Determinants of Primary Pyomyositis in Northern Uganda
David Lagoro Kitara *
Department of Surgery, Faculty of Medicine, Gulu University, Gulu, Uganda.
Paul Okot Bwangamoi
Department of Pharmacy, Faculty of Medicine, Gulu University, Gulu, Uganda.
Henry Wabinga
Department of Pathology, College of Health Sciences, Makerere University, Uganda.
Michael Odida
Department of Pathology, College of Health Sciences, Makerere University, Uganda.
*Author to whom correspondence should be addressed.
Abstract
Aim: To describe the determinants of primary pyomyositis in Northern Uganda.
Study Design and Setting: A case-control and a cohort study designs were conducted in Hospitals in Northern Uganda.
Methods: Primary pyomyositis patients were consecutively recruited and followed to discharge. Controls had minor trauma and were age and sex matched with cases. Patients were admitted, investigated (clinical features, imaging, hematology, clinical chemistry and histology from muscle biopsy); managed surgically and followed up to discharge. Those that did not meet the inclusion criteria for diagnosis histologically were excluded. Ethical approval was obtained from Gulu University IRB.
Results: The determinants of primary pyomyositis were: HIV positivity with low CD4 counts (<250 cells/ml) (χ2=11.748; p<0.001; aOR 11.292 at 95% CI (0.698,182.707) (p=0.088)); clinical features of immunosuppression/AIDS (χ2=12.70; p<0.001; aOR 6.50 at 95% CI (0.000,2.500) (p=0.850)); High serum creatinine level (χ2=20.191; p<0.001; aOR 6.070 at 95% CI (0.289,127.545) (p=0.317)) and Low serum albumin (malnutrition) (χ2=103.247; p<0.001; aOR 226.004 at 95% CI (13.449, 3797.786) (p<0.001)).
Conclusion: The determinant of primary pyomyositis was low serum albumin (malnutrition) while clinical features of immunosuppression/AIDS, high serum creatinine level and HIV positivity with low CD4 counts were risk factors but not independent predictors of this disease.
Keywords: Determinants of primary pyomyositis, clinical presentations, Gulu, Uganda