Paul Edward Okello
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ABOUT THE FELLOWPaul Edward Okello holds a Bachelor of Science (Hons) in Applied Biology from De Montfort University, a post graduate diploma in Tropical Medicine and Hygiene and MSc Medical Microbiology both from London School of Hygiene and Tropical Medicine, United Kingdom. His BSc thesis was on “The development of a model bacterial biofilm system” while the MSc thesis was on “Serological responses to Bartonella henselae” the aetiological agent of Cat Scratch Disease. Paul has worked in many medical laboratories in Uganda, the most recent and notable of which was his role as Head of Microbiology Laboratory at Joint Clinical Research Centre between June 2007 and December 2015. Paul is currently hosted at Uganda National Health Laboratories Services (UNHLS). At UNHLS, Paul has developed his skills in Applied Epidemiology, effective Communication, and Laboratory support for disease surveillance and public health emergency response. Paul intends to build a career in Field Epidemiology with particular emphasis on the growth of Medical Microbiology to support Public health response. Achievements at the host site
Program-specific achievementsDescriptive analysis of public health surveillance data and submitted a report on “Secondary data analysis of various HIV prophylactic treatments by HIV positive mothers and risk of infants’ HIV positivity”. Based on 2015 EID data from the Central Public Health Laboratory. Field investigations:
Bulletin articles
Quality improvement project report submitted: Addressing HIV viral load timeliness, test uptake and utilization for achievement of higher viral load suppression rates using continuous quality improvement approach in two health facilities in Mbale District. Abstracts presented
National:
Newspaper article
Policy brief: Co-authored one on Control of Tick-Borne Crimean-Congo Hemorrhagic Fever Outbreaks in Uganda using the One-Health Approach,pending publication in UNIPH Epidemiology bulletin of April 2018 Manuscripts:
HIV Project &Secondary data analysis: Risk factors for HIV infection in the youth (15-24 years): Voluntary Counselling and Testing-based surveillance at Mildmay Uganda clinic, 2011-2013 Epidemiology study& secondary data analysis: Risk factors for low CD4 count among persons testing HIV positive for the first time: Voluntary Counselling and Testing-based surveillance at Mildmay Uganda clinic, 2011-2013 Summary of Epidemiological Study:Title: Risk factors for low CD4 count among HIV positive persons: Voluntary Counselling and Testing-based surveillance at Mildmay Uganda Clinic, 2011-2013 Introduction: Studies show that in addition to HIV and Anti-Retroviral Therapy (ART) there are other non-biological factors such as demographics and socio-economic status that can affect CD4 cell counts. We analyzed data from the Voluntary Counseling and Testing (VCT) surveillance study at Mildmay Uganda to assess the risk factors for deteriorated or low CD4 counts in clients testing HIV positive between 2011 and 2013. Our objective is to determine the level of CD4 count and factors associated with its levels at the time of HIV diagnosis before ART initiation. Methods: We analyzed data for 1910 persons aged 13–73 years who presented for HIV VCT at Mildmay Clinic between January 2011 and October 2013. These persons were counselled, interviewed, and tested for HIV. The clinic staff did the CD4 count test for persons who tested HIV positive. We computed proportions (univariate analysis), crude risk ratios by cross tabulations (bivariate analysis), and adjusted risk ratios (multivariate logistic regression) to determine risk factors for low CD4 count. Results: We identified 1910 subjects who were HIV positive, with CD4 test results and ARV naive; 660 (34.6%) were males and 1250 (65.4%) females. All the subjects reported to be Ugandans aged between 13 and 73 years; 647 (33.9%) lived in Kampala district, 1093 (57.2%) lived in Wakiso district, while 170 (8.9%) lived in other districts. First time testers were 716 (37.5%) while those who had ever tested before were 1194 (62.5%). Persons who had never tested for HIV and for CD4 count were more likely to have higher CD4 count above 200 cells/mm3 (AOR 0.65, 95% CI = 0.43-0.89). Older persons above 50 years were less likely to have deteriorated CD4 counts (AOR =0.29, 95% CI = 0.12-0.72). Conclusion: Persons who tested for HIV and for CD4 count for the first time had higher CD4 counts compared to those who had ever tested before, probably because those who had tested earlier did not promptly start ARV use for various reasons. Between 2011 and 2013 when the Mildmay study was done, the Test and Treat policy was not yet adopted and so many people who tested HIV positive were not immediately initiated on ART. Youthful persons under 49 years were more likely to have low CD4 count compared to persons above 50 years. This is probably because the younger persons were not immediately started on ART or that they cared less about their health. |
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