Outbreak of type A foodborne botulism at a boarding school, Uganda, 2008.

Botulism has rarely been reported in Africa. In October 2008, botulism was reported in three Ugandan boarding-school students. All were hospitalized and one died. A cohort study was performed to assess food exposures among students, and clinical specimens and available food samples were tested for botulinum toxin. Three case-patients were identified; a homemade, oil-based condiment was eaten by all three. In the cohort study, no foods were significantly associated with illness. Botulinum toxin type A was confirmed in clinical samples. This is the first confirmed outbreak of foodborne botulism in Uganda. A homemade, oil-based condiment was the probable source. Consumption of homemade oil-based condiments is widespread in Ugandan schools, putting children at risk. Clinicians and public health authorities in Uganda should consider botulism when clusters of acute flaccid paralysis are seen. Additionally, schools should be warned of the hazard of homemade oil-based condiments, and take steps to prevent their use.

The proportion of asthma and patterns of asthma medications prescriptions among adult patients in the chest, accident and emergency units of a tertiary health care facility in Uganda.

BACKGROUND: Asthma is a common chronic disease with high morbidity. In Uganda, the proportion of asthma in health care facilities and the extent to which asthma management guidelines are followed is unknown. OBJECTIVES: To determine the proportion of adult patients diagnosed with asthma and the proportion of asthma patients that receives recommended asthma therapy prescriptions according to Global Initiative for Asthma with GINA management and prevention guidelines, in the chest clinic and accident and emergency (A&E) departments in Mulago Hospital. METHODS: A retrospective chart review at Mulago Hospital chest clinic and A&E department from January 1(st) 2009 to December 31(st) 2009 was performed. Patients diagnosed with asthma were identified and medications prescribed were recorded. Patients were categorized as having received recommended asthma therapy prescriptions (if therapy was compatible GINA guidelines) or not. Proportions of asthmatics in the two departments and those who received recommended asthma therapy were calculated. RESULTS: One hundred thirty four (134) of 792 patients in the chest clinic (16.9%) were diagnosed with asthma. At the A&E four hundred and sixteen (416) patients out of 16 800 (2.5%) were diagnosed with asthma. Sixty nine point seven (69.7%) were female. The median age was 29 years (IQR, 19-42). Wheezing was the commonest presenting symptom (55%). Recommended asthma therapy prescriptions were 47.4% for the chest clinic, and 32.2% of the patients at A&E department received asthma therapy prescriptions as recommended for asthma exacerbations management during hospitalization. CONCLUSION: Asthma accounts for a significant proportion of outpatients in the chest clinic. The majority of the patients do not receive recommended asthma therapy prescriptions.