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Prevalence and factors associated with glomerular hyperfiltration among children aged 2 to 18 years with sickle cell anemia at Jinja Regional Referral Hospital.
(Kampala International University, 2023-09) Omar Abdikarim Abdulle
Introduction: Even though progression in children’s care with SCD have raised, their prolonged-term survival is characterized by long-standing diseases such as long-standing kidney disease. Renal involvement occurs all the time of life of a patient with SCA and contribute greatly reduced life expectancy of patients with sickle cell disease, accounting for 16–18% of mortality.
The study aimed at determining the prevalence and factors associated with glomerular hyperfiltration among children aged 2 to 18 years with sickle cell anemia at Jinja Regional Referral Hospital (JRRH). The study also described the proportion of microalbuminuria among SCA children with glomerular hyperfiltration.
Methods: An analytic and descriptive cross-sectional hospital-based study was conducted among children with Sickle cell anemia. Consecutive enrolment of study participants was done until the sample size of 245 was achieved. The prevalence of glomerular hyperfiltration was analyzed as percentage with its corresponding 95% CI. To determine factors associated with glomerular hyperfiltration, bivariate and multivariate logistic regression were run. Both unadjusted (crude) odds ratios with their corresponding 95% confidence interval (CI) and adjusted OR with their corresponding 95% CI were reported. The proportion of microalbuminuria among study participants with glomerular hyperfiltration was determined as a fragment of participants with albuminuria and glomerular hyperfiltration over the number of study participants with glomerular hyperfiltration.
Results: The prevalence of glomerular hyperfiltration was 28.00%. The independent risk factors for glomerular hyperfiltration were age and severe anemia. Children who were in the age group of 14 – 16 years had 3.91 folds the risk of developing Glomerular Hyperfiltration (aOR 3.91, 95%CI 1.41-37.23, P=0.023) and children who had severe anemia were 9.47 folds the risk of developing Glomerular Hyperfiltration (aOR 9.47, 95%CI 1.57-57.05, P<0.001).
Conclusion: This study suggests that a considerable proportion of children in this population experience glomerular hyperfiltration. The results underscore the importance of considering age, and severe anemia in the management and care of these patients. This study suggests that a significant proportion of SCA children with glomerular hyperfiltration may be experiencing early kidney damage or dysfunction, as evidenced by the presence of MA.
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Prevalence and Factors Associated with Hypertension and Diabetes Mellitus among Adult HIV Patients on Protease Inhibitor-Containing ART Regimens attending Fort-Portal Regional Referral Hospital, Western Uganda
(Kampala International University, 2023-05) Dr. Peter K. Kyaligonza, Jr.
Background: Despite all the progress made due to HAART, the long-term adverse effects of PIs pose challenges in recent decades due to cross resistance and toxicities coinciding with a surge in HTN and DM. In Uganda, there is no adequate evidence on the magnitude of HTN and DM in HIV-infected individuals receiving PI-based ART regimens i.e., recent data are on either HTN alone or DM alone but not both.
Objective: To determine the prevalence and factors associated with HTN and/or DM among HIV patients on a PI-containing ART regimens at Fort Portal Regional Referral Hospital, western Uganda.
Methods: A Hospital based cross-sectional study was conducted among 104 randomly selected HIV-positive adults taking PI-containing ART. Data were collected using a structured questionnaire and analyzed using SPSS version 15. Descriptive statistics were used to describe the data. A logistic regression model was used to identify associated factors with HTN and/or DM among PLWHA as well as the associated factors between duration of PI-containing ART and HTN and/or DM.
Results: The prevalence of HTN and DM comorbidity was 6.7% (3.2-13.6) (95% CI). That of HTN alone was 26.9% (19.2-36.4) (95% CI) and DM alone had a prevalence of 27.9% (20-37.4) (95% CI). Having a family history of HTN and DM (aOR 12.16; 95% CI: 1.37-108) was the only factor associated with HTN and DM. Taking alcohol (aOR 13.94; 95% CI: 2.43-80.08), a positive family history of HTN and DM (aOR 12.01; 95% CI: 3.18-45.36), being obese (aOR 5.41; 95% CI: 1.08-27.16) were associated with HTN. Being 40 years and older (aOR 5.94; 95% CI: 1.59-22.19) was associated with DM.
Conclusions:The prevalence of HTN and/or DM was high in the study area. Being 40 years or older, consumption of alcohol, high viral load, and family history of HTN and DM increased the odds of getting HTN and/or DM in PLWHA on PI based ART regimens.
We, therefore, recommend that HIV patients should be screened for HTN and DM. Addressing modifiable factors through counseling on dietary intake of fast and junk food and cessation of alcohol intake would help to improve the longevity of patients on ART.
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Health-related quality of life and factors associated with depression among people with oculocutaneous albinism in Jinja District, Uganda.
(Kampala International University, 2023-05) Dr. Inena Wa Inena Gaylord
Depression is among the common psychiatric disorders with high prevalence in the general population across the world. Studies carried out on specific populations have shown that this prevalence is higher in vulnerable populations including people living with albinism. Despite the fact that several aspects linked with it have been found among people with oculocuteneous albinism in the Busoga region, data have remained unclear locally. Limited information is available regarding prevalence of depression, its associated factors and health related quality of life in the study area. The main objective of the present study was to determine the health related quality of life and factors associated with depression among people with oculocutaneous albinism in Jinja, Uganda.
Methods
A cross-sectional design was used to capture data from a study sample size of 384 adults living with oculocutaneous albinism who were involved in completion of the screening tests for depression Hopkins Symptom Checklist-25(HSCL-25). The summation of scores for depression were averaged and the probable depression determined for each participant using a cut-off of 1.75. Logistic regression analyses were used to examine associations between depression and associated factors. Dermatology life quality index (DLQI) was used to assess the health related quality of life. The DLQI was calculated by the summation of the score of each question resulting in a maximum of 30 and a minimum of 0. The higher was the score, the more quality of life was impaired.
Results
The analyses revealed that the prevalence of depression among people with oculocutaneous albinism in Jinja city stands at 65.4 %. The risk of depression was significantly associated with age (AOR = 1.059, 95% CI = 1.020–1.100, P = 0.003), history of diabetes mellitus (AOR = 12.030, 95% CI = 1.117–12.961, P = 0.040) and taking chronically medication (AOR = 6.583, 95% CI = 1.618– 26.782, P = 0.008).Family support (AOR = 0.505, 95% CI = 0.286–0.892, P = 0.019) and marital
status (AOR = 0.505, 95% CI = 0.286–0.892, P = 0.019) were significantly protective factors.
The mean Dermatology Life Quality Index scores was 14.55. Oculocutaneous albinism had no effect on the quality of life of only 5.7% of the participants. On the remaining 95% affected participants, 48.7% were largely affected.
Conclusions
These findings show that the estimated prevalence of depression among people with oculocutaneous albinism in the study area is high and worrying and oculocutaneous albinism highly impacts negatively the quality of life of people with oculocutaneous albinism. Strategies targeted at early interventions and ultimately depression prevention need urgent attention in order to reduce risk factors of the disease and improve the health related quality of life of People with oculocutaneous albinism in the study area.
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Prevalence and Factors Associated with Anemia among women with Helminthiasis attending Antenatal Care at Fort Portal Regional Referral Hospital.
(Kampala International University, 2023) Dr. Akena Geoffrey
Anemia is a global public health problem that affects around a quarter of the world's population, especially in developing nations (Dorsamy et al., 2022). Its burden is estimated to be around 40% of pregnant women worldwide (Dorsamy et al., 2022). Compared to women who did not have intestinal worms (16.4%), anemia was more prevalent in pregnant women with intestinal worms (55.6%) (Bolka & Gebremedhin, 2019).
Aim: To determine the prevalence and factors associated with anemia among women with helminthiasis attending Antenatal Clinic at Fort Portal Regional Referral Hospital.
Method and Materials: This was a hospital-based cross-sectional study conducted from November 2022 to March 2023. A total of 420 pregnant women with helminthiasis attending ANC at Fort portal regional referral hospital were consecutively enrolled. Interviewer-administered questionnaires and laboratory report forms were used to obtain data. Descriptive statistical analysis followed by binary logistic regression were done. All data analyses were conducted using IBM SPSS statistics version 23.
Results: we enrolled 420 participants, (The prevalence of anemia among them was 26.2%; with 39.1% having mild anemia, 35.5% had moderate anemia and 25.5% had severe form). The factors that independently associated with anemia among women with helminthiasis at the multivariate stage were women who were students (aOR= 0.167, 95% CI: 0.045-0.627, p=0.008), those who took helminthic medications in ≥3months (aOR= 0.107, 95% CI: 0.013-0.882, p=0.038), those whose source of water was borehole (aOR= 0.598, 95% CI: 0.359-0.995, p=0.048) and those who were at gestational age ranging between 14-27 weeks (aOR= 0.567, 95% CI: 0.351-0.915, p=0.020).
Conclusions and recommendations: This study found that the prevalence of anemia among women with helminthiasis at Fort portal regional referral hospital was relatively higher than the regional prevalence. Mild form of anemia remains rampant. Being a student was protective and pregnant women who last took deworming medicines >3 months ago runs risk of suffering from anemia. While taking borehole water was protective and being in a gestational age between 14 and 27 weeks was also protective. Intense health education focusing on iron supplementation and deworming drug prophylaxis adherence to all pregnant women by the health workers.
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Prevalence and Factors Associated With Rota-Virus Diarrhoea among Children 3-24 Months At Fort Portal Regional Referral Hospital
(Kampala International University, 2023-05-15) Laker Goretty
Rota-virus, the most common cause of severe acute diarrhea in the world, has a significant morbidity and fatality rate in children under the age of five, with Children between the ages of 4 - 24 months experiencing the most symptomatic illness. Typically spread from person to person by the oral-fecal route. Therefore, identification and classification of dehydration status forming the foundation of care, are crucial to the evaluation of acute diarrhea.
Problem statement: the impact of rotavirus immunization post introduction of virus is not well established. A data from Fort portal regional referral hospital was not able to identify the causes of diarrhea in children seen at the facility.
Methodology: This was a cross-sectional, quantitative, descriptive and analytical hospital-based study on 268 children 3-24months with acute watery diarrhea who attended Fort-portal regional referral hospital, between December 2022 and February 2023. Stool specimens were tested for rotavirus infection using rapid immunochromatographic assay test (Fastep kits sensitivity=96.8%-99.9% specificity=97.7%-100.0%). Data were cleaned and analysed using SPSS 22.
Results: Out of 268 children with acute watery diarrhea, 133 (49.6%) were females, aged <12 months 177 (66.0%), with diarrhea duration less than 5 days 220 (82.1%). children who were positive for rotavirus infection were 42 (15.7%) (95% CI =11.2%-20.1%). Severe dehydration was present in 2 (4.8%), some dehydration in 28(66.7%), no dehydration 12 (28.6%). The factors that were significantly associated with Rota-virus diarrhea at multivariable level were; child’s age less than 12 months (AOR=8.866, CI=1.549-50.738, P=0.014). male child (AOR=0.083, CI=0.019-0.356, P=0.001), child from a home with another person with diarrhea (AOR=17.821, CI=3.484-91.166, P=0.001) , child from a home where water for home use was gotten from a well (AOR=50.170, CI=4.401-71.966, P=0.002).Conclusion: The prevalence of Rota-virus diarrhea was three times less in the post Rota-virus vaccination period compared to pre-rota vaccination period. Majority of the participants with rotavirus diarrhea had some dehydration. The factors that were significantly associated with Rota-virus diarrhea were child’s age, gender, having another person at home with diarrhea and use of water from the well for domestic purpose.