Publications by authors named "Mugabi Timothy"
Cryptococcal meningitis is a fungal infection that is typically caused by and most commonly seen in severely immunosuppressed patient. This disease causes severe neurologic disease due to elevated intracranial pressures. In this case report, we describe a patient with newly diagnosed HIV presenting to the hospital with cryptococcal meningitis complicated by sudden vision loss.
View Article and Find Full Text PDFCerebrospinal fluid (CSF) protein levels exhibit high variability in HIV-associated cryptococcal meningitis; however, its clinical implications remain unclear. We analyzed data from 890 adults with HIV-associated cryptococcal meningitis randomized into two clinical trials in Uganda between 2015 and 2021. CSF protein was grouped into < 100 mg/dl (72%, n = 641) and ≥ 100 mg/dl (28%, n = 249).
View Article and Find Full Text PDFCryptococcal meningitis is one of the leading causes of death in sub-Saharan Africa among patients with advanced HIV disease. Early diagnosis is crucial in improving treatment outcomes. Despite advances and the availability of modern and point-of-care diagnostics for cryptococcosis, gaps still exist in resource-constrained settings, leading to unfavorable treatment outcomes.
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- The IMPROVE trial aims to improve outcomes for adults suffering from HIV-associated cryptococcal meningitis by testing two TPT strategies for preventing tuberculosis (TB).
- The study will enroll 205 participants in Uganda, who will be randomized to receive either early inpatient or standard outpatient initiation of a one-month TB treatment regimen.
- The trial will assess the safety, feasibility, and treatment completion rates, with a focus on gathering data that could enhance TB prevention methods in high-risk populations.
Article Synopsis
- - The review addresses the challenges in diagnosing and treating patients with a history of cryptococcal meningitis who experience recurring symptoms after improvement, highlighting significant gaps in current medical knowledge.
- - The authors analyzed data from 28 cases of paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 cases of microbiological relapse, finding that traditional indicators like CD4 and cerebrospinal fluid white cell counts are insufficient for differentiating between these two conditions.
- - They emphasize that cryptococcal antigen tests are inadequate for distinguishing relapse from other recurrent symptoms, urging the need for newer research definitions and the development of fast, reliable diagnostic tests.
Introduction: Uganda has until recently mostly referred patients for complex hepato-pancreato-biliary (HPB) surgery abroad due to lack of local expertize. We report indications and a spectrum of surgeries performed in the first 4 years following the establishment of a routine HPB service at Lubaga Hospital (LH), Kampala, Uganda. We also detailed the challenges encountered in setting up this service.
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- In a study of 890 adults with HIV-associated cryptococcal meningitis, researchers found that cerebrospinal fluid (CSF) protein levels varied significantly, impacting clinical outcomes.
- Approximately one-third of the participants had elevated CSF protein (≥100 mg/dL), leading to associations with more severe clinical presentations, such as impaired consciousness and seizures, but also indicated better fungal clearance and immune responses.
- The study concluded that higher CSF protein levels could be a useful indicator for immune activation and could help predict patient prognosis in cryptococcal meningitis.
Purpose Of Review: Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Inadequate diagnostic testing and treatment regimens adapted from pulmonary tuberculosis without consideration of the unique nature of TBM are among the potential drivers. This review focuses on the progress being made in relation to both diagnosis and treatment of TBM, emphasizing promising future directions.
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- Amphotericin B is the primary treatment for severe fungal infections, and a new less-toxic oral formulation called lipid nanocrystal (LNC) amphotericin has been developed for potential use.
- A clinical trial tested LNC amphotericin against traditional intravenous amphotericin for treating cryptococcal meningitis in HIV patients, focusing on safety, efficacy, and survival rates.
- Results showed that the oral formulation had comparable effectiveness and was associated with fewer severe side effects compared to intravenous treatment, suggesting it could be a safer alternative for patients.
Background: We report here on a prospective hospital-based cohort study that investigates predictors of 30-day and 90-day mortality and functional disability among Ugandan stroke patients.
Methods: Between December 2016 and March 2019, we enrolled consecutive hemorrhagic stroke and ischemic stroke patients at St Francis Hospital Nsambya, Kampala, Uganda. The primary outcome measure was mortality at 30 and 90 days.