6 results on '"Hasan M"'
Search Results
2. Response to Antiretroviral Therapy in HIV- Infected Patients Attending a Public, Urban Clinic in Kampala, Uganda.
- Author
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Spacek, Lisa A., Shihab, Hasan M., Kamya, Moses R., Mwesigire, Doris, Ronald, Allan, Mayanja, Harriet, Moore, Richard D., Bates, Michael, and Quinn, Thomas C.
- Subjects
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HIV , *ANTIRETROVIRAL agents , *THERAPEUTICS , *PATIENTS , *MULTIVARIATE analysis - Abstract
Background. Access to antiretroviral therapy and human immunodeficiency virus (HIV) care is increasing in resource-limited settings. We evaluated clinical, behavioral, and demographic risk factors associated with virologic suppression in a public, urban clinic in Kampala, Uganda. Methods. We conducted a cross-sectional, observational study of 137 HIV-infected patients who were receiving antiretroviral therapy at the infectious diseases clinic at Mulago Hospital (Kampala). We measured the prevalence of viral suppression, evaluated risk factors associated with virologic failure, and documented phenotypic resistance patterns and genotypic mutations. Results. A total of 91 (66%) of 137 participants had an undetectable viral load (<400 copies/mL) after a median duration of 38 weeks (interquartile range, 24-62 weeks) of antiretroviral therapy. Median CD4 cell count was 163 cells/mm³ (interquartile range, 95-260 cells/mm³). The majority of the patients (91%) were treated with nonnucleoside reverse-transcriptase inhibitor-based 3-drug regimens. In multivariate analysis, treatment with the first antiretroviral regimen was associated with viral suppression (odds ratio, 2.6; 95% confidence interval, 1.1- 6.1). In contrast, a history of unplanned treatment interruption was associated with virologic treatment failure (odds ratio, 0.2; 95% confidence interval, 0.1-0.6). Of 124 participants treated with nonnucleoside reverse-transcriptase inhibitors, 27 (22%) were documented to have experienced virologic treatment failure. The most common mutation detected was K103N (found in 14 of 27 patients with virologic treatment failure). Conclusions. Although many HIV-infected people treated in Kampala, Uganda, have advanced HIV disease, the majority of patients who received antiretroviral therapy experienced viral suppression and clinical benefit. Because of the frequent use of nonnucleoside reverse-transcriptase inhibitor-based therapy, the majority of resistance was against this drug class. In resource-limited settings, initiation of therapy with a potent, durable regimen, accompanied by stable drug supplies, will optimize the likelihood of viral suppression. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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3. Exploring the mental health and psychosocial problems of Congolese refugees living in refugee settings in Rwanda and Uganda: a rapid qualitative study.
- Author
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Chiumento, Anna, Rutayisire, Theoneste, Sarabwe, Emmanuel, Hasan, M. Tasdik, Kasujja, Rosco, Nabirinde, Rachel, Mugarura, Joseph, Kagabo, Daniel M., Bangirana, Paul, Jansen, Stefan, Ventevogel, Peter, Robinson, Jude, and White, Ross G.
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MENTAL health ,SOCIAL support ,VIOLENCE against women ,REFUGEES ,REFUGEE camps - Abstract
Background: Refugees fleeing conflict often experience poor mental health due to experiences in their country of origin, during displacement, and in new host environments. Conditions in refugee camps and settlements, and the wider socio-political and economic context of refugees' lives, create structural conditions that compound the effects of previous adversity. Mental health and psychosocial support services must address the daily stressors and adversities refugees face by being grounded in the lived reality of refugee's lives and addressing issues relevant to them. Methods: We undertook a rapid qualitative study between March and May 2019 to understand the local prioritisation of problems facing Congolese refugees living in two refugee settings in Uganda and Rwanda. Thirty free list interviews were conducted in each setting, followed by 11 key informant interviews in Uganda and 12 in Rwanda. Results: Results from all interviews were thematically analysed following a deductive process by the in-country research teams. Free list interview findings highlight priority problems of basic needs such as food, shelter, and healthcare access; alongside contextual social problems including discrimination/inequity and a lack of gender equality. Priority problems relating to mental and psychosocial health explored in key informant interviews include discrimination and inequity; alcohol and substance abuse; and violence and gender-based violence. Conclusions: Our findings strongly resonate with models of mental health and psychosocial wellbeing that emphasise their socially determined and contextually embedded nature. Specifically, findings foreground the structural conditions of refugees' lives such as the physical organisation of camp spaces or refugee policies that are stigmatising through restricting the right to work or pursue education. This structural environment can lead to disruptions in social relationships at the familial and community levels, giving rise to discrimination/inequity and gender-based violence. Therefore, our findings foreground that one consequence of living in situations of pervasive adversity caused by experiences of discrimination, inequity, and violence is poor mental health and psychosocial wellbeing. This understanding reinforces the relevance of feasible and acceptable intervention approaches that aim to strengthening familial and community-level social relationships, building upon existing community resources to promote positive mental health and psychosocial wellbeing among Congolese refugees in these settings. [ABSTRACT FROM AUTHOR]
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- 2020
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4. Bilateral pedal edema in an HIV patient: Lopinavir/Ritonavir-containing treatment regimen as a potential cause?
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Shihab, Hasan M., Lutwama, Fred, Piloya, Theresa, Castelnuovo, Barbara, Kambugu, Andrew D., and Colebunders, Robert
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EDEMA , *BODY fluid disorders , *HIV-positive persons , *HIV infections , *ANTIVIRAL agents , *ANTIRETROVIRAL agents , *HIGHLY active antiretroviral therapy - Abstract
A large number of patients are switched to second-line antiretroviral therapy, especially in resource limited settings. Lopinavir/Ritonavir is the main drug used in second-line treatment regimens. We describe a patient attending an HIV treatment centre in Kampala, Uganda, who presented with bilateral non-tender pitting inflammatory edema two weeks after switching to a Lopinavir/Ritonavir-containing second-line treatment regimen. The lack of an alternate explanation led us to suspect that Lopinavir/Ritonavir was potentially responsible for the edema. [ABSTRACT FROM AUTHOR]
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- 2009
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5. Evaluation of Dynabeads and Cytospheres Compared With Flow Cytometry to Enumerate CD4+ T Cells in HIV-lnfected Ugandans on Antiretroviral Therapy.
- Author
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Lulwama, Fred, Serwadda, Ronnie, Mayanja-Kizza, Harriet, Shihab, Hasan M., Ronald, Allan, Kamya, Moses R., Thomas, David, Johnson, Elizabeth, Quinn, Thomas C., Moore, Richard D., and Spacek, Lisa A.
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HIV infections , *FLOW cytometry , *LYMPHOCYTES , *ANTIRETROVIRAL agents , *T cells - Abstract
The article compares the CD4 lymphocyte count obtained on replicate samples from HIV-positive Ugandans followed for 18 months by two manual bead-based assays with those generated by flow cytometry at the Infectious Diseases Institute in Kampala, Uganda. It discusses the use of Dynal Biotech's Dynabeads and Beckman Coulter's Cytospheres. The article shows that manual bead-based assays may provide a less expensive alternative to flow cytometry.
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- 2008
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6. Evaluation of Dynabeads and Cytospheres compared with flow cytometry to enumerate CD4+ T cells in HIV-infected Ugandans on antiretroviral therapy.
- Author
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Lutwama F, Serwadda R, Mayanja-Kizza H, Shihab HM, Ronald A, Kamya MR, Thomas D, Johnson E, Quinn TC, Moore RD, and Spacek LA
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- Adult, Antiretroviral Therapy, Highly Active, Female, Flow Cytometry, Humans, Male, Uganda, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes immunology, HIV Infections drug therapy, HIV Infections immunology, Immunomagnetic Separation, Monitoring, Physiologic methods
- Abstract
Background: Laboratory-based monitoring of antiretroviral therapy is essential but adds a significant cost to HIV care. The World Health Organization 2006 guidelines support the use of CD4 lymphocyte count (CD4) to define treatment failure in resource-limited settings., Methods: We compared CD4 obtained on replicate samples from 497 HIV-positive Ugandans (before and during ART) followed for 18 months by 2 manual bead-based assays, Dynabeads (Dynal Biotech), and Cytospheres (Beckman Coulter) with those generated by flow cytometry at the Infectious Diseases Institute in Kampala, Uganda., Results: We tested 1671 samples (123 before ART) with Dynabeads and 1444 samples (91 before ART) with Cytospheres. Mean CD4 was 231 cells/mm (SD, 139) and 239 cells/mm (SD, 140) by Dynabeads and flow cytometry, respectively. Mean CD4 was 186 cells/mm (SD, 101) and 242 cells/mm (SD, 136) by Cytospheres and flow cytometry, respectively. The mean difference in CD4 count by flow cytometry versus Dynabeads were 8.8 cells/mm (SD, 76.0) and versus Cytospheres were 56.8 cells/mm (SD, 85.8). The limits of agreement were -140.9 to 158.4 cells/mm for Dynabeads and -112.2 to 225.8 cells/mm for Cytospheres. Linear regression analysis showed higher correlation between flow cytometry and Dynabeads (r=0.85, r=0.73, slope=0.85, intercept=28) compared with the correlation between flow cytometry and Cytospheres (r=0.78, r=0.60, slope=0.58, intercept=45). Area under the receiver operating characteristics curve to predict CD4<200 cells/mm was 0.928 for Dynabeads and 0.886 for Cytospheres., Conclusion: Although Dynabeads and Cytospheres both underestimated CD4 lymphocyte count compared with flow cytometry, in resource-limited settings with low daily throughput, manual bead-based assays may provide a less expensive alternative to flow cytometry.
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- 2008
- Full Text
- View/download PDF
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