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Search Results: 1 - 10 of 208386 matches for " L. Mugenyi "
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Factors Determining Survival and Retention among HIV-Infected Children and Adolescents in a Community Home-Based Care and a Facility-Based Family-Centred Approach in Kampala, Uganda: A Cohort Study
W. Massavon,L. Barlow-Mosha,L. Mugenyi,W. McFarland,G. Gray,R. Lundin,P. Costenaro,M. M. Nannyonga,M. Penazzato,D. Bagenda,C. P. Namisi,D. Wabwire,M. Mubiru,S. Kironde,D. Bilardi,A. Mazza,M. G. Fowler,P. Musoke,C. Giaquinto
ISRN AIDS , 2014, DOI: 10.1155/2014/852489
Abstract: We describe factors determining retention and survival among HIV-infected children and adolescents engaged in two health care delivery models in Kampala, Uganda: one is a community home-based care (CHBC) and the other is a facility-based family-centred approach (FBFCA). This retrospective cohort study reviewed records from children aged from 0 to 18 years engaged in the two models from 2003 to 2010 focussing on retention/loss to follow-up, mortality, use of antiretroviral therapy (ART), and clinical characteristics. Kaplan Meier survival curves with log rank tests were used to describe and compare retention and survival. Overall, 1,623 children were included, 90.0% (1460/1623) from the CHBC. Children completed an average of 4.2 years of follow-up (maximum 7.7 years). Median age was 53 (IQR: 11–109) months at enrolment. In the CHBC, retention differed significantly between patients on ART and those not (log-rank test, adjusted, ). Comparing ART patients in both models, there was no significant difference in long-term survival (log-rank test, , adjusted, ), while retention was higher in the CHBC: 94.8% versus 84.7% in the FBFCA (log-rank test, , adjusted ). Irrespective of model of care, children receiving ART had better retention in care and survival. 1. Background Sub-Saharan Africa (SSA) is home to the vast majority of infants, children, and adolescents living with HIV and morbidity and mortality remain high [1–3]. For example, mortality among HIV-infected children has been measured at 4.3% per year in East Africa and 8.3% in West Africa [4, 5]. A recent meta-analysis conducted in SSA reported a higher risk of early death among perinatally infected children [6]. Studies have also shown that substantial proportions of children and adolescents initiate treatment in SSA with advanced disease (46.3%–72.0%) and comorbidities such as tuberculosis (TB) (5.7%–34.0%) and malnutrition (33%–54%) that tend to be associated with early mortality and poor clinical outcomes [7–10]. Significant child mortality can be averted if antiretroviral therapy (ART) is started early [11–14]. However, despite overwhelming evidence demonstrating the benefits of ART, in practice high mortality and poor retention persist among HIV-infected children and adolescents in care in the resource-limited settings of SSA. In addition to scarce resources for programmes for children, the situation is compounded by a combination of factors including late HIV diagnosis, missed opportunities to initiate ART, health care programmes not tailored to the needs of the infected child and their family,
Emergence and Persistence of Minor Drug-Resistant HIV-1 Variants in Ugandan Women after Nevirapine Single-Dose Prophylaxis
Andrea Hauser, Kizito Mugenyi, Rose Kabasinguzi, Claudia Kuecherer, Gundel Harms, Andrea Kunz
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0020357
Abstract: Background Nevirapine (NVP) single-dose is still a widely used antiretroviral prophylaxis for the prevention of vertical HIV-1 transmission in resource-limited settings. However, the main disadvantage of the Non-nucleoside Reverse Transcriptase Inhibitor (NNRTI) NVP is the rapid selection of NVP-resistant virus with negative implications for subsequent NNRTI-based long-term antiretroviral therapy (ART). Here, we analysed the emergence of drug-resistant HIV-1 including minor variants in the early phase after NVP single-dose prophylaxis and the persistence of drug-resistant virus over time. Methods and Findings NVP-resistant HIV-1 harbouring the K103N and/or Y181C resistance mutations in the HIV-1 reverse transcriptase gene was measured from 1 week up to 18 months after NVP single-dose prophylaxis in 29 Ugandan women using allele-specific PCR assays capable of detecting drug-resistant variants representing less than 1% of the whole viral population. In total, drug-resistant HIV-1 was identified in 18/29 (62%) women; rates increased from 18% to 38% and 44% at week 1, 2, 6, respectively, and decreased to 18%, 25%, 13% and 4% at month 3, 6, 12 and 18, respectively. The proportion of NVP-resistant virus of the total viral population was significantly higher in women infected with subtype D (median 40.5%) as compared to subtype A (median 1.3%; p = 0.032, Mann-Whitney U test). 33% of resistant virus was not detectable at week 2 but was for the first time measurable 6–12 weeks after NVP single-dose prophylaxis. Three (10%) women harboured resistant virus in proportions >10% still at month 6. Conclusions Current WHO guidelines recommend an additional postnatal intake of AZT and 3TC for one week to avoid NVP resistance formation. Our findings indicate that a 1-week medication might be too short to impede the emergence of NVP resistance in a substantial proportion of women. Furthermore, subsequent NNRTI-based ART should not be started earlier than 12 months after NVP single-dose prophylaxis.
Tsetse Fly (G.f. fuscipes) Distribution in the Lake Victoria Basin of Uganda
Mugenyi Albert?,Nicola A Wardrop?,Peter M Atkinson?,Steve J Torr?,Susan C Welburn
PLOS Neglected Tropical Diseases , 2015, DOI: 10.1371/journal.pntd.0003705
Abstract: Tsetse flies transmit trypanosomes, the causative agent of human and animal African trypanosomiasis. The tsetse vector is extensively distributed across sub-Saharan Africa. Trypanosomiasis maintenance is determined by the interrelationship of three elements: vertebrate host, parasite and the vector responsible for transmission. Mapping the distribution and abundance of tsetse flies assists in predicting trypanosomiasis distributions and developing rational strategies for disease and vector control. Given scarce resources to carry out regular full scale field tsetse surveys to up-date existing tsetse maps, there is a need to devise inexpensive means for regularly obtaining dependable area-wide tsetse data to guide control activities. In this study we used spatial epidemiological modelling techniques (logistic regression) involving 5000 field-based tsetse-data (G. f. fuscipes) points over an area of 40,000 km2, with satellite-derived environmental surrogates composed of precipitation, temperature, land cover, normalised difference vegetation index (NDVI) and elevation at the sub-national level. We used these extensive tsetse data to analyse the relationships between presence of tsetse (G. f. fuscipes) and environmental variables. The strength of the results was enhanced through the application of a spatial autologistic regression model (SARM). Using the SARM we showed that the probability of tsetse presence increased with proportion of forest cover and riverine vegetation. The key outputs are a predictive tsetse distribution map for the Lake Victoria basin of Uganda and an improved understanding of the association between tsetse presence and environmental variables. The predicted spatial distribution of tsetse in the Lake Victoria basin of Uganda will provide significant new information to assist with the spatial targeting of tsetse and trypanosomiasis control.
Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study
William Massavon,Levi Mugenyi,Martin Nsubuga,Rebecca Lundin,Martina Penazzato,Maria Nannyonga,Charles Namisi,Resty Ingabire,Daniel Kalibbala,Susan Kironde,Paola Costenaro,Davide Bilardi,Antonio Mazza,Bart Criel,James K. Tumwine,Janet Seeley,Carlo Giaquinto
ISRN Public Health , 2014, DOI: 10.1155/2014/623690
Abstract: Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes. 1. Background In the wake of the human immunodeficiency virus (HIV) epidemic in Sub-Saharan Africa (SSA), alternative service delivery models like the Community Home-Based Care (CHBC) [1–6] have evolved to fill the gap left by overstretched and underresourced health systems. CHBC includes any form of care (physical, psychosocial, palliative, and spiritual) given to the sick and the affected in their own homes and care extended from the hospital or health facility to their homes through family participation and community involvement [7, 8]. CHBC provides for the unmet needs of the large and growing population of PLHA in many resource-limited settings [7, 9, 10]. However, the effects of CHBC on national HIV and TB outcomes have not been examined in detail. In Uganda, the first CHBC programmes were established in 1987 in response to increasing numbers of acutely ill HIV/AIDS patients leading to congestion of hospital wards, increased staff workload, and excessive pressure on infrastructure. Three different organisations pioneered this approach: Kitovu Mobile HIV Programme, The AIDS Support Organization (TASO), and Nsambya Hospital Home Care Department, popularly known as Nsambya Home Care (NHC). TASO was started by local people, whereas, Kitovu Mobile and Nsambya Home Care were pioneered
Computing Reachable Sets as Capture-Viability Kernels in Reverse Time  [PDF]
No?l Bonneuil
Applied Mathematics (AM) , 2012, DOI: 10.4236/am.2012.311219
Abstract: The set SF(x0;T) of states y reachable from a given state x0 at time T under a set-valued dynamic x’(t)∈F(x (t)) and under constraints x(t)∈K where K is a closed set, is also the capture-viability kernel of x0 at T in reverse time of the target {x0} while remaining in K. In dimension up to three, Saint-Pierre’s viability algorithm is well-adapted; for higher dimensions, Bonneuil’s viability algorithm is better suited. It is used on a large-dimensional example.
Three Dimensional Evolution of SN 1987A in a Self-Gravitating Disk  [PDF]
L. Zaninetti
International Journal of Astronomy and Astrophysics (IJAA) , 2013, DOI: 10.4236/ijaa.2013.32010
Abstract:

The introduction of an exponential or power law gradient in the interstellar medium (ISM) allows to produce an asymmetric evolution of the supernova remnant (SNR) when the framework of the thin layer approximation is adopted. Unfortunately both the exponential and power law gradients for the ISM do not have a well defined physical meaning. The physics conversely is well represented by an isothermal self-gravitating disk of particles whose velocity is everywhere Maxwellian. We derived a law of motion in the framework of the thin layer approximation with a control parameter of the swept mass. The photon’s losses, which are often neglected in the thin layer approximation, are modeled trough velocity dependence. The developed framework is applied to SNR 1987A and the three observed rings are simulated.

The Luminosity Function of Galaxies as Modeled by a Left Truncated Beta Distribution  [PDF]
L. Zaninetti
International Journal of Astronomy and Astrophysics (IJAA) , 2014, DOI: 10.4236/ijaa.2014.41013
Abstract: A first new luminosity function of galaxies can be built starting from a left truncated beta probability density function, which is characterized by four parameters. In the astrophysical conversion, the number of parameters increases by one, due to the addition of the overall density of galaxies. A second new galaxy luminosity function is built starting from a left truncated beta probability for the mass of galaxies once a simple nonlinear relationship between mass and luminosity is assumed; in this case the number of parameters is six because the overall density of galaxies and a parameter that regulates mass and luminosity are added. The two new galaxy luminosity functions with finite boundaries were tested on the Sloan Digital Sky Survey (SDSS) in five different bands; the results produce a better fit than the Schechter luminosity function in two of the five bands considered. A modified Schechter luminosity function with four parameters has been also analyzed.
On the Dark Matter’s Halo Theoretical Description  [PDF]
L. M. L. M. Chechin
Journal of Modern Physics (JMP) , 2012, DOI: 10.4236/jmp.2012.35052
Abstract: We argued that the standard field scalar potential couldn’t be widely used for getting the adequate galaxies’ curve lines and determining the profiles of dark matter their halo. For discovering the global properties of scalar fields that can describe the observable characteristics of dark matter on the cosmological space and time scales, we propose the simplest form of central symmetric potential celestial-mechanical type, i.e. U(φ) = –μ/φ. It was shown that this potential allows get rather satisfactorily dark matter profiles and rotational curves lines for dwarf galaxies. The good agreement with some previous results, based on the N-body simulation method, was pointed out. A new possibility of dwarf galaxies’ masses estimation was given, also.
Analytical Approximation to the Dynamics of a Binary Stars System with Time Depending Mass Variation  [PDF]
Gustavo V. López, Elkin L. López
Journal of Applied Mathematics and Physics (JAMP) , 2018, DOI: 10.4236/jamp.2018.63053
Abstract: We study the classical dynamics of binary stars when there is an interchange of mass between them. Assuming that one of the stars is more massive than others, the dynamics of the lighter one is analyzed as a function of its time depending mass variation. Within our approximations and models for mass transference, we obtain a general result which establishes that if the lightest star looses mass, its period increases. If the lightest star wins mass, its period decreases.
Quantization and Stable Attractors in a DissipativeOrbital Motion  [PDF]
Daniel L. Nascimento, Antonio L. A. Fonseca
Journal of Modern Physics (JMP) , 2011, DOI: 10.4236/jmp.2011.24030
Abstract: We present a method for determining the motion of an electron in a hydrogen atom, which starts from a field Lagrangean foundation for non-conservative systems that can exhibit chaotic behavior. As a consequence, the problem of the formation of the atom becomes the problem of finding the possible stable orbital attractors and the associated transition paths through which the electron mechanical energy varies continuously until a stable energy state is reached.
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