Showing papers by "Makerere University published in 1992"

Epilepsy and retarded growth in a hyperendemic focus of onchocerciasis in rural western Uganda.

Abstract: A remarkably high number of patients with epilepsy was observed in Kyarusozi subcounty Uganda where infection with Onchocerca volvulus is hyperendemic A survey was conducted from April 22 to May 4 1991 in Kyarusozi subcounty when all patients with epilepsy and growth retardation were invited for medical examination A full history was taken and a physical examination as well as a mental state assessment were carried out for all patients A total of 231 persons were screened of whom 91% were below the age of 19 years The infection rate with Onchocerca volvulus in patients with epilepsy (61%) and retarded growth (70%) was significantly higher than in the general population of Kyarusozi subcounty The prevalence of epilepsy in the study area was estimated to be at least 2% The cardinal clinical features were pigeon chest increased curvature of the dorsum hyperextended joints poor oral hygiene and dental caries with disproportionately large and displaced maloccluded teeth Additional features were malnutrition including dry atrophic scaly skin skin sores and golden hair The thyroid gland was enlarged in 74% of the children with physical growth retardation Secondary sexual characteristics were absent or poorly developed in a further 13% The data seemed to indicate that social adaptation and psychological functioning are more often disturbed in individuals who suffer from the combined effects of epilepsy onchocerciasis and growth retardation than in patients with onchocerciasis epilepsy or growth retardation along This investigation suggests that onchocerciasis is associated with epilepsy psychological impairment retarded growth and retarded sexual development Should further studies confirm a relationship between Onchocerca volvulus infection epilepsy and mental development the public health importance of onchocerciasis would have the be reconsidered to control Onchocerca volvulus infection more vigorously

Absence of Mycobacterium avium complex disease in patients with AIDS in Uganda.

Abstract: The absence of disease due to Mycobacterium avium in Ugandan patients with AIDS, which we previously observed in a blood culture study, has been confirmed and our observations have been extended to 165 additional clinical isolates. Fourteen soil and water samples from the Ugandan environment have been cultured and revealed a high frequency of isolation of M. avium. The absence of M. avium complex disease in Uganda remains unexplained.

Cultural Determinants of Sexual Risk Behavior for AIDS among Baganda Women

Abstract: Social scientists interviewed 65 HIV-infected Baganda women (cases) and 65 HIV-free women (controls) attending the pediatric clinic at Mulago Hospital in Kampala Uganda to examine cultural determinants of sexual risk behaviors for AIDS. These 17-30 year old women did not know their serostatus. Baganda society expects women have sex only with their husbands while it allows husbands to have >1 partner. All women averaged 1 sexual partner in the last year for fear of infant death if they had sex with anyone other than the childs father during pregnancy or lactation. Yet over the last 5 years cases had more partners than controls (2.5 vs. 2; p=.001). Cases were more likely to report that it was traditionally expected for women to have sex with other men during certain times such as funerals and weddings (37% vs. 20%; p<.05). HIV-positive women were more apt to note economic reasons as justification for having sex with someone other than their husband (47% vs. 35%; p=.05). All the women knew about AIDS. Even though more cases knew that having 1 partner helps prevent AIDS (75% vs. 65%) the difference was insignificant. No significant difference in knowledge of other prevention means existed between the 2 groups. Both HIV-positive women (86%) and HIV-negative women (77%) were afraid of acquiring AIDS through sexual intercourse since they knew their husbands participated in risky behavior. Cases were more likely to have reduced risk behavior particularly by having only 1 partner to avoid AIDS than controls (63% vs. 35%; p<.01). Women who did not change behavior did not change because they already had 1 partner. Only 5% of cases and 3% of controls had ever used condoms. Thus health education programs must address financial needs to motivate women to practice risk reduction behavior. Research is needed to understand sexual behavior to determine whether male sexual behavior poses a great risk of HIV infection in women.

Human papillomavirus (hpv) DNA in penile carcinomas and in two cell lines from high‐incidence areas for genital cancers in Africa

Abstract: Biopsies of 13 penile cancers (PC), from patients living in regions of Uganda with a high incidence of genital cancers, were studied for the presence, molecular characteristics and physical state of DNA related to that of human papillomavirus (HPV) types 6, 11, 16, 18, 31 and 33. HPV DNA sequences were detected in all PC specimens by dot/Southern blot analyses and by gene amplification of DNA sequences highly conserved among several HPVs. HPV 16 DNA sequences were found in one PC; DNA sequences with low homology to HPV16 or HPV18 were present in all other samples. Viral DNA is primarily integrated in the cellular DNA. To isolate and characterize a possible highly oncogenic HPV, a genomic library of the DNA extracted from the PC-8 biopsy has been constructed in the EcoRI arms of the EMBL4 phage. A single phage containing 8.30-kb HPV16-related sequences has been identified and the 3 segments of 0.45, 0.65 and 7.2 kb, released by EcoRI digestion, have been independently subcloned in pUC18 for further analysis.

Contraception and Prevalence of Sexually Transmitted Diseases among Adolescents and Young Adults in Uganda

Abstract: The study is aimed at (i) exploring the knowledge and attitudes of adolescents (15-19 years old) and young adults (20-24 years old) towards sex and contraception (condoms) and (ii) determining their level of knowledge and attitudes towards sexually transmitted diseases (STD) as well as the prevalence of the latter among the sexually active adolescents and young adults. A sample of 4510 respondents (1545 males and 2965 females) aged 15-24 years from urban and rural areas were interviewed. The majority of adolescents and young adults surveyed have a negative attitude towards the use of condoms although most of them agreed that they prevent STD. Over 95% of the respondents have heard about STD and their level of knowledge is relatively high; slightly higher for urban residents and for young males. Approximately 21% of the male and 8% of the female respondents admitted having ever contracted STD. The gap between contraceptive knowledge and practice is rather wide. Only a small proportion of the respondents were using condoms at the time of the survey.

Financing of higher education in Uganda

Abstract: Uganda faces severe financial constraints which have resulted in a serious decline in the quality of higher education and the government faces an urgent need to find new sources of finance for higher education. At present virtually all tuition costs and students' living expenses are financed from public funds, whereas families must bear a substantial part of the costs of primary and secondary education. This “inverted pyramid” is inequitable and results in substantial transfer of income from poor tax payers to rich parents and their children. This article considers arguments for increased cost recovery and the introduction of student loans and also considers obstacles to student loans in Uganda.

Knowledge, attitudes, and practices and their policy implications in childhood diarrhoea in Uganda.

Abstract: A nationwide study of the knowledge, attitudes, and practices about childhood diarrhoea among health workers and mothers of children less than 5-years old was conducted in Uganda during 1987. We found that each child, on the average, has 6 episodes of diarrhoea in a year. While most parents (65%) continue with almost normal feeding practices during their children's diarrhoea, as is officially recommended, there are some foods that are traditionally withheld. The use of oral rehydration therapy in the form of a salt and sugar solution is very limited and needs to be promoted. Herbal treatment for diarrhoea is a widespread practice and needs to be studied further to ascertain its usefulness. Over 55% of mothers recognise poor hygiene as the most important cause of childhood diarrhoea. The general level of sanitation is not satisfactory and needs to be improved to achieve the widespread availability of safe water and adequate means of human waste disposal for all homes. The radio was found to be a potentially effective tool for health education, and the need to provide all health workers with continuing education about diarrhoea management was identified.

Hyperostotic fish bones (“Tilly bones”) from presumably Pliocene phosphorites of the Lake Manyara area, northern Tanzania

Abstract: Hyperostotic fish bones from the presumable Pliocene phosphate-bearing deposits along Lake Manyara, Tanzania, are described. In contrast to marine occurrences of this kind, the pathological structures described herein are the first hyperostotic bones (“Tilly bones”) from a lacustrine paleoenvironment. The origin of the pathological alteration is probably related to extreme hydrochemical conditions of the former Lake Manyara, especially its high content of fluorine.

Murder during sleep-walking.

Abstract: The issue of criminal responsibility is no easy matter to resolve at times. One such instance is offered by the case of the sleep walker who commits a violent act in the course of his sleep. However, sleep-walking disorder has not received much professional attention. In this article the author reports one case of sleep-waking disorder (Somnambulism) in which murder was committed in cold blood.

AIDS‐related stigma, personal risks and career objectives among makerere medical students

Abstract: Questionnaires administered to 150 randomly selected students at Makerere Medical School revealed negative attitudes toward persons with acquired immunodeficiency syndrome (AIDS) depending on personal variables yet a commitment to remain in the medical profession in spite of the personal risks. 80.5% of the medical students were male with a mean age of 24.73 years and 19.5% were female with a mean age of 22.69 years. Age religion and tribe were not significantly associated with AIDS-related stigma. Male students were more likely to associate AIDS with stigma than female counterparts but this trend was found to decline with each additional year of medical education. 13% of students perceived themselves to be at no risk of human immunodeficiency virus (HIV) infection 33% reported a slight risk 22% perceived a moderate risk and 16% reported a high or very high chance of infection; the remaining 16% were unable to provide a risk estimate. Occupational hazards of greater concern included needle pricks and contact with body fluids. 40% regarded their prior sexual behavior not occupational factors as the source of their HIV risk. To reduce HIV risk 69% suggested in sexual practices and 21% recommended work practices such as the use of protective equipment. 78% of students reported that they had already made alterations in their sexual practices notably condom use in response to the AIDS epidemic. Finally 84% indicated a determination to remain in the medical profession despite their perception of increased susceptibility to HIV infection and 69% said this threat would not influence their choice of specialty. The presence of stigma among these students suggests a need for a training component to address fear of AIDS and the perception that AIDS patients are morally irresponsible.

Morbidity and mortality in the Special Care Baby Unit of New Mulago Hospital, Kampala.

Abstract: The morbidity and mortality of admissions to the Special Care Baby Unit at New Mulago Hospital, Kampala are described for 1598 infants seen during the 12-month period of 1989. The overall neonatal mortality rate on the Unit was 18.0%, which has shown only slight improvement during the period 1984-1989. The major causes of death were, in descending order of frequency: birth asphyxia, respiratory distress syndrome, aspiration syndromes, very low birthweight, infection, anaemia and congenital malformations. Birth asphyxia was the most common cause of death in infants weighing over 2500 g while respiratory distress syndrome predominated among deaths below 2500 g. Birth injuries and transient tachypnoea of the newborn were also common reasons for admission. Difficulties of caring for infants requiring special care in a developing country are emphasized. These include inadequate equipment and supplies, poor investigative facilities and scarcity of well trained personnel. The situation is further aggravated by low morale among health workers due to poor working conditions.

The ‘Nubians’ of East Africa: a discussion

Abstract: (1992). The ‘Nubians’ of East Africa: a discussion. Institute of Muslim Minority Affairs. Journal: Vol. 13, No. 1, pp. 196-214.

Lake flies in Lake Victoria: Their biomass and potential for use in animal feeds

Abstract: Insects exhibiting swarming habits in Lake Victoria include mainly the Chironomidae, the Chaoboridae and Povilla adusta (Ephemeroptera). Their early life cycles are spent in the lake as benthos and standard bathymetrie procedures were undertaken to estimate the standing crop biomass of the larvae in Murchison Bay. Povilla was principally a boring invertebrate preferring dried logs (113 g Povilla nymphs per kg of host plant material). Cyperus papyrus carried 5 g C. denudalas 2.5 g and Phragmites mauritanus 1.0 g of Povilla per kg of host plant material. Povilla also occurred in the benthos at 40 g/m2. The Chironomidae and Chaoboridae had a mean standing crop biomass of 80 g/m2 and 3 g/m2 respectively. Their total biomass for the bay was estimated at 16060 metric tonnes for the Chironomidae, 7920 m. t. for Povilla and 660 m. t. for the Chaoborids. Adult swarming habits of the lakefly were closely correlated with lunar phases and the adults were easily trapped at night using kerosene lamps. Biochemical tests of the nutrient value of lakefly showed high levels of protein content (62%), minerals (18%), a low fat content (3.9%) and low moisture content (9%). This makes the lakefly ideal as an additive in animal feeds and growth experiments with poultry and aquaculture fish are currently going on to test the suitability of lakefly as an ingredient in animal feeds.

Chemical evaluation of Lake Victoria lakefly as nutrient source in animal feeds

Abstract: Biochemical analysis of lakefly (chironomid/chaoborid mixtures and Povilla adusta samples) were conducted to determine their nutrient value and their potential as source of high quality nutrients in animal feeds. The results showed lakefly as rich in protein (62–67 g/100 g), fat (10 g/100 g) and ash (4–6 g/100 g). Moisture was low as was crude fibre. Povilla were richer in crude protein (67.4 g/100 g) and calcium (152 mg/100 g). The chironomid chaoborid mixture was however extremely rich in phosphorus (1.2 × 103 mg/100 g) and potassium (1.2 × 103 mg/100 g). Other trace elements were present in significant quantities as were niacine, thiamine and riboflavin. It is therefore deemed feasible to produce high quality nutrient concentrates from lakefly material for use in animal feeds. Further work Is however essential to determine lakefly digestibility and palatability and to ascertain suitable lakewide harvest techniques for the lakefly.

Stability in a multi-species assemblage of large herbivores in East Africa: an alternative interpretation.

Abstract: Prins and Douglas-Hamilton (1990) analyzed data based on nine census counts of large herbivore species in Lake Manyara National Park, northern Tanzania, over the period 1959–1984. Their major conclusion was that even if individual species-showed large fluctuations in numbers, the different species compensated the fluctuations of the other species in a way resulting in a constancy of total herbivore biomass, constancy of plant biomass consumption, and “overall stability of the system under natural conditions”. The authors believed that they had found a support for this view by calculating the “stability index” based on correlations between numbers of large herbivores. In this paper I show that Prins and Douglas-Hamilton's calculation of the stability index was not justified. Grazing and browsing pressure by large herbivores in Lake Manyara National Park seems to be remarkably constant. However, available information does not allow any rigorous conclusions about the stability of this community. We need more data from other systems dominated by large herbivores to be able to make comparisons and to be able to say which systems are more stable and in what sense.

Aseptic necrosis of the head of the femur among sickle cell anaemia patients in Uganda.

Abstract: A number of HbSS patients presenting with aseptic necrosis of the femoral head have been seen at Mulago Hospital in Kampala, Uganda. A record review of the hospital's Sickle Cell Anaemia Clinic for the period 1985-1989 revealed that aseptic necrosis of the femoral head has been diagnosed in 2.9% (47/1611) of patients attending regularly. The largest number of diagnosed patients were in the 15-24 year old age group; peak incidence occurred in 20-24 year old women. Diagnosis in this series of patients was generally delayed and management was accordingly difficult. It is suggested that clinicians ask directly about pain in the hip of sickle cell patients rather than waiting spontaneous reporting. Such an approach may improve early detection of this potentially crippling problem.

Anaplasmosis in Uganda. III. Parasitological and serological evidence of Anaplasma infection in Ugandan goats.

Abstract: Randomly selected goat sera from north-western, central, and south-western regions of Uganda were analyzed parasitologically and serologically for evidence of anaplasmosis. Prevalence rates of 3.2% by parasitemia, 4.8% by card-agglutination test, and 12.9% by DOT-ELISA combined with western blotting were established. Parasitologically positive samples were consistently serologically positive. Positive samples were all from either the north-western or south-western regions of the country. Goats in these regions graze with cattle and are presumable exposed to the same tick species. There was no evidence of clinical caprine anaplasmosis, whereas bovine anaplasmosis cases are very common. Rhipicephalus evertsi was frequently observed on goats which cograze with cattle.

Anaplasmosis in Uganda. I. Use of dried blood on filter papers and serum samples for serodiagnosis of anaplasmosis--a comparative study.

Abstract: The suitability of blood collected on filter papers in comparison with corresponding conventional serum samples in the diagnosis of bovine anaplasmosis was studied using the complement fixation test, DOT-ELISA, Western immunoblot and rapid card agglutination test. Dried blood on Whatman filter paper no. 1 was eluted in PBS 0.05% Tween 20 giving an initial dilution of 1:10. The reactivity of the eluted samples in both DOT-ELISA and Western immunoblotting were similar to those obtained with the corresponding straight serum sample dilutions. Filter paper samples gave lower reactivity in the remaining tests when compared with corresponding serum samples. There was no significant difference in the reactivity between the eluates from filter papers stored at temperatures ranging between 15.5 and 24 degrees C and those kept refrigerated. Storage at 15.5 to 24 degrees C did not significantly affect reactivity for up to six months. Eluates from filter papers stored for six months at 15.5 to 24 degrees C continued to give similar reactivity as those from freshly prepared filter papers in both DOT-ELISA and Western blot, and in the rapid card agglutination test. It is concluded that collecting blood on filter papers is a suitable technique for large scale seroepidemiological studies on anaplasmosis and offers many advantages in developing countries where transport and cold chain facilities are a major constraint.

Aortic - Iliac Thrombosis in Bovine

Abstract: Blood is maintained in a fluid form within the vascular system by the body maintaining a balance between the clotting mechanism, fibrin and platelets deposition on the one hand and the activity of fibrinolytic enzymes on the other. Thrombosis occurs if the clotting mechanism and the fibrin and platelets deposition within the vascular system become excessive and exceeds the fibrinolytic activity of the fibrinolysin. Three factors known as the Virchow's triads consisting of damage to vessel wall and endothelium, changes in the blood flow and changes in the composition of the blood are generally considered to constitute the main pathogenetic mechanism of thrombosis. Because of the low blood pressure and the nature of the blood flow on the veinous side of the circulation, veinous thrombosis occurs more commonly than arterial thrombosis. Arterial thrombosis involving either the aorta, cranial messenteric artery, coronary artery or iliac arteries are commonly known to occur in horses infected with Strongylus vulgaris, in cats with idiopathic cardiomyopathy and in man due to atheriosclerosis or atheromas. In cattle most cases of thrombosis reported involved the caudal vena cava (1,2,3,). Thrombosis affecting smaller arteries and arterioles in cattle are known to occur in malignant catarrhal fever as the result of fibrinoid degeneration and arteritis or arteriolitis and in infection with Haemophilus somnus which causes ischaemic septicaemic thrombomeningoencephalitis. Thrombosis affecting larger arterial blood vessels are rare. This paper describes unique cases of extensive thrombosis of the aorta, it's branches and the iliac arteries in three cows examined at postmortem.