Moffat Nyirenda
Dados Biográficos
| ID | 5497337 |
|---|---|
| NOME | Moffat Nyirenda |
| PRENOMES | Moffat |
| SOBRENOME | Nyirenda |
| ASSINATURA | NYIRENDA M |
| AFILIAÇÕES | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0003-2120-4806 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 23 |
| TOTAL DE CITAÇÕES | 8 |
| TOTAL COMO AUTOR | 23 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2012 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 2 |
Barriers and facilitators to tele-support psychotherapy versus standard in-person mental health services for youth (15–30 Years) with depression in Kampala District, Uganda
Depression remains a critical mental health challenge among young people in low-resource settings, where financial, structural, and social barriers frequently limit care access. Digital approaches, including Tele-Support Psychotherapy (TSP), have emerged as promising, scalable alternatives to Standard in-person Mental Health Services (SMHS), yet evidence comparing their implementation remains limited. This study explored facilitators and barriers…
Educational films for improving perinatal outcomes associated with gestational diabetes in Uganda and India
INTRODUCTION: Gestational diabetes mellitus (GDM) is associated with a high risk of adverse perinatal outcomes. We evaluated whether a film-based educational intervention for pregnant women and healthcare providers to improve timely detection and management of GDM could reduce the incidence of adverse perinatal outcomes. METHODS: Two parallel-group cluster randomised trials were conducted in Uganda and India. A package of 7 interconnected cultura…
The contribution of maternal glucose to birth weight is smaller in Uganda (sub-Saharan Africa) than in Afro-Caribbean or white ethnicity mother–child pairs from outside Africa
INTRODUCTION: Glucose is a major determinant of fetal growth, but its relative contribution in different ethnic groups or populations is not fully understood. The Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study established a relationship between glucose and birth weight in multiple ethnic groups. However, the HAPO Study did not include any cohorts from sub-Saharan Africa (SSA), where 17% of the world population lives. This study aims to…
Prevalence and factors associated with mental health challenges among adolescents with HIV and viral non-suppression in rural northern Uganda
Introduction Adolescents living with HIV (ALWH) face significant mental health challenges, such as depression and anxiety, which negatively impact their HIV treatment outcomes. This study investigated the prevalence and factors associated with mental health challenges among adolescents with unsuppressed viral loads in Northern Uganda. Methods In 2021, 121 dyads of caregivers and ALWH (10 to 18 years) with unsuppressed viral loads were recruited f…
Estimated cost-savings from integrated care for HIV, diabetes and hypertension in sub-Saharan Africa
Background In a cluster-randomised trial in Uganda and Tanzania, we showed that integrated management, compared with standard vertical care, could achieve a high standard of care for diabetes and hypertension without adversely affecting outcomes for HIV. However, evidence on the value for money of integrated care is needed to inform policy.Objective Our economic evaluation aimed to establish the value for money of integrated care compared with ve…
Worldwide trends in underweight and obesity from 1990 to 2022
BACKGROUND: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS: ). For school-aged children and adolescents, we report thinness (BMI 2 SD above the median). FINDINGS: From 1990 to 20…
Kangaroo mother care prior to clinical stabilisation
Kangaroo mother care (KMC) is an evidence-based method to improve newborn survival. However, scale-up even for stable newborns has been slow, with reported barriers to implementation. We examined facilitators and barriers to initiating KMC before stabilisation amongst neonates recruited to the OMWaNA study in Uganda. The OMWaNA study was a randomised controlled trial that examined the mortality effect of KMC prior to stabilisation amongst newborn…
Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda
Purpose This study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda. Methods Participants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Par…
Waist circumference and glycaemia are strong predictors of progression to diabetes in individuals with prediabetes in sub-Saharan Africa
Sub-Saharan Africa is projected to have the highest increase in the number of people with diabetes worldwide. However, the drivers of diabetes in this region have not been clearly elucidated. The aim of this study was to evaluate the incidence of diabetes and the predictors of progression in a population-based cohort with impaired fasting glucose (IFG) in Malawi. We used data from an extensive rural and urban non-communicable disease survey. One …
Tools for assessing child and adolescent stunting
Stunting affects 149 million children worldwide and is a form of chronic malnutrition defined by low height-for-age. Surveys and intervention programmes depend on effective assessment and identification of affected individuals. Gold standard assessment is based on height-for-age Z-score (HAZ): HAZ
Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa
Evidence on the benefits of integrated care remains limited. More robust evidence will be essential to guide scale-up beyond research sites
Associations between low HDL, sex and cardiovascular risk markers are substantially different in sub-Saharan Africa and the UK
INTRODUCTION: Low high-density lipoprotein (HDL) is widely used as a marker of cardiovascular disease risk, although this relationship is not causal and is likely mediated through associations with other risk factors. Low HDL is extremely common in sub-Saharan African populations, and this has often been interpreted to indicate that these populations will have increased cardiovascular risk. We aimed to determine whether the association between HD…
Digital messaging to support control for type 2 diabetes (StAR2D)
Trial registration: ISRCTN, ISRCTN70768808. Registered 1 July 2015, http://www.isrctn.com/I ISRCTN70768808
Understanding kidney disease in rural central Uganda – Findings from a qualitative study
As part of a multicentre study on kidney disease (ARK) undertaken in Malawi, South Africa and Uganda we undertook a social science component in Uganda to gather information on people's understandings and perceptions of a diagnosis of kidney dysfunction, treatment and treatment seeking. We recruited 46 people who had been given information about kidney dysfunction and had been found to have some, usually early, signs of mild impairment. Data were …
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3–6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean B…
Brain MRI and cognitive function seven years after surviving an episode of severe acute malnutrition in a cohort of Malawian children
Objective To assess differences in cognition functions and gross brain structure in children seven years after an episode of severe acute malnutrition (SAM), compared with other Malawian children. Design Prospective longitudinal cohort assessing school grade achieved and results of five computer-based (CANTAB) tests, covering three cognitive domains. A subset underwent brain MRI scans which were reviewed using a standardized checklist of gross ab…
Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations
Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critica…
Evaluating a complex research capacity-building intervention
There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article s…
Reliability of reporting of HIV status and antiretroviral therapy usage during verbal autopsies
OBJECTIVE: Verbal autopsies (VAs) are interviews with a relative or friend of the deceased; VAs are a technique used in surveillance sites in many countries with incomplete death certification. The goal of this study was to assess the accuracy and validity of data on HIV status and antiretroviral therapy (ART) usage reported in VAs and their influence on physician attribution of cause of death. DESIGN: This was a prospective cohort study. METHODS…
The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care
Among patients in HIV care 26.6% had hypertension and/or diabetes. Close to two-thirds of hypertension diagnoses was stage I and of those few had an indication for antihypertensive pharmacotherapy. According to our criteria, 13.0% of HIV patients in care required drug treatment for hypertension and/or diabetes
Patterns and risk factors for deaths from external causes in rural Malawi over 10 years
The high proportion of alcohol-related deaths in men, the predominance of drowning, deaths linked to uncontrolled epilepsy, and the possible protective effect of school attendance suggest areas for intervention
Adult non-communicable disease mortality in Africa and Asia
BACKGROUND: Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among muc…
Data Resource Profile
Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russ…
Evaluating a complex research capacity-building intervention
There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article s…
Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa
Evidence on the benefits of integrated care remains limited. More robust evidence will be essential to guide scale-up beyond research sites
Data Resource Profile
Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russ…
Adult non-communicable disease mortality in Africa and Asia
BACKGROUND: Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among muc…
Patterns and risk factors for deaths from external causes in rural Malawi over 10 years
The high proportion of alcohol-related deaths in men, the predominance of drowning, deaths linked to uncontrolled epilepsy, and the possible protective effect of school attendance suggest areas for intervention
Reliability of reporting of HIV status and antiretroviral therapy usage during verbal autopsies
OBJECTIVE: Verbal autopsies (VAs) are interviews with a relative or friend of the deceased; VAs are a technique used in surveillance sites in many countries with incomplete death certification. The goal of this study was to assess the accuracy and validity of data on HIV status and antiretroviral therapy (ART) usage reported in VAs and their influence on physician attribution of cause of death. DESIGN: This was a prospective cohort study. METHODS…
The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care
Among patients in HIV care 26.6% had hypertension and/or diabetes. Close to two-thirds of hypertension diagnoses was stage I and of those few had an indication for antihypertensive pharmacotherapy. According to our criteria, 13.0% of HIV patients in care required drug treatment for hypertension and/or diabetes
Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations
Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critica…
Evaluating a complex research capacity-building intervention
There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article s…
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3–6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean B…
Brain MRI and cognitive function seven years after surviving an episode of severe acute malnutrition in a cohort of Malawian children
Objective To assess differences in cognition functions and gross brain structure in children seven years after an episode of severe acute malnutrition (SAM), compared with other Malawian children. Design Prospective longitudinal cohort assessing school grade achieved and results of five computer-based (CANTAB) tests, covering three cognitive domains. A subset underwent brain MRI scans which were reviewed using a standardized checklist of gross ab…
Understanding kidney disease in rural central Uganda – Findings from a qualitative study
As part of a multicentre study on kidney disease (ARK) undertaken in Malawi, South Africa and Uganda we undertook a social science component in Uganda to gather information on people's understandings and perceptions of a diagnosis of kidney dysfunction, treatment and treatment seeking. We recruited 46 people who had been given information about kidney dysfunction and had been found to have some, usually early, signs of mild impairment. Data were …
Associations between low HDL, sex and cardiovascular risk markers are substantially different in sub-Saharan Africa and the UK
INTRODUCTION: Low high-density lipoprotein (HDL) is widely used as a marker of cardiovascular disease risk, although this relationship is not causal and is likely mediated through associations with other risk factors. Low HDL is extremely common in sub-Saharan African populations, and this has often been interpreted to indicate that these populations will have increased cardiovascular risk. We aimed to determine whether the association between HD…
Digital messaging to support control for type 2 diabetes (StAR2D)
Trial registration: ISRCTN, ISRCTN70768808. Registered 1 July 2015, http://www.isrctn.com/I ISRCTN70768808
Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda
Purpose This study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda. Methods Participants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Par…
Waist circumference and glycaemia are strong predictors of progression to diabetes in individuals with prediabetes in sub-Saharan Africa
Sub-Saharan Africa is projected to have the highest increase in the number of people with diabetes worldwide. However, the drivers of diabetes in this region have not been clearly elucidated. The aim of this study was to evaluate the incidence of diabetes and the predictors of progression in a population-based cohort with impaired fasting glucose (IFG) in Malawi. We used data from an extensive rural and urban non-communicable disease survey. One …
Tools for assessing child and adolescent stunting
Stunting affects 149 million children worldwide and is a form of chronic malnutrition defined by low height-for-age. Surveys and intervention programmes depend on effective assessment and identification of affected individuals. Gold standard assessment is based on height-for-age Z-score (HAZ): HAZ
Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa
Evidence on the benefits of integrated care remains limited. More robust evidence will be essential to guide scale-up beyond research sites
Worldwide trends in underweight and obesity from 1990 to 2022
BACKGROUND: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS: ). For school-aged children and adolescents, we report thinness (BMI 2 SD above the median). FINDINGS: From 1990 to 20…
Kangaroo mother care prior to clinical stabilisation
Kangaroo mother care (KMC) is an evidence-based method to improve newborn survival. However, scale-up even for stable newborns has been slow, with reported barriers to implementation. We examined facilitators and barriers to initiating KMC before stabilisation amongst neonates recruited to the OMWaNA study in Uganda. The OMWaNA study was a randomised controlled trial that examined the mortality effect of KMC prior to stabilisation amongst newborn…
Prevalence and factors associated with mental health challenges among adolescents with HIV and viral non-suppression in rural northern Uganda
Introduction Adolescents living with HIV (ALWH) face significant mental health challenges, such as depression and anxiety, which negatively impact their HIV treatment outcomes. This study investigated the prevalence and factors associated with mental health challenges among adolescents with unsuppressed viral loads in Northern Uganda. Methods In 2021, 121 dyads of caregivers and ALWH (10 to 18 years) with unsuppressed viral loads were recruited f…
Estimated cost-savings from integrated care for HIV, diabetes and hypertension in sub-Saharan Africa
Background In a cluster-randomised trial in Uganda and Tanzania, we showed that integrated management, compared with standard vertical care, could achieve a high standard of care for diabetes and hypertension without adversely affecting outcomes for HIV. However, evidence on the value for money of integrated care is needed to inform policy.Objective Our economic evaluation aimed to establish the value for money of integrated care compared with ve…
Barriers and facilitators to tele-support psychotherapy versus standard in-person mental health services for youth (15–30 Years) with depression in Kampala District, Uganda
Depression remains a critical mental health challenge among young people in low-resource settings, where financial, structural, and social barriers frequently limit care access. Digital approaches, including Tele-Support Psychotherapy (TSP), have emerged as promising, scalable alternatives to Standard in-person Mental Health Services (SMHS), yet evidence comparing their implementation remains limited. This study explored facilitators and barriers…
Educational films for improving perinatal outcomes associated with gestational diabetes in Uganda and India
INTRODUCTION: Gestational diabetes mellitus (GDM) is associated with a high risk of adverse perinatal outcomes. We evaluated whether a film-based educational intervention for pregnant women and healthcare providers to improve timely detection and management of GDM could reduce the incidence of adverse perinatal outcomes. METHODS: Two parallel-group cluster randomised trials were conducted in Uganda and India. A package of 7 interconnected cultura…
The contribution of maternal glucose to birth weight is smaller in Uganda (sub-Saharan Africa) than in Afro-Caribbean or white ethnicity mother–child pairs from outside Africa
INTRODUCTION: Glucose is a major determinant of fetal growth, but its relative contribution in different ethnic groups or populations is not fully understood. The Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study established a relationship between glucose and birth weight in multiple ethnic groups. However, the HAPO Study did not include any cohorts from sub-Saharan Africa (SSA), where 17% of the world population lives. This study aims to…
Medicine (19 obras) · Environmental health (12 obras) · Internal Medicine (10 obras) · Population (10 obras) · Demography (9 obras) · Disease (5 obras) · Family medicine (5 obras) · Health care (5 obras) · HIV/AIDS Research and Interventions (5 obras) · Nursing (5 obras)