Prevalence and factors associated with rotavirus diarrhea among children aged 3-24 months after the introduction of the vaccine at a referral hospital in Uganda: a cross-sectional study.

BACKGROUND: Rotavirus has a significant morbidity and mortality in children under two years. The burden of rotavirus diarrhea 4 years post introduction of rotavirus vaccine in Uganda is not well established. This study aimed to determine the prevalence, severity of dehydration and factors associated with rotavirus diarrhea among children aged 3 to 24 months after the introduction of the vaccine at Fort Portal Regional Referral hospital. METHODS: This was a cross-sectional hospital-based study in which children with acute watery diarrhea were included. A rectal tube was used to collect a stool sample for those unable to provide samples. Stool was tested for rotavirus using rapid immunochromatographic assay. Data was analysed using SPSS version 22 with logistic regression done to determine the factors. RESULTS: Out of 268 children with acute watery diarrhea, 133 (49.6%) were females. Rotavirus test was positive in 42 (15.7%), majority of whom had some dehydration 28(66.7%). The factors that were independently associated with rotavirus diarrhea were; age < 12 months (AOR = 8.87, P = 0.014), male gender (AOR = 0.08, P = 0.001), coming from a home with another person with diarrhea (AOR = 17.82, P = 0.001) or a home where the water source was a well (AOR = 50.17, P = 0.002). CONCLUSION: The prevalence of rotavirus diarrhea was three times less in the post rotavirus vaccination period compared to pre-rota vaccination period. Majority of the participants with rotavirus diarrhea had some dehydration. There is need for provision of safe water sources to all homes. Surveillance to determine the cause of the non rota diarrhea should be done.

Prevalence and Factors Associated with Iron Deficiency Anaemia among Children Aged 6-23 Months in Southwestern Uganda.

Iron deficiency anaemia is still a global public health concern with the highest burden among children 6 to 23 months due to their rapid growth spurt exceeding breastmilk supply. Therefore, nutritional supply is a key source of iron to attain the required nutrients for better growth and development. This was a cross-sectional descriptive study done at Ishaka Adventist Hospital (IAH) and Kampala International University Teaching Hospital (KIUTH) from April to July 2022. Participants were consecutively enrolled in the study. Structured questionnaires, 24-hour dietary recall, and clinical assessment were used to obtain data. Data analysis was done using the statistical package for social scientists (SPSS) V22.0. Bivariable and multivariable analyses were done using logistic regression for associations with significance set at P value < 0.05. A total of 364 participants were enrolled, with the majority being males (198, 54.4%) and born at term (333, 91.5%). The modal age was 12-17 months [163(44.8%)] with a mean age of 14.1 months (SD 5.32). The overall prevalence of IDA was 151/364 (41.5%). The factors associated with IDA included male sex (aOR 1.61), current episode of diarrhoea (aOR 1.71), poor meal frequency (aOR 1.78), no vegetable consumption (aOR 2.47), and consuming fruits once (aOR 1.97) in 7 days preceding the study. The study finds a high prevalence of IDA among infants 6-23 months with at least four in 10 being affected. Screening for IDA should be recommended in male children with current diarrhoea, poor intake of fruits and vegetables, and poor meal frequency. The Mentzer index is an equally good alternative screening test for IDA.

Chronic obstructive pulmonary disease burden, grades and erythrocytosis at a tertiary hospital in western Uganda.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide among people over 40 years of age, and erythrocytosis is one of the major complications associated with increased mortality among COPD patients. The study aimed to determine the proportion of COPD, associated factors, and the burden of erythrocytosis among COPD participants. METHODS AND MATERIALS: A descriptive cross-sectional study design was used. A consecutive sampling technique was used to obtain study participants at the Fort Portal Regional Referral Hospital outpatient clinic. Focused history and physical examination were carried out to select eligible participants. Participants were screened using the COPD population screener for spirometry after consenting to participate. The study enrolled all adults at risk of having COPD based on the COPD population screener and able to undergo spirometry. Spirometry was carried out according to the Global Chronic Obstructive Lung Disease and European Respiratory Society guidelines, and haemoglobin concentration was measured. RESULTS: One hundred eighty participants were enrolled in the study, most of whom were females. The modal and mean age of participants was 60 years with 139 (77.2%) females and primary as the highest education level 149(82.8%). The proportion of COPD was 25% (45) [95% CI 18.9 - 32] and highest among females (68.9%) and those aged 60 years and above (70%). The combined COPD assessment tool groups had a proportion of 55.6%, 37.8%, 4.4%, and 2.2% for groups A, B, C, and D, respectively. Age < 50 years was protective against COPD, while for every additional year of smoking, there was an associated 6.5% increased risk compared to the general population. Additionally, the proportion of erythrocytosis among COPD participants was 6.7%. CONCLUSIONS AND RECOMMENDATIONS: There was a high proportion of COPD among study participants (25%), with a 6.7% proportion of erythrocytosis. We recommend a complete blood count for every patient in groups C and D of the ABCD COPD GOLD groups.

A rare presentation of urolithiasis in a child with urine retention from a nonendemic area: a case report and literature review.

Even though urolithiasis in general is not uncommon, urethral stones have an incidence of less than 0.3% and are 20 times less common in children. Though cases of urethral stones have been reported in children from endemic areas, they are even rarer in countries like Uganda that are not endemic for urolithiasis. Case Presentation: The authors present a 7-year-old male who presented with acute urine retention. Though the diagnosis of retention was made in a lower-level health facility, the cause of the retention was not determined till the patient arrived at a general hospital. Diagnosis of an obstructing stone in the penile urethra was made clinically. Meatotomy and stone extraction were done, and a urethral catheter was passed. Clinical Discussion and Conclusion: When attending to children with acute urine retention, urolithiasis should be kept among the differential diagnoses, even in areas that are not endemic for urinary tract stones. A thorough clinical evaluation may be all that is needed to make a diagnosis.

Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda.

BACKGROUND: Despite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda. METHODS: The study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level. RESULTS: The prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality. CONCLUSION: The prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea.

Congenital Malaria in a 2-Day-Old Neonate: A Case Report and Literature Review.

Congenital malaria is the presence of malaria parasites in a blood smear obtained from a neonate usually within 24 hours to 7 days of life. It has for long been regarded a rare condition. However, recent data indicate that congenital malaria complicates around 35.9% of live births globally, 0-37% in Sub-Saharan Africa and about 4-6.1% in Eastern Uganda. We present a 2-day-old neonate who presented with fever, irritability, and failure to breastfeed. Laboratory tests indicated that the neonate had a positive Giemsa-stained peripheral smear for Plasmodium falciparum, with a positive malaria rapid diagnostic test (MRDT) for P. falciparum malaria. The mother had a negative peripheral film for malaria and a negative MRDT. The neonate was managed with intravenous artesunate with improvement.

Compartment syndrome following intramuscular self-injection of kerosene and rodenticide: A case report.

INTRODUCTION AND IMPORTANCE: Kerosene and rodenticides are used in many households in developing countries. This case report aims to discuss the progression and management of a patient with intentional kerosene and rodenticide poisoning. To our knowledge, this is the first documented case of blended kerosene-rodenticide poisoning in medical literature. CASE PRESENTATION: This report describes a 23-year-old man who survived after intramuscular self-injection of 5 ml of kerosene mixed with a rodenticide into his left upper limb, with intent to commit suicide. He was admitted to our hospital following a convulsion and brief loss of consciousness. Compartment syndrome developed within 24 h of admission, necessitating urgent fasciotomy, repeated surgical debridement, limb elevation, wound cleaning and dressing, in addition to intravenous fluids, antibiotics, and close observation. Blood transfusion, phytomenadione (vitamin K1), tetanus toxoid, and analgesics were recommended. The patient also received physiotherapy, and was treated for depression. The limb healed completely, with contractures at the left wrist joint. CLINICAL DISCUSSION: Injected kerosene and rodenticide may result in compartment syndrome and variable local and systemic complications which require multifaceted care and a prolonged follow-up period. CONCLUSION: Seemingly minor injuries at presentation may quickly progress into considerable complications such as compartment syndrome. It is imperative that physicians comprehensively investigate patients with poisoning for multiorgan dysfunction. Anticipation of local and systemic complications of injected poisons and timely medical and surgical intervention is life-saving.

Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants.

Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.