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Background: Metabolic syndrome (MetS), a cluster of metabolic dysregulations indicative of increased cardiometabolic risk is on the rise in Sub-Saharan Africa. The study aimed to determine the prevalence of MetS and its components, among corporate employees in Kampala, Uganda. Methods: A cross-sectional survey was undertaken among 408 adults who were employees from seven corporate companies in Kampala, using the WHO STEPwise NCD screening approach. Metabolic syndrome was measured using the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the International Diabetes Federation (IDF) criteria with the waist circumference (WC) cut-off points adapted for Sub-Saharan African populations. Results: The mean population age (standard deviation [SD]) of the respondents was 34years (± 8.87) years and 52% of them were females. The prevalence of MetS was 22.8% (NCEP ATPIII) and 28.4% (IDF). Of the respondents who did not have MetS, 75% had at least one metabolic dysregulation. Of those respondents with MetS, only 31% perceived that they were at risk of this cluster of metabolic dysregulations. In this analysis, we observed that the systolic blood pressure (BP) and the body mass index (BMI) correlated strongly (r = 0.81 and r = 0.71) with the diastolic BP and waist circumference (WC), respectively. Age on the other hand correlated fairly with the WC and BMI (both r values = 0.46). Principal component analysis showed that the greatest loadings in principle factors one, two and three were from central obesity, with low HDL-C explaining 60.8% variance in the population. Age, BMI, family history of having cardiometabolic disorders, and perceived cardiometabolic disease risk (CMR) were associated with an increased risk of MetS by 5, 8.86, 1.55, and 2.73 (all P values were < 0.05) respectively in this group of respondents. These risks remained for age, BMI and perceived CMR after removing the confounding effects of education status, marital status and family history of cardiometabolic disease. Being single on the other hand, was associated with a reduced risk of MetS (0.23, p < 0.009). Conclusion: While the primary contributors to the high prevalence of MetS among corporate employees in Kampala, Uganda were the high BP, high WC and high fasting blood sugar (FBS); age, BMI and perceived CMR were the key determinants of MetS. Future MetS interventions should aim to control and monitor obesity indicators in this population. Additionally, the findings inform targeted screening parameters for cardiometabolic risk assessment and suggest the need for further research into a weighted algorithm for MetS in this population.
RESUMEN
AIM: To characterize AmpC-beta lactamases among Enterobacteriaceae isolates from clinical samples at Mbarara Regional Referral Hospital. STUDY DESIGN: Laboratory-based descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Microbiology Department, Mbarara Regional Referral Hospital and MBN clinical Laboratories, between May to September 2013. METHODOLOGY: This study included 293 Enterobacteriaceae isolates recovered from clinical specimens that included blood, urine, stool and aspirates. AmpC Beta lactamase production was determined using disc placement method for cefoxitin at a break point of <18mm. Common AmpC plasmid mediated genes were EBC, ACC, FOX, DHA, CIT and MOX were; was determined by Multiplex PCR as described by Hanson and Perez-Perez. RESULTS: Plasmid mediated AmpC phenotype was confirmed in 107 of the 293 (36.5%) cefoxitin resistant isolates with 30 isolates having more than one gene coding for resistance. The commonest source that harbored AmpC beta lactamases was urine and E. coli was the most common AmpC producer (59.5%). The genotypes detected in this study, included EBC (n=36), FOX (n=18), ACC (n=11), CIT (n=10), DHA (n=07) and MOX (n=1). CONCLUSION: Our findings showed that prevalence of AmpC beta-lactamase at MRRH was high (39.6), with EBC as the commonest genotype among Enterobacteriaceae Urine and E. coli were the commonest source and organism respectively that harbored AmpC beta-lactamases. There's rational antimicrobial therapy and antibiotic susceptibility tests should be requested by health workers especially patients presenting with urinary tract infections and bacteraemias.