Unexpected Huge Prevalence of Intracardiac Extension of Wilms Tumor-A Single Center Experience from a Ugandan Hospital.

Wilms tumor (WT) is the most common primary renal malignancy in young children. WT vascular extension to the inferior vena cava (IVC) occurs in 4-10% of cases and can reach the right atrium (RA) in 1%. Data on WT clinical presentation and outcome in developing countries are limited.

A protocol to clinically evaluate liquid biopsies as a tool to speed up diagnosis of children and young adults with aggressive infection-related lymphoma in East Africa "(AI-REAL)".

Background: The capacity for invasive tissue biopsies followed by histopathology diagnosis in sub-Saharan Africa is severely limited. Consequently, many cancer patients are diagnosed late and outcomes are poor. Here, we propose to evaluate circulating tumour (ct) DNA analysis ("liquid biopsy"), a less invasive and faster approach to diagnose endemic EBV-driven lymphomas (EBVL) in East Africa.

Estimating the Risk of Maternal Death at Admission: A Predictive Model from a 5-Year Case Reference Study in Northern Uganda.

Background: Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda.

Methods: This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019.

Plasma EBV DNA: A Promising Diagnostic Marker for Endemic Burkitt Lymphoma.

Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in regions of equatorial Africa where malaria is holoendemic. The tumor is consistently associated with Epstein-Barr virus (EBV). Screening for EBV DNA in plasma in a high-risk population in Hong Kong has been shown to be useful in facilitating the early diagnosis of nasopharyngeal carcinoma, another EBV-associated tumor.

Evidence of Artemisinin-Resistant Malaria in Africa.

Background: In the six Southeast Asian countries that make up the Greater Mekong Subregion, has developed resistance to derivatives of artemisinin, the main component of first-line treatments for malaria. Clinical resistance to artemisinin monotherapy in other global regions, including Africa, would be problematic.

Methods: In this longitudinal study conducted in Northern Uganda, we treated patients who had infection with intravenous artesunate (a water-soluble artemisinin derivative) and estimated the parasite clearance half-life.

Is Gastric Involvement by Strongyloides stercoralis in an Immunocompetent Patient a Common Finding? A Case Report and Review of the Literature.

Purpose: Gastric infection with Strongyloides stercoralis (SS) usually occurs in immunocompromised patients. The unexpected observation of this parasite in an otherwise healthy young lady who had undergone upper endoscopy and biopsy sampling of the gastro-duodenal mucosa, prompted us to review the literature to ascertain the conditions favouring gastric colonization by SS.

Methods: Pathology files of gastroduodenal biopsies received at St.

Cango Lyec (Healing the Elephant): Chronic Hepatitis B Virus among post-conflict affected populations living in mid-Northern Uganda.

Background: The legacy of war in Northern Uganda continues to impact people's health and wellbeing in the Acholi region. Despite increasing attention to Hepatitis B Virus (HBV) in Uganda and globally, concerns remain that unique drivers of infection, and barriers to screening, and treatment, persist among those affected by conflict.

Methods: Cango Lyec (Healing the Elephant) cohort survey involved conflict-affected adults aged 13-49 in three mid-Northern Uganda districts (Gulu, Amuru and Nwoya).

Tetanus in a rural low-income intensive care unit setting.

Tetanus is a potentially severe but preventable infection. In resource-rich settings, vaccination programmes have reduced tetanus to a rare disease, though still carrying an overall mortality of some 13%. However, in low-income settings, tetanus remains common, and is a significant cause of mortality-though major World Health Organisation programmes are successfully targeting neonatal and maternal disease.

Why women die after reaching the hospital: a qualitative critical incident analysis of the 'third delay' in postconflict northern Uganda.

Objectives: To critically explore and describe the pathways that women who require emergency obstetrics and newborn care (EmONC) go through and to understand the delays in accessing EmONC after reaching a health facility in a conflict-affected setting.

Design: This was a qualitative study with two units of analysis: (1) critical incident technique (CIT) and (2) key informant interviews with health workers, patients and attendants.

Setting: Thirteen primary healthcare centres, one general private-not-for-profit hospital, one regional referral hospital and one teaching hospital in northern Uganda.

Incidence of male breast carcinoma in North Uganda: A survey at Lacor Hospital, Gulu, during 2009-2016.

Background: Little information is available on male breast cancer (MBC) incidence from sub-Saharan Africa.

Objective: This is a retrospective study on MBC in rural North Uganda, based on the pathology records of a private, non-profit, missionary hospital.

Methods: All male patients that had histological diagnosis of breast carcinoma from January 2009 to December 2016 were included in this study.

Prostate hyperplasia in St Mary's Hospital Lacor: utility of prostate specific antigen in screening for prostate malignancy.

Introduction: Prostate cancer is the second commonest cancer in men worldwide. At present, every patient with lower urinary tract symptoms (LUTS) in St. Mary's Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level.

Ex vivo susceptibility of Plasmodium falciparum to antimalarial drugs in Northern Uganda.

In Uganda, artemether-lumefantrine was introduced as an artemisinin-based combination therapy (ACT) for malaria in 2006. We have previously reported a moderate decrease in ex vivo efficacy of lumefantrine in Northern Uganda, where we also detected ex vivo artemisinin-resistant Plasmodium falciparum. Therefore, it is necessary to search for candidate partner alternatives for ACT.

Neonatal small bowel perforation in ileal atresia in a low resource setting: A case report.

Jejunoileal atresia is a common cause of neonatal intestinal obstruction with high mortality and morbidity in a low resource setting where surgical care is lacking. Herein, a 4-day-old presented with features of acute abdomen and septicemia, managed with ileostomy diversion, and recovered uneventfully.

Prevalence and predictors of work-related musculoskeletal disorders among workers of a gold mine in south Kivu, Democratic Republic of Congo.

Background: Work-related musculoskeletal disorders (WRMSDs) are a major constraint to worker performance and health. However, research on their prevalence and associated factors among workers at gold mines in the Democratic Republic of Congo (DRC) is insufficient. The present study aimed to determine the prevalence and predictors of WRMSDs among workers of a Gold Mine in South Kivu, DRC.

Neonatal tetanus in St. Mary's Hospital Lacor: A case report.

Umbilical stump sepsis in a nonpassively immunized neonate poses a high risk to neonatal tetanus. Management of neonatal tetanus is still a great challenge in resource-limited settings where some health facilities lack tetanus toxoid containing vaccines, ventilator support, and inaccessibility of tetanus immunoglobulin.

Hepatitis B and HIV coinfection in Northern Uganda: Is a decline in HBV prevalence on the horizon?

Background: The available data concerning hepatitis B virus (HBV) infection in Uganda are limited, particularly in the case of people living with HIV/AIDS (PLWH). HBV is not routinely tested when starting antiretroviral therapy (ART). We aimed to determine the prevalence, the correlates of the risk of HBV infection, and the association with outcomes of ART among PLWH attending a busy HIV clinic in a referral hospital in Northern Uganda.

Prevalence of HIV-associated esophageal candidiasis in sub-Saharan Africa: a systematic review and meta-analysis.

Background: Esophageal candidiasis (OC) is a common AIDS-defining opportunistic infection. Antiretroviral therapy (ART) reduces the occurrence of OC and other opportunistic infections among persons living with HIV (PLHIV). We sought to determine and compare the prevalence of OC in the ART and pre-ART era among PLHIV in sub-Saharan Africa (SSA).

Intensive-care management of snakebite victims in rural sub-Saharan Africa: An experience from Uganda.

Background: Antivenom is rarely available for the management of snakebites in rural sub-Saharan Africa(sSA).

Objectives: To report clinical management and outcomes of 174 snakebite victims treated with basic intensive-care interventions in a rural sSA hospital.

Methods: This cohort study was designed as a retrospective analysis of a database of patients admitted to the intensive care unit (ICU) of St.

Cango Lyec (Healing the Elephant): HIV incidence in post-conflict Northern Uganda.

Background: Civil war in Northern Uganda resulted in widespread atrocities, human rights violations, and death, and caused millions to flee to internally displaced persons camps. War-related traumas combined with difficulties accessing HIV prevention and health services has led to extreme HIV-related vulnerability among conflict-affected people who survived the war. Objectives were to (1) determine HIV incidence among conflict-affected people in Northern Uganda and (2) identify vulnerabilities associated with HIV infection.

Recovery and stable persistence of chloroquine sensitivity in Plasmodium falciparum parasites after its discontinued use in Northern Uganda.

Background: Usage of chloroquine was discontinued from the treatment of Plasmodium falciparum infection in almost all endemic regions because of global spread of resistant parasites. Since the first report in Malawi, numerous epidemiological studies have demonstrated that the discontinuance led to re-emergence of chloroquine-susceptible P. falciparum, suggesting a possible role in future malaria control.

Thirty-day postoperative outcome of patients with non-traumatic gastroduodenal perforations in southwestern Uganda.

We studied our 30-day postoperative outcomes in patients with non-traumatic gastroduodenal perforation (NTGDP) in Mbarara Regional Referral Hospital, southwestern Uganda. We conducted a one-year prospective study of patients who underwent exploratory laparotomy for suspected NTGDP between June 2016 and July 2017. Twenty-nine patients had NTGDP, the male-to-female ratio was 3:1 and median age was 60 years (range = 13-80 years).

Mothers' perceptions of the practice of kangaroo mother care for preterm neonates in sub-Saharan Africa: a qualitative systematic review protocol.

Objective: The objective of this review is to explore the experiences of mothers with the practice of kangaroo mother care (KMC) for preterm neonates at home in sub-Saharan Africa.

Introduction: About 7000 newborn babies die every day around the world. About 80% of these deaths occur in sub-Saharan Africa and southern Asia.