Browsing by Author "Mwambi, Bashir"

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Assessment of the diagnostic performance of TrueHb ® point-of-care hemometer compared with Sysmex i3 analyzer among patients at International Hospital Kampala, Uganda
(Dove Press, 2019-04-01) Taremwa, Ivan Mugisha; Ndeze, Ivan; Mwambi, Bashir; Atuhairwe, Christine; Achieng, Diana Inda; Natukunda, Bernard
Aim/Objective: To assess the diagnostic performance of TrueHb ® point-of-care (POC) hemometer compared with Sysmex i3 analyzer at International Hospital Kampala, Uganda. Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb ® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17–40.38). The mean difference of the TrueHb ® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095–0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161–2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb ® hemometer was 2.46 mins (95% CI: 2.37–2.55). Conclusion: TrueHb ® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.
Common uropathogens among diabetic patients with urinary tract infection at Jinja Regional Referral Hospital, Uganda
(Afr J Lab Med, 2018-02-09) Nabaigwa, Barbara I; Mwambi, Bashir; Okiria, John; Oyet, Caesar
Between June 2015 and October 2015, 159 mid-stream urine samples from diabetic patients were cultured. The prevalence of urinary tract infection was high at 22% and women were more affected compared with men (P = 0.017). Factors associated with urinary tract infection in these patients were age, sex and high blood glucose levels. Diabetic patients should be screened periodically for urinary tract infection.
Haematological Parameters of Pregnant Women Attending Antenatal Care at Nakaseke Hospital, Central Uganda
(cient periodique, 2018-12-03) Kyakulaga, Philip; Mwambi, Bashir; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Introduction Establishment of haematological ranges is key to laboratory diagnoses and management of pregnancy-related complications. The parameters to a large extent ought to be population-based, never the less, there are limited studies on the reference ranges of pregnant women for the local population. This study reports on the haematological parameters of pregnant women attending antenatal care at Nakaseke Hospital, central Uganda. Materials and Methods A cross-sectional study involving pregnant women was conducted from the month of May to August 2018. Ethylene diamine tetraacetic acid (EDTA) venous blood samples were collected and a full blood count (FBC) was run. Data for the haematological parameters was presented in tabular form as mean ± SD in reference to 95% reference intervals. Results One hundred and thirty-five adult (18 years, and above) consented pregnant women were enrolled. The red blood cells (RBCs) counts and haemoglobin concentration showed a gradual decrease during the first two trimesters and a slight increase during the third trimester. There was no significant change in MCV. The white blood cells (WBCs) did not show a significant change in the total count from the first to the second trimesters, and there was a significant rise during the third trimester. The granulocytes were affected by the increase in numbers. Platelet count decreased during the first to the third trimesters. Conclusion This study has explored a variance in the haematological parameters. This necessitates incorporation of specific reference ranges for clinical care and management of gestational disorders.
Hematological abnormalities in HIV-antiretroviral therapy naïve clients as seen at an immune suppression syndrome clinic at Mbarara Regional Referral Hospital, southwestern Uganda
(Dove Press, 2018-06-27) Katemba, Crispus; Muzoora, Conrad; Muwanguzi, Enoch; Mwambi, Bashir; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Aim/objective: To assess the common hematological abnormalities among HIV-antiretroviral therapy (ART) naïve clients attending an immune suppression syndrome (ISS) clinic at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Patients and methods: This was a cross-sectional study carried out during the months of March to August 2016 at the ISS clinic of MRRH. We collected approximately 4.0 mL of EDTA anticoagulated blood samples, which were assayed for complete blood count, CD4+ cell count and thin-film examination. Correlation of the hematological abnormalities with CD4+ cell counts was done using correlation coefficient (r) and analysis of variance (F ), and the p-value was set at ≤0.05. Results: A total of 141 clients were enrolled. Of these, 67.38% (95/141) were anemic, 26.24% (40/141) had thrombocytopenia while 26.95% (38/141) had leucopenia. Of the 95 participants with anemia, 89.47% (85/95) presented with normocytic-normochromic anemia, 8.42% (8/95) with microcytic-hypochromic anemia and 2.11% (2/95) with macrocytic-hypochromic anemia. Anemia was not different across the several World Health Organization (WHO) stages of HIV infection disease progression (p>0.05). Statistically significant differences were present among participants with leucopenia (p<0.05). Also, leucopenia was more prevalent (11/38) among participants in WHO stage 4 of HIV infection. CD4+ cell counts correlated with thrombocytopenia (r=0.24, p<0.05) and leucopenia (r=0.15, p<0.05). Conclusion: People living with HIV/AIDS (PLWHIV/AIDS) ought to be routinely monitored and treated for the occurrence of hematological abnormalities. Early initiation of ART can help to prevent some hematological abnormalities.
Knowledge, perception and practices towards sickle cell disease:
(BMC Public Health, 2018) Tusuubira, Sharifu K; Nakayinga, Ritah; Mwambi, Bashir; Odda, John; Kiconco, Sylvia; Komuhangi, Alimah
Background: Worldwide, the burden of Sickle Cell Disease (SCD) has not been amply addressed. In Africa, Uganda has the 5th highest burden, a situation aggravated by limited and inaccessible formal social support structures to aid patients and families cope better with the psychosocial burden of SCD. In addition, this has been coupled with stigmatization and discrimination of people living with sickle cell disease-causing isolation from family and society. Method: This cross-sectional study, therefore, set out to determine the attitudes, perception and level of awareness towards Sickle Cell disease in Ugandan communities. The study used an interviewer administered questionnaires to collect the data. Results: Out of 110 people sampled; 91.2% of the respondents had ever heard of SCD with the highest proportion 38.7% hearing of SCD from friends and family. Close to half of the respondents 48% knew that SCD is inherited, however a large proportion 44.2% did not know the cause of SCD. However, 68.7% of the respondents said they cannot marry a person with SCD. Conclusion: The study results indicate that more effort needs to be done to promote sickle cell awareness in Uganda communities with an emphasis on the inclusion of sickle cell in health education campaigns.
Laboratory assessment of SD Bioline HIV/ Syphilis Duo Kit among pregnant women attending antenatal clinic Mayuge Health Center III, East central Uganda
(BMC Research Notes, 2019-04-25) Taremwa, Ivan Mugisha; Twelwanike, Alupakusadi; Mwambi, Bashir; Atuhairwe, Christine
Objective: Efforts to dual eradication of mother-to-child transmission of human immune deficiency virus (HIV) and syphilis have improved in the previous decades. This has however been hindered by limited validation studies. A cross-sectional study was conducted among adult pregnant women attending antenatal care clinic at Mayuge Health Center III. Two milliliters of venous blood were collected into Ethylene di-amine tetra acetic acid vacutainers and tested for HIV and syphilis using the SD Bioline HIV/Syphilis Duo assay, and the national HIV and syphilis testing algorithm. Sensitivity and specificity were calculated for the Duo Kit against the gold standards within 95% confidence intervals. Results: Three hundred and eighty-two (382) participants were enrolled. Their mean age was 25.8 years. The prevalence of HIV was 1.8% (95% confidence interval 1.23–2.41); while that of syphilis was 2.1% (95% confidence interval 1.81–2.54), and the dual infection was 0.52% (95% confidence interval 0.37–0.92). The sensitivity and specificity of the SD Bioline HIV/Syphilis Duo assay were all 100.0% (95% confidence interval 99.5 to 100.0 and 98.6 to 100.0, respectively). The performance of the SD Bioline HIV/Syphilis Duo Kit was optimal, reassuring its aptness for use, and favourable qualities to a limited resource setting.
Microbial contaminants isolated from itemsand work surfaces in the post- operativeward at Kawolo general hospital, Uganda
(Bio Med Central, 2018-02-06) Sserwadda, Ivan; Lukenge, Mathew; Mwambi, Bashir; Mboowa, Gerald; Walusimbi, Apollo; Segujja, Farouk
Background: Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the transmission of such organisms have inevitably contributed to the elevated mortality, morbidity and antibiotic resistances. Methods: A total of 138 samples were collected during the study from Kawolo general hospital. Swab samples were collected from various work surfaces and fomites which consisted of; beds, sink taps, infusion stands, switches, worktables and scissors. Cultures were done and the susceptibility patterns of the isolates were determined using Kirby-Bauer disc diffusion method. Data was analyzed using Stata 13 and Microsoft Excel 2013 packages. Results: A total of 44.2% (61/138) of the collected swab specimens represented the overall bacterial contamination of the sampled articles. Staphylococcus aureus and Klebsiella pneumonia accounted for the highest bacterial contaminants constituting of 75.4% (46/61) and 11.5% (7/61) respectively. Infusion stands and patient beds were found to have the highest bacterial contamination levels both constituting 19.67% (12/61). The highest degree of transmission of organisms to patients was found to be statistically significant for patient beds with OR: 20.1 and p-value8X10−4.Vancomycin, ceftriaxone and ciprofloxacin were the most effective antibiotics with 100%, 80% and 80% sensitivity patterns among the isolates respectively. Multi-drug resistant (MDR)Staphylococcus aureus accounted for 52% (24/46)with 4% (1/24) classified as a possible extensively drug-resistant (XDR) whereas Gram-negative isolates had 27% (4/15)MDR strains out of which 50%(2/4) were classified as possible pan-drug resistant (PDR).Conclusion:The high prevalence of bacterial contaminants in the hospital work environment is an indicator of poor orineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re-examine the effectiveness of decontamination and sterilization practices within Kawolo general hospital. We also recommend the installation of a sound Microbiology unit at the hospital to take on susceptibility testing to check on the empirical use of antibiotics as a way of reducing the rampant elevations in drug resistance.
Prevalence and Factors Associated with Intestinal Candidiasis among HIV Infected Clients Attending Anti-retroviral Therapy Clinic at Kisoro District Hospital, Western Uganda
(SCIENCEDOMAIN international (SDI), 2018) Bamanya, Sharon; Mubiru, Martha Nakaye; Mwambi, Bashir; Mucungunzi, Justus; Hersi, Dahir Ali; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Aim: To determine the prevalence and associated factors of intestinal candidiasis among people living with human immune deficiency virus (PLWHIV) attending Kisoro district Hospital in Western Uganda. Study Design: This was a cross-sectional study. Place and Duration of Study: This was conducted in the anti-retroviral therapy (ART) clinic at Kisoro District Hospital (KDH) from May 2016 to June 2017. Methodology: The study analyzed fresh stool and ethylene di-amine tetra acetic acid venous blood specimens from 148 HIV seropositive adult participants. Stool samples were microscopically examined as wet preparation and cultured on Sabouraud dextrose agar for isolation and identification of fungal pathogens. Blood was used to assay their CD 4 +, cell counts. Data were analyzed and presented as proportions. Results: The prevalence of intestinal candidiasis was 62.84%. It was highest among participants with CD 4 + cells below 250/μL, and more among male participants 75% (36/48).
Prevalence of Anemia and Its Associated Socio-Demographic Factors Among Pregnant Women Attending an Antenatal Care Clinic at Kisugu Health Center IV, Makindye Division, Kampala, Uganda
(Dovepress, 2020) Mahamoud, Naimo Khalif; Mwambi, Bashir; Oyet, Caesar; Segujja, Farouk; Webbo, Fred; Okiria, John Charles; Taremwa, Ivan Mugisha
Aims/Objectives: This study sought to determine the prevalence, morphological character- ization and associated socio-demographic factors of anemia among pregnant women attend- ing Kisugu Health Centre IV, Makindye Division, Kampala, in Uganda. Methods: This was a cross-sectional study that employed laboratory analysis of blood samples to determine hemoglobin concentration, and a structured questionnaire to obtain socio-demographic factors associated with anemia during pregnancy. Results: We enrolled 345 pregnant women aged 15 to 43 years. The median, interquartile range, and mean Hb levels were 8.1g/dL, 6.4 ± 2.1g/dL and 7.9g/dL, respectively. There were 89 participants whose Hb levels were indicative of anemia, giving anemia prevalence of 25.8% (95% confidence interval: 21.6–29.8). Of these, 25 (28.1%) had mild anemia, 46 (51.7%) had moderate anemia, while 18 (20.2%) had severe anemia. Thin blood film examination showed normocytic-hypochromic (75.3%), then microcytic-hypochromic (21.6%), and macrocytic- hypochromic red blood cells (3.4%). The socio-demographic factors of gestational age, parity, and mother’s occupation were significantly associated with the risk of anemia (p< 0.05). Conclusion: We report a high prevalence of anemia among pregnant women; with a majority of hypochromic-microcytic anemia. This may necessitate more anemia awareness and it requires institution of nutritional interventions to avert fetal-maternal complications
Prevalence, morphological characterization, and associated factors of anemia among children below 5 years of age attending St. Mary’s Hospital Lacor, Gulu District, Northern Uganda
(Dove Press, 2018-10-30) Ocan, Apollo; Oyet, Caesar; Webbo, Fred; Mwambi, Bashir; Taremwa, Ivan Mugisha
Aim/objective: The aim of this study was to determine the prevalence, severity, morphological characterization, and the associated factors of anemia among children under the age of 5 years at St. Mary’s Hospital Lacor, Gulu District, Northern Uganda. Materials and methods: A structured questionnaire was administered to each participant’s parent/caregiver to collect data on sociodemographic factors, feeding pattern, and history of chronic illness. Hemoglobin (Hb) estimation was performed using a HemoCue 201 + analyzer. Peripheral thin and thick blood films were made from venous blood and stained with Giemsa to morphologically characterize red blood cells (RBCs) and investigate hemoparasites, respectively. We collected and examined stool specimens from each participant using wet preparations and formol–ether concentration technique for intestinal parasites. Descriptive statistics was used to describe study participants and to determine the prevalence of anemia. Logistic regression analysis was done to determine the factors associated with acquiring anemia at a P-value≤ 0.05. Results: The study enrolled 343 children below the age of 5 years. Of these, 62.7% (N=215) were females. The IQR, median, and mean Hb levels were 5.1±3.2 g/dL, 8.2 g/dL, and 7.9 g/dL, respectively. Overall, 160 (46.6%, 95% CI: 42.1–51.46) children had anemia. The magnitude of severe, moderate, and mild anemia was 11.9%, 58.8%, and 29.4%, respectively. Morphologic characterization of anemia revealed hypochromic-microcytic (65.4%, N=106), hypochromic- macrocytic (15.4%, N=25), and normochromic-microcytic (19.1%, N=31) anemia. Factors associated with anemia were parasitic infestation, history of chronic disease, lack of complementary foods, complementary feeding for not more than twice a month, and households’ with annual income less than 200,000 Ugandan Shillings. Conclusion: We report the high prevalence of anemia among children below 5 years of age in Gulu District, Northern Uganda. Thus, strategies geared at addressing the etiologic causes (such as nutrient deficiency and parasitic infections) are key to reduce it in the region.
To test or not: occurrence of sickle cell trait and assessment of the awareness toward its screening among patients attending Magale Health Center IV, Namisindwa District, Eastern Uganda
(Dove Press, 2018-11-21) Mandu, Keneth; Tusuubira, Sharifu K; Mwambi, Bashir; Webbo, Fred; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Purpose: To evaluate the occurrence of sickle cell trait (SCT), assess patient awareness and evaluate the performance of a sickle cell hemoglobin-S (dithionate-qualitative solubility) point- of-care test among patients seeking care at Magale Health Center IV, Namisindwa District, Eastern Uganda. Materials and methods: We conducted a cross-sectional study, in which we consecutively enrolled participants aged ≥18 years at Magale Health Center IV. Four millilitres of EDTA blood were collected by venipuncture and screened for SCT using solubility testing, and confirmed with hemoglobin (Hb) electrophoresis at Central Public Health Laboratory (CPHL), Kampala, Uganda. A structured questionnaire was used to assess participants’ awareness of SCT. Data were presented as proportion, and measurements of diagnostic test performance were calculated. Results: We enrolled 242 participants, of these 58.7% (N = 142) were females. Their mean age was 26.4 years (range 18–49). Of the 242 participants, 11, who represent 4.5% (95% CI: 3.3–5.9), tested positive. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid sickle cell test were 63.64%, 100%, 100% and 98.30%, respectively. There was a knowledge gap regarding sickle cell awareness. Conclusion: The occurrence of SCT was high, and the point-of-care test showed high diagnostic reliability. The risk of SCT is associated with genetic predisposition as indicated by Hb electrophoresis. Community sensitization is key to avert the associated risk of Hb defects.