Department of Internal Medicine

Permanent URI for this collection

https://bdears.busitema.ac.ug/handle/123456789/9628

Browse

Recent Submissions

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Prevalence, patterns and factors associated with abnormal lung function among mycobacterium tuberculosis survivors in Mbale regional referral hospital, Uganda.
    (Busitema University, 2026) Lume, Ivan
    Background: Tuberculosis (TB) remains the leading cause of death from a single infectious disease, with Africa contributing substantially to the global burden. Although improvements in early diagnosis and treatment have increased treatment success rates, a considerable proportion of TB survivors develop persistent respiratory impairment, including abnormal lung functionafter completion of treatment. Objectives: To determine the prevalence, patterns and factors associated with abnormal lung functions among TB survivors managed at Mbale Regional Referral Hospital (MRRH), between January 2020 and December 2024. Methods: We conducted a cross-sectional study among 309 TB survivors managed at MRRH. Sociodemographic and clinical data were extracted from medical records. Lung function was assessed using pre- and post-bronchodilator spirometry to determine forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and spirometry patterns were classified as obstructive, restrictive, mixed, or normal. Data were analysed using Stata 17. Bivariate and multivariable analyses were performed using modified Poisson regression to identify factors associated with abnormal lung function. Results: Most participants were male, 176 (57.0%), and the mean age was 42.0 years (SD 12.2). Overall, the prevalence of abnormal lung function was 163 (52.8%). The most common spirometry abnormality was an obstructive pattern, 88 (28.5%), followed by a restrictive pattern, 62 (20.1%), and a mixed pattern, 13 (4.2%). In multivariable analysis, outpatient status at the time of TB diagnosis (aPR 1.34; 95% CI: 1.05–1.71; p=0.021), rural residence (aPR 1.34; 95% CI: 1.06–1.69; p=0.015), exposure to biomass fuel (aPR 1.58; 95% CI: 1.06–2.35; p=0.024), and having more than one previous episode of TB (aPR 1.41; 95% CI: 1.08–1.83; p=0.011) were significantly associated with abnormal lung function. Conclusion: Abnormal lung function was common among TB survivors at MRRH, affecting more than half of the study participants. Obstructive lung function abnormality was the predominant spirometry pattern. Outpatient status at TB diagnosis, rural residence, biomass fuel exposure and recurrent TB were independently associated with abnormal lung function. These findings highlight the need for structured post-TB respiratory follow-up, including spirometry screening and targeted interventions for high-risk survivors.
  • No Thumbnail Available
    Item
    Prevalence and factors associated with abnormal lung function among adolescents and adults aged 12 years and above with sickle cell disease in eastern Uganda : a cross-sectional study.
    (Busitema University, 2026) Achiro, Kevin
    Background: Sickle Cell Disease (SCD) is the most prevalent genetic condition in the world caused by a mutation in the beta-globin gene. The lungs are among the progressively damaged organs by this condition. The majority of research conducted in Africa is restricted to younger individuals with SCD, and yet there is a downward trajectory in lung function with age. Due to advancements in care, many young people with SCD are living into adulthood, and therefore, it's critical to comprehend the anomalies in lung function that these individuals experience. Aim: This study aimed to determine the prevalence, patterns, and factors associated with abnormal lung function among adolescents and adults aged 12 years and above with SCD in Eastern Uganda. Methods: This was a hospital-based cross-sectional study conducted among 228 individuals with SCD aged ≥12 years attending the Sickle Cell Clinic (SCC) at Mbale Regional Referral Hospital (MRRH). The inclusion criteria were individuals with SCD aged 12 years and above who provided informed consent or assent, as appropriate. Exclusion criteria included those who were critically ill, had musculoskeletal disorders capable of influencing lung function, verified cases of pneumonia, pulmonary tuberculosis, or any other respiratory illness being treated or diagnosed at the time of enrollment. Lung function was assessed using spirometry. Sociodemographic and clinical data were collected using a pretested questionnaire. Data were analysed using R version 4.5.2. Descriptive statistics summarised participant characteristics and spirometric patterns. Prevalence was estimated with 95% confidence intervals, and logistic regression was used to identify factors associated with abnormal lung function. ORs, aORs, 95% confidence intervals, and p-values were reported; p < 0.05 was considered statistically significant. Results Of 228 enrolled participants, 218 with valid spirometry were analysed. The median age was 17 years (IQR 14–22), 53.2% were male, 70.6% had a history of recurrent acute chest syndrome, and 92.7% were receiving hydroxyurea therapy. The prevalence of abnormal lung function was 47.2% (103/218; 95% CI: 40.7–53.9%). Restrictive lung pattern was the most common abnormality (48.5%), followed by obstructive pattern with reversibility (26.2%). In multivariable analysis, Haemoglobin levels showed the strongest association, with moderate anaemia (aOR 6.04, 95% CI 2.26 to 16.15, p < 0.001) and severe anaemia (aOR 13.99, 95% CI 4.98 to 39.28, p < 0.001) having higher odds than mild or normal haemoglobin. Each additional year of age was associated with 9% higher odds of abnormal lung function (aOR 1.09, 95% CI 1.02 to 1.17, p = 0.009; likelihood ratio test for age p = 0.007) and non-use of hydroxyurea (aOR: 3.54; 95% CI: 1.01–12.49; p = 0.049) were independently associated with abnormal lung function. Conclusion Adolescents and adults with SCD frequently have impaired lung function, with a restrictive spirometric pattern being the most common. Significant predictors included growing older, anaemia, and non-use of hydroxyurea. Pulmonary outcomes may be improved by routine lung function evaluation, proper management of anaemia, and optimisation of disease-modifying treatment.