Browsing by Author "Bwayo, Denis"

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    Prevalence and factors associated with haematological side effects in MDR/RR-TB patients on linezolid-based regimens in Uganda : a multicentre retrospective study.
    (Research Square, 2025) Apio, Esther; Baluku, Joseph Baruch; Bwayo, Denis; Masaba, Peter J; Kirabo, Erias; Kebesu, Jasper; Nankunda, Oreb; Imalignat, Julius; Katuramu, Richard
    Background: Linezolid holds a critical role in the management of multidrug-resistant and rifampicinresistant tuberculosis (MDR/RR-TB), a severe global health threat. The World Health Organisation strongly recommends its inclusion in treatment regimens for these challenging forms of tuberculosis. Despite its efficacy, linezolid is frequently associated with haematological toxicity, a complication insufficiently documented in resource-limited settings like Uganda. Objective: This study aimed to ascertain the prevalence and identify associated factors of haematological side effects in MDR/RR-TB patients receiving linezolid-based regimens in Uganda. Methods: A multicentre retrospective study was conducted, reviewing patient records from four Ugandan hospitals (2020 – 2024). Data were collected on the prevalence of anaemia: Haemoglobin (Hb) level below 12 g/dL for women or below 13 g/dL for men. Thrombocytopenia: Platelet count below 150,000/µL. Leukopenia: White blood cell (WBC) count below 3,700/mm³.Modified Poisson regression with robust error variance identified independent risk factors for these haematological side effects. Results: Out of 412 eligible patients, 62.9% developed at least one haematological side effect. Thrombocytopenia (56.6%) and leukopenia (56.3%) were the most common, followed by anaemia (43.7%). Most of these side effects occurred within the first month of linezolid initiation. Risk factors for developing at least one of the side effects included rural residence (adjusted Prevalence Ratio (aPR) 1.6; 95% CI: 1.11–2.33), divorced/widowed status (aPR 4.1; 95% CI: 1.58–10.77), and smoking (aPR 1.7; 95% CI: 1.28–2.80). Despite the high prevalence of side effects, 86% achieved treatment success (cure and completion); however, loss to follow-up was higher among those with toxicities, at 15.1% (39/259) and 5.9% (9/153) in those without hematologic side effects. Conclusion: Linezolid-related haematological toxicities are common and occur early in treatment. Targeted monitoring of high-risk patients may improve treatment adherence and outcomes. Keywords: MDR-TB, Linezolid, Haematological toxicity, Anaemia, Thrombocytopenia, Leukopenia, Treatment outcomes
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    Systematic review and meta-analysis of the prevalence and clinical profile of lean type 2 diabetes mellitus in Africa.
    (Elsevier Ltd., 2025) Oreb, Nankunda; Katuramu, Richard; Bwayo, Denis; Waheed, Ahmed
    Introduction Lean Type 2 diabetes mellitus (T2DM), defined as individuals with body mass index (BMI) < 25 kg/m2, presents distinct clinical and biochemical characteristics across populations, particularly in Africa. This review assessed the prevalence and clinical-biochemical profiles of lean T2DM in Africa, aiming to improve understanding and management strategies. Methods This systematic review and meta-analysis involved 11 observational studies on lean T2DM in African adults. Specific BMI definitions [<25 Kg/m2] and clinical parameters were assessed, while non-observational studies were excluded. Data was analysed using STATA 18. Results The pooled prevalence of lean T2DM in African populations was 38.5 % (95 % CI: 26.8 %-50.9 %, I2 = 96.71 %, p < 0.001]). Clinical characteristics reveal a mean age of 48.35 years and a pooled mean BMI of 25.45 kg/m2. Metabolic assessments indicated raised HbA1c levels with a pooled median 9.34 % [95 %CI: 8.60–10.08 %, I2 = 97.44 %, p < 0.001]). Insulin resistance was low, as indicated by HOMA2-IR levels. Conclusions This review revealed a high prevalence of lean T2DM in Africa and identified unique clinical and biochemical characteristics. The findings suggest a potential need for more tailored approaches in assessing this phenotype, which remains underrepresented in current guidelines. Larger, well-designed studies are needed to strengthen the evidence base and inform effective treatment strategies.
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    Tuberculosis treatment success rate and its predictors among TB HIV co-infected patients in East and North Eastern Uganda.
    (Springer Nature, 2025) Omara, Godfrey; Bwayo, Denis; Mukunya, David; Nantale, Ritah; Okia, David; Matovu, K. B. Joseph; Wanume, Benon; Alunyo, Patrick Jimmy; Olupot-Olupot, Peter
    TB/HIV co-infection is associated with poorer treatment outcomes compared to TB alone. This study assessed the TB treatment success rate and its predictors among TB/HIV co-infected patients in East and North Eastern Uganda. A retrospective cohort design was used, involving 324 patients treated between July 2019 and July 2021 at three regional referral hospitals. Treatment success, defined as completing therapy with or without bacteriologic confirmation, was achieved by 71.9% of patients (95% CI 67–77%). Loss to follow-up was 12%, mortality 9.9%, treatment failure 0.3%, and 5.2% were not evaluated. Patients lacking sputum monitoring at five months were significantly less likely to achieve treatment success (aRR 0.48, 95% CI 0.34–0.66). These findings underscore the importance of effective follow-up to improve outcomes for TB/HIV co-infected patients. Keywords Tuberculosis, Treatment success rate, Treatment outcomes, HIV, Uganda