Publications by authors named "Bangirana P"
Background: Caregivers of young children may have been particularly vulnerable to mental health challenges during the COVID-19 pandemic due to its negative impacts on their housing, finances, and childcare demands. This study explored the associations between COVID-19-related experiences and symptoms of depression and anxiety among Ugandan caregivers.
Methods: This cross-sectional study included 100 Ugandan caregivers of young children aged 6-59 months with uncomplicated malaria and iron deficiency (N = 85) and without malaria or anemia (N = 15) who were enrolled in the Optimizing Iron Status in Malaria-Endemic Areas (OptiM) study.
Article Synopsis
- A study conducted in Uganda followed children aged 6 months to 4 years who were discharged from the hospital after being treated for specific severe malaria manifestations, comparing their post-discharge health to asymptomatic community children.
- Over 12 months, 56.6% of children with severe malaria experienced one or more hospitalizations, significantly higher than the 30.8% of community children, with a majority of the hospitalizations being malaria-related.
- The findings indicate a pressing need for research into post-discharge malaria prevention treatments to help reduce the healthcare burden on children who have suffered from severe malaria.
Article Synopsis
- Interpersonal violence poses a major public health issue, particularly for individuals with severe mental illnesses, as highlighted in a study conducted at Butabika Hospital, Kampala, Uganda.
- The study found that approximately 34% of participants reported experiencing interpersonal violence in the past year, with 29% indicating physical violence and 11% sexual violence.
- Older age correlated with lower odds of experiencing violence, while individuals who committed physical violence had higher likelihoods of being victimized, suggesting the need for targeted screening and educational interventions for younger adults.
Introduction: Few studies have described post-discharge morbidity of children with specific manifestations of severe malaria (SM) beyond severe malarial anemia or cerebral malaria.
Methods: Children 6 months to 4 years of age admitted at Jinja and Mulago hospitals in Uganda, with one or more of the five most common manifestations of SM, cerebral malaria (n=53), respiratory distress syndrome (n=108), malaria with complicated seizures (n=160), severe malarial anemia (n=155) or prostration (n=75), were followed for 12 months after discharge, along with community children (CC) (n=120) recruited from the household or neighborhood of the children with SM. Incidence and risk of post-discharge readmission, death or outpatient clinic visits were compared between children with SM and CC.
Objective: Academic achievement in school-age children is crucial for advancing learning goals. Children with sickle cell anaemia (SCA) in Sub-Saharan Africa may be at risk of disease-associated school difficulties. Limited data exist on the academic achievement of children with SCA in the region.
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- - The study compared neurocognitive functions in Ugandan children aged 1-12 years with sickle cell anemia (SCA) to their non-SCA siblings, finding that SCA children had significantly lower cognitive scores, particularly in older age groups.
- - Methods included standardized tests for cognition, executive function, and attention, along with stroke risk assessments, revealing that younger SCA children did not differ significantly from their siblings in cognitive abilities.
- - Results showed that disease status, age, and prior stroke were key predictors of neurocognitive outcomes in SCA children, highlighting the need for further research on interventions that could improve their cognitive functioning.
Persistent neurodisability is a known complication in paediatric survivors of cerebral malaria and severe malarial anaemia. Tau, ubiquitin C-terminal hydrolase-L1, neurofilament-light chain, and glial fibrillary acidic protein have proven utility as biomarkers that predict adverse neurologic outcomes in adult and paediatric disorders. In paediatric severe malaria, elevated tau is associated with mortality and neurocognitive complications.
View Article and Find Full Text PDFIntroduction: Neurocognitive function in Ugandan children aged 1-12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings to identify risk factors for disease-associated impairment.
Methods: This cross-sectional neurocognitive function study of children with SCA (N=242) and non-SCA siblings (N=127) used age- and linguistically-appropriate standardized tests of cognition, executive function and attention for children ages 1-4 and 5-12 years. Test scores were converted to locally derived age-normalized z-scores.
Background: The relationship of apolipoprotein-E4 (APOE4) to mortality and cognition after severe malaria in children is unknown.
Methods: APOE genotyping was performed in children with cerebral malaria (CM, n = 261), severe malarial anemia (SMA, n = 224) and community children (CC, n = 213). Cognition was assessed over 2-year follow-up.
Background: There is little research on alcohol and other drugs (AOD) use by school-age children in low-resource settings like Uganda. Including the voices of children in research can inform prevention and early intervention efforts for those at risk of AOD use. The aim of this study was to understand the perspectives of children aged 6 to 13 years regarding AOD in Uganda.
View Article and Find Full Text PDFCerebrovascular injury frequently occurs in children with sickle cell anaemia (SCA). Limited access to magnetic resonance imaging and angiography (MRI-MRA) in sub-Saharan Africa impedes detection of clinically unapparent cerebrovascular injury. Blood-based brain biomarkers of cerebral infarcts have been identified in non-SCA adults.
View Article and Find Full Text PDFBackground And Objectives: For children with cerebral malaria, mortality is high, and in survivors, long-term neurologic and cognitive dysfunctions are common. While specific clinical factors are associated with death or long-term neurocognitive morbidity in cerebral malaria, the association of EEG features with these outcomes, particularly neurocognitive outcomes, is less well characterized.
Methods: In this prospective cohort study of 149 children age 6 months to 12 years who survived cerebral malaria in Kampala, Uganda, we evaluated whether depth of coma, number of clinical seizures, or EEG features during hospitalization were associated with mortality during hospitalization, short-term and long-term neurologic deficits, or long-term cognitive outcomes (overall cognition, attention, memory) over the 2-year follow-up.
Background: Malaria affects 24 million children globally, resulting in nearly 500,000 child deaths annually in low- and middle-income countries (LMICs). Recent studies have provided evidence that severe malaria infection results in sustained impairment in cognition and behaviour among young children; however, a formal meta-analysis has not been published. The objective was to assess the association between severe malaria infection with cognitive and behavioural outcomes among children living in LMICs.
View Article and Find Full Text PDFIntroduction: Cerebral malaria is one of the most severe manifestations of malaria and is a leading cause of acquired neurodisability in African children. Recent studies suggest acute kidney injury (AKI) is a risk factor for brain injury in cerebral malaria. The present study evaluates potential mechanisms of brain injury in cerebral malaria by evaluating changes in cerebrospinal fluid measures of brain injury with respect to severe malaria complications.
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- Conflict in the Democratic Republic of Congo has caused many refugees to flee to Uganda and Rwanda, leading to mental health issues like depression due to stressors they face.
- A clinical trial is testing an adapted form of Community-based Sociotherapy (aCBS) to see if it can reduce depressive symptoms among these refugees, comparing it to standard care.
- The trial involves 64 groups assigned to either aCBS or usual care, measuring mental health outcomes over 18 and 32 weeks, while also assessing cost-effectiveness and implementation processes.
Article Synopsis
- Research indicates that children who have experienced cerebral malaria (CM) or severe malarial anemia (SMA) may face long-term academic challenges, particularly in reading skills.
- A study in Uganda analyzed the academic performance of children who had CM or SMA, finding lower reading and spelling scores compared to their peers from the same community.
- The presence of additional malaria episodes after discharge further worsened reading outcomes, suggesting that preventive measures against malaria may help improve academic achievement in these children.
Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to HIV, but the extent of benefit is unclear.
Setting: Children were recruited from hospital and health centers providing HIV care and treatment in Nairobi, Kenya.
Methods: Cognitive, behavioral, and motor outcomes were assessed in children with HIV and early ART (<1 year), children with HIV and late ART (1.
Background: Malaria in pregnancy has been associated with worse cognitive outcomes in children, but its association with behavioral outcomes and the effectiveness of malaria chemoprevention on child neurodevelopment are not well characterized.
Methods: To determine if more effective malaria chemoprevention in mothers and their children results in better neurodevelopment, 305 pregnant women were randomly assigned to 3 doses of sulfadoxine-pyrimethamine, 3 doses of dihydroartemisinin-piperaquine (DP), or monthly DP during pregnancy, and their 293 children were assigned to DP every 3 months or monthly DP from 2 to 24 months of age. Cognition, language, and motor function were assessed at 12, 24.
Article Synopsis
- Global changes in amino acid levels were studied in Ugandan children with severe malaria (SM) to assess their long-term health outcomes, particularly kidney function and cognition.
- The study found deficiencies in certain sulfur-containing amino acids and identified specific amino acid increases related to mortality and chronic kidney disease (CKD).
- Unique amino acid profiles in children with SM were linked to negative health consequences, including higher risks of mortality and cognitive issues, especially attention problems in younger children.
Background: Murine experimental cerebral malaria studies suggest both protective and deleterious central nervous system effects from alterations in the interleukin-33 (IL-33)/ST2 pathway.
Methods: We assessed whether soluble ST2 (sST2) was associated with neuronal injury or cognitive impairment in a cohort of Ugandan children with cerebral malaria (CM, n=224) or severe malarial anemia (SMA, n=193).
Results: Plasma concentrations of sST2 were higher in children with CM than in children with SMA or in asymptomatic community children.
Introduction: Children and adolescents living with HIV (C/ALHIV) are at a risk for significant neurocognitive deficits. There is limited literature that addresses the role of socioeconomic factors in neurocognitive deficits among CALHIV in Sub Saharan Africa (SSA), as it is very difficult to establish this causal relationship. Our systematic review was guided by the biodevelopmental framework that assumes that foundations of health and adversity affect later development and life outcomes.
View Article and Find Full Text PDFBackground: Forcibly displaced people are at elevated risk of experiencing circumstances that can adversely impact on mental health. Culturally and contextually relevant tools to assess their mental health and psychosocial needs are essential to inform the development of appropriate interventions and investigate the effectiveness of such interventions.
Methods: We conducted two related studies: (1) to translate and contextually adapt the Patient Health Questionnaire (PHQ-9), a measure of depressive symptomatology, along with assessment instruments measuring levels of daily stress (Checklist for Daily & Environmental Stressors; CDES), social capital (Shortened and Adapted Social Capital Assessment Tool; SASCAT) and perceived social support (Multidimensional Scale of Perceived Social Support; MSPSS) for use with Congolese refugees; (2) to conduct pilot testing of the assessment instruments (including cognitive interviewing about participants' views of completing them) and a validation of the adapted PHQ-9 using a 'known group' approach by recruiting Congolese refugees from refugee settings in Rwanda (n = 100) and Uganda (n = 100).
Background: Mortality in severe malaria remains high in children treated with intravenous artesunate. Acute kidney injury (AKI) is a common complication of severe malaria, but the interactions between AKI and other complications on the risk of mortality in severe malaria are not well characterized.
Methods: Between 2014 and 2017, 600 children aged 6-48 months to 4 years hospitalized with severe malaria were enrolled in a prospective clinical cohort study evaluating clinical predictors of mortality in children with severe malaria.
Background: Perinatal HIV and antiretroviral therapy exposure may influence neurocognitive outcomes, although evidence is mixed and most studies are limited to outcomes in the first 24 months. We compared neurocognitive outcomes in school-aged children who were HIV exposed uninfected (CHEU) with those in children who were HIV unexposed uninfected (CHUU).
Setting: Children were recruited from a health center in Nairobi, Kenya.
Article Synopsis
- A study conducted in Uganda followed 598 children with severe malaria and 118 community children over 12 months to investigate the prevalence and outcomes of acute kidney injury (AKI) and persistent kidney disease (acute kidney disease, AKD) following AKI.
- The findings revealed a high incidence of AKI at 45.3%, with a significant link to in-hospital mortality, especially among those with severe AKI.
- The study emphasized that children with unresolved AKI faced increased risks of developing AKD and higher post-discharge mortality, highlighting potential benefits of paracetamol use during hospitalization.