Faculty of Health Sciences

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On the Use of Bayesian Network Classifiers to Classify Patients with Peptic Ulcer Among Upper Gastrointestinal Bleeding Patients
(IEEE, 2012) Nazziwa, Aisha; Mohd, Bakri Adam
A Bayesian network classifier is one type of graphical probabilistic models that is capable of representing relationship between variables in a given domain under study. We consider the naïve Bayes, tree augmented naïve Bayes (TAN) and boosted augmented naïve Bayes (BAN) to classify patients with peptic ulcer disease among upper gastro intestinal bleeding patients. We compare their performance with IBk and C4.5. To identify relevant variables for peptic ulcer disease, we use some methodologies for attributes subset selection. Results show that, blood urea nitrogen, hemoglobin and gastric malignancy are important for classification. BAN achieves the best accuracy of and AUC of (0.81) followed by TAN with 72.4 and 0.76 respectively among Bayesian classifiers. While the accuracy of the TAN is improved with attribute selection, the BAN and IBK are better off without attribute selection.
Comparison of the Naive Bayes Classifier and Instance Based Learner in Classifying Upper Gastrointestinal Bleeding
(MATEMATIKA, 2013) Naziwa, Aisha; Mohd, Bakri Adam; Shamarina, Shohaimi
Upper gastrointestinal bleeding is a medical emergence that results in high medical costs and death. Management of this disease requires ascertaining the cause of bleeding. The cause of bleeding is classified into esophageal and gastric causes. Based on health survey data, this study compares the accuracy of the naive Bayes classifier and an instance based learner in the classification of the cause of bleeding. The two classifiers are learned and trained on data collected from patients admitted for upper gastrointestinal bleeding. The naive Bayes classifier achieves a classification accuracy of 71% accuracy compared to 68% of the instance based learner
Effect of Missing Value Methods on Bayesian Network Classification of Hepatitis Data
(International Journal of Computer Science and Telecommunication, 2013-06) Naziwa, Aisha; Mohd, Bakri Adam; Shamarina, Shohaimi
Missing value imputation methods are widely used in solving missing value problems during statistical analysis. For classification tasks, these imputation methods can affect the accuracy of the Bayesian network classifiers. This paper study’s the effect of missing value treatment on the prediction accuracy of four Bayesian network classifiers used to predict death in acute chronic Hepatitis patients. Missing data was imputed using nine methods which include, replacing with most common attribute, support vector machine imputation (SVMI), K-nearest neighbor (KNNI), Fuzzy K-means Clustering (FKMI), K-means Clustering Imputation (KMI), Weighted imputation with K-Nearest Neighbor (WKNNI), regularized expectation maximization (EM), singular value decomposition (SVDI), and local least squares imputation (LLSI). The classification accuracy of the naive Bayes (NB), tree augmented naive Bayes (TAN), boosted augmented naive Bayes (BAN) and general Bayes network classifiers (GBN) were recorded. The SVMI and LLSI methods improved the classification accuracy of the classifiers. The method of ignoring missing values was better than seven of the imputation methods. Among the classifiers, the TAN achieved the best average classification accuracy of 86.3% followed by BAN with 85.1%.
Classification models for predicting the source of gastrointestinal bleeding in the absence of hematemesis
(Basic Research Journal of Medicine and Clinical Sciences, 2013-08) Nazziwa, Aisha; Mohd, Bakri Adam; Shamarina, Shohaimi
Management of acute gastrointestinal bleeding necessitates the identification of the source of bleed. The source of bleeding which is clear in patients presenting with hematemesis, is unclear in the absence of it. Logistic regression, decision tree, naïve Bayes, LogitBoost and KNN models were constructed from non endoscopic data of 325 patients admitted via the emergence department (ED) for GIB without hematemesis. The performance of the models in predicting the source of bleeding into upper gastrointestinal bleeding or lower gastrointestinal bleeding was compared. Overall the models demonstrate good performance with regards to sensitivity specificity, PPV, NPV and classification accuracy on the simulated data. On the GIB data, the naive Bayes model performed best with a prediction accuracy and sensitivity of 86%, specificity of 85% and area under curve of 92%. Classification models can help to predict the source of gastrointestinal bleeding for patients presenting without hematemesis and may generally be useful in decision support in the ED. The models should be explored further for clinical relevance in other settings
Bayesian Network Classification of Gastrointestinal Bleeding
(Universiti Putra Malaysia Press (Pertanika Journal of Science & Technology), 2014) Nazziwa, Aisha; Mohd, Bakri Adam; Shamarina, Shohaimi; Aida, Mustapha
The source of gastrointestinal bleeding (GIB) remains uncertain in patients presenting without hematemesis. This paper aims at studying the accuracy, specificity and sensitivity of the Naive Bayesian Classifier (NBC) in identifying the source of GIB in the absence of hematemesis. Data of 325 patients admitted via the emergency department (ED) for GIB without hematemesis and who underwent confirmatory testing were analysed. Six attributes related to demography and their presenting signs were chosen. NBC was used to calculate the conditional probability of an individual being assigned to Upper Gastrointestinal bleeding (UGIB) or Lower Gastrointestinal bleeding (LGIB). High classification accuracy (87.3 %), specificity (0.85) and sensitivity (0.88) were achieved. NBC is a useful tool to support the identification of the source of gastrointestinal bleeding in patients without hematemesis
Malariometric indices from Iganga, Uganda: baseline characterization in preparation of GMZ2 vaccine trial
(2014) Kaddumukasa, M; Buwembo, W; Sekikubo, M; Naiwumbwe, H; Namusoke, F; Kiwuwa, S; Oketch, B; Noor, R; Chilengi, R; Mworozi, E; Kironde, Fred
Background: Malaria still remains the leading cause of childhood morbidity and mortality in Uganda. Interventions like malaria vaccines which reduce the malaria burden are needed in malaria endemic communities. There is need to establish baseline characteristics in vaccine trial study sites. This study determined the following baseline malariometric indices: spleen rates, bed net use, malaria parasitaemia and malaria episodes in an inception cohort of children aged 12 – 60 months in Iganga district, Uganda. Methods: In a longitudinal cohort study, 748 children were enrolled with 397 in an active follow up arm and 351 in a passive arm. The children in the two arms were followed for 6 months to determine the incidence of malaria episodes. Results: The overall baseline spleen rate was 8.2% (61/748) among the study participants. Of the households surveyed, about 36% reported using bed nets and almost 30% of the users had insecticide-treated nets. 274 (36.6%) of the study participants had a history of fever in the past 24 hrs at the time of the baseline survey. All participants had a peripheral blood smear for malaria parasites done at enrollment with 76.8% having the asexual form of malaria parasites. The malaria episodes per child per year were 1.5 and 0.79 in the active and passive follow up arms respectively. Conclusions: There is a high prevalence of malaria asexual parasitaemia in children below five years. The bed net usage still remains low among this population. These baseline malariometric indices have important implication for malaria control interventions.
Prevalence of glucose-6-phosphate dehydrogenase deficiency and its association with Plasmodium falciparum infection among children in Iganga distric in Uganda
(Biomed central, 2014) Bwayo, Denis; Kaddumukasa, Mark; Ddungu, Henry; Kironde, Fred
Background: Glucose-6-phosphate dehydrogenase (G6PD) is a metabolic enzyme involved in the pentose phosphate pathway, its especially important in red blood cell metabolism. Glucose-6-phosphate dehydrogenase deficiency is an X-linked recessive hereditary disease characterised by abnormally low levels of G6PD. About 400 million people worldwide have a deficiency of this enzyme. The remarkable geographic correlation of G6PD deficiency distribution with historical endemicity patterns of malaria has led to suggestions that the two could be linked. Some studies have concluded that G6PD deficiency confers resistance to malaria. Objective: To determine the prevalence of G6PD deficiency, and determine its relationship with prevalence and incidence of P. falciparum infection among children in Uganda. Methods: This was longitudinal study involving 245 children, 135 were actively followed up for 12 months. G6PD status was assessed for using PCR-RFLP method. A thick smear was done to determine presence of plasmodium trophozoites and parasite densities. Results: A total of 245 children between 6 months and 9 years were recruited. Of these 46.5% were males. Overall prevalence for the X-linked G6PD A- mutation was; 79.59% wild type, 12.65% heterozygous and 7.76% homozygous or hemizygous. Among the males 14% were hemizygous. At baseline, 40.8% had asymptomatic P falciparum infection. There was no statistically significant difference in prevalence and incidence rates of malaria infection among the different G6PD genotypes with prevalence among heterozygous, homozygous, and wild type being 29%, 42.6% and 43% respectively (p = 0.11) and incidence among heterozygous and wild type being 0.56 and 0.52 episodes/year (p = 0.5). The heterozygous G6PD A- females had a lower parasite density compared to the wild type (2505 vs 941 parasites/μL; P = 0.024). Conclusions: This study showed that 20.41% of the population in this part of Uganda carry the G6PD A-mutation, within the range of 15-32% seen in other parts of Africa. P. falciparum infection incidence and prevalence rates are similar among the G6PD genotypes though, once infected, P. falciparum parasite densities are lowest among G6PD A- heterozygous females. This suggests differences in P. falciparum infection rates and severity of disease could be mediated by differences in parasite densities among the different G6PD genotypes.
Polymorphisms in Plasmodium falciparum Chloroquine Resistance Transporter and Multidrug Resistance 1 Genes: Parasite Risk Factors that Affect Treatment Outcomes for P. falciparum Malaria after Artemether-Lumefantrine and Artesunate-Amodiaquine
(2014) Venkatesan, M; Gadalla, N. B.; Stepniewska, K; Kironde, Fred
Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter ( pfcrt) and P. falciparummultidrug resistance1(pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemetherlumefantrine (AL) have not been clearly defined. Individual patient data from 31 clinical trials were harmonized and pooled by using standardized methods from the WorldWide Antimalarial Resistance Network. Data for more than 7,000 patients were analyzed to assess relationships between parasite polymorphisms in pfcrt and pfmdr1 and clinically relevant outcomes after treatment with AL or ASAQ. Presence of the pfmdr1 gene N86 (adjusted hazards ratio = 4.74, 95% confidence interval = 2.29 – 9.78, P < 0.001) and increased pfmdr1 copy number (adjusted hazards ratio = 6.52, 95% confidence interval = 2.36–17.97, P < 0.001) were significant independent risk factors for recrudescence in patients treated with AL. AL and ASAQ exerted opposing selective effects on single-nucleotide polymorphisms in pfcrt and pfmdr1. Monitoring selection and responding to emerging signs of drug resistance are critical tools for preserving efficacy of artemisinin combination therapies; determination of the prevalence of at least pfcrt K76T and pfmdr1 N86Y should now be routine.
Differences in affinity of monoclonal and naturally acquired polyclonal antibodies against Plasmodium falciparum merozoite antigens
(2015) Reddy, S. B.; Anders, R. F.; Cross, N; Mueller, I; Senn, N; Stanisic, D. I.; Siba, P. M.; Wahlgren, M; Kironde, Fred; Beeson, J. G.; Persson, K. E. M
Background: Malaria is a major global cause of deaths and a vaccine is urgently needed. Results: We have employed the P. falciparum merozoite antigens MSP2-3D7/FC27 and AMA1, used them in ELISA, and coupled them in different ways using surface plasmon resonance (SPR) and estimated affinity (measured as kd) of monoclonal as well as naturally-acquired polyclonal antibodies in human plasma. There were major differences in kd depending on how the antigens were immobilized and where the His-tag was placed. For AMA1 we could see correlations with invasion inhibition. Using different immobilizations of proteins in SPR, we could see only moderate correlations with levels of antibodies in ELISA, indicating that in ELISA the proteins were not uniformly bound and that antibodies with many specificities exist in natural immunisation. The correlations between ELISA and SPR were enhanced when only parasite positive samples were included, which may indicate that high affinity antibodies are difficult to maintain over long periods of time. We found higher kd values for MSP2 (indicating lower affinity) compared to AMA1, which might be partly explained by MSP2 being an intrinsically disordered protein, while AMA1 is globular. Conclusions: For future vaccine studies and for understanding immunity, it is important to consider how to present proteins to the immune system to achieve highest antibody affinities.
Parasite Specific Antibody Increase Induced by an Episode of Acute P. falciparum Uncomplicated Malaria
(2015) Kaddumukasa, M; Lwanira, C; Lugaajju, A; Katabira, E; Persson, K. E. M.; Wahlgren, M; Kironde, Fred
Introduction There is no approved vaccine for malaria, and precisely how human antibody responses to malaria parasite components and potential vaccine molecules are developed and maintained remains poorly defined. In this study, antibody anamnestic or memory response elicited by a single episode of P. falciparum infection was investigated. Methods This study involved 362 malaria patients aged between 6 months to 60 years, of whom 19% were early-diagnosed people living with HIV/AIDS (PLWHA). On the day malaria was diagnosed and 42 days later, blood specimens were collected. Parasite density, CD4+ cells, and antibodies specific to synthetic peptides representing antigenic regions of the P. falciparum proteins GLURP, MSP3 and HRPII were measured. Results On the day of malaria diagnosis, Immunoglobulin (IgG) antibodies against GLURP, MSP3 and HRP II peptides were present in the blood of 75%, 41% and 60% of patients, respectively. 42 days later, the majority of patients had boosted their serum IgG antibody more than 1.2 fold. The increase in level of IgG antibody against the peptides was not affected by parasite density at diagnosis. The median CD4+ cell counts of PLWHAs and HIV negative individuals were not statistically different, and median post-infection increases in anti-peptide IgG were similar in both groups of patients. Conclusion In the majority (70%) of individuals, an infection of P. falciparum elicits at least 20% increase in level of anti-parasite IgG. This boost in anti-P. falciparum IgG is not affected by parasite density on the day of malaria diagnosis, or by HIV status.
Novel flow cytometry technique for detection of Plasmodium falciparum specific B‑cells in humans: increased levels of specific B‑cells in ongoing infection
(Malaria Journal, 2015) Lugaajju, Allan; Sreenivasulu, Reddy. B; Rönnberg, Caroline; Wahlgren, Mats; Kironde, Fred; Persson, Kristina E. M.
Background: Malaria caused by Plasmodium falciparum is still a major health threat in endemic areas especially for children below 5 years of age. While it is recognized that antibody immunity plays an important role in controlling the disease, knowledge of the mechanisms of sustenance and natural boosting of immunity is very limited. Before, it has not been possible to investigate malaria specific B-cells directly in flow cytometry, making it difficult to know how much of a B cell response is due to malaria, or how much is due to other immunological stimulators. Methods: This study developed a technique using quantum dots and schizont extract made from ghosts of infected erythrocytes, to be able to investigate P. falciparum specific B-cells, something that has never been done before. Results: Major differences in P. falciparum specific B-cells were found between samples from immune (22.3 %) and non-immune (1.7 %) individuals. Samples from parasite positive individuals had the highest proportions of specific B-cells (27.9 %). Conclusion: The study showed increased levels of P. falciparum-specific B-cells in immune individuals, with the highest levels in active malaria infections, using a new technique that opens up new possibilities to study how these cells are sustained in vivo after natural infections. It will also be useful in vaccine studies. Keywords: Plasmodium falciparum, Quantum dots, Ghost infected red blood cells, Malaria, B-cells
Frequency of RANTES gene polymorphisms and their association with incidence of malaria: a longitudinal study on children in Iganga district, Uganda
(Bio Med Central, 2015) Lwanira, C. N.; Mukasa, M. K; Swedberg, G; Kironde, Fred
Background: The severity and outcome of malaria is influenced by host immunity in which chemokines such as Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES) play an important role. Previous studies show that variations in the RANTES gene affect RANTES protein production, hence altering host immunity. In this study, the relationship between presence of mutations in RANTES and incidence of malaria in a cohort of children living in a malaria-endemic area of Uganda was determined. Methods: This was a longitudinal study comprising of 423 children aged between 6 months and 9 years, who were actively followed up for 1 year. Malaria episodes occurring in the cohort children were detected and the affected children treated with national policy drug regimen. Mutations in the RANTES gene were determined by PCR–RFLP method and their frequencies were calculated. A multivariate negative binomial regression model was used to estimate the impact of RANTES mutations on malaria incidence. In all statistical tests, a P-value of <0.05 was considered as significant. Results: The frequencies of the −403A and In1.1C allele were 53.7 and 19.2 %, respectively. No mutations were found at the −28 locus. After adjustment of incidence rates for age, blood group, insecticide-treated bed net (ITN) use, malaria history and the sickle cell trait, 1n1.1T/C heterozygotes and homozygotes showed a non-significant trend towards higher incidence rates compared to wild-type individuals (IRR = 1.10; P = 0.55 and IRR = 1.25; P = 0.60, respectively). Similarly, there was no significant difference in malaria incidence rates between RANTES −403G/A heterozygotes or homozygotes and those without mutations (IRR = 1.09; P = 0.66 and IRR = 1.16; P = 0.50, respectively). No relation was seen between RANTES polymorphisms, baseline parasite densities and the time to first re-infection after administration of anti-malaria drugs. Conclusions: This study showed that the −403A mutation occurs in nearly half of the study population and the In1.1C allele occurs in one in every four children. Despite the high frequency of these mutations, there was no clear association with malaria incidence. Other studies evaluating more markers, that could potentially modulate RANTES gene transcription alongside other genetic modifiers of malaria susceptibility, may provide further explanations to these less dramatic findings.
ANALYSIS OF NON-LINEAR TRANSMISSION OF EBOLA VIRUS DISEASE AND THE IMPACT OF PUBLIC HEALTH CONTROL INTERVENTIONS IN HOSPITAL
(Islamic University Journal, 2015-06) Nazziwa, Aisha; Babangida, Bala Garba; Noor, Kasim; Adiukwu, Roseline Nwawure; Ngaloru, Stellamaris Ngozi; Mafuyai, Yaks Mabur; Obi, Edith Nkeiru; Onwunali, Magnus Chibueze; Obanny, Adolphus
Epidemiological data on infection outbreaks are challenging to analyze, despite improved control interventions Ebola virus Disease (EVD) remains a serious risk in Guinea (West Africa) with 607 reported cases and 406 deaths recorded (66.8%) as of 20th August, 2014.In this study we use modified epidemiological modeling SEIR to analyze data from an Ebola outbreak in Guinea from 22nd march – 20th August,2014 We use Bayesian inference with non – linear transmission times incorporated into augmented dataset as latent variables. Despite the lack of detailed data, most data sets record the time on symptom onset but transmission time is not observable. We inferred from such dataset records using structured Hidden Markov Models HMMS. Infectivity is determined before and after public health interventions for hospitalized cases. We estimate the number of secondary cases generated by an index case in the absence of control interventions (Ro). Our estimate of Ro is 1.57 (CI95 0.82-1.92) and the mean value of estimated detection rate is 0.75 (CI95 0.59 -0.93) with a coefficient of correlation between 𝛽 and v as – 0.23. We perform sensitivity analysis of the final epidemic size tothe time of intervention, which ensures the uniqueness and the global stability of the positive endemic equilibrium state.
Characterization and Antimicrobial Susceptibility Patterns of Isolates from Ward Fomites
(British Biotechnology Journal, 2016) Segujja, Farouk; Mwambi, Bashir; Drago, Charles Kato; Lubowa, Nathan Musisi; Mugambwa, Joseph; Wabuyi, Patrick
Aim: The study was conducted to determine antimicrobial susceptibility patterns among isolates from ward fomites at Kiwoko Hospital and to detect resistances in the form of Macrolide Lincosamide StreptograminB (MLSB), Methicillin Resistant Staphylococcus aureus (MRSA), Extended Spectrum β Lactamases (ESBLs), AmpC, and Multi Drug Resistant (MDR) pathogens. Study Design: Laboratory based cross-sectional study. Place and Duration of Study: The study was conducted in various wards and sections at Kiwoko Hospital, a rural setting in the central region of Uganda, between January and June 2015. Methodology: We recruited 290 samples from the Surgical, Medical, Maternity and Pediatric wards as well as the Out Patient Department (OPD) at Kiwoko Hospital for the study. Samples were taken by swabbing the different surfaces and instruments which included; sphygmomanometers, stethoscopes, beds, nurses’ stations, staff/visitors’ chairs, door handles, patients’ crepe bandages, curtains, switches, and sink handles among others. Susceptibility testing was done using the disc diffusion methods by Kirby Bauer for phenotypic expression of MLSB resistances, MRSA, MSSA, ESBL, MDR and AmpC. Co-resistances exhibited by isolated ESBL producers were also phenotypically tested. Results: Of the 290 surfaces and instruments swabbed, 57.59% (CI= 49.18 - 67.01) carried bacterial pathogens and by using standard surface agar plating methods, Staphylococcus aureus was the mostly isolated pathogen 43 (25.75%), followed by Klebsiella pneumoniae 35 (20.96%), Escherichia coli 31 (18.55%), Pseudomonas aeruginosa 20 (11.98%), Enterococcus faecalis 12 (7.19%), Staphylococcus epidermidis 10 (5.98%), Proteus mirabilis 9 (5.39%), Bacillus spp. 4 (2.40%), and Staphylococcus saprophyticus 3 (1.80%). Among enterobacteriaceae, 5 (6.67%, CI= 2.16 – 15.56) were identified as AmpC producers and 16 (21.33%, CI= 12.19 - 34.64) as ESBL producers out of which 4/16 (25.00%, CI = 6.81 – 64.01) showed ESBL co-resistance. Of the 43 Staphylococcus aureus isolates, 9.30% were MRSA (CI = 2.53 - 23.82) and 90.70% MSSA (CI = 64.49 - 100). In MLSB resistance patterns, 23.26% of the total S. aureus isolates were constitutive MLSB while 6.98% showed inducible MLSB as 27.91% exhibited an MS phenotype. Out of all the isolates recovered from fomites, 27/167 (16.17%, CI = 10.65 – 23.52) were identified as Multi Drug Resistant (MDR). Conclusion: Hospital fomites harbored resistant pathogens that could well persist for a long period of time thereby predisposing patients to Hospital acquired infections. Therefore, routine screening of clinical samples for MLSB, ESBL, AmpC, MRSA and MDR could significantly monitor potential treatment failures in the management of resistant bacterial infections spread by pathogens on ward items and surfaces at Kiwoko Hospital, Uganda.
Individual risk factors contributing to the prevalence of teenage pregnancy among teenagers at Naguru teenage center kampala, Uganda
(Primary Healthcare: Open Access, 2016) Akanbi, F; Afolabi, K; Aremu, A
Introduction: Teenage pregnancy and its effects on teen motherhood are among the major societal challenges of the teenagers in the contemporary global community. In a 30 million population 25 percent pregnancy rate among adolescents is an issue of great concern to the government and the whole of Uganda. Objective: This study identifies and analyses the individual factors contributing to the prevalence of teenage pregnancy among teenagers assessing Naguru teenage centre. Methodology: A cross sectional study design was used employing both quantitative and qualitative approaches using 384 population sample size among teenagers assessing Naguru teenage centre. A consecutive sampling technique with structured questionnaire was used to identify the individual factors contributing to teenage pregnancy. Data were statistically analysed using SPSS for the relationship between the variables. Results: The result shows that 4 in every 10 teenagers accessing Naguru teenage centre were pregnant. Individual risk factors found to be associated with teenage pregnancy were educational level (P=0.024, X2=7.452), age at the start of contraceptives (P=0.049, X2=7.852), siblings are sexually active (X2=12.727, P=0.005) and siblings ever got pregnant (X2=15.214, P<0.001). Teenagers that were not educated (OR=3.437, CI=6.906-1.711) were more likely to be pregnant. Teenagers who start the use of contraceptives at the age of 13years and above were more likely to get pregnant (OR=2.484, CI=4.938-1.25). Teenagers whose siblings were sexually active (OR=5.308, CI=11.295-2.494) were more likely to get pregnant. Teenagers whose siblings ever got pregnant were more likely to get pregnant (OR=2.575, CI=4.642-1.428). Conclusion: The study concluded that the prevalence of teenage pregnancy among teenager accessing Naguru teenage centre is moderately high. Risk factors for teenage pregnancy were educational level, age at the start of contraceptives, sibling sexually active and siblings ever got pregnant. Recommendation: Government, Stakeholders, community leaders, teachers and parents have more efforts such as sensitization, monitoring, counseling, etc to intensify on various means of reducing teenager’s pregnancy.
Comparative Detection of Foot-and-Mouth Disease Virus by the two Commonly used Assays of NSP ELISA and RT-PCR in Uganda with Quantitative Real Time RT-PCR on Field Samples
(Global Journal of Medical Research, 2016) Mukasa, Hussein Kafeero
Foot-and-mouth disease (FMD) is a viral disease of Ungulates; both Artiodactyla and Perissodactyla. The mortality rates are low in adult animals but it affects milk yield and international trade. In endemic countries, diagnosis can be based on clinical signs. But these are shared by other vesicular diseases, so a laboratory is needed to confirm the disease. In Uganda the commonly used assays for the laboratory diagnosis of FMD are NSP ELISA and RT-PCR. Serology using ELISA techniques may fail to distinguish between vaccinated and new infection so compromising its sensitivity. The gel passed PCR is involves a lot of advance sample treatment increasing errors due to carry over which also compromises its sensitivity. This work reports comparative the detection of foot-and-mouth virus by NSP ELISA and RTPCR with real time PCR which was taken as the gold standard. The assays were compared in terms of sensitivity, specificity and disease prevalence and likelihood ratios. A total of 176 cattle were used from which samples that included epithelial tissues (17.05%) and oral swabs (84.09%) were collected from outbreak cases in Eastern Districts of Mbale and Budaka.
The S-Gene Mutations in the Circulating HBV Genotypes/Sub-Genotypes Associated with Hepatitis B Infection in Uganda and their Effects on Cytokines Expression in Liver Disease Progression
(Global Journal of Medical Research, 2016) Kafeero, Hussein Mukasa; Kawooya, Abubaker; Namusoke, Mariam; Atiku, Saad; Mugambwa, Joseph
The causal agent for hepatitis B is called hepatitis B virus (HBV). It is a partially double stranded circular DNA virus of the family Hepadnaviridae. It has been implicated as the leading cause of hepatocellular carcinoma and only second to tobacco among the global human carcinogens. Liver damage as a result of HBV infection is due to host immune response and is modulate by cytokines. The HBV is classified into 10 genotype denoted as A, B, C, D, E, F, G, H, I and J together with several sub-genotypes which have diverse geographical distribution. These genotypes influence liver disease progression and severity as well as response to antiviral therapies. Mutations in the S-gene have been implicated in the paradoxical coexistence of HBsAg and the anti-HBs antibodies which is associated with advanced liver diseases including hepatocellular carcinoma and liver cirrhosis.
Characterization and Antimicrobial Susceptibility Patterns of Isolates from Ward Fomites
(British Biotechnology Journal, 2016) Segujja, Farouk; Mwambi, Bashir; Drago, Charles Kato; Lubowa, Nathan Musisi; Mugambwa, Joseph; Wabuyi, Patrick
Aim: The study was conducted to determine antimicrobial susceptibility patterns among isolates from ward fomites at Kiwoko Hospital and to detect resistances in the form of Macrolide Lincosamide StreptograminB (MLSB), Methicillin Resistant Staphylococcus aureus (MRSA), Extended Spectrum β Lactamases (ESBLs), AmpC, and Multi Drug Resistant (MDR) pathogens. Study Design: Laboratory based cross-sectional study. Place and Duration of Study: The study was conducted in various wards and sections at Kiwoko Hospital, a rural setting in the central region of Uganda, between January and June 2015. Methodology: We recruited 290 samples from the Surgical, Medical, Maternity and Pediatricwards as well as the Out Patient Department (OPD) at Kiwoko Hospital for the study. Samples were taken by swabbing the different surfaces and instruments which included; sphygmomanometers, stethoscopes, beds, nurses’ stations, staff/visitors’ chairs, door handles, patients’ crepe bandages, curtains, switches, and sink handles among others. Susceptibility testing was done using the disc diffusion methods by Kirby Bauer for phenotypic expression of MLSB resistances, MRSA, MSSA, ESBL, MDR and AmpC. Co-resistances exhibited by isolated ESBL producers were also phenotypically tested. Results: Of the 290 surfaces and instruments swabbed, 57.59% (CI= 49.18 - 67.01) carried bacterial pathogens and by using standard surface agar plating methods, Staphylococcus aureus was the mostly isolated pathogen 43 (25.75%), followed by Klebsiella pneumoniae 35 (20.96%), Escherichia coli 31 (18.55%), Pseudomonas aeruginosa 20 (11.98%), Enterococcus faecalis 12 (7.19%), Staphylococcus epidermidis 10 (5.98%), Proteus mirabilis 9 (5.39%), Bacillus spp. 4 (2.40%), and Staphylococcus saprophyticus 3 (1.80%). Among enterobacteriaceae, 5 (6.67%, CI= 2.16 – 15.56) were identified as AmpC producers and 16 (21.33%, CI= 12.19 - 34.64) as ESBL producers out of which 4/16 (25.00%, CI = 6.81 – 64.01) showed ESBL co-resistance. Of the 43 Staphylococcus aureus isolates, 9.30% were MRSA (CI = 2.53 - 23.82) and 90.70% MSSA (CI = 64.49 - 100). In MLSB resistance patterns, 23.26% of the total S. aureus isolates were constitutive MLSB while 6.98% showed inducible MLSB as 27.91% exhibited an MS phenotype. Out of all the isolates recovered from fomites, 27/167 (16.17%, CI = 10.65 – 23.52) were identified as Multi Drug Resistant (MDR). Conclusion: Hospital fomites harbored resistant pathogens that could well persist for a long period of time thereby predisposing patients to Hospital acquired infections. Therefore, routine screening of clinical samples for MLSB, ESBL, AmpC, MRSA and MDR could significantly monitor potential treatment failures in the management of resistant bacterial infections spread by pathogens on ward items and surfaces at Kiwoko Hospital, Uganda.
Sexual behavior effect of orally administered crude aqueous extract of Terminalia schimperiana Root in male Wistar rat
(Plant Journal, 2016) Awotunde, O.S
The Proximate composition, phytochemical composition and the effect of oral administration of aqueous extract of Terminalia schimperiana root on male wistar rat sexual behavior were determined. The root was collected and extracted with water, the phytochemical screening was carried out using the standard procedures and revealed the presence of alkaloids, saponins, Phenolics, anthocyanin and Tannins. The Proximate analysis results obtained showed the amount of crude protein, crude fat and total carbohydrates to be 6.31±0.75, 4.64±0.82 and 17.79 ±0.53 respectively of the sample while the percentage of crude fiber, ash and moisture content in the root sample were 32.72 ±0.59, 0.35±0.12 and 10.35±0.18 respectively. Aqueous extract of Terminalia schimperiana root was orally administered to sexually active rats in a daily dose of 1000, 2000 and 3000 mg/Kg body weight for 5 days, the sexual behavior was monitored and testosterone serum level was measured on Terminalia schimperiana treated rats, control rats “that received vehicle” and the reference group “ that received Powmax”. Oral administration of Terminalia schimperiana significantly increased the mount frequency, intromission frequency and prolonged the ejaculatory latency. In addition, a significant increase in the copulatory efficacy was reported for the test groups and testosterone serum level was significantly increased in Terminalia schimperiana treated rats compared to controls and reference. The present study revealed that continuous administration of Terminalia schimperiana aqueous extract for a period of 5 days improves the sexual motivation and performance in adult male rats, an effect that may be linked to increased testosterone level, the nutrient composition and the phytochemicals.
Antioxidant activities of Hydro-ethanol and Saponin extracts of Terminalia schimeperiana root
(Der Pharmacia Lettre, 2017) Awotunde, O.S; Dhanabal, S.P; Rajeshkumar, Raman; Chasitainya, MVNL
In this present paper we have investigated the Antioxidant activity of Hydro-ethanol and Saponin fractions of Terminalia schimperiana root for its free radical scavenging activity by adopting ABTS and DPPH in vitro methods. The extracts were investigated for the antioxidant activity using 2, 2 - diphenyl, 1- picryl hydrazyl (DPPH) and 2, 2 azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) scavenging activity, reducing capacity and competition with DMSO. The result suggested that the polar Hydro-ethanol fraction was found to have potent DPPH antioxidant activity with IC50 value of 19.36± 0.436 μg/ml and ABTS scavenging activity with IC50 value of 0.9420± 0.011 μg/ml, while the Saponin fraction has moderate DPPH scavenging activity with IC50 of 59.33± 0.417 μg/ml and moderate ABTS scavenging activity with IC50 value of 2.273± 0.036 μg/ml (Rutin DPPH IC50 value= 14.5±0.29 μg/ml, Rutin ABTS IC5O value= 0.2976± 0.012 μg/ml, Ascorbic acid ABTS IC50 value= 2.62± 0.20, Ascorbic acid DPPH IC50 value=9.51± 0.22).

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