School of Medicine (KABSOM)

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Open Access
A 5-year Retrospective Review of the Presentation Pattern and Management outcomes of Uterine Fibroids in a Nigerian Tertiary Hospital.
(Kabale University, 2024) Madunatu, Chimezie Michael; Okoro, Chukwuemeka Chukwubuikem; Onyejiaka, Chukwudubem Chinagorom; Enechukwu, Chukwunonso Isaiah; Ofojebe, Chukwuemeka Jude; Ani, Vincent Chinedu; Eleje, George Uchenna; Mbachu, Ikechukwu Innocent; Okafor, Chigozie Geoffrey; Okoro, Amarachukwu Doris; Okafor, Christiana Nkiru; Oguejiofor, Charlotte Blanche; Eze, Stephen Chijioke
Background: Uterine fibroids are a common gynecological condition affecting reproductive-age women. Although fibroids are considered benign, they are a cause of major quality-of-life issues for women in their reproductive age. Objectives: To determine the prevalence, pattern of presentations and management outcomes of uterine fibroids over 5 years. Materials and Methods: This is a retrospective review of the prevalence, clinical presentations, and outcome of the management of uterine fibroid over 5 years (between January 1st, 2017, and 31st December 2021) at Nnamdi Azikiwe University Teaching Hospital (NAUTH). The case files of women who were managed for uterine fibroid during this period were obtained from the hospital’s Health Records department to extract relevant information. The social, demographic, and clinical data of the subjects were extracted using a designed proforma. The outcome measures included the prevalence, clinical presentations, and management outcomes of uterine fibroids. Data was analyzed using the SPSS 26.0 IBM Corporation. Results: The prevalence of uterine fibroids was 10.7% of all gynecological cases that were presented to the clinic. Participants, mean age was 39.11±7.01 years, most (75.4%) being nulliparous. Abdominal swelling was the commonest (62.3%) pattern of presentation and most of the subjects presented late with a mean duration of symptoms of 38.2±9.82 months. Surgery was the commonest method of treatment with myomectomy being the modality used in 86.5% of subjects. The common postoperative complication was anemia which was reported in 15.2% of the subjects. Conclusion: Uterine fibroid prevalence in this review of 10.66% is high and so also are the associated complications. The symptoms correlate with delayed presentations common in our locality. Surgical management comprising predominantly myomectomy and hysterectomy remained the commonest treatment option in our environment.
Open Access
Adherence to Viral Load Testing Guidelines, Barriers, and Associated Factors Among Persons Living with HIV on ART in Southwestern Uganda: a Mixed-Methods Study.
(Kabale University, 2024) Lubega, Polly; Nalugya, Sylivia Juliet; Kimuli, Angella Namyalo; Twinokusiima, Majoreen; Khasalamwa, Mercy; Kyomugisa, Richard; Kabami, Jane; Owaraganise, Asiphas
Background: Uganda adapted Viral load (VL) testing for monitoring HIV treatment success and virologic failure. However, there is a paucity of data on how the VL testing guidelines are followed in practice in HIV clinics. This study determined the adherence to national guidelines on VL testing, barriers, and associated factors in persons living with HIV (PLHIV) on ART in southwestern Uganda. Methods: We conducted a cross-sectional mixed methods study from April to May 2021 at four HIV clinics in southwestern Uganda. Patient chart review using a checklist that captured age, gender, and level of a healthcare facility, dates of ART initiation, dates VL specimens were drawn, line of ART, and patient adherence to ART was done. Continuous data were summarized using mean and median and Chi-square was used for categorical data. We performed regression analysis to determine factors associated with adherence to viral load testing guidelines at a 95% level of significance. Key informant interviews with managers of the health facility, ART clinic, and laboratory were carried out, and thematic analysis was conducted to explore barriers to adherence to VL testing guidelines. Results: The participants’ mean (SD) age was 39.9(±13.1) years, 39.5% were male, 45.8% received care at a general hospital and the median duration of ART was 5 years (IQR;3–7). Of the 395 patient charts reviewed, 317 had their VL testing (80.3%) per the guidelines (defined as up to one month post-due date). Receiving care at a hospital (aOR=2.20; 95%CI 1.30–3.70; p=0.002) and increasing patient age (aOR=1.02; 95%CI 1.02–1.06; p=0.020) were the factors associated with adhering to VL testing guidelines. Long turnaround times of VL results and insufficient VL testing kits were cited by providers as barriers. Conclusion: We found suboptimal adherence to VL testing guidelines in PLHIV on ART in southwestern Uganda. Increasing patient age and getting care at a higher-level health facility were associated with guideline-based viral VL testing. The long turnaround time of VL test results and inadequate test kits hindered compliance with VL monitoring guidelines. Strategies that target young PLHIV and lower-level health facilities, increase the stock of consumables, and Shorten VL results turnaround time are needed to improve adherence to VL testing guidelines.
Open Access
Adverse Maternal Outcomes and Associated Factors Among Mothers of Advanced Age delivering at a Tertiary Hospital, Southwestern Uganda: A Cross-Sectional Study.
(Kabale University, 2024) Masembe, Sezalio; Migisha, Richard; Turyasingura, Godwin; Aheisibwe, Hillary; Nzabandora, Emmanuel; Lule, John C.
Background Mothers of advanced age, defined as pregnant women aged≥35 years at the time of giving birth, are traditionally known to be associated with increased risks of adverse maternal outcomes. We determined the prevalence of adverse maternal outcomes and associated factors among mothers of advanced age who delivered at Kabale Regional Referral Hospital (KRRH), in Southwestern Uganda. Methods. We conducted a cross-sectional study at the Maternity Ward of KRRH from April to September 2023. We consecutively enrolled pregnant women aged≥35 years during their immediate post-delivery period and before discharge. We obtained data on their socio-demographic, obstetric, and medical characteristics and their maternal outcomes using interviewer-administered questionnaires. We define adverse maternal outcome as any complication sustained by the mother that was related to pregnancy, delivery, and immediate post-partum events (obstructed labor, antepartum hemorrhage, mode of delivery [cesarean or vacuum extraction], postpartum hemorrhage, hypertensive disorders of pregnancy, preterm or postdate pregnancy, anemia, premature rupture of membranes, multiple pregnancy, and maternal death). A participant was considered to have an adverse outcome if they experienced any one of these complications. We identified factors associated with adverse outcomes using modified Poisson regression. Results Out of 417 participants, most were aged 35–37 years (n=206; 49.4%), and had parity≥5 (65.5%). The prevalence of adverse maternal outcomes was 37.6% (n=157, 95%CI: 33.1–42.4%). Common adverse maternal outcomes included caesarian delivery (23%) and obstructed labor (14.4%). Other complications included anemia in pregnancy (4.5%), chorioamnionitis (4.1%), preterm prelabour rupture of membranes (3.9%), and chronic hypertension and preeclampsia (both 2.4%). Factors associated with adverse maternal outcomes were precipitate labor (adjusted prevalence ratio [aPR]=1.95, 95%CI: 1.44–2.65), prolonged labor, lasting>12 h (aPR=2.86, 95%CI: 1.48–3.16), and chronic hypertension (aPR=2.01, 95%CI: 1.34–3.9). Conclusion Approximately two-fifth of the advanced-aged mothers surveyed had adverse outcomes. Mothers with prolonged labor, precipitate labor, and chronic hypertension were more likely to experience adverse outcomes. We recommend the implementation of targeted interventions, emphasizing proper management of labor as well as close monitoring of hypertensive mothers, and those with precipitate or prolonged labor, to mitigate risks of adverse outcomes within this study population.
Open Access
African animal trypanocide resistance: A systematic review and meta-analysis
(2024-02) Keneth, Iceland Kasozi; Ewan, Thomas MacLeod; Susan, Christina Welburn
African animals resistance ( AATr) continues to undermine global efforts to eliminate the transmission of africa intrypanosomiasis in endemic communities. the continued lack of new trypanocides has participated drug misuse and over use, thus contributing to the devlopment of the AADr phenotype. in this study, we investigated the threate associated with AAtr by using the major globally available chemotherapeutic agents. Methods: A total of seven electronic databases were screened for an article on trypanocide resistance in AATr by using keywords on preclinical and clinical trials with the number of animals with treatment relapse, days taken to relapse, and resistant gene markers using the PRISMA checklist. Data were cleaned using the SR deduplicator and covidence and analyzed using Cochrane RevMan®. Dichotomous outputs were presented using risk ratio (RR), while continuous data were presented using the standardized mean difference (SMD) at a 95% confidence interval. Results: A total of eight publications in which diminazene aceturate (DA), isometamidium chloride (ISM), and homidium chloride/bromide (HB) were identified as the major trypanocides were used. In all preclinical studies, the development of resistance was in the order of HB > ISM > DA. DA vs. ISM (SMD = 0.15, 95% CI: −0.54, 0.83; I 2 = 46%, P = 0.05), DA vs. HB (SMD = 0.96, 95% CI: 0.47, 1.45; I 2 = 0%, P = 0.86), and HB vs. ISM (SMD = −0.41, 95% CI: −0.96, 0.14; I2 = 5%, P = 0.38) showed multiple cross-resistance. Clinical studies also showed evidence of multi-drug resistance on DA and ISM (RR = 1.01, 95% CI: 0.71–1.43; I2 = 46%, P = 0.16). To address resistance, most preclinical studies increased the dosage and the treatment time, and this failed to improve the patient’s prognosis. Major markers of resistance explored include TbAT1, P1/P2 transporters, folate transporters, such as F-I, F-II, F-III, and polyamine biosynthesis inhibitors. In addition, immunosuppressed hosts favor the development of AATr.
Open Access
Allium Cepa (Onion) Extract Enhances and Protects Testicular Function and Architecture against Paraquat Induced Oxidative Damage.
(International Journal of Life science and Pharma Research, 2020) Uzozie Chikere, Ofoego; Ejike, Daniel Eze
Allium cepa (A. cepa) is consumed for its health benefits. This study investigated the therapeutic potentials of ethanolic extract of A. cepa bulbs against paraquat-induced testicular toxicity in animal model. Thirty Wistar rats were split into control and five test groups (n=5). Group A (Control) received feed and water; test groups (B-F) were treated orally as follows: group B (20 mg/kg b.w. of paraquat for 4weeks); group C (1000 mg/kg b.w. of A. cepa extract for 4weeks); group D (a co-administration of 20 mg/kg b.w. of paraquat and 100 mg/kg b.w. of A. cepa extract for 4weeks); group E (a co-administration of 20 mg/kg b.w. of paraquat and 1000 mg/kg b.w. of A. cepa extract for 4weeks); and group F (1000 mg/kg b.w. of A. cepa extract for 2weeks before co-administration with 20 mg/kg b.w. of paraquat for 2weeks). In the end, sperm count, morphology, motility, sera testosterone levels, malondialdehyde (MDA) and superoxide dismutase (SOD) levels as well as histology of the testes were assessed. Paraquat administration caused significantly (P<0.05) reduced sperm count, motility, alteration in sperm morphology and induced cell death. Oral gavage of paraquat also caused significant (P<0.05) decrease in serum testosterone and SOD levels with concomitantly elevated MDA levels. However, following the co-administration with ethanolic extract of A. cepa to experimental rats, there was an improvement in sperm parameters (count, motility and morphology) as well as in sera testosterone and SOD levels. It can be concluded that A. cepa exerts strong antioxidant effects in a dose-dependent manner in ameliorating testicular toxicity induced by paraquat in animal models.
Open Access
Amaranth leaf extract protects against hydrogen peroxide induced oxidative stress in Drosophila melanogaster
(BMC, 2021) Johnmark, Ndinawe; Hellen, W. Kinyi
Objective: Amaranths leaves are rich in ascorbic acid and polyphenol compounds which have antioxidant activity. The aim of this study was to evaluate their in vivo antioxidant activity. The effect of consumption of Amaranth leaf extract on in vivo antioxidant activity, catalase enzyme activity and H2O2 induced oxidative stress in Drosophila melanogaster flies was assessed. Results: Consumption of Amaranth leaf extract was associated with increased survival on exposure to H2o2 in a dose dependent manner in Drosophila melanogaster flies. The study concludes that the ethanolic extract of Amaranth leaves offer protection against hydrogen peroxide-induced oxidative stress.
Open Access
Analgesic Appraisal of Bidens pilosa (Asteraceae) Leaf Extracts Used in Management of Oral Lesion Pain in HIV/AIDS Patients in Rodents
(Scientific Research Publishing Inc., 2018-06-29) Joseph Obiezu, Chukwujekwu Ezeonwumelu; Muhammad, Ntale; Steve, Okwudili Ogbonnia; Ezera, Agwu; Julius, Kihdze Tanayen; Ahmed, Adebowale Adedeji; Okonkwo, Chukwudi Onyeka; Ambrose, Amamchukwu Akunne; Jennifer, Chibuogwu Ebosie; Frederick, Byarugaba
Oral lesions, diarrhoea, Pneumocystis carinii pneumonia, tuberculosis and urinary tract infections are some of the opportunistic infections (OIs) which arise when the CD4 cells of the HIV/AIDS patient fall below 200 cells/mm3. HIV/AIDS infection complications include tissue damage from oral lesions accompanied with pains. Pain is a disagreeable sensory and sensitive experience associated with actual or potential tissue damage. This condition requires immediate treatment with analgesics and antibiotics. However, the inability of rural dwellers to afford readily available drugs is a consequence for using herbs like Bidens pilosa whose local usefulness in the management of oral lesions of HIV/AIDS has not been proven scientifically. Therefore, the objective of this study was to provide the scientific basis in rats for the traditional healers’ use of Bidens pilosa leaves’ extracts in managing pain associated with oral lesions of HIV/AIDS patients in South Western Uganda. Assessment of the analgesic effects of Bidens pilosa was conducted using acetic acid in mice, formalin-induced pain and tail flick methods in rats. Both aqueous and ethanolic extracts of the leaves of Bidens pilosa produced statistically significant dose dependent inhibition of acetic acid induced pain, non dose dependent pain reduction in formalin induced pain, (p < 0.05; student t-test) and non dose dependent tail withdrawal pattern (p < 0.05, Multivariate ANOVA test). Hence, we conclude that extracts of Bidens pilosa have an analgesic basis for their local use in treatment of oral lesions associated pain in HIV/AIDS patients in South-Western Uganda.
Open Access
An analysis of heavy metals contamination and estimating the daily intakes of vegetables from Uganda
(Toxicology Research and Application, 2021) Keneth Iceland, Kasozi; Eric Oloya, Otim; Herbert Izo, Ninsiima; Gerald, Zirintunda; Andrew, Tamale; Justin, Ekou; Grace Henry, Musoke; Robert, Muyinda; Kevin, Matama; Regan, Mujinya; Henry, Matovu; Fred, Ssempijja; Ejike, Daniel Eze; Mauryn, Atino; Bede, Udechukwu; Ronald, Kayima; Patrick, Etiang; Emmanuel Tiyo, Ayikobua; Stellamaris, Kembabazi; Ibe Michael, Usman; Sheu Oluwadare, Sulaiman; Phyllis Candy, Natabo; Grace Nambatya, Kyeyune; Gaber El-Saber, Batiha; Ochan, Otim
Environmental contamination with elevated levels of copper (Cu), cobalt (Co), iron (Fe), zinc (Zn), lead (Pb), chromium (Cr 6þ), cadmium (Cd), and nickel (Ni)—all states of which are found in Uganda—raises health risk to the public. Pb, Cr 6þ, Cd, and Ni for instance are generally considered nonessential to cellular functions, notwithstanding the importance of the oxidative state of the metals in bioavailability. As such, we aimed in this study (i) to evaluate heavy metal concentrations in four vegetables from a typical open-air market in Uganda, (ii) to assess the safety of consuming these vegetables against the World Health Organization (WHO) recommended limits of heavy metals consumption, and (iii) to formulate a model of estimated daily intake (EDI) among consumers in the country. Methods: This was a cross-sectional study conducted in five georeferenced markets of Bushenyi district in January 2020. Amaranthus, cabbages, scarlet eggplants, and tomatoes were collected from open markets, processed, and analyzed by atomic absorption spectrometry. Modeled EDI, principal component (PCA) and cluster analysis (CA) were conducted to identify relationships in the samples. Results: The levels of essential elements in the four vegetables were found to fall from Co > Cu > Fe > Zn. Those of non-essential metals were significantly higher and followed the pattern Cd > Cr > Pb > Ni. The highest EDI values were those of Cu in scarlet eggplants, Zn in amaranthus, Fe in amaranthus, Co in amaranthus, Pb in cabbages, total Cr in scarlet eggplant, Cd in cabbages and tomatoes, and Ni in cabbages. In comparison to international limits, EDIs for Zn, Cu, Co and Fe were low while Ni in cabbages were high. PCA showed high variations in scarlet eggplant and amaranthus. The study vegetables were found to be related with each other, not according to the location of the markets from where they were obtained, but according to their species by CA. Conclusion: The presence of non-essential elements above WHO limits raises policy challenges for the consumption and marketing of vegetables in the study area. Furthermore, low EDIs of essential elements in the vegetables create demand for nutritious foods to promote healthy communities
Open Access
An analysis of heavy metals contamination and estimating the daily intakes of vegetables from Uganda
(Toxicology Research and Application, 2021) Keneth Iceland, Kasozi; Eric, Oloya Otim
Environmental contamination with elevated levels of copper (Cu), cobalt (Co), iron (Fe), zinc (Zn), lead (Pb), chromium (Cr6þ), cadmium (Cd), and nickel (Ni)—all states of which are found in Uganda—raises health risk to the public. Pb, Cr6þ, Cd, and Ni for instance are generally considered nonessential to cellular functions, notwithstanding the importance of the oxidative state of the metals in bioavailability. As such, we aimed in this study (i) to evaluate heavy metal concentrations in four vegetables from a typical open-air market in Uganda, (ii) to assess the safety of consuming these vegetables against the World Health Organization (WHO) recommended limits of heavy metals consumption, and (iii) to formulate a model of estimated daily intake (EDI) among consumers in the country. Methods: This was a cross-sectional study conducted in five georeferenced markets of Bushenyi district in January 2020. Amaranthus, cabbages, scarlet eggplants, and tomatoes were collected from open markets, processed, and analyzed by atomic absorption spectrometry. Modeled EDI, principal component (PCA) and cluster analysis (CA) were conducted to identify relationships in the samples. Results: The levels of essential elements in the four vegetables were found to fall from Co > Cu > Fe > Zn. Those of non-essential metals were significantly higher and followed the pattern Cd > Cr > Pb > Ni. The highest EDI values were those of Cu in scarlet eggplants, Zn in amaranthus, Fe in amaranthus, Co in amaranthus, Pb in cabbages, total Cr in scarlet eggplant, Cd in cabbages and tomatoes, and Ni in cabbages. In comparison to international limits, EDIs for Zn, Cu, Co and Fe were low while Ni in cabbages were high. PCA showed high variations in scarlet eggplant and amaranthus. The study vegetables were found to be related with each other, not according to the location of the markets from where they were obtained, but according to their species by CA. Conclusion: The presence of non-essential elements above WHO limits raises policy challenges for the consumption and marketing of vegetables in the study area. Furthermore, low EDIs of essential elements in the vegetables create demand for nutritious foods to promote healthy communities.
Open Access
Annona muricata Linn and Khaya grandifoliola C.DC. Reduce Oxidative Stress In Vitro and Ameliorate Plasmodium berghei-Induced Parasitemia and Cytokines in BALB/c Mice
(Journal of Evidence-Based Integrative Medicine, 2021) Hope, Onohuean; Abdullateef I, Alagbonsi; Keneth Iceland, Kasozi
Background. Annona muricata and Khaya grandifoliola are ethnomedicinally used for the treatment of malaria and have been experimentally shown to have an anti-plasmodial effect, but the mechanisms involved are not fully understood. This study investigated the effect of the ethanol extracts of their leaves on parasitemia, radical scavenging and cytokines in Plasmodium berghei ANKA-infected BALB/c mice. Methods. BALB/c mice were infected with P. berghei and treated with chloroquine, A. muricata or K. grandifoliola extract for 4 days. The percentage of parasitemia and the level of cytokine expression were determined after treatment. Trace element, phytochemical and nitric oxide (NO) scavenging activity, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging properties assays were done to study the antioxidant effects of AN and KG in vitro. Results. P. berghei con-sistently increased parasitemia in BALB/c mice. The tested doses (100-, 200-, and 400 mg/kg) of A. muricata and K. grandifoliola attenuated the P. berghei-induced elevation of parasitemia and cytokines (TNF-a, IL-5, and IL-6) in vivo during the experimental period, though not as much as chloroquine. Moreover, both extracts scavenged the DPPH and NO radicals, though A. muricata had more anti-oxidant effect than K. grandifoliola in-vitro. Conclusion. The ethanol extracts of A. muricata and K. grandifoliola reduce parasitemia in P. berghei-treated mice BALB/c by scavenging free radicals and reducing cytokines, though the extracts were not as effective as chloroquine.
Open Access
Anti-Malarial Effects of Five Traditional Nigerian Medicinal Plant Extracts on Plasmodium Berghei-Infected Rats
(FUDMA Journal of Sciences (FJS), 2021) Ugochukwu Vincent, Igbokwe; Ejike, Daniel Eze; Moses Dele, Adams; Karimah Mohammed, Rabiu; Iliya, Ezekiel; Prisca Ojochogu, Ajeka; Peace Ogechukwu, Okpara
This work focusses on comparative determination of the effects of plant extracts: bitter leaf (BL), sour lime (SL), grape (G), pawpaw (PP) and unripe pineapple (UPA) in female rats induced into malaria with Plasmodiumberghei. Thirty female rats weighing 120-160 g were allotted into five groups (n=6). Group A (negative control) were infected but not treated. Animals in Groups B–E which were infected were given 500 mg/kg body weight (BW) of malanter DS (reference antimalarial drug), 500 mg/kg BW of BL, 250 mg/kg BW each of SL and BL as well as 250 mg/kg BW each of G, PP and UPA. Treatment was done orally once daily for 14 days after which a few related analyses were carried out. Before treatment, parasitemia count of animals in groups B-E was substantially (p<0.05) higher when juxtaposed with group A. AST and ALT activities was substantively (p<0.05) elevated in group B-E when matched with group A. Plasmodium berghei induction notably (p<0.05) lowered white blood cell (WBC) and monocyte (Mono) levels at all groups. After 7 days of treatment, the extracts and drug which appreciably (p<0.05) lowered plasmodium count, RBC, WBC, PCV, Hb, Plat, Lymph, Mono, Granul levels did not meaningfully(p>0.05) affect the activities of ALP, AST and ALT. After 14 days of treatment, the extracts and drug exceptionally (p<0.05) reduced plasmodium count, WBC and ALP activity at all groups. These results give suggestive evidence that the plant extracts either singly or combined, could be a promising anti-plasmodial candidate.
Open Access
Anti-obesity effects of Erythrina abyssinica stem bark extract in flies exposed to a high fat diet
(www.cell.com/heliyon, 2022-08) Oscar Hilary, Asiimwe; Eddie, Wampande; John, Rubaihayo; Keneth Iceland, Kasozi; Hellen, Wambui Kinyi
Background: An in vitro assay on Sigmoidin A from Erythrina abyssinica stem bark revealed its potency to inhibit pancreatic lipase. However, studies indicate activity of extract bioactive compounds in combination far exceed the favorable effects of each individual compound due to synergy and additive effects. In this study, we provide information on the effect of E. abyssinica stem bark extract in Drosophila melanogaster. The objective of the study was to determine the safety and effects of E. abyssinica stem bark extract on fly survival, body weight, tri- glycerides, sterol, total protein, and catalase activity of obese male D. melanogaster. Methods: Obesity was induced by exposing D. melanogaster white mutant w 1118 to coconut food for two weeks. Groups 1–3 were fed on coconut food þ fenofibrate at 25 mM, 50 mM, and 75 mM. Groups 4–6 were fed on coconut food þ E. abyssinica stem bark extract at concentrations of 2.5 g/ml, 5.0 g/ml, and 7.5 g/ml. The positive control was exposed to only coconut food while the negative control was on regular food. Fly survival observa- tions were done for 15 days, while acute and chronic effects were done at 30 min and after 48 h respectively following treatment. Body mass, negative geotaxis, reducing power of the extract, triglycerides (TG/TP), sterol, total protein levels, and catalase activity were measured after 10 days of exposure to the experimental diets. Results: Fly survival changes were observed after 10 days and E. abyssinica stem bark extract had the strongest reducing power at 7.5 g/ml extract concentration. E. abyssinica stem bark extract reduced body mass, triglyceride levels (TG/TP), sterol levels, and modulated catalase activity at 7.5 g/ml extract concentration. Though the standard drug fenofibrate had the highest fat accumulation reduction potential, the extract at 7.5 g/ml was much safer in reducing fat accumulation in obese male D. melanogaster than other concentration used. Conclusion: Antioxidants in E. abyssinica stem bark extract are responsible for the observed anti-obesity activity.
Open Access
Antimalarial Combination Therapies Increase Gastric Ulcers Through an Imbalance of Basic Antioxidative‑Oxidative Enzymes in Male Wistar Rats.
(Kabale University, 2020) Kalange, Muhamudu; Nansunga, Miriam; Keneth Iceland, Kasozi; Kasolo, Josephine; Namulema, Jackline; Kasande Atusiimirwe, Jovile; Tiyo Ayikobua, Emanuel; Ssempijja, Fred; Munanura, Edson Ireeta; Matama, Kevin; Semuyaba, Ibrahim; Zirintunda, Gerald Gerald; Okpanachi, Alfred Omachonu
Objective: Antimalarials are globally used against plasmodium infections, however, information on the safety of new antimalarial combination therapies on the gastric mucosa is scarce. The aim of this study was to investigate the effects of Artesunate-Amodiaquine and Artemether-Lumefantrine on ulcer induction. Malondialdehyde (MDA), reduced glutathione (GSH) and major histological changes in male Wistar rats following ulcer induction using Indomethacin were investigated. Gastric ulcers were in four groups; Group I was administered Artesunate, group II received Artesunate- Amodiaquine, group III received Artemether-Lumefantrine, and group IV was a positive control (normal saline). GroupV was the negative control consisting of healthy rats. Results: Antimalarial combination therapies were associated with a high gastric ulcer index than a single antimalarial agent, Artesunate. In addition, levels of MDA were significantly higher in the combination of therapies while levels of GSH were lower in comparison to Artesunate and the negative control. Microscopically, antimalarial combination therapies were associated with severe inflammation and tissue damage than Artesunate in the gastric mucosa showing that antimalarial combination therapies exert their toxic effects through oxidative stress mechanisms, and this leads to cellular damage. Findings in this study demonstrate a need to revisit information on the pharmacodynamics of major circulating antimalarial agents in developing countries. Keywords: Antimalarials, Pharmacodynamics, Antimalarial Agents, Malaria, Developing Countries, Gastric Ulcers.
Open Access
Antimicrobial resistance profile among bacteria isolated from patients presenting with wounds at Kabale Regional Referral Hospital, South western Uganda
(Research Square, 2020) Andrew, Baguma; Benson, Musinguzi; Kagirita, Atek Atwiine; Joel, Bazira
Background: Bacterial Wound infection and antimicrobial resistance remains a public health challenge. The challenge remains worse due to nosocomial bacterial infection often characterized by multidrug resistance. Infected wounds are often associated with delayed epidermal maturation resulting into prolonged hospitalization. Data on profile of clinical significant bacteria and their respective antibiotic drug resistance in Uganda is still limited. In this study we emphasized on phenotypic characterization of bacteria that cause wound infections at Kabale Regional Hospital (KRRH) and determining the respective antimicrobial susceptibility profiles. Methods: Between June 2016 – to June 2017 a total of 276 Pus specimens were collected from patients at KRRH and analyzed for bacterial infection by standard bacterial cultures techniques. Pus specimens were all from wounds (surgical and non-surgical). Antibiotic susceptibility testing was performed and reported based on CLSI guidelines. Results One-hundred and ninety-five specimens were positive following bacterial culture (70.7%). Staphylococcus aureus and Escherichia coli were the most frequently isolated bacteria. Antibiotic drug resistance testing revealed that 68% of S. aureus isolates were Methicillin resistant. For Escherichia coli isolates, 73% were ciprofloxacin and levofloxacin resistant while resistance to Imipenem was common among Klebsiella sp. Conclusions: Wound infection is mainly caused by gram negative bacteria particularly, Escherichia coli , Klebsiella spp., Proteus spp., and Pseudomonas spp. G positive cocci particularly S. aureus is also an important pathogen among other implicated gram positive cocci. There are high levels of multi - antimicrobial resistance among both Gram negative and Gram positive bacteria.
Open Access
Anxiety, Anger and Depression Amongst Low-Income Earners in Southwestern Uganda During the COVID-19 Total Lockdown
(Kabale University, 2021) Archibong, Victor; Usman, Ibe Michael; Keneth Iceland, Kasozi; Osamudiamwen, Eric Aigbogun Jr.; Josiah, Iﬁe; Monima, Ann Lemuel; Ssebuufu, Robinson; Chekwech, Gaudencia; Terkimbi, Swase Dominic; Owoisinke, Okon; Mbiydzenyuy, Ngala Elvis; Adeoye, Azeez; Aruwa, oshua Ojodale; Afodun, Adam Moyosore; Odoma, Saidi; Ssempijja, Fred; Ayikobua, Emmanuel Tiyo; Ayuba, John Tabakwot; Nankya, Viola; Onongha, Comfort; Sussan, Henry; Matama, Kevin; Yusuf, Helen; Nalugo, Halima; MacLeod, Ewan; Welburn, Susan Christina
Background: Low-income earners are particularly vulnerable to mental health, consequence of the coronavirus disease 2019 (COVID-19) lockdown restrictions, due to a temporary or permanent loss of income and livelihood, coupled with government-enforced measures of social distancing. This study evaluates the mental health status among low-income earners in southwestern Uganda during the ﬁrst total COVID-19 lockdown in Uganda. Methods: A cross-sectional descriptive study was undertaken amongst earners whose income falls below the poverty threshold. Two hundred and ﬁfty-three (n = 253) male and female low-income earners between the ages of 18 and 60 years of age were recruited to the study. Modiﬁed generalized anxiety disorder (GAD-7), Spielberger’s State-Trait Anger Expression Inventory-2 (STAXI-2), and Beck Depression Inventory (BDI) tools as appropriate were used to assess anxiety, anger, and depression respectively among our respondents. Results: Severe anxiety (68.8%) followed by moderate depression (60.5%) and moderate anger (56.9%) were the most common mental health challenges experienced by low-income earners in Bushenyi district. Awareness of mental healthcare increased with the age of respondents in both males and females. A linear relationship was observed with age and depression (r = 0.154, P = 0.014) while positive correlations were observed between anxiety and anger (r = 0.254, P < 0.001); anxiety and depression (r = 0.153, P = 0.015) and anger and depression (r = 0.153, P = 0.015). Conclusion: The study shows the importance of mental health awareness in low resource settings during the current COVID-19 pandemic. Females were identiﬁed as persons at risk to mental depression, while anger was highest amongst young males. Keywords: COVID-19 response, Africa, Socio-economic impacts, Psychosocial, Hunger, Women.
Open Access
Assessing Knowledge, Attitudes and Practice of Hand Washing with Soap among Mothers and Caregivers of Children under Five years in Ntungamo District, Uganda
(Texila International Journal of Public Health, 2020) Topher, Byamukama
Background: The study of hand washing practices in Ntungamo district is part of a larger strategy being implemented in different countries to decrease the prevalence of childhood diarrhea, in the frame work of the global public – private partnership for hand washing with soap. Purpose: This study of hand washing practices using soap in Ntungamo district aimed at reducing childhood diarrhea prevalence in the district. It represents a preliminary study designed to collect the information necessary to design appropriate strategies to reduce diarrhea prevalence in under five years of age. Methods: The study used quantitative and qualitative methods to collect data from a representative sample of several supervision areas of Ntungamo district. Results: The practice of hand washing after latrine use among the respondents was very low (52%) compared to washing hands before and after meals (77%). The study also revealed a low use of soap during hand washing where (52%) who washed their hands after contact with feces, only 14.6% used soap. Whereas whose who washed their hands while handling food were77%, but out of 77% only 28% used soap There was no diarrhea reported among respondents that had A-level education and only 20% of those that had post-secondary education reported having diarrhea episodes among the under-five compared to 64% that reported diarrhea among the under-fives for those that had incomplete primary level of education, 57% among the households of functional adult learning graduates and 49% for those that completed primary level of education.
Open Access
Bee Venom—A Potential Complementary Medicine Candidate for SARS-CoV-2 Infections
(Frontiers in Public Health, 2020) Keneth Iceland, Kasozi; Simon Peter, Musinguzi
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 directly interacts with angiotensin-converting enzyme 2 (ACE-2) receptors in the human body. Complementary therapies that impact on expression of IgE and IgG antibodies, including administration of bee venom (BV), have efficacy in the management of arthritis, and Parkinson’s disease. A recent epidemiological study in China showed that local beekeepers have a level of immunity against SARS-CoV-2 with and without previous exposure to virus. BV anti-inflammatory properties are associated with melittin and phospholipase A2 (PLA2), both of which show activity against enveloped and non-enveloped viruses, including H1N1 and HIV, with activity mediated through antagonist activity against interleukin-6 (IL-6), IL-8, interferon-g (IFN-g), and tumor necrosis factor-a (TNF-a). Melittin is associated with the underexpression of proinflammatory cytokines, including nuclear factor-kappa B (NF-kB), extracellular signal-regulated kinases (ERK1/2), and protein kinase Akt. BV therapy also involves group III secretory phospholipase A2 in the management of respiratory and neurological diseases. BV activation of the cellular and humoral immune systems should be explored for the application of complementary medicine for the management of SARS-CoV-2 infections. BV “vaccination” is used to immunize against cytomegalovirus and can suppress metastases through the PLA2 and phosphatidylinositol-(3,4)-bisphosphate pathways. That BV shows efficacy for HIV and H1NI offers opportunity as a candidate for complementary therapy for protection against SARS-CoV-2.
Open Access
Behavioural Response To Self-Medication Practice Before and During Covid-19 Pandemic in Western Uganda
(Patient Preference and Adherence, 2022) Samuel Sunday, Dare; Ejike, Daniel Eze; Isaac, Echoru; Ibe Michael, Usman; Fred, Ssempijja; Edmund Eriya, Bukenya; Robinson, Ssebuufu
Background: Self-medication has become a serious public health problem posing great risks, especially with the increasing number of cases of COVID-19 disease globally and in Uganda. This may be partly because of the absence of a recognized treatment for the disease, however, the differing prevalence and nature from country to country may influence human behavioral responses. Purpose: This study aimed to investigate the behavioral response to self-medication practices during the COVID-19 pandemic and lockdown in comparison to the pre-COVID period in Western Uganda. Methods: A descriptive cross-sectional survey was conducted from June to August 2020 in western Uganda using online Google forms and printed questionnaires to investigate the level of self-medication practice before and during the COVID-19 pandemic. This included 280 participants, aged 18 and above who consented to participate in the study. Participants were selected using a convenience sampling technique, and sampling was done by sending a structured online questionnaire via Google forms and printed questionnaires to participants who did not use the online Google forms. Results: Respondents that knew about self-medication were 97% of the 272 participants. Those that are aware of self-medication, have heard about it either through different avenues. Respondents who practiced self-medication before the COVID-19 pandemic were 239 (88%); those who practiced self-medication during the COVID-19 pandemic were 156 (57%); those that did not were 115 (43%). There was a statistically significant decrease in the number of respondents who practice self-medication during the COVID-19 pandemic lockdown compared to the practice before the pandemic lockdown. p < 0.05 at 95% confidence interval (OR = 5.39, 95% CI = 3.48, 8.32). Conclusion: Our investigation showed adequate knowledge of self-medication and a high level of self-medication practice with a decrease in self-medication practices during the COVID-19 pandemic lockdown compared to the practice before the lockdown
Open Access
Biological Properties, Bioactive Constituents, and Pharmacokinetics of Some Capsicum spp. and Capsaicinoids
(International Journal of Molecular Science, 2020-07-22) Gaber, El-Saber Batiha; Ali, Alqahtani; Oluwafemi, Adeleke Ojo; Hazem M., Shaheen; Lamiaa, Wasef; Mahmoud, Elzeiny; Mahmoud, Ismail; Mahmoud, Shalaby; Toshihiro, Murata; Adrian, Zaragoza-Bastida; Nallely, Rivero-Perez; Amany, Magdy Beshbishy; Keneth, Iceland Kasozi; Philippe, Jeandet; and Helal F., Hetta
Pepper originated from the Capsicum genus, which is recognized as one of the most predominant and globally distributed genera of the Solanaceae family. It is a diverse genus, consisting of more than 31 different species including five domesticated species, Capsicum baccatum, C. annuum, C. pubescen, C. frutescens, and C. chinense. Pepper is the most widely used spice in the world and is highly valued due to its pungency and unique flavor. Pepper is a good source of provitamin A; vitamins E and C; carotenoids; and phenolic compounds such as capsaicinoids, luteolin, and quercetin. All of these compounds are associated with their antioxidant as well as other biological activities. Interestingly, Capsicum fruits have been used as food additives in the treatment of toothache, parasitic infections, coughs, wound healing, sore throat, and rheumatism. Moreover, it possesses antimicrobial, antiseptic, anticancer, counterirritant, appetite stimulator, antioxidant, and immunomodulator activities. Capsaicin and Capsicum creams are accessible in numerous ways and have been utilized in HIV-linked neuropathy and intractable pain.
Open Access
Birthing experience and quality of life after vacuum delivery and second-stage caesarean section: a prospective cohort study in Uganda
(Tropical Medicine and International Health, 2018) Barbara, Nolens; Thomas, van den Akker; John, Lule; Sulphine, Twinomuhangi; Roosmalen, Jos van; Josaphat, Byamugisha
objective To assess perceptions of women undergoing vacuum extraction or second-stage caesarean section (SSCS) in a tertiary referral hospital in sub-Saharan Africa. methods Prospective cohort study, with six-month follow-up, of women who gave birth to a term singleton in cephalic presentation by vacuum extraction (n = 289) or SSCS (n = 357) between 25 November 2014, to 8 July 2015, in Mulago Hospital, Uganda. Excluded were women who had failed vacuum extraction, severe birth complications and those whose babies had died. Outcome measures were birthing experience satisfaction, physical component summary (PCS) and mental component summary (MCS) of the SF-12 quality-of-life questionnaire, pain scores and dyspareunia. results One day after vacuum extraction, 63.7% (181/284) of women were feeling well vs. 48.1% (167/347) after SSCS (OR 1.89; 95%CI 1.37–2.61) and mean pain sores were 2.70 vs. 3.87 (P < 0.001). In both groups, >90% of women were satisfied with their birthing experience. At six weeks, in vacuum extraction vs. SSCS, mean pain sores were 0.40 vs. 0.89 (P < 0.001); mean PCS was 48.67 vs. 44.03 (P < 0.001); mean MCS was 52.80 vs. 51.23 (P = 0.203); 40% (70/175) vs. 28.3% (70/247) of women had resumed sexual intercourse (OR 1.69; 95%CI 1.12–2.54) and 21.4% (15/70) vs. 28.6% (20/70) had dyspareunia (OR 0.68; 95%CI 0.32–1.47). No differences were found at six months after birth. conclusion One day and six weeks after birth, outcomes were better in women who had vacuum extraction. At six months, outcomes were similar. To promote quick recovery, vacuum extraction should be the first intervention considered in the second stage of labour.