NRU :: Browsing by Author "Kasangaki, Arabat"

Browsing by Author "Kasangaki, Arabat"

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Association between oral candidiasis and low CD4+ count among HIV positive patients in Hoima Regional Referral Hospital
(BMC Oral Health, 2014) Nanteza, Martina; Tusiime, Jayne B.; Kalyango, Joan; Kasangaki, Arabat
The aim of this study was to determine the prevalence of Human Immune Virus (HIV) related oral lesions and their association with Cluster of Differentiation 4 (CD4+) count among treatment naïve HIV positive patients. Methods: This was a descriptive and analytical cross sectional study. Participants were 346 treatment naïve HIV positive adult patients. These were consecutively recruited from Hoima Regional Referral hospital between March and April 2012. Data collection involved interviews, oral examinations and laboratory analysis. Results: A total of 168(48.6%) participants had oral lesions. The four commonest lesions were oral candidiasis (24.9%, CI = 20.6-29.7%), melanotic hyperpigmentation (17.3%, CI = 13.7-21.7%), kaposi sarcoma (9.3%, CI = 6.6-12.8%) and Oral Hairy Leukoplakia (OHL) (5.5%, CI = 3.5-8.4%). There was significant association between oral candidiasis and immunosuppression measured as CD4+ less than 350 cells/mm3 (OR = 2.69, CI = 1.608-4.502, p < 0.001). Oral candidiasis was the only oral lesion significantly predictive of immunosuppression (OR = 2.56, CI = 1.52-4.30, p < 0.001) with a Positive Predictive Value (PPV) of 48.2%, Negative Predictive Value (NPV) of 74.3%, 38.1% sensitivity and specificity of 81.4%. Conclusion: Oral candidiasis can be considered as a marker for immunesuppression, making routine oral examinations essential in the management of HIV positive patients.
Attendance and Utilization of Antenatal Care (ANC) Services: Multi-Center Study in Upcountry Areas of Uganda
(Open journal of preventive medicine, 2015) Kawungezi, Peter Chris; AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W.; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah
Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda.
Characteristics of Pyogenic Odontogenic Infection in Patients Attending Mulago Hospital, Uganda: A Cross-Sectional Study
(BMC microbiology, 2015) Kityamuwesi, Richard; Muwaz, Louis; Kasangaki, Arabat; Kajumbula, Henry; Rwenyonyi, Charles Mugisha
Predisposing factors of pyogenic odontogenic infection include dental caries, pericoronitis, periodontitis, trauma to the dentition and the supporting structures or complications of dental procedures. The infections are usually polymicrobial involving normal endogenous flora. We characterised pyogenic odontogenic infection in patients attending Mulago Hospital, Uganda.Of the 130 patients, 62 (47.7%) were female. The most frequently involved fascial spaces were: the buccal, 52 (25.4%); submasseteric, 46 (22.4%) and the submandibular space, 36 (17.5%). Dental caries was the most prevalent predisposing factor, particularly of the lower third molar teeth. Viridans Streptococci Group and Staphylococcus aureus were the most frequent bacterial isolates: 23.5% and 19.4%, respectively. All Viridans Streptococci isolates were resistant to penicillin G, sulfamethoxazole/trimethoprim (cotrimoxazole), ampicillin and tetracycline, but susceptible to vancomycin. All Staphylococcus aureus strains were resistant to cotrimoxazole and ampicillin while retaining susceptibility to vancomycin, cefotaxime, linezolid, moxifloxacin and amoxicillin/clavulanate. Thirty five (26.9%) patients were HIV infected and the HIV status did not significantly influence the pattern of odontogenic infection.Dental caries was the most prevalent predisposing factor for pyogenic odontogenic infection. High prevalence of bacterial resistance to ampicillin and cotrimoxazole suggests the need for regular antibiotic susceptibility tests of isolates and rational use of antibiotics in the management of these infections. Prevention requires strengthening of oral health in the community.
Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial
(PLoS ONE, 2015) Birungi, Nancy; Fadnes, Lars T.; Okullo, Isaac; Kasangaki, Arabat; Nankabirwa, Victoria; Ndeezi, Grace; Tumwine, James K.; Tylleskär, Thorkild; Atle Lie, Stein; Nordrehaug Åstrøm, Anne
Although several studies have shown short term health benefits of exclusive breastfeeding (EBF), its long term consequences have not been studied extensively in low-income contexts. This study assessed the impact of an EBF promotion initiative for 6 months on early childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern Uganda. Methods Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24 clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention or standard of care. At the 5 year follow-up, ECC was recorded under field conditions using the World Health Organization’s decayed missing filled tooth (dmft) index. Adjusted negative binomial and linear regression were used in the analysis. Results Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI 20.7–22.9) and 21.3(CI 20.7–21.9) months, respectively. The mean dmft was 1.5 (standard deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively. Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65–1.2). Comparing the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48 (-0.72 to 1.7). Conclusion PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5 years of age. This study contributes to the body of evidence that promotion of exclusive breastfeeding does not raise oral health concerns. However, the high burden of caries calls for efforts to improve the oral health condition in this setting.
Etiology and Pattern of Mandibular Fractures among Patients Attending Oral and Maxillofacial Surgery Unit in Mulago Hospital, Uganda: A Cross–Sectional Study
(Archives of Dentistry and Oral Health, 2018) Mpiima, Patrick; Kasangaki, Arabat; Nkamba, Eriab; Rwenyonyi, Charles Mugisha
The mandible is one of the most commonly fractured bones of the facial skeleton because of its anatomical prominence. The objective of the study was to establish the etiological factors and pattern of mandibular fractures among patients (n=73) aged 3 – 55 years attending the Oral and Maxillofacial Surgery Unit of Mulago Hospital.This was a hospital based cross-sectional study among patients with mandibular fractures who were consecutively recruited after informed consent. The data were collected using a structured questionnaire and clinical oral examination. The collected data were analyzed using Statistical Package for Social Sciences, version 17 for Windows, Chicago, Illinois, USA.There were 73 patients with 107 mandibular fracture sites. Most fractures were caused by road traffic accident (58%) and assault (38%), and especially among pedestrians and passengers. About half of the patients with fractures were aged 21-30 years. The sex ratio of the patients was 7.7 males versus 1 female. About 17% of the patients were under the influence of alcohol during injury. Majority (69.9%) of the injuries occurred in the Kampala Metropolitan area. Single fractures were observed in 55% of the patients and half of them, displaced. About 91% of the patients with multiple fractures were bilateral. The present study indicated that road traffic accidents and assaults were major causes of madibular fractures, particularly among the youths in the studied population. Males were more prone to mandibular fractures.
Oral Manifestations in HIV/AIDSInfected Children
(European journal of dentistry, 2011) Rwenyonyi, Charles Mugisha; Kutesa, Annet; Muwazi, Louis; Okullo, Isaac; Kasangaki, Arabat; Kekitinwa, Addy
To assess factors influencing the distribution of oral manifestations in HIV/AIDS-infected children attending the Paediatric Infectious Disease Clinic in Mulago Hospital, Kampala. This was a cross-sectional study comprising 237 children (males/females: 113/124) aged 1 to 12 years. The parents/guardians were interviewed to obtain demographic information, oral hygiene practices, dietary habits and health seeking behaviours as well as any medications taken. The children were clinically examined for oral lesions based on World Health Organization criteria with modifications. About 71.7% of the children cleaned their teeth. About 16.9% of the children had visited a dentist since birth, mainly for emergency care. One or more oral lesions were recorded in 73% of the children of whom 19.0% experienced discomfort during oral functions. Cervical lymphadenopathy, oral candidiasis and gingivitis were the most common soft tissue oral lesions: 60.8%, 28.3% and 19.0%, respectively. Except for dental caries, the overall frequency distribution of soft tissue oral lesions was significantly lower in children on highly active antiretroviral therapy (HAART) as compared to their counterparts not on HAART. The prevalence of dental caries in deciduous and permanent dentitions was 42.2% and 11.0%, respectively. Tooth brushing and previous visits to the dentist were indirectly and significantly associated with dental caries. About 5.9% (n=14) of the children had <200 CD3 + CD4 T-lymphocyte cells per μl of blood. The majority of the children had one or more oral lesions, particularly in the group not on HAART. Some of the lesions were associated with discomfort during oral functions. (Eur J Dent 2011;5:291-298)
Pain Experience and Pain Control among Trauma Patients in Oral and Maxillofacial Surgery Clinic of Mulago Hospital, UgandaPain Experience and Pain Control among Trauma Patients in Oral and Maxillofacial Surgery Clinic of Mulago Hospital, Uganda
(International Journal of Research Studies in Medical and Health Sciences, 2018) Kugonza, Gonzaga; Kasangaki, Arabat; Muwazi, Louis; Rwenyonyi, Charles Mugisha
Pain is an unpleasant sensory and emotional experience often described as tissue damage, in the presence/absence of actual tissue damage or somatic disease. The aim of the present study was to establish pain experience of trauma patients and pain management practices of health care practitioners during invasive interventions in the Oral and Maxillofacial Surgery Clinic of Mulago Hospital. This was a cross sectional study on 187 trauma patients scheduled for invasive interventions who were consecutively recruited. Pain experience was evaluated using a horizontal Visual Analogue Scale to ascertain their pain experience before and during invasive procedures. During surgical invasive procedure, no and mild pain were defined as successful whereas moderate and severe pain were considered failed pain control.Before invasive intervention, 74.3% of the participants reportedly experienced either no or mild pain. During invasive procedures, all participants reported feeling some degree of pain; 21.4% being mild in nature. Overall, there was no consistency in pain control techniques applied for any given intervention with the exception of surgical toilet and zygomatic arch elevation, where anesthetic infiltration was the only technique applied. During surgical toilet, pain control was successful in 84.6% of the participants, while splinting of teeth and intermaxillary fixation, infiltration was successful in 50% and <20% of the participants, respectively. Eyelet wire removal was performed in 40.1% (n=75) of the participants with no form of pain control with 70.6% (n=53) of the participants reporting severe pain during the procedure.Most participants reported a higher degree of pain during the intervention compared to their pre-intervention time. No pain control was provided to patients during eyelet wire removal, most of whom reported severe pain. Most interventions had varied approaches to the pain control techniques with the exception of surgical toilet and elevation of the zygomatic arch.
Prevalence and Factors Associated with Dental Caries among Children and Adults in Selected Districts in Uganda
(African Health Sciences, 2015) Kutesa, Annet; Kasangaki, Arabat; Nkamba, Moses; Muwazi, Louis; Okullo, Isaac; Rwenyonyi, Charles Mugisha
The aim was to determine the prevalence and factors associated with dental caries among adults and children in seven districts of Uganda.Participants aged 11-13 (n=1230) and 35-44 years (n=648) were randomly selected from urban and rural areas of Gulu, Soroti, Jinja, Masaka, Kabale, Kabarole and Hoima districts. They were examined by 4 trained and calibrated dentists for dental caries using Decayed, Missing and Filled teeth index as described by World Health Organisation.Overall mean DMFT score was 0.73 for children and 4.71 for adults. Generally, there was a higher mean DMFT score in the rural (2.19) compared to urban areas (1.97). In all the districts, except Hoima, there was a higher mean DMFT score of children in rural compared to urban. In adults, similar trend was mainly registered in Masaka, Hoima and Gulu districts. Most participants (79.9%, n=1309)occasionally ate sugared snacks. Overall, 95% (n=1795) of the participants cleaned their teeth with plastic tooth brushes (71.7%) and chewing sticks (8.3%).Although the severity of dental caries was low, the disease was widespread in the study population. A high proportion of participants reported consumption of sugared snacks and drinks, which calls for oral health education.
Prevalence of Oral Diseases/Conditions in Uganda
(African health sciences, 2005) Muwazi, Louis M.; Rwenyonyi, Charles M.; Tirwomwe, Francis J.; Ssali, Charles; Kasangaki, Arabat; Nkamba, Moses E.; Ekwaru, Paul
The aim was to report the prevalence of oral diseases/conditions among a Ugandan population. Subjects aged 12 (n=696) and 35-44 years (n=396) were chosen from randomly selected urban and peri-urban areas of Arua, Mbale, Kampala and Mbarara districts. They were clinically examined by 4 trained and calibrated dentists for oral diseases/conditions using criteria described by World Health Organisation. Dental caries (DMFT ≥1) was recorded in 40% and 62.5% of the children and adults, respectively. The overall mean DMFT score was 0.9 for children and 3.4 for adults. Caries was significantly more severe in females as compared to males in children (p<0.05), whereas in adults, there was no significant gender difference. Kampala had a significantly higher mean DMFT score compared to other districts in all age groups (p>0.05). Culculus deposits were generally, more prevalent in adults as compare to children except in Mbarara district. Gum bleeding was also significantly more prevalent among children as compared to adults (p<0.05). Significantly higher prevalence of gum bleeding in both children and adults was recorded in Arua district as compared to other areas (p<0.05). Each of the age groups had a prevalence of malocclusion of 61%. However, the severity of malocclusion varied between age groups and districts. The prevalence of dental fluorosis was 3% and 4% for children and adults, respectively. All subjects in Arua district were fluorosis-free. Tetracycline enamel staining was less than 1% in both age groups. Enamel attrition was more prevalent in adults as compared to children: 19% versus 1%.The prevalence of oral diseases/conditions was generally low among the study population. Caries experience was significantly higher in the Kampala (urban) district as compared to rural districts in all age groups; the D - component being the major contributor.

Browsing by Author "Kasangaki, Arabat"

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