Browsing by Author "Kafeero, Hussein Mukasa"

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Hepatitis B virus (HBV) serological patterns among the HBsAg negative hospital attendees screened for immunization
(Scientific Reports, 2022-05-06) Kafeero, Hussein Mukasa; Ndagire, Dorothy; Ocama, Ponsiano; Kato, Charles Drago; Wampande, Eddie; Walusansa, Abdul; Kajumbula, Henry; Kateete, David; Sendagire, Hakim
The Hepatitis B virus (HBV) is a highly infectious virus and is endemic in Uganda. It is one of the major etiological agents for liver diseases including liver cancer. In this work, we evaluated the prevalence of the HBV serological markers and the associated socio-demographic factors among hepatitis B surface antigen (HBsAg) seronegative persons screened during routine immunization against the virus in eastern Uganda. Data on the socio-demographic characteristics were collected using a structured questionnaire, while that on the serological markers were obtained from serum samples and evaluated by using the 5-panel HBV One Step Hepatitis B Virus Combo Test Device ( FastepR, HBV-P43M). The following markers were evaluated by the panel: HBsAg, HBsAb, HBcAb, and HBeAb. Data were analyzed using SPSS (version 26), and multinomial logistic regression was used to elicit the adjusted odds ratio. All the analysis were performed at a 95% confidence limit, and a P value ≤ 0.05 was considered significant. The 424 participants included in this study were mainly female (62.3%), married (55.4%) and aged 30 years and above (54.2%). The seropositivity of the HBsAb, HBeAb, HBcAb marker prevalence rates was 48(11.3%), 73(17.2%) and 45(10.6%) respectively. The majority of the participants (327, 77.1%) did not present with any marker. Married paricipants were significantly associated with reduced HBsAb seropositvity rate, whereas young people aged 18–29 years were associated the with increased odds of HBsAb seropositivity (p < 0.05). Male participants were significantly associated with the HBeAb and HBcAb seropositivity (p < 0.05). Similarly, contact with an HBV infected person was significantly associated with HBeAb and HBcAb seropositivity (p < 0.05). Further still, blood transfusion was significantly associated with the increased risk of HBcAb seropositivity (P < 0.05). This study has revealed a prevalence of HBV serological markers among the HBsAg seronegative persons in this community and an increased risk of transmission of the virus in the community. Our findings have key consequences pertaining the interventions that are pertinent in the control and prevention of the spread of the virus among apparently health persons. Hepatitis B virus (HBV) is the causative agent for liver inflammatory diseases, which, if not diagnosed in a timely manner and subsequently managed, are likely to progress to chronic liver diseases, liver fibrosis, liver cirrhosis, and liver cancer1. The virus has been implicated as one the most common oncogenic virus in humans2. It is a highly transmissible virus and is 50 to 100 times more infectious than Human Immune deficiency Virus (HIV). In addition, it has extreme resilience, allowing it to survive for several days on dry surfaces. This complicates its epidemiology and explains the increased chances of intra-familial horizontal transmissions3. Despite the presence of a safe and highly efficacious vaccine, HBV infection is still one of the major global health problems4. The Uganda Population-Based Impact Assessment (UPHIA) 2016–2017 survey reported a drastic decrease in the prevalence of HBV in Uganda5. According to this survey, the national prevalence of HBV dropped from 10% in the general population in 20156 to 4.3% in 2016 and 4.1% in 2017, with east-central posting a prevalence of 2.1%. However, HBV is a chronic infection and these data are suggestive of either massive death of the chronically infected persons or a higher level of sero-conversion to HBsAb between the sampling intervals. Nevertheless, the rapid sero-conversion indicated by a high prevalence of the HBsAb with normal levels of the correlates of liver damage over a short period of time seems to be unrealistic. Similarly, the drastic decrease in the risk of infection because of improved immunity or public health awareness appears idealistic. The relative importance of the socio-demographic factors to HBV infection varies from population to population7, and their contribution to community spread of HBV have been previously reported with concordance in some studies and contradictions in other studies8– 12. Understanding these sociodemographic factors related to infection and their relationship with markers of HBV exposure will provide plausible answers to the recent drastic decline in HBV in Uganda. To understand the sero-prevalence of hepatitis B virus, screening of a large number of people is needed. Serological markers for detection of HBV are diverse13 and include hepatitis B surface antibody (HBsAb), hepatitis B pre-core antibody (HBeAb), hepatitis B pre-core antigen (HBeAg), hepatitis B core antibody (HBcAb) and hepatitis B surface antigen (HBsAg). However, in resource limited settings, screening for hepatitis B virus infection is limited to only the HBsAg using the rapid diagnostic test. Unfortunately, the use of a single marker of exposure is associated with vast irregularities in the diagnosis of HBV. This inconclusive diagnosis is likely to mislead clinicians in their decisions when managing the HBV-infected persons as well as the decision to discard donated blood for transfusion by local and regional blood banks. HBV exposure markers have high sensitivity but low specificity, justifying the need to investigate them not in isolation for comprehensive case management and explicit assessment of blood for transfusion. The Anti-HBc is characteristic of a hidden HBV carrier state and/ or resolved disease14. Anti-HBs antibodies are associated with acquired immunity either due to previous exposure and natural response to the virus or due to vaccination15, whereas the Anti-HBe antibody is a marker of the minimally infective phase and disease remission or recovery from the infection16. Thus, as eluded from above, the relative significance of different sociodemographic risk factors for infection, the comparative expression of markers of liver damage and the relative prevalence of different markers of exposure to HBV at the community level can provide constructive clues on the trend of HBV prevalence and infectivity in a population. Consequently, we sought to understand the current state of the risk factors for HBV infection and the prevalence of the markers of immunity against HBV among HBsAg seronegative individuals to justify the drastic reduction in the burden of HBV in Uganda.
Relationship Between School Gardening and Self-Efficacy Towards Weekly Fruit & Vegetable Intake
(AIJR Publisher., 2020-11-27) Kafeero, Hussein Mukasa; Kavuma, David; Mbabazi, Scovia
The study was designed to understand the relationship between school gardens and student’s self-efficacy and its effect on weekly intake of fruits and vegetables. The survey used two Ugandan secondary schools; one having a well-established school garden with all students having equal opportunities to participate in the growing, harvesting and consumptions of fruits and vegetables, another not. The study followed a cross-sectional study design employing quantitative research methods. The target population comprised of late adolescents 18-22 years attending the two-selected secondary school; one in Kampala and another in Luwero districts. The school in Luwero district engaged students in gardening activities while the school in Kampala did not. Self-administered structured questionnaire was given to students to answer questions in line with the specific objectives. Data was analyzed by using Mann Whitney U test, Pearson Rank Correlation, Odds ratio and test of proportion. The mean ages of thegirls and boys in the school exposed to gardening activities were 19.10±1.4 and 19.2±2.86respectively while those for students in the unexposed school were 18.62±1.21 and 19.11±1.29 respectively. The study had more males (56.3%) than females (43.7%). Neither group met the World Health Organization (WHO), Food and Agricultural Organization (FAO) and United States Department of Agriculture (USDA) recommendation of ≥35 servings per week (≥5 servings per day) for both fruits and vegetables consumption. However, the exposed students had more weekly servings of fruits and vegetables (P>0.05) and had higher self-efficacy towards dietary intake of fruits and vegetables (P=0.007). School garden based intervention can significantly improve student’s self-efficacy towards fruit & vegetable dietary intake increasing the weekly consumption of fruits and vegetables. The findings of the study will inform policy makers on the role of school gardens in enhancing fruit and vegetable intake by in-school adolescents as they develop the Uganda’s school health policy.
The S-Gene Mutations in the Circulating HBV Genotypes/Sub-Genotypes Associated with Hepatitis B Infection in Uganda and their Effects on Cytokines Expression in Liver Disease Progression
(Global Journal of Medical Research, 2016) Kafeero, Hussein Mukasa; Kawooya, Abubaker; Namusoke, Mariam; Atiku, Saad; Mugambwa, Joseph
The causal agent for hepatitis B is called hepatitis B virus (HBV). It is a partially double stranded circular DNA virus of the family Hepadnaviridae. It has been implicated as the leading cause of hepatocellular carcinoma and only second to tobacco among the global human carcinogens. Liver damage as a result of HBV infection is due to host immune response and is modulate by cytokines. The HBV is classified into 10 genotype denoted as A, B, C, D, E, F, G, H, I and J together with several sub-genotypes which have diverse geographical distribution. These genotypes influence liver disease progression and severity as well as response to antiviral therapies. Mutations in the S-gene have been implicated in the paradoxical coexistence of HBsAg and the anti-HBs antibodies which is associated with advanced liver diseases including hepatocellular carcinoma and liver cirrhosis.
TREAT-B Algorithm for Treatment Eligibility Among Chronically Infected Hepatitis B Virus Persons in a Low and a High Endemic Region: A Potential Strategy Towards Virus Elimination by 2030
(Frontiers in Virology, 2022-04-11) Kafeero, Hussein Mukasa; Ndagire, Dorothy; Ocama, Ponsiano; Drago, Charles; Wampande, Eddie; Kajumbula, Henry; Kateete, David Patrick; Walusansa, Abdul; Kudamba, Ali; Ssenku, Jamilu E.; Sendagire, Hakim
Background: Little is known about treatment eligibility in Africa for the hepatitis B virus (TREAT-B) algorithm. We investigated the treatment eligibility among the HBV chronically infected patients in a low and a high endemic region using the TREAT-B algorithm. Methods: We recruited 227 treatment-naïve HBV-infected hospital attendees from the low and high HBV endemic regions. We assessed the treatment eligibility by testing for HBeAg serostatus and ALT levels. Socio-demographic data were collected with a structured questionnaire. The accessory correlates of treatment eligibility (AST, ALP, ALB, GGT, and TBIL) and the socio-demographic factors were analyzed by both univariate and multinomial logistic regression using the SPSS and Medcalc. The analysis was done at 95% CI and a p < 0.05 was considered statistically significant. Results: Overall, 56.8% of the participants qualified for treatment at TREAT-B cutoffs of ≥2, with those from the low endemic region (90, 69.8%) having significantly higher treatment eligibility indication than those from the high endemic region (p < 0.05). Alcohol use and household contact with an HBV-infected person were independent socio-demographic factors significantly associated with treatment eligibility for both low and high endemic regions (p < 0.05). However, birth place was only indicated for treatment eligibility among the high endemic participants (p < 0.05). AST, GGT, and total bilirubin were the liver-related parameters significantly associated with treatment eligibility (p < 0.05), with GGT and AST being significantly elevated among the eligible low endemic dwellers compared to high endemic dwellers (p < 0.05). Conclusion: Using TREAT-B algorithm can be a plausible alternative to the orthodox methods to specify treatment eligibility with the potential to scale up interventions targeting HBV management and elimination.