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Psychiatric disorders in HIV-positive individuals in urban Uganda
(Psychiatric Bulletin, 205) Ovuga, Emilio; Boardman, Jed; Wasserman, Danuta
There is a well-documented strong association between depressive disorders and HIV/AIDS (e.g. Maj et al, 1994; Perkins et al, 1994; Judd et al, 1997). High levels of depression are seen in people with HIV/AIDS attending primary care clinics (Savetsky et al, 2001) and in HIV medical clinics (Lyketsos et al, 1994a). There appears to be a sustained rise in depressive symptoms as AIDS develops (Lyketsos et al, 1994b). Depression is also associated with HIV-related risk behaviours among those without HIV (Kelly et al, 1993). Nevertheless, most persons affected by HIV/AIDS in Uganda do not receive any care for their mental health problems. The early cases of AIDS were described in Uganda, but there has been little work examining the existence of psychiatric disorders in AIDS/HIV in that country. The national rate of HIV at the end of 2003 was 4.1% (UNAIDS, 2004), but is as high as 13% in war-torn northern Uganda. Of adult deaths at Mulago Hospital, Kampala, 60-70% are attributable to HIV.Wilk & Bolton (2002) investigated how people in two districts of Uganda (Masaka and Rakai), which have been severely affected by HIV, perceive the mental health affects of the disease. The individuals interviewed described two independent depression-like syndromes resulting from the HIV epidemic and rates of depressive disorder were estimated to be 21% in these districts (Bolton et al, 2004). Anecdotal evidence also links HIV/AIDS to suicide in Uganda (Musisi et al, 2001; Kinyanda & Musisi, 2002).
Investigating factors associated with uptake of HIV voluntary counselling and testing among pregnant women living in North Uganda
(Psychological and Socio-medical Aspects of AIDS/HIV,, 207) Cawthorne, A.; Nattabi, B.; Ayella, E. O.; Ogwang, M.; Declich, S.; Fabiani, M.
We investigated factors potentially associated with the uptake of HIV voluntary counselling and testing (VCT), which is the first step in acceding to programmes for the prevention of mother-to-child transmission of HIV infection. For the period 2001 2003, we estimated the VCT uptake among the 12,252 first-time attendees of the Antenatal Clinic (ANC) at Lacor Hospital (Gulu District, North Uganda). Associations between VCT uptake and socio-demographic characteristics and reproductive history were evaluated using log binomial regression models. VCT uptake was 55.6% for the overall study period; it increased from 51.0% in 2001 to 58.6% in 2002 and 57.7% in 2003 (PB/0.001). Having some education [primary versus none, adjusted prevalence proportion ratio (PPR) /1.05, 95% confidence intervals (CI): 1.00 1.10] and being unmarried (cohabitating, PPR /1.07, 95% CI: 1.03 1.10; single/widowed/divorced, PPR /1.10, 95% CI: 1.03 1.18) were significantly associated with VCT uptake. Associations of borderline significance were found for: recent change of residence, having a partner with a modern occupation, and past use of contraceptives. VCTuptake is still low in this district of North Uganda. Although some socio-demographic factors were found to have been associated with uptake, the associations were weak and not of public-health significance.
Mycobacteria causing human cervical lymphadenitis in pastoral communities in the Karamoja region of Uganda
(Epidemiology & Infection, 208) Oloya, J.; Opuda-Asibo, J.; Kazwala, R.; Demelash, A. B.; Skjerve, E.; Lund, A.; Johansen, T. B.; Djonne, B.
Mycobacteria from lymph node biopsies of patients with cervical lymphadenitis reporting for tuberculosis treatment in Matany and Moroto Hospitals in the transhumant areas of Karamoja, Uganda were isolated and characterized. The AccuProbe1 culture identiﬁcation kits for Mycobacterium tuberculosis complex (MTC), M. avium complex (MAC) and M. avium were used to identify the isolates. Spoligotyping, IS901 PCR and IS1311 and IS1245 restriction fragment length polymorphism (RFLP) were used to characterize the isolates. Of the 43 biopsies, ten M. avium, seven M. tuberculosis, three M. bovis, and two M. intracellulare were isolated. Two isolates could not be identiﬁed with AccuProbe1 and from 19 samples no mycobacteria could be isolated. Three isolates with the Beijing spoligotype were identiﬁed from the seven M. tuberculosis isolates. The spoligopatterns of the M. bovis isolates had previously been detected in cattle in Uganda. Isolation of members of the MAC group reﬂects the complex interaction between the transhumant communities, water sources and their cattle. None of the M. avium isolates harboured IS901, and all showed several bands on IS1311 and IS1245 RFLP, in accordance with M. avium subsp. hominissuis. Composite dendrograms of IS1311 and IS1245 RFLP showed that the isolates were similar and identical patterns were found. The isolation of M. bovis conﬁrms the human infection with zoonotic mycobacteria in areas where consumption of raw milk and meat is routine. Isolation of environmental mycobacteria also conﬁrms their increasing role in human disease and the occupational risk of infection in the transhumant ecosystem in the absence of safe drinking water and environmental contamination.
Buruli (Mycobacterial) Ulceration in Uganda. (A New Focus of Buruli Ulcer in Madi District, Uganda.)
(East African Medical Journal, 1965) Lunn, H. F.; Connor, D. H.; Wilks, N. E.; Barnley, G. R.; Kamunvi, F.; Clancey, J. K.; Bee, J. D. A.
A form of skin ulceration, Buruli ulcer, has been described in Uganda which differs from the ordinary tropical ulcer in its clinical and histological appearances and its lack of response to antibiotics [this Bulletin, 1962, v. 59, 204]. A similar form of ulceration has been described in Australia, and a Mycobacterium (M. ulcerans) isolated. This, or a similar organism, has been found in Buruli ulcer in Uganda [ibid., 1963, v. 60, 375]. In 1962, a new focus of the disease was found in the Madi district, an area along the Nile in the north of the country bordering on the Sudan. A team from Makerere medical school visited the area in 1963 to study the condition.
Ethnobotanical uses of Lantana trifolia L. and Sida cuneifolia Roxb. in Mukungwe and Wabinyonyi sub-counties of central Uganda
(Journal of Complementary Medicine Research, 1970) Nalubega, Rebecca; Nyanzi, Steven A.; Nakavuma, Jesca L.; Kamatenesi-Mugisha, Maud
Aim: This was an ethnobotanical study that was carried out to establish the traditional uses of Lantana trifolia L. and Sida cuneifolia Roxb. plants in selected parts of Central Uganda. Methods: The ethnobotanical study was done in August and September, 2012 in Mukungwe and Wabinyonyi sub-counties in Masaka and Nakasongola Districts respectively located in Central Uganda. Study sites and respondents were purposefully selected and information was obtained through semi-structured interview guides, key informant interview guides as well as observations. Eighty respondents were considered for semi-structured interviews and 15 for key informant interviews. Results: Seven ethnobotanical uses for Lantana trifolia were cited by respondents and majority (46.25%) of them used it as a herbal remedy. As a herbal remedy, Lantana trifolia managed 13 human disease conditions and mainly used in the management of cough and common colds by 22.5% of the respondents. Four ethnobotanical uses were cited for Sida cuneifolia and majority of the respondents (62.5%) used it as a herbal remedy as well as sweeping brooms. As a herbal remedy, Sida cuneifolia was reported to be useful in management of 12 disease conditions, fractures and sprains (bone setting) being mentioned by the majority of the of respondents (36.25 %). Conclusion: In conclusion, Lantana trifolia and Sida cuneifolia were culturally important ethnomedicines. Scientific validation of traditional claims as well as conservation of these plants should be encouraged in order to preserve and promote their use.
A Pepsin-Revealed Material Possibly Related to Chromosomal Banding
(Chromosoma, 1978) Byarugaba, Wilson
The enzymes pepsin, c~-chymotrypsin, trypsin, RNase and DNase were applied to preparations of human metaphase chromosomes before staining to study whether dissociable materials related to the formation of G-, Q- and C-bands would be seen. Treatment with active pepsin but not the other enzymes revealed material with ribonucleo-protein properties which dissociated from the chromosomes and formed a halo. - Lateral extensions from the chromatids stretched to the rim of the halo and appeared at positions corresponding to G-bands. A G-band may be defined as a ring of stable chromatid-matrix binding at positions where the chromatids coil to form lateral extensions.
Long-Term Experience With Burkitt’s Lymphoma In Uganda
(International journal of cancer, 1980) Olweny, Charles L.M.; Mbiddde, Edward Katongole; Otim, David; Lwanga, Stephen K.; Magrath, Ian T.; Ziegler, John L.
The cumulative results and long-term follow-up of all patients with Burkitt's lymphoma treated at the Uganda cancer Institute Kampala are reported. The annual admission rate is 29. The tumor patients commonly present with jaw swelling (72%), abdominal swelling (56%) and central nervous system involvement (30%). Complete response rate is achieved in a high proportion of patients (81 %). About 50% of these relapse, equal numbers relapsing before and after 3 months. The most important factor influencing remission duration and survival is disease stage. Other important factors are treatment protocols and, to a lesser extent, the type of relapse. Central nervous system relapse does not necessarily augur poor prognosis as second remissions and long-term survival can be achieved with appropriate therapy. Presently 25% of all treated patients have survived free of disease well beyond 5 years.
Borderline Tuberculoid Leprosy following BCG Vaccination. A Case Report
(INTERNAL IONAL JOURNAL OF LEPROSY, 1981) Stoner, Gerald L.; Belehu, Ayele; Nsibambi, John; Warndorff, Jan
We describe a case of leprosy in a child following vaccination with Bacillus Calmette-Guerin (BCG). Our finding confirms observations made more than 20 years ago (2 . 5 ' 9 ) and illustrates a concept of the leprosy spectrum which has important implications for the design and interpretation of a leprosy vaccine trial
Birth Asphyxia. I. Measurement of Visual Evoked Potential (VEP) in the Healthy Fetus and Newborn Lamb
(1981) Woods, James R.; Coppes, Valerie; Brooks, Daniel E.; Knowles, Peggy J.; Freeman, Marla; Parisi, Valerie; Omara, Peter; Mccarty, Garland E.
The visual evoked potential (VEP) of five healthy, near-term exteriorized fetal lambs was compared with the VEP obtained from the same animals during the first hour after ventilation. Characteristics of the individual wave components and their relationship to blood pressure, heart rate, and arterial blood gas measurements concomitantly obtained were examined. ~esults show that the VEP of the healthy fetus is a stable, reproducible signal consisting of four basic components, and that the latencies (msec) and the amplitude (pV) of the individual components of the VEP are similar to those of the newborn. In two related experiments, fetal asphyxia of unknown duration was encountered during fetal exteriorization and instrumentation. In the first case, neonatal acidosis persisted despite aggressive resuscitation efforts and was accompanied by an atypical VEP. In the second case, the neonatal VEP obtained after 15 min of resuscitation was markedly depressed despite restoration of acid-base balance but gradually recovered during the remainder of the 1-hr newborn period. In conclusion, the VEP is a reproducible measure of cortical function in the healthy fetus and neonate and may reflect the acute status of cerebral function during fetal asphyxia and neonatal resuscitation.
Infantile Autism in Kenya
(The Indian Journal of Pediatrics, 1982) Dhadphale, Manohar; Lukwago, Mariam G.; Gajjar, Menakeshi
Clinical features of infantile autism in three African children from Kenya are described. There is no essential difference in features of childhood autism as described in the west. In this prospective study the authors were able to confirm the onset of major symptoms of infantile autism before the age of three years and also an upper socio-economic background of the parents of all three cases.
Multibacillary Leprosy in an 1 8-month-old Child: a case report
(Leprosy review, 1984) Nsibambi, J.; Berhan, T.Y.; Diepen, T. Warndorff van
A case of multibacillary leprosy, proven on slit-skin smears and skin biopsy, is reported in a child aged 18 months in Ethiopia. The father and 2 other children were not available for examination, but the mother was a registered case of mid-borderline (BB) leprosy of 5 years' duration. The clinical, bacteriological and histopathological findings are described and discussed in relation to the accepted incubation period of leprosy and the possibility of intra-uterine infection.
Effects of chronic health conditions on school adaptation
(Paediatrics research,, 1984) Fowler, G. Mary
This study of children with chronic health conditions (CHC) assessed the relationship of demographic and health variables to school achievement and absenteeism. From July 1982 to June 1983 data were collected in 11 subspeciality clinics on 270 children followed at a tertiary care center. Academic performance and days absent for the prior year were obtained from schools. Physicians rated subjects' activity limitation. The CHC group was 61% male, 68% white, mean age 12 years. Children with cystic fibrosis, arthritis, sickle cell disease, hemophilia, and spina bifida averaged the most days absent (>20), while those with chronic lung and cardiac conditions averaged the least (10). Total CHC achievement scores were well below the state average (53rd vs. 63rd percentile). Group scores were highest for general hematology, hemophilia, chronic bowel and lung. Scores were lowest for epilepsy (39th), sickle cell (24th), and spina bifida (21st), and these groups had the highest rates of repeated grades and special services. Overall CHC group achievement was unrelated to school absence. A stepwise regression model related demographic and health variables to log of days absent and achievement scores. Achievement was correlated with socioeconomic status, race, grade failure, and type of CHC (r2=.44; p=.0001) while school absence was mainly related to health variables (activity limitation, number of clinic visits, specific CHC) and female sex (r2=.17; p=.0001). For CHC children, demographic factors were important predictors of academic performance. CHC children of low socioeconomic status were at double jeopardy for poor school achievement.
Time course of the changes in uterine vascular permeability associated with the development of the decidual cell reaction in ovariectomized steroid-treated rats
(Reproduction, 1984) Milligan, S. R.; Mirembe, Florence M.
Uterine vascular permeability and tissue blood volume during the development of the oil-induced decidual cell reaction (DCR) in ovariectomized steroid\x=req-\ treated rats were assessed by measuring the extravascular accumulation of 125I-labelled human serum albumin and the tissue content of 51 Cr-labelled red cells 30 min after intravenous administration. Within 15 min of oil instillation into one uterine horn, the vascular permeability of the horn was significantly elevated. Permeability rose to a sharp peak (10 times control levels) 9 h after oil instillation, but dropped to 5 times control values by 12 h and continued a steady decline over the next 7 days. Although a marked increase in uterine weight was associated with the development of the DCR, there was no significant change in blood volume/g tissue until 4 days after oil instillation.
Slim disease
(Lancet, 1985) Sewankambo, K.Nelson
A new disease has recently been recognised in rural Uganda. Because the major symptoms are weight loss and diarrhoea, it is known locally as slim disease. It is strongly associated with HTLV-III infection (63 out of 71 patients) and affects females nearly as frequently as males. The clinical features are similar to those of enteropathic acquired immunodeficiency syndrome as seen in neighbouring Zaire. However, the syndrome is rarely associated with Kaposi's sarcoma (KS), although KS is endemic in this area of Uganda. Slim disease occurs predominantly in the heterosexually promiscuous population and there is no clear evidence to implicate other possible means of transmission, such as by insect vectors or re-used injection needles. The site and timing of the first reported cases suggest that the disease arose in Tanzania.
Intraluminally injected oil induces changes in vascular permeability in the 'sensitized' and 'non-sensitized' uterus of the mouse
(Reproduction, 1985) Milligan, S. R.; Mirembe, Florence M.
After suitable sensitization of ovariectomized mice with progesterone and oestradiol, the intrauterine instillation of oil produces a massive decidual cell reaction. Vascular permeability, as reflected by the extra-vascular accumulation of 125I-labelled human serum albumin, increased after oil instillation and was maintained at 2\p=n-\3times control values for at least the next 3 days. Although oil instillation did not produce a decidual response in females treated with progesterone alone, an increase in vascular permeability (about 2 times control levels) still occurred. This response peaked 8 h after oil instillation and was not maintained. These results indicate that the progesterone\x=req-\dominated uterus which has not been sensitized with oestradiol cannot be viewed as completely unresponsive to the stimulus of oil and demonstrate that a marked increase in vascular permeability is not itself sufficient to induce decidualization of progesterone-dominated uterine stromal cells. The uterine extravascular accumulation of 125I-labelled albumin was increased both in association with tribromoethanol anaesthesia and after oestradiol treatment of progesterone-primed animals. In pregnant mice, the appearance of Pontamine Sky Blue spots provided an earlier indication of implantation than did determination of total uterine extravascular 125I\x=req-\ labelled albumin accumulation.
Blackwater Fever Caused By Plasmodium Vivax Infection In The Acquired Immune Deficiency Syndrome
(British medical journal, 1988) Mbidde,Edward Katongole; Banura, Cecil; Kizito,Alexandria
Blackwater fever is usually associated with malaria caused by Plasmodium falciparum infection in susceptible subjects. It is not associated with other parasites in man.' We describe a case of blackwater fever caused by P vivax infection in a patient with the acquired immune deficiency syndrome (AIDS).
A study of knowledge, attitudes and practices (KAP) of a rural community on malaria and the mosquito vector.
(East African medical journal, 1989) Ongore, D.; Kamunvi, F.; Knight, R.
A study of malaria on the Kano Plain, Kisumu District, Western Kenya, was carried out between April and August, 1985. The study included a knowledge, attitudes and practices (K.A.P.) survey on malaria illness and the mosquito vector. Overall knowledge about malaria illness was found to be good. However, treatment and prevention practices of malaria were found to be poor. Knowledge of the mosquito and its relationship to malaria was found to be high. Knowledge of methods of prevention of mosquito bites was also found to be high but actual use of the methods was low. Knowledge of traditional methods of prevention of mosquito bites was also found to be high. Actual use was again found to be low.
Aflatoxigenic Aspergilli in foods and feeds in Uganda
(Journal of Food Quality, 1990) Sebunya, Teresa K.; Yourtee, David M.
Studies conducted during the sixties and the seventies on food crops in Uganda showed that the populace was exposed to consumption of aflatoxin-contaminated foods. These studies also linked the highest incidence of liver cancer in the world to the presence of high levels of aflatoxins in the food and beverages. After a lapse of a decade, it was of interest to investigate the occurrence of aflatoxins and aflatoxigenic fungi in staple Ugandan food crops and poultry feeds derived from these foodstuffs. A simple, rapid and reproducible procedure was used. The procedure consisted of growing or culturing feed grains on a selective medium, Aspergillus flavus/parasiticus agar (AFPA) followed by screening for aflatoxin producing fungi on a coconut agar medium (CAM) under UV light with a subsequent confirmatory screening method for aflatoxin production by the fungi in pure culture. Fifty-four samples consisting of corn and peanuts, soybean and poultry feed were analyzed for content of aflatoxigenic. A. flavus/parasiticus and 25 of the samples were also screened for aflatoxins B1 and G1, zearalenone, sterigmatocystin, ochratoxin A, citrinin, vomitoxin, and diacetoxyscirpenol (DAS). Aflatoxigenic A. flavus/parasiticus was detected from the majority of corn (77%), peanuts (36% human food and 83.3% animal feed) and poultry feed (66.6%). but not from soybean samples. Two samples out of 25 contained detectable levels of aJatosin B, (20 ppb). For the jirst time other mycotoxins, zearalenone (3 samples) and vomitoxin (2 samples) were detected in corn from Uganda.
Dynamics of Spread of HIV-I Infection in a Rural District of Uganda
(British Medical Journal, 1991) Wawer, Maria J.; Serwadda, David; Musgrave, Stanley D; Konde-Lule, Joseph K; Musagara, Maako; Sewankambo, Nelson K.
To define the geographical distribution of HIV infection and the community characteristics associated with HIV prevalence in a rural population of Uganda. Seroprevalence survey and interviews of the population aged 13 years and older in 21 randomly selected clusters. Rural population of Rakai district, south west Uganda. 1292 adults, of whom 594 men and 698 women gave a blood sample and answered the questionnaire. HIV status determined by ELISA and western blotting in relation to community characteristics. The weighted seroprevalence of HIV for the district was 12.6% with prevalence by cluster varying from 1.2% to 52.8%. Seroprevalence was highest in main road trading centres (men 26%, women 47%), intermediate in rural trading villages on secondary roads (men 22%, women 29%), and lowest in rural agricultural villages (men 8%, women 9%). For both men and women, multiple regression showed a strong negative association between cluster seroprevalence and the proportion of the population employed in agriculture (beta = -0.677 for men, -0.807 for women). Among women, cluster seroprevalence increased with a higher proportion of the population reporting multiple sex partners (beta = 0.814), external travel (beta = 0.579), and injections (beta = 0.483). Community characteristics, particularly the proportion of the population in agriculture, are associated with HIV prevalence and can be used for targeting interventions. The seroprevalences of HIV suggest spread of infection from main road trading centres, through intermediate trading villages, to rural agricultural villages.
Focus Group Interviews About AIDS in Rakai District of Uganda
(Social Science & Medicine, 1993) Konde-Lule, Joseph K.; Musagara, M.; Musgrave, S.
Focus group interviews about AIDS were held in Rakai district, Uganda during early 1990 with groups from various sections of the community. It was found that the knowledge of AIDS symptoms and its transmission were widespread. Attitudes regarding many aspects of sexual behavior, AIDS patients, condoms, injections, hospital treatment, sexually transmitted diseases and an AIDS cure were investigated. We found that most people no longer fear casual contact with AIDS patients but they blame spouses of people with AIDS for spreading the infection. Condoms are generally not trusted. Many people feel that condoms cannot prevent transmission of the AIDS virus and some fear that they may get torn and cause complications in women. Most people now do not like injections for treatment and when necessary, prefer disposable needles and syringes. Hospital treatment for AIDS patients is not trusted very much, and many people believe that AIDS patients are intentionally killed off by doctors. Sexual behavior was extensively discussed and it was found that there is generally a reduced level of multiple sexual partners. The reduction is more marked in rural areas but the urban areas are still having higher levels of multiple sexual partnets.

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