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Rates of Anti-Tuberculosis Drug Resistance in Kampala-Uganda Are Low and Not Associated with HIV Infection  [PDF]
Deus Lukoye,Frank G. J. Cobelens,Nicholas Ezati,Samuel Kirimunda,Francis E. Adatu,Joseph K. Lule,Fred Nuwaha,Moses L. Joloba
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0016130
Abstract: Drug resistance among tuberculosis patients in sub-Saharan Africa is increasing, possibly due to association with HIV infection. We studied drug resistance and HIV infection in a representative sample of 533 smear-positive tuberculosis patients diagnosed in Kampala, Uganda.
Long Delays and Missed Opportunities in Diagnosing Smear-Positive Pulmonary Tuberculosis in Kampala, Uganda: A Cross-Sectional Study  [PDF]
Ibrahim Sendagire,Maarten Schim Van der Loeff,Mesach Mubiru,Joseph Konde-Lule,Frank Cobelens
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014459
Abstract: Early detection and treatment of tuberculosis cases are the hallmark of successful tuberculosis control. We conducted a cross-sectional study at public primary health facilities in Kampala city, Uganda to quantify diagnostic delay among pulmonary tuberculosis (PTB) patients, assess associated factors, and describe trajectories of patients' health care seeking.
Burden of tuberculosis in Kampala, Uganda
Guwatudde,David; Zalwango,Sarah; Kamya,Moses R.; Debanne,Sara M.; Diaz,Mireya I.; Okwera,Alphonse; Mugerwa,Roy D.; King,Charles; Whalen,Christopher C.;
Bulletin of the World Health Organization , 2003, DOI: 10.1590/S0042-96862003001100006
Abstract: objective: to determine the prevalence and incidence of tuberculosis in one of uganda's poor peri-urban areas. methods: multi-stage sampling was used to select a sample of households whose members were evaluated for presence of signs and/or symptoms of active tuberculosis; history of tuberculosis treatment; and relevant demographic, socioeconomic, and household environment characteristics. patients with suspected tuberculosis underwent standardized evaluation for active disease. findings: a sample of 263 households with 1142 individuals was evaluated. nineteen people were classified as having had tuberculosis during the one-year reference period (may 2001-april 2002): nine (47%) cases already had been diagnosed through the health care system, while 10 cases (53%) were diagnosed through the survey. the prevalences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 14.0 (95% confidence interval (ci) 7.8-20.3) and 4.4 (ci = 0.83-7.89) per thousand, respectively. the incidences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 9.2 (ci = 3.97-14.4) and 3.7 (ci = 0.39-6.95) per thousand per year, respectively. conclusion: the rate of tuberculosis in this peri-urban community was exceptionally high and may be underestimated by current surveillance systems. the need for interventions aimed at reducing tuberculosis transmission in this, and other similar communities with high case rates, is urgent.
Burden of tuberculosis in Kampala, Uganda  [cached]
Guwatudde David,Zalwango Sarah,Kamya Moses R.,Debanne Sara M.
Bulletin of the World Health Organization , 2003,
Abstract: OBJECTIVE: To determine the prevalence and incidence of tuberculosis in one of Uganda's poor peri-urban areas. METHODS: Multi-stage sampling was used to select a sample of households whose members were evaluated for presence of signs and/or symptoms of active tuberculosis; history of tuberculosis treatment; and relevant demographic, socioeconomic, and household environment characteristics. Patients with suspected tuberculosis underwent standardized evaluation for active disease. FINDINGS: A sample of 263 households with 1142 individuals was evaluated. Nineteen people were classified as having had tuberculosis during the one-year reference period (May 2001-April 2002): nine (47%) cases already had been diagnosed through the health care system, while 10 cases (53%) were diagnosed through the survey. The prevalences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 14.0 (95% confidence interval (CI) 7.8-20.3) and 4.4 (CI = 0.83-7.89) per thousand, respectively. The incidences for all forms of tuberculosis and for sputum smear-positive tuberculosis were 9.2 (CI = 3.97-14.4) and 3.7 (CI = 0.39-6.95) per thousand per year, respectively. CONCLUSION: The rate of tuberculosis in this peri-urban community was exceptionally high and may be underestimated by current surveillance systems. The need for interventions aimed at reducing tuberculosis transmission in this, and other similar communities with high case rates, is urgent.
Diverticular disease of the colon in Kampala, Uganda
Elsie Kiguli-Malwadde, Henry Kasozi
African Health Sciences , 2002,
Abstract: Background: Diverticular disease of the colon has been reported to be a disease of the western world, however of recent it has been described in the Africans. Objective: To study the clinical, demographic and radiological features of diverticular disease of the colon in Kampala, Uganda. Methods: A retrospective and prospective descriptive study was carried out between January 1995 December 1996 and January 1998 December 2000. The period January 1995-December 1996 was retrospective while January 1998-December 20000 was prospective. Thirty-one consecutive patients were found to have diverticular disease of the colon at barium enema studies in two major hospitals and two private x-ray units in Kampala, Uganda. Results: Thirty-one patients were seen during the study period; all were over 40 years of age. The commonest presenting complaint was rectal bleeding in 13 patients followed by abdominal pain in 12 patients. Most patients were found to eat a mixed type of diet, that is both low and high residue food. Radiologically the diverticulae appeared as flask shaped or rounded outpouchings at barium enema. This would sometimes be accompanied by a serrated appearance of the affected area. The commonest site affected was the sigmoid colon followed by the ascending colon. Conclusion: Although it was previously reported that diverticular disease was unknown in black Africans, it has been noted that cases are now being increasingly discovered. It is recommended that our index of suspicious for diverticular disease of the colon and its complications should also increase. African Health Sciences 2002; 2(1): 29-32
Eliminating the category II retreatment regimen from National Tuberculosis Programme guidelines: the Georgian experience
Furin,Jennifer; Gegia,Medea; Mitnick,Carole; Rich,Michael; Shin,Sonya; Becerra,Mercedes; Drobac,Peter; Farmer,Paul; Hurtado,Rocio; Joseph,J Keith; Keshavjee,Salmaan; Kalandadze,Iagor;
Bulletin of the World Health Organization , 2012, DOI: 10.1590/S0042-96862012000100014
Abstract: problem: the category ii retreatment regimen for management of tuberculosis in previously treated patients was first introduced in the early 1990s. it consists of 8 months of total therapy with the addition of streptomycin to standard first-line medications. a review of 6500 patients on category ii therapy in georgia showed poor outcomes and high rates of streptomycin resistance. approach: the national tuberculosis program used an evidence-based analysis of national data to convince policy-makers that category ii therapy should be eliminated from national guidelines in georgia. local setting: the world health organization tuberculosis case-notification rate in georgia is 102 per 100 000 population. all patients receive culture and drug susceptibility testing as a standard part of tuberculosis diagnosis. in 2009, routine surveillance found multidrug-resistant tuberculosis in 10.6% of newly diagnosed patients and 32.5% of previously treated cases. relevant changes: category ii retreatment regimen is no longer used in georgia. treatment is guided by results of drug susceptibility testing - using rapid, molecular tests where possible - for all previously treated tuberculosis patients. lessons learnt: there was little resistance to policy change because the review was initiated and led by the national tuberculosis program. this experience can serve as a successful model for other countries to make informed decisions about the use of category ii therapy.
Suicide in urban Kampala, Uganda: a preliminary exploration
E Kinyanda, D Wamala, S Musisi, H Hjelmeland
African Health Sciences , 2011,
Abstract: Background: Suicide was investigated in the urban setting of Kampala, Uganda. Objectives: Firstly, to explore the use of two research methodologies, a retrospective review of patient records and the psychological autopsy methodology in suicide research in Uganda. Secondly to investigate the characteristics and correlates of urban suicide in Uganda. Results: A male to female ratio of suicide of 3.4:1 and a peak age of suicide in the 20-39 years age group were found. The main methods of suicide were hanging and ingestion of poison (organophosphates). Problems with social networks, negative life events, higher psychological distress and lower quality of life were associated with suicide at univariate analysis. It was only psychological distress that retained significance at multivariate analysis. Conclusion: The retrospective review of records at Mulago hospital was beset by incomplete records whereas a pilot psychological autopsy study was well accepted and might contribute valuable data in African settings.
Molecular Detection of Resistance to Rifampin and Isoniazid among Patients Eligible for Retreatment Regimen in Côte d’Ivoire in 2012  [PDF]
Kouassi N’Guessan, Timothée Ouassa, Jean-Serge Assi, André Tehe, Jean-Marc Assande, André Guei, Jacquemin Kouakou
Advances in Infectious Diseases (AID) , 2013, DOI: 10.4236/aid.2013.32010
Abstract:

Drug-resistant tuberculosis is an important health problem in Cote d’Ivoire. Patients of category I treatment are based on 2RHZE/4RH regimen. For the patients of category II, the 2RHZES/1RHZE/5HRE regimen is systematically initiated. Study objective was to describe the susceptibility profile to Rifampin and Isoniazid among previously treated patients who are eligible for retreatment and who had received the 2RHZES/1RHZE/5HRE regimen in Cote d’Ivoire with a molecular method in 2012. Two sputum samples were collected to each patient recruited in the reference regional centres for tuberculosis. Sputum samples were decontaminated by NALC method. The DNA extraction was realized with 500 μl of decontaminated sputum sample with smear-positive. MTBDRplus assay version 1.0 was performed according to the manufacturer’s instruction. An internal quality control program with positive and negative controls was implemented for interpretation of results. A total of 278 patients were enrolled, 148 (53.2%) were recurrent TB cases, 118 (42.5%) failure cases, and 12 (4.3%) defaulters. From sputum of previously treated patients, mutli-drug resistant tuberculosis was diagnosed for 60 (69.8%, 95% IC, 60% - 80%) treated with the 2RHZE/4RH regimen, 24 (75%, 95% IC, 60% - 90%) with the 2RHZES/1RHZE/5HRE regimen, 60 (41%, 95% IC, 33% - 49%) recurrent TB cases, and 4 (33.3%) defaulters. The comparison of resistance rates to Rifampin estimated from sputum samples in the categories of treatment failures and the recurrence TB cases showed a statistically significant difference. In Cote d’Ivoire, genotype? MTBDRplus assay has permitted to estimate the prevalence of MDR-TB in categories of previously treated patients for tuberculosis.

Burden of alcohol use in the Uganda police in Kampala district
Emilio Ovuga, Charles Madrama
African Health Sciences , 2006,
Abstract: Background: Alcohol dependence is one of the leading causes of the global burden of disease. Among members of the Uganda Police Force, alcohol dependence has been a major contributor of poor mental health, poor work output and forced retirement. Objective: This study was carried out to determine the prevalence of alcohol dependence and associated psychosocial problems in the Uganda Police Force in Kampala District. Methods of Study: A sample of police officers selected by systematic sampling strategy from two large barracks in Kampala District participated. A semi-structured questionnaire designed to elicit information on the perceived impact of alcohol use was used. Prevalence rate was derived from ICD-10 criteria for alcohol dependence, and psychosocial problems in alcohol dependence. Results: Twenty respondents (19.2%) met criteria for alcohol use disorder, 26.0% met criteria for alcohol use problems and 9.6% reported that their health was poor. Alcohol use disorder or problems were significantly associated with lack of job satisfaction, poor health, problems in implementing personal plans, disciplinary problems, inability to save from personal earnings, debts, and absenteeism from work. Conclusion: One in five police officers met criteria for alcohol use disorder while one in four experienced psychosocial problems related to alcohol use. The results suggest serious implications for the quality of services provided by the Uganda Police. There is a need to establish measures to provide services for those affected, and a further need to establish preventative measures against alcohol dependence in the police force. African Health Sciences Vol. 6(1) 2006: 14-20
Determinants of fast food consumption in Kampala, Uganda
SA Ayo, J Bonabana-Wabbi, D Sserunkuuma
African Journal of Food, Agriculture, Nutrition and Development , 2012,
Abstract: Consumption of fast-food in Uganda is becoming an increasingly important component of the food market as more of the working class choose to dine out rather than prepare meals at home. Despite the importance of the fast-food sector, limited attempts have been made to study the consumption and expenditure behaviour of consumers of fast-food in Uganda. The main objective of this study was to assess characteristics influencing the consumption of fast-food in Kampala district. Specifically, the objectives of the study were: to assess the factors influencing the probability of consuming fast-food; and to determine the level of expenditure on fastfood. Primary data on socio-economic characteristics were collected from a sample of 300 respondents using a multi-stage sampling procedure. The study revealed that majority (90%) of the respondents consumed fast-food. The consumption of fast-food was most motivated by their taste and convenience. Results from the Heckman model show that household size, education level and distance from work-place to restaurant negatively influenced the probability of fast-food consumption and level of expenditure on fast-food while disposable monthly income had a positive effect on the probability of consumption and level of expenditure on fast-food. The high demand for fast-food is seen as an easy solution to consumers’ busy schedules and limited meal preparation time. As changing tastes and need for convenience become the goal of households, consumption of fast-food will be expected to rise especially in urban areas. This increase in fast-food consumption, coupled with rising population and urbanization in Uganda offers new market opportunities for agribusiness firms to exploit the growing demand by investing in the fast-food sector and producing sufficiently for this market. In addition, fast-food establishments should ensure proximity of their products and services to the consumers as convenience greatly influences fast-food consumption. Future research should include identification of sources of agricultural products used by fast-food outlets to provide information about the contribution of the fast-food sector to agricultural marketing and farmers’ livelihoods in Uganda.
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