Gastrointestinal malignancies at five regional referral hospitals in Uganda.

BACKGROUND: There is a paucity of published data regarding the trend and distribution of gastrointestinal malignancies in Uganda. OBJECTIVES: To study the trend and distribution of gastrointestinal malignancies over a 10 year period at five regional referral hospitals in Uganda. METHODS: Patient's charts with histologically confirmed diagnoses of gastrointestinal malignancies for the period 2002-2011 were identified. Case information, which included age at diagnosis, sex, and year of diagnosis, primary anatomic site of the tumour and hospitals attended, was retrospectively abstracted. Patient's clinical and demographic features were compared. RESULTS: Oesophageal cancer was the most common (28.8%) followed by liver (25.8%), stomach (18.4%) and colorectal (14.3%). The mean age at diagnosis for all the cancers was not significantly different in both sexes 54.1, (SD16.1) versus 53.6, (SD 14.7). The highest mean annual number of cases of oesophageal and stomach cancers was 21.8, (SD 15.5) and 16.6, (SD 13.0) respectively from Mbarara Hospital; Lacor had the highest mean annual number of liver cancer cases (21, SD 17.7) followed by Mbale (11.4, SD 8.3). The mean annual number of colorectal cancers was highest in Mbale Hospital (10.3, SD 8.1) followed by Lacor (4.9, SD 3.9). The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was different, P<0.001. CONCLUSION: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is increasing in Uganda. There is a need for awareness, endoscopic and radiological assessment of symptomatic individuals and a need for screening of high index patients.

Cross-sectional survey of hearing impairment and ear disease in Uganda.

OBJECTIVE: To determine the prevalence and causes of disabling hearing loss in adults and children in Uganda. STUDY DESIGN: Cross-sectional survey of ear disease and hearing impairment. SETTING: A random cluster sample design of the population from the Masindi district of Uganda following the World Health Organization (WHO) guidelines, using a modified version of the WHO Ear Disease Survey Protocol. MAIN OUTCOME MEASURE: The prevalence of disabling hearing impairment using the WHO definitions (excluding 0.5 kHz owing to high background noise levels). RESULTS: In the study, 6041 participants were enrolled and underwent audiometric evaluation and an ear examination. The prevalence of disabling hearing impairment was 11.7% in adults and 10.2% in children. A further 2.3% of children in whom thresholds could not be measured were deemed to have significant hearing loss based on screening questions and/or sound-field stimuli. Correctable causes such as dry perforations, cerumen impaction, and chronic suppurative otitis media resulted in disabling hearing loss in 17% of adult subjects and 41% of children. Preventable hearing loss, such as meningitis and noise-induced hearing loss, was present in a further significant percentage of subjects. CONCLUSIONS: Ear disease and hearing impairment were found to be important health problems in the Ugandan population. Preventable ear disease is a major cause of hearing loss in the population. It is hoped that the findings of this study will draw attention to the problem in Uganda and will lead to proper allocation of resources for the prevention and treatment of hearing loss and ear disease.