Background: Cancer burden in sub-Saharan Africa is on the rise with one-third of cancers estimated to be caused by infectious agents. Head and neck squamous cell cancer (HNSCC) is the sixth most common malignancy in sub-Saharan Africa and includes tumors in the Upper Aero-digestive Tract (UADT). The established risk factors are tobacco and alcohol exposure with a recent recognition of the role of Human Papilloma Virus (HPV). The HPV related HNC is seen predominantly in the oropharynx, presents at a younger age and has a better prognosis. With a rapidly increasing incidence of these cancers in the developed world, it was important to study HPV in HNC in Uganda. The HPV can be detected using P16 immunohistochemistry as a surrogate marker thus making it suitable for screening. The study aimed at establishing the presence of HPV and the commonly affected sites in UADT squamous cell carcinoma (SCC) at Uganda Cancer Institute (UCI) using P16 immunohistochemistry. Methodology: This was a cross sectional study in which 59 patients with histologically proven SCC from the oral cavity, oropharynx, larynx and hypopharynx were recruited. These patients' demographics and clinical data were collected. Tissue sections from retrieved histology samples were stained by Haematoxylin and Eosin to reconfirm SCC. Subsequently, P16 expression was determined using P16 immunohistochemistry. Results: Seventy-one patients were enrolled and 59 patients with confirmed SCC of the sites of interest were analyzed. The majority (79.7%) of the participants were male and over 50 years. 59.3% were tobacco smokers, 66.1% used alcohol, 52.2% used both. Only 27.1% used none of the substances. Only 27.1% of the participants were HIV positive. Most of the tumors were in the larynx (37.3%) and 64.4% were overall TNM stage 4. The overall prevalence of HPV in UADT SCC at UCI was 20.3, 95%CI 10.9-32.8. The oropharynx had the highest prevalence (30.8%). Conclusion: The prevalence of HPV in UADT SCC at UCI is significant at 20.3%. The most affected site, is the oropharynx. Vigilant HPV screening of these sites with confirmation where possible is recommended.

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Hearing impairment is a significant disability. According to the World Health Organization (WHO), more than 80% of the world's approximately 120 million people with hearing impairment live in developing countries. Cochlear implant is the only therapeutic intervention for those with severe-profound sensorineural hearing loss. We are reporting an interesting case of the very first cochlear implant operation carried out in Uganda. The patient was a 23 year old male whose presenting complaint was inability to hear in the left ear for three and a half years and in the right ear for one year. He had been treated for TB(Tuberculosis) mastoiditis . After the 8 months of treatment, the otorrhea persisted and he underwent a tympanomastoidectomy on the same ear. He reported no familial history of hearing loss. On examination, ENT examination revealed a small pars flaccida retration pocket of the right tympanic membrane with cholesteatoma. The left ear had an intact tympanic membrane. Pure tone audiometry revealed profound sensorineural hearing loss in both ears( see attached PTA results), CT scan of the temporal bone showed normal inner ear anatomy bilaterally and mild sclerotic changes in both mastoid bones. He then had surgery on his right ear which included cochlear implantation. The cochlear implant (CI) was activated on the first postoperative day remotely via internet with the help of the cochlear implant team at New York University Cochlear Implant Center and the patient was immediately able to appreciate some sounds. He received a pneumococcal vaccine on the first postoperative day and was discharged the following day.

<p class="abstract"><strong>Background:</strong> A case control was carried out to study the prevalence, the pattern and associated factors of hearing loss among Ugandan children with sickle cell anaemia.</p><p class="abstract"><strong>Methods:</strong> One hundred and thirty-two children known sickle cell and one hundred thirty aged matched non-SCA controls were recruited after medical ethics committee approval and informed consent. Two obtain information on socio-demographic characteristics, history, and examination of the participants, a structured questionnaire was administered. Pure tone audiometry (PTA) was used to assess the hearing in a sound-treated room.  </p><p class="abstract"><strong>Results:</strong> Twenty-two of the children had hearing impairment compared to 6 controls. Prevalence of hearing loss found among children with SCA was 17% but in the control group the prevalence found was 5%. Sensorineural hearing loss (SNHL) affected 39%, conductive (CHL) 25% and mixed (MHL) 14% among cases compared to CHL 7%, SNHL 7% and MHL 7% among the controls. The hearing loss varied from mild to moderate (95%). All sickle cell children had high-frequency hearing loss. There was a statistically significant association of hearing loss and neurologic motor deficit.</p><p class="abstract"><strong>Conclusions:</strong> Sickle patients are at risk of developing hearing loss as the study demonstrated a difference in hearing threshold in children living with sickle cell anaemia and the controls. High frequencies were more affected. The neurologic motor deficit was highly associated with hearing loss among patients with SCA compared to controls.</p>

Background Otitis media with effusion (OME) is common in children aged between 6 months to 4 years, and it is one of the causes of hearing loss (HL) in children worldwide. OME is a type of inflammation of the middle ear in which there is collection of the fluid. The later causes HL which interferes with speech and language development, communication skills, school performance, psychosocial skills, and quality of life of children. Methods This was a prospective cross-sectional study on 246 children aged 2 -12 years, attending Mulago National Referral Hospital (MNRH). Consecutive sampling procedure was used to reach each participant under ethical considerations until the sample size was reached. All children aged 2-12 years who meeting inclusion criteria were examined first by the Paediatrician and then by the Principal Investigator. Patients who had diagnosis of OME following the otoscopy and tympanometry findings were then proceed for audiological assessment. Prevalence of OME was summarized as a proportion and multivariate analysis was used to determine the factors associated with OME. Data was analyzed using STATA version 13.0. Results A total of 246 children were recruited into the study. Of the 246 children, 60% were male. The median age of the participants was 4.8±2.8 years. The prevalence of OME was found to be 11%. Upper respiratory tract infections (URTI), recurrent AOM (p= 0.005, OR:5.14, 95% CI: 1.66-15.96), and snoring (p= 0.000, OR: 6.32, 95% CI: 2.32-17.26) were found to be strongly associated with OME in children aged 2-12 years attending MNRH. Conclusions The prevalence of OME among children 2-12 years attending MNRH was found to be 11%. There is association between OME and URTI, recurrent AOM, and snoring in children aged 2-12 years attending MNRH.