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1. Impact of early continuous positive airway pressure in the delivery room (DR-CPAP) on neonates < 1500 g in a low-resource setting: a protocol for a pilot feasibility and acceptability randomized controlled trial

Author

Burgoine, Kathy, Ssenkusu, John M., Nakiyemba, Alice, Okello, Francis, Napyo, Agnes, Hagmann, Cornelia, Namuyonga, Judith, Hewitt-Smith, Adam, Martha, Muduwa, Loe, Kate, Grace, Abongo, Denis, Amorut, Wandabwa, Julius, and Olupot-Olupot, Peter

Published
2024
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2. A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Published
2023
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4. Serious bacterial infections among Ugandan neonates : aetiology, clinical findings and one year outcomes

Author

Burgoine, Kathy

Abstract

Title: Serious bacterial infections among Ugandan neonates: Aetiology, clinical findings and one year outcomes. Author: K L Burgoine Background: Globally, serious bacterial infections, such as sepsis, pneumonia and meningitis, are a leading cause of neonatal mortality. In sub-Saharan Africa (SSA) there are believed to be up to 2.6 million cases of pSBI every year, leading to an estimated 250,000 deaths. Diagnosis is challenging since signs and symptoms are often non-specific and laboratory facilities are limited. In low-resource settings, the diagnosis of a possible serious bacterial infection (pSBI) relies on clinical algorithms. Cranial ultrasound (cUS) is a relatively cheap, safe and portable method of assessing the neonatal brain that could be used to detect findings indicative of CNS involvement. There are also limited data on the outcomes of pSBI survivors. This is one of the first studies in SSA to assess the role of cUS in the evaluation of infants with pSBI and the early developmental outcome of infants admitted with pSBI. Aims: In term neonates presenting with pSBI to a neonatal unit in eastern Uganda: • Describe the clinical presentation, aetiology and neonatal outcomes • Describe findings on cUS scans at presentation and correlate the imaging findings with presentation, CSF analysis and neonatal mortality • Compare cUS findings to a cohort of similar aged well term neonates. • Describe findings on serial cUS scans up to 28 days • Evaluate mortality, growth and developmental impairment up to 12 months of age and compare it to the contemporaneous control cohort • Investigate the risk factors that contribute to poor early childhood outcome in term-born infants that experienced a possible severe bacterial infection (pSBI) during the neonatal period. Methods: Over a 1-year period, any term neonates presenting to the neonatal unit at Mbale Regional Referral Hospital who met the definition of pSBI were screened for inclusion. We described the microbiological aetiology using blood and CSF culture, the presenting clinical features and the neonatal outcomes. Each neonate had a standard cUS examination performed. The images were interpreted systematically by one of two experts blinded to the clinical details. A contemporaneous cohort of well term neonates were recruited. They underwent the same clinical and cUS examination. We followed-up surviving infants at 2, 6 and 12 months of age to evaluate survival, growth and development. The Bayley Scales of Infant Development-3rd edition (BSID-III) was used and developmental impairment was defined as a scaled-score < -1SD below the mean. Poor outcome was defined as either death, hydrocephalus, post-neonatal seizures or developmental impairment at 12 months of age. Results: 214 neonates with pSBI were recruited. Definite or possible pathogens were identified in 5.6% (12/214) of blood cultures. The most common pathogens isolated were Staphylococcus Aureus, Klebsiella and Escherichia coli. Potential pathogens were isolated in 0% (0/189) of CSF cultures. The overall neonatal mortality was 9.3% (20/214). The neonatal mortality from neonatal meningitis was 22.2% (6/27). Early cUS scans were available for 196/214 (91.6%) neonates with pSBI. There was no observed association between cUS findings at presentation and neonatal mortality. Moderate and severe cortical and/or white matter (WM) echogenicities were significantly associated with abnormal CSF analysis. The presence of signs suggestive of encephalopathy or meningism were associated with abnormal cortical, WM, and basal ganglia and thalami (BGT) echogenicity, ventricular dilatation and bright ventricular lining. At 12 months 164/187 survivors of pSBI were available for assessment; 4/187 infants had died during the post-neonatal period. Developmental impairment was evident across all domains of the BSID-III and the rates of impairment ranged from 7.9% to 14.6%. 24/44 control infants were available for assessment and none of these infants were impaired in any of the 5 domains. The raw scores and the scaled scores for all five neurocognitive domains were significantly lower for survivors of pSBI compared to control infants. Survivors of neonatal meningitis, had the highest rates of developmental impairment, being 24%, 35% and 24% in cognitive, language and motor domains respectively. Survivors of neonatal meningitis had a 12 to 18-fold increased risk of developmental impairment across all domains. By 12 months of age 30.5% (54/177) of infants had a poor outcome. After adjustment for sex, age and weight, the following factors increased the risk of poor outcome: age <48 hours at presentation, respiratory distress (aOR 2.7, 95%CI 1.2-6.2), neonatal seizures (aOR 13.0 (5.2-32.4)), opisthotonus (aOR 9.5 (3.5-27.0)), hypotonia (aOR 3.0 (1.1-8.3)) and raised CSF protein (aOR 9.5 (2.3-38.6)). cUS findings at presentation, significantly associated with poor outcome were abnormal cortex (aOR 6.9 (2.0-23.5)), abnormal white matter (aOR 2.0 (1.0-3.9)), abnormal basal ganglia (aOR 13.6 (2.7-68.2)) and abnormal thalami (aOR 5.28 (1.8-15.2)). Conclusion: It is clear that serious bacterial infections during the neonatal period, even without meningitis, may have a substantial public health and economic burden in SSA. Presentation before 48 hours of age, lower weight, several readily recognisable clinical signs as well as raised CSF protein and cortical, white matter, and central grey matter abnormalities seen on cUS, were all significant predictors of poor outcome. These risk factors will enable us to better consider which infants need more intensive follow-up, early intervention and support. Improving our understanding of the specific aetiologies associated with mortality, developmental impairment and post-infectious hydrocephalus, is now necessary to inform prevention strategies and treatment approaches.

Published
2021
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5. Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda: an observational case-control study

Author

Morton, Sarah U, Hehnly, Christine, Burgoine, Kathy, Ssentongo, Paddy, Ericson, Jessica E, Kumar, M Senthil, Hagmann, Cornelia, Fronterre, Claudio, Smith, Jasmine, Movassagh, Mercedeh, Streck, Nicholas, Bebell, Lisa M, Bazira, Joel, Kumbakumba, Elias, Bajunirwe, Francis, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Nsubuga, Brian K, Natukwatsa, Davis, Nalule, Esther, Magombe, Joshua, Erickson, Tim, Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Onen, Justin, Ssenyonga, Peter, Mugamba, John, Warf, Benjamin C, Kulkarni, Abhaya V, Lane, Jessica, Whalen, Andrew J, Zhang, Lijun, Sheldon, Kathryn, Meier, Frederick A, Kiwanuka, Julius, Broach, James R, Paulson, Joseph N, and Schiff, Steven J

Published
2023
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6. Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

Author

Hehnly, Christine, Ssentongo, Paddy, Bebell, Lisa M., Burgoine, Kathy, Bazira, Joel, Fronterre, Claudio, Kumbakumba, Elias, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Morton, Sarah U., Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Mugamba, John, Onen, Justin, Roberts, Drucilla J., Sheldon, Kathryn, Sinnar, Shamim A., Smith, Jasmine, Ssenyonga, Peter, Kiwanuka, Julius, Paulson, Joseph N., Meier, Frederick A., Ericson, Jessica E., Broach, James R., and Schiff, Steven J.

Published
2022
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8. Vaginal microbiome topic modeling of laboring Ugandan women with and without fever

Author

Movassagh, Mercedeh, Bebell, Lisa M., Burgoine, Kathy, Hehnly, Christine, Zhang, Lijun, Moran, Kim, Sheldon, Kathryn, Sinnar, Shamim A., Mbabazi-Kabachelor, Edith, Kumbakumba, Elias, Bazira, Joel, Ochora, Moses, Mulondo, Ronnie, Nsubuga, Brian Kaaya, Weeks, Andrew D., Gladstone, Melissa, Olupot-Olupot, Peter, Ngonzi, Joseph, Roberts, Drucilla J., Meier, Frederick A., Irizarry, Rafael A., Broach, James R., Schiff, Steven J., and Paulson, Joseph N.

Published
2021
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10. Neonatal emollient therapy and massage practices in Africa: a scoping review.

Author

Blanks, Keona J H, Musaba, Milton W, Ren, Lily, Burgoine, Kathy, Mukunya, David, Clarke, Andrew, Williams, Sarah, Gebremichael, Tewodros, Waiswa, Peter, and Darmstadt, Gary L

Subjects
MASSAGE therapy, SKIN care, SKIN care products, NEWBORN infants, NOSOCOMIAL infections
Abstract

There have been few reports from Africa on the use and health effects of emollient therapy for newborn infants. We aimed to describe neonatal skin care practices in Africa, and to illuminate opportunities to introduce evidence-based interventions to improve these practices. We conducted a scoping review of the quantitative and qualitative published peer-reviewed and grey literature in English on emollient use in Africa. Outcomes of interest included neonatal skin care practices, with a focus on the application of oils and other products to infant skin, including in association with bathing and massage. We screened 5257 articles and summarised findings from 23 studies—13 qualitative, nine quantitative and one mixed methods—that met our study criteria. Seven studies reported the use of emollients for perceived benefits, including thermal care, treatment for illness, promotion of growth and development, infection reduction, skin condition improvement, spirituality and lubrication to aid massage. Four studies reported the quantitative health impact of skin care product applications, including improvements in skin condition, neurodevelopment and bone growth, as well as a reduction in nosocomial infections. This review highlights opportunities for skin care intervention and future research on neonatal skin care practices in Africa. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Neonatal Paenibacilliosis: Paenibacillus Infection as a Novel Cause of Sepsis in Term Neonates With High Risk of Sequelae in Uganda

Author

Ericson, Jessica E, primary, Burgoine, Kathy, additional, Kumbakumba, Elias, additional, Ochora, Moses, additional, Hehnly, Christine, additional, Bajunirwe, Francis, additional, Bazira, Joel, additional, Fronterre, Claudio, additional, Hagmann, Cornelia, additional, Kulkarni, Abhaya V, additional, Kumar, M Senthil, additional, Magombe, Joshua, additional, Mbabazi-Kabachelor, Edith, additional, Morton, Sarah U, additional, Movassagh, Mercedeh, additional, Mugamba, John, additional, Mulondo, Ronald, additional, Natukwatsa, Davis, additional, Kaaya, Brian Nsubuga, additional, Olupot-Olupot, Peter, additional, Onen, Justin, additional, Sheldon, Kathryn, additional, Smith, Jasmine, additional, Ssentongo, Paddy, additional, Ssenyonga, Peter, additional, Warf, Benjamin, additional, Wegoye, Emmanuel, additional, Zhang, Lijun, additional, Kiwanuka, Julius, additional, Paulson, Joseph N, additional, Broach, James R, additional, and Schiff, Steven J, additional

Published
2023
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16. High Burden of Neurodevelopmental Delay among Children Born to Women with Obstructed Labour in Eastern Uganda: A Cohort Study

Author

Chebet, Martin, primary, Musaba, Milton W., additional, Mukunya, David, additional, Makoko, Brian, additional, Napyo, Agnes, additional, Nantale, Ritah, additional, Auma, Proscovia, additional, Atim, Ketty, additional, Nahurira, Doreck, additional, Lee, Seungwon, additional, Okello, Dedan, additional, Ssegawa, Lawrence, additional, Bromley, Kieran, additional, Burgoine, Kathy, additional, Ndeezi, Grace, additional, Tumwine, James K., additional, Wandabwa, Julius, additional, and Kiguli, Sarah, additional

Published
2023
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17. Neonatal Paenibacilliosis: Paenibacillus infection as a Novel Cause of Sepsis in Term Neonates with High Risk of Sequelae in Uganda

Author

Ericson, Jessica E, Burgoine, Kathy, Kumbakumba, Elias, Ochora, Moses, Hehnly, Christine, Bajunirwe, Francis, Bazira, Joel, Fronterre, Claudio, Hagmann, Cornelia, Kulkarni, Abhaya V, Kumar, M Senthil, Magombe, Joshua, Mbabazi-Kabachelor, Edith, Morton, Sarah U, Movassagh, Mercedeh, Mugamba, John, Mulondo, Ronald, Natukwatsa, Davis, Nsubuga Kaaya, Brian, Olupot-Olupot, Peter, Onen, Justin, Sheldon, Kathryn, Smith, Jasmine, Ssentongo, Paddy, Ssenyonga, Peter, Warf, Benjamin, Wegoye, Emmanuel, Zhang, Lijun, Kiwanuka, Julius, Paulson, Joseph N, Broach, James R, Schiff, Steven J, Ericson, Jessica E, Burgoine, Kathy, Kumbakumba, Elias, Ochora, Moses, Hehnly, Christine, Bajunirwe, Francis, Bazira, Joel, Fronterre, Claudio, Hagmann, Cornelia, Kulkarni, Abhaya V, Kumar, M Senthil, Magombe, Joshua, Mbabazi-Kabachelor, Edith, Morton, Sarah U, Movassagh, Mercedeh, Mugamba, John, Mulondo, Ronald, Natukwatsa, Davis, Nsubuga Kaaya, Brian, Olupot-Olupot, Peter, Onen, Justin, Sheldon, Kathryn, Smith, Jasmine, Ssentongo, Paddy, Ssenyonga, Peter, Warf, Benjamin, Wegoye, Emmanuel, Zhang, Lijun, Kiwanuka, Julius, Paulson, Joseph N, Broach, James R, and Schiff, Steven J

Abstract

Paenibacillus thiaminolyticus may be an underdiagnosed cause of neonatal sepsis. We prospectively enrolled a cohort of 800 full-term neonates presenting with a clinical diagnosis of sepsis at two Ugandan hospitals. Quantitative polymerase chain reaction specific to P. thiaminolyticus and to the Paenibacillus genus were performed on the blood and cerebrospinal fluid (CSF) of 631 neonates who had both specimen types available. Neonates with Paenibacillus genus or species detected in either specimen type were considered to potentially have paenibacilliosis, (37/631, 6%). We described antenatal, perinatal, and neonatal characteristics, presenting signs, and 12-month developmental outcomes for neonates with paenibacillosis vs. clinical sepsis. Median age at presentation was 3 days (interquartile range 1, 7). Fever (92%), irritability (84%) and clinical signs of seizures (51%) were common. Eleven (30%) had an adverse outcome: 5 (14%) neonates died during the first year of life; 5 of 32 (16%) survivors developed postinfectious hydrocephalus (PIH) and one (3%) additional survivor had neurodevelopmental impairment without hydrocephalus. Paenibacillus species was identified in 6% of neonates with signs of sepsis who presented to two Ugandan referral hospitals; 70% were P. thiaminolyticus. Improved diagnostics for neonatal sepsis are urgently needed. Optimal antibiotic treatment for this infection is unknown but ampicillin and vancomycin will be ineffective in many cases. These results highlight the need to consider local pathogen prevalence and the possibility of unusual pathogens when determining antibiotic choice for neonatal sepsis. [Abstract copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.]

Published
2023

18. Paenibacillus spp infection among infants with postinfectious hydrocephalus in Uganda:an observational case-control study

Author

Morton, Sarah U, Hehnly, Christine, Burgoine, Kathy, Ssentongo, Paddy, Ericson, Jessica E, Kumar, M Senthil, Hagmann, Cornelia, Fronterre, Claudio, Smith, Jasmine, Movassagh, Mercedeh, Streck, Nicholas, Bebell, Lisa M, Bazira, Joel, Kumbakumba, Elias, Bajunirwe, Francis, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Nsubuga, Brian K, Natukwatsa, Davis, Nalule, Esther, Magombe, Joshua, Erickson, Tim, Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Onen, Justin, Ssenyonga, Peter, Mugamba, John, Warf, Benjamin C, Kulkarni, Abhaya V, Lane, Jessica, Whalen, Andrew J, Zhang, Lijun, Sheldon, Kathryn, Meier, Frederick A, Kiwanuka, Julius, Broach, James R, Paulson, Joseph N, Schiff, Steven J, Morton, Sarah U, Hehnly, Christine, Burgoine, Kathy, Ssentongo, Paddy, Ericson, Jessica E, Kumar, M Senthil, Hagmann, Cornelia, Fronterre, Claudio, Smith, Jasmine, Movassagh, Mercedeh, Streck, Nicholas, Bebell, Lisa M, Bazira, Joel, Kumbakumba, Elias, Bajunirwe, Francis, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Nsubuga, Brian K, Natukwatsa, Davis, Nalule, Esther, Magombe, Joshua, Erickson, Tim, Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Onen, Justin, Ssenyonga, Peter, Mugamba, John, Warf, Benjamin C, Kulkarni, Abhaya V, Lane, Jessica, Whalen, Andrew J, Zhang, Lijun, Sheldon, Kathryn, Meier, Frederick A, Kiwanuka, Julius, Broach, James R, Paulson, Joseph N, and Schiff, Steven J

Abstract

Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs. The second study assessed Paenibacillus in blood and cerebrospinal fluid (CSF) from neonates with sepsis. The third study assessed Paenibacillus in CSF from infants with hydrocephalus. In this observational study, we recruited mother-newborn pairs with and without maternal fever (mother-newborn cohort), neonates (aged ≤28 days) with sepsis (sepsis cohort), and infants (aged ≤90 days) with hydrocephalus with and without a history of neonatal sepsis and meningitis (hydrocephalus cohort) from three hospitals in Uganda between Jan 13, 2016 and Oct 2, 2019. We collected maternal blood, vaginal swabs, and placental samples and the cord from the mother-newborn pairs, and blood and CSF from neonates and infants. Bacterial content of infant CSF was characterised by 16S rDNA sequencing. We analysed all samples using quantitative PCR (qPCR) targeting either the Paenibacillus genus or Paenibacillus thiaminolyticus spp. We collected cranial ultrasound and computed tomography images in the subset of participants represented in more than one cohort. No Paenibacillus spp were detected in vaginal, maternal blood, placental, or cord blood specimens from the mother-newborn cohort by qPCR. Paenibacillus spp was detected in 6% (37 of 631 neonates) in the sepsis cohort and, of these, 14% (5 of 37 neonates) developed postinfectious hydrocephalus. Paenibacillus was the most enriched bacterial genera in postinfectious hydrocephalus CSF (91 [44%] of 209 patients) from the hydrocephalus cohort, with 16S showing 94% accuracy when validated by qPCR. Imaging showed progression from Paenibacillus spp-related meningitis to postinfectious

Published
2023

19. 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus

Author

Ericson, Jessica E, primary, Burgoine, Kathy, additional, Hehnly, Christine, additional, Kumbakumba, Elias, additional, Ochora, Moses, additional, Bajunirwe, Francis, additional, Bazira, Joel, additional, Fronterre, Claudio, additional, Hagmann, Cornelia, additional, Kulkarni, Abhaya, additional, Senthil Kumar, M, additional, Magombe, Joshua, additional, Mbabazi-Kabachelor, Edith, additional, Morton, Sarah, additional, Movassagh, Mercedeh, additional, Mugamba, John, additional, Mulondo, Ronald, additional, Muwanguzi, Abraham, additional, Natukwatsa, Davis, additional, Kaaya, Brian Nsubuga, additional, Olupot-Olupot, Peter, additional, Onen, Justin, additional, Sheldon, Kathryn, additional, Smith, Jasmine, additional, Ssentongo, Paddy, additional, Ssenyonga, Peter, additional, Warf, Benjamin, additional, Wegoye, Emmanuel, additional, Zhang, Lijun, additional, Broach, James, additional, Kiwanuka, Julius, additional, Paulson, Joseph, additional, and Schiff, Steven, additional

Published
2022
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20. Neonatal Paenibacilliosis:Paenibacillus thiaminolyticusas a Novel Cause of Neonatal Sepsis with High Risk of Sequelae in Uganda

Author

Ericson, Jessica E., primary, Burgoine, Kathy, additional, Kumbakumba, Elias, additional, Ochora, Moses, additional, Hehnly, Christine, additional, Bajunirwe, Francis, additional, Bazira, Joel, additional, Fronterre, Claudio, additional, Hagmann, Cornelia, additional, Kulkarni, Abhaya V., additional, Kumar, M. Senthil, additional, Magombe, Joshua, additional, Mbabazi-Kabachelor, Edith, additional, Morton, Sarah U., additional, Movassagh, Mercedeh, additional, Mugamba, John, additional, Mulondo, Ronald, additional, Natukwatsa, Davis, additional, Kaaya, Brian Nsubuga, additional, Olupot-Olupot, Peter, additional, Onen, Justin, additional, Sheldon, Kathryn, additional, Smith, Jasmine, additional, Ssentongo, Paddy, additional, Ssenyonga, Peter, additional, Warf, Benjamin, additional, Wegoye, Emmanuel, additional, Zhang, Lijun, additional, Kiwanuka, Julius, additional, Paulson, Joseph N., additional, Broach, James R., additional, and Schiff, Steven J., additional

Published
2022
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22. Additional file 1 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 1: Appendix 1. Poster shown and given in the antenatal period to supplement alcohol based hand rub training in the BabyGel trial.

Published
2023
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23. Additional file 2 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 2: Appendix 2. Poster shown and given in the postnatal period to supplement alcohol based hand rub training in the BabyGel trial.

Published
2023
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24. Additional file 6 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 6: Picture 1. Components of a Maama birth kit given to pregnant women in the BabyGel Trial. Picture 2. Alcohol Based Handrub Package given to pregnant women in the intervention arm of the BabyGel Trial.

Published
2023
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25. Additional file 4 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 4.

Published
2023
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26. Additional file 3 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 3: Appendix 3. Alcohol based hand rub training guide used in the BabyGel trial.

Published
2023
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28. Additional file 5 of A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol

Author

Chebet, Martin, Mukunya, David, Burgoine, Kathy, Kühl, Melf-Jakob, Wang, Duolao, Medina-Lara, Antonieta, Faragher, Eric Brian, Odiit, Amos, Olupot-Olupot, Peter, Stadskleiv Engebretsen, Ingunn Marie, Waniaye, John Baptist, Wandabwa, Julius, Tylleskär, Thorkild, and Weeks, Andrew

Abstract

Additional file 5.

Published
2023
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30. Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study

Author

Kirabira, Victoria Nakibuuka, primary, Nakaggwa, Florence, additional, Nazziwa, Ritah, additional, Nalunga, Sanyu, additional, Nasiima, Ritah, additional, Nyagabyaki, Catherine, additional, Sebunya, Robert, additional, Latigi, Grace, additional, Pirio, Patricia, additional, Ahmadzai, Malalay, additional, Ojom, Lawrence, additional, Nabwami, Immaculate, additional, Burgoine, Kathy, additional, and Blencowe, Hannah, additional

Published
2022
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32. Cytomegalovirus Infections in Ugandan Infants:Newborn-Mother Pairs, Neonates with Sepsis, and Infants with Hydrocephalus

Author

Hehnly, Christine, Ssentongo, Paddy, Bebell, Lisa M., Burgoine, Kathy, Bazira, Joel, Fronterre, Claudio, Kumbakumba, Elias, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Morton, Sarah U., Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Onen, Justin, Roberts, Drucilla J., Sheldon, Kathryn, Sinnar, Shamim A., Smith, Jasmine, Ssenyonga, Peter, Paulson, Joseph N., Meier, Frederick A., Ericson, Jessica E., Broach, James R., Schiff, Steven J., Hehnly, Christine, Ssentongo, Paddy, Bebell, Lisa M., Burgoine, Kathy, Bazira, Joel, Fronterre, Claudio, Kumbakumba, Elias, Mulondo, Ronald, Mbabazi-Kabachelor, Edith, Morton, Sarah U., Ngonzi, Joseph, Ochora, Moses, Olupot-Olupot, Peter, Onen, Justin, Roberts, Drucilla J., Sheldon, Kathryn, Sinnar, Shamim A., Smith, Jasmine, Ssenyonga, Peter, Paulson, Joseph N., Meier, Frederick A., Ericson, Jessica E., Broach, James R., and Schiff, Steven J.

Abstract

Objective To estimate the prevalence of cytomegalovirus (CMV) infections in newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus in Uganda. Design and Methods Three populations: (1) newborn-mother pairs, (2) neonates with sepsis, and (3) infants (≤ 3 months) with non-postinfectious (NPIH) or postinfectious (PIH) hydrocephalus, were evaluated for CMV infection at three medical centers in Uganda. Quantitative PCR (qPCR) was used to characterize the prevalence of CMV. Results The overall CMV prevalence in 2498 samples in duplicate across all groups was 9%. In newborn-mother pairs, there was a 3% prevalence of cord blood CMV positivity and 33% prevalence of maternal vaginal shedding. In neonates with clinical sepsis there was a 2% CMV prevalence. Maternal HIV seropositivity (aOR, 25.20; 95% CI, 4.43-134.26; p= 0.0001), residence in Eastern Uganda (aOR, 11.06; 95% CI, 2.30-76.18; p=0.003), maternal age < 25 years (aOR, 4.54; 95% CI, 1.40-19.29; p=0.02), and increasing neonatal age (aOR, 1.08 for each day older; 95% CI, 1.00-1.16; p= 0.05), were associated risk factors for CMV in neonates with clinical sepsis. We found a two-fold higher maternal vaginal shedding in Eastern (45%) vs Western (22%) Uganda during parturition (n=22/49 vs. 11/50, Fisher's exact test, p=0.02). In infants with PIH, the prevalence in blood was 24% and in infants with NPIH it was 20%. CMV was present in the CSF of 13% of infants with PIH compared to 0.5% of infants with NPIH (n=26/205 vs. 1/194, p<0.0001). Conclusion Our findings highlight that congenital and postnatal CMV prevalence is substantial in this African setting and the long-term consequences are uncharacterized.

Published
2022

33. 1328. Paenibacillosis: An Emerging Cause of Neonatal Sepsis and Postinfectious Hydrocephalus

Author

Ericson, Jessica E, Burgoine, Kathy, Hehnly, Christine, Kumbakumba, Elias, Ochora, Moses, Bajunirwe, Francis, Bazira, Joel, Fronterre, Claudio, Hagmann, Cornelia, Kulkarni, Abhaya, Senthil Kumar, M, Magombe, Joshua, Mbabazi-Kabachelor, Edith, Morton, Sarah, Movassagh, Mercedeh, Mugamba, John, Mulondo, Ronald, Muwanguzi, Abraham, Natukwatsa, Davis, Kaaya, Brian Nsubuga, Olupot-Olupot, Peter, Onen, Justin, Sheldon, Kathryn, Smith, Jasmine, Ssentongo, Paddy, Ssenyonga, Peter, Warf, Benjamin, Wegoye, Emmanuel, Zhang, Lijun, Broach, James, Kiwanuka, Julius, Paulson, Joseph, Schiff, Steven, Ericson, Jessica E, Burgoine, Kathy, Hehnly, Christine, Kumbakumba, Elias, Ochora, Moses, Bajunirwe, Francis, Bazira, Joel, Fronterre, Claudio, Hagmann, Cornelia, Kulkarni, Abhaya, Senthil Kumar, M, Magombe, Joshua, Mbabazi-Kabachelor, Edith, Morton, Sarah, Movassagh, Mercedeh, Mugamba, John, Mulondo, Ronald, Muwanguzi, Abraham, Natukwatsa, Davis, Kaaya, Brian Nsubuga, Olupot-Olupot, Peter, Onen, Justin, Sheldon, Kathryn, Smith, Jasmine, Ssentongo, Paddy, Ssenyonga, Peter, Warf, Benjamin, Wegoye, Emmanuel, Zhang, Lijun, Broach, James, Kiwanuka, Julius, Paulson, Joseph, and Schiff, Steven

Abstract

Background The etiology of neonatal sepsis is often not identified. Molecular methods can identify pathogens that culture-based methods miss. Most cases of neonatal sepsis globally are treated empirically per WHO guidelines with intravenous ampicillin and gentamicin, which may not be the best regimen for all pathogens. Methods We prospectively enrolled 800 neonates presenting with signs of sepsis to two Ugandan hospitals. Blood and cerebrospinal fluid were subjected to 16S rRNA sequencing, which identified Paenibacillus thiaminolyticus in 33/800 (4%) neonates. We confirmed the presence of P. thiaminolyticus by quantitative polymerase chain reaction (PCR). We describe neonatal and birth characteristics, presenting signs, and 12-month developmental outcomes for neonates with paenibacillosis. We performed antibiotic susceptibility testing and genomic analyses on three clinical isolates successfully grown in the laboratory. Results Neonates presented at a median age of 3 (1, 7) days. Fever (86%), irritability (78%) and seizures (52%) were common presenting signs (Figure). Most neonates were born vaginally (73%) at a medical facility (79%). Twelve (36%) had an adverse outcome: 5 (15%) neonates died; 4 (14%) survivors developed postinfectious hydrocephalus and three (9%) additional survivors had neurodevelopmental impairment. All three isolates were resistant to vancomycin, two were resistant to penicillin and ampicillin and one was unlikely to be sensitive to ceftriaxone; all were susceptible to gentamicin and meropenem. The genomes of all three strains contained multiple beta-lactamase genes and a cluster of genes that encodes a type IV pilus. Clinical signs at presentation for neonates with good and poor outcomes followng paenibacillosis. Conclusion Molecular methods such as 16S rRNA sequencing and PCR can be used to improve the identification of pathogens causing neonatal sepsis. Paenibacillosis is an important emerging cause of neonatal sepsis in Uganda and is likely

Published
2022

34. Serious bacterial infections among Ugandan neonates: Aetiology, clinical findings and one year outcomes

Author

Burgoine, Kathy, Gladstone, Melissa, Weeks, Andrew, Olupot-Olupot, Peter, and Schiff, Steven

Abstract

Title: Serious bacterial infections among Ugandan neonates: Aetiology, clinical findings and one year outcomes. Author: K L Burgoine Background: Globally, serious bacterial infections, such as sepsis, pneumonia and meningitis, are a leading cause of neonatal mortality. In sub-Saharan Africa (SSA) there are believed to be up to 2.6 million cases of pSBI every year, leading to an estimated 250,000 deaths. Diagnosis is challenging since signs and symptoms are often non-specific and laboratory facilities are limited. In low-resource settings, the diagnosis of a possible serious bacterial infection (pSBI) relies on clinical algorithms. Cranial ultrasound (cUS) is a relatively cheap, safe and portable method of assessing the neonatal brain that could be used to detect findings indicative of CNS involvement. There are also limited data on the outcomes of pSBI survivors. This is one of the first studies in SSA to assess the role of cUS in the evaluation of infants with pSBI and the early developmental outcome of infants admitted with pSBI. Aims: In term neonates presenting with pSBI to a neonatal unit in eastern Uganda: • Describe the clinical presentation, aetiology and neonatal outcomes • Describe findings on cUS scans at presentation and correlate the imaging findings with presentation, CSF analysis and neonatal mortality • Compare cUS findings to a cohort of similar aged well term neonates. • Describe findings on serial cUS scans up to 28 days • Evaluate mortality, growth and developmental impairment up to 12 months of age and compare it to the contemporaneous control cohort • Investigate the risk factors that contribute to poor early childhood outcome in term-born infants that experienced a possible severe bacterial infection (pSBI) during the neonatal period. Methods: Over a 1-year period, any term neonates presenting to the neonatal unit at Mbale Regional Referral Hospital who met the definition of pSBI were screened for inclusion. We described the microbiological aetiology using blood and CSF culture, the presenting clinical features and the neonatal outcomes. Each neonate had a standard cUS examination performed. The images were interpreted systematically by one of two experts blinded to the clinical details. A contemporaneous cohort of well term neonates were recruited. They underwent the same clinical and cUS examination. We followed-up surviving infants at 2, 6 and 12 months of age to evaluate survival, growth and development. The Bayley Scales of Infant Development-3rd edition (BSID-III) was used and developmental impairment was defined as a scaled-score

Published
2022
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35. Paenibacillus Infection Causes Neonatal Sepsis and Subsequent Postinfectious Hydrocephalus in Ugandan Infants

Author

Morton, Sarah U., primary, Hehnly, Christine, additional, Burgoine, Kathy, additional, Ssentongo, Paddy, additional, Ericson, Jessica E., additional, Kumar, M. Senthil, additional, Hagmann, Cornelia, additional, Fronterre, Claudio, additional, Smith, Jasmine, additional, Movassagh, Mercedeh, additional, Streck, Nicholas, additional, Bebell, Lisa, additional, Bazira, Joel, additional, Kumbakumba, Elias, additional, Bajunirwe, Francis, additional, Mulondo, Ronald, additional, Mbabazi-Kabachelor, Edith, additional, Kaaya, Brian, additional, Natukwatsa, Davis, additional, Nalule, Esther, additional, Magombe, Joshua, additional, Erickson, Tim, additional, Ngonzi, Joseph, additional, Ochora, Moses, additional, Olupot Oluput, Peter, additional, Onen, Justin, additional, Ssenyonga, Peter, additional, Mugamba, John, additional, Warf, Benjamin, additional, Kulkarni, Abhaya V., additional, Lane, Jessica, additional, Whalen, Andrew, additional, Zhang, Lijun, additional, Sheldon, Kathryn, additional, Meier, Frederick A., additional, Kiwanuka, Julius, additional, Broach, James R., additional, Paulson, Joseph N., additional, and Schiff, Steven, additional

Published
2022
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41. Cytomegalovirus Infections in Ugandan Infants:Newborns, Neonates with Sepsis and Infants with Hydrocephalus

Author

Hehnly, Christine, primary, Ssentongo, Paddy, additional, Bebell, Lisa, additional, Burgoine, Kathy, additional, Bazira, Joel, additional, Fronterre, Claudio, additional, Kumbakumba, Elias, additional, Mulondo, Ronald, additional, Mbabazi-Kabachelor, Edith, additional, Morton, Sarah U., additional, Ngonzi, Joseph, additional, Ochora, Moses, additional, Olupot Oluput, Peter, additional, Onen, Justin, additional, Roberts, Drucilla J., additional, Sheldon, Kathryn, additional, Sinnar, Shamim A., additional, Smith, Jasmine, additional, Ssenyonga, Peter, additional, Paulson, Joseph N., additional, Meier, Frederick A., additional, Ericson, Jessica E., additional, Broach, James R., additional, and Schiff, Steven, additional

Published
2021
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43. Vaginal Microbiome Topic Modelling of Laboring Ugandan Women With and Without Fever

Author

Movassagh, Mercedeh, primary, Bebell, Lisa M., additional, Burgoine, Kathy, additional, Hehnly, Christine, additional, Zhang, Lijun, additional, Moran, Kim, additional, Sheldon, Kathryn, additional, Sinnar, Shamim A., additional, Mbabazi, Edith, additional, Kumbakumba, Elias, additional, Bazira, Joel, additional, Ochoa, Moses, additional, Mulondo, Ronnie, additional, Nsubuga, Brian K., additional, Weeks, Andrew, additional, Gladstone, Melissa, additional, Olupot-Olupot, Peter, additional, Ngonzi, Joseph, additional, Roberts, Drucilla J., additional, Meier, Frederick A., additional, Irizarry, Rafael, additional, Broach, James, additional, Schiff, Steven J., additional, and Paulson, Joseph N., additional

Published
2020
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44. Paenibacillus infection with frequent viral coinfection contributes to postinfectious hydrocephalus in Ugandan infants

Author

Paulson, Joseph N., primary, Williams, Brent L., additional, Hehnly, Christine, additional, Mishra, Nischay, additional, Sinnar, Shamim A., additional, Zhang, Lijun, additional, Ssentongo, Paddy, additional, Mbabazi-Kabachelor, Edith, additional, Wijetunge, Dona S. S., additional, von Bredow, Benjamin, additional, Mulondo, Ronnie, additional, Kiwanuka, Julius, additional, Bajunirwe, Francis, additional, Bazira, Joel, additional, Bebell, Lisa M., additional, Burgoine, Kathy, additional, Couto-Rodriguez, Mara, additional, Ericson, Jessica E., additional, Erickson, Tim, additional, Ferrari, Matthew, additional, Gladstone, Melissa, additional, Guo, Cheng, additional, Haran, Murali, additional, Hornig, Mady, additional, Isaacs, Albert M., additional, Kaaya, Brian Nsubuga, additional, Kangere, Sheila M., additional, Kulkarni, Abhaya V., additional, Kumbakumba, Elias, additional, Li, Xiaoxiao, additional, Limbrick, David D., additional, Magombe, Joshua, additional, Morton, Sarah U., additional, Mugamba, John, additional, Ng, James, additional, Olupot-Olupot, Peter, additional, Onen, Justin, additional, Peterson, Mallory R., additional, Roy, Farrah, additional, Sheldon, Kathryn, additional, Townsend, Reid, additional, Weeks, Andrew D., additional, Whalen, Andrew J., additional, Quackenbush, John, additional, Ssenyonga, Peter, additional, Galperin, Michael Y., additional, Almeida, Mathieu, additional, Atkins, Hannah, additional, Warf, Benjamin C., additional, Lipkin, W. Ian, additional, Broach, James R., additional, and Schiff, Steven J., additional

Published
2020
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45. The Bacterial and Viral Complexity of Postinfectious Hydrocephalus in Uganda

Author

Paulson, Joseph N., primary, Williams, Brent L., additional, Hehnly, Christine, additional, Mishra, Nischay, additional, Sinnar, Shamim A., additional, Zhang, Lijun, additional, Ssentongo, Paddy, additional, Mbabazi-Kabachelor, Edith, additional, Wijetunge, Dona S. S., additional, von Bredow, Benjamin, additional, Mulondo, Ronnie, additional, Kiwanuka, Julius, additional, Bajunirwe, Francis, additional, Bazira, Joel, additional, Bebell, Lisa M., additional, Burgoine, Kathy, additional, Couto-Rodriguez, Mara, additional, Ericson, Jessica E., additional, Erickson, Tim, additional, Ferrari, Matthew, additional, Gladstone, Melissa, additional, Guo, Cheng, additional, Haran, Murali, additional, Hornig, Mady, additional, Isaacs, Albert M., additional, Kaaya, Brian Nsubuga, additional, Kangere, Sheila M., additional, Kulkarni, Abhaya V., additional, Kumbakumba, Elias, additional, Li, Xiaoxiao, additional, Limbrick, David D., additional, Magombe, Joshua, additional, Morton, Sarah U., additional, Mugamba, John, additional, Ng, James, additional, Olupot-Olupot, Peter, additional, Onen, Justin, additional, Peterson, Mallory R., additional, Roy, Farrah, additional, Sheldon, Kathryn, additional, Townsend, Reid, additional, Weeks, Andrew D., additional, Whalen, Andrew J., additional, Quackenbush, John, additional, Ssenyonga, Peter, additional, Galperin, Michael Y., additional, Almeida, Mathieu, additional, Atkins, Hannah, additional, Warf, Benjamin C., additional, Lipkin, W. Ian, additional, Broach, James R., additional, and Schiff, Steven J., additional

Published
2020
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50. The reality of using primaquine

Author

Bancone Germana, Burgoine Kathy L, and Nosten François

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Primaquine is currently the only medication used for radical cure of Plasmodium vivax infection. Unfortunately, its use is not without risk. Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency have an increased susceptibility to haemolysis when given primaquine. This potentially fatal clinical syndrome can be avoided if patients are tested for G6PD deficiency and adequately informed before being treated. Case presentation A 35-year old male presented to our clinic on the Thai-Burmese border with a history and clinical examination consistent with intravascular haemolysis. The patient had been prescribed primaquine and chloroquine four days earlier for a P. vivax infection. The medication instructions had not been given in a language understood by the patient and he had not been tested for G6PD deficiency. The patient was not only G6PD deficient but misunderstood the instructions and took all his primaquine tablets together. With appropriate treatment the patient recovered and was discharged home a week later. Conclusions Whilst primaquine remains the drug of choice to eradicate hypnozoites and control P. vivax transmission, the risks associated with its use must be minimized during its deployment. In areas where P. vivax exists, patients should be tested for G6PD deficiency and adequately informed before administration of primaquine.

Published
2010
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