Browsing by Author "Egesa, Walufu Ivan"

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    Bubble Nasal Continuous Positive Airway Pressure (bNCPAP): An Effective Low-Cost Intervention for Resource Constrained Setting
    (International journal of pediatrics, 2020) Egesa, Walufu Ivan; Waibi, William Mugowa
    Preterm birth complications are responsible for almost one-third of the global neonatal mortality burden, and respiratory distress syndrome remains the single most common cause of these preventable deaths. Since its inception, almost half a century ago, nasal continuous positive airway pressure (NCPAP) has evolved to become the primary modality for neonatal respiratory care in both the developed and developing world. Although evidence has demonstrated the effectiveness of low-cost bubble NCPAP in reducing newborn mortality, its widespread use is yet to be seen in resource-constrained settings. Moreover, many tertiary hospitals in developing countries still utilise an inexpensive locally assembled bNCPAP system of unknown efficacy and safety. This review provides a brief overview of the history, physiological benefits, indications, contraindications, and complications of bNCPAP. Evidence regarding the effectiveness of low-cost bNCPAP in the neonatal intensive care unit is also summarised. The article further details a locally assembled bNCPAP system used in resource-constrained settings and highlights the care package for neonates receiving bNCPAP, failure criteria, and strategies for weaning.
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    Compartment Syndrome Following Intramuscular Self-injection of Kerosene and Rodenticide: A case report
    (International journal of surgery case reports, 2021) Asiimwe, Daniel; Egesa, Walufu Ivan; Waibi, William Mugowa; Kajoba, Dickson; Kumbakulu, Patrick Kumbowi
    Kerosene and rodenticides are used in many households in developing countries. This case report aims to discuss the progression and management of a patient with intentional kerosene and rodenticide poisoning. To our knowledge, this is the first documented case of blended kerosene-rodenticide poisoning in medical literature. This report describes a 23-year-old man who survived after intramuscular self-injection of 5 ml of kerosene mixed with a rodenticide into his left upper limb, with intent to commit suicide. He was admitted to our hospital following a convulsion and brief loss of consciousness. Compartment syndrome developed within 24 h of admission, necessitating urgent fasciotomy, repeated surgical debridement, limb elevation, wound cleaning and dressing, in addition to intravenous fluids, antibiotics, and close observation. Blood transfusion, phytomenadione (vitamin K1), tetanus toxoid, and analgesics were recommended. The patient also received physiotherapy, and was treated for depression. The limb healed completely, with contractures at the left wrist joint. Injected kerosene and rodenticide may result in compartment syndrome and variable local and systemic complications which require multifaceted care and a prolonged follow-up period. Seemingly minor injuries at presentation may quickly progress into considerable complications such as compartment syndrome. It is imperative that physicians comprehensively investigate patients with poisoning for multiorgan dysfunction. Anticipation of local and systemic complications of injected poisons and timely medical and surgical intervention is life-saving.
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    Congenital Malaria in a 2-Day-Old Neonate: A Case Report and Literature Review
    (Case Reports in Infectious Diseases, 2021) Kajoba, Dickson; Egesa, Walufu Ivan; Petit, Habonimana Jean; Laker, Goretty; Waibi, William Mugowa; Asiimwe, Daniel
    Congenital malaria is the presence of malaria parasites in a blood smear obtained from a neonate usually within 24 hours to 7 days of life. It has for long been regarded a rare condition. However, recent data indicate that congenital malaria complicates around 35.9% of live births globally, 0–37% in Sub-Saharan Africa and about 4–6.1% in Eastern Uganda. We present a 2-day-old neonate who presented with fever, irritability, and failure to breastfeed. Laboratory tests indicated that the neonate had a positive Giemsa-stained peripheral smear for Plasmodium falciparum, with a positive malaria rapid diagnostic test (MRDT) for P. falciparum malaria. The mother had a negative peripheral film for malaria and a negative MRDT. The neonate was managed with intravenous artesunate with improvement.
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    Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants
    (International Journal of Pediatrics, 2021) Egesa, Walufu Ivan; Odoch, Simon; Odong, Richard Justin; Nakalema, Gloria; Asiimwe, Daniel; Ekuk, Eddymond; Twesigemukama, Sabinah; Turyasiima, Munanura; Lokengama, Rachel Kwambele; Waibi, William Mugowa; Abdirashid, Said; Kajoba, Dickson; Kumbakulu, Patrick Kumbowi
    Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.
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    Intestinal Obstruction in a Child with Massive Ascariasis
    (Case Reports in Pediatrics, 2021) Turyasiima, Munanura; Matovu, Paul; Kiconco, Gloria; Egesa, Walufu Ivan; Sunday, Phillip; Nakandi, Lydia; Musa, Kirya; Oluka, Denis; Byendera, Martin
    Soil-transmitted helminths are so prevalent in the tropics and low developing countries. Pediatric clinical presentation of ascariasis, the most common helminth, as the intestinal obstruction is not only rare but also less described. We present a case of a 4- year-old girl with massive ascariasis. She presented with a 3-day history of acute abdominal pain associated with vomiting and an episode of passing long white roundworms, about 5 cm in length, through the nose. (e child had mild constipation and passed pellets of hard stool once in the last 72 hours. She was in fair general condition at the examination but had significant findings on abdominal examination. On palpation, there was a soft mass localized in the left paraumbilical area and no tenderness, with normal bowel sounds on auscultation. Exploratory laparotomy was sanctioned where roundworms (Ascaris lumbricoides), saucepan full, were delivered through a 2.5 cm enterotomy incision. Postoperative management was carried out, and the child discharged on the 7th day of treatment including a 3-day course of albendazole 400 mg daily.
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    Prevalence, feeding practices, and factors associated with undernutrition among HIV-exposed uninfected children aged 6 to 18 months in Bushenyi district, western Uganda: A cross-sectional study
    (Researchsquare, 2022) Kumbakulu, Patrick Kumbowi; Ndeezi, Grace; Egesa, Walufu Ivan; Nakalema, Gloria; Odoch, Simon; Kambele, Rachel Lokengama; Twesigemukama, Sabinah; Asiimwe, Daniel; Waibi, William M.; Elmi, Said Abdirashid; Nduwimana, Martin
    HIV-exposed children are vulnerable to undernutrition. Understanding the prevalence and factors with undernutrition remains essential for developing effective strategies to reduce the impact of malnutrition among this vulnerable population.
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    Sickle Cell Disease in Children and Adolescents: A Review of the Historical, Clinical, and Public Health Perspective of Sub-Saharan Africa and Beyond
    (International Journal of Pediatrics, 2022) Egesa, Walufu Ivan; Nakalema, Gloria; Waibi, William M.; Turyasiima, Munanura; Amuje, Emmanuel; Kiconco, Gloria; Odoch, Simon; Kumbakulu, Patrick Kumbowi; Abdirashid, Said; Asiimwe, Daniel
    Sickle cell disease (SCD) is an umbrella term for a group of life-long debilitating autosomal recessive disorders that are caused by a single-point mutation (Glu→Val) that results in polymerization of hemoglobin (Hb) and reversible sickle-shape deformation of erythrocytes. This leads to increased hemolysis of erythrocytes and microvascular occlusion, ischemia-reperfusion injury, and tissue infarction, ultimately causing multisystem end-organ complications. Sickle cell anemia (HbSS) is the most common and most severe genotype of SCD, followed by HbSC, HbSβ0thalassemia, HbSβ+thalassemia, and rare and benign genotypes. Clinical manifestations of SCD occur early in life, are variable, and are modified by several genetic and environmental factors. Nearly 500 children with SCD continue to die prematurely every day, due to delayed diagnosis and/or lack of access to comprehensive care in sub-Saharan Africa (SSA), a trend that needs to be urgently reversed. Despite proven efficacy in developed countries, newborn screening programs are not universal in SSA. This calls for a consolidated effort to make this possible, through the use of rapid, accurate, and cheap point-of-care test kits which require minimal training. For almost two decades, hydroxyurea (hydroxycarbamide), a century-old drug, was the only disease-modifying therapy approved by the U.S. Food and Drug Administration. Recently, the list expanded to L-glutamine, crizanlizumab, and voxelotor, with several promising novel therapies in the pipeline. Despite its several limitations, hematopoietic stem cell transplant (HSCT) remains the only curative intervention for SCD. Meanwhile, recent advances in gene therapy trials offer a glimpse of hope for the near future, although its use maybe limited to developed countries for several decades.