Mulago Hospital

About: Mulago Hospital is a healthcare organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Health care. The organization has 542 authors who have published 545 publications receiving 34804 citations.

Retinal Pigment Epithelial Cells are a Potential Reservoir for Ebola Virus in the Human Eye.

Abstract: Purpose Success of Ebola virus (EBOV) as a human pathogen relates at the molecular level primarily to blockade the host cell type I interferon (IFN) antiviral response. Most individuals who survive Ebola virus disease (EVD) develop a chronic disease syndrome: approximately one-quarter of survivors suffer from uveitis, which has been associated with presence of EBOV within the eye. Clinical observations of post-Ebola uveitis indicate involvement of retinal pigment epithelial cells. Methods We inoculated ARPE-19 human retinal pigment epithelial cells with EBOV, and followed course of infection by immunocytochemistry and measurement of titer in culture supernatant. To interrogate transcriptional responses of infected cells, we combined RNA sequencing with in silico pathway, gene ontology, transcription factor binding site, and network analyses. We measured infection-induced changes of selected transcripts by reverse transcription-quantitative polymerase chain reaction. Results Human retinal pigment epithelial cells were permissive to infection with EBOV, and supported viral replication and release of virus in high titer. Unexpectedly, 28% of 560 upregulated transcripts in EBOV-infected cells were type I IFN responsive, indicating a robust type I IFN response. Following EBOV infection, cells continued to express multiple immunomodulatory molecules linked to ocular immune privilege. Conclusions Human retinal pigment epithelial cells may serve as an intraocular reservoir for EBOV, and the molecular response of infected cells may contribute to the persistence of live EBOV within the human eye. Translational relevance This bedside-to-bench research links ophthalmic findings in survivors of EVD who suffer from uveitis with interactions between retinal pigment epithelial cells and EBOV.

A pilot study to determine if nurses trained in basic neonatal resuscitation would impact the outcome of neonates delivered in Kampala Uganda.

Abstract: Summary Aims and Objectives: To determine if a team dedicated to basic neonatal resuscitation in the delivery ward of a teaching hospital would impact the outcome of neonates delivered in Kampala, Uganda. Methods: A five-member team of nurses, trained in basic neonatal resuscitation attended 1046 deliveries over a thirty-one day pilot period. They were available in the delivery ward twenty-four hours each day. Outcomes studied included the number of stillbirths recorded on the delivery ward, the number of neonates admitted to the special care baby unit (SCBU), the number of babies admitted to SCBU who died and the mortality in the different weight categories. APGAR scores before and after intervention was also compared. Admission diagnoses between the two groups were also compared. Outcome data collected during this pilot period was compared with historic controls from the previous 31 days in the same unit. Patients and Setting: A delivery ward, 22 000 deliveries per year. Results: The stillbirth rate and admission rate to the SCBU were unchanged. Basic neonatal resuscitation in this setting decreased the incidence of asphyxia (defined as failure to initiate and sustain breathing or an APGAR score of <7 at 5 min), improved APGARS and a decrease in the mortality of babies weighing more than 2 kg. Conclusion: The resuscitation team reduced the incidence of and mortality from asphyxia and improved the outcome of babies greater than 2 kg. This pilot study provides evidence of the beneficial effect of basic neonatal resuscitation in this setting.

The Brain Drain Myth: Retention of Specialist Surgical Graduates in East, Central and Southern Africa, 1974-2013.

Abstract: This study assesses the retention of specialist surgical graduates from training programmes across eight countries in East, Central and Southern Africa from 1974 to 2013. It addresses the gap in existing data by analysing retention rates of surgical graduates by comparing graduating institution to current location. Data were assessed by country, region, specialty and gender with a view to informing national and regional healthcare and education strategies. Twenty-five institutions train surgeons in the ten countries covered by the College of Surgeons of East, Central and Southern Africa (COSECSA)—24 Universities and the College itself. These institutions were requested in November 2014 to supply details of graduates from their postgraduate surgical training programmes. Complete graduate lists were returned by the College and 14 universities by March 2016. These surgical graduates were compared against the database of current practising surgeons in the region held by COSECSA. Data were cross-checked against medical council registers, surgical society records, and with members and fellows of COSECSA. Data were incomplete for 126 surgical graduates. Of the remaining 1038 surgical graduates, 85.1% were retained in the country they trained in, while 88.3% were retained within the COSECSA region. Ninety-three per cent (93.4%) were retained within Africa. Of the eight countries, Malawi had the highest retention rate with 100% of surgical graduates remaining in country, while Zimbabwe had the lowest rate with 65.5% remaining. High surgical graduate retention rates across the region indicate that the expansion of national surgical training initiatives is an effective solution to addressing the surgical workforce shortage in East, Central and Southern Africa and counters long-held arguments regarding brain drain in this region.

The response of the internal anal sphincter in man to stimulation of the presacral nerve.

Abstract: 1. In man under nitrous oxide/oxygen anesthesia, stimulation of the peripheral part of the presacral nerve supply to the rectal and anal region produces relaxation of the internal anal sphincter.