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Intestinal intussusception in an adult caused by helminthic parasitosis

Intestinal intussusception is an uncommon acute condition in adults and is most commonly caused by an intestinal tumor mass. Helminthic parasitosis is a widespread infection in Africa, and the load of worms is often high in individuals living in areas with inadequate sanitation. We report a case of intestinal obstruction caused by Ascaris lumbricoides infection, which was complicated by ileo-caecal intussusception and required surgical treatment in a 40-year-old Ugandan woman. This case reinforces the importance of anthelminthic prophylaxis in African rural areas

Reward strategies and job satisfaction in private companies: a case of Uganda Breweries-Luzira

Purpose: This study aimed to determine the relationship between reward structures and employee job satisfaction at Uganda Breweries, Port Bell in Luzira. Research methodology: It was cross-sectional, quantitative though involving qualitative elements. The study involved 150 respondents sampled using purposive and convenience sampling strategies. Data was collected using a self-administered questionnaire and an interview guide. The findings reveal a significant positive relationship between financial rewards structures and employees' job satisfaction at Uganda Breweries. Results: The findings suggest a significant positive relationship between non-financial rewards structures and employees' job satisfaction at Uganda Breweries Port Bell at Luzira. The findings further advocate for enhanced attention linking promotions to job satisfaction of employees at Uganda Breweries.  It is concluded that financial rewards, non-financial reward strategies and promotions had a highly positive significant relationship on employee job satisfaction at Uganda Breweries-Luzira. Limitation: This study was limited to Uganda Breweries at Port Bell, a private company and so its findings may not easily be generalised across organisations. Contribution: The results can be useful to private-sector managers. Keywords: Financial rewards, Non-financial reward, Job satisfaction, Decision-making, Incom

Knowledge and misconceptions about HIV counseling and testing (HCT) among the post-conflict youths of Gulu, Northern Uganda. A prospective study design

Background: Uganda has been reported as the most successful country in Africa in reducing the prevalence of HIV/AIDS from 18% to 6.4% over the last two decades. There is evidence to suggest that despite a significant decline between 1992 and 2002, HIV prevalence has stagnated over the last 5-9 years at between 6.1 and 6.5% and it is rising in some parts of the country such as Gulu. This rise are thought to be due to the high levels of stigma and superstition preventing HIV counseling and testing (HCT). WHO reports in 2009 showed that only 20% of Uganda’s populations knew their HIV sero-status. This study was designed to find out the knowledge, misconceptions, attitude and practices of youths of Gulu about HCT. Methods: A cross-sectional study was conducted in Gulu, Pece among the youths 15 to 35 years. An in-depth interview using a questionnaire was administered to youths of Commercial Road Sub-ward. Informed consent and ethical approval was obtained and 86 respondents were interviewed. Results: Ninety three percent of respondents had knowledge about HCT and 97.7% were able to mention two or more of its benefits. Most (88.4%) agreed on public disclosure of their HIV status and 84.9% would encourage others to undertake it. Only 36.1% of respondents had undertaken HCT while the rest had not undertaken it due to fear of stigmatization. Conclusion: There is adequate knowledge, good attitude but poor practice and misconceptions to HCT. The young adults in Gulu should be supported in a special program to enable them undertake HCT and access other services for HIV/AIDS prevention.Pan African Medical Journal 2012; 12:3

Incidence of male breast carcinoma in North Uganda: a survey at Lacor Hospital, Gulu, during 2009-2016

BACKGROUND: Little information is available on male breast cancer (MBC) incidence from sub-Saharan Africa.OBJECTIVE: This is a retrospective study on MBC in rural North Uganda, based on the pathology records of a private, non-profit, missionary hospital.METHODS: All male patients that had histological diagnosis of breast carcinoma from January 2009 to December 2016 were included in this study.RESULTS: In time span of 8 years, there were 337 consecutive breast cancer presentations, including 21 MBC (6.2%). The latter patients showed advanced disease (mean symptom duration: 20.3 months; mean tumour size: 5cm;) skin ulceration and ipsilateral lymph node metastasis: 60%). The mean age was 60.52 years (from 30 to 85 yrs). Ductal infiltrating carcinoma was the prevalent histological type in our series (65%), followed by an unusually high rate of papillary carcinomas (15%). There appeared to be a prevalence for left breasts (11 LT versus 6 RT; 64.7%), a finding also observed in the majority of MBC.CONCLUSIONS: This study is representative of the scenario in Northern Uganda, where MBC accounts for 6.2% of breast cancers, More information on the occurrence and risk factors of this unusual neoplasm in African countries may prompt prevention of chronic liver disease and early recognition and treatment of MBC

Implementation of intensified tuberculosis case finding among people living with HIV in Kampala, Uganda: a cross sectional study

Introduction: Intensified Case Finding (ICF) is a cost-effective strategy for tuberculosis (TB) control and improving quality of life however, its implementation by health workers is generally reported as low in Uganda. There is limited information on the level of ICF implementation and the barriers or facilitators to its implementation among public health facilities in Kampala Capital City Authority (KCCA). In this study we determined the level of ICF implementation, facilitators and its barriers in KCCA public health facilities. Methods: We conducted a cross-sectional study between May-July 2015. We purposively selected six KCCA public health facilities and conducted exit interviews with patients attending Anti-Retroviral Therapy (ART) clinics to assess whether they were screened for TB. In-depth and key informant interviews with health workers were conducted to explore their experiences in implementing ICF. Results: Overall, ICF implementation was sub optimal. Less than 10% (30/321) clients reported being screened for current cough, fever, weight loss or night sweats. Conversely, 90.0% (289/321) clients screened for at least one TB symptom with cough being the most frequently asked symptom 87.5% (281/321). Of 131 clients who were screened and reported having at least one TB symptom, 36.6% (48/131) were sent to the laboratory, 2.3% (3/131) for X-Ray and 61.1% (80/131) to pharmacy. Training, support supervision, proper coordination, and support from implementing partners were facilitators of ICF implementation. Poor staff attitude, irregular supply of ICF related inputs/materials, high workload, transport and stigma were key barriers to ICF policy implementation. Conclusion: ICF implementation at ART clinics in KCCA public health facilities was sub optimal. Health workers’ attitude, training, support supervision and stigma of TB clients should be addressed for better ICF implementation

Home-based tuberculosis contact investigation in Uganda: a household randomised trial.

IntroductionThe World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.MethodsWe performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.ResultsThere were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14% versus 15%; difference -1%, 95% CI -9% to 7%, p=0.81) and yields of confirmed TB (1.5% versus 1.1%, p=0.62) and new HIV (2.0% versus 1.8%, p=0.90) diagnoses were similar.ConclusionsHome-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components

Risks of adverse perinatal and maternal outcomes among women with hypertensive disorders of pregnancy in southwestern Uganda.

INTRODUCTION: Hypertensive disorders of pregnancy (HDP) are a leading cause of global perinatal (fetal and neonatal) and maternal morbidity and mortality. We sought to describe HDP and determine the magnitude and risk factors for adverse perinatal and maternal outcomes among women with HDP in southwestern Uganda. METHODS: We prospectively enrolled pregnant women admitted for delivery and diagnosed with HDP at a tertiary referral hospital in southwestern Uganda from January 2019 to November 2019, excluding women with pre-existing hypertension. The participants were observed and adverse perinatal and maternal outcomes were documented. We used multivariable logistic regression models to determine independent risk factors associated with adverse perinatal and maternal outcomes. RESULTS: A total of 103 pregnant women with a new-onset HDP were enrolled. Almost all women, 93.2% (n = 96) had either pre-eclampsia with severe features or eclampsia. The majority, 58% (n = 60) of the participants had an adverse perinatal outcome (36.9% admitted to the neonatal intensive care unit (ICU), 20.3% stillbirths, and 1.1% neonatal deaths). Fewer participants, 19.4% (n = 20) had an adverse maternal outcome HELLP syndrome (7.8%), ICU admission (3%), and postpartum hemorrhage (3%). In adjusted analyses, gestational age of < 34 weeks at delivery and birth weight <2.5kg were independent risk factors for adverse perinatal outcomes while referral from another health facility and eclampsia were independent risk factors for adverse maternal outcomes. CONCLUSION: Among women with HDP at our institution, majority had preeclampsia with severe symptoms or eclampsia and an unacceptably high rate of adverse perinatal and maternal outcomes; over a fifth of the mothers experiencing stillbirth. This calls for improved antenatal surveillance of women with HDP and in particular improved neonatal and maternal critical care expertise at delivering facilities. Earlier detection and referral, as well as improvement in initial management at lower level health units and on arrival at the referral site is imperative

Farmers’ perceptions of commercial insect-based feed for sustainable livestock production in Kenya

This study evaluated farmer’s perceptions of commercial insect-based feed (IBF) products and assessed factors that would influence adoption. Findings show that over 90% of the farmers were willing to use IBF. The principal component analysis (PCA) identified feed performance; social acceptability of the use of insects in feed formulation; feed versatility and marketability of livestock products reared on IB as key attributes that would inform farmers’ purchase decisions. Public partnerships with resource-endowed farmers and farmer groups are recommended to improve knowledge sharing on IBF.Australian Centre for International Agricultural Research (ACIAR