Browsing by Author "Okullo, Isaac"
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Item Comparison of the Hyperglycemic Control of M. oleifera Leaves Aqueous Extract and Glibenclamide Tablets in Alloxan Monohydrate Induced Diabetic Rats(Asian Journal of Research in Medical and Pharmaceutical Sciences, 2019) Kasolo, Josephine N.; Namaganda, Agnes; Nfambi, Joshua; Kimuli, Ivan; Muwonge, Haruna; Okullo, IsaacDiabetes being one of the commonest non-communicable diseases worldwide has no cure. The available hypoglycemic drugs are costly, and have associated long-term side effects. M. oleifera leaves are used in many countries in Africa and Asia to treat diabetes. The study compared the hyperglycemic control of M. oleifera leaves aqueous extract and Glibenclamide tablet in alloxan monohydrate induced diabetic rats. Methods: Twenty-four female Wistar albino rats, made diabetic using alloxan monohydrate, received either M. oleifera extract, glibenclamide or distilled water were delivered intragastric. The mean body weight and mean fasting blood sugar were measured over a period of 28 days. Results: Rats that received distilled water had a mean fasting blood sugar of 329.3+44.9 mg/dl at the beginning, which increased to 448.0+189.9 mg/dl on day 14; all the rats were dead by day 21. The rats that received M. oleifera had blood sugar 443.4+134.7 mg/dl at the beginning, dropped to 166.5+162.79 mg/dl by day 14, and to 88.7+41.0 mg/dl by day 28. Rats that received glibenclamide had blood sugar 517.6+139.3mg/dl at the beginning, dropped to 209.0+201.9 mg/dl on day 14, and to 89.7+42.85 mg/dl on day 28. The blood sugar of the M. oleifera and glibenclamide groups reached normal level by day 21 and remained within the normal range up to day 28. Conclusion: Moringa oleifera leaves aqueous extract has similar pattern to glibenclamide tablet in causing hypoglycemia to alloxan monohydrate induced diabetic rats.Item Concurrently wasted and stunted children 6-59 months in Karamoja, Uganda: prevalence and case detection(Maternal and Child Nutrition, 2020) Adobea Odei Obeng-Amoako, Gloria; Myatt, Mark; Conkle, Joel; Kaijuka Muwaga, Brenda; Aryeetey, Richmond; Okwi, Andrew Livex; Okullo, Isaac; Mupere, Ezekiel; Wamani, Henry; Briend, André; Karamagi, Charles Amnon Sunday; Nakayaga Kalyango, JoanWe assessed prevalence of concurrently wasted and stunted (WaSt) and explored the overlaps between wasted, stunted, underweight and low mid-upper arm circumference (MUAC) among children aged 6–59 months in Karamoja, Uganda. We also determined optimal weight-for-age (WAZ) and MUAC thresholds for detecting WaSt. We conducted secondary data analysis with 2015–2018 Food Security and Nutrition Assessment (FSNA) cross-sectional survey datasets from Karamoja. Wasting, stunting and underweight were defined as <−2.0 z-scores using WHO growth standards. Low MUAC was defined as <12.5 cm. We defined WaSt as concurrent wasting and stunting. Prevalence of WaSt was 4.96% (95% CI [4.64, 5.29]). WaSt was more prevalent in lean than harvest season (5.21% vs. 4.53%; p = .018). About half (53.92%) of WaSt children had low MUAC, and all were underweight. Younger children aged <36 months had more WaSt, particularly males. Males with WaSt had higher median MUAC than females (12.50 vs. 12.10 cm; p < .001). A WAZ <−2.60 threshold detected WaSt with excellent sensitivity (99.02%) and high specificity (90.71%). MUAC threshold <13.20 cm had good sensitivity (81.58%) and moderate specificity (76.15%) to detect WaSt. WaSt prevalence of 5% is a public health concern, given its high mortality risk. All children with WaSt were underweight and half had low MUAC. WAZ and MUAC could be useful tools for detecting WaSt. Prevalence monitoring and prospective studies on WAZ and MUAC cut-offs for WaSt detection are recommended. Future consideration to integrate WAZ into therapeutic feeding programmes is recommended to detect and treat WaSt children.Item 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, AnneAlthough 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.Item A health care professionals training needs assessment for oncology in Uganda(Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, CharlesCancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to downstaging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region. Methods: This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the Open Data Kit platform from which the data was exported to Stata version 15 for analysis using the Wilcoxon signed-rank test and Somers-Delta. Results: There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall, the research and audit domain had the highest ranking for all the health workers (Somers-D = 0.60). The respondent’s level of education had a significant effect on the observed ranking (P value = 0.03). Most of the continuing medical education (CME) topics suggested by the participants were in the clinical task-related category. Conclusion: The “research and audit” domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME programme content, peer support networks and tailored training for the individual health care provider.Item A health care professionals training needs assessment for oncology in Uganda(Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, CharlesCancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to down staging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region.Item Oral Manifestations in HIV/AIDSInfected Children(European journal of dentistry, 2011) Rwenyonyi, Charles Mugisha; Kutesa, Annet; Muwazi, Louis; Okullo, Isaac; Kasangaki, Arabat; Kekitinwa, AddyTo 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)Item Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda(BMC oral health, 2014) Muwazi, Louis; Mugisha Rwenyonyi, Charles; Nkamba, Moses; Kutesa, Annet; Kagawa, Mike; Mugyenyi, Godfrey; Kwizera, Godfrey; Okullo, IsaacLiterature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals. Methods: This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes. Results: Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05). Conclusion: Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance.Item 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 MugishaThe 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.Item Prevalence of Latent Tuberculosis Infection among Paramedical Students in Two Hospitals in Uganda(International Journal of Research Studies in Medical and Health Sciences, 2017) Okullo, Isaac; Kaducu, Felix; Katamba, Achilles; Muwazi, Louis; Nkamba, Moses; Kutesa, Annet; Mugisha Rwenyonyi, CharlesThe risk of transmission of Mycobacterium tuberculosis to health-care workers in many low and middle-income countries is greater when large numbers of infectious (smear positive) tuberculosis (TB) patients are managed at health facilities. The present study was carried out in Mulago and Gulu teaching hospitals in Uganda among 291 students on the Public Health Dentistry (n=73), Clinical Officers (n=92) and Nursing (n=126) programmes to determine their latent TB infection status. Socio-demographic factors of the participants were recorded and TST induration was read after 48 to 72 hours. Chi-square statistics were used to compare latent TB infection among pre-clinic and clinical year students in different study programmes. About 87% (n=254) of the respondents had Bacillus Calmette–Guérin vaccination skin scar. Of the 291 respondents (response rate, 89.5%), 92.4% developed an induration after TST. The mean diameter of the induration was 12.61 mm (95% CI: 11.95-13.26). A prevalence of latent TB infection (80.4%) with TST induration reading of ≥10 mm was found among the respondents. Significantly more Nursing had an induration ≥10 mm than the Dental (p=0.046) and the Clinical Officer students (p=0.047). The observed prevalence of latent TB infection was high, indicating a high level of transmission of Mycobacteria tuberculosis among the young health worker students, which is a risk to patients under their care. It is important to screen trainees upon entering into the study programmes in order to determine the magnitude of latent TB infection for better policy guidance.Item Reversal Effects of N-Acetyl Cysteine on Moringa oleifera Leaves-Induced Sub-Acute Hepatotoxicity in Wistar Albino Rats(Neuroscience & Medicine, 2019) Kasolo, Josephine N.; Namaganda, Agnes; Bbosa, Godfrey S.; Muwonge, Haruna; Lukande, Robert; Nfambi, Joshua; Kimuli, Ivan; Okullo, IsaacM. oleifera is a highly valued medicinal plant used widely from time immemorial to treat various ailments. However, with continued un-standardized use of the plant leaves, studies have reported organ toxicity to the liver, kidney and the heart. As communities continue to use M. oleifera leaves for its medicinal and nutritional values, there is need to find an antidote for its hepatotoxicity. Aim: The study established the reversal effect of N-Acetyl Cysteine (NAC) on M. oleifera aqueous leaf extract-induced hepatotoxicity in Wistar albino rats. Methods: Twenty-four (24) rats received a toxic dose (8.05 g/kg bwt) of M. oleifera leaf extract for 28 days to cause sub-acute hepatotoxicity. They were divided into 4 groups of 6 rats each. Group I received 1 ml normal (control group), Group II received 1000 ng/kg NAC, Group III received 1200 mg/kg NAC and Group IV received 1500 mg/kg NAC. Another group of 6 rats (Group V) received 0.75 mg/kg Paracetamol to cause hepatotoxicity. Group V (a positive control) received the prescribed clinical dose of 1200 mg/kg NAC which reverses the hepatotoxicity. All the NAC doses were given once a day intragastric for 7 days. On days: 1, 3 and 7 of receiving NAC, liver serum enzymes and bilirubin were measured. On day 7 the animals were sacrificed and liver tissue harvested for histopathology analysis. Results: A dose of 8.05 g/kg of M. oleifera leaf extract and 0.75 mg/kg Paracetamol were able to induce hepatotoxicity in Wister albino rats in 28 days. The M. oleifera extract induced hepatotoxic rats treated with NAC at doses of 1000 mg/kg, 1200 mg/kg and 1500 mg/kg, had a reduction in mean serum liver enzymes, plus reduced mean serum bilirubin levels. The liver histopathological analysis showed reduced inflammation after treatment with NAC for 3 and 7 days in the M. oleifera and paracetamol induced hepatotoxic rats. Conclusion: NAC can reverse M. oleifera leaf aqueous extract-induced sub-acute hepatotoxicity in Wistar Albino rats.Item The role of Helmet use on Severity and Pattern of Maxillofacial Injuries among Motorcycle Crash Victims attending Mulago Hospital, Uganda(Journal Of Dentistry And Oral Implants, 2017) Komakech, Joses O.; Okullo, Isaac; Lakor, Francis; Rwenyonyi, Charles MugishaThe objective of the study was to establish the role of helmet use on severity and pattern of maxillofacial injuries among motorcycle crash victims attending Mulago Hospital. This was descriptive cross sectional case series study using a questionnaire in form of an oral interview, clinical examination and review of medical records of the pa tients. The pattern of injuries was assessed based on the demarcated regions of the face. The severities of the injuries were scored using the Facial Injury Severity Scale. The data were analysed using SPSS version 17.0. There were 105 participants (male/female: 97/8) aged 15 to 63 years. Most participants (n= 74, 70.5%) were riders and the rest were passengers. There were no female riders. Most participants were from Kampala and surrounding districts. Overall, 35.2% of the participants had helmets: 50% of the riders and 0% of the passengers. About 73% o the participants used Three Quarter Shell helmet design. There was no significant difference in the pattern of injuries between the passengers and non helmeted riders (p=0.076). There was a higher frequency helmeted riders (n = 15, 40.5%) with pan-facial fractures compared to other participants. Non helmeted riders and passen gers had significantly more injuries to the lower two thirds of the face compared to the helmeted riders. Passen gers had less severe facial injuries compared to riders. We conclude that about a third of the participants who were riders used helmets, being particularly the Three Quarter Shell design. The helmeted riders had more severe maxillofacial injuries and of panfacial category as compared to other participants. The passengers had least severe injuries compared to riders. It is recommended to carry out further studies to elucidate on motorcycle related max illofacial injuries especially in regard to the quality of helmets and their adequate useItem Variation in Caries Experience and Sugar Intake among Secondary School Students in Urban and Rural Uganda(Acta Odontologica Scandinavica, 2003) Okullo, Isaac; Åstrøm, Anne Nordrehaug; Haugejorden, Ola; Rwenyonyi, Charles MugishaThe objective was to assess the socio-demographic variation in caries experience and sugar intake among urban (Kampala) and rural (Lira) students in Uganda. In a cross-sectional survey, a total of 1146 adolescents aged between 13 and 19 years (response rate 87%) attending 10 secondary schools, 5 rural and 5 urban, completed questionnaires in respective schools. Clinical examination was conducted among 372 respondents (response rate 90%) from the main survey and dental caries was assessed. The results showed that a total of 80% of the students had DMFT >0. The corresponding rates in Kampala and Lira were 85% and 76% (P < 0.05), respectively. The mean DMFT, DT, and MT for the sample were 2.9, 2.5, and 0.5. Adjusted mean DMFT scores were 2.4 in Kampala and 3.3 in Lira (P < 0.05). The mean frequency sugar score was 2.6 and sugar consumption was higher in females and in students of highly educated parents compared to their counterparts in the opposite groups. In conclusion, higher mean DMFT scores in urban than in rural areas are often reported from developing countries but this does not seem to apply to the Ugandan areas investigated. Kampala and Lira students were equally exposed to sweets and soft drinks but the differences in sugar consumption between students of higher and lower educated parents were most marked in Lira.