ORCID Profile
0000-0001-9862-4724
Current Organisation
UNSW Sydney
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Publisher: Wiley
Date: 13-07-2020
DOI: 10.1111/TMI.13454
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2014
Publisher: JMIR Publications Inc.
Date: 08-2020
Abstract: ollowing the successful scale-up of antiretroviral therapy (ART), the focus is now on ensuring good quality of life (QoL) and sustained viral suppression in people living with HIV. The access to mobile technology in the most burdened countries is increasing rapidly, and therefore, mobile health (mHealth) technologies could be leveraged to improve QoL in people living with HIV. However, data on the impact of mHealth tools on the QoL in people living with HIV are limited to the evaluation of SMS text messaging these are infeasible in high-illiteracy settings. he primary and secondary outcomes were to determine the impact of interactive voice response (IVR) technology on Medical Outcomes Study HIV QoL scores and viral suppression at 12 months, respectively. ithin the Call for Life study, ART-experienced and ART-naïve people living with HIV commencing ART were randomized (1:1 ratio) to the control (no IVR support) or intervention arm (daily adherence and pre-appointment reminders, health information tips, and option to report symptoms). The software evaluated was Call for Life Uganda, an IVR technology that is based on the Mobile Technology for Community Health open-source software. Eligibility criteria for participation included access to a phone, fluency in local languages, and provision of consent. The differences in differences (DIDs) were computed, adjusting for baseline HIV RNA and CD4. verall, 600 participants (413 female, 68.8%) were enrolled and followed-up for 12 months. In the intervention arm of 300 participants, 298 (99.3%) opted for IVR and 2 (0.7%) chose SMS text messaging as the mode of receiving reminders and health tips. At 12 months, there was no overall difference in the QoL between the intervention and control arms (DID=0.0 i P /i =.99) or HIV RNA (DID=0.01 i P /i =.94). At 12 months, 124 of the 256 (48.4%) active participants had picked up at least 50% of the calls. In the active intervention participants, high users (received & % of reminders) had overall higher QoL compared to low users (received & % of reminders) (92.2 versus 87.8, i P /i =.02). Similarly, high users also had higher QoL scores in the mental health domain (93.1 versus 86.8, i P /i =.008) and better appointment keeping. Similarly, participants with moderate use (51%-75%) had better viral suppression at 12 months (80/94, 85% versus 11/19, 58%, i P /i =.006). verall, there was high uptake and acceptability of the IVR tool. While we found no overall difference in the QoL and viral suppression between study arms, people living with HIV with higher usage of the tool showed greater improvements in QoL, viral suppression, and appointment keeping. With the declining resources available to HIV programs and the increasing number of people living with HIV accessing ART, IVR technology could be used to support patient care. The tool may be helpful in situations where physical consultations are infeasible, including the current COVID epidemic. linicalTrials.gov NCT02953080 t2/show/NCT02953080
Publisher: Springer Science and Business Media LLC
Date: 06-05-2019
Publisher: African Journals Online (AJOL)
Date: 20-04-2020
DOI: 10.4314/AHS.V20I1.18
Abstract: Background: The World Health Organization recommends antiretroviral therapy (ART) for all HIV-infected patients at all CD4 counts. However, there are concerns that asymptomatic patients may have poorer viral suppression and high attrition. Objectives: We sought to determine attrition and viral suppression among healthy HIV-infected patients initiated on ART in program settings. Methods: This cross-sectional study enrolled ART-experienced patients attending two PEPFAR-supported, high-volume clinics in K ala, Uganda. Eligible patients were years and had completed at least six months on ART. Participants were inter- viewed on socio-demographics, ART history and plasma viral load (VL) determined using Abbott Real-time. Predictors of viral suppression ( copies/ml) were determined using multivariate logistic regression. Results: Overall, 267 participants were screened, 228 were eligible and 203 (89%) retained in care (visit within 90 days). Of the 203 participants, 115 (56.7%) were key-populations. Viral suppression was achieved in 173 patients (85% 95% CI, 80.3%- 90.1%). The factors associated with viral suppression were prior VL tests (AOR 6.98 p-value .001) and receiving care from a general clinic (AOR 5.41 p=0.009). Conclusion: Asymptomatic patients initiated on ART with high baseline CD4 counts, achieve high viral suppression with low risk of attrition. VL monitoring and clinic type are associated with viral suppression. Keywords: Key populations viral load acquired immunodeficiency syndrome.
Publisher: Public Library of Science (PLoS)
Date: 27-05-2016
Publisher: Public Library of Science (PLoS)
Date: 03-12-2015
Publisher: Elsevier BV
Date: 03-2017
Publisher: Students Journal of Health Research Africa
Date: 2022
DOI: 10.51168/SJHRAFRICA.V3I3.98
Abstract: Introduction: The risk of occupational injuries in municipal solid waste workers in most low- and middle-income countries is increasing. This study sought to determine the use of PPE and its association with injuries among casual waste workers in a prototypical city. Methods: This was a cross-sectional study of casual waste workers at a large city landfill site in K ala, Uganda. Structured questionnaires were used to obtain data on PPE use and occupational injuries within one year before the study. Multivariate logistic regression was used to determine the relationship between PPE use and occupational injury. Results: The study was conducted between May 2020 and December 2020 and enrolled 81 participants, 44 (54%) of whom were male. Overall, 27 (33%) reported not using PPE, while 53 (65%) reported experiencing injuries. In the multivariable logistic regression model, the use of PPE was associated with lower odds of injury (odds ratio [OR] 0.09, 95% 95% confidence interval [95% CI], 0.01–0.57 P=0.011). In contrast, perceived risk was associated with a greater risk of injury (OR 34.95 95% CI, 7.00, 174.56 P .001). Prior training on PPE use (adjusted odds ratio, AOR 44.69 95% CI 6.12–342.02 P=0.002), and older age (AOR 1.16 95% CI 1.03–1.31 P=0.014), were associated with higher odds of PPE use. Additionally, waste pickers and sorters were more likely to use PPE than site traders. Conclusions: Among casual waste workers, there was suboptimal use of PPE and a high rate of occupational injuries. This study suggests that the non-use of PPE may be due to a lack of access and training. Recommendations: We recommend surveillance of injuries among workers in the waste management sector as well as regular training in routine and proper use of PPEs.
Publisher: Springer Science and Business Media LLC
Date: 13-06-2021
DOI: 10.1186/S13063-021-05352-Z
Abstract: Throughout the last decade, tuberculosis (TB) treatment success has not surpassed 90%, the global target. The impact of mobile health interventions (MHIs) on TB treatment outcomes is unknown, especially in low- and middle-income countries (LMICs). MHIs, including interactive voice response technology (IVRT), may enhance adherence and retention in the care of patients with tuberculosis and improve TB treatment outcomes. This study seeks to determine the impact of IVRT-based MHI on TB treatment success (treatment completion and cure rates) in patients with TB receiving care at five public health facilities in Uganda. We used a theory-based and human-centered design (HCD) to adapt an already piloted software to design “Call for life-TB” (CFL-TB), an MHI that utilizes IVRT to deliver adherence and appointment reminders and allows remote symptom reporting. This open-label, multicenter, randomized controlled trial (RCT), with nested qualitative and economic evaluation studies, will determine the impact of CFL-TB on TB treatment success in patients with drug-susceptible TB in Uganda. Participants ( n = 274) at the five study sites will be randomized (1:1 ratio) to either control (standard of care) or intervention (adherence and appointment reminders, and health tips) arms. Multivariable regression models will be used to compare treatment success, adherence to treatment and clinic appointments, and treatment completion at 6 months post-enrolment. Additionally, we will determine the cost-effectiveness, acceptability, and perceptions of stakeholders. The study received national ethical approval and was conducted in accordance with the international ethical guidelines. This randomized controlled trial aims to evaluate interactive voice response technology in the context of resource-limited settings with a high burden of TB and high illiteracy rates. The software to be evaluated was developed using HCD and the intervention was based on the IMB model. The software is tailored to the local context and is interoperable with the MHI ecosystem. The HCD approach ensures higher usability of the MHI by integrating human factors in the prototype development. This research will contribute towards the understanding of the implementation and impact of the MHI on TB treatment outcomes and the health system, especially in LMICs. ClinicalTrials.gov NCT04709159 . Registered on January 14, 2021.
Publisher: Public Library of Science (PLoS)
Date: 17-02-2023
DOI: 10.1371/JOURNAL.PONE.0282001
Abstract: The effect of long-term exposure to antiretroviral therapy (ART) on hypertension in sub-Saharan Africa remains unclear. We aimed to determine the prevalence and incidence of hypertension in people living with HIV (PLWH) with more than 10 years of ART in Uganda. The analysis was performed within a cohort of adult PLWH with more than 10 years of ART at an HIV clinic in K ala, Uganda. Participants were eligible for this analysis if they had ≥2 follow-up visits. Hypertension was defined as two consecutive systolic blood pressure (SBP) measures greater than 140 mmHg and/or diastolic blood pressure (DBP) greater than 90 mmHg, and/or documented diagnosis and/or the initiation of antihypertensives. We determined the proportion of PLWH with hypertension at baseline and used multivariable logistic regression to determine the factors associated with prevalent hypertension. To determine the incidence of hypertension, follow-up began from the cohort baseline date and was censored at the last clinic visit or date of the event, whichever occurred earlier. Multivariable Poisson regression was used to determine the adjusted incidence rate ratios (aIRR) of hypertension according to demographic, ART, and clinical characteristics. Of the 1000 ALT participants, 970 (97%) had ≥2 follow-up visits, and 237 (24.4%) had hypertension at baseline. The odds of prevalent hypertension were 1.18 for every 5-year increase in age (adjusted odds ratio (aOR) 1.18, 95% CI 1.10–1.34) and were higher among males (aOR 1.70, 95% CI 1.20–2.34), participants with diabetes mellitus (aOR 2.37, 95% CI 1.10–4.01), obesity (aOR 1.99, 95% CI 1.08–3.60), high cholesterol (aOR 1.47, 95% CI 1.16–2.01), and those with prior exposure to stavudine (aOR 2.10, 95% CI 1.35–3.52), or nevirapine (aOR 1.90, 95% CI 1.25–3.01). Of the 733 participants without hypertension at baseline, 116 (15.83%) developed hypertension during 4671.3 person-years of follow-up (incidence rate 24.8 per 1000 person-years 95% CI 20.7–29.8). The factors associated with incident hypertension were obesity (adjusted incidence rate ratio (aIRR) 1.80, 95% CI 1.40–2.81), older age (aIRR 1.12 per 5-year increase in age, 95% CI 1.10,1.25), and renal insufficiency (aIRR1.80, 95% CI 1.40–2.81). The prevalence and incidence of hypertension were high in this heavily treated PLWH cohort. Therefore, with increasing ART coverage, HIV programs in SSA should strengthen the screening for hypertension in heavily treated PLWH.
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/HIV.13273
Abstract: To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)‐based antiretroviral therapy (ART) versus non‐nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts. Eligible people with HIV were aged ≥18 years who initiated a new three‐drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow‐up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ≥140 mmHg and/or diastolic BP ≥90 mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART naïve or experienced at baseline. Overall, 4606 people living with HIV were eligible (INSTIs 3164, NNRTIs 807, PIs 635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113–130) mmHg, 78 (70–82) mmHg, and 43 (34–50) years, respectively. Over 8380.4 person‐years (median follow‐up 1.5 [IQR 1.0–2.7] years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person‐years, 95% confidence interval [CI] 118.9–134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76 95% CI 1.47–2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07 95% CI 0.89–1.29). The results were similar when the analysis was stratified by ART status at baseline. Although unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART‐naïve and ART‐experienced participants within RESPOND.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-09-2014
Publisher: JMIR Publications Inc.
Date: 11-02-0015
DOI: 10.2196/22229
Abstract: Following the successful scale-up of antiretroviral therapy (ART), the focus is now on ensuring good quality of life (QoL) and sustained viral suppression in people living with HIV. The access to mobile technology in the most burdened countries is increasing rapidly, and therefore, mobile health (mHealth) technologies could be leveraged to improve QoL in people living with HIV. However, data on the impact of mHealth tools on the QoL in people living with HIV are limited to the evaluation of SMS text messaging these are infeasible in high-illiteracy settings. The primary and secondary outcomes were to determine the impact of interactive voice response (IVR) technology on Medical Outcomes Study HIV QoL scores and viral suppression at 12 months, respectively. Within the Call for Life study, ART-experienced and ART-naïve people living with HIV commencing ART were randomized (1:1 ratio) to the control (no IVR support) or intervention arm (daily adherence and pre-appointment reminders, health information tips, and option to report symptoms). The software evaluated was Call for Life Uganda, an IVR technology that is based on the Mobile Technology for Community Health open-source software. Eligibility criteria for participation included access to a phone, fluency in local languages, and provision of consent. The differences in differences (DIDs) were computed, adjusting for baseline HIV RNA and CD4. Overall, 600 participants (413 female, 68.8%) were enrolled and followed-up for 12 months. In the intervention arm of 300 participants, 298 (99.3%) opted for IVR and 2 (0.7%) chose SMS text messaging as the mode of receiving reminders and health tips. At 12 months, there was no overall difference in the QoL between the intervention and control arms (DID=0.0 P=.99) or HIV RNA (DID=0.01 P=.94). At 12 months, 124 of the 256 (48.4%) active participants had picked up at least 50% of the calls. In the active intervention participants, high users (received % of reminders) had overall higher QoL compared to low users (received % of reminders) (92.2 versus 87.8, P=.02). Similarly, high users also had higher QoL scores in the mental health domain (93.1 versus 86.8, P=.008) and better appointment keeping. Similarly, participants with moderate use (51%-75%) had better viral suppression at 12 months (80/94, 85% versus 11/19, 58%, P=.006). Overall, there was high uptake and acceptability of the IVR tool. While we found no overall difference in the QoL and viral suppression between study arms, people living with HIV with higher usage of the tool showed greater improvements in QoL, viral suppression, and appointment keeping. With the declining resources available to HIV programs and the increasing number of people living with HIV accessing ART, IVR technology could be used to support patient care. The tool may be helpful in situations where physical consultations are infeasible, including the current COVID epidemic. ClinicalTrials.gov NCT02953080 t2/show/NCT02953080
Publisher: Wiley
Date: 03-02-2014
DOI: 10.1111/TMI.12273
Publisher: Massachusetts Medical Society
Date: 18-07-2019
Publisher: Springer Science and Business Media LLC
Date: 15-04-2020
DOI: 10.1186/S12936-020-03230-8
Abstract: In 2012, the World Health Organization recommended that pregnant women in malaria-endemic countries complete at least three (optimal) doses of intermittent preventive treatment (IPTp) using sulfadoxine-pyrimethamine (SP) to prevent malaria and related adverse events during pregnancy. Uganda adopted this recommendation, but uptake remains low in East-Central and information to explain this low uptake remains scanty. This analysis determined correlates of uptake of optimal doses of IPTp-SP in East-Central Uganda. This was a secondary analysis of the 2016 Uganda Demographic Health Survey data on 579 women (15–49 years) who attended at least one antenatal care (ANC) visit and had a live birth within 2 years preceding the survey. Uptake of IPTp-SP was defined as optimal if a woman received at least three doses partial if they received 1–2 doses or none if they received no dose. Multivariate analysis using multinomial logistic regression was used to determine correlates of IPTp-SP uptake. Overall, 22.3% of women received optimal doses of IPTp-SP, 48.2% partial and 29.5% none. Attending ANC at a lower-level health centre relative to a hospital was associated with reduced likelihood of receiving optimal doses of IPTp-SP. Belonging to other religious faiths relative to Catholic, belonging to a household in the middle relative to poorest wealth index, and age 30 and above years relative to 25–29 years were associated with higher likelihood of receiving optimal doses of IPTp-SP. In East-Central Uganda, uptake of optimal doses of IPTp-SP is very low. Improving institutional delivery and household wealth, involving religious leaders in programmes to improve uptake of IPTp-SP, and strengthening IPTp-SP activities at lower level health centers may improve uptake of IPTp-SP in the East-Central Uganda.
Publisher: Wiley
Date: 07-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-01-2021
No related grants have been discovered for Dathan M Byonanebye.