Purpose Hypothyroidism has been reported at a prevalence of 6% in children and adolescents with Sickle cell anemia. In this study, we determined the prevalence and factors associated with hypothyroidism among children with Sickle cell anemia attending the Sickle Cell Clinic, in Mulago hospital, Uganda. Methods A cross-sectional study was conducted among children aged 6 months − 17 years with a confirmed diagnosis of Sickle Cell Anemia, with no prior diagnosis of hypothyroidism and in steady state attending the Sickle Cell Clinic in Mulago hospital. Data was collected using a structured questionnaire and a blood sample was used to measure thyroid stimulating hormone and free thyroxine. Results Of the 332 children enrolled, sixty (18.1%) participants had sub-clinical hypothyroidism (95% CI: 14.3 — 22.6). Factors associated with hypothyroidism included constipation [adjusted odds ratio: 3.1, 95% CI:1.0 — 9.0, p = 0.043] and male sex [adjusted odds ratio:2.0, 95% CI:1.1— 3.5, p = 0.025]. Conclusion Approximately 1 in 5 children (18.1%) had sub-clinical hypothyroidism. Males and children who presented with constipation were more likely to have sub-clinical hypothyroidism.
Background Sickle cell anemia (SCA) leads to chronic end organ damage including the thyroid gland. This is postulated to be due to recurrent hemolysis leading to iron overload, vaso - occlusive crises, micro-vasculature obstruction due to red cell entrapment and frequent transfusions. Hypothyroidism has been reported at a prevalence of 6% in children and adolescents with SCA. Hypothyroidism may affect brain and physical development. In this study, we determined the prevalence and factors associated with hypothyroidism among children with SCA attending the Sickle Cell Clinic (SCC), Mulago hospital in Uganda. Methods A cross-sectional study was conducted among children aged 6 months − 17 years with a confirmed diagnosis of SCA, no prior diagnosis of hypothyroidism and in steady state attending the SCC in Mulago hospital. Data was collected using a structured questionnaire and a blood sample obtained was used to measure thyroid stimulating hormone (TSH) and free thyroxine (FT4). Clinical hypothyroidism was defined as TSH level > 9 mIU/L and free T4 < 0.6 ng/dL [primary hypothyroidism] or normal or low TSH level and free T4 < 0.6 ng/dL [central hypothyroidism]. Sub-clinical hypothyroidism was TSH ranging between 4.5 and10 mIU/L with normal age appropriate free T4 levels. Multivariate logistic regression models were constructed to determine the factors associated with hypothyroidism. A p < 0.05 was considered significant. Results Of the 332 children enrolled, 50.3% (167/332) were female; median age (IQR) was 6 (3–10) years. Sixty (18.1%) participants had hypothyroidism (95% CI: 14.3 — 22.6) and all the 60 had sub-clinical hypothyroidism. Factors associated with hypothyroidism included constipation [aOR: 3.1, 95% CI:1.0 — 9.0, p = 0.043] and male sex [aOR:2.0, 95% CI:1.1— 3.5, p = 0.025]. Conclusions Approximately 1 in 5 children (18.1%) had hypothyroidism. Males and children who presented with constipation were more likely to have hypothyroidism. This suggests that clinicians should screen all children with SCA who present with constipation for hypothyroidism and those found with hypothyroidism should be treated appropriately to improve their growth and quality of life.
Introduction hepatitis B virus (HBV) is one of the commonest causes of acute and chronic liver diseases worldwide. HBV can be transmitted by exposure to infected blood and human secretions through sharp injuries and splashes. Health workers are among the most high-risk groups because they regularly interact with patients. A seroprevalence survey conducted in Uganda in 2014 found a higher prevalence of HBV in Gulu Municipality compared to the rest of Uganda. Methods a cross-sectional study was conducted among health workers in Gulu Regional Hospital. A stratified random sampling was used. Knowledge ratings and Likert scale were used to score knowledge, attitudes and risks of HBV infections in a qualitative assessment. Ethical approval was obtained and SPSS was used for data analysis. A p-value less than 0.05 was considered significant. Results one hundred and twenty-six (126) respondents participated; 65 (51.6%) were male, 80 (63.5%) were aged 20-29 years, 74 (58.7%) were not married, 86 (68.3%) had a work experience of 0-9 years, 64 (50.8%) had good knowledge, 90(71.4%) had positive attitude, 114 (90.5%) had high to very high pre-exposure risks, and 75 (59.5%) had moderate to high exposure and post-exposure risks. There was no significant difference in knowledge ( X 2 = 13.895; p = 0.178) and work experience ( X 2 = 21.196; p = 0.097) among the health workers. Conclusion there is a high pre-exposure, exposure and post-exposure risks of HBV infection among health workers in Gulu Hospital. There is need to augment awareness on HBV infection and design strategies to strengthen and implement infection control measures including HBV vaccination among health workers.
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