BackgroundWorldwide, the burden of chronic rhinosinusitis (CRS) is variable, but not known in Uganda. CRS has significant negative impact on quality of life (QOL) and as such QOL scores should guide adjustments in treatment strategies. However, most of these studies have been done in the west. Our hypothesis was that QOL scores of the majority of CRS patients in low- to- middle income countries are poorer than those among patients without CRS. The aim of this study was to determine the burden of CRS among patients re-attending the Otolaryngology clinic and whether CRS is related to poor QOL.MethodsA cross sectional study was conducted at Mbarara Regional Referral Hospital Otolaryngology clinic. One hundred and twenty-six adult re-attendees were consecutively recruited. Data was collected using a structured questionnaire and the Sinonasal Outcome Test 22 (SNOT 22) questionnaire measured QOL.ResultsThe proportion of re-attendees with CRS was 39.0% (95% CI 30–48%). Majority of CRS patients had poor quality of life scores compared to non-CRS (88% versus 20% p < 01). The poor quality of life scores on the SNOT 22 were almost solely as a result of the functional, physical and psychological aspects unique to CRS.ConclusionsCRS is highly prevalent among re-attendees of an Otolaryngology clinic at a hospital in resource limited settings and has a significant negative impact on the QOL of these patients.
None of the most common types of deletions in the GJB2 gene (c.35delG, c.167delT or c.235delC) were found in this large cohort of deaf children from Uganda. This prompts a search for genetic causes of deafness among this and other previously studied African populations.
BackgroundThe Uganda Hearing Project is a non-profit program assisting with teaching of ear surgery in Uganda. The project started with cadaveric temporal bone courses in 2003 and 2005, including donation of operating microscopes and ear instruments. In 2006, three surgical groups started regular surgical teaching visits.MethodsA retrospective chart review of all cases of middle ear surgery performed in Uganda from 2003 to 2009. Surgeries by local surgeons without foreign presence were coded as ‘local’ and those performed with assistance of visiting surgeons were coded as ‘visitors’.ResultsIn 2005, two middle ear surgeries using the operating microscope were done in the Ugandan teaching hospitals by Ugandan Otolaryngologists alone. From the onset of surgical visits in 2006, a total of 193 middle ear surgeries were performed - 115 tympanomastoidectomies, 77 tympanoplasties, and 1 cochlear implant. In 2006 (one surgical teaching visit), 6 middle ear surgeries were performed with visiting surgeon presence and 2 surgeries were performed by the local team alone. This increased in 2007 (2 visits) and again in 2008 (3 visits) to 34 cases with visiting surgeon presence and 48 local cases.ConclusionsThe temporal bone courses and donation of operating microscopes to Ugandan hospitals have revolutionized middle ear surgery in Uganda. The surgical visits by the Uganda Hearing Project have led to a 24-fold increase in annual middle ear surgeries performed with the operating microscope by Ugandan Otolaryngologists. Increased frequency of surgical visits was correlated with an increase in local surgical output, hopefully resulting in improved care for Ugandans with ear disorders.
A 6-year-old girl was referred to the ENT (Ear nose and throat) unit at Mulago National Referral Hospital with a foreign body in the esophagus diagnosed by routine chest radiograph. The child's parents recall she had ingested a round object (galvanised iron umbrella cap of a roofing nail) two years prior to this, but they thought that the child had passed it out in stool since she had continued eating and swallowing normally. On arrival at the National referral hospital, the child had two esophagoscopies done but the foreign body was not seen, not until a barium swallow was done was it confirmed that the FB(foreign body) had perforated the esophagus and entered the mediastinum. The cardiothoracic surgeons were consulted, and they removed the foreign body via a thoracotomy. The child recovered well and was discharged from hospital on day 55.
BackgroundAerodigestive foreign bodies (ADFB) in children are a common emergency in ENT clinics globally. The aim of this study was to determine the prevalence and common types of ADFB’s presenting to a referral hospital in South Western Uganda, and to review clinical presentation and factors that influence their occurrence among children under 12 years of age.MethodsWe conducted a case control study comprising 40 cases and 80 unmatched controls. Consecutive and random sampling were used for the cases and controls respectively. A questionnaire was used to collect data. Clinic records were reviewed to calculate prevalence.ResultsPrevalence was 6.6 % of all paediatric cases seen in the ENT department that year. The most common symptoms included: history of choking [45 %], sudden cough [72.5 %], stridor [60 %] and failure to swallow [35 %]. The most common location for an airway foreign body was the right main bronchus [40 %] and the upper one third of the oesophagus [32.5 %] for digestive tract foreign bodies. Seeds and coins were most frequently removed. Children from upper level SES had a significantly lower risk of foreign body occurrence [OR = 0.29, p = 0.02] compared to those from a low SES. Also significantly, most cases were referrals from other government health centres [p = <0.01]. The male to female ratio among cases was 2:1. Children of older mothers were less likely to have an ADFB.ConclusionPrevalence of ADFB’s is relatively high. The most common symptoms are a history of choking, cough and failure to swallow. Age under 5 years, male sex, younger maternal age and low socioeconomic status increased odds of ADFBs.
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