Makerere University

About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Acquired immunodeficiency syndrome (AIDS). The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.

Anaemia and blood transfusion in African children presenting to hospital with severe febrile illness

Abstract: Severe anaemia in children is a leading cause of hospital admission and a major cause of mortality in sub-Saharan Africa, yet there are limited published data on blood transfusion in this vulnerable group We present data from a large controlled trial of fluid resuscitation (Fluid Expansion As Supportive Therapy (FEAST) trial) on the prevalence, clinical features, and transfusion management of anaemia in children presenting to hospitals in three East African countries with serious febrile illness (predominantly malaria and/or sepsis) and impaired peripheral perfusion Of 3,170 children in the FEAST trial, 3,082 (97%) had baseline haemoglobin (Hb) measurement, 2,346/3,082 (76%) were anaemic (Hb <10 g/dL), and 33% severely anaemic (Hb <5 g/dL) Prevalence of severe anaemia varied from 12% in Kenya to 41% in eastern Uganda 1,387/3,082 (45%) children were transfused (81% within 8 hours) Adherence to WHO transfusion guidelines was poor Among severely anaemic children who were not transfused, 52% (54/103) died within 8 hours, and 90% of these deaths occurred within 25 hours of randomisation By 24 hours, 128/1,002 (13%) severely anaemic children had died, compared to 36/501 (7%) and 71/843 (8%) of those with moderate and mild anaemia, respectively Among children without severe hypotension who were randomised to receive fluid boluses of 09% saline or albumin, mortality was increased (106% and 105%, respectively) compared to controls (72%), regardless of admission Hb level Repeat transfusion varied from ≤2% in Kenya/Tanzania to 6 to 13% at the four Ugandan centres Adverse reactions to blood were rare (04%) Severe anaemia complicates one third of childhood admissions with serious febrile illness to hospitals in East Africa, and is associated with increased mortality A high proportion of deaths occurred within 25 hours of admission, emphasizing the need for rapid recognition and prompt blood transfusion Adherence to current WHO transfusion guidelines was poor The high rates of re-transfusion suggest that 20 mL/kg whole blood or 10 mL/kg packed cells may undertreat a significant proportion of anaemic children Future evaluation of the impact of a larger volume of transfused blood and optimum transfusion management of children with Hb of <6 g/dL is warranted Please see related article: http://dxdoiorg/101186/s12916-014-0248-5

Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda

Abstract: The sex behavior and HIV serostatus of 824 adolescents aged 13-19 years in 31 randomly selected community clusters of rural Rakai district Uganda were surveyed and followed-up during 1990-92. No one under age 15 years was infected with HIV. However 1.8% of men and 19.0% of women aged 15-19 years were HIV-seropositive. 21.3% of women who were married or in some other consensual union were infected with HIV as were 29.1% of women reporting no permanent relationship and 4.3% of women who reported being in no current relationship at all. After multivariate adjustment female sex age 17-19 years residence in trading centers or trading villages and a history of sexually transmitted disease symptoms were significantly associated with HIV infection. 79% of the adolescents provided a follow-up serological sample. While no men aged 13-14 years seroconverted during the study HIV seroincidence was 0.6 per 100 person-years of observation among women aged 13-14 years. There was an average of 1.1 and 3.9 seroconversions per 100 person-years of observation among men and women aged 15-19 years respectively before reaching age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years at 3.9 per 100 person-years of observation was 13 times higher than that among the HIV-seronegative. By 1992 there was almost universal knowledge of the sexual transmission of HIV a smaller proportion of youth reported having sex with multiple partners and the level of condom use had increased over baseline.

Hydrogen chemical potentials and diffusion coefficients in hydrogen diffusion membranes

Abstract: Palladium and palladium alloys are quite widely used as membranes for hydrogen permeation, because of their resistance to embrittlement and to irreversible deformations during cycles of absorption and desorption of hydrogen1–3. The isothermal relationships between hydrogen diffusion coefficient, DH, and hydrogen content, n (ratio of hydrogen/metal atoms) has both technological and academic interest. The most detailed form of relationships2,3 between DH and n have been those reported for deuterium in Pd75Ag25 by Hickman4 within the temperature range 300–500°C, and for protium in Pd7Ag23 within the range 30–75°C by Kussner5. For increasing values of n up to n ∼ 0.2, Kussner5 reported significant corresponding decreases of DH (by a factor of ∼ 8 from n=0 up to n ∼ 0.16 at 30°C). This is the reverse of trends in the values of DH with increasing n suggested by measurements of anelastic effects3,6,7 and also by the permeation rate measurements of Hickman4 at 300 and 400°C. Here we report measurements of diffusion through Pd81Pt19 alloy, the results of which are consistent with Gorskii's hypothesis relating long-range anelastic diffusion of lattice interstitials to elastic strain gradients.

Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: Rationale, overview and methods of AFFIRM

Abstract: There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.