Introduction The first-year post-diagnosis is the most challenging and stressful period in the lifetime of a young child and adolescent living with diabetes, given the adjustments that are meant to be adopted. Therefore, psychosocial factors affecting newly diagnosed children and adolescents need to be well understood and children supported to improve treatment adherence. However, evidence concerning psychosocial experiences among young patients with diabetes is scant in Uganda. This study explores the perceptions and experiences of newly diagnosed children and adolescents in Uganda. Methods A qualitative exploratory design was employed. We recruited participants aged 6 to <18 years diagnosed within twelve months from three study sites: Mulago National Referral Hospital, Wakiso HCIV, and St Francis Nsambya Hospital. Twenty in-depth interviews were conducted, and textual data were analysed thematically using a framework approach. Results We identified five themes: battling with symptoms, emotions at diagnosis, challenges in coping with diabetes management, changes I have made, and positive outcomes registered. The analysis found that young people living with diabetes experience a new world of adjustments, including insulin therapy, routine blood glucose monitoring, and dietary changes that are often difficult to deal with, especially in the first year after diagnosis. Discussion Continuous psychosocial support to newly diagnosed young children and adolescents with T1DM is vital. Addressing psychosocial challenges may improve adherence to treatment regimens. Conclusion Our findings have demonstrated the mixed experiences of newly diagnosed young children and adolescents living with diabetes, from anxiety and stigmatization to independence.
Introduction: The prevalence of obesity among people diag-nosed with Type 2 Diabetes Mellitus (T2DM) has been widely documented. However, the specific composition of this body-weight remains largely unknown. The study aimed to understand the body composition of T2DM patients using the bioelectric impedance analysis technique, comparing findings to sex and age-matched controls. Materials and Methods: A comparative case-control study was carried out among 139 known cases of Type 2 diabetes aged 18 to 78 years randomly sampled from the diabetic clinic of Mbarara Regional Referral Hospital. We matched them to 139 hos-pital controls who were healthy non-diabetic attendants. Body composition parameters were computed and summarized as medi-ans and interquartile ranges. Differences in the medians of body composition parameters were further assessed using the Mann-Whitney U test. Fat-free and fat mass indices were derived to offer a precise estimation of body composition parameters adjusted for height differences among study participants. Results: Cases had significantly higher median systolic blood pressure, pulse rate, weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), total fat percentage, fat mass amount, Fat Mass Index, visceral fat, and metabolic age than their counterparts, whereas controls had significantly higher median total body water percentage versus cases. The highest significant differences occurred in fat percentage composition (Cases: β: 6.9 (95% C.I: 4.4, 9.4); Controls: Ref) followed by visceral fat (Cases: β: 3.5 (95% C.I: 2.5, 4.4); controls: Ref) and Fat Mass Index (Cases: 95% C.I: 2.6 (95% C.I: 1.6, 3.7). Cases had significantly higher Fat Mass Index, visceral fat and fat percentage (all p<0.05) than con-trols. Conclusions: Routine assessment of body composition of T2DM patients needs to be done to assess the amount, type and pattern of weight gain to prevent increases in adiposity.
Background: Given the global urgency to improve tuberculosis (TB) case detection, a renewed interest in active case finding (ACF) has risen. Missed TB cases pose a serious threat as they continue to fuel TB transmission in the community. We aimed to assess the feasibility of community based ACF for TB among people living in a pastoralist community in Uganda and determine its impact on case detection and treatment uptake. Methods: Between April and May 2019, four third year medical and nursing students placed at Moroto Regional Referral for community orientation worked together with community health workers to conduct a door-to-door survey for TB in pastoralist communities of Nadunget Sub County, Moroto district. The community health workers and the Medical/Nursing students performed symptom screening, collected sputum and facilitated specimen transport to the laboratory. Gene Xpert MTB/RIF assay was performed at the regional referral Hospital for all sputum samples. The community health workers were tasked to follow up on all those clients whose samples turned out to be positive so that they could start treatment as soon as possible. All presumptive cases with negative sputum results were referred to the TB clinic for further evaluation. Results: In one month, we screened 385 individuals and identified 143 aged above 15 years with symptoms suggestive of TB. Among the presumptive cases, 132 (92%) reported a cough of more than two weeks and we were able to obtain sputum samples from 84(58.7%) participants. We diagnosed 11, including 8 bacteriologically confirmed TB cases using Gene Xpert and there was no multidrug resistant case identified. The median time from sputum collection to notification of the positive result was 3 days. All the positive cases were followed up and initiated on treatment. Conclusion: The findings from our study suggest that in a pastoralist community, ACF for TB using a sensitive symptom screen followed by Gene Xpert contributed to improved case detection of TB, shortening the turnaround time hence timely initiation of patients on TB treatment.
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