Gulu University Research Articles

High Anion Gap Metabolic Acidosis among Children with Nodding Syndrome (NS) in Northern Uganda: Case Series

Aims: To conduct a hormonal and biochemical studies on 10 patients with diagnosis of probable Nodding Syndrome (NS). Study Design: A cross-sectional study Place and Duration of Study: Atanga Health Center III in Pader District in Northern Uganda in September 2012. Methodology: We recruited consecutively 10 children with probable Nodding Syndrome who had been admitted for symptomatic management of seizures, injuries resulting from falls and nutritional rehabilitation. History, physical examinations, biophysical measurements (anthropometry) and blood investigations including serum electrolytes, liver function tests, thyroid hormones and vitamin D assays. Ethical approval was obtained from Gulu University Institutional Review Committee. Results: All children had severely low serum calcium and bicarbonate levels and a high Anion Gap. Thyroid hormones and vitamin D assays were largely normal. Conclusion: Children with Nodding Syndrome undergoing treatment for seizure control and nutritional rehabilitation have high Anion Gap metabolic acidosis. Original Research Article British Journal of Medicine & Medical Research, 4(6): 1301-1314, 2014 1302

Cohort profile: mental health following extreme trauma in a northern Ugandan cohort of War-Affected Youth Study (The WAYS Study).

War experiences are associated with the risk of long-term mental health problems. The War-affected Youths (WAYS) Study comprises a cohort of 539 youths (61% female) aged between 18 to 25 (at baseline) randomly sampled from the population of war-affected youths in northern Uganda. The study aims to chart the trajectory of long-term mental health consequences of war and the roles of individual, family, and community contextual risk and protective factors in influencing the course of mental health using Social Ecology Model, thus, addressing both the individual and its social ecology. Knowledge of postwar contexts may inform policy and guide interventions on postwar psychosocial adjustment and reintegration in conflict-prone Great Lakes region of Africa (Rwanda, Burundi, DR Congo, Uganda, Central African Republic, and South Sudan). Two waves of data collection have been conducted and more data collection is planned. At baseline, information on demographic characteristics, pre-war experiences, psychosocial outcomes, coping, stigma/discrimination, family and community acceptance and relationship, family functioning, and post-war experiences were obtained. At follow-up, information on general health, gender-based violence, PTSD, social skills, trauma memory quality, rumination, self-esteem, and psychosocial outcomes were collected. Approval to access the data can be obtained on application to the Principal Investigator upon submission of a research proposal with ethical approval from the applicant's institution. This research is funded by Wellcome Trust and Gulu University.

ISS outreach Sub-Saharan Africa insight: Uganda 2011

IntroductionUganda has a vibrant radiology organization and this wasexplored with the result of an outreach effort being directedto Uganda. An outreach activity was organized in collabo-ration with the Association of Radiologists of Uganda(ARU) at the campus of Makerere University School ofMedicine from 8–10 September 2011.Uganda is a landlocked country in East Africa withKenya on its eastern border, the Democratic Republic ofthe Congo to the west, Southern Sudan to the north, Rwandato the southwest, and Tanzania to the south. Lake Victoria,which is also shared by Kenya and Tanzania, lies to thesouth. Uganda with a population of 36 million is multi-tribalincluding the Baganda (16.9%), Banyakole (9.5%), Basoga(8.4%), Bakiga (6.9%), Iteso (6.4%), Langi (6.1%), Acholi(4.7%), Bagisu (4.6%), Lugbara (4.2%), Bunyoro (2.7%),and others (29.6%) [1].Uganda has a literacy rate of about 74%. The averageexpenditure on health is 8.2% of the GDP and per capitaincome is $1,317 [1, 2]. The physician density is about 0.12per 1,000 and the hospital bed density is 0.4 per 1,000.Infant mortality rate is 63 per 1,000. The average life ex-pectancy is 53.45 years (52.4 men and 54.54 female) [1].Medical educationThere are five medical schools in Uganda; namely, Makerereuniversity in the capital city Kampala, Mbarara university inthe western region, Gulu university in the northern region,Busitema university in the central region, Kampala interna-tional university, Kampala in the central region and anothercampus in the western region and Nsambya in the centralregion. The first three are government owned while the othertwo are private. Medical school training is modeled after theBritish system where medical school is 5 years of trainingafterhighschool.Graduationisfollowedby1yearofrotatinginternshipinthecoreclinicaldisciplinesofmedicine,surgery,obstetrics and gynecology, and pediatric. Postgraduate train-ing in radiology comprises 3 years of training leading up to amasters degree in radiology. Makerere and Mbarara NationalReferralandTeachinguniversitiesaretheonlyonesofferingamaster of medicine degree in diagnostic radiology.Master of Medicine in Diagnostic Radiology takes 3 years.The training modes include lectures, tutorials, practicals,course work, research and assessment. The assessment entailsoral, practical and theory examinations. The course units areRadiological Physics, Photography, Radiological Anatomy,Special Radiological Techniques, Clinical Radiology, ClinicalCase Description, Nuclear Medicine and Radio-oncology,Interventional Radiology, Obstetric and Gynecology, SmallParts and Musculoskeletal Ultrasound, Teleradiology andComputer Science, Epidemiology and Biostatistics, HealthSystem Management and Research Methodology. VirtuallyalltheradiologistsinUgandatrainedlocally,withafewhavingelectives in Germany and Macmaster University in Canada.The government subsidizes health care by providing freehealth facilities for the population at the government ownedhospitals and clinic, but these are grossly inadequate. Largesegments of the population have to provide their own healthcare. The ratio of individual expenditure on health to

Structural validity and reliability of the integrated conflict and violence scale

The study validated structure stability, reliability and sub-scale distinctiveness of integrated conflict and violence scale (ICVS) and was cross-sectional; war-affected grade 5 school children participated. ICV internal factorial validity and reliability were evaluated; eigenvalue size and scree plots were used for factor selection. A variable retention factor load threshold of >0.30 was used: Cronbach's α tests confirmed reliability increments. Pair-wise Pearson correlation tests evaluated sub-scale distinctiveness. Gulu University granted ethical clearance. A total of 280 grade 5 children from 50 primary schools participated: 53% of them were males. Two factors accounted for 100% of variability in attitudes; 18 variables were retained. Expelled variables were: ‘If I catch some one stealing my sugar cane I will fight’ and ‘a bully should be forgiven’. Sub-scale internal consistency reliability coefficients were 0.73 and 0.65, respectively and distinctiveness correlation coefficient was −0.06. The ICVS was validated using standard criteria. Emerging two-factor scale has acceptable psychometric properties especially factorial structure, internal consistency and sub-scale distinctiveness.