Prevalence of Malaria and TB Coinfection at a National Tuberculosis Treatment Centre in Uganda

Baluku, Joseph Baruch; Nassozi, Sylvia; Gyagenda, Brian; Namanda, Margret; Andia-Biraro, Irene; Worodria, William; Byakika-Kibwika, Pauline

doi:10.1155/2019/3741294

Cited by 19 publications

(24 citation statements)

References 32 publications

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“…We analysed data from a cross‐sectional study that enrolled bacteriologically confirmed TB patients at the National Tuberculosis Treatment Center (NTTC) in Uganda between August 2017 and March 2018 [16]. In this analysis, the inclusion criteria were adults (≥18 years) with bacteriologically confirmed TB who had AEC measurement.…”

Section: Methodsmentioning

confidence: 99%

“…Axillary temperature was measured using a digital thermometer (Royal Care® Model: MT 1027, SOJOY ELECTRONICS, China). The Mtb bacillary load was extracted from the laboratory result slip issued by a peripheral TB diagnostic laboratory and standardised as described in the primary study [16]. Full haemogram parameters were determined on peripheral blood using an automated haemoanalyser (Sysmex ® XN series – XN 1000) at MNRH haematology laboratory.…”

Section: Methodsmentioning

confidence: 99%

“…HIV testing was conducted according to the Uganda national HIV testing guidelines [18]. Study methods of the primary study are described in detail elsewhere [16].…”

Section: Methodsmentioning

confidence: 99%

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Absolute eosinophil count correlates with temperature and CD4 count independently of HIV infection among tuberculosis patients

Baluku

Anguzu

Bongomin

et al. 2020

Tropical Med Int Health

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Objective To determine clinical correlates of the peripheral absolute eosinophil count (AEC) among bacteriologically confirmed TB patients in Uganda. Materials and Methods We evaluated data of bacteriologically confirmed adult TB patients who had a peripheral blood AEC measurement at the National TB Treatment Center in Uganda during a cross‐sectional study. We performed linear regression analysis for correlates of log‐transformed AEC. Results We included 235 patients in this analysis with a median (interquartile range, IQR) age of 31 (24–39) years. 60.4% were male, and 33.6% had TB/HIV co‐infection. In a multivariable linear regression model that controlled for age, residence type, HIV status, weight loss, anorexia, body mass index, CD8+ T‐cell count, haemoglobin level and TB bacillary load, males had a 47.0% higher AEC than females (adjusted coefficient (R2) = 0.385, 95% confidence interval (CI) 0.012–0.759 P = 0.043). Also, a 1 °C raise in temperature resulted in an 11.5% decrease in the AEC (R2 = −0.122 95% CI (−0.233 to −0.011) P = 0.031) while a 1 cell/mm3 increase in the CD4+ T‐cell count resulted in a 0.10% increase in the AEC (R2 = 0.001 95% CI (0.000–0.001) P = 0.032). Conclusion The AEC was higher among males than females, consistent with the normal population distribution of AEC among Ugandans. The AEC was weakly but positively correlated with the CD4 count and negatively correlated with temperature.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Absolute eosinophil count correlates with temperature and CD4 count independently of HIV infection among tuberculosis patients

Baluku

Anguzu

Bongomin

et al. 2020

Tropical Med Int Health

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“…We analysed data from a cross-sectional study that enrolled adult bacteriologically confirmed TB patients at the National Tuberculosis Treatment Centre (NTTC) in Uganda between August 2017 and March 2018. 15 Demographic data, clinical symptoms and signs, full hemogram parameters, CD4+ and CD8+ T-lymphocyte counts were extracted from the master dataset. A full description of methods employed in determination of these variables is provided elsewhere.…”

Section: Study Measurementsmentioning

confidence: 99%

“…A full description of methods employed in determination of these variables is provided elsewhere. 15 CD4+ and CD8+ T-lymphocyte counts were determined by flow cytometry using a flow cytometer (BD FACSCalibur™). We defined CD4+ T-lymphocytopenia as a CD4+ count of <418 cells/mm 3 considering a normal range estimate of 418-2105 cells/mm 3 for Ugandans.…”

Section: Study Measurementsmentioning

confidence: 99%

<p>Prevalence and Predictors of CD4+ T-Lymphocytopenia Among HIV-Negative Tuberculosis Patients in Uganda</p>

Baluku¹,

Musaazi²,

Mulwana³

et al. 2020

RRTM

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Purpose: CD4+ T-lymphocytopenia is a risk for tuberculosis (TB) infection, reactivation and severe disease. We sought to determine the prevalence and predictors of CD4 T-lymphocytopenia among HIV-negative patients with bacteriologically confirmed TB in Uganda. Patients and Methods: Eligible participants were adult HIV-negative patients with bacteriologically confirmed TB at the National TB Treatment Centre in Uganda. CD4+ and CD8+ T-lymphocyte counts were determined by flow cytometry. We defined CD4+ T-lymphocytopenia as a CD4+ T-lymphocyte count of <418 cells/mm 3 as per the population estimate for Ugandans. We performed logistic regression analysis to determine predictors of CD4+ T-lymphocytopenia. Results: We enrolled 216 participants whose mean age (standard deviation (±SD)) was 32.5 (±12.1) years, of whom 146 (67.6%) were males. The prevalence of CD4+ T-lymphocytopenia was 25% (54/216) (95% confidence interval (CI): 19.6-31.2%). Patients with anaemia (adjusted odds ratio (aOR): 3.83, 95% CI: 1.59-9.23, p = 0.003), weight loss (aOR: 3.61, 95% CI: 1.07-12.23, p = 0.039) and a low CD8+ T-cell count (aOR: 6.10, 95% CI: 2.68-13.89, p < 0.001) were more likely to have CD4+ T-lymphocytopenia while those with monocytosis (aOR: 0.35, 95% CI: 0.14-0.89, p = 0.028) were less likely to have CD4+ T-lymphocytopenia. Conclusion: There was a high prevalence of CD4+ T-lymphocytopenia among HIVnegative TB patients. Patients with weight loss, anaemia and a low CD8+ count were more likely to have CD4+ T-lymphocytopenia while those with monocytosis were less likely to have CD4+ lymphocytopenia. The findings suggest that CD4+ lymphocytopenia is indicative of severe disease and globally impaired cell-mediated immune responses against TB.

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Sensitivity and specificity of the mean corpuscular volume and CD4/CD8 ratio in discriminating between rifampicin resistant and rifampicin sensitive tuberculosis

Baluku

Musaazi

Mulwana

et al. 2020

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Background There is need for simple, cost effective and widely available point of care tests for low level health facilities in developing countries to screen for drug resistant tuberculosis (TB) after bacteriological confirmation of TB by smear microscopy. We evaluated the sensitivity and specificity of the mean corpuscular volume (MCV) and CD4/CD8 ratio in discriminating between rifampicin resistant (RR-TB) and rifampicin sensitive (RS-TB) tuberculosis. Methods We performed a secondary analysis of data from a cross sectional study that enrolled adult participants with bacteriologically confirmed pulmonary TB at a national tuberculosis treatment center in Uganda. Blood samples were tested for CD4 and CD8 cell counts, HIV serology and a full hemogram. Rifampicin sensitivity and the bacillary load grade were determined by Xpert MTB/RIF®. Fifty-five participants that had RR-TB (cases) were matched with 110 participants that had RS-TB (controls) for age, sex and HIV status in a ratio of 1:2 respectively. Sensitivity (Se), specificity (Sp), area under curve (AUC) analysis and determination of optimal cut-offs were performed using receiver operating characteristic curves. Results Cases differed from controls with respect to residence (p = 0.031), bacillary load grade (p < 0.010) and MCV (p = 0.021). The Se, Sp and AUC of the MCV (cut-off of > 74.6 femtolitres (fl)) were 88.9%, 34% and 0.607 (p = 0.021) respectively for RR-TB. Among HIV positive participants, the respective Se, Sp and AUC of the MCV for RR-TB (cut-off of > 72.5 fl) were 97.2%, 22.2% and 0.608 (p = 0.061). The respective Se, Sp and AUC of the CD4/CD8 ratio (cut-off of > 0.40) were 67.3%, 50.0% and 0.559 (p = 0.199) on the overall and 54.1%, 71.6% and 0.628 (p = 0.024) among the HIV positive participants for RR-TB. Conclusion The MCV had a high sensitivity but very low specificity for RR-TB. The CD4/CD8 ratio had a low sensitivity and specificity for RR-TB among HIV positive individuals. The utility of either test is low due to low diagnostic accuracy.

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Prevalence of Malaria and TB Coinfection at a National Tuberculosis Treatment Centre in Uganda

Cited by 19 publications

References 32 publications

Absolute eosinophil count correlates with temperature and CD4 count independently of HIV infection among tuberculosis patients

Absolute eosinophil count correlates with temperature and CD4 count independently of HIV infection among tuberculosis patients

<p>Prevalence and Predictors of CD4+ T-Lymphocytopenia Among HIV-Negative Tuberculosis Patients in Uganda</p>

Sensitivity and specificity of the mean corpuscular volume and CD4/CD8 ratio in discriminating between rifampicin resistant and rifampicin sensitive tuberculosis

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