Browsing by Author "Nakalema, Gloria"

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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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    Predictors Patterns Of Bacterial Urinary Tract Infections Among Febrile Children Under-Five Years Of Age At Kampala International University Teaching Hospital
    (Chemistry and Pharmacy, 2015) Nakalema, Gloria; Ortiz, Yamile A.; Agwu, Ezera
    An accurate and reliable diagnosis of UTI in children is critical because they are usually underdiagnosed or over-diagnosed especially in children under five years of age. Antimicrobial susceptibility results are key to effective intervention. This study was done to determine the predictors patterns of bacterial urinary tract infections among febrile children aged less than 5 years presenting at Kampala International University Teaching Hospital. A hospital-based cross-sectional study was conducted in entry points of the pediatric ward of KIU-TH between December 2020 and March 2021. The study enrolled a total of 350 children 2-59 months by consecutive enrolment. Urinalysis and urine culure was done, clinical and demographic data was collected using questionnaires and data analysed using SPSS version 27 with significance at 95% confidence interval. Factors that were independently predictive of a UTI were age less than 24 months (p 0.002), male children (p 0.010), undernutrition (p 0.012), diarrhea (p 0.032), vomiting (p 0.005). Children who were wiped back to front after defecation (p 0.021), diapers use (p 0.014). Among the laboratory urinalysis predictors, Children with nitrites and those with more than 5 white blood cells at urine microscopy were 17.875(p <0.001) and 6.505(p<0.001) times more likely to suffer from Urinary tract infection respectively
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    Prevalence patterns of bacterial urinary tract infections among febrile children under-five years of age at Kampala International University Teaching Hospital
    (Chemistry and Pharmacy, 2015) Nakalema, Gloria; Ortiz, Yamile A.; Agwu, Ezera
    Accurate and reliable diagnosis of UTI in children is critical because they are usually underdiagnosed or over-diagnosed especially in children under five years of age. Antimicrobial susceptibility results are key to effective intervention. This study was done to determine the prevalence patterns of bacterial urinary tract infections among febrile children aged less than 5 years presenting at Kampala International University Teaching Hospital. A hospital-based cross-sectional study was conducted in entry points of the pediatric ward of KIU-TH between December 2020 and March 2021. The study enrolled a total of 350 children 2-59 months by consecutive enrolment. Urinalysis and urine culure was done, clinical and demographic data was collected using questionnaires and data analysed using SPSS version 27 with significance at 95% confidence interval. Out of 350 children studied, 97 (27.7%) had a UTI. E.coli was the most commonly isolated uropathogen (56.7%). There is a high intra hospital prevalence of bacterial UTIs among febrile children under five years of age with with E.Coli as the predominant causative organism.
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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.
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    Susceptibility patterns of bacterial urinary tract infections among febrile children under-five years of age at Kampala International University Teaching Hospital
    (IDOSR Journal of Biology, Chemistry and Pharmacy, 2015) Nakalema, Gloria; Ortiz, Yamile A.; Agwu, Ezera
    A reliable diagnosis of UTI in children is critical because they are usually under diagnosed or over-diagnosed especially in children under five years of age. Antimicrobial susceptibility results are key to effective intervention. This study was done to determine the prevalence, predictors, and susceptibility patterns of bacterial urinary tract infections among febrile children aged less than 5 years presenting at Kampala International University Teaching Hospital. A hospital-based cross-sectional study was conducted in entry points of the pediatric ward of KIU-TH between December 2020 and March 2021. The study enrolled a total of 350 children 2-59 months by consecutive enrollment. Urinalysis and urine culure was done, clinical and demographic data was collected using questionnaires and data analysed using SPSS version 27 with significance at 95% confidence interval. Isolates had a sensitivity pattern to Imipenem of 93.4%, Ciprofloxacin (85.4%), Amikacin (77.4%) and were extremely resistant to Cotrimoxazole (83.3%), Amoxicillin (80.0%) and Ampicillin (74.4%). There is a high resistance to commonly used antibiotics thus need to review the treatment protocols of UTI.