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Sembajwe FL, Namaganda A, Nfambi J, Muwonge H, Katamba G, Nakato R, Nabachenje P, Kawala Kagoya E, Namubamba A, Kiggundu D, Bitek B, Kalyesubula R, Iputo J. Dietary intake, body composition and micronutrient profile of patients on maintenance hemodialysis attending Kiruddu National Referral Hospital, Uganda: A cross sectional study. PLoS One 2023; 18:e0291813. [PMID: 37856499 PMCID: PMC10586598 DOI: 10.1371/journal.pone.0291813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
Patients on maintenance hemodialysis are at a great risk for altered nutritional status, characterized by protein energy wasting and micronutrient deficiency due to medication interactions and dietary restrictions. This study determined the dietary intake, micronutrient profile and body composition of patients on maintenance hemodialysis at Kiruddu National referral hospital (KNRH), Uganda. A cross sectional study was done among adult CKD patients on maintenance hemodialysis therapy at KNRH. Data concerning patients' demographics, clinical history and dietary intake was obtained using interactive and quantitative food frequency questionnaires. Body composition was obtained using the TANITA BC-351, Japan weighing Bathroom scale and anthropometric measurements using standard methods and procedures. Serum micronutrient profile assessment was done using the COBAS Auto analyzer. Data analysis was done using the SPSS software version 20. T-test was used to make comparisons and logistic regression analysis was done to check for any correlations. A P-value of < 0.05 was considered statistically significant. Among the 63 hemodialysis patients, 38% were female, with a median duration of hemodialysis of 12 months and the overall age range of patients was 31-40 years. Majority (92.1%) of the patients had hypertension. Carbohydrates like maize flour were highly consumed, in addition to eggs among the proteins on the daily basis. Fruits and vegetables were not highly consumed. Regarding body composition; 75% of the study participants had normal Body mass Index (BMI), the mean muscle mass was 51.94±8.68, body fat was 15.25±7.35, bone mass was 2.77±0.46 and body water was 62.04±9.06. Patients had deranged micronutrient levels especially for Vitamin D, Potassium and phosphorus. In conclusion, hemodialysis patients at KNRH, have altered nutritional status as evidenced by altered body weight for some patients and deranged micronutrient levels. We recommend that hemodialysis patients should be regularly assessed for nutritional status, appropriately treated and educated about their nutritional status.
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Affiliation(s)
- Fred Lawrence Sembajwe
- Department of Medical Physiology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Agnes Namaganda
- Department of Medical Physiology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Department of Medical Physiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joshua Nfambi
- Department of Medical Physiology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Haruna Muwonge
- Department of Medical Physiology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Godfrey Katamba
- Department of Physiology, College of Health, Medicine and Life Sciences, King Ceasor University, Kampala, Uganda
| | - Ritah Nakato
- Department of Pharmacology, College of Medicine, Lira University, Lira, Uganda
| | - Prossy Nabachenje
- Department of Pediatrics, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Enid Kawala Kagoya
- Department of Community Health and Behavioural Sciences, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Annet Namubamba
- Department of Public Health, School of public Health Kololo Annex, Makerere University, Kampala, Uganda
| | - Daniel Kiggundu
- Department of Medicine, Dialysis Unit, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Brian Bitek
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Robert Kalyesubula
- Department of Medical Physiology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Jehu Iputo
- Department of Medical Physiology, College of Health Sciences, Makerere University, Kampala, Uganda
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Ndeezi G, Mor SM, Ascolillo LR, Tasimwa HB, Nakato R, Kayondo LN, Tzipori S, Mukunya D, Griffiths JK, Tumwine JK. Giardia duodenalis in Ugandan Children Aged 9-36 Months in Kampala, Uganda: Prevalence and Associated Factors. Am J Trop Med Hyg 2023:tpmd220436. [PMID: 37253438 DOI: 10.4269/ajtmh.22-0436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/23/2023] [Indexed: 06/01/2023] Open
Abstract
Giardia duodenalis is a common gastrointestinal pathogen globally that has been associated with growth failure in children. Most of the studies have been done in school-age children, and there is a paucity of data in pre-school children. We determined the prevalence and factors associated with G. duodenalis infection in children aged 9-36 months presenting to Mulago Hospital with diarrhea or cough. Demographic and socio-economic characteristics, animal ownership, medical history, and physical examination findings were recorded. Stool was tested for G. duodenalis using real-time quantitative polymerase chain reaction (qPCR), and additional tests included stool microscopy and qPCR for Cryptosporidium. The overall prevalence of G. duodenalis infection was 6.7% (214/3,173). In children with diarrhea the prevalence was 6.9% (133/1,923), whereas it was 6.5% (81/1,250) in those with cough as the main symptom. Of 214 children with G. duodenalis infection, 19 (8.9%) were co-infected with Cryptosporidium. Older children (25-36 months) were more likely to have G. duodenalis infection (adjusted odds ratio [aOR]: 2.93, 95% CI: 1.93-4.43). Use of an unimproved toilet (aOR: 1.38, 95% CI: 1.04-1.83) and the wet season (aOR: 1.33, 95% CI: 1.00-1.77) were associated with increased infection. Other factors associated with infection were recurrent diarrhea (aOR: 2.46, 95% CI: 1.64-3.70) and passing of mucoid stool (aOR: 2.25, 95% CI: 1.08-4.66). Having a ruminant at the homestead was also associated with infection (aOR: 1.83, 95% CI: 1.20-2.79). Giardia duodenalis infection occurred in 1 of 15 children aged 9-36 months with diarrhea or cough in Kampala, Uganda. Further studies are needed to clarify the zoonotic significance of G. duodenalis infection in this setting.
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Affiliation(s)
- Grace Ndeezi
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Siobhan M Mor
- Institute for Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
| | - Luke R Ascolillo
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Hannington B Tasimwa
- Department of Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ritah Nakato
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lilian N Kayondo
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Saul Tzipori
- Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts
| | - David Mukunya
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Jeffrey K Griffiths
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
- Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
| | - James K Tumwine
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pediatrics and Child Health, Kabale University School of Medicine, Kabale, Uganda
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Nakato R, Tumwine JK, Nanzigu S, Naluyima S, Buzibye A, Alinayitwe L, Makoha C, Mukonzo JK. Antiretroviral drugs found in pork on Ugandan market: Implications for HIV/AIDS treatment. One Health 2020; 9:100125. [PMID: 32195312 PMCID: PMC7076142 DOI: 10.1016/j.onehlt.2020.100125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ritah Nakato
- Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Uganda
| | - James K Tumwine
- Department of pediatrics, Makerere University College of Health Sciences, Uganda
| | - Sarah Nanzigu
- Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Uganda
| | - Sandra Naluyima
- Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Uganda
| | - Allan Buzibye
- Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Uganda
| | | | - Carol Makoha
- Department of Clinical Epidemiology, Makerere University College of Health Sciences, Uganda
| | - Jackson K Mukonzo
- Department of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Uganda
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Mor SM, Ascolillo LR, Nakato R, Ndeezi G, Tumwine JK, Okwera A, Sponseller JK, Tzipori S, Griffiths JK. Expectoration of Cryptosporidium Parasites in Sputum of Human Immunodeficiency Virus-Positive and -Negative Adults. Am J Trop Med Hyg 2018; 98:1086-1090. [PMID: 29405104 PMCID: PMC5928827 DOI: 10.4269/ajtmh.17-0741] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Indexed: 11/29/2022] Open
Abstract
Respiratory cryptosporidiosis is thought to be a rare, end-stage complication of HIV. Few studies have systematically examined the frequency of such infection in adults. Sputum specimens submitted for tuberculosis (TB) testing at Mulago Hospital, Uganda, were anonymously retested for Cryptosporidium using real-time polymerase chain reaction (PCR). Visual confirmation using immunofluorescence confocal microscopy was performed for a subset of PCR-positive samples. Of 824 sputum samples tested, 24 (2.9%) were Cryptosporidium positive. Prevalence in sputum ranged between 0% and 10% in each month of the study and exceeded TB prevalence in some months. In this referral population, respiratory Cryptosporidium prevalence was lower in people with HIV (1.3% versus 4.4% without HIV, P = 0.028) and higher in those with TB (6.8% versus 2.6% without TB, P = 0.086). The weak association between respiratory Cryptosporidium infection and TB persisted after controlling for HIV (odds ratio = 3.2, 95% confidence interval: 0.9, 11.8; P = 0.080). This is the first study to document adult respiratory tract cryptosporidiosis in a referral population with presumed TB. These findings 1) confirm that Cryptosporidium respiratory infection occurs in HIV-negative and -positive adults; 2) suggest there is potential for Cryptosporidium to be disseminated or transmitted by coughing or expectoration; and 3) identify possible synergy between Cryptosporidium and TB in the respiratory tract.
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Affiliation(s)
- Siobhan M Mor
- University of Sydney School of Veterinary Science, Sydney, Australia.,Tufts University School of Medicine, Boston, Massachusetts
| | | | - Ritah Nakato
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace Ndeezi
- Makerere University College of Health Sciences, Kampala, Uganda
| | - James K Tumwine
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Alphonse Okwera
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Jerlyn K Sponseller
- Tufts University Cummings School of Veterinary Medicine, Grafton, Massachusetts
| | - Saul Tzipori
- Tufts University Cummings School of Veterinary Medicine, Grafton, Massachusetts
| | - Jeffrey K Griffiths
- Tufts University School of Medicine, Boston, Massachusetts.,Tufts University Cummings School of Veterinary Medicine, Grafton, Massachusetts
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