Lymphomas diagnosed in Uganda during the HIV/AIDS pandemic.

BACKGROUND: There are numerous reports from different countries documenting a change in frequency and profile of lymphomas after the onset of the HIV/AIDS pandemic. In Uganda little is known concerning the distribution of lymphoma subtypes diagnosed at the Department of Pathology, Makerere University College of Health Sciences during this period. OBJECTIVE: To examine the frequency and diagnostic profile of lymphomas diagnosed in Uganda in the HIV/AIDS era. DESIGN: Retrospective study. SETTING: Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda. SUBJECTS: One thousand and thirteen patients diagnosed with lymphomas in the period 1980-1989. RESULTS: The most common type of non-Hodgkin lymphoma was Burkitt lymphoma (36%). The frequencies of lymphocytic and histiocytic types were 34.5% and 8.2% respectively. CONCLUSION: There was a decrease in histopathologically diagnosed lymphomas in Uganda in the period 1980-1989. Burkitt lymphoma continues to be the most common subtype diagnosed, some major lymphoma subtypes like T-cell and follicular lymphomas were not reported in the country in the HIV/AIDS era.

Blood pressure profiles among Makerere University undergraduate students.

UNLABELLED: The purpose of this study was to set reference values for spot blood pressure and its derivatives among Makerere university undergraduate students. STUDY DESIGN: This was a cross- sectional study. MATERIALS AND METHODS: A total of 183 undergraduates including 63 females and 120 males participated in the study. Blood pressure was measured, with the respondent seated, using a sphygmomanometer. Mean arterial pressure was determined as the average of the systolic and diastolic values. Pulse pressure was the difference between systolic and diastolic values. Dividing systolic by diastolic values gave the required ratio. Histograms and cumulative percentages of these results were plotted and used to set the central 95 th percentile range as the reference values. RESULTS: Empirical ranges were: systolic BP 100-179 mmHg; diastolic BP 60-139 mmHg; systolic: diastolic pressure ratio 1.20-2.30 mmHg, mean arterial pressure 80-159 mmHg and pulse pressure 20-85 mmHg. The reference ranges covering the central 95 percentile were: systolic BP 100-150 mmHg, diastolic BP 64-100, systolic: diastolic BP ratio 1.29-2.03, the mean arterial pressure 85121 mmHg, and pulse pressure 25-70 mmHg. According to the systolic pressure, 35% were normal, 54% pre-hypertensive and 11% hypertensive. According to diastolic values, 48% were normotensive, 43% pre-hypertensive and 18% hypertensive. The mean arterial pressure was distributed like the parent pressures. The pulse pressure and the systolic:diastolic ratio were trimodally distributed with the three peaks corresponding to normotension, pre-hypertension and hypertension. CONCLUSION AND RECOMMENDATION: Reference values for the university student population have been derived and they are recommended for application in clinical evaluation.

Patient delay factors in women presenting with breast cancer in a low income country.

BACKGROUND: In low income countries, many patients with breast cancer present with advanced disease which is majorly attributed to late presentation and this is associated with poor survival rates. The aim of this study was to determine the magnitude of patient delay and the factors that influence, delay in seeking health care in female breast cancer patients. METHODS: A cross-sectional study was done between January and April 2014 at a tertiary breast unit. Female patients with breast cancer above the age of 18 years were interviewed. Ethical approval was obtained. RESULTS: In total 162 patients were recruited, the mean patient delay in months was 22.6 (SD = 26.4), median delay was 13 months and range was 1-127 months. 139 (89 %) patients delayed by more than 3 months after noticing symptoms of breast anomaly. Patients with no social support from spouses and family were more likely to delay (OR = 7.1, 95 % CI 2.4-21.5, p = 0.001), those who perceived the symptoms as very serious were less likely to delay (OR = 0.2, 95 % CI 0.1-0.6, p = 0.007). There was a significant association between delayed presentation and advanced stage at presentation (p = 0.006). CONCLUSION: Most women (89 %) with breast cancer delayed by more than 3 months to seek the first medical consultation after noticing symptoms. Patients who had no social support from their families were more likely to delay.

Takayasu's arteritis (pulseless disease) in Uganda.

We report herein the case of a 23 year old woman who was referred to Mulago National Referral and Faculty of Medicine Makerere University Teaching Hospital because of sudden collapse, left sided weakness and headache for management. The patient underwent a battery of investigations but died five days after admission. The post mortem findings were extensive infarction the right cerebrum extending from parietal to occipital lobes. There was thickening of the wall and complete obliteration of right common carotid artery. The left common carotid artery was severely stenosed with marked thickening of the wall. The subclavian artery was thickened and completely obliterated. Microscopically there was intimal thickening by fibrous connective tissue and infiltrate of chronic inflammatory cells in the walls of the three affected branches of the oarta. These gross microscopic features were compatible with Takayasu's arteritis (TA).

Knowledge, attitudes and practices of Ugandan men regarding prostate cancer.

BACKGROUND: The incidence of prostate cancer in Uganda is one of the highest recorded in Africa. Prostate cancer is the most common cancer among men in Uganda. OBJECTIVE: This study assessed the current knowledge, attitudes and practices of adult Ugandan men regarding prostate cancer. SUBJECTS AND METHODS: We conducted a descriptive cross-sectional study using interviewer administered questionnaires and focus group discussions among 545 adult men aged 18-71 years, residing in Kampala, the capital of Uganda. Quantitative data were analyzed with SPSS version 20. Qualitative data were collected using audio recorded focus group discussions, transcribed and analyzed by clustering into themes. RESULTS: The majority of the respondents (324, 59.4%) were aged 18-28 years, 295 (54.1%) had heard about prostate cancer and 250 (45.9%) had never heard about it. The commonest source of information about prostate cancer was the mass media. Only 12.5% of the respondents obtained information about prostate cancer from a health worker, 37.4% did not know the age group that prostate cancer affects and 50.2% could not identify any risk factor for prostate cancer. Participants in the focus group discussions confused prostate cancer with gonorrhea and had various misconceptions about the causes of prostate cancer. Only 10.3% of the respondents had good knowledge of the symptoms of prostate cancer and only 9% knew about serum prostate specific antigen (PSA) testing. Although 63.5% thought they were susceptible to prostate cancer, only 22.9% considered getting and only 3.5% had ever undergone a serum PSA test. CONCLUSION: There was generally poor knowledge and several misconceptions regarding prostate cancer and screening in the study population. Community based health education programs about prostate cancer are greatly needed for this population.

Initial attempt to establish population reference values for blood glucose and lipids in Makerere University undergraduate students.

UNLABELLED: The purpose of this study was to establish blood glucose and lipid profile of Makerere University undergraduate students. STUDY DESIGN: This was a cross-sectional study. MATERIALS AND METHODS: A total of 183 students participated in the study. Capillary blood glucose was read instantly on a finger prick sample off Sensorex glucose analyzer. Venous blood from the antecubital vein was used for lipid assays. Total cholesterol was assayed by the oxidase-peroxidase enzyme system. Plasma triacylglycerols were analyzed using the glycerokinase-oxidase reagents. HDL and LDL cholesterol were analyzed using homogeneous enzymatic methods. Concentration results for each variable were plotted in histograms and the type of distribution established. Summary statistics were then calculated non- parametrically to set reference values. RESULTS: Empirical ranges were: Cholesterol 2.1-7.2 mmol/L; triacylglycerols 0.4-6.87 mmol/L; HDLC 0.09-2.13 mmol/L; LDLC 0.95-5.38 mmol/L and capillary blood glucose 2.72-9.21 mmol/L. The reference ranges covering the central 95 percentile were: Cholesterol 2.65-5.15 mmol/L, triacylglycerols 0.61-4.03 mmol/L; HDLC 0.58-1.97 mmol/L; LDLC 1.25-3.57 mmol/L and capillary blood glucose 3.11-7.55 mmol/L. CONCLUSION: The established reference values for the age group 20-26 years were: Total Cholesterol 2.65-5.15 mmol/L, LDL 1.25-3.57 mmol/L, HDL 0.58-1.97 mmol/L, TG 0.61-4.03 mmol/L and capillary blood glucose 3.11-7.55 mmol/L which differed from set international values. RECOMMENDATIONS: We recommend the establishment of indices for the indigenous populations, conscientiously planned diets, and regular exercise.