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

Prostate hyperplasia in St Mary\u2019s Hospital Lacor: utility of prostate specific antigen in screening for prostate malignancy

Introduction: Prostate cancer is the second commonest cancer in men worldwide. At present, every patient with lower urinary tract symptoms (LUTS) in St. Mary\u2019s Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level. We sought to determine the association between PSA and malignant prostate histology. Methods: This was a retrospective study. Data on age, PSA, prostate volume and prostate histology reported between Jan 2012 and Dec 2019 were retrieved from St. Mary\u2019s Hospital Lacor archive and analyzed using STATA SE/13.0. Results: Records of 97 patients with LUTS was analyzed. The median (range) age of the patients was 71 (43-100) years. Median (range) of prostate volume was 91.8 (8.0-360.0) cc. Overall, PSA ranged from 0.21 to 399.2 ng/ml. Prostate histology showed 3.1% acinar adenocarcinoma, 24.7% adenocarcinoma and 72.2% benign prostatic hyperplasia. The median PSA amongst patients with malignant and non-malignant prostates were 15.8 ng/ml and 6.07 ng/ml respectively. Serum PSA level was significantly higher in patients with malignant prostate histology (Difference of mean= 9.7; p=0.001). Conclusion: Patients with LUTS and PSA levels of 15ng/ml or more were more likely to have malignant prostate histology

Ebola Hemorrhagic Fever Transmission and Risk Factors of Contacts, Uganda1

From August 2000 through January 2001, a large epidemic of Ebola hemorrhagic fever occurred in Uganda, with 425 cases and 224 deaths. Starting from three laboratory-confirmed cases, we traced the chains of transmission for three generations, until we reached the primary case-patients (i.e., persons with an unidentified source of infection). We then prospectively identified the other contacts in whom the disease had developed. To identify the risk factors associated with transmission, we interviewed both healthy and ill contacts (or their proxies) who had been reported by the case-patients (or their proxies) and who met the criteria set for contact tracing during surveillance. The patterns of exposure of 24 case-patients and 65 healthy contacts were defined, and crude and adjusted prevalence proportion ratios (PPR) were estimated for different types of exposure. Contact with the patient’s body fluids (PPR = 4.61%, 95% confidence interval 1.73 to 12.29) was the strongest risk factor, although transmission through fomites also seems possible

TOPICAL ISSUE: HIV AND AIDS - IMPACT OF VOLUNTARY COUNSELLING AND TESTING AND HEALTH EDUCATION ON HIV PREVENTION AMONG SECONDARY SCHOOL STUDENTS IN NORTHERN UGANDA

The study aim was to evaluate the impact of Voluntary Counselling and Testing (VCT) and School Health Education (SHE) on HIV/AIDS related knowledge, behaviours and risk perception among secondary school students in Northern Uganda. A post-test only control group study was conducted among 1,312 secondary school students classified as follows: students involved in SHE and VCT (group 1); only in SHE (group 2); in neither VCT nor SHE (group 3, control group). Almost all students are aware of AIDS and condoms and how to prevent HIV infection: abstinence and condom use were the most reported preventive measures. About 60% of those in groups 2 and 3 were sexually active compared to 31% in group 1 (P<0.001). Students of group 3 had earlier sexual debut (median age=15) than those in group 2 (median age=16) (P<0.001). No significant differences in condom use with any type of partner were observed, although students in group 2 were more likely to report consistent condom use. Overall, two-third of the students say they do not feel they are at risk of infection, but almost 70% of them reported no reason. Despite considerable knowledge about AIDS, many students engage in unprotected sex and re thus at risk of infection . Students exposed to VCT and SHE seemed to have safer behaviour, suggesting that these programs should be expanded and further research should be conducted on the effects. SHE could be the appropriate method to reach youth and their families in poor-resources settings, whereas VCT could be the appropriate choice as part of a comprehensive service delivered to the users

Echocardiographic Screening for Rheumatic Heart Disease in a Ugandan Orphanage: Feasibility and Outcomes

Background: Rheumatic heart disease (RHD) is a major cause of cardiovascular disease in developing nations, leading to more than 230,000 deaths annually. Most patients seek medical care only when long-term structural and hemodynamic complications have already occurred. Echocardiographic screenings ensure the early detection of asymptomatic subjects who could benefit from prophylaxis, monitoring and intervention, when appropriate. The aim of this study is to assess the feasibility of a screening program and the prevalence of RHD in a Ugandan orphanage. Methods: We performed an RHD-focused echocardiogram on all the children (5&ndash;14 years old) living in a north Ugandan orphanage. Exams were performed with a portable machine (GE Vivid-I). All the time intervals were recorded (minutes). Results: A total of 163 asymptomatic children were screened over 8 days (medium age 9.1; 46% male; 17% affected by severe motor impairment). The feasibility rate was 99.4%. An average of 20.4 exams were performed per day, with an average of 15.5 images collected per subject. Pathological mitral regurgitation (MR) was found in 5.5% of subjects, while at least two morphological features of RHD were found in 4.3%, leading to 1 &ldquo;definite RHD&rdquo; (0.6%) case and 13 &ldquo;borderline RHD&rdquo; cases (8.1%). Six congenital heart defects were also noted (3.7%): four atrial septal defects, one coronary artery fistula and one Patent Ductus Arteriosus. Conclusions: We demonstrated the feasibility of an echocardiographic screening for RHD in an orphanage in Uganda. A few factors, such as good clinical and hygienic care, the availability of antibiotics and closeness to a big hospital, may account for the low prevalence of the disease in our population