Knowledge gaps, attitude and beliefs of the communities about sickle cell disease in Eastern and Western Uganda.

BACKGROUND: The management of sickle cell disease (SCD) has remained insurmountable in developing countries such as Uganda, because most communities are not aware of it. OBJECTIVE: To determine knowledge gaps, attitudes and beliefs of the communities about sickle cell disease in Eastern and Western Uganda. DESIGN: Cross sectional descriptive study. SETTING: The districts of Sironko and Mbale in Eastern Uganda and Mbarara and Ntungamo in Western Uganda. SUBJECTS: Households, students and health workers. RESULTS: Household respondents from Eastern Uganda were more aware of SCD than those from Western (p < 0.001), with the majority reporting that they had seen more people with SCD in their communities than those from the West (p < 0.001). Fewer (< 1.9%) believed SCD was due to witch craft. Eight per cent of household respondents in Eastern believed it was a curse from God compared to 2% in the West. Less than 18% of the household respondents knew they could have children with SCD and (< 52%) of health workers knew SCD screening methods. Fewer (< 14%) of the health workers had participated in screening. Less than 20% of the respondents knew their sickle cell status. CONCLUSION: Respondents from Eastern Uganda were more aware of SCD than those from Western. Minority of the respondents knew their SCD status and few health staff knew how to screen it. There is need to sensitise communities and policy makers about prevention, screening and treatment of SCD.

Plasma cholesterol and related lipid levels of seemingly healthy public service employees in Kampala, Uganda.

BACKGROUND: As Uganda's economy improves, many people tend to adopt western diets and sedentary life styles that predispose to cardiovascular diseases including hypertension. These may be in silent danger without any typical symptoms to send early warning signals. In Uganda, cardiovascular diseases (CVD) and diabetes mellitus are rapidly emerging as major causes of morbidity and mortality. OBJECTIVE: This study was conducted to determine spot levels of plasma lipid indicators of CVD in seemingly healthy public service employees in Kampala, Uganda. The purpose of this study was achieved through analysis of fasting plasma samples for the following: Total cholesterol (TC), Triacylglycerols (TG), High density lipoprotein cholesterol (HDL), Low density lipoprotein cholesterol (LDL), and molar ratios of LDL/HDL, TC/ HDL, and TC/TG. METHODS: One hundred and seventy four fasting executives 85 males and 89 females employed in public service in Kampala, Uganda, were investigated to determine enzymatically spot levels of TC, TG, HDL, and LDL from which their mutual ratios were calculated. RESULTS: In each of the 7 parameters studied, the samples showed risk factors for CVD at the following rates: HDL 10%, LDL/HDL 12%, TG 47%, LDL 48%, TC/HDL 53% TC 66%, TG/HDL 68%,. CONCLUSIONS: In all the cut off points used, each analyte had a significant percentage of public service employees at risk of CVD. It is therefore concluded that hypercholesterolaemia and other dyslipidemias exist among seemingly healthy public service employees in Kampala, Uganda, and this needs urgent intervention at both individual and national levels.

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.

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.

The accuracy of self monitoring blood glucose meter systems in Kampala Uganda.

BACKGROUND: Many blood glucose self monitoring systems are privately and publicly used by people in Uganda and technical and human errors may occur during their operation. Many patients were referred to Kololo polyclinic laboratory to have their blood glucose checked because the values obtained on the patients' glucose meter systems did not tally with familiar clinical signs and symptoms. This prompted an experimental set up to check glucose meter systems using a larger number of patients. OBJECTIVE: The objective was to collate the technical conditions and standing operational procedures of four common glucose meter systems; observe the time, ambient temperature and humidity at which the meter systems operate locally; and compare the performance of three meter systems A, B, and C with the Sensorex glucose meter system on a number of capillary blood samples. SETTING: Kololo polyclinic laboratory--a privately run facility in Kampala, Uganda. DESIGN: An experimental set up to compare four glucose meter systems. METHODS: Instruction manuals of the four glucose monitoring systems were studied and used to familiarize with the meter operations. One hundred and fourteen capillary blood specimens were assayed for blood glucose. Blood glucose values were instantly read off the four randomly set meter systems A, B, C, and Sensorex, noting the time, ambient temperature and humidity. Results from meter systems A, B, and C were regressed against those of Sensorex using Epi-Info computer program. RESULTS: Blood glucose concentration levels on meter system A tallied with those on Sensorex meter system. However, those on meter system B and C were significantly lower and different. Temperature and humidity adversely affected the analytical performance of meter systems B and C in the Kampala environ. CONCLUSION: Some of the blood glucose monitoring systems in Kampala, Uganda are poor performers and may lead to the mismanagement of patients. There is need for a system to ensure national quality control of blood glucose monitoring systems.

A pepsin-revealed material possibly related to chromosomal banding.

The enzymes pepsin, alpha-chymotrypsin, trypsin, RNase and DNase were applied to preparations of human metaphase chromosomes before staining to study whether dissociable materials related to the formation of G-, Q- and C-bands would be seen. Treatment with active pepsin but not the other enzymes revealed material with ribonucleo-protein properties which dissociated from the chromosomes and formed a halo.--Lateral extensions from the chromatids stretched to the rim of the halo and appeared at positions corresponding to G-bands. A G-band may be defined as a ring of stable chromatid-matrix binding at positions where the chromatids coil to form lateral extensions.

Toxicity of antibiotics on cultured human skin fibroblasts.

Human diploid fibroblasts cultured in Dulbecco's Modified Eagle's medium (DME) were exposed to different concentrations of 15 antibiotics to determine the limiting toxic concentration. The number of cells surviving after antibiotic treatment was given as the index of toxicity. No visible chromosomal damage could be detected when half the maximal toxic concentration was applied. The maximum limiting concentration was found to be the same for both the preconfluent and postconfluent phases.