Plasma vitamin C concentration in pregnant women with pre-eclampsia in Mulago hospital, Kampala, Uganda.

BACKGROUND: Oxidative stress plays a role in the aetiology of pre-eclampsia and vitamin C may prevent pre-eclampsia. OBJECTIVE: To determine the association between plasma vitamin C and pre-eclampsia in Mulago Hospital, Kampala, Uganda. METHODS: This case-control study was conducted at Mulago Hospital from 1(st) May 2008 to 1(st) May 2009; 207 women were the cases and 352 women were the controls. Plasma vitamin C was assayed in the women using a colorimetric method. An independent t test was used to find the difference in the means of plasma vitamin C and logistic regression was used to find the association between plasma vitamin C and pre-eclampsia. RESULTS: The mean plasma vitamin C was 1.7(SD=0.7) × 10(3) µg/L in women with pre-eclampsia and 1.9(SD=0.7) × 10(3) µg/L in women with normal pregnancy (P=0.005). Women with low plasma vitamin C were at an increased risk of pre-eclampsia (OR 2.91, 95% CI: 1.56-5.44). CONCLUSION: There was a strong association between low plasma vitamin C, and pre-eclampsia in women attending antenatal clinics at Mulago Hospital, Kampala. Health workers need to advise women at risk in the antenatal period about diet, especially foods which are rich in vitamin C to probably reduce pre-eclampsia.

The Effects of Enhanced Access to Antiretroviral Therapy : a Qualitative Study of Community Perceptions in Kampala city; Uganda

Introduction: Since 2001; Antiretroviral Therapy (ART) has been integrated as part of the Uganda National Program for Comprehensive HIV/AIDS Care and Support. If patients take Antiretroviral drugs (ARVs) as prescribed; quality of life is expected to improve and patients become healthier. It is; however; postulated that scale up of ARVs could erode the previous achievement in behaviour change interventions. This study examined community perceptions and beliefs on whether enhanced access to ARVs increases risk beha-viour. It also examined people's fears regarding HIV/AIDS infection and the use of ARVs. Methods: This was a qualitative study that utilized Focus Group Discussions (FGDs) and Key Informant (KI) interviews. Participants were purposefully sampled. Twenty FGDs comprising of 190 participants and 12 KI interviews were conducted. FGDs were conducted with adult men and women (above 25 years); and youth (male and female) while KI interviews were held with Kampala City Council officials; Kawempe Division Local Council officials; health workers and religious leaders. All data was tape recorded with consent from participants and transcribed thereafter. Typed data was analyzed manually using qualitative latent content analysis technique. Results: Most participants felt that enhanced access to ART would increase risky sexual behaviour; namely promiscuity; lack of faithfulness among couples; multiple partners; prostitution; unprotected sexual practices; rape and lack of abstinence as the risky sexual behaviours. A few FGDs; however; indicated that increased ART access and counselling that HIV-positive people receive promoted positive health behaviour. Some of the participants expressed fears that the increased use of ARVs would promote HIV transmission because it would be difficult to differentiate between HIV-positive and HIV-negative persons since they all looked healthy. Furthermore; respondents expressed uncertainty about ARVs with regard to adherence; sustainable supply; and capacity to ensure quality of ARVs on the market Con- clusions: There are fears and misconceptions that enhanced access to ART will increase risky sexual behaviour and HIV transmission. Information Education and Communi-cation (IEC) on ART use and availability should be enhanced among all people. Prevention programs which are modified and specific to the needs of the people living with HIV should be developed and implemented; and should include information on the ability of individuals to transmit HIV even when they are on ART