Publications by authors named "Bazira Joel"

Article Synopsis
  • A study at Mbarara Regional Referral Hospital investigated the prevalence of bacterial colonization in the amniotic fluid of women with premature rupture of membranes (PROM) and its potential impact on health outcomes.
  • Researchers enrolled 144 women and found a 35.4% prevalence of bacterial colonization, with significant isolates and notable antibiotic resistance patterns identified, including high sensitivity to ciprofloxacin.
  • Factors linked to bacterial colonization included being a first-time mother (prime gravidity), obesity, and having been referred from another facility.
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  • Urinary tract infections (UTIs) are common bacterial infections mainly caused by Enterobacteriaceae, with an increasing issue of carbapenem-resistant strains (CRE) making treatment difficult, particularly in Uganda.
  • A study in southwestern Uganda involved 111 outpatient participants found to have carbapenemase genes from a larger sample of 2,371 UTI patients, revealing a higher genotypic prevalence (24.4%) of these resistance genes compared to just 5.7% found using traditional susceptibility testing.
  • The most prevalent carbapenemase gene was blaVIM, and the study identified that a significant portion (14.4%) of the isolates carried multiple resistance genes, highlighting a serious concern in managing UTIs
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Article Synopsis
  • The study highlights the serious threat of antibacterial resistance (ABR) in low-resource areas like East Africa, specifically focusing on multi-drug resistant urinary tract infections (MDR UTIs).
  • Researchers examined a variety of factors, including behavioral, environmental, socioeconomic, and demographic influences, that contribute to the risk of developing MDR UTIs among outpatients in Kenya, Tanzania, and Uganda.
  • Findings suggest that individuals at higher risk tend to have multiple social and environmental disadvantages, indicating that effective interventions should consider these intersecting factors rather than just focusing on antibiotic use alone.
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is widely used as an indicator of recent faecal pollution of water. Most strains are commensals; however, isolates in water samples have been shown to carry antibiotic resistance determinants. In total, 47 were isolated from selected drinking water sources in Mbarara, Uganda.

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Objective: To determine the association between MetS and its components with cervical cancer among women in South-western Uganda.

Methods: We conducted an unmatched case-control study on 470 participants in a 1:2 case-to-control ratio among women in southwestern Uganda. We recruited 157 women with cervical cancer as cases and 313 women without cervical cancer as controls at the Mbarara Regional Referral Hospital Cervical Cancer Clinic.

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Background: Neglected tropical diseases (NTDs), including soil-transmitted helminths (STHs) and schistosomiasis, continue to impose a heavy burden, especially in sub-Saharan Africa and Uganda, despite being preventable. Integration of NTD management into primary healthcare has been inadequate. While researchers have explored community perspectives, there is a notable gap in understanding the viewpoints of healthcare workers (HCW), which is crucial for effective NTD control strategies.

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Background The stage of disease at diagnosis is one of the major determinants of survival in women with cervical cancer. Most women with cervical cancer in low- and middle-income countries (LMICs) present to hospitals with advanced stages, thus reducing their survivorship following the diagnosis. Factors correlated with late-stage disease at diagnosis are not completely explored.

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Despite the global implementation of preventive strategies against Human Papilloma Virus (HPV) infection, the incidence of invasive cervical cancer rose by nearly 1.3-fold, from 471,000 annual cases in 2000 to 604,000 cases in 2020. With over 340,000 deaths annually, cervical cancer is the fourth leading cause of cancer mortality in women globally.

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Carbapenem-resistant Enterobacteriaceae (CRE) have diminished treatment options causing serious morbidities and mortalities. This systematic review and meta-analysis assessed the prevalence and associated factors of Enterobacteriaceae infections in clinical, livestock and environmental settings globally. The population intervention comparison and outcome strategy was used to enroll studies using the preferred reporting system for systematic review and meta-analysis to include only cross-sectional studies.

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Background: Neglected tropical diseases (NTDs) affect millions of people in Africa, with Uganda bearing a significant burden. The World Health Organization (WHO) set a goal to reduce NTDs and improve access to diagnosis and management by 2030. However, NTDs have not been well integrated into primary healthcare in many countries, including Uganda, due to limited knowledge and resources among health workers.

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Article Synopsis
  • - Antimicrobial resistance (AMR) is a significant public health issue in Uganda, highlighted by a study that analyzed data from 10 tertiary hospitals between October 2020 and March 2023, revealing varying levels of resistance among different patient demographics and specimen types.
  • - Among the 2754 isolates collected, common pathogens included common strains with only a small percentage being susceptible to key antibiotics like ceftriaxone (28%) and methicillin (44% susceptibility, with 56% identified as MRSA).
  • - The study found trends in susceptibility changes over time, revealing significant decreases in effectiveness of ciprofloxacin and gentamicin, indicating a pressing need for improved antimicrobial stewardship to combat AMR drivers.
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This study assessed the physical, chemical, and microbiological quality with emphasis on risk score, source apportionment, geochemistry, feacal coliforms and water quality index of drinking water from selected water sources. A cross-sectional study was conducted in six villages in Mbarara city, south-western Uganda. Each selected source was inspected using a WHO-adopted sanitary inspection questionnaire.

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Background: In low- and middle-income countries, antibiotics are often prescribed for patients with symptoms of urinary tract infections (UTIs) without microbiological confirmation. Inappropriate antibiotic use can contribute to antimicrobial resistance (AMR) and the selection of MDR bacteria. Data on antibiotic susceptibility of cultured bacteria are important in drafting empirical treatment guidelines and monitoring resistance trends, which can prevent the spread of AMR.

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Antibacterial resistance (ABR) is a major public health threat. An important accelerating factor is treatment-seeking behaviour, including inappropriate antibiotic (AB) use. In many low- and middle-income countries (LMICs) this includes taking ABs with and without prescription sourced from various providers, including health facilities and community drug sellers.

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High-income countries have documented a significant decline in the incidence and mortality of cervical cancer over the past decade but such data from low and middle-income countries such as Uganda is limited to ascertain trends. There is also paucity of data on the burden of cervical cancer in comparison to other gynaecologic malignancies and there is a likelihood that the incidence might be on the rise. To describe the current trends and magnitude of cervical cancer in comparison to other gynaecological malignancies histological types, we conducted a retrospective records review of charts of patients admitted with gynaecological malignancies on the gynaecological ward of Mbarara Regional Referral Hospital (MRRH) between January 2017 and December 2022.

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Article Synopsis
  • The study investigates how the COVID-19 pandemic impacted care-seeking behaviors and antibiotic use for urinary tract infection-like symptoms in Uganda and Tanzania, two East African countries with different COVID-19 policies.
  • Data was collected from outpatient patients with UTI symptoms at three time points: before COVID-19, during early COVID-19, and later in the pandemic, focusing on delays in seeking care and antibiotic use.
  • Findings showed that while delays in seeking care decreased during the pandemic, inappropriate antibiotic use, particularly metronidazole and doxycycline, significantly increased, raising concerns about adherence to treatment guidelines.
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Background: Fungal-bacterial cocolonization and coinfections pose an emerging challenge among patients suspected of having pulmonary tuberculosis (PTB); however, the underlying pathogenic mechanisms and microbiome interactions are poorly understood. Understanding how environmental microbes, such as fungi and bacteria, coevolve and develop traits to evade host immune responses and resist treatment is critical to controlling opportunistic pulmonary fungal coinfections. In this project, we propose to study the coexistence of fungal and bacterial microbial communities during chronic pulmonary diseases, with a keen interest in underpinning fungal etiological evolution and the predominating interactions that may exist between fungi and bacteria.

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Background: The accumulation of resistance genes in Escherichia coli (E. coli) strains imposes limitations in the therapeutic options available for the treatment of infections caused by E.coli.

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Background: Paenibacillus thiaminolyticus is a cause of postinfectious hydrocephalus among Ugandan infants. To determine whether Paenibacillus spp is a pathogen in neonatal sepsis, meningitis, and postinfectious hydrocephalus, we aimed to complete three separate studies of Ugandan infants. The first study was on peripartum prevalence of Paenibacillus in mother-newborn pairs.

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Background: A key factor driving the development and maintenance of antibacterial resistance (ABR) is individuals' use of antibiotics (ABs) to treat illness. To better understand motivations and context for antibiotic use we use the concept of a patient treatment-seeking pathway: a treatment journey encompassing where patients go when they are unwell, what motivates their choices, and how they obtain antibiotics. This paper investigates patterns and determinants of patient treatment-seeking pathways, and how they intersect with AB use in East Africa, a region where ABR-attributable deaths are exceptionally high.

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Background: Paenibacillus thiaminolyticus may be an underdiagnosed cause of neonatal sepsis.

Methods: We prospectively enrolled a cohort of 800 full-term neonates presenting with a clinical diagnosis of sepsis at 2 Ugandan hospitals. Quantitative polymerase chain reaction specific to P.

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High land areas in Uganda are suitable for the farming of Artemisia annua. However, harvested A. annua from these areas contain varying concentrations of antimalarial components.

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Antibacterial resistance (ABR) is a major public health threat. An important accelerating factor is treatment-seeking behaviours, including inappropriate antibiotic (AB) use. In many low- and middle-income countries (LMICs) this includes taking ABs with and without prescription sourced from various providers, including health facilities and community drug sellers.

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Background: Poverty is a proposed driver of antimicrobial resistance, influencing inappropriate antibiotic use in low-income and middle-income countries (LMICs). However, at subnational levels, studies investigating multidimensional poverty and antibiotic misuse are sparse, and the results are inconsistent. We aimed to investigate the relationship between multidimensional poverty and antibiotic use in patient populations in Kenya, Tanzania, and Uganda.

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Background: Leptospirosis is an emerging neglected zoonotic disease that presents with nonspecific signs/symptoms and it can be mistaken for other diseases. Owing to limited diagnostic capacity and unawareness, the data on human leptospirosis particularly in neonates are scarce in many sub-Saharan countries. It has been underreported hindering preventive and control measures in place.

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