Browsing by Author "Mutyaba, Twaha"

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    Evaluation of 'see-see and treat' strategy and role of HIV on cervical cancer prevention in Uganda
    (Reproductive Health, 2010) Mutyaba, Twaha; Mirembe, Florence; Sandin, Sven; Weiderpass, Elisabete
    There is scant information on whether Human Immunodeficiency Virus (HIV) seropositivity has an influence on the outcome of treatment of precancerous cervical lesions using cryotherapy. We studied the prevalence of cervical abnormalities detectable by visual inspection and cervical lesions diagnosed by colposcopy according to HIV serostatus and described the outcomes of cryotherapy treatment. Trained nurses examined women not previously screened for cervical cancer using visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) in two family planning/post natal clinics in Kampala, Uganda, from February 2007 to August 2008. Women with abnormal visual inspection findings were referred for colposcopic evaluation and HIV testing. Women with precancerous cervical lesions detected at colposcopy were treated mainly by cryotherapy, and were evaluated for treatment outcome after 3 months by a second colposcopy.
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    Incidence of postcesarean infections in relation to HIV status in a setting with limited resources
    (Acta Obstetricia et Gynecologica Scandinavica, 2005) Björklund, Kenneth; Mutyaba, Twaha; Nabunya, Evelyn; Mirembe, Florence
    The aim of the present study was to assess the incidence of postcesarean infections in relation to HIV status in a setting where resources are limited, HIV infection is common, and antiretroviral treatment is not generally available. Methods. The setting was a tertiary African obstetric unit with 27 000 deliveries annually. The study design was prospective and the sample consisted of 1600 of cesarean sections. All women requiring cesarean section were eligible for inclusion. HIV status was registered from the antenatal card only. For the analysis, the participants were divided into two categories: those with negative or unknown HIV status and those with positive HIV status. The main outcome measures are endometritis, wound infection, and mobilization parameters. Results. A total of 1526 cases, of which 1492 were emergency cesarean sections, were included in the analysis. HIV status was negative or unknown in 1430 cases and positive in 96. In the HIV-negative/unknown group, the incidence of endometritis was 8.5% (121/ 1430), wound infection 5.0% (71/1430), and endometritis and/or wound infection 10.8% (154/1430). In the HIV-positive group, the corresponding incidences were 51.0% (49/96), 29.2% (28/96), and 65.5% (63/96), respectively. The indication for cesarean section was dystocia in 79% (134/170) of the women who developed endometritis. Conclusions. The results indicate that women with untreated HIV infection are at very high risk of postcesarean infection in low resourced settings.
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    Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening
    (Reproductive Health, 2007) Mutyaba, Twaha; Faxelid, Elisabeth; Mirembe, Florence; Weiderpass, Elisabete
    Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits.
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    Male partner involvement in reducing loss to follow-up after cervical cancer screening in Uganda
    (International Journal of Gynecology & Obstetrics, 2009) Mutyaba, Twaha; Mirembe, Florence; Sandin, Sven; Weiderpass, Elisabete
    To evaluate the efficacy of male partner involvement in reducing loss to follow-up among women in Uganda referred for colposcopy after a positive cervical cancer-screening test. Methods: In 2 familyplanning/ postnatal clinics at Mulago Hospital, Kampala, Uganda, 5094 women were screened for cervical lesions. Those who screened positive were referred for colposcopy; half were allocated to the intervention group and half to the control group. In the intervention group, information about the screening findings and a request to assist their partner in attending the next examination were sent to male partners. In the control group, a standard service was provided, which did not include a letter to the male partner. Logistic regression models were applied to calculate the probability of women returning for colposcopy. Results: Of the 834 women referred, 209 (25%) did not return for colposcopy: 143/419 (34%) from the control group and 66/415 (16%) from the intervention group. Women in the intervention group were more likely to return (odds ratio 2.8; 95% confidence interval, 1.9–3.9). Conclusion: Male partner involvement significantly reduced loss to follow-up among women referred for colposcopy.