition of NFL to the model did not change the association between OSA and RAVLT. Conclusions:OSAwas associated with lower memory performance in middle-aged adults. However, this effect was not mediated by NFL. Additional studies are needed to determine the neural correlates of cognitive dysfunction in OSA.

Research paper thumbnail of Prevalence and factors associated with depressive disorders in an HIV+ rural patient population in southern Uganda

Journal of Affective Disorders, 2011

ABSTRACT Depressive disorders are estimated to occur in nearly half of HIV-infected individuals w... more ABSTRACT Depressive disorders are estimated to occur in nearly half of HIV-infected individuals worldwide. To examine the prevalence and cardinal demographic, psychosocial and clinical features associated with having any depressive disorder, sub-clinical depression, current and lifetime depressive disorders among patients with human immunodeficiency virus (HIV) in southern Uganda. Five hundred HIV+ individuals were screened for depression using a 20 item self-reporting questionnaire (SRQ-20) and evaluated with the mini neuropsychiatric interview(MINI) that assessed current and lifetime depressive disorders. The prevalence estimates of any depressive disorder, subclinical depression, both current and lifetime major depression, and bipolar depression were 46.4%, 17.8%, 25% and 3.6% respectively. In comparison to non-depressed patients, those with sub-clinical depression were less likely to have high levels of self-efficacy, more likely to be using ART for less than one year, have advanced HIV disease and current alcohol use disorders (AUD&#39;s). Those with both current and lifetime depressive disorders were less likely to be 85% adherent to antiretroviral therapy (ART), have social support and high levels of self-efficacy, more likely to have tuberculosis and past manic episodes. Those with only lifetime depressive disorders were more likely to have current AUD&#39;s and past manic episodes. Information concerning exposures and outcomes was collected simultaneously, thus causal relationships are difficult to establish. Sub-clinical depression, major depression and bipolar depression are widespread among HIV patients receiving ART. Integration of mental health services into HIV Care is desperately needed.

Research paper thumbnail of Prevalence of neuropsychiatric adverse events and associated factors among adult patients on dolutegravir attending Mulago ISS clinic

Research paper thumbnail of The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study

International Journal of STD & AIDS

Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a... more Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case–control study to assess the risk of hyperglycemia associated with use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia while controls had no hyperglycemia as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis...

Research paper thumbnail of Prevalence and Factors Associated with Risky Sexual Behaviors among Patients with Severe Mental Illness in Uganda: A Descriptive Cross Sectional Study

Open Journal of Psychiatry

Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar... more Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric outpatient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months' periods was 24.2% (95% CI: 20.2%-28.7%). The factors that were independently significantly associated with RSB were: trauma related

Research paper thumbnail of The risk of hyperglycaemia associated with the use of dolutegravir among adults living with HIV in Kampala, Uganda: a case-control study

The Lancet Global Health, 2022

BACKGROUND Emerging evidence suggests a possible association between hyperglycaemia and use of do... more BACKGROUND Emerging evidence suggests a possible association between hyperglycaemia and use of dolutegravir, a preferred first-line antiretroviral agent in sub-Saharan Africa. Rigorous studies are needed to validate this association in the light of increasing dolutegravir use and burden of non-communicable diseases among people living with HIV. METHODS We conducted a case-control study in Kampala, Uganda to assess the risk of hyperglycaemia associated with dolutegravir-based antiretroviral therapy (ART). Cases were people living with HIV with hyperglycaemia and controls were people living with HIV without hyperglycaemia, confirmed by fasting plasma glucose and 2-hour oral glucose tolerance tests. Data were collected by interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on dolutegravir use before diagnosis of hyperglycaemia while controlling for potential confounders through multivariable logistic regression. FINDINGS A total 435 participants were included (204 cases, 231 controls). At bivariate analysis, significant differences in age, education, current body-mass index, hypertension as a comorbidity, previous ART regimen, and current ART regimen existed between cases and controls. Among the 204 cases, 54 (27%) had hyperglycaemic levels that were diagnostic of prediabetes, with 150 (74%) being diagnostic of diabetes. Of note, 75 (40%) participants previously treated with dolutegravir changed to other ART regimens after being diagnosed with hyperglycaemia. In multivariable analysis, patients with previous dolutegravir use had nearly 30-times greater odds of hyperglycaemia compared with those who had non-dolutegravir based regimens (adjusted odds ratio [aOR] 29·06 [95% CI 9·86-85·70]). The odds of hyperglycaemia also increased with age (56 years and older vs 18-35 years, aOR 7·53 [95% CI 2·65-21·38]), and hypertension (aOR 5·64 [2·60-12·21]). INTERPRETATION Our study shows a strong association between previous dolutegravir exposure and hyperglycaemia. Given the benefits of dolutegravir, its wide-scale roll-out in sub-Saharan Africa, and the growing burden of diabetes, systematic screening of hyperglycaemia before initiation of dolutegravir, routine glucose monitoring, and the consideration of alternate regimens for those at risk for diabetes are needed. FUNDING This research was supported by the US National Institutes of Health, Fogarty International Center and Global Health Equity Scholars (grant D43TW010540).

Research paper thumbnail of Prevalence of Relapse of Alcohol Use Disorder and the Association With Self-Efficacy and Perceived Social Support in Butabika Hospital

Background Alcohol use disorder (AUD) is a problem globally and Uganda has one of the highest per... more Background Alcohol use disorder (AUD) is a problem globally and Uganda has one of the highest per capita alcohol consumption rates in sub-Saharan Africa. Relapse is a distressing aspect in the treatment of AUD and it is mediated by self-efficacy and perceived social support besides other psychosocial factors. In Uganda, there is paucity of data regarding relapse of AUD and the association with self-efficacy and perceived social support hence the need to carry out this study. Objective To determine the prevalence of relapse of AUD and the association with self-efficacy and perceived social support at Butabika hospital. Methods A cross-sectional study design was used and 269 participants that received treatment for AUD at hospital in the period between 1st /01/2016 and 31st /12/2017 were consecutively recruited. Participants were assessed for relapse of AUD using the SCID-5 substance use disorder section. Data was collected using a socio-demographic questionnaire, the general self-eff...

Research paper thumbnail of The Risk of Hyperglycemia Associated with Use of Dolutegravir Among Adults Living with HIV in Kampala, Uganda: A Case-Control Study

SSRN Electronic Journal, 2021

Research paper thumbnail of A comparative study of the prevalence and clinical features associated with depression among HIV- positive and HIV- negative elderly patients in Mulago Hospital

The dissertation is submitted to the directorate of research and graduate training in partial ful... more The dissertation is submitted to the directorate of research and graduate training in partial fullfilment of the requirements for the award of the Degree of master of medicine in psychiatry of Makerere University.

Research paper thumbnail of A comparison of the prevalence and clinical features of depression in HIV-positive and HIV-negative elderly patients in Uganda

Background Depression is a leading contributor to the burden of disease worldwide, a serious co m... more Background Depression is a leading contributor to the burden of disease worldwide, a serious co morbidity and critical barrier to Human Immunodeficiency Virus (HIV) care and prevention especially in Sub- Saharan Africa. It is unclear if among elderly HIV/ Acquired Immune Deficiency Syndrome (AIDS) positive individuals the characteristics of the illness presents different as compared to elderly HIV/AIDS negative individuals. We thus set out to compare the prevalence and clinical features associated with depression among elderly HIV positive and elderly HIV negative patients in Mulago Hospital. Methods This was a comparative cross sectional study of HIV positive and HIV negative individuals aged ≥ 60 years. They were enrolled from the Assessment Centre and the AIDS clinic in Mulago Hospital. The Geriatric Depression Scale was used to screen for depression, any individual score of ≥10, had the diagnosis of depression confirmed using the Mini-International Neuropsychiatric Interview. Da...