Browsing by Author "Mwambi, Bashir"

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    AmpC-BETA Lactamases among Enterobacteriaceae Isolated at a Tertiary Hospital, South Western Uganda
    (British biotechnology journal, 2014) Nakaye, Martha; Bwanga, Freddie; Itabangi, Herbert; Iramiot, J. Stanley; Mwambi, Bashir; Bazira, Joel
    To characterize AmpC-beta lactamases among Enterobacteriaceae isolates from clinical samples at Mbarara Regional Referral Hospital. Study Design—Laboratory-based descriptive cross-sectional study Place and Duration of Study—Microbiology Department, Mbarara Regional Referral Hospital and MBN clinical Laboratories, between May to September 2013. Methodology—This study included 293 Enterobacteriaceae isolates recovered from clinical specimens that included blood, urine, stool and aspirates. AmpC Beta lactamase production was determined using disc placement method for cefoxitin at a break point of <18mm. Common AmpC plasmid mediated genes were EBC, ACC, FOX, DHA, CIT and MOX were; was determined by Multiplex PCR as described by Hanson and Perez-Perez. Results—Plasmid mediated AmpC phenotype was confirmed in 107 of the 293 (36.5%) cefoxitin resistant isolates with 30 isolates having more than one gene coding for resistance. The commonest source that harbored AmpC beta lactamases was urine and E. coli was the most common AmpC producer (59.5%). The genotypes detected in this study, included EBC (n=36), FOX (n=18), ACC (n=11), CIT (n=10), DHA (n=07) and MOX (n=1). Conclusion—Our findings showed that prevalence of AmpC beta-lactamase at MRRH was high (39.6), with EBC as the commonest genotype among Enterobacteriaceae Urine and E. coli were the commonest source and organism respectively that harbored AmpC beta-lactamases. There‘s rational antimicrobial therapy and antibiotic susceptibility tests should be requested by health workers especially patients presenting with urinary tract infections and bacteraemias.
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    Assessment Of The Diagnostic Performance Of Truehb Point-Of-Care Hemometer Compared With Sysmex I3 Analyzer Among Patients At International Hospital Kampala, Uganda
    (Journal of blood medicine, 2019) Taremwa, Ivan Mugisha; Ndeze, Ivan; Mwambi, Bashir; Atuhairwe, Christine; Achieng, Diana Inda; Natukunda, Bernard
    To assess the diagnostic performance of TrueHb® point-of-care (POC) hemometer compared with Sysmex i3 analyzer at International Hospital Kampala, Uganda.We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated.The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17–40.38). The mean difference of the TrueHb® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095–0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161–2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb® hemometer was 2.46 mins (95% CI: 2.37–2.55). TrueHb® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.
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    Knowledge, Perception and Practices Towards Sickle Cell Disease: A Community Survey among Adults in Lubaga Division, Kampala Uganda
    (BMC Public Health, 2018) Tusuubira, Sharifu K.; Nakayinga, Ritah; Mwambi, Bashir; Odda, John; Kiconco, Sylvia; Komuhangi, Alimah
    Worldwide, the burden of Sickle Cell disease (SCD) has not been amply addressed. In Africa, Uganda has the 5th highest burden, a situation aggravated by limited and inaccessible formal social support structures to aid patients and families cope better with the psychosocial burden of SCD. In addition, this has been coupled with stigmatization and discrimination of people living with sickle cell disease causing isolation from family and society.This cross sectional study therefore set out to determine the attitudes, perception and level of awareness towards Sickle Cell disease in Ugandan communities. The study used an interviewer administered questionnaires to collect the data.Out of 110 people sampled; 91.2% of the respondents had ever heard of SCD with the highest proportion 38.7% hearing of SCD from friends and family. Close to half of the respondents 48% knew that SCD is inherited, however a large proportion 44.2% did not know the cause of SCD. However, 68.7% of the respondents said they cannot marry a person with SCD.The study results indicate that more effort needs to be done to promote sickle cell awareness in Uganda communities with emphasis on the inclusion of sickle cell in health education campaigns.
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    Otomycosis among Patients Presenting with Ear Discharges at a Tertiary Hospital in South Western Uganda
    (International Journal of TROPICAL DISEASE & Health, 2018) Itabangi, Herbert; Katawera, Victoria; Nyaitera, Victoria; Iramiot, Jacob Stanley; Nakaye, Martha; Mwambi, Bashir; Mukasa Kiguli, James; Bazira, Joel; Byarugaba, Fredrick
    To the determine prevalence, mycology profile, associated symptoms and risk factors of otomycosis among patients that present with an ear discharge. Study Design: This was a cross-sectional study in which survey data was analysed. Place and Duration of Study: Departments of Microbiology and ENT, Faculty of Medicine, Mbarara University Teaching Hospital, between 2013 and 2015. Methodology: We recruited 117 patients (52 men, 65 women of age range 1-69 years) presenting with a discharging ear. Both newly enrolled and follow-up patients were included in the study. Clinically, patients were assessed for symptoms, possible predisposing factors, and treatment history. For laboratory diagnosis, ear swabs were aseptically collected and mycology profile determined using both direct examination and culture techniques. Fungal identification was through stimulation of fruiting bodies such as conidia or chlamydospores and biochemical identification. Results: Of the 117 participants enrolled, fungal infection was detected in 24 (20.51%) with direct microscopy and confirmed in 16 (13.68%) by culture. Otomycosis was more common among the youth (54%). There were no statistically significant symptoms associated with otomycosis. However, HIV/AIDS and mastoidectomy were significant predisposing factors (38%, p = 0.001 and 25%, p = 0.002, respectively). Aspergillus species (76.47%), Candida albicans (17.65%) and Cladosporium species (5.88%) were the agents commonly associated with otomycosis in this region. Conclusion: Otomycosis can be common and is an important disease of the external ear, especially in at-risk individuals. In southwestern Uganda, the disease is common among young males and aetiology is mainly due to Aspergillus and Candida albicans but other opportunists such as Cladosporium species may also be implicated. Thus, there is a need for routine checks followed by robust diagnostic approaches as a means for evidence-based patient management.
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    Prevalence and Antibiotic Susceptibility Patterns of Clinical Isolates of Methicillin- Resistant Staphylococcus aureus in a Tertiary Care Hospital in Western Uganda
    (British Microbiology Research Journal, 2014) Stanley, Iramiot J.; Bwanga, Freddie; Itabangi, Herbert; Nakaye, Martha; Mwambi, Bashir; Bazira, Joel
    To determine the prevalence and antibiotic susceptibility patterns of clinical isolates of methicillin resistant Staphylococcus aureus isolated at Mbarara Regional Referral Hospital. Method: A total of 400 S. aureus isolates recovered from various clinical specimens at Mbarara Regional Referral Hospital were included in this study. Phenotypic screening was performed using Oxacillin. Presence of mecA gene was studied using polymerase chain reaction (PCR). The mecA positive isolates were tested for susceptibility to, Vancomycin, Imipenem, Fusidic acid, Trimethoprim/Sulfamethoxazole, Clindamycin and Linezolid using the Kirby Bauer technique. Results: Of the 300 isolates of S. aureus 31.3% (94) were phenotypically MRSA and 38% (114) had the mecA gene. All the MRSA isolates were susceptible to vancomycin and linezolid but were highly resistant to trimethoprim/sulfamethoxazole (70.2%). Of the 114 MRSA isolates 19.3% (22) were multi-drug resistant S. aureus (MDR-MRSA). The study found that there was a significant difference between genotypic and phenotypic detection methods (p < 0.001). Conclusion: The prevalence of MRSA in Mbarara is high (38%) with a high resistance to trimethoprim/sulfamethoxazole. The detection of mecA gene is a good predictor of methicillin resistance in S. aureus. There is a worrying prevalence of MDR MRSA among the clinical isolates of S. aureus in South Western Uganda.
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    Prevalence of RhD Variants Among Blood Donors At Gulu Regional Blood Bank, Gulu, Northern Uganda
    (Journal of blood medicine, 2017) Ojok, Polycarp; Oyet, Caesar; Webbo, Fred; Mwambi, Bashir; Taremwa, Ivan M.
    The aim of this study was to determine the prevalence of RhD variant phenotypes among voluntary non-remunerated blood donors (VNRBDs) at Gulu Regional Blood Bank (GRBB), Northern Uganda.We conducted a cross-sectional study, in which the first 4.0 mL of ethylenediaminetetraacetic acid (EDTA) blood samples were collected from VNRBDs and typed for their ABO and RhD blood group status using IgM and IgG monoclonal typing antisera, respectively. Blood samples that tested as RhD negative were further investigated for RhD variant phenotypes using indirect antihuman globulin hemagglutination technique.We assayed 138 RhD-negative blood samples obtained from VNRBDs. Of these, 66.7% (n=92) were males. Their median age was 24.4 years (range, 14–33 years). Majority of the participants were of ABO blood group O (62.8%, n=86), followed by A (19.7%, n=27), then B (13.9%, n=19) and least AB (3.6%, n=6). The prevalence of RhD variant phenotypes was 0.7% (n=1; 95% confidence interval, 0.5–0.9). There was no statistical association of RhD variant phenotypes with donor gender, tribe and their ABO blood groups.This study has revealed a high prevalence of RhD variant among blood donors at GRBB in Northern Uganda. It further highlights a potential risk of alloimmunization, as the present blood typing practices do not identify RhD variant phenotypes.