Browsing by Author "Atwiine, Barnabas"

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    High Expression of WT1 and Low Expression of p53 in Archived Blocks of Children with Wilms Tumor in South Western Uganda
    (Dove, 2024-03) Ssenkumba, Brian; Atwiine, Barnabas; Mitala, Yekosani; Adongo, Janet; Olowo, Samuel; Nabulya, Rita; Diaz Anaya, Amnia; Atwine, Raymond
    Abstract Brian Ssenkumba,1 Barnabas Atwiine,2,3 Yekosani Mitala,1 Janet Adongo,4 Samuel Olowo,4 Rita Nabulya,1 Amnia Diaz Anaya,1 Raymond Atwine1 1Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Paediatrics and Child Health, Mbarara Regional Referral Hospital, Mbarara, Uganda; 4Department of Nursing, Mbarara University of Science and Technology, Mbarara, UgandaCorrespondence: Brian Ssenkumba, Department of Pathology, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda, Tel +256701364029, Email ssenkumbabrianldp15@gmail.comPurpose: The determination of the presence or absence of anaplasia in Wilms tumor is difficult sometimes creating diagnostic errors and is worsened by the use of neoadjuvant chemotherapy, which causes cellular alterations that may mimic anaplasia. This study described the histological features of Wilms tumor and their association with WT1 and p53 expression in archived specimens in South Western Uganda.Patients and Methods: A series of 308 formalin-fixed paraffin-embedded tissue blocks belonging to 85 children were retrospectively recruited in the only public Histopathology laboratory in South Western Uganda. Rabbit monoclonal Anti-Wilms tumor protein antibody [(CAN-R9) IHC-56-2] ab89901 and rabbit monoclonal Anti-p53 antibody [E26] ab32389 were used to assess the expression of WT1 and p53, respectively. The expression of WT1 and p53 were reported as proportions, Chi-square was also performed to assess for associations and statistical significance was considered when the p-value was less than 0.05.Results: The median age was 3.5 with an interquartile range of (2– 6) years. Mixed histology was the most common at 35.29% (95% CI:25.77– 46.14). Anaplasia was present in 5.88% (95% CI:2.44– 13.52) of the specimens. p53 and WT1 expressions were 13.0% (95% CI:7.25– 22.04), and 41.0% (95% CI: 31.11– 52.04), respectively. Conclusion: Mixed-type histology is the most common histologic feature of Wilms tumor with high expression of WT1 and a low expression of p53 implying that these can be used routinely to confirm the diagnosis as well as anaplasia in South Western Uganda. Keywords: children, Wilms tumor, p53, WT1, South Western Uganda
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    Money was the Problem”: Financial Difficulty is the Main Reason for Treatment Abandonment by Children with Cancer in South West Uganda
    (Authorea Preprints, 2021) Atwiine, Barnabas; Busingye, Imelda; Kyarisiima, Rose; Baluku, Emmanuel; Mbabazi, Ruth; Bamwine, Brian; Ankunda, Siyadora; Libes, Jaime; Weinstein, Howard; Schwartz, Kevin; Kiwanuka, Gertrude
    Treatment abandonment contributes significantly to poor survival of children with cancer in low-middle-income countries (LMICs). In order to inform an approach to this problem at our Cancer Unit, we investigated why caregivers withdraw their children from treatment. Methods – In a qualitative study, in-depth interviews were conducted with caregivers of children who had abandoned cancer treatment at the Paediatric Cancer Unit (PCU) of Mbarara Regional Referral Hospital (MRRH) in South Western Uganda, between May 2017 and September 2020. Recorded in-depth interviews with caregivers were transcribed and analyzed to identify themes of caregiver self-reported reasons for treatment abandonment. Results - Seventy-seven out of 343 (22.4%) children treated for cancer at MRRH abandoned treatment during the study period; 20 contactable and consenting caregivers participated in the study. The median age of children’s caregivers was 37 years and most (65%) were mothers. At the time of this study, eight (40%) children were alive and 5 (62.5%) were males; with a median age of 6.5 years. Financial difficulties, other obligations, the child falsely appearing cured, preference for alternative treatments, belief that cancer was incurable, fear that the child’s death was imminent and chemotherapy side-effects were the caregivers’ reasons for treatment abandonment. Conclusions and Recommendation – Treatment abandonment among children with cancer in Uganda is, most times, as a result of difficult conditions beyond the caregivers’ control and needs to be approached with empathy and support.
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    “Moneywas the problem”: Caregivers’ self-reported reasons for abandoning their children’s cancer treatment in southwest Uganda
    (Pediatric Blood & Cancer, 2021) Atwiine, Barnabas; Busingye, Imelda; Kyarisiima, Rose; Baluku, Emmanuel; Mbabazi, Ruth; Bamwine, Brian; Ankunda, Siyadora; Libes, Jaime; Weinstein, Howard; Schwartz, Kevin; Kiwanuka, Gertrude
    Treatment abandonment contributes significantly to poor survival of children with cancer in low- and middle-income countries (LMIC). In order to inform an approach to this problem, we investigated why caregivers withdraw their children from treatment. Methods: In a qualitative study, carried out in October and November 2020, in-depth interviews were conducted with caregivers of children who had abandoned cancer treatment at the PediatricCancerUnit ofMbarara Regional ReferralHospital in southwesternUganda. Recorded in-depth interviewswere transcribed and analyzed to identify themes of caregivers’ self-reported reasons for treatment abandonment. The study was approved by the Review and Ethics Committee of Mbarara University of Science and Technology. Results: Seventy-seven out of 343 (22.4%) children diagnosed with cancer abandoned treatment during the study period; 20 contactable and consenting caregivers participated in the study. The median age of the caregivers was 37 years and most (65%)were mothers.At the time of this study, eight (40%) childrenwere alive and five (62.5%)were males; with a median age of 6.5 years. Financial difficulty, other obligations, the child falsely appearing cured, preference for alternative treatments, belief that cancer was incurable, fear that the child’s death was imminent and chemotherapy side effectswere the caregivers’ reasons for treatment abandonment. Conclusions and recommendation: Seeking cancer treatment for children inUganda is an expensive venture and treatment abandonment is mainly caused by caregivers’ difficult socio-economic circumstances. This problem needs to be approached with empathy and support rather than blame.