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2. Effect of ready-to-use supplementary food on mortality in severely immunocompromised HIV-infected individuals in Africa initiating antiretroviral therapy (REALITY): an open-label, parallel-group, randomised controlled trial

Author

Mugyenyi, Peter, Kityo, Cissy, Musiime, Victor, Wavamunno, Priscilla, Nambi, Esther, Ocitti, Paul, Ndigendawani, Milly, Kabahenda, Sheila, Kemigisa, Mable, Acen, Juliet, Olebo, David Francis, Mpamize, Gordon, Amone, Alex, Okweny, David, Mbonye, Andrew, Nambaziira, Florence, Rweyora, Angela, Kangah, Mary, Kabaswahili, Beatrice, Abach, James, Abongomera, George, Omongin, Joseph, Aciro, Irene, Philliam, Aleti, Arach, Beatrice, Ocung, Emmanuel, Amone, Geoffrey, Miles, Peter, Adong, Claudia, Tumsuiime, Constance, Kidega, Patrick, Otto, Ben, Apio, Florence, Baleeta, Keith, Mukuye, Andrew, Abwola, Mary, Ssennono, Fred, Baliruno, David, Tuhirwe, Stephen, Namisi, Ronald, Kigongo, Fredrick, Kikyonkyo, Dickson, Mushahara, Furaha, Tusiime, Julian, Musiime, Alex, Nankya, Agnes, Atwongyeire, Dickens, Sirikye, Sowal, Myalo, Sula, Noowe, Nelson, Lugemwa, Abbas, Kasozi, Mariam, Mwebe, Sandra, Atwine, Lorna, Senkindu, Tapson, Natuhurira, Ian, Katemba, Chrispus, Ninsiima, Emily, Acaku, Moses, Kyomuhangi, Joy, Ankunda, Rogers, Tukwasibwe, Deogratious, Ayesiga, Lillian, Hakim, James, Nathoo, Kusum, Bwakura-Dangarembizi, Mutsa, Reid, Andrew, Chidziva, Ennie, Mhute, Tawand, Tinago, Gloria, Bhiri, Joyline, Mudzingwa, Shepherd, Phiri, Misheck, Steamer, John, Nhema, Ruth, Warambwa, Colin, Musoro, Godfrey, Mutsai, Shirley, Nemasango, Beauty, Moyo, Columbus, Chitongo, Stuart, Rashirai, Kennias, Vhembo, Sydney, Mlambo, Brian, Nkomani, Sanele, Ndemera, Buxton, Willard, Marko, Berejena, Chipo, Musodza, Yeukai, Matiza, Patience, Mudenge, Boniface, Guti, Vongai, Etyang, Anthony, Agutu, Clara, Berkley, Jay, Maitland, Kathryn, Njuguna, Patricia, Mwaringa, Shalton, Etyang, Timothy, Awuondo, Ken, Wale, Stephen, Shangala, Jimmy, Kithunga, Jefwa, Mwarumba, Salim, Said Maitha, Salma, Mutai, Robert, Lozi Lewa, Margaret, Mwambingu, Gabriel, Mwanzu, Alfred, Kalama, Connie, Latham, Helen, Shikuku, Joyce, Fondo, Amos, Njogu, Anne, Khadenge, Connie, Mwakisha, Bryan, Siika, Abraham, Wools-Kaloustian, Kara, Nyandiko, Winston, Chepkorir-Cheruiyot, Priscilla, Sudoi, Allan, Wachira, Simon, Meli, Betty, Karoney, Mercy, Nzioka, Agnes, Tanui, Michael, Mokaya, Martha, Ekiru, Wilson, Mboya, Chris, Mwimali, Dorothy, Mengich, Cecilia, Choge, Julie, Injera, Wilfred, Njenga, Kennedy, Cherutich, Salinah, Anyango Orido, Millicent, Omondi Lwande, Gerald, Rutto, Peter, Mudogo, Alice, Kutto, Irene, Shali, Amina, Jaika, Linda, Jerotich, Hellen, Pierre, Mowlem, Mallewa, Jane, Kaunda, Symon, Van Oosterhout, Joep, O'Hare, Bernadette, Heydermann, Robert, Gonzalez, Carmen, Dzabala, Nettie, Kelly, Christine, Denis, Brigitte, Selemani, George, Nyondo- Mipando, Linda, Chirwa, Emmie, Banda, Peter, Mvula, Linley, Msuku, Harrison, Ziwoya, Milton, Manda, Yollam, Nicholas, Simon, Masesa, Clemens, Mwalukomo, Thandi, Makhaza, Lumbani, Sheha, Irene, Bwanali, Joseph, Limbuni, Molly, Gibb, Diana M, Thomason, Margaret J, Walker, Ann Sarah, Pett, Sarah L, Szubert, Alexander J, Griffiths, Anna, Wilkes, Helen, Rajapakse, Chathurika, Spyer, Moira J, Prendergast, Andrew J, Klein, Nigel, Rauchenberger, Mary, Van Looy, Nadine, Little, Emma, Fairbrother, Keith, Cowan, Frances, Seeley, Janet, Bernays, Sarah, Kawuma, Rachel, Mupambireyi, Zivai, Chepkorir, Priscilla, Melly, Betty, Walker, A Sarah, and Berkley, James A

Published
2018
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4. Implementation of a novel ultrasound training programme for midwives in Malawi: A mixed methods evaluation using the RE-AIM framework

Author

Viner, Alexandra C., primary, Malata, Monica P., additional, Mtende, Medrina, additional, Membe-Gadama, Gladys, additional, Masamba, Martha, additional, Makwakwa, Enita, additional, Bamuya, Catherine, additional, Lissauer, David, additional, Stock, Sarah J., additional, Norman, Jane E., additional, Reynolds, Rebecca M., additional, Magowan, Brian, additional, Freyne, Bridget, additional, Gadama, Luis, additional, Cunningham-Burley, Sarah, additional, Nyondo-Mipando, Linda, additional, and Chipeta, Effie, additional

Published
2023
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6. Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: A randomised controlled trial

Author

Kityo, Cissy, Szubert, Alexander J., Siika, Abraham, Heyderman, Robert, Bwakura-Dangarembizi, Mutsa, Lugemwa, Abbas, Mwaringa, Shalton, Griffiths, Anna, Nkanya, Immaculate, Kabahenda, Sheila, Wachira, Simon, Musoro, Godfrey, Rajapakse, Chatu, Etyang, Timothy, Abach, James, Spyer, Moira J., Wavamunno, Priscilla, Nyondo-Mipando, Linda, Chidziva, Ennie, Nathoo, Kusum, Klein, Nigel, Hakim, James, Gibb, Diana M., Walker, A. Sarah, and Pett, Sarah L.

Subjects
Testing, Drug therapy, Raltegravir -- Testing, HIV infections -- Drug therapy
Abstract

Author(s): Cissy Kityo 1, Alexander J. Szubert 2, Abraham Siika 3, Robert Heyderman 4,5, Mutsa Bwakura-Dangarembizi 6, Abbas Lugemwa 7, Shalton Mwaringa 8, Anna Griffiths 2, Immaculate Nkanya 1, Sheila [...], Background In sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly after starting antiretroviral therapy (ART). This group also has the greatest risk of morbidity and mortality associated with immune reconstitution inflammatory syndrome (IRIS), a paradoxical response to successful ART. Integrase inhibitors lead to significantly more rapid declines in HIV viral load (VL) than all other ART classes. We hypothesised that intensifying standard triple-drug ART with the integrase inhibitor, raltegravir, would reduce HIV VL faster and hence reduce early mortality, although this strategy could also risk more IRIS events. Methods and findings In a 2x2x2 factorial open-label parallel-group trial, treatment-naive adults, adolescents, and children >5 years old infected with HIV, with cluster of differentiation 4 (CD4) 0.7) and despite significantly greater VL suppression with raltegravir-intensified ART at 4 weeks (343/836 [41.0%] versus 113/841 [13.4%] with standard ART, p < 0.001) and 12 weeks (567/789 [71.9%] versus 415/803 [51.7%] with standard ART, p < 0.001). Through 48 weeks, there was no evidence of differences in mortality (aHR = 0.98 [95% CI 0.76-1.28], p = 0.91); in serious (aHR = 0.99 [0.81-1.21], p = 0.88), grade-4 (aHR = 0.88 [0.71-1.09], p = 0.29), or ART-modifying (aHR = 0.90 [0.63-1.27], p = 0.54) adverse events (the latter occurring in 59 [6.5%] participants with raltegravir-intensified ART versus 66 [7.3%] with standard ART); in events judged compatible with IRIS (occurring in 89 [9.9%] participants with raltegravir-intensified ART versus 86 [9.5%] with standard ART, p = 0.79) or in hospitalisations (aHR = 0.94 [95% CI 0.76-1.17], p = 0.59). At 12 weeks, one and two raltegravir-intensified participants had predicted intermediate-level and high-level raltegravir resistance, respectively. At 48 weeks, the nucleoside reverse transcriptase inhibitor (NRTI) mutation K219E/Q (p = 0.004) and the non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations K101E/P (p = 0.03) and P225H (p = 0.007) were less common in virus from participants with raltegravir-intensified ART, with weak evidence of less intermediate- or high-level resistance to tenofovir (p = 0.06), abacavir (p = 0.08), and rilpivirine (p = 0.07). Limitations of the study include limited clinical, radiological, and/or microbiological information for some participants, reflecting available services at the centres, and lack of baseline genotypes. Conclusions Although 12 weeks of raltegravir intensification was well tolerated and reduced HIV viraemia significantly faster than standard triple-drug ART during the time of greatest risk for early death, this strategy did not reduce mortality or clinical events in this group and is not warranted. There was no excess of IRIS-compatible events, suggesting that integrase inhibitors can be used safely as part of standard triple-drug first-line therapy in severely immunocompromised individuals. Trial registration ClinicalTrials.gov NCT01825031. Trial registration International Standard Randomised Controlled Trials Number ISRCTN 43622374.

Published
2018
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7. A systematic literature review of preference-based health related\ud quality-of-life measures applied and validated for use in childhood and adolescent populations in sub-Saharan\ud Africa

Author

Ngwira, Lucky-Gift, Khan, Kamran, Maheswaran, Hendramoorthy, Sande, Linda, Nyondo-Mipando, Linda, Smith, Sarah C., Petrou, Stavros, and Niessen, Louis

Subjects
wa_950, wa_395, wa_320, ws_100
Abstract

Objectives: Consideration of health status in children and adolescents now includes broader concepts such as health-related\ud quality-of-life (HRQoL). Globally, there is a need for relevant preference-based HRQoL measures (PBMs) for use in children\ud and adolescents, yet measurement of HRQoL in these groups presents particular challenges. This article systematically\ud reviews the available generic childhood PBMs and their application and cross-cultural validation in sub-Saharan African (sSA).\ud Methods: A systematic review of published literature from January 1, 1990, to February 8, 2017, was conducted using MEDLINE\ud (through OvidSP), EMBASE (OvidSP), EconLit (EBSCOhost), PsycINFO, Web of Science, and PubMed.\ud Results: A total of 220 full-text articles were included in a qualitative synthesis. Ten generic childhood PBMs were identified,\ud of which 9 were adapted from adult versions and only 1 was developed specifically for children. None of the measures were\ud originally developed in sSA or other resource-constrained settings. The Health Utilities Index Mark 3 (HUI3) and the EQ-5D-Y\ud were the only measures that had been applied in sSA settings. Further, the HUI3 and the EQ-5D-Y were the only generic\ud childhood PBM that attempted to establish cross-cultural validation in sSA. Five of the 6 of these validation studies were\ud conducted using the EQ-5D-Y in a single country, South Africa.\ud Conclusions: The findings show that application of generic childhood PBMs in sSA settings has hitherto been limited to the\ud HUI3 and EQ-5D-Y. Most adaptations of existing measures take an absolutist approach, which assumes that measures can be\ud used across cultures. Nevertheless, there is also need to ensure linguistic and conceptual equivalence and undertake\ud validation across a range of sSA cultural contexts.

Published
2021

10. How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo

Author

Ghilardi, Ludovica, primary, Okello, George, additional, Nyondo-Mipando, Linda, additional, Chirambo, Chawanangwa Mahebere, additional, Malongo, Fathy, additional, Hoyt, Jenna, additional, Lee, Jieun, additional, Sedekia, Yovitha, additional, Parkhurst, Justin, additional, Lines, Jo, additional, Snow, Robert W, additional, Lynch, Caroline A., additional, and Webster, Jayne, additional

Published
2020
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12. Effect of ready-to-use supplementary food on mortality in severely immunocompromised HIV-infected individuals in Africa initiating antiretroviral therapy (REALITY): an open-label, parallel-group, randomised controlled trial

Author

Mallewa, Jane, primary, Szubert, Alexander J, additional, Mugyenyi, Peter, additional, Chidziva, Ennie, additional, Thomason, Margaret J, additional, Chepkorir, Priscilla, additional, Abongomera, George, additional, Baleeta, Keith, additional, Etyang, Anthony, additional, Warambwa, Colin, additional, Melly, Betty, additional, Mudzingwa, Shepherd, additional, Kelly, Christine, additional, Agutu, Clara, additional, Wilkes, Helen, additional, Nkomani, Sanele, additional, Musiime, Victor, additional, Lugemwa, Abbas, additional, Pett, Sarah L, additional, Bwakura-Dangarembizi, Mutsa, additional, Prendergast, Andrew J, additional, Gibb, Diana M, additional, Walker, A Sarah, additional, Berkley, James A, additional, Kityo, Cissy, additional, Wavamunno, Priscilla, additional, Nambi, Esther, additional, Ocitti, Paul, additional, Ndigendawani, Milly, additional, Kabahenda, Sheila, additional, Kemigisa, Mable, additional, Acen, Juliet, additional, Olebo, David Francis, additional, Mpamize, Gordon, additional, Amone, Alex, additional, Okweny, David, additional, Mbonye, Andrew, additional, Nambaziira, Florence, additional, Rweyora, Angela, additional, Kangah, Mary, additional, Kabaswahili, Beatrice, additional, Abach, James, additional, Omongin, Joseph, additional, Aciro, Irene, additional, Philliam, Aleti, additional, Arach, Beatrice, additional, Ocung, Emmanuel, additional, Amone, Geoffrey, additional, Miles, Peter, additional, Adong, Claudia, additional, Tumsuiime, Constance, additional, Kidega, Patrick, additional, Otto, Ben, additional, Apio, Florence, additional, Mukuye, Andrew, additional, Abwola, Mary, additional, Ssennono, Fred, additional, Baliruno, David, additional, Tuhirwe, Stephen, additional, Namisi, Ronald, additional, Kigongo, Fredrick, additional, Kikyonkyo, Dickson, additional, Mushahara, Furaha, additional, Tusiime, Julian, additional, Musiime, Alex, additional, Nankya, Agnes, additional, Atwongyeire, Dickens, additional, Sirikye, Sowal, additional, Myalo, Sula, additional, Noowe, Nelson, additional, Kasozi, Mariam, additional, Mwebe, Sandra, additional, Atwine, Lorna, additional, Senkindu, Tapson, additional, Natuhurira, Ian, additional, Katemba, Chrispus, additional, Ninsiima, Emily, additional, Acaku, Moses, additional, Kyomuhangi, Joy, additional, Ankunda, Rogers, additional, Tukwasibwe, Deogratious, additional, Ayesiga, Lillian, additional, Hakim, James, additional, Nathoo, Kusum, additional, Reid, Andrew, additional, Mhute, Tawand, additional, Tinago, Gloria, additional, Bhiri, Joyline, additional, Phiri, Misheck, additional, Steamer, John, additional, Nhema, Ruth, additional, Musoro, Godfrey, additional, Mutsai, Shirley, additional, Nemasango, Beauty, additional, Moyo, Columbus, additional, Chitongo, Stuart, additional, Rashirai, Kennias, additional, Vhembo, Sydney, additional, Mlambo, Brian, additional, Ndemera, Buxton, additional, Willard, Marko, additional, Berejena, Chipo, additional, Musodza, Yeukai, additional, Matiza, Patience, additional, Mudenge, Boniface, additional, Guti, Vongai, additional, Berkley, Jay, additional, Maitland, Kathryn, additional, Njuguna, Patricia, additional, Mwaringa, Shalton, additional, Etyang, Timothy, additional, Awuondo, Ken, additional, Wale, Stephen, additional, Shangala, Jimmy, additional, Kithunga, Jefwa, additional, Mwarumba, Salim, additional, Said Maitha, Salma, additional, Mutai, Robert, additional, Lozi Lewa, Margaret, additional, Mwambingu, Gabriel, additional, Mwanzu, Alfred, additional, Kalama, Connie, additional, Latham, Helen, additional, Shikuku, Joyce, additional, Fondo, Amos, additional, Njogu, Anne, additional, Khadenge, Connie, additional, Mwakisha, Bryan, additional, Siika, Abraham, additional, Wools-Kaloustian, Kara, additional, Nyandiko, Winston, additional, Chepkorir-Cheruiyot, Priscilla, additional, Sudoi, Allan, additional, Wachira, Simon, additional, Meli, Betty, additional, Karoney, Mercy, additional, Nzioka, Agnes, additional, Tanui, Michael, additional, Mokaya, Martha, additional, Ekiru, Wilson, additional, Mboya, Chris, additional, Mwimali, Dorothy, additional, Mengich, Cecilia, additional, Choge, Julie, additional, Injera, Wilfred, additional, Njenga, Kennedy, additional, Cherutich, Salinah, additional, Anyango Orido, Millicent, additional, Omondi Lwande, Gerald, additional, Rutto, Peter, additional, Mudogo, Alice, additional, Kutto, Irene, additional, Shali, Amina, additional, Jaika, Linda, additional, Jerotich, Hellen, additional, Pierre, Mowlem, additional, Mallewa, Jane, additional, Kaunda, Symon, additional, Van Oosterhout, Joep, additional, O'Hare, Bernadette, additional, Heydermann, Robert, additional, Gonzalez, Carmen, additional, Dzabala, Nettie, additional, Denis, Brigitte, additional, Selemani, George, additional, Nyondo- Mipando, Linda, additional, Chirwa, Emmie, additional, Banda, Peter, additional, Mvula, Linley, additional, Msuku, Harrison, additional, Ziwoya, Milton, additional, Manda, Yollam, additional, Nicholas, Simon, additional, Masesa, Clemens, additional, Mwalukomo, Thandi, additional, Makhaza, Lumbani, additional, Sheha, Irene, additional, Bwanali, Joseph, additional, Limbuni, Molly, additional, Walker, Ann Sarah, additional, Griffiths, Anna, additional, Rajapakse, Chathurika, additional, Spyer, Moira J, additional, Klein, Nigel, additional, Rauchenberger, Mary, additional, Van Looy, Nadine, additional, Little, Emma, additional, Fairbrother, Keith, additional, Cowan, Frances, additional, Seeley, Janet, additional, Bernays, Sarah, additional, Kawuma, Rachel, additional, and Mupambireyi, Zivai, additional

Published
2018
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14. How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo

Author

Ghilardi, Ludovica, Okello, George, Nyondo-Mipando, Linda, Chirambo, Chawanangwa Mahebere, Malongo, Fathy, Hoyt, Jenna, Lee, Jieun, Sedekia, Yovitha, Parkhurst, Justin, Lines, Jo, Snow, Robert W., Lynch, Caroline A., Webster, Jayne, Ghilardi, Ludovica, Okello, George, Nyondo-Mipando, Linda, Chirambo, Chawanangwa Mahebere, Malongo, Fathy, Hoyt, Jenna, Lee, Jieun, Sedekia, Yovitha, Parkhurst, Justin, Lines, Jo, Snow, Robert W., Lynch, Caroline A., and Webster, Jayne

Abstract

Background: Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated. Methods: A document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps. Results: Three different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC). Conclusions: Maps were generally used t

15. A Systematic Literature Review of Preference-Based Health-Related Quality-of-Life Measures Applied and Validated for Use in Childhood and Adolescent Populations in Sub-Saharan Africa.

Author

Ngwira LG, Khan K, Maheswaran H, Sande L, Nyondo-Mipando L, Smith SC, Petrou S, and Niessen L

Subjects
Adolescent, Adult, Child, Humans, Research Design, South Africa, Health Status, Quality of Life
Abstract

Objectives: Consideration of health status in children and adolescents now includes broader concepts such as health-related quality-of-life (HRQoL). Globally, there is a need for relevant preference-based HRQoL measures (PBMs) for use in children and adolescents, yet measurement of HRQoL in these groups presents particular challenges. This article systematically reviews the available generic childhood PBMs and their application and cross-cultural validation in sub-Saharan African (sSA)., Methods: A systematic review of published literature from January 1, 1990, to February 8, 2017, was conducted using MEDLINE (through OvidSP), EMBASE (OvidSP), EconLit (EBSCOhost), PsycINFO, Web of Science, and PubMed., Results: A total of 220 full-text articles were included in a qualitative synthesis. Ten generic childhood PBMs were identified, of which 9 were adapted from adult versions and only 1 was developed specifically for children. None of the measures were originally developed in sSA or other resource-constrained settings. The Health Utilities Index Mark 3 (HUI3) and the EQ-5D-Y were the only measures that had been applied in sSA settings. Further, the HUI3 and the EQ-5D-Y were the only generic childhood PBM that attempted to establish cross-cultural validation in sSA. Five of the 6 of these validation studies were conducted using the EQ-5D-Y in a single country, South Africa., Conclusions: The findings show that application of generic childhood PBMs in sSA settings has hitherto been limited to the HUI3 and EQ-5D-Y. Most adaptations of existing measures take an absolutist approach, which assumes that measures can be used across cultures. Nevertheless, there is also need to ensure linguistic and conceptual equivalence and undertake validation across a range of sSA cultural contexts., (Copyright © 2021. Published by Elsevier Inc.)

Published
2021
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