Tuberculosis (TB) Co-infection with HIV/AIDS: Clinical Presentation at Lacor Hospital, a Post-conflict Northern Uganda.

Aims: To characterize the various clinical presentations of TB diagnosed in HIV/AIDS patients in the post-conflict Northern Uganda. Study Design and Setting: A prospective cohort study was conducted on 320 TB/HIV/AIDS coinfected patients at St. Mary’s Hospital, Lacor which is a specialist hospital in Gulu, Northern Uganda from July 2009 to July 2010. Methodology: Clinical features of confirmed 320 HIV sero-positive patients with confirmed TB coinfection (170 males and 150 females) recruited consecutively were studied and followed up for three months, their clinical presentations analyzed using SPSS version13.0. Ethics and Review Committee approved the study and those who did not meet the inclusion criteria were excluded. All patients gave an informed consent/Assent for the study. Results: The commonest clinical presentations were fever 316(98.8%), productive cough 268(83.7%), evening/night sweats 267(83.4%), general malaise 277(86.6%), wasting 228(71.3%), anaemia 220(68.8%) and lymphadenopathy 100(31.3%). The clinical features which were associated statistically and significantly with TB/HIV/AIDS co-infection were: Low grade fever (p=0.006); haemoptysis (p=0.001); Night sweats and evening fevers (p=0.043); Chest pain (p=0.041); General malaise (p=0.037) and wasting (p=0.047). Most patients 262(81.9%) improved and were discharged on Directly Observed Therapy Short-course (DOTS) while 58(18.1%) died. Conclusion: Clinical assessment is a very important adjuvant in TB/HIV/AIDS co-epidemic diagnosis. Early diagnosis and prompt management of TB co-infection ensured longer life and reduced morbidity and mortality.

HIV/AIDS stigmatization, the reason for poor access to hiv counseling and testing (HCT) among the youths in Gulu (Uganda)

HIV/AIDS-related stigma still exists in many communities in Uganda. Stigma perpetuates discrimination and this may be a key contributor to the spread of HIV/AIDS in this country. Right from the beginning; HIV/AIDS epidemic has been accompanied with fear; ignorance and denial; leading to stigmatization and discrimination against people living with HIV/AIDS and their families. A study conducted by Uganda AIDS Commission (UAC) in Uganda indicated that 64 of the people who tested for HIV/AIDS did not disclose status to their partners due to fear of stigmatization. A cross-sectional study was conducted in Gulu District; Pece sub County among the youths 15 to 35 years old. A structured questionnaire was administered to 86 consented youths who were consecutively selected. Ethical approval was obtained from Gulu Hospital. Most youths (90) practiced stigmatization; (93.1) respondents had adequate knowledge on HIV counseling and testing (HCT). However; only (36.1) had undertaken HCT and the majority did not do because of fear of stigmatization. There is sufficient knowledge; a positive attitude but a poor practice to HCT. There is high level of HIV/AIDS stigmatization among the youths.nef Gene Products; Human Immunodeficiency Virus bAdolescent Medicine cDiscrimination

The Postoperative Complications Prediction in Mulago Hospital using POSSUM Scoring System

Introduction: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction. The postoperative complications of patients who underwent Laparotomy in Mulago hospital were studied using POSSUM scoring system. The main objective of this study was to determine the postoperative complications of Laparotomy in Mulago Hospital; between September 2003 and February 2004. Methods: consecutive patients; who underwent Laparotomy in Mulago; were studied using POSSUM system for development of complications. For each patient operated; they were followed up in wards until discharge. When the postoperative complications were reported; they were reexamined by the surgeons; treated and followed up for 30 days postoperatively. Phone contacts were used for the follow up. Surgical reviews were conducted once a week in Mulago Hospital and the data obtained recorded in the data sheet for the patients. Results: Seventy-six patients were studied. The observed post operative complications were as follows: Respiratory tract infection (28.2); wound haemmorrhage (18.2); anaemia (15.5); hypotension (14.1); UTI (2.2); Anastomotic leak (1.4); Wound sepsis (9.9); wound dehiscence (4.2); Thromboembolism (1.4). The postoperative nursing care significantly determined the outcomes. Conclusion: Postoperative complications can be predicted in the modern management of surgery especially while using a scoring system