Ivan Mugisha | Mbarara University of Science and Technology (MUST) (original) (raw)
Papers by Ivan Mugisha
Clinical Infectious Diseases
Background In people with human immunodeficiency virus (PWH), the World Health Organization–recom... more Background In people with human immunodeficiency virus (PWH), the World Health Organization–recommended tuberculosis (TB) 4-symptom screen (W4SS) targeting those who need molecular rapid testing may be suboptimal. We assessed the performance of different TB screening approaches in severely immunosuppressed PWH enrolled in the guided-treatment group of the STATIS trial (NCT02057796). Methods Ambulatory PWH with no overt evidence of TB and CD4 count <100 cells/µL were screened for TB prior to antiretroviral therapy (ART) initiation with W4SS, chest radiograph (CXR), urine lipoarabinomannan (LAM) test, and sputum Xpert MTB/RIF (Xpert). Correctly and wrongly identified cases by screening approaches were assessed overall and by CD4 count threshold (≤50 and 51–99 cells/µL). Results Of 525 enrolled participants (median CD4 count, 28 cells/µL), 48 (9.9%) were diagnosed with TB at enrollment. Among participants with a negative W4SS, 16% had either a positive Xpert, a CXR suggestive of TB,...
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 2022
Background Imperative need exists to search for new anti-TB drugs that are safer, and more effect... more Background Imperative need exists to search for new anti-TB drugs that are safer, and more effective against drug-resistant strains. Medicinal plants have been the source of active ingredients for drug development. However, the slow growth and biosafety level requirements of M. tuberculosis culture are considerable challenges. M. smegmatis can be used as a surrogate for M. tuberculosis. In the current study, preliminary phytochemical screening and antimycobacterial activity evaluation of crude methanolic extracts of medicinal plants against M. smegmatis, and two M. tuberculosis strains, were conducted. Materials and Methods Crude methanolic extracts, obtained from the leaves of L. camara, roots of C. sanguinolenta, and stem barks of Z. leprieurii, were tested for antimycobacterial activity against M. smegmatis (mc2155), pan-sensitive (H37Rv), and rifampicin-resistant (TMC-331) M. tuberculosis, using visual Resazurin Microtiter Assay (REMA) on 96 well plates. Preliminary qualitative phytochemical screening tests were performed using standard chemical methods. Results The three methanolic extracts inhibited mycobacterial growth in vitro. They were more active against rifampicin-resistant strain with MICs of 176, 97, and 45 µg/mL for L. camara, C. sanguinolenta, and Z. leprieurii extracts, respectively. The lowest activity was observed against M. smegmatis with MICs of 574, 325, and 520 µg/mL, respectively. Against H37Rv, activity was intermediate to those of TMC-331 and mc2155. However, L. camara extract showed the same activity against H37Rv and M. smegmatis. Preliminary phytochemical analysis revealed alkaloids, flavonoids, phenolic compounds, saponins, tannins, and terpenoids. Conclusions Leaves of L. camara, roots of C. sanguinolenta, and stem barks of Z. leprieurii exhibit antimycobacterial activity against M. smegmatis, pan-sensitive, and rifampicin-resistant M. tuberculosis. This offers the possibilities for novel therapeutic opportunities against TB including multidrug-resistant TB. Further investigations on safety and mechanisms of action are required. These studies could be done using M. smegmatis as a surrogate for the highly pathogenic M. tuberculosis.
Additional file 1. Questionnaire.
International Blood Research & Reviews, 2017
Background: Hepatitis B infection is a disease of public health significance. The burden of the d... more Background: Hepatitis B infection is a disease of public health significance. The burden of the disease among the pregnant women at Mbarara Regional Referral Hospital was not known yet determining seropositivity at antenatal care could prevent HBV in the newborn. This study assessed the prevalence and factors associated with hepatitis B surface antigen positivity among women attending antenatal care at Mbarara Regional Referral Hospital. Methods: This was a cross-sectional study that consisted of 385 pregnant women who attended antenatal care clinic at Mbarara Regional Referral Hospital in a period of three months beginning December 2018 to February 2018. Blood samples were tested for HBsAg using immune-chromatography and positive samples confirmed using the ARCHITECT S2000r system. Data was collected using a structured questionnaire. Logistic regression analysis to assess associated factors with HBsAg was done, results were presented in tables. Results: Three hundred eighty-five women were enrolled in the study. Their median age was 26 years. Prevalence of current (HBsAg) was 3.12% (95% CI 1.62-5.38%). Prevalence of HBsAg was higher. The factors associated with HBsAg positivity were having more than one sexual partner 10.3% or 4.695% CI (1.34-16.30) p-value=0.016, history of valval ulcerations 0. R=3.35(CI 1.04-10.77), p-value=0.045 and history of body piercing 12.88% (CI 1.34-124.40), p=0.0027. Conclusion: The prevalence of hepatitis B surface antigen positivity among pregnant women receiving antenatal care at Mbarara Regional Referral Hospital is high. According to the WHO classification of hepatitis B infection, results show intermediate endemicity, and this clearly points to the need for universal screening of all women attending antenatal care at Mbarara Hospital.
Journal of Blood Medicine, 2019
Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemo... more Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb ® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17-40.38). The mean difference of the TrueHb ® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095-0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161-2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb ® hemometer was 2.46 mins (95% CI: 2.37-2.55). Conclusion: TrueHb ® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, Jan 8, 2018
The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden coun... more The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ≥ 5-10 and > 10 years, respectively (p = 0.599). Xp...
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
![Research paper thumbnail of Assessment of the diagnostic performance of TrueHb®, point-of-care hemometer compared with Sysmex i3 analyzer among patients at International Hospital Kampala, Uganda [Corrigendum]](https://attachments.academia-assets.com/75779456/thumbnails/1.jpg)
](Journal of Blood Medicine
Background: Medical-incident reporting (MIR) ensures patient safety and delivery of quality of ca... more Background: Medical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH). Methods: We conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH. Results: The results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p-value 0.669). Conclusion: Medical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.
BMC Health Services Research, Apr 3, 2020
BackgroundMedical-incident reporting (MIR) ensures patient safety and delivery of quality of care... more BackgroundMedical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH).MethodsWe conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH.ResultsThe results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p- value 0.669).ConclusionMedical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, Jan 8, 2018
The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden coun... more The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ≥ 5-10 and > 10 years, respectively (p = 0.599). Xp...
Clinical Infectious Diseases
Background In people with human immunodeficiency virus (PWH), the World Health Organization–recom... more Background In people with human immunodeficiency virus (PWH), the World Health Organization–recommended tuberculosis (TB) 4-symptom screen (W4SS) targeting those who need molecular rapid testing may be suboptimal. We assessed the performance of different TB screening approaches in severely immunosuppressed PWH enrolled in the guided-treatment group of the STATIS trial (NCT02057796). Methods Ambulatory PWH with no overt evidence of TB and CD4 count <100 cells/µL were screened for TB prior to antiretroviral therapy (ART) initiation with W4SS, chest radiograph (CXR), urine lipoarabinomannan (LAM) test, and sputum Xpert MTB/RIF (Xpert). Correctly and wrongly identified cases by screening approaches were assessed overall and by CD4 count threshold (≤50 and 51–99 cells/µL). Results Of 525 enrolled participants (median CD4 count, 28 cells/µL), 48 (9.9%) were diagnosed with TB at enrollment. Among participants with a negative W4SS, 16% had either a positive Xpert, a CXR suggestive of TB,...
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 2022
Background Imperative need exists to search for new anti-TB drugs that are safer, and more effect... more Background Imperative need exists to search for new anti-TB drugs that are safer, and more effective against drug-resistant strains. Medicinal plants have been the source of active ingredients for drug development. However, the slow growth and biosafety level requirements of M. tuberculosis culture are considerable challenges. M. smegmatis can be used as a surrogate for M. tuberculosis. In the current study, preliminary phytochemical screening and antimycobacterial activity evaluation of crude methanolic extracts of medicinal plants against M. smegmatis, and two M. tuberculosis strains, were conducted. Materials and Methods Crude methanolic extracts, obtained from the leaves of L. camara, roots of C. sanguinolenta, and stem barks of Z. leprieurii, were tested for antimycobacterial activity against M. smegmatis (mc2155), pan-sensitive (H37Rv), and rifampicin-resistant (TMC-331) M. tuberculosis, using visual Resazurin Microtiter Assay (REMA) on 96 well plates. Preliminary qualitative phytochemical screening tests were performed using standard chemical methods. Results The three methanolic extracts inhibited mycobacterial growth in vitro. They were more active against rifampicin-resistant strain with MICs of 176, 97, and 45 µg/mL for L. camara, C. sanguinolenta, and Z. leprieurii extracts, respectively. The lowest activity was observed against M. smegmatis with MICs of 574, 325, and 520 µg/mL, respectively. Against H37Rv, activity was intermediate to those of TMC-331 and mc2155. However, L. camara extract showed the same activity against H37Rv and M. smegmatis. Preliminary phytochemical analysis revealed alkaloids, flavonoids, phenolic compounds, saponins, tannins, and terpenoids. Conclusions Leaves of L. camara, roots of C. sanguinolenta, and stem barks of Z. leprieurii exhibit antimycobacterial activity against M. smegmatis, pan-sensitive, and rifampicin-resistant M. tuberculosis. This offers the possibilities for novel therapeutic opportunities against TB including multidrug-resistant TB. Further investigations on safety and mechanisms of action are required. These studies could be done using M. smegmatis as a surrogate for the highly pathogenic M. tuberculosis.
Additional file 1. Questionnaire.
International Blood Research & Reviews, 2017
Background: Hepatitis B infection is a disease of public health significance. The burden of the d... more Background: Hepatitis B infection is a disease of public health significance. The burden of the disease among the pregnant women at Mbarara Regional Referral Hospital was not known yet determining seropositivity at antenatal care could prevent HBV in the newborn. This study assessed the prevalence and factors associated with hepatitis B surface antigen positivity among women attending antenatal care at Mbarara Regional Referral Hospital. Methods: This was a cross-sectional study that consisted of 385 pregnant women who attended antenatal care clinic at Mbarara Regional Referral Hospital in a period of three months beginning December 2018 to February 2018. Blood samples were tested for HBsAg using immune-chromatography and positive samples confirmed using the ARCHITECT S2000r system. Data was collected using a structured questionnaire. Logistic regression analysis to assess associated factors with HBsAg was done, results were presented in tables. Results: Three hundred eighty-five women were enrolled in the study. Their median age was 26 years. Prevalence of current (HBsAg) was 3.12% (95% CI 1.62-5.38%). Prevalence of HBsAg was higher. The factors associated with HBsAg positivity were having more than one sexual partner 10.3% or 4.695% CI (1.34-16.30) p-value=0.016, history of valval ulcerations 0. R=3.35(CI 1.04-10.77), p-value=0.045 and history of body piercing 12.88% (CI 1.34-124.40), p=0.0027. Conclusion: The prevalence of hepatitis B surface antigen positivity among pregnant women receiving antenatal care at Mbarara Regional Referral Hospital is high. According to the WHO classification of hepatitis B infection, results show intermediate endemicity, and this clearly points to the need for universal screening of all women attending antenatal care at Mbarara Hospital.
Journal of Blood Medicine, 2019
Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemo... more Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb ® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17-40.38). The mean difference of the TrueHb ® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095-0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161-2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb ® hemometer was 2.46 mins (95% CI: 2.37-2.55). Conclusion: TrueHb ® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, Jan 8, 2018
The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden coun... more The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ≥ 5-10 and > 10 years, respectively (p = 0.599). Xp...
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Blood Medicine
Background: Medical-incident reporting (MIR) ensures patient safety and delivery of quality of ca... more Background: Medical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH). Methods: We conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH. Results: The results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p-value 0.669). Conclusion: Medical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.
BMC Health Services Research, Apr 3, 2020
BackgroundMedical-incident reporting (MIR) ensures patient safety and delivery of quality of care... more BackgroundMedical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH).MethodsWe conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH.ResultsThe results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p- value 0.669).ConclusionMedical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, Jan 8, 2018
The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden coun... more The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ≥ 5-10 and > 10 years, respectively (p = 0.599). Xp...