Bio

PROF. OBURRA HERBERT O

May 2006 to May 2012   : Chairman, Department of Surgery, University of Nairobi

Sept 2001-2006:Associate Professor of ENT-HN Surgery. Section Head of ENT-HN Surgery, University of Nairobi

Educational Background And Academic/Professional Qualifications

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Publications


2015

Irungu, CW, Oburra HO, Ochola B.  2015.  Prevalence and Predictors of Malnutrition in Nasopharyngeal Carcinoma., 2015. Clinical medicine insights. Ear, nose and throat. 8:19-22. Abstract

We assessed the prevalence and predictors of malnutrition in patients with nasopharyngeal carcinoma. Sixty cases and 123 controls matched for age and gender were included. Bio-data, dietary history, height, weight, body mass index (BMI), ideal body weight, and serum albumin levels were recorded. Pretreatment weight loss of >5% was present in 35% of subjects (P < 0.0001). A BMI of < 18.5 kg/m(2) was present in 13.3% (P < 0.001), percent ideal body weight of <90% was present in 30% (P < 0.001), and serum albumin levels <30 g/dL was present in 23.3% (P < 0.001) of cases. Nasopharyngeal carcinoma increased the likelihood of having a BMI < 18.5 kg/m(2) (odds ratio, 9.3 (3.4-25.3) P ≤ 0.001). Logistic regression shows that stage IV disease was associated with a decrease in all parameters except protein-calorie intake. Stage IV nasopharyngeal carcinoma is a predictive marker for weight loss and low serum albumin levels. Nutritional management is important for ensuring the patients' ability to withstand chemoradiation and thus improve survival and quality of life.

2014

Karanja, BW, Oburra HO, Masinde P, Dalton Wamalwa.  2014.  Prevalence of hearing loss in children following bacterial meningitis in a tertiary referral hospital., 2014. BMC research notes. 7:138. Abstract

This study aimed to examine hearing function in a group of children aged between the ages of six months and twelve years admitted with bacterial meningitis so as to determine the prevalence and degree of sensorineural hearing loss in them. This prospective study was conducted in the audiology unit and paediatric wards of Kenyatta National Hospital, KNH.

Menach, OP, Patel A, Oburra HO.  2014.  Demography and histologic pattern of laryngeal squamous cell carcinoma in kenya., 2014. International journal of otolaryngology. 2014:507189. Abstract

Background. Laryngeal squamous cell carcinoma is a common head and neck cancer worldwide. Objective. To determine the demographic characteristics of patients with laryngeal cancer, establish their tumor characteristics and relate it to their smoking and alcohol ingestion habits. Methods. Fifty cases and fifty controls were recruited of matching age, sex, and region of residence. History and pattern of cigarette smoking and alcohol ingestion was taken and analyzed. Results. 33 (66%) of the cases and 3 (6%) among controls were current cigarette smokers. 74% had smoked for more than 30 years, P < 0.0001 OR 21.3 (95% CI: 2.6-176.1). There was a male predominance (96%) and most cases (62%) were from the ethnic communities in the highland areas of Kenya predominantly in Central and Eastern provinces. Very heavy drinkers had increased risk of P < 0.0001 OR, 6.0 (95% CI: 1.957-18.398) and those who smoked cigarettes and drank alcohol had poorly differentiated tumors G3, P < 0.001, OR 11.652 (95% CI 2.305-58.895), and G4, P=0.52 OR 7.286 (95% CI 0.726-73.075). They also presented with advanced disease (73.6%). Conclusion. Cigarette smoking and alcohol ingestion are strong risk factors for development of late stage and poorly differentiated laryngeal squamous cell carcinoma in Kenya.

2013

Karanja, BW, Obura HO, Masinde P, Wamalwa D.  2013.  Risk Factors for Hearing Loss in Children following Bacterial Meningitis in a Tertiary Referral Hospital. Abstractrisk_factors_for_hearing_loss_in_children_following_bacterial.pdf

This study aimed to examine hearing function in children admitted with bacterial meningitis to determine the risk factors for sensorineural hearing loss. Setting. The study was conducted in the audiology unit and paediatric wards of Kenyatta National Hospital. Subjects and Methods. The study involved 83 children between the ages of six months and twelve years admitted with bacterial meningitis. The median age for the children examined was 14. On discharge they underwent hearing testing to evaluate for presence and degree of hearing loss. Results. Thirty six of the 83 children (44.4%) were found to have at least a unilateral mild sensorineural hearing loss during initial audiologic testing. Of the children with hearing loss, 22 (26.5%) had mild or moderate sensorineural hearing loss and 14 (16.9%) had severe or profound sensorineural hearing loss. Significant determinants identified for hearing loss included coma score below eight, seizures, cranial nerve neuropathy, positive CSF culture, and fever above 38.7 degrees Celsius. Conclusions. Sensorineural hearing loss was found to be highly prevalent in children treated for bacterial meningitis. There is need to educate healthcare providers on aggressive management of coma, fever, and seizures due to their poor prognostic value on hearing.

2012

P, M, HO O, A P.  2012.   Cigarette Smoking and alcohol ingestion as risk factors for laryngeal squamous cell carcinoma at Kenyatta National Hospital. . Clinical Medicine Insights 2012. Ear, Nose and Throat . :517:524.
Karuga, G, Oburra H, Muriithi C.  2012.  Risk Factors of Early Complications of Tracheostomy at Kenyatta National Hospital. . East and Central African Journal of Surgery.. 17(1):51-56. Abstract

Background: A tracheostomy is a surgical intervention that can mean the difference between life and death and has been practiced for thousands of years. The aim of this study was to identify risk factors that contribute to complications following tracheostomies. The aim of this study was to establish the determinants of early complications following tracheostomies in Kenyatta National Hospital.
Methods: This was a prospective cohort study carried out at Kenyatta National Hospital. A total of 100 patients undergoing tracheostomy between October 2010 and March 2011 were recruited. Ethical approval was obtained from Kenyatta National Ethics and Research Committee and consent obtained from all patients recruited. Data was analyzed in Stata version 11.0. Association between complications and various patient and surgery characteristics was investigated via a series of univariable and multivariable logistic regression.
Results: The age ranged from one year old to eighty nine years old. In the study, 7/100 patients died, majority secondary to decannulation. Prevalence of intraoperative complications was 23% while that of post operative complications was 42%. Intraoperative haemorrhage was the most common complication (21%). There was increased morbidity of 2% for every year increase in age above the mean and a 31 fold higher risk of complications in patients who had a neck mass.
Conclusion The prevalence of complications following tracheostomies in this study was comparable with the findings from other studies. The study found an increased risk of complications with increased age of the patient and patients with a distorted neck anatomy. The importance of properly trained staff in perioperative care of patients post tracheostomy cannot be over emphasized.

2010

B, O, HO O.  2010.  Hearing disorders in HIV positive adult patients not on anti- retroviral drugs at Kenyatta National Hospital. . East African Medical Journal . 87:570-573. AbstractWebsite

Objectives: To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts.
Design: Case control study.
Setting: comprehensive care clinic (CCC) and voluntary counseling and testing centre at Kenyatta National Hospital.
Subjects: One hundread and ninety four HIV positive patients attending CCC and 124 HIV negative subjects recruited from voluntary counseling and testing (VCT) centre.
Results: Hearing loss (HL) was present in 33.5% of HIV positive compared to 8.1% in negative subjects. No gender bias in HL Sensorineural hearing loss (SNHL) was the most common and the frequencies most ‘affected were four and eight kHz

Conclusion: Hearing loss is more prevalent in HIV positive individuals not on anti - retroviral drugs than negative normal subjects. Low CD4 cell count and advanced HIV diseases were associated with increased chance of having a hearing loss. Otological care should be part of the comprehensive care of HIV positive patients.

Oburra, HO.  2010.  Presentation and initial assessment of laryngeal cancer at Kenyatta National Hospital. MEDICOM: The African Journal of Hospital and Scientific Medicine, (2010) Vol 25: 33 - 36. : MEDICOM Abstract

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Herbert O. Oburra, Tobias Sholz,  Jochen A. Werner,  Isaac M. Macharia,  Peter Masinde,  Joyce Aswani,  Anselmy Opiyo
MEDICOM The African Journal of Hospital and Scientific Medicine, (2010) Vol  25: 33 - 36
Abstract
Head and neck cancer occupies over 50% of in-patient beds at the Ear, Nose and Throat-Head and Neck Surgery Unit of the Kenyatta National Hospital. Laryngeal cancer is the third most common head and neck cancer after nasopharyngeal and oral cancers.
Aim: To determine the demographic features, symptomatology, morbid anatomy, histology and disease stage of laryngeal cancer, and to assess the efficiency of the hospital facility in coping with initial work-up and diagnosis of the patients with laryngeal cancer from 1996 to 2001.
Setting: Department of Ear, Nose and Throat/Head and Neck Surgery at The Kenyatta National Hospital
Study design: Retrospective review of case notes of 100 patients admitted to the unit between 1996 and 2001.
Results: Male to female ratio was 24:1. The peak age at presentation was 50 to 70 years with a mean of 60.6 years. Duration of delay between onset of symptoms and presentation to the unit was 4 to 300 weeks with a mean of 50 weeks. Long history of hoarseness of voices and respiratory stridor were the most frequent symptoms. Preoperative tracheostomy rate was 81%. Vocal cords were involved in 54% of cases, 33% supraglottic, 6% subglottic and 7% indeterminate. Delay in obtaining histological results after biopsy ranged from 1 to 71 days with a mean of 43 days. Ninety five per cent of cases had various grades of squamous cell carcinoma. GI differentiation was found in 36%, G2 in 25% and G3 carcinomas involving the vocal cords tended to be well differentiated.
 

2005

O, PROFOBURRAHERBERT, PETER DRMUGWE.  2005.  Macfadyen C, Gamble C, Garner P, Macharia I, Mackenzie I, Mugwe P, Oburra H, Otwombe K, Taylor S, Williamson P.Topical quinolone vs. antiseptic for treating chronic suppurative otitis media: a randomized controlled trial.Clin Otolaryngol. 2005 Apr;30(2):1. Clin Otolaryngol. 2005 Apr;30(2):193-4.. : MEDICOM Abstract
Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Herbert O. Oburra, Tobias Sholz,  Jochen A. Werner,  Isaac M. Macharia,  Peter Masinde,  Joyce Aswani,  Anselmy Opiyo MEDICOM The African Journal of Hospital and Scientific Medicine, (2010) Vol  25: 33 - 36 Abstract Head and neck cancer occupies over 50% of in-patient beds at the Ear, Nose and Throat-Head and Neck Surgery Unit of the Kenyatta National Hospital. Laryngeal cancer is the third most common head and neck cancer after nasopharyngeal and oral cancers. Aim: To determine the demographic features, symptomatology, morbid anatomy, histology and disease stage of laryngeal cancer, and to assess the efficiency of the hospital facility in coping with initial work-up and diagnosis of the patients with laryngeal cancer from 1996 to 2001. Setting: Department of Ear, Nose and Throat/Head and Neck Surgery at The Kenyatta National Hospital Study design: Retrospective review of case notes of 100 patients admitted to the unit between 1996 and 2001. Results: Male to female ratio was 24:1. The peak age at presentation was 50 to 70 years with a mean of 60.6 years. Duration of delay between onset of symptoms and presentation to the unit was 4 to 300 weeks with a mean of 50 weeks. Long history of hoarseness of voices and respiratory stridor were the most frequent symptoms. Preoperative tracheostomy rate was 81%. Vocal cords were involved in 54% of cases, 33% supraglottic, 6% subglottic and 7% indeterminate. Delay in obtaining histological results after biopsy ranged from 1 to 71 days with a mean of 43 days. Ninety five per cent of cases had various grades of squamous cell carcinoma. GI differentiation was found in 36%, G2 in 25% and G3 carcinomas involving the vocal cords tended to be well differentiated.  

2002

O, PROFOBURRAHERBERT.  2002.  Oburra HO, Lieser M, D. Laryngorhinootologie. 2002 May;81(5):357-64.. : MEDICOM Abstract
BACKGROUND: In the time of evidence based medicine the analysis of the influence of demographic parameters and different environmental factors on the treatment concepts in a country is often neglected. This is also true for Otorhinolaryngology. METHOD: An evaluation of the situation concerning distribution of physicians, diagnostic procedures and epidemiology in Kenya has been performed. These factors are discussed in consideration of their effect on the incidence of different diseases and their treatment under the specific socio-economic conditions for the otolaryngological situation in Kenya. RESULTS: In Kenya 28 otolaryngologists are registered that concentrate on few urban regions. Chronic otitis media, malignant tumors in the head and neck region and AIDS associated diseases have meanwhile increased dramatically. Numerous instruments and equipment for diagnosis are missing. Bigger equipment for CT scans are nearly exclusively used by private hospitals. PERSPECTIVE: Beside a better provision with different equipment for diagnosis it is especially the organization of certain training programmes where local physicians are further educated that may lead to an optimised medical care in Kenya.

2001

O, PROFOBURRAHERBERT.  2001.  Oburra HO, Idenya M.Frequency of adenotonsillectomy in some Nairobi hospitals.East Afr Med J. 2001 Jul;78(7):338-42.. East Afr Med J. 2001 Jul;78(7):338-42.. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.
O, PROFOBURRAHERBERT.  2001.  Gacani W, Bal IS, Babu MA, Oburra HO.Distant metastases from nasopharyngeal carcinoma at Kenyatta National Hospital, Nairobi.East Afr Med J. 2001 Dec;78(12):678-81.. East Afr Med J. 2001 Dec;78(12):678-81.. : MEDICOM Abstract
OBJECTIVES: To determine the frequency and site of distant infraclavicular metastases of nasopharyngeal carcinoma (NPC), the stage of the primary tumour at presentation of metastasis and the histological trends. To determine if there is a correlation between the follow-up rate and different metastatic sites. DESIGN: A retrospective study. SETTING: Ear nose and throat surgical and radiotherapy clinics at Kenyatta National Hospital, Nairobi. SUBJECTS: Case notes, radiotherapeutic and laboratory records of patients presenting with NPC between January 1981 and December 1990. RESULTS: The frequency of distant NPC metastases was 14.6% and 92.3% manifested within 24 months of admission. It was most frequent in the males, a younger age group and early T1 disease. Bilaterality of the neck nodes had no relevance on metastatic rate. The bone (66.7%) was the most common distant metastatic destination followed by the liver (23.2%). Liver metastasis was associated with a shorter follow-up period. CONCLUSION: Apart from the late presentation of locoregional disease, the findings are similar to studies elsewhere. The preponderance of early primary disease in patients with distant metastasis need further appraisal as it preliminarily suggests existence of specific biological markers that favour metastases. This can only be done after recruiting more cases.
O, PROFOBURRAHERBERT.  2001.  Gachani W, Bal I.S., Oburra H. Distant metastasis from nasopharyngeal carcinoma at Kenyatta National Hospital.. East African Medical Journal, 2001; 78: 678-682. also published in Metastases in Head and Neck Cancer Edited by Lippert BM and Werner JA Proceedings of 2nd International Symposium January 25-27, 2001, Marburg, Germany. Tectum Verlag, Marburg 2001).. : MEDICOM Abstract
BACKGROUND: In the time of evidence based medicine the analysis of the influence of demographic parameters and different environmental factors on the treatment concepts in a country is often neglected. This is also true for Otorhinolaryngology. METHOD: An evaluation of the situation concerning distribution of physicians, diagnostic procedures and epidemiology in Kenya has been performed. These factors are discussed in consideration of their effect on the incidence of different diseases and their treatment under the specific socio-economic conditions for the otolaryngological situation in Kenya. RESULTS: In Kenya 28 otolaryngologists are registered that concentrate on few urban regions. Chronic otitis media, malignant tumors in the head and neck region and AIDS associated diseases have meanwhile increased dramatically. Numerous instruments and equipment for diagnosis are missing. Bigger equipment for CT scans are nearly exclusively used by private hospitals. PERSPECTIVE: Beside a better provision with different equipment for diagnosis it is especially the organization of certain training programmes where local physicians are further educated that may lead to an optimised medical care in Kenya.
O, PROFOBURRAHERBERT.  2001.  Oburra H and Idenya M. The frequency of adenotonsillectomy in a sample of Hospitals in Nairobi, Kenya. Surgical indications, timing and complications in 97 cases of adenotonsillectomy. East African Medical Journal, 2001: 78: 338-342.. East African Medical Journal, 2001: 78: 338-342.. : MEDICOM Abstract
BACKGROUND: In the time of evidence based medicine the analysis of the influence of demographic parameters and different environmental factors on the treatment concepts in a country is often neglected. This is also true for Otorhinolaryngology. METHOD: An evaluation of the situation concerning distribution of physicians, diagnostic procedures and epidemiology in Kenya has been performed. These factors are discussed in consideration of their effect on the incidence of different diseases and their treatment under the specific socio-economic conditions for the otolaryngological situation in Kenya. RESULTS: In Kenya 28 otolaryngologists are registered that concentrate on few urban regions. Chronic otitis media, malignant tumors in the head and neck region and AIDS associated diseases have meanwhile increased dramatically. Numerous instruments and equipment for diagnosis are missing. Bigger equipment for CT scans are nearly exclusively used by private hospitals. PERSPECTIVE: Beside a better provision with different equipment for diagnosis it is especially the organization of certain training programmes where local physicians are further educated that may lead to an optimised medical care in Kenya.

1998

O, PROFOBURRAHERBERT.  1998.  Oburra HO.Ear, nose and throat/head and neck medical services in developing countries: challenges and future perspectives.East Afr Med J. 1998 Jun;75(6):317-8.. East Afr Med J. 1998 Jun;75(6):317-8.. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.
O, PROFOBURRAHERBERT.  1998.  Oburra H. Otolaryngology/Head and neck surgical services in developing countries: Challenges and future perspectives.. Editorial. East African Medical Journal 75: 321, 1998. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.
O, PROFOBURRAHERBERT.  1998.  Oburra, H. Causes of ear trauma in Kenyan patients.. East African Medical Journal 75:323, 1998.. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.
O, PROFOBURRAHERBERT.  1998.  Oburra, H. Late presentation of laryngeal and nasopharyngeal cancer in Kenyatta National Hospital.. East African Medical Journal 75: 223, 1998.. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.

1996

O, PROFOBURRAHERBERT, PETER DRMUGWE.  1996.  Smith AW, Hatcher J, Mackenzie IJ, Thompson S, Bal I, Macharia I, Mugwe P, Okoth-Olende C, Oburra H, Wanjohi Z.Randomised controlled trial of treatment of chronic suppurative otitis media in Kenyan schoolchildren.Lancet. 1996 Oct 26;348(9035):1128-33. Lancet. 1996 Oct 26;348(9035):1128-33. : MEDICOM Abstract

BACKGROUND: The outcomes of treatment of chronic suppurative otitis media (CSOM) are disappointing and uncertain, especially in developing countries. Because CSOM is the commonest cause of hearing impairment in children in these countries, an effective method of management that can be implemented on a wide scale is needed. We report a randomised, controlled trial of treatment of CSOM among children in Kenya; unaffected schoolchildren were taught to administer the interventions. METHODS: We enrolled 524 children with CSOM, aged 5-15 years, from 145 primary schools in Kiambu district of Kenya. The schools were randomly assigned treatments in clusters of five in a ratio of two to dry mopping alone (201 children), two to dry mopping with topical and systemic antibiotics and topical steroids (221 children), and one to no specific treatment (102 children). Schools were matched on factors thought to be related to their socioeconomic status. The primary outcome measures were resolution of otorrhoea and healing of tympanic membranes on otoscopy by 8, 12, and 16 weeks after induction. Absence of perforation was confirmed by tympanometry, and hearing levels were assessed by audiometry. 29 children were withdrawn from the trial because they took non-trial antibiotics. There was no evidence of differences in timing of withdrawals between the groups. FINDINGS: By the 16-week follow-up visit, otorrhoea had resolved in a weighted mean proportion of 51% (95% CI 42-59) of children who received dry mopping with antibiotics, compared with 22% (14-31) of those who received dry mopping alone and 22% (9-35) of controls. Similar differences were recorded by the 8-week and 12-week visits. The weighted mean proportions of children with healing of the tympanic membranes by 16 weeks were 15% (10-21) in the dry-mopping plus antibiotics group, 13% (5-20) in the dry-mopping alone group, and 13% (3-23) in the control group. The proportion with resolution in the dry-mopping alone group did not differ significantly from that in the control group at any time. Hearing thresholds were significantly better for children with no otorrhoea at 16 weeks than for those who had otorrhoea, and were also significantly better for those whose ears had healed than for those with otorrhoea at all times. INTERPRETATION: Our finding that dry mopping plus topical and systemic antibiotics is superior to dry mopping alone contrasts with that of the only previous community-based trial in a developing country, though it accords with findings of most other trials in developed countries. The potential role of antibiotics needs further investigation. Further, similar trials are needed to identify the most cost-effective and appropriate treatment regimen for CSOM in children in developing countries. PIP: 524 children aged 5-15 years with chronic suppurative otitis media (CSOM) were enrolled in a study to determine the effectiveness of different treatment regimens. The subjects were from 145 primary schools in Kenya's Kiambu district. 201 children received dry mopping treatment, 221 received dry mopping with topical and systemic antibiotics and topical steroids, and 102 received no treatment. Participating schools were matched on factors thought to be related to their socioeconomic status. 29 children were withdrawn from the trial for taking non-trial antibiotics, with no evidence observed of differences in the timing of withdrawals between the two groups. At 16 weeks of follow-up, otorrhoea had resolved in a weighted mean proportion of 51% of children who received dry mopping with antibiotics, 22% of children who received dry mopping alone, and 22% of untreated children. Similar differences were observed at 8 and 12 weeks of follow-up. The weighted mean proportions of children with healing of the tympanic membranes by 16 weeks were 15% in the dry-mopping plus antibiotics group, 13% in the dry-mopping alone group, and 13% in the control group. Hearing thresholds were significantly better for children with no otorrhoea at 16 weeks than for those who had otorrhoea, and were also significantly better for those whose ears had healed than for those with otorrhoea at all times.

O, PROFOBURRAHERBERT.  1996.  Galina N, Oburra H and Aluoch JR. Sensorineural hearing loss in patients with sickle cell anaemia in Kenya.. East African Medical Journal, 73:471 1996. : MEDICOM Abstract
OBJECTIVES: To determine the frequency of adenotonsillectomy in a sample of Kenyan hospitals and to review indications, timing and complications in 97 cases of adenotonsillectomy done by the authors. DESIGN: Retrospective, descriptive study. SETTING: Kenyatta National, Nairobi, Aga Khan, Gertrude and Mater Hospitals. RESULTS: Adenotonsillectomy is the most frequent otolaryngologic surgical operation. Indications for surgery were upper airway obstruction in 61.3%, recurrent tonsillitis in 28.7% and both in 7.5%. Surgery was indicated during the acute stage in 6.8% of cases. There was one case of post-operative acute airway obstruction. Post operative bleeding from the tonsillar bed was encountered in 2.1% of cases. CONCLUSION: Adenotonsillectomy is the most common otolaryngologic surgical operation in our set-up. The low frequency of complications and a short hospital stay puts up a case for routine adenotonsillectomy as a day surgery procedure.

1995

Obura, HO.  1995.  Complications following bilateral turbinectomy. AbstractWebsite

Thirty four patients undergoing bilateral inferior turbinectomy for obstruction of the upper airway are prospectively reviewed. The indication for the operation was persistent nasal obstruction interfering with sleep and speech. Their ages ranged from seven years to 50 years. The most common post operative complications were synaechiae (15%), atrophic rhinitis (15%), persistent obstruction (12%) and abnormal nasal sensation (9%).

O, PROFOBURRAHERBERT.  1995.  A prevalence study of ear problems in school children in Kiambu district, Kenya, May 1992.Int J Pediatr Otorhinolaryngol. 1995 Nov;33(3):197-205.. Int J Pediatr Otorhinolaryngol. 1995 Nov;33(3):197-205.. : MEDICOM Abstract
Information on the prevalence of hearing impairment and related ear pathologies in children in sub-Saharan Africa is scarce. A pilot study for a clinical trial of simple treatments for chronic suppurative otitis media (CSOM) in school children in Kiambu district, Kenya, provided information on the prevalence of hearing impairment and ear pathologies. Five-thousand-three-hundred-sixty-eight children from 57 randomly chosen primary schools in Kiambu district were examined. Simple otoscopy was performed by clinical officers with specialty training in ENT, and hering testing was performed by trained nurses, using a hand held field audiometer. Microbiological specimens were obtained from those children with CSOM. Five-point-six percent of the children had a hearing impairment of > 30 dB HL in one or both ears, with 2.2% having bilateral hearing impairment. Two-point-four percent had at least one perforated tympanic membrane, and 1.1% had CSOM. Eight-point-six percent of the children had wax obstructing the tympanic membrane. There is evidence of a relationship between hearing impairment and both CSOM and wax obstructing the tympanic membrane. The most common organisms found were Pseudomonas spp. (34%), Proteus spp. (34%) and Eschericia coli (19%). These results are comparable with other studies in Africa and indicate a considerable burden of ear disease in Kiambu district, Kenya.
O, PROFOBURRAHERBERT.  1995.  Oburra, H. Complications following inferior turbinectomy in thirty-four patients.. East African Medical Journal,1995; 72: 101, 1995. : MEDICOM Abstract

BACKGROUND: The outcomes of treatment of chronic suppurative otitis media (CSOM) are disappointing and uncertain, especially in developing countries. Because CSOM is the commonest cause of hearing impairment in children in these countries, an effective method of management that can be implemented on a wide scale is needed. We report a randomised, controlled trial of treatment of CSOM among children in Kenya; unaffected schoolchildren were taught to administer the interventions. METHODS: We enrolled 524 children with CSOM, aged 5-15 years, from 145 primary schools in Kiambu district of Kenya. The schools were randomly assigned treatments in clusters of five in a ratio of two to dry mopping alone (201 children), two to dry mopping with topical and systemic antibiotics and topical steroids (221 children), and one to no specific treatment (102 children). Schools were matched on factors thought to be related to their socioeconomic status. The primary outcome measures were resolution of otorrhoea and healing of tympanic membranes on otoscopy by 8, 12, and 16 weeks after induction. Absence of perforation was confirmed by tympanometry, and hearing levels were assessed by audiometry. 29 children were withdrawn from the trial because they took non-trial antibiotics. There was no evidence of differences in timing of withdrawals between the groups. FINDINGS: By the 16-week follow-up visit, otorrhoea had resolved in a weighted mean proportion of 51% (95% CI 42-59) of children who received dry mopping with antibiotics, compared with 22% (14-31) of those who received dry mopping alone and 22% (9-35) of controls. Similar differences were recorded by the 8-week and 12-week visits. The weighted mean proportions of children with healing of the tympanic membranes by 16 weeks were 15% (10-21) in the dry-mopping plus antibiotics group, 13% (5-20) in the dry-mopping alone group, and 13% (3-23) in the control group. The proportion with resolution in the dry-mopping alone group did not differ significantly from that in the control group at any time. Hearing thresholds were significantly better for children with no otorrhoea at 16 weeks than for those who had otorrhoea, and were also significantly better for those whose ears had healed than for those with otorrhoea at all times. INTERPRETATION: Our finding that dry mopping plus topical and systemic antibiotics is superior to dry mopping alone contrasts with that of the only previous community-based trial in a developing country, though it accords with findings of most other trials in developed countries. The potential role of antibiotics needs further investigation. Further, similar trials are needed to identify the most cost-effective and appropriate treatment regimen for CSOM in children in developing countries. PIP: 524 children aged 5-15 years with chronic suppurative otitis media (CSOM) were enrolled in a study to determine the effectiveness of different treatment regimens. The subjects were from 145 primary schools in Kenya's Kiambu district. 201 children received dry mopping treatment, 221 received dry mopping with topical and systemic antibiotics and topical steroids, and 102 received no treatment. Participating schools were matched on factors thought to be related to their socioeconomic status. 29 children were withdrawn from the trial for taking non-trial antibiotics, with no evidence observed of differences in the timing of withdrawals between the two groups. At 16 weeks of follow-up, otorrhoea had resolved in a weighted mean proportion of 51% of children who received dry mopping with antibiotics, 22% of children who received dry mopping alone, and 22% of untreated children. Similar differences were observed at 8 and 12 weeks of follow-up. The weighted mean proportions of children with healing of the tympanic membranes by 16 weeks were 15% in the dry-mopping plus antibiotics group, 13% in the dry-mopping alone group, and 13% in the control group. Hearing thresholds were significantly better for children with no otorrhoea at 16 weeks than for those who had otorrhoea, and were also significantly better for those whose ears had healed than for those with otorrhoea at all times.

1990

O, PROFOBURRAHERBERT.  1990.  Oburra HO.Ear, nose and throat problems in developing countries.East Afr Med J. 1990 Jan;67(1):1-3.. East Afr Med J. 1990 Jan;67(1):1-3.. : MEDICOM Abstract
Information on the prevalence of hearing impairment and related ear pathologies in children in sub-Saharan Africa is scarce. A pilot study for a clinical trial of simple treatments for chronic suppurative otitis media (CSOM) in school children in Kiambu district, Kenya, provided information on the prevalence of hearing impairment and ear pathologies. Five-thousand-three-hundred-sixty-eight children from 57 randomly chosen primary schools in Kiambu district were examined. Simple otoscopy was performed by clinical officers with specialty training in ENT, and hering testing was performed by trained nurses, using a hand held field audiometer. Microbiological specimens were obtained from those children with CSOM. Five-point-six percent of the children had a hearing impairment of > 30 dB HL in one or both ears, with 2.2% having bilateral hearing impairment. Two-point-four percent had at least one perforated tympanic membrane, and 1.1% had CSOM. Eight-point-six percent of the children had wax obstructing the tympanic membrane. There is evidence of a relationship between hearing impairment and both CSOM and wax obstructing the tympanic membrane. The most common organisms found were Pseudomonas spp. (34%), Proteus spp. (34%) and Eschericia coli (19%). These results are comparable with other studies in Africa and indicate a considerable burden of ear disease in Kiambu district, Kenya.
O, PROFOBURRAHERBERT.  1990.  Oburra, H. Editorial: Ear Nose and Throat problems in developing countries.. East African Medical Journal, 1990; 67: 1.. : MEDICOM Abstract
Information on the prevalence of hearing impairment and related ear pathologies in children in sub-Saharan Africa is scarce. A pilot study for a clinical trial of simple treatments for chronic suppurative otitis media (CSOM) in school children in Kiambu district, Kenya, provided information on the prevalence of hearing impairment and ear pathologies. Five-thousand-three-hundred-sixty-eight children from 57 randomly chosen primary schools in Kiambu district were examined. Simple otoscopy was performed by clinical officers with specialty training in ENT, and hering testing was performed by trained nurses, using a hand held field audiometer. Microbiological specimens were obtained from those children with CSOM. Five-point-six percent of the children had a hearing impairment of > 30 dB HL in one or both ears, with 2.2% having bilateral hearing impairment. Two-point-four percent had at least one perforated tympanic membrane, and 1.1% had CSOM. Eight-point-six percent of the children had wax obstructing the tympanic membrane. There is evidence of a relationship between hearing impairment and both CSOM and wax obstructing the tympanic membrane. The most common organisms found were Pseudomonas spp. (34%), Proteus spp. (34%) and Eschericia coli (19%). These results are comparable with other studies in Africa and indicate a considerable burden of ear disease in Kiambu district, Kenya.

1981

Oburra, HO.  1981.  Empyema Thoracis In Kenyatta National Hospital. Abstract

This is a combined prospective and retrospective
review 'study of empyema thoracis. Twenty patients admitted
to Kenyatta National Hospital wards between November, 1980
and April 1981 were studied prospectively. Seventy nine patients admitted between January 1975 and October 1980 were
studied retrospectively. Both groups have been reviewed
to highlight various aspects of this disease, particularly
its potentially crippling effect on the respiratory system
and the fact that this is a preventable situation which is
not yet fully appreciated in our country.
Pulmonary disease was the most prevalent underlying
aetiology in this series. Mycobacteria and Staph. Aureus
were the most frequent causative organism followed by
various gram negative bacteria. Culture was negative in 21%
of all cases reviewed. The tendency of children under
10 years of age to have staphylococcal and multibacterial
infection was noted.
The ever increasing pneumonectomy rate on the background
of inadequate initial. treatment coupled with
scarcity of surgical beds and theatre time is highlighted.
Finally paediatric age and presence of underlying disea were shown to have positive relationship with increased
mortality, while traumatic and tuberculous aetiologies
were found to have a higher risk of eventual pneumonectomy.

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