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Abindu V, Hope D, Aleni M, Andru M, Ayiasi RM, Afayo V, Oyet C, Kiconco R. Missed Diagnosis of Gestational Diabetes Mellitus Due to Selective Screening: Evidence from a Cross-Sectional Study in the West Nile Sub-Region, Uganda. Diabetes Metab Syndr Obes 2024; 17:1309-1319. [PMID: 38505540 PMCID: PMC10949170 DOI: 10.2147/dmso.s447855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose To ascertain the prevalence and risk factors of gestational diabetes mellitus (GDM) in pregnant women receiving antenatal care (ANC) services within the West Nile subregion of Uganda. Patients and Methods An analytical cross-sectional study was conducted on 233 pregnant women who are within 24-28 weeks of gestation and are receiving ANC services in selected hospitals. GDM was diagnosed according to the World Health Organization (WHO) criteria (2013). A questionnaire and anthropometric measurements were used to obtain relevant data. The chi-square test and logistic regression were used to determine the association between GDM and the study variables, including participants' sociodemographic and medical characteristics. Results The prevalence of hyperglycemia first detected in pregnancy among the participants tested was 8%. Overall, 7.45% had GDM and 0.53% had diabetes mellitus in pregnancy. The fasting plasma glucose test alone was positive in 86.7% of the GDM cases. The factors that were significantly associated with GDM included age ≥25 years (p = 0.017, AOR = 3.51) and body mass index (BMI) ≥25 kg/m2 (p = 0.024, AOR = 2.67). Out of the participants diagnosed with GDM, 28.6% did not have a known risk factor. Of the pregnant women with GDM, 57% would have been missed if the selective screening in the national clinical guidelines had been followed. Urinary tract infection (UTI) and Candida were detected in 36.36% and 13.85% of the participants, respectively. Conclusion The study provides new data on the prevalence of GDM in rural settings in the West Nile subregion of Uganda. Of the participants, 7.5% were diagnosed with GDM, of which 57% would have been missed based on the selective screening of the national clinical guidelines. The study findings support the universal screening of GDM in pregnant women.
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Affiliation(s)
- Vincent Abindu
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Derick Hope
- Department of Medical Laboratory Science - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Mary Aleni
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Monicah Andru
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Richard Mangwi Ayiasi
- Department of Public Health - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Victor Afayo
- Department of Obstetrics and Gynaecology, Arua Regional Referral Hospital, Arua, West Nile, Uganda
| | - Caesar Oyet
- Department of Medical Laboratory Science - Faculty of Health Sciences, Clark International University, Kampala, Central, Uganda
| | - Ritah Kiconco
- Department of Clinical Biochemistry - Faculty of Health Sciences, Soroti University, Soroti, Teso, Uganda
- Department of Medical Laboratory Sciences - Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Southwestern, Uganda
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2
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Oyom AP, Okello E, Acam V, Aramo C, Mwambi B, Okiria JC, Oyet C. Prevalence and antifungal susceptibility of gastrointestinal candidiasis among diabetic patients: A cross-sectional study. Afr J Lab Med 2020; 9:997. [PMID: 33354526 PMCID: PMC7736660 DOI: 10.4102/ajlm.v9i1.997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/12/2020] [Indexed: 01/04/2023] Open
Abstract
Background Gastrointestinal candidiasis is the most predominant opportunistic human mycosis, especially in diabetic patients. There is a global increase in antifungal resistance coupled with a rarity of information on antifungal susceptibility profiles in Uganda. Objective This study aimed to determine the occurrence and antifungal susceptibility of gastrointestinal candidiasis in diabetic patients. Methods Stool and fasting blood specimens were obtained from randomly sampled consenting patients with diabetes mellitus at St. Francis Hospital Nsambya in Kampala, Uganda to determine Candida infection, fasting blood glucose and glycated haemoglobin levels. Susceptibility testing was performed on Muller Hilton agar supplemented with 2% glucose and 0.2 µg of methylene blue, using the E-test diffusion method. Results Among the 241 patients included in the analyses, the overall prevalence of gastrointestinal candidiasis was 15.4% (n = 37). Candida albicans (62.16%, n = 23) was the predominant species, followed by Candida glabrata (18.92%, n = 7), Candida tropicalis (8.11%, n = 3), Candida krusei (5.41%, n = 2) and Candida dublinensis (5.41%, n = 2). Resistance was observed with miconazole (48.65%), clotrimazole (18.92%) and fluconazole (8.11%). No resistance to itraconazole and nystatin was observed. Gastrointestinal candidiasis was associated with poor glucose control (p ≤ 0.001), prior use of antibiotics (p ≤ 0.001), antifungals (p ≤ 0.001) and corticosteroids (p ≤ 0.001) and was more common among female patients (p = 0.01). Conclusion Occurrence of gastrointestinal candidiasis was relatively low among our participants, and infection was associated with poor glucose control, female sex and use of antifungals, antibiotics and corticosteroids.
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Affiliation(s)
- Anthony P Oyom
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - Emmanuel Okello
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - Victoria Acam
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - Christine Aramo
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - Bashir Mwambi
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - John C Okiria
- Department of Clinical Medicine and Community Health, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
| | - Caesar Oyet
- Department of Medical Laboratory Sciences, Faculty of Allied Health, Clarke International University (formerly International Health Sciences University), Kampala, Uganda
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Mahamoud NK, Mwambi B, Oyet C, Segujja F, Webbo F, Okiria JC, Taremwa IM. 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. J Blood Med 2020; 11:13-18. [PMID: 32021527 PMCID: PMC6980843 DOI: 10.2147/jbm.s231262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/07/2020] [Indexed: 12/05/2022] Open
Abstract
AIMS/OBJECTIVES This study sought to determine the prevalence, morphological characterization and associated socio-demographic factors of anemia among pregnant women attending 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.
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Affiliation(s)
- Naimo Khalif Mahamoud
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Bashir Mwambi
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Caesar Oyet
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Farouk Segujja
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Fred Webbo
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
- Lancet Laboratories, Kampala, Uganda
| | - John Charles Okiria
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
| | - Ivan Mugisha Taremwa
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda
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Hope D, Ampaire L, Oyet C, Muwanguzi E, Twizerimana H, Apecu RO. Antimicrobial resistance in pathogenic aerobic bacteria causing surgical site infections in Mbarara regional referral hospital, Southwestern Uganda. Sci Rep 2019; 9:17299. [PMID: 31754237 PMCID: PMC6872727 DOI: 10.1038/s41598-019-53712-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/05/2019] [Indexed: 11/09/2022] Open
Abstract
Surgical site infections (SSI) remain a common postoperative complication despite use of prophylactic antibiotics and other preventive measures, mainly due to increasing antimicrobial resistance. Here, we present antimicrobial resistance rate of bacteria isolated in clinical cases of SSI. A hospital based descriptive cross sectional study was conducted on 83 consented postoperative patients with clinical SSI. Data on patients was obtained using structured data collection form. Two swabs were collected aseptically from each patient. Bacteriological culture examination and identification was done following standard microbiological techniques. Antibiotic susceptibility test was done by Kirby-Bauer disc diffusion method. Gram negative bacteria (GNB) were predominant (65.59%) with the dominant being Klebsiella species (29.03%). Overall 86% of aerobic bacteria isolated were multidrug resistant (MDR) where 65.63% and 96.72% of Gram positive and Gram negative isolates were MDR respectively. All the isolates with exception of Enterococci species were resistant to ampicillin. GNB showed high resistance to ceftriaxone, sulfamethoxazole/trimethoprim and gentamicin. All the isolated Klebsiella spp were MDR. S. aureus were all resistant to oxacillin. The isolation rate was higher in emergency, males and dirty wounds in relation to nature of surgery, gender and class of surgical wound respectively. These findings necessitate judicious antibiotic use and calls for surveillance of SSIs periodically as well as strict adherence to good sanitation practice to reduce spread of drug-resistant pathogens.
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Affiliation(s)
- Derick Hope
- Department of Medical Microbiology, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda.
| | - Lucas Ampaire
- Department of Medical Laboratory Sciences, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda
| | - Caesar Oyet
- School of Allied Health, Clarke International University, P.O. BOX 7782, Kampala, Uganda
| | - Enoch Muwanguzi
- Department of Medical Laboratory Sciences, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda
| | - Hillary Twizerimana
- Obstetrics and Gynecology Unit, Mbarara Regional Referral Hospital, P.O. BOX 40, Mbarara, Uganda
| | - Richard Onyuthi Apecu
- Department of Medical Laboratory Sciences, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda
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Okia CC, Aine B, Kiiza R, Omuba P, Wagubi R, Muwanguzi E, Apecu RO, Okongo B, Oyet C. Prevalence, Morphological Classification, And Factors Associated With Anemia Among Pregnant Women Accessing Antenatal Clinic At Itojo Hospital, South Western Uganda. J Blood Med 2019; 10:351-357. [PMID: 31695541 PMCID: PMC6815785 DOI: 10.2147/jbm.s216613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The study aimed to determine the prevalence, morphological classification, and risk factors of anemia among pregnant mothers attending antenatal clinic at Itojo hospital, Ntungamo district, southwestern Uganda. PATIENTS AND METHODS After obtaining an informed consent, 5mL of blood was collected from the vein of each participant for complete blood count (CBC) and peripheral film report. The CBC was performed using HumaCount 80 hematology analyzer (HUMAN Gesellschaft für Biochemica und Diagnostica mbH Max-Planck-Ring 21 65,205 Wiesbaden Germany). Peripheral blood smears were made and stained using Wright's Romanowsky stain and examined under ×1000 magnification for morphological classification of anemia. Structured questionnaires were administered to each participant to collect information on patients' demography and risk factors of anaemia in pregnancy. The data generated were prepared in EXCEL and later transferred to SPSS version 20 for analysis. Univariate logistic regression and multivariate logistic regression were used to evaluate the association of socio-demographic characteristics of the participants with anemia. A 95% confidence level was used and statistical significance was reached at p<0.05. RESULTS One hundred and sixty-three participants (n=163) were recruited for the study with the median age of 25 years and range of (17 to 40 years). The overall prevalence of anemia was 12 (7.4%), the morphological classification was 1 (8.3%) normocytic normochromic anemia, 6 (50%) microcytic hypochromic anemia, and 5 (41.7%) macrocytic anemia. Spouse occupation (p=0.03), household income (p=0.04), use of insecticide-treated mosquito nets (p=0.001), history of urinary tract infection (p=0.002), use of haematinics (p≤0.001), and history of postpartum hemorrhage (p=0.03) were significantly associated with anemia in pregnancy. CONCLUSION Despite the reported high prevalence of anemia in pregnancy in other areas within the country, anemia prevalence was low in this study. Routine screening for anemia at all antenatal care clinics countrywide is recommended.
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Affiliation(s)
- Claire Catherine Okia
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Boaz Aine
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Ronald Kiiza
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patrick Omuba
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Robert Wagubi
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Enoch Muwanguzi
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Richard Onyuthi Apecu
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Benson Okongo
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Caesar Oyet
- Department of Clinical Chemistry, School of Medical Laboratory Sciences, Institute of Allied Health, Clarke International University, Kampala, Uganda
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Aramo C, Oyom AP, Okello E, Acam V, Okiria JC, Mwambi B, Oyet C. Assessing the prevalence and risk factors of pre-diabetes among the community of Iganga municipality, Uganda: a cross sectional study. BMC Res Notes 2019; 12:553. [PMID: 31470894 PMCID: PMC6717370 DOI: 10.1186/s13104-019-4589-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/21/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The prevalence of pre-diabetes is increasing globally with more than 470 million people projected to develop pre-diabetes by 2030. In Africa, the average prevalence of pre-diabetes was estimated at 7.3% in 2015 and affected individual will develop type 2 diabetes mellitus within few decades. The aim of the study was to determine the prevalence of pre-diabetes and associated risk factors among residents of Iganga municipality. A cross-sectional study was conducted among males and females aged 13-60 years. District health office provided updated household list from which sampling of the villages was performed based on probability proportionate to population. Consented participants were prepared for the study, allowing fasting for 8 to 10 h before blood collection the next morning. Individuals with impaired fasting glucose, were subjected to OGTT. RESULTS 130 participants were enrolled, of which 98 were women. The mean age of the participants was 35 years. The prevalence of pre-diabetes was 3.8%. The proportion of impaired glucose tolerance was higher in current smokers (p = 0.01), obese participants (p = 0.002) and hypertensive participants (p < 0.001). Prevalence of pre-diabetes is high in this community and is associated with current smoking, hypertension and high BMI.
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Affiliation(s)
- Christine Aramo
- Clarke International University, P O Box 7782, Kampala, Uganda
| | | | - Emmanuel Okello
- Clarke International University, P O Box 7782, Kampala, Uganda
| | - Victoria Acam
- Clarke International University, P O Box 7782, Kampala, Uganda
| | | | - Bashir Mwambi
- Clarke International University, P O Box 7782, Kampala, Uganda
| | - Caesar Oyet
- Clarke International University, P O Box 7782, Kampala, Uganda
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Ocan A, Oyet C, Webbo F, Mwambi B, Taremwa IM. 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. J Blood Med 2018; 9:195-201. [PMID: 30464670 PMCID: PMC6217135 DOI: 10.2147/jbm.s184126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
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.
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Affiliation(s)
- Apollo Ocan
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda,
| | - Caesar Oyet
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda,
| | - Fred Webbo
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda, .,Lancet Laboratories, Kampala, Uganda
| | - Bashir Mwambi
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda,
| | - Ivan Mugisha Taremwa
- Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda,
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Abstract
Background Blood transfusion with allogeneic blood products is a common medical intervention to treat anemia or prepare patients for surgical procedures. Generally, the blood units are secured and stored prior to expected transfusion. During storage, a number of biochemical changes occur (generally known as storage lesion), which can affect the efficacy of blood transfusion. The aim of the study was to evaluate the biochemical changes that occur in blood units during storage and to project the impact of these changes on transfusion. Methods The study protocol was approved by the Faculty of Medicine Research Ethics committee of Mbarara University of Science and Technology. A total of 200 blood recipients were categorized into two study arms: group I received fresh blood (n=100) and group II received old blood (n=100), who were formally consented and recruited consecutively. A total of 2 mL of venous blood was collected from each participant in EDTA tubes before transfusion (for pre-transfusion hemoglobin [Hb] estimation) and after transfusion (for post-transfusion Hb estimation). Each crossmatched unit was sampled to collect plasma for pH, lactate and potassium assays. Data were analyzed with STATA version 12.0. Results A total of 200 blood transfusion recipients aged 1–60 years were enrolled in the study. Up to 60% of the participants were females. The pH of the stored blood dropped from 7.4 to 7.2 in the first 3 days to ~7.0 by day 11 and to <7.0 by day 35 (p=0.03). The average rise in lactate level was 25 g/dL in blood stored for 0 to 11 days and 32.4 g/dL in blood stored for 21–35 days. The highest increase was encountered in blood stored beyond 28 days: 40–57 g/dL by 35 days (p=0.001). Potassium levels equally increased from ~4.6 mmol/L in the first 5 days of storage to ~14.3 mmol/L by 11 days. From the third week of blood storage and beyond, there was exponential increase in potassium levels, with the highest record in blood units stored from 30 to 35 days (p=0.068). Conclusion Whole blood stored for >14 days has reduced efficacy with increased markers of red cell storage lesion such as increased potassium level, lactate and fall in pH. These lesions increase the length of hospital stay.
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Affiliation(s)
- Caesar Oyet
- Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda,
| | - Benson Okongo
- Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda,
| | - Richard Apecu Onyuthi
- Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda,
| | - Enoch Muwanguzi
- Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda,
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Roh ME, Oyet C, Orikiriza P, Wade M, Kiwanuka GN, Mwanga-Amumpaire J, Parikh S, Boum Y. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda(1). Emerg Infect Dis 2018; 22:1494-8. [PMID: 27434741 PMCID: PMC4982177 DOI: 10.3201/eid2208.160619] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non-P. falciparum malarial infections.
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10
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Oyet C, Roh ME, Kiwanuka GN, Orikiriza P, Wade M, Parikh S, Mwanga-Amumpaire J, Boum Y. Evaluation of the Deki Reader™, an automated RDT reader and data management device, in a household survey setting in low malaria endemic southwestern Uganda. Malar J 2017; 16:449. [PMID: 29115991 PMCID: PMC5678817 DOI: 10.1186/s12936-017-2094-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 10/28/2017] [Indexed: 11/24/2022] Open
Abstract
Background Early diagnosis of suspected malaria cases with a rapid diagnostic test (RDT) has been shown to be an effective malaria control tool used in many resource-constrained settings. However, poor quality control and quality assurance hinder the accurate reporting of malaria diagnoses. Recent use of a portable, battery operated RDT reader (Deki Reader™, Fio Corporation) has shown to have high agreement with visual inspection across diverse health centre settings, however evidence of its feasibility and usability during cross sectional surveys are limited. This study aimed to evaluate the performance of the Deki Reader™ in a cross-sectional survey of children from southwestern Uganda. Methods A two-stage, stratified cluster sampling survey was conducted between July and October 2014 in three districts of southwestern Uganda, with varying malaria transmission intensities. A total of 566 children aged 6–59 months were included in the analysis. Blood samples were collected and tested for malaria using: the SD Bioline Malaria Ag Pf/Pan RDT and microscopy. Results were compared between visual inspection of the RDT and by the Deki Reader™. Diagnostic performance of both methods were compared to gold-standard microscopy. Results The sensitivity and specificity of the Deki Reader™ was 94.1% (95% CI 69.2–99.6%) and 95.6% (95% CI 93.4–97.1%), respectively. The overall percent agreement between the Deki Reader™ and visual RDT inspection was 98.9% (95% CI 93.2–99.8), with kappa statistic of 0.92 (95% CI 0.85–0.98). Conclusions The findings from this study suggest that the Deki Reader™ is comparable to visual inspection and performs well in detecting microscopy-positive Plasmodium falciparum cases in a household survey setting. However, the reader’s performance was highly dependent on ensuring adequate battery life and a work environment free of dirt particles.
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Affiliation(s)
- Caesar Oyet
- Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Michelle E Roh
- Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Gertrude N Kiwanuka
- Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | | | - Martina Wade
- Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Sunil Parikh
- Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Juliet Mwanga-Amumpaire
- Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.,Epicentre Mbarara Research Centre, P.O. Box 1956, Mbarara, Uganda
| | - Yap Boum
- Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.,Epicentre Mbarara Research Centre, P.O. Box 1956, Mbarara, Uganda
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Ojok P, Oyet C, Webbo F, Mwambi B, Taremwa IM. Prevalence of RhD variants among blood donors at Gulu Regional Blood Bank, Gulu, Northern Uganda. J Blood Med 2017; 8:151-154. [PMID: 28979173 PMCID: PMC5608233 DOI: 10.2147/jbm.s145550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim/objective The aim of this study was to determine the prevalence of RhD variant phenotypes among voluntary non-remunerated blood donors (VNRBDs) at Gulu Regional Blood Bank (GRBB), Northern Uganda. Materials and methods We conducted a cross-sectional study, in which the first 4.0 mL of ethylenediaminetetraacetic acid (EDTA) blood samples were collected from VNRBDs and typed for their ABO and RhD blood group status using IgM and IgG monoclonal typing antisera, respectively. Blood samples that tested as RhD negative were further investigated for RhD variant phenotypes using indirect antihuman globulin hemagglutination technique. Results We assayed 138 RhD-negative blood samples obtained from VNRBDs. Of these, 66.7% (n=92) were males. Their median age was 24.4 years (range, 14–33 years). Majority of the participants were of ABO blood group O (62.8%, n=86), followed by A (19.7%, n=27), then B (13.9%, n=19) and least AB (3.6%, n=6). The prevalence of RhD variant phenotypes was 0.7% (n=1; 95% confidence interval, 0.5–0.9). There was no statistical association of RhD variant phenotypes with donor gender, tribe and their ABO blood groups. Conclusion This study has revealed a high prevalence of RhD variant among blood donors at GRBB in Northern Uganda. It further highlights a potential risk of alloimmunization, as the present blood typing practices do not identify RhD variant phenotypes.
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Affiliation(s)
- Polycarp Ojok
- Institute of Allied Health Sciences, International Health Sciences University, Kampala
- Gulu Regional Blood Bank, Gulu
| | - Caesar Oyet
- Institute of Allied Health Sciences, International Health Sciences University, Kampala
| | - Fred Webbo
- Institute of Allied Health Sciences, International Health Sciences University, Kampala
- Lancet Laboratories, Kampala, Uganda
| | - Bashir Mwambi
- Institute of Allied Health Sciences, International Health Sciences University, Kampala
| | - Ivan M Taremwa
- Institute of Allied Health Sciences, International Health Sciences University, Kampala
- Correspondence: Ivan M Taremwa, Institute of Allied Health Sciences, International Health Sciences University, PO Box 7782, Kampala, Uganda, Tel +256 7 7434 6368, Email
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Nabaigwa BI, Mwambi B, Okiria J, Oyet C. Common uropathogens among diabetic patients with urinary tract infection at Jinja Regional Referral Hospital, Uganda. Afr J Lab Med 2017; 7:621. [PMID: 29850436 PMCID: PMC5963006 DOI: 10.4102/ajlm.v7i1.621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 09/08/2017] [Indexed: 01/11/2023] Open
Abstract
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.
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Affiliation(s)
| | - Bashir Mwambi
- International Health Sciences University, Kampala, Uganda
| | - John Okiria
- International Health Sciences University, Kampala, Uganda
| | - Caesar Oyet
- International Health Sciences University, Kampala, Uganda
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Roh ME, Oyet C, Orikiriza P, Wade M, Mwanga-Amumpaire J, Boum Y, Kiwanuka GN, Parikh S. Screening for Glucose-6-Phosphate Dehydrogenase Deficiency Using Three Detection Methods: A Cross-Sectional Survey in Southwestern Uganda. Am J Trop Med Hyg 2016; 95:1094-1099. [PMID: 27672207 DOI: 10.4269/ajtmh.16-0552] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/12/2016] [Indexed: 11/07/2022] Open
Abstract
Despite the potential benefit of primaquine in reducing Plasmodium falciparum transmission and radical cure of Plasmodium vivax and Plasmodium ovale infections, concerns over risk of hemolytic toxicity in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PDd) have hampered its deployment. A cross-sectional survey was conducted in 2014 to assess the G6PDd prevalence among 631 children between 6 and 59 months of age in southwestern Uganda, an area where primaquine may be a promising control measure. G6PDd prevalence was determined using three detection methods: a quantitative G6PD enzyme activity assay (Trinity Biotech® G-6-PDH kit), a qualitative point-of-care test (CareStart™ G6PD rapid diagnostic test [RDT]), and molecular detection of the G6PD A- G202A allele. Qualitative tests were compared with the gold standard quantitative assay. G6PDd prevalence was higher by RDT (8.6%) than by quantitative assay (6.8%), using a < 60% activity threshold. The RDT performed optimally at a < 60% threshold and demonstrated high sensitivity (≥ 90%) and negative predictive values (100%) across three activity thresholds (below 60%, 30%, and 40%). G202A allele frequency was 6.4%, 7.9%, and 6.8% among females, males, and overall, respectively. Notably, over half of the G202A homo-/hemizygous children expressed ≥ 60% enzyme activity. Overall, the CareStart™ G6PD RDT appears to be a viable screening test to accurately identify individuals with enzyme activities below 60%. The low prevalence of G6PDd across all three diagnostic modalities and absence of severe deficiency in our study suggests that there is little barrier to the use of single-dose primaquine in this region.
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Affiliation(s)
- Michelle E Roh
- Yale School of Public Health, New Haven, Connecticut.,University of California, San Francisco, California
| | - Caesar Oyet
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patrick Orikiriza
- Mbarara University of Science and Technology, Mbarara, Uganda.,Médecins sans Frontières Epicentre, Mbarara Research Centre, Mbarara, Uganda
| | - Martina Wade
- Yale School of Public Health, New Haven, Connecticut
| | - Juliet Mwanga-Amumpaire
- Mbarara University of Science and Technology, Mbarara, Uganda.,Médecins sans Frontières Epicentre, Mbarara Research Centre, Mbarara, Uganda
| | - Yap Boum
- Mbarara University of Science and Technology, Mbarara, Uganda.,Médecins sans Frontières Epicentre, Mbarara Research Centre, Mbarara, Uganda
| | | | - Sunil Parikh
- Yale School of Public Health, New Haven, Connecticut.
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