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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).
The effect of knowledge on uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda
(NCBI, 2018) Atuhairwe, Christine; Amongin, Dinah; Agaba, Elly; Mugarura, Steven; Taremwa, Ivan Mugisha
Background: Breast cancer, the third most frequent cancer of women is preventable through knowledge of breast self-examination. Of the 44% of women diagnosed with breast cancer at the Uganda Cancer Institute, only 22% go for a check-up in less than three months. This study explored the effect of breast cancer knowledge on the uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda. Methods: A household survey of women in Kyadondo County was conducted from June 2014 to August 2015. This involved studying in-depth using a questionnaire the level of breast cancer knowledge of the respondents. Data was analyzed using logistic regression model. Chi-square test was used to establish relationships between knowledge base factors and the uptake of breast cancer prevention modalities. Results: This study has established an empirical relationship between uptake of breast cancer prevention modalities and source of information especially radio (OR 1.94 95% CI: 1.16–3.24), television (OR 1.82 95%CI: 1.14–2.93), awareness of breast cancer (OR 4.03 95%CI: 1.01–15.98), knowledge on how to reduce the risk of breast cancer (OR 1.98 95% CI: 1.20–3.27), what reduces breast cancer acquisition (OR 2.75 95% CI: 1.42–5.35), how to check for signs of breast cancer especially through breast self-examination (OR 3.09 95% CI: 1.62–5.88), and other methods of breast cancer diagnosis in a health care set up. Conclusion: The women’s level of breast cancer awareness as a primary prevention strategy was found wanting, and requires a boost through community health education.
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.
Agony resulting from cultural practices of canine bud extraction among children under five years in selected slums of Makindye:
(BMC Oral health, 2018) Atim, Fiona; Nagaddya, Teddy; Nakaggwa, Florence; Mboowa, Mary Gorrethy N; Kirabira, Peter; Okiria, John Charles
Background: Canine Bud Extraction (CBE) is a process of removing or gouging children’s healthy canine tooth buds embedded underneath the gum using traditional unsterilized tools. The practice of CBE commonly known as false teeth removal continues to be an adopted cultural intervention of choice, in the prevention of morbidity and mortality from common childhood illnesses. However, it is a practice against the rights of children with serious consequences. While CBE is associated with the perceived myth of curative gains, the agony emanating from the cultural practice exposes children to ill-health conditions such as dehydration, malnutrition, blood-borne diseases like HIV/AIDs, septicemia, fever and death. This research sought to understand the factors underpinning the practice of CBE among urban slum dwellers. Method: A cross-sectional study was conducted from five randomly selected slums in Makindye division; 298 household heads or guardians with children below 5 years, who had ever suffered from false teeth were interviewed. The variables measured included guardians’ socio-demographic profiles, determinants of CBE, common childhood illnesses assumed to be treated with CBE and the reported side-effects associated with the practice. Results: Of the 298 respondents with children who had ever suffered from “false teeth” interviewed, 56.7% had two or more children below 5 years and 31.9% were from the central region. The proportion of households practicing CBE was 90.3%; 69.8% of the caretakers mentioned that it was done by traditional healers and for 12.1% by trained health workers (dentists). Number of children (OR = 2.8, 95% CI: 1.1–7.2) and the belief that CBE is bad (OR = 0.1, 95% CI: < 0.001, p < 0.001) had a statistically significant association with CBE. Additionally, number of children (χ2 = 4.9, p = 0.027) and 2 sets of beliefs (CBE treats diarrhea (χ2 = 12.8, p = 0.0017) and CBE treats fever (χ2 = 15.1, p = 0.0005) were independent predictors of CBE practice. A total of 55.7% respondents knew that there were side effects to CBE and 31% mentioned death as one of them. Conclusion: The high proportion of households practicing CBE from this study ought to awaken the perception that the practice is ancient. CBE in this community as the study suggests was strongly driven by myths. The strong belief that CBE is bad provides an opportunity for concerted effort by primary health care providers, policymakers and the community to demystify the myths associated with false teeth and the gains of CBE.
Socio-Ecological model factors influencing fruit and vegetable consumption among adolescents in Nakawa division, Kampala Capital City Authority, Uganda
(open access text, 2018-01-02) Nagawa, Margaret; Kirabira, Peter; Atuhairwe, Christine; Taremwa, Ivan Mugisha
There is ample evidence to assert the benefits of fruits and vegetable (F&V ) consumption towards health promotion and chronic disease prevention. Despite this, most of the population does not meet the recommendations of consumption. This study assessed the factors that influence fruits and vegetable consumption using a socio ecological model among adolescents in Nakawa division, Kampala Capital City Authority in Uganda. A cross-sectional study was conducted on 301 adolescents, using an interviewer-administered questionnaire. Data was analyzed using SPSS and presented as tables. Statistical significance was considered for variables with p values less than 0.05. While 282 (93.7%) of the respondents regarded it vital to eat fruits and vegetables, only 47.2% ate them weekly, 23.6% bi-weekly and 24.6% after every fortnight; with bananas as the most (52.5%). Consumption of fruits and vegetables was significantly associated with variables of type of school attended, attitude, discussion of community gatherings and lack of religious taboos. Interventions ought to be multi-sectorial to promote fruits and vegetable intake such as health education. Also, increased fruit and vegetable production is desired to augment their uptake as a daily meal serving.
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.
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.
Assessment of Pneumococcal Conjugate Vaccination on Nasopharyngeal Pneumococcal Carriage:
(SCIENCEDOMAIN international (SDI), 2018-03-21) Onyango, Bournventure; Angurini, Kabaka; Taremwa, Ivan Mugisha
Aims: To determine the nasopharyngeal carriage of Streptococcus pnuemoniae among children under-5 years of age who have been vaccinated with Pneumococcal Conjugate Vaccine (PCV-10) and those unvaccinated in Mbale Municipality, Eastern Uganda. Study Design: This was a cross-sectional study. Place and Duration of Study: The study was conducted in Mbale Municipality Health Centres, Eastern Uganda during the period of September 2015 and June 2016.Methodology: We enrolled 280 children (140 vaccinated with PCV 10 and 140 unvaccinated). Demographic data were obtained from the caregivers and vaccination status from the caregiver and the vaccination card. Nasopharyngeal swabs were tested for Streptococcus pneumonia at least four weeks post-immunization. Pneumococcal carriage was defined by a positive culture, with identification of Streptococcus pnuemoniae. Results: The overall prevalence of Streptococcus pnuemoniae carriage was 123 of280 (43.93%; 95% Confidence interval: 39.88-47.69) with the rate among the immunized of 14.29% (95%% CI: 11.33-16.73), compared to the 78.57% (95%CI: 81.34-88.61) among the unvaccinated children. The odds ratio of pneumococcal carriage was 7.4 among the unvaccinated children compared to the PCV immunized children. Conclusion: Vaccination with PCV offers protection to the risk of pneumococcal carriage. This study emphasizes the value of monitoring for the impact of PCV vaccination program in order to reassure health care workers and families.
Retention of HIV-Positive Adolescents in Care:
(Hindawi, 2018-05-06) Izudi, Jonathan; Mugenyi, John; Mugabekazi, Mary; Muwanika, Benjamin; Tumukunde, Victor Spector; Katawera, Andrew; Kekitiinwa, Adeodata
Background. Low retention of HIV-positive adolescents in care is a major problem across HIV programs. Approximately 70% of adolescents were non-retained in care at Katooke Health Center, Mid-Western Uganda. Consequently, a quality improvement (QI) project was started to increase retention from 29.3% in May 2016 to 90% in May 2017. Methods. In May 2016, we analyzed data for retention, prioritized gaps with theme-matrix selection, analyzed root causes with fishbone diagram, developed site-specific improvement changes and prioritized with countermeasures matrix, and implemented improvement changes with Plan-Do-Study-Act (PDSA). Identified root causes were missing follow-up strategy, stigma and discrimination, difficult health facility access, and missing scheduled appointments. Interventions tested included generating a list of adolescents who missed scheduled appointments, use of mobile phone technology, and linkage of adolescents to nearest health facilities (PDSA 1), Adolescent Only Clinic (PDSA 2), and monthly meetings to address care and treatment challenges (PDSA 3). Results. Retention increased from 17 (29.3%) in May 2016 to 60 (96.7%) in August 2016 and was maintained above 90% until May 2017 (with exception of February and May 2017 recording 100% retention levels). Conclusion. Context-specific, integrated, adolescent-centred interventions implemented using QI significantly improved retention in Mid-Western Uganda.
Circumstances of child deaths in Mali and Uganda:
(Elsevier Ltd, 2018-06) Willcox, Merlin L; Kumbakumba, Elias; Diallo, Drissa; Mubangizi, Vincent; Kirabira, Peter; Nakaggwa, Florence; Mutahunga, Birungi; Diakité, Chiaka; Dembélé, Eugene; Traoré, Mamadou; Daou, Pierre; Bamba, Drissa; Traoré, Amadou; Berthé, Diafara; Wooding, Nick; Dinwoodie, Kieran; Capewell, Sarah; Foster, Hamish; Rowena, Neville; Ngonzi, Joseph; Kabakyenga, Jerome; Mant, David; Harnden, Anthony
Background Interventions to reduce child deaths in Africa have often underachieved, causing the Millennium Development Goal targets to be missed. We assessed whether a community enquiry into the circumstances of death could improve intervention effectiveness by identifying local avoidable factors and explaining implementation failures. Methods Deaths of children younger than 5 years were ascertained by community informants in two districts in Mali (762 deaths) and three districts in Uganda (442 deaths) in 2011–15. Deaths were investigated by interviewing parents and health workers. Investigation findings were reviewed by a panel of local health-care workers and community representatives, who formulated recommendations to address avoidable factors and, subsequently, oversaw their implementation. Findings At least one avoidable factor was identified in 97% (95% CI 96–98, 737 of 756) of deaths in children younger than 5 years in Mali and 95% (93–97, 389 of 409) in Uganda. Suboptimal newborn care was a factor in 76% (146 of 194) of neonatal deaths in Mali and 64% (134 of 194) in Uganda. The most frequent avoidable factor in postneonatal deaths was inadequate child protection (mainly child neglect) in Uganda (29%, 63 of 215) and malnutrition in Mali (22%, 124 of 562). 84% (618 of 736 in Mali, 328 of 391 in Uganda) of families had consulted a health-care provider for the fatal illness, but the quality of care was often inadequate. Even in official primary care clinics, danger signs were often missed (43% of cases in Mali [135 of 396], 39% in Uganda [30 of 78]), essential treatment was not given (39% in Mali [154 of 396], 35% in Uganda [27 of 78]), and patients who were seriously ill were not referred to a hospital in time (51% in Mali [202 of 396], 45% in Uganda [35 of 78]). Local recommendations focused on quality of care in health-care facilities and on community issues influencing treatment-seeking behaviour. Interpretation Local investigation and review of circumstances of death of children in sub-Saharan Africa is likely to lead to more effective interventions than simple consideration of the biomedical causes of death. This approach discerned local public health priorities and implementable solutions to address the avoidable factors identified.
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.
In Vivo Antiplasmodial Activity and Safety of the Aqueous Ethanolic Shoot Extracts of Phyllanthus amarus Schum. and Thonn
(IJPPR, 2018-06-30) Odda, J.; Waako, P; Obua, C; Kabasa, J D
Background: Monoherbal aqueous shoot extracts of Phyllanthus amarus Schum. and Thonn (Euphorbiaceae) is used in traditional medical practice in Tororo, Uganda to treat malaria fevers. Previous studies have demonstrated antibabesial, anti HIV, antibacterial, trypanosomal effects as well as antiplasmodial activity based on schizonts. However, there is hardly any study reporting the antiplasmodial activity on any part of P. amarus targeting trophozoites. Objective: To evaluate the In vivo antiplasmodial activity against trophozoites and safety of aqueous ethanolic shoot extracts of Phyllanthus amarus Schum. and Thonn. Materials and Method: Standard methods of extraction were used to obtain the crude extract as well as semi purified fraction from the study plant extract. Aqueous ethanolic shoot extracts of Phyllanthus amarus were tested for their In vivo antiplasmodial activity in Plasmodium berghei infected mice and evaluated by the standard 4- day suppressive test. Acute toxicity studies of Phyllanthus amarus was performed in at the Department of Pharmacology and Therapeutics – Makerere University College of Health Sciences using established methods. Results revealed In vivo antiplasmodial activity with good suppression activity ranging from 53.40% to 69.46%. In toxicity tests, no mice died within 24 hours of exposure to the test drug at room temperature even at 5000 mg/Kg indicating that it is nontoxic. Conclusion: Aqueous - ethanolic extract of Phyllanthus amarus shoot extract possesses useful In vivo antiplasmodial activity against trophozoites when used at doses that cause no marked toxicity in mice.
To Know and to Act:
(Austin publishing Group, 2018-07-19) Taremwa, Ivan Mugisha
Perspective for Methicillin-resistant Staphylococcus Aureus colonization, Antibiotic Susceptibility Patterns and Risk factors for Colonization among People Living with HIV at Nyenga Hospital, Buikwe District, in Central Uganda
(open access pub, 2018-07-31) Ssenyonga, Benedict; Mwebaze, Sarah; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background: Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods: We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results: We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug-resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion: These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
Prevalence and factors associated with hyperglycaemia among children under-five years of age at holy innocents childrens’ hospital, mbarara district, south-western Uganda
(open access text, 2018-08-13) Segutunga, George Friday; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background: Childhood hyperglycaemia is a critical observation because of its links to complications ranging from prolonged hospitalisation to mortality. This study reports the prevalence, clinical patterns and factors associated with hyperglycaemia among children under-five years of age at Holy Innocents Children's’ Hospital (HICH), Mbarara in south-western Uganda. Materials and methods: This was a hospital-based, cross-sectional study conducted during the period between April to July 2017. The study enrolled children under-five years attending outpatients department (OPD) whose caregivers had consented. Random blood glucose levels, height and weight of children were taken; in addition, a structured questionnaire was administered. Results: We enrolled 284 children, of whom, 40.3% (n=114) were aged between 12 to 23 months (mean age: 24.6 months, median age: 9.7 months; IQR: 5.8–46.8 months). There were 124 boys (43.7%). Thirty-nine participants were hyperglycaemic, giving a prevalence of 13.7%, (95% Confidence Interval: 8.4-18.2), with varied clinical patterns. Obese children were six times more likely to be hyperglycaemic (P=0.000). Although those who were overweight did not show statistical significance of hyperglycaemia, they were four times more at risk. Conclusion: Childhood hyperglycemia is highly prevalent in this setting, with the majority of the affected cases being unknown to both health workers and the caregivers. This impedes their medical intervention and also inclines to very poor glycaemic control. This compels the need to regularly monitor glucose levels to subside preventable deaths.
A Tool to Mitigate Denial of Service Attacks on Wired Networks
(open access Journal, 2018-09) Kyambadde, George; Ngubiri, John
Presently, several institutions share information, resources, and files over computer networks. Network environments are susceptible to various security risks including computer viruses, Trojans, and malicious malware, making networks inefficient due to exhausted bandwidth and computing resources. Ultimately, compromised networks/servers are made unavailable to legitimate users. Such a security problem is called a Denial-of-Service (DoS) attack. It is imperative to mitigate DoS attacks immediately. This study presented a tool based on a packet filtering approach, used to mitigate flooding attacks. This was an experimental study conducted in an environment similar to the production environment of the project case study. The developed prototype consists of the mitigation and tracking modules. To evaluate the responsiveness of the proposed system, its performance was compared with an Uncomplicated Firewall (ufw) (Ubuntu default firewall), we experimented with the firewall and the proposed system independently but in similar environment. Results indicated that the prototype system ably mitigated the DoS flooding attacks (UDP and ICMP flooding attacks) and also responded fairly faster than Ubuntu standard firewall .
Heavy Metal Accumulation in Maize (Zea mays L.) Grown on Chromated Copper Arsenate (CCA) Contaminated Soil Amended with Treated Composted Sewage Biosolid
(Scientific Research publishing, 2018-10) Nakiguli, C. K.; Namakula, B.; Odda, J.; Wasswa, J.; Ntambi, E.
A pot experiment was conducted to investigate the heavy metal accumulation in maize ( Zea mays L.) plant grown in chromated copper arsenate (CCA) soil amended with treated composted sewage biosolid. The initial concentrations of chromium, copper, arsenate in the CCA soil and sewage biosolid were determined by atomic absorption spectrophotometer. These were found to be, in CCA soil: 365.8 ± 6.18, 109.22 ± 14.04, 28.22 ± 3.8 and in sewage biosolid: 35 ± 1.06, 1.0 ± 0.02, 0 mg∙kg −1 respectively. The concentration of Cr, Cu and As determined in both the roots and shoots generally decreased with increase in percentage amendment concentration and number of days (20 and 40 days after planting). At 20 days, the total metal concentration ranges in roots were As (5.54 ± 0.03 - 6.69 ± 1.14), Cr (9.59 ± 0.02 - 13.22 ± 0.03), Cu (2.28 ± 0.06 - 4.53 ± 0.37) mg∙kg −1 while at 40 days the values were As (5.60 ± 0.19 - 6.08 ± 0.01), Cr (9.47 ± 0.04 - 10.95 ± 0.09), Cu (3.94 ± 0.19 - 4.64 ± 0.07) mg∙kg −1 . For the shoot system, the concentrations of the metals at 20 days were As (5.28 ± 0.03 - 5.90 ± 0.13), Cr (9.30 ± 0.05 - 10.07 ± 0.06), Cu (3.64 ± 0.12 - 4.72 ± 0.15) mg/kg while at 40 days the values obtained were As (5.28 ± 0.03 - 5.9 ± 0.13), Cr (9.69 ± 0.14 - 10.07 ± 0.03), Cu (2.94 ± 0.72 - 4.53 ± 0.03) mg∙kg −1 . The roots accumulated the three heavy metals more than the shoot system at all treatments used. Concentration of arsenic, chromium and copper in the plants decreased with increasing percentage amendments. The results suggest relatively low bioavailability of the three metals in CCA soil treated with high percentages of sewage biosolid as an amendment.
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.
Cross‐sectional study on the adherence to malaria guidelines in lakeshore facilities of Buyende and Kaliro districts, Uganda
(Bio Med Central, 2018-11-19) Kaula, Henry; Kiconco, Sylvia; Luigi, Nunez
Background: Uganda adopted the Integrated Management of Malaria (IMM) guidelines, which require testing all suspected cases of malaria prior to treatment and which have been implemented throughout the country. However, adherence to IMM guidelines has not been explicitly investigated, especially in lakeshore areas such as Buyende and Kaliro, two districts that remain highly burdened by malaria. This study assesses the level of adherence to IMM guidelines and pinpoints factors that influence IMM adherence by health providers in Buyende and Kaliro. A cross-sectional study among 197 patients and 26 healthcare providers was conducted. The algorithm for adherence to IMM guidelines was constructed to include physical examination, medical history, laboratory diagnosis, and anti-malarial drug prescription. Adherence was measured as a binary variable, and binary regression was used to identify factors associated with adherence to IMM guidelines. Results: Only 16 (8.1%) of the 197 patients had their medical history and physical examinations taken, while the majority (65.5%) of the patients were recommended for malaria (laboratory) testing. Regarding adherence to prescription guidelines, 127 (64.5%) of the patients received artemisinin combination therapy (ACT) drug prescription. On the other hand, 18.6% of those who tested negative received an ACT drug/prescription and 10.1% tested positive but did not receive an ACT drug or prescription. Overall adherence to IMM guidelines was only 3.1%. The only factor that significantly influenced adherence to IMM guidelines was training; healthcare providers who had attended recent training on these guidelines were almost three times more likely to adhere to the IMM guidelines compared to those who had not attended recent training (OR = 2.858, 95% CI 1.754–4.659). Conclusions: The findings indicate very low levels of adherence to IMM guidelines among healthcare workers in the lakeshore areas of Kaliro and Buyende districts. Since adherence was independently influenced, majorly by training healthcare workers on these guidelines, recommendations include facilitating training on IMM guidelines throughout Uganda.
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.

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