Chronic genital ulcer disease with subsequent development of methicillin-resistant Staphylococcus aureus (MRSA ) urethritis and bacteraemia in an HIV-seropositive person – A case observation

HIV-seropositive persons are at increased risk of methicillin-resistant Staphylococcus aureus (MRSA). Genital ulcerative disease and sexually transmitted infection with subsequent MRSA infection in HIV-seropositive persons have been documented only once. We report a case of a 44-year-old man who presented to the Infectious Diseases Institute, Kampala, Uganda, with chronic genital ulcer disease and who subsequently developed MRSA urethritis and bacteraemia. This case also demonstrates that persistent genital ulcer disease in HIV-seropositive persons may be as a result of concurrent MRSA infection

Autoimmune polyglandular syndrome type 1 in a 12-year-old Ugandan girl

Autoimmune polyglandular syndrome type 1 (APS-1), also known as autoimmune polyendocrinopathy-candidiasisectodermal dystrophy syndrome, is a very rare disorder of childhood. It is mainly characterised by the presence of at least two of the following: chronic mucocutaneous candidiasis, chronic hypoparathyroidism and autoimmune Addison’s disease. We report on the case of a 12-year-old Ugandan female patient who presented with featuresthat were most consistent with APS-1 (chronic mucocutaneous candidiasis and hypoparathyroidism). Significant clinical improvement was noted following oral antifungal therapy

A case of palatal perforation caused by toxoplasmosis

We describe the case of a 35-year-old HIV-positive man seen at the Infectious Diseases Institute, Kampala, Uganda, with a 2-week history of palatal perforation

Basis of selection of first and second line highly active antiretroviral therapy for hiv/aids on genetic barrier to resistance: a literature review.

The effectiveness of combination antiretroviral therapy (cART) continues to improve as treatment choices expand with the development of new antiretroviral agents and regimens. However, the successful long-term treatment of HIV/AIDS is under threat from the emergence of drug-resistant strains to multiple agents and entire drug classes.Key words: genetic barrier, highly active antiretroviral therapy, HIV resistanc

Intractable Chronic Vulval Ulceration Presenting as Immune Reconstitution Inflammatory Syndrome in a Treatment-Failure Patient: A Case Observation

HIV-1 treatment-failure patients are increasingly being initiated on second-line antiretroviral therapy. The case we describe is of a treatment-failure patient who developed intractable chronic vulval ulceration presenting as immune reconstitution inflammatory syndrome (IRIS), following complete viral suppression with second-line highly active antiretroviral treatment (HAART). To the best of our knowledge, this is the first reported case of intractable vulval ulceration IRIS in an HIV-1 treatment-failure patient

Immune reconsitution inflammatory syndrome among adolescents: a report of cases in a resource-limited setting (Uganda)

We report immune reconstitution inflammatory syndromes in a cohort of adolescents/young adults over a period of 1 year at the Infectious Diseases Institute, Kampala, Uganda

Transitioning behaviourally infected HIV-positive young people into adult care: Experiences from the young person’s point of view

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa.Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning.Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012.Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed.Conclusion. There is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers.S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.88

An investigation of factors which influence integrating indigenous knowledge of medicinal plants into the learning programme for Grade 9 General Science

This study explores knowledge of some medicinal plants amongst the sub-urban community of and around a township in the Eastern Cape province. This qualitative interpretivist case study presents the prior knowledge of medicinal plants possessed by Grade 9 learners, which is used as a springboard toward interviewing traditional healers, herbal practitioners and lecturers at a university in the departments of Botany and Pharmacy. The data obtained from the informants reveals the factors that can influence integration of indigenous knowledge of medicinal plants in the learning programme for grade 9 General Science. These factors include: prior knowledge and enthusiasm of Grade 9 learners and teachers, support of the community which include parents, traditional healers, herbal practitioners and professionals who could introduce indigenous knowledge of medicinal plants into formal education, availability of resource materials and complexity of identifying pharmacologically tested plants from other indigenous medicinal plants. The analysis and discussion of the findings, have led me to conclude that the enthusiasm of learners who have a rich background of indigenous knowledge on medicinal plants is likely to be hampered by the unenthusiastic teachers as well as the reluctance of herbal practitioners in their communities to part with this knowledge. Hence I recommend that teachers be motivated through workshops and in-service training, conducted by goverr\ment paid herbal practitioners using the prior knowledge of learners as a stepping-stone

Lived Experiences of Women Following a Stillbirth Delivery in Mityana Hospital

Background: The World Health Organization (WHO) defines a stillbirth as a baby born with no signs of life at or after 28 weeks' gestation. In high income countries, it is evident that a new-born will survive after 25 weeks’ gestation, compared to 28-32 weeks’ gestation in low resource countries. The global stillbirth rate is estimated to be 13.9 still births per 1000 total births. In Africa, the still birth rate is 10 times that of the developed countries, indicating 29 births Vs 3 per 1000 live births. This paper recounts women’s experiences following the delivery of a Stillbirth.  Materials and Methods: The study used a Phenomenological study design to describe the essence of the women’s experiences following the delivery of a Stillbirth. The study focused on 16 women aged 17-35, who had experienced stillbirths both macerated and fresh, these were the primary sources of information for the study. The in-depth interviews held with participants revealed that the stillbirth Phenomenon has a major negative impact on the reproductive health lives of women and the magnitude of grief and the associated mysteries surrounding stillbirth make the whole experience unbearable. The paper looks at the short and long term experiences of birthing a silent baby and the different strategies used by women to cope with the experience. Findings: The Stillbirth Phenomenon has a major negative impact on the reproduction lives of women. The magnitude of grief and the associated mysteries surrounding stillbirth make the whole experience unbearable. Women experience untold grief from the loss, coping with the sad memory of loss for all their life and at time with little or no support. Conclusion: Although they always come up with self-coping mechanisms, there is a need to provide psychological and social support to these mothers who have experienced a still birth. The findings from this study show the physical, social and psychological challenges women endure during the occurrence of the stillbirth phenomenon. These findings can be used to inform efforts aimed at providing support to women who fall victim of stillbirth so as to make the experience less painful. The findings will also pave way for more research on experiences of women following Stillbirths events and other silent tragedies impacting maternal health in the country and the world at large. Keywords: Stillbirth, Experiences, Grief, bereavement, Care and Support, Coping, phenomenology DOI: 10.7176/JHMN/92-04 Publication date:August 31st 202