Master of Medicine in Pediatrics and Child Health

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    Prevalence and Factors Associated with Bacteremia Among Children Aged Under Five Years Hospitalized with Severe Acute Malnutrition in Jinja Regional Referral Hospital
    (Kampala International University, 2024-03) Dr. Abdirazak Mohamed Omar
    Background Severe acute malnutrition, the most common cause of immunodeficiency worldwide, impacts the host's natural and acquired defense mechanisms. This causes the disease to become more severe, episodes to last longer and opportunistic infections to occur. In addition, the symptoms and signs of infectious diseases are frequently concealed, making early clinical identification and treatment challenging. This study purposed to determine the prevalence, antibiogram and to describe factors associated with bacteremia among under-fives hospitalized with severe acute malnutrition (SAM) in Jinja Regional Referral Hospital (JRRH). Methods This was a hospital based cross sectional-analytical study, in which children under five years admitted with SAM at JRRH were enrolled. A blood sample was taken for culture and sensitivity. Bacteremia was defined as any bacterial growth. The factors associated with bacteremia were determined using binary logistic regression in SPSS version 27. Results In our study, majority of the participants were females 107(61.7%). Fifty percent of the participants were aged ≤ 2 years. The prevalence of bacteremia was 11.5% (95% CI=6.9-16.7%). In the multivariate analysis, age ≤ 2 years (AOR=4.822, 95%CI=1.365-17.037, P=0.015), having a primary care giver not his/her own mother (AOR=8.720, 95%CI=1.896-40.091, P=0.005) and being a referral-in (AOR=10.195, 95%CI=4.097-25.370, P<0.001) were independently associated with presence of bacteremia. The most prevalent organism isolated was Staphylococcus aureus (N=12/20) followed by Klebsiella pneumoniae (N=5/20) and Streptococcus pneumoniae (N=3/20). The highest sensitivity was to Meropenem, Vancomycin, Ceftriaxone, Chloramphenicol and Levofloxacin while the highest levels of resistance were found against Ampicillin and Amoxicillin overall. Conclusion The prevalence of bacteremia was high. Children admitted with severe acute malnutrition should be screened for bacteremia, with the main focus on those below 2 years, those whose primary care taker aren’t their own mothers and those referred-in. We suggest that the routine use of ampicillin and Gentamicin for prophylaxis against bacterial infection among children with SAM should be reviewed in view of the high resistance against both drugs found in our study.
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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.