Browsing by Author "Okwi, Andrew Livex"

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    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, Joan
    We 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.
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    Detection of Cervical Cytological Abnormalities by Pap smears Method among Women Attending the Screening Clinic of Nsambya Hospital
    (Journal of Pathology Research Reviews and Reports, 2019) Boaz, Mwesigwa; Okwi, Andrew Livex; Emmanuel, Othieno
    Cervical cancer is an important public health problem. In Uganda, it ranks the most frequent cause of cancer among women aged between 15 to 44 years of age. Early detection and eradication of cervical cancer and its precursor lesions is the mainstay for control of this disease. The Pap smear method is the most cost-effective means of screening cervical pre-malignant, malignant processes and non-neoplastic lesions. Aim: To describe the cervical cytological abnormalities as detected byPap smear method and to determine the prevalence of such abnormalities Methodology: This was a prospective study, in which a total of 175 women were recruited from May to June, 2016. Cervical samples were collected from these women and stained according to the papanicolaou staining protocol. Results were reported using the 2014 Bethesda reporting system. Results: Out of 175 cases, 163 (93.1%) were reported as negative for intraepithelial lesion or malignancy [NILM]. Cervical intraepithelial lesions were reported in 12 (6.9%) cases which included atypical squamous cells of undetermined significance [ASCUS] in 4(2.3%) cases, atypical squamous cells cannot exclude high grade squamous intraepithelial lesions [ASCH] in 1(0.6%) case, low-grade squamous intraepithelial lesion [LSIL] in 5 (2.9%) cases, high-grade squamous intraepithelial lesion [HSIL] in 1(0.6%) case and atypical glandular cells [AGC] in 1(0.6%) case. Conclusion: Cervical cytology by Pap smear method should be used to screen women routinely because it is an effective method in detecting pre-malignant and malignant lesions of the cervix.
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    Knowledge, Attitude, and Beliefs of Communities and Health Staff about Echinococcus granulosus Infection in Selected Pastoral and Agropastoral Regions of Uganda
    (Journal of parasitology research, 2018) Othieno, Emmanuel; Ocaido, Michael; Mupere, Ezekiel; Omadang, Leonard; Oba, Peter; Okwi, Andrew Livex
    According to World Health Organization (WHO) [1] cystic echinococcosis (CE) is a neglected zoonotic infection found throughout the world and is associated with high morbidity and mortality in poor resource countries especially in pastoral communities in Africa (Macpherson et al. [2]). In Uganda, the prevalence ofCE has been found to vary between pastoral and agropastoral communities, with pastoral communities being at higher risk than agropastoral communities (Othieno et al. [3]). High prevalence of CE has equally been reported in livestock (Chamai et al. [4] and Magambo et al. [5]) and in dogs (Inangolet et al. [6] and Oba et al. [7]). Cystic echinococcosis is caused by a species of Echinococcus, namely, Echinococcus granulosus, whose definitive hosts are the carnivores such as dogs. Usually dogs become infected with Echinococcus granulosus by eating infected internal organs such as liver and lungs from dead animals that contain tape worm embryos. The dogs pass out tapeworm eggs in their stool, which can cause infection in other animals and/or in humans who accidentally swallow the eggs. In humans, Echinococcus granulosus forms slow-growing cysts (called hydatid cysts) in different organs of the body which can be very difficult to remove or treat in some cases (Nahmias et al. [8]).
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    Prevalence and risk factors of Echinococcus granulosus infection in dogs in Moroto and Bukedea districts in Uganda
    (Tropical animal health and production, 2016) Oba, Peter; Ejobi, Francis; Omadang, Leonard; Chamai, Martin; Okwi, Andrew Livex; Othieno, Emmanuel; Inangolet, Francis Olaki; Ocaido, Michael
    A cross sectional study was conducted in Moroto and Bukedea districts of Uganda from May to September 2013 to determine the prevalence and risk factors of Echinococcus granulosus infection in dogs. Fresh dog faecal samples were collected, preserved in 70 % ethanol, and later screened for presence of taeniid eggs using zinc chloride floatation method. Positive samples were confirmed by a copro-PCR (polymerase chain reaction) for E. granulosus using NADH dehydrogenase sub-unit 1 gene (NADH1) as a target molecular marker. Structured questionnaires and focus group discussions were used to collect quantitative and qualitative data for risk factor identification. Study sub-counties were selected by simple random sampling. Overall apparent prevalence of taeniid infection in dogs of 14.9 % (39/261, confidence interval 10.6–19.2) in both districts was recorded using the faecal floatation test. The sensitivity of the faecal floatation test was found to be 78 % (25/32), while the specificity was 93 % (215/229). Copro-PCR results revealed a true prevalence of 14.4 % (9.91–19.0, 95 % CI) in dogs in Moroto district and 7.4 % (2.14–12.60, 95 % CI) in Bukedea district. The overall true prevalence of cystic echinococcosis (CE) was 12.2 % (8.70–15.76, 95 % CI) in both districts. The major risk factors identified using logistic regression were uncontrolled access of dogs to animal slaughter facilities, higher cattle herd sizes and lack of knowledge about the disease. It was recommended that restricting dog access to infected tissues and public health education about epidemiology of CE should be done.
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    Prevalence of Cancerous and Pre-malignant Lesions of Cervical Cancer and their Association with Risk Factors as seen among women in the Regions of Uganda
    (Journal of Clinical and Laboratory Medicine, 2017) Okwi, Andrew Livex; Wandabwa, Julius; Okoth, Anthony; Othieno, Emmanuel
    Cervical cancer is the second cause of death among women in Uganda. Little is known about the prevalence and risk factors associated with cancerous and pre-malignant lesions of cervical cancer in the regions of Uganda. Methods: A cross sectional survey was carried out in the regions of Uganda. Women who reported to Gynecology Clinics were consecutively screened for cancerous and pre-malignant lesions using the Papanicolaou method. A structured questionnaire was used to collect data on risk factors. The power of associations between the risk factors and cancerous and pre-malignant lesions of cervical cancer were determined using the odds ratio and 95% confidence interval. The p value <0.05 was considered as statistically significant. Results: Prevalence of 1.2% of cancerous and 11.2% of pre-malignant lesions was detected in all the regions. The risk factors for both cancerous and premalignant lesions were: Early coitus (OR 3.03, CI:1.01.10-10.05; p<0.024) and (OR 1.41 CI:0.98-2.20; p<0.032) respectively, sexually transmitted infections (STDs) (OR 6.07, CI: 1.77-27.22; p<0.001) and (OR 6.52, CI:4.33-9.10; p<0.001) respectively, polygamy (OR 3.13, CI: 0.98-11.77; p<0.027) and (OR 2.74, CI:1.71-4.43; p<0.001) correspondingly, alcohol (OR 3.72, CI: 1.19-13.77; p<0.011) and (OR 1.71, CI:1.20-2.47; p<0.001) respectively, increased sexual partners (OR 8.03, CI:2.20-53.1; p<0.001) and (OR 3.69, CI:2.51-5.48; p<0.001) respectively. Smoking and high parity were risk factor for only cancerous lesions. Although there was no statistical difference between women who had married more than once and those who had single marriage , the likelihood that women who had married more than once would get cancerous and premalignant lesions was high (OR 1.18, p<0.389) and (OR 1.36, p<0.122) respectively. Conclusion and Recommendations: Age at 1st coitus, STDs, polygamy, smoking, increased sexual partners and alcohol were the risk factors for cancerous and premalignant lesions. Sensitization of the communities and regularly screening for cervical cancer should be encouraged for its control and management.
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    Risk factors associated with cystic echinococcosis in humans in selected pastoral and agro-pastoral areas of Uganda
    (Int J One Health, 2017) Othieno, Emmanuel; Okwi, Andrew Livex; Mupere, Ezekiel; Zeyhle, Eberhard; Oba, Peter; Chamai, Martin; Omadang, Leonard; Olaki Inangolet, Francis; Siefert, Ludwing; Ejobi, Francis; Ocaido, Michael
    It was to determine the risk factors responsible of occurrence of cystic echinococcosis (CE) of humans in the pastoral and agro-pastoral (PAP) in Uganda. Materials and Methods: A cross-sectional study was conducted in districts: Moroto, Napak, Nakapiripirit and Amudat in Karamoja region; in agro-pastoral communities of Teso region, in the districts of Kumi and Bukedea; Nakasongola district in Central region and in Kasese district in the Western region. People were subjected to voluntary ultrasound screening for CE. Those found positive to CE on ultrasound screening were interviewed using a special designed form to find out the probable predisposing factors for acquisition of CE infection. Predisposing factors considered were location, age, sex, dog ownership, occupation, water source, and religion. Univariate and multivariate logistic regression analysis was performed to identify key risk factors. Results: In Karamoja region, being female, age beyond 40 years and open spring water sources were the risk factors. While for Nakasongola age beyond 40 years was a risk factor. In Kasese dog ownership, age >60 years and being a Muslim were risk factors. In Teso region dog ownership and age >60 years were the risk factors. Conclusion: Being a pastoralist, a female, increasing age beyond 40 years, open spring water sources, dog ownership and being a Muslim were the risk factors for CE in PAP areas in Uganda.
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    Solubility tests and the peripheral blood film method for screening for sickle-cell disease: A cost benefit analysis
    (South African Medical Journal, 2009) Okwi, Andrew Livex; Ocaido, Michael; Byarugaba, Wilson; Magala Ndugwa, Christopher; Parkes, Arthur
    To determine the cost benefit of screening for sicklecell disease among infants at district health centres in Uganda using sickling, solubility tests and the peripheral blood film method. Methods. Pilot screening services were established at district health centres. Cost benefit analysis (CBA) was performed in four scenarios: A1 – where there are no sickle-cell screening services at district health centres and all children are referred either to Mulago national referral hospital or A2 – a regional hospital for haemoglobin (Hb) electrophoresis; B1 – when there are screening services at district health centres, only positive samples are taken either to Mulago Hospital or B2 – the regional hospital for confirmation using haemoglobin electrophoresis. Calculations were done in Uganda shillings (USh).