Browsing by Author "Okot, Jerom"

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    Coronavirus disease–2019 Morbidity and Mortality among Health Care Workers in Uganda
    (Therapeutic Advances in Infectious Disease, 2022) Ssetaba, Leoson Junior; Mirembe, Joy; Omega, Jotham; Okot, Jerom; Kiguli, Sarah; Nakwagala, Frederick Nelson; Bongomin, Felix
    Health care workers (HCWs) are at increased risk of acquiring coronavirus disease 2019 (COVID-19). This study aimed to determine and compare the morbidity and mortality rates due to COVID-19 among the HCWs and the general population (non-HCWs). We conducted a retrospective chart review. We accessed electronic database of participants admitted at Mulago National Referral Hospital COVID-19 Treatment Unit (CTU) between March 2020 and September 2021. Participants with missing occupations were excluded. Of 594 eligible participants, 6.4% (n=38) were HCWs. Compared with non-HCWs, HCWs were much younger (48 versus 55 years, p=0.020). The proportion of participants with severe disease (73.7% versus 77.6%, p=0.442), who had not received COVID-19 vaccine (91.2% versus 94.7%, p=0.423), mortality rate (44.7% versus 54.8%, p=0.243) and the median length of hospitalization (6 versus 7 days, p=0.913) were similar among HCWs and non-HCWs, respectively. A higher proportion of HCWs required oxygen therapy (24.3% versus 9.7%, p<0.01). At admission, the presence of cough (p=0.723), breathlessness (p=0.722), fever (p=0.19), sore throat (p=0.133), comorbidities (p=0.403) and headache (p=0.162) were similar across groups. Rhinorrhoea was more common among HCWs (34.4% versus 16.6%, p=0.017). Among HCWs, nurses had the highest morbidity (52.6%) and mortality (58.8%). The morbidity and mortality among HCWs in Uganda were substantial, with a low COVID-19 vaccination rate and a higher requirement for oxygen therapy despite a younger age.
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    COVID-19, HIV-Associated Cryptococcal Meningitis, Disseminated Tuberculosis and Acute Ischaemic Stroke: A Fatal Foursome
    (Infection and Drug Resistance, 2021) Bongomin, Felix; Sereke, Senai Goitom; Okot, Jerom; Katsigazi, Ronald; Kiiza Kandole, Tadeo; Oriekot, Anthony; Olum, Ronald; Atukunda, Angella; Baluku, Joseph Baruch; Nakwagala, Frederick
    Several viral, bacterial and fungal co-infections have been associated with increased morbidity and mortality among patients with COVID-19. We report a fatal case of severe COVID-19 pneumonia in a patient with a recent diagnosis of advanced HIV disease complicated by cryptococcal meningitis, disseminated tuberculosis and acute ischemic stroke. Case Presentation: A 37-year-old Ugandan woman was diagnosed with HIV infection 8 days prior to her referral to our center. She was antiretroviral naïve. Her chief complaints were worsening cough, difficulty in breathing, fever and altered mental status for 3 days with a background of a 1-month history of coughing with associated drenching night sweats and weight loss. The reverse transcriptase–polymerase chain reaction for SARS-CoV-2 of her nasopharyngeal swab sample was positive. Chest radiograph demonstrated military pattern involvement of both lungs. The serum and cerebrospinal fluid cryptococcal antigen tests were positive. Urine lipoarabinomannan and sputum GeneXpert were positive for Mycobacterium tuberculosis. Computed tomography of the brain showed a large acute ischemic infarct in the territory of the right middle cerebral artery. Regardless of the initiation of treatment, that is, fluconazole 1200 mg once daily, enoxaparin 60 mg, intravenous (IV) dexamethasone 6 mg once daily, oral fluconazole 1200 mg once daily, IV piperacillin/tazobactam 4.5 g three times daily and oxygen therapy, the patient passed on within 36 hours of admission. Conclusion: Co-infections worsen COVID-19 outcomes.
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    Fear of COVID-19 and the Media Influence on Herbal Medication Use in Uganda: A Cross-Sectional Study
    (Risk Management and Healthcare Policy, 2021) Musoke, Phillip; Nantaayi, Brandy; Kato Ndawula, Rodney; Wannyana, Babrah; Ssewante, Nelson; Wekha, Godfrey; Olum, Ronald; Nakyagaba, Lourita; Nassozi, Dianah Rhoda; Nabukeera, Germinah; Kanyike, Andrew Marvin; Ojilong, Daniel; Madut Akech, Gabriel; Kajjimu, Jonathan; Kiwumulo, Joshua; Agira, Drake; Okot, Jerom; Bongomin, Felix
    The coronavirus disease-2019 (COVID-19) pandemic has created fear in people around the world. This has led to the widespread use of various herbal remedies in its prevention and treatment regardless of the paucity of scientific evidence about their safety and efficacy. This study assessed the fear of COVID-19 and the influence of media on the use of herbal medicine to prevent or treat COVID-19 in Uganda. Methods: In the first 2 weeks of July 2021, a descriptive online cross-sectional study was carried out anonymously in the general population in Uganda. A validated questionnaire was used to collect data on herbal medicine use and the influence of media. Fear of COVID-19 was rated using the Fear of COVID-19 Scale (FCV-19S). Results: We recruited 488 participants, 273 (55.9%) were female, with a median age of 25 (range: 18–73) years. Sixty-seven (57.8%) participants had a confirmed COVID-19 diagnosis. The mean FCV-19S score was 21.7 SD 5.9 with 53.3% reporting high levels of COVID-19 fear. About 57.4% of participants reported using herbal remedies either to prevent or treat COVID-19-like symptoms. Media was the main source of information, with more than 80% of the participants reporting seeing or accessing information about herbal medication use. Women (adjusted odds ratio (aOR): 1.74, 95% CI: 1.2–2.5, p=0.003) and people with a previously confirmed COVID-19 diagnosis (aOR: 3.1, 95% CI: 1.35–7.14, p=0.008) had a statistically significantly higher FCV-19S score. Being unemployed (aOR: 1.0, 95% CI: 1.1–2.3, p=0.008) and a female (aOR: 1.0, 95% CI: 1.1–2.3, p=0.012) were statistically significantly associated with herbal medicine use. Participants who used herbal remedies had a higher median FCV-19S score compared to non-users (23 versus 21, p<0.001). Conclusion: The use of herbal medicines to treat or prevent COVID-19 is a widespread practice among the general population in Uganda amidst the high levels of fear of COVID-19.
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    Fungal diseases in Africa: epidemiologic, diagnostic and therapeutic advances
    (Therapeutic Advances in Infectious Disease, 2022) Bongomin, Felix; Kibone, Winnie; Okot, Jerom; Nsenga, Lauryn; Olum, Ronald; Baruch Baluku, Joseph
    The spectrum of fungal diseases that affect humans is broad, ranging from asymptomatic superficial mycoses to deep systemic diseases due to opportunistic or primary fungal pathogens. 1 Recently, the COronaVIrus Disease 2019 (COVID-19) pandemic has highlighted mucormycosis as an important opportunistic fungal disease, especially in patients with uncontrolled diabetes mellitus and prolonged, high-dose corticosteroid use.2 Fungal diseases substantially contribute to the burden of diseases in Africa, mainly driven by heavy affliction of poverty, tuberculosis (TB) and human immunodeficiency virus (HIV) (Figure 1).3,4 Recent estimates of the burden of key fungal diseases are summarized in Table 1. The overarching aim of the special collection was to provide a state-of-the-art overview of our current understanding of various aspects of fungal diseases in Africa. It was overwhelmingly successful with a total of 14 high-quality submissions summarized below.
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    Oral health seeking behaviors of adults in Nebbi District, Uganda: a community‑based survey
    (BMC oral health, 2021) Ocwia, Juliet; Olum, Ronald; Atim, Pamela; Laker, Florence; Okot, Jerom; Goitom Sereke, Senai; Baruch Baluku, Joseph; Kiguli, Sarah; Bongomin, Felix
    Dental health is often neglected by the majority of the population and has contributed to the global burden of oral diseases. We assessed awareness, utilization and barriers to seeking oral health care among adults in Nebbi District, Uganda. Methods: A community-based, cross sectional study was conducted in the central division, Nebbi District in Uganda among adults between the age of 18 years or older. An interviewer-administered, semi-structured questionnaire was used for data collection on socio-demographic characteristics, oral health awareness, oral health utilization, associated factors and barriers. Results: A total of 400 adults with a median age of 32 years (interquartile range 24–43) years were enrolled. More than half (57.5%, n = 230) of the participants were female. Participants identified smoking (42.8%, n = 171) and consumption of sugary foodstuffs (29.0%, n = 116) as risk factors for oral disease. Not brushing was also identified by 260 participants (65.0%) as the cause of tooth decay and 95.8% (n = 383) believed brushing one’s teeth could prevent tooth decay. Of the 51.5% (n = 206) who had experienced a toothache or discomfort 12 months prior to the study but only about half (52%, n = 106) had sought healthcare from a dental clinic or facility. About 89.5% (n = 94) of the participants were able to see a dentist during their last visits. Dental carries (76.6%, n = 70) and gum bleeding (14.9%, n = 14) were the most frequent reasons for visiting a dental clinic, and 73.7% (n = 70) had their tooth extracted. Barriers to seeking oral healthcare were cost of treatment (47.5%, n = 190), and long waiting time (18.5%, n = 74). The odds of seeking oral healthcare was 2.8-fold higher in participants who were being married (Odds ratio (OR): 2.8, 95% CI 1.3–6.3, p = 0.011) and 3.5-fold higher among housewives (COR: 3.5, 95% CI 1.1–11.4, p = 0.040). Conclusion: About half of the participants had sought healthcare following a dental condition. Cost of treatment seems to be an important factor affecting utilization of oral health services. Optimization of costs, and creating awareness regarding benefits of utilizing preventive dental services are recommended.