Prof Godfrey Mutashambara Rwegerera, MD, MMED, MPA-HRM - University of Botswana - Associate Professor

Prof Godfrey Mutashambara Rwegerera

MD, MMED, MPA-HRM

University of Botswana

Associate Professor

Gaborone, Select a State/Province | Botswana

Main Specialties: Internal Medicine

Additional Specialties: INTERNAL MEDICINE, PUBLIC ADMINISTRATION AND HUMAN RESOURCE MANAGEMENT

ORCID logohttps://orcid.org/0000-0002-5896-6065


Top Author

Prof Godfrey Mutashambara Rwegerera, MD, MMED, MPA-HRM - University of Botswana - Associate Professor

Prof Godfrey Mutashambara Rwegerera

MD, MMED, MPA-HRM

Introduction

Prof Godfrey Mutashambara Rwegerera graduated as a Medical Doctor at University of Dar es Salaam in 2004, then from 2007 to 2010 studied and graduated with Master of Internal Medicine at Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. Prof Rwegerera further studied Master of Public Administration in Human Resource Management at University of Botswana in Gaborone, Botswana and graduated in October 2017. From February 2006 to September 2010 Prof Rwegerera worked at capacity of Medical Officer at Emergency and Medical Department of Muhimbili National Hospital in Dar es Salaam, Tanzania before joining Hubert Kairuki Memorial University as a Lecturer for a period of nine (9) months from March to December 2011. Prof Rwegerera then joined University of Botswana in January 2012 where he is working To date. He was promoted to the rank of Senior Lecturer in September 2014 and subsequently promoted to the rank of Associate Professor in June 2018. At University of Botswana, Prof Rwegerera is involved in several activities including teaching, research and services to community, professional and several committees within the University. Prof Rwegerera is also a Consultant Physician at Princess Marina Hospital, a tertiary hospital in Gaborone, Botswana.

Primary Affiliation: University of Botswana - Gaborone, Select a State/Province , Botswana

Specialties:

Additional Specialties:

Research Interests:


View Prof Godfrey Mutashambara Rwegerera’s Resume / CV

Metrics

Number of Publications

23

Publications

Number of Profile Views

514

Profile Views

Number of Article Reads

155

Reads

Education

Jun 2017
UNIVERSITY OF BOTSWANA
MASTER OF PUBLIC ADMINISTRATION IN HUMAN RESOURCE MANAGEMENT
Dec 2010
MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES
MASTER OF MEDICINE
Dec 2004
UNIVERSITY OF DAR ES SALAAM
DOCTOR OF MEDICINE

Experience

Jan 2012
University of Botswana
Associate Professor

Top co-authors

Dereje Habte
Dereje Habte

University of Botswana

3
Amos Massele
Amos Massele

School of Medicine

3
Julius Chacha Mwita
Julius Chacha Mwita

University of Botswana

2
Michael Mwandri
Michael Mwandri

University of Botswana

2
Brian Godman
Brian Godman

Karolinska Institutet

2
Bene D Paramadhas
Bene D Paramadhas

e 5 Nyangabwe Hospital

1

Publications

23Publications

155Reads

The prevalence of microalbuminuria and associated factors among patients with type 2 diabetes mellitus in Botswana.

Niger J Clin Pract 2018 Nov;21(11):1430-1437

Faculty of Medicine, Department of Internal Medicine, University of Botswana and Department of Medicine, Princess Marina Hospital, Gaborone, Botswana.

View Article
November 2018
2 Reads
0.410 Impact Factor

Short stature and growth hormone deficiency: unexpected manifestations of McCune-Albright syndrome.

BMJ Case Rep 2018 Aug 27;2018. Epub 2018 Aug 27.

Department of Radiology, Princess Marina Hospital, Gaborone, Botswana.

View Article
August 2018
8 Reads

Cavernous sinus thrombosis in a 14-year old boy

Turk J Pediatr 2017; 59: 719-723

The Turkish Journal of Pediatrics

Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder occurring as a result of sepsis or secondary to aseptic causes in the setting of a thrombophilic disorder that has over the years been linked to high morbidity and mortality rates; this being despite availability of a wide number of new broad-spectrum antibiotics. We present a case of a 14-year old boy who had presented with two weeks’ duration of worsening bitemporal headache followed by facial swelling on the background history of chronic non-specific headache of few months duration. He was diagnosed to have cavernous sinus thrombosis secondary to pansinusitis. The course of his illness was complicated by a stroke despite prompt treatment with antibiotics and anticoagulation. The case highlights the importance of high index of suspicion in patients with unexplained headache and need for investigation and early referral to prevent occurrence of cavernous sinus thrombosis.

View Article
July 2018
4 Reads

Leydig cell tumor of the testis presenting with gynaecomastia due to hyperprolactinemia after orchiectomy

Case Reports in Internal Medicine. 2017 Oct 10;4 (4): 28-32

Case Reports in Internal Medicine

Leydig cell tumors (LCT) are rare and represent 1% to 3% of all tumors of the testis. LCTs can either be benign or malignant with clinical presentation varying from testicular mass associated with endocrinal manifestations to metastatic lesions in case of malignant tumors. We describe a 25-year-old man who presented with an isolated painless mass of the left testes which was confirmed by ultrasonography. An orchiectomy was subsequently performed and the histopathological analysis revealed a leydig cell tumor. Three months after surgery, the patient presented with bilateral gynaecomastia; estradiol, testosterone and gonadotropin levels as well as tumor markers (carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and human chorionic gonadotropin (-HCG) were within normal ranges but prolactin was high in two different measurements. No evidence of tumor recurrence or metastases was found and different underlying causes of hyperprolactinemia including use of drugs, pituitary adenoma, hypothyroidism and renal failure were ruled out. After 6 month of treatment with Cabergoline the prolactin level and breast size were remarkably reduced. Patients with benign LCT have a favourable prognosis but in order to rule out tumor recurrence or a persistent effect of their hormonal disorder, follow-up should include regular hormonal and imaging studies.

View Article
October 2017
5 Reads

Disseminated Burkitt’s lymphoma with a Pancreatic Mass in a HIV Positive Woman Diagnosed by Axillary Lymph Node Biopsy

Journal of Clinical and Diagnostic Research. 2017 Aug, Vol-11(8):14-16

Journal of Clinical and Diagnostic Research

Burkitt’s Lymphoma (BL) is a highly aggressive B cell lymphoma of non Hodgkin’s type usually presenting in extranodal sites for endemic and sporadic types of the disease. Like other Non-Hodgkin’s Lymphomas (NHL), HIV positive associated BL is associated with peripheral Lymphadenopathy. We present a case of 22-year-old newly diagnosed HIV positive female patient who presented with generalized peripheral lymphadenopathy and obstructive jaundice. Initial work up was suggestive of acute pancreatitis with further evaluation revealing a pancreatic head mass. BL was confirmed both by axillary lymph node biopsy and immunohistochemistry highlighting the importance of high index of suspicion and prompt histopathological diagnosis to enable treatment of this fatal disease that is potentially curable

View Article
August 2017
5 Reads

Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana

Alex J Med (2017), http://dx.doi.org/10.1016/j.ajme.2017.01.005

Alexandria Journal of Medicine

Background: Health-related quality of life (HRQOL) is an important aspect of diabetes mellitus care. The objective of the study was to determine the HRQOL of diabetes mellitus (DM) patients in Botswana as little known in Africa. Materials and methods: A cross-sectional study of 380 randomly selected DM patients in a tertiary clinic in Gaborone, Botswana was conducted to obtain Data on HRQOL and structured questionnaire was used to collect information on sociodemographic and clinical characteristics. Multivariate logistic regression to determine sociodemographic and clinical characteristics associated. Results: Majority of patients were female with no formal education or primary level of education. Mean HbA1c was 7.97% (SD: 2.02) and most patients had poor glycemic control. The majority had both worse physical composite score (PCS-12) and mental composite score (MCS-12), with worse proportions of the two. Female gender, older age 65 years, and the presence of three or more documented diabetic complications were associated with significant worse PCS-12. Presence of two diabetic complications, three or more diabetic complications, and musculoskeletal disease were associated with significant MCS-12. Conclusions: Diabetic patients in Botswana have relatively poor HRQOL. The fact that most patients present late with complications calls for policy attention to diagnose diabetes mellitus early and prevent associated complications, ultimately improving health-related quality of life among diabetes mellitus patients.

View Article
June 2017
6 Reads

The prevalence of chronic kidney disease and associated factors among patients admitted at princess marina hospital, Gaborone, Botswana.

Niger J Clin Pract 2017 Mar;20(3):313-319

Department of Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

View Article
March 2017
9 Reads
0.410 Impact Factor

Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future

Alex J Med (2017), http://dx.doi.org/10.1016/j.ajme.2017.01.005

Alexandria Journal of Medicine

Background: Diabetes mellitus (DM) is a major global public health problem. Lack of adherence to medication causes suboptimal glycemic control increasing complication rates, costs and mortality. The objective of the study was to determine current antidiabetic medication adherence in Botswana and assess associated factors so as to direct potential future interventions. Materials and methods: A cross-sectional study among 376 randomly selected diabetic patients attending a leading clinic in Gaborone, Botswana. Eight item Morisky Medication adherence questionnaire was used to assess antidiabetic medication adherence. A structured questionnaire was also used to collect information on factors influencing adherence including age, gender, education, type and duration of diabetes, treatment, complications and HIV status. Data were entered and analyzed using STATA Version 14, and logistic regression performed. Results: Over forty percent (41.8%) of patients were non-adherent to antidiabetic medications. Studied sociodemographic characteristics and clinical variables did not affect adherence. HIV positive status was associated with a statistically significant better adherence at multivariate analysis. Conclusion: Adherence to antidiabetic medication was found to be suboptimal in a setting where medicines are provided free of charge. Only HIV positivity was found to be significantly associated with better adherence, probably due to effect of greater psychosocial support and counselling as part of HIV treatment. There is a need to carry out studies to further improve understanding of factors associated with medication adherence that are pertinent to Botswana and similar settings given the growing prevalence of diabetes.

View Article
March 2017
4 Reads

A rare case of turner syndrome mosaicism in an African black woman

Case Reports in Internal Medicine. 2016 September 19; 3 (4)

Case Reports in Internal Medicine

Turner syndrome (TS) is a chromosomal disorder caused by partial or complete absence of an X chromosome in at least one tissue of the body with about 50% of patients having a different chromosome formula. The 45, X/46, XY mosaicism variety is rare. We present a case of a 32-year-old black African female patient with a history of primary amenorrhea and clinical stigmata of TS without signs of virilization. The laboratory parameters were consistent with the characteristic hypergonadotropic hypogonadism found in Turner Syndrome. Laparoscopy showed streak gonads and hypoplastic uterus and the findings of the cytogenetic studies were consistent with a diagnosis of 45, X/46, XY Mosaicism. The chromosome study was decisive to confirm the diagnosis

View Article
September 2016
5 Reads

Metastatic cutaneous epithelioid hemangioendothelioma involving right atrium - a case report

Case Reports in Internal Medicine. 2016 June 23; 3 (3)

Case Reports in Internal Medicine

Epithelioid hemangioendothelioma (EHE) is a rare vascular endothelial tumour with unpredictable malignant potential. The common sites involved are the lung, liver and soft tissues; with cardiac involvement being a very rare occurrence. The diagnosis of this rare vascular tumor is made by typical histopathological findings and confirmed by specific immunohistochemistry. We present a case of a patient with a long standing painless scalp lesion who presented with pulmonary symptoms and ultimately diagnosed to have metastatic cutaneous EHE involving the lungs, pericardium and right atrium.

View Article
June 2016
5 Reads

Chronic multiple lung abscesses presenting as a left lung apical mass: a ticking bomb?

Pan Afr Med J 2014 17;17:292. Epub 2014 Apr 17.

Department of Internal Medicine, Princess Marina Hospital, Gaborone, Botswana.

View Article
August 2015
4 Reads

The triad of Iron deficiency anemia, hepatosplenomegaly and growth retardation with normal serum zinc levels in a 14‑year‑old boy

Niger J Clin Pract 2015;18:690-2.

Nigerian Journal of Clinical Practice

A triad of iron deficiency anemia, hepatosplenomegaly and growth retardation occurring in tandem with zinc deficiency has been reported in the past as components of either Prada's syndrome or hypopituitarism. There are no documented cases of such triad occurring in the presence of normal serum zinc levels. We report a case of a 14‑year‑old boy who presented with iron deficiency anemia, hepatosplenomegaly, geophagia and growth retardation with pubertal delay. Investigations ruled out hypopituitarism and coeliac disease. The patient improved dramatically and attained puberty within 15 months of intense nutritional intervention. In conclusion, iron deficiency anemia occurring in the triad without zinc deficiency as seen in this case report has not been reported before; this calls for more research to be able to explain the findings.

View Article
June 2015
3 Reads

Adherence to anti-diabetic drugs among patients with Type 2 diabetes mellitus at Muhimbili National Hospital, Dar es Salaam, Tanzania- A cross-sectional study.

Pan Afr Med J 2014 7;17:252. Epub 2014 Apr 7.

University of Botswana, School of Medicine, Gaborone, Botswana.

View Article
May 2015
17 Reads

An audit of consent practices and perceptions of lumbar puncture, Botswana inpatient setting experience

African Journal of Emergency Medicine (2015) 5, 66–69

African Journal of Emergency Medicine

Introduction: The epidemic of HIV/AIDS in sub-Saharan Africa has led to significant increases in the burden of meningitis, especially cryptococcal meningitis.Morbidity and mortality resulting from meningitis occur partly due to delays in performing lumbar punctures both for diagnostic and therapeutic purposes. This study was conducted with the primary objective of exploring the attitudes and concerns that patients have with regard to lumbar puncture, and also to assess current consenting practices of doctors with regard to lumbar puncture. Methods: A descriptive cross-sectional study was conducted in medical wards of Princess Marina Hospital, a tertiary hospital in Gaborone, Botswana. Data were collected by means of a questionnaire-based survey involving patients or their next of kin, and doctors. Other relevant information was obtained from patient charts. Data collection involved 12 patients and 23 doctors. Results: Of the 12 patients interviewed, four stated that the reasons for doing lumbar puncture (LP) were explained to them. One respondent stated that LP risks were mentioned, while two stated that they were given the option to refuse LP. Most patients’ possible reasons for refusal of LP was attributed to fear of pain. Five (42.7%) patients/next of kin had never heard of LP before, and most of the interviewed patients associated the procedure with death and paralysis, while none associated with meningitis or HIV. Twenty-two (95.7%) of 23 doctors stated that they routinely consent patients for LP, 11 (47.8%) mentioned risks, and nine (39.1%) stated that the patient has the option to decline the procedure. Only 26% of doctors routinely used local anaesthesia while 22% routinely asked for written consent. Conclusion: Contrasting responses between doctors and patients indicates a need for standard consenting practices among doctors. Also, patients’ attitudes and receptiveness to lumbar punctures can be improved through education on lumbar puncture indications, benefits, and risks.

View Article
March 2015
4 Reads

Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

Tanzania Journal of Health Research. October 2014; 16 (4)

Tanzania Journal of Health Research

Isolated hepatic tuberculosis presenting as a mass either with or without fever can be confused with hepatocellular carcinoma. Clinical examination and laboratory investigations are not specific. Radiological investigations such as ultrasound and computed tomography cannot confirm the diagnosis; hence it is vital to always make an effort to demonstrate presence of acid fast bacilli in aspirated pus or necrotic material from a liver mass. We present a case of 50 years old male patient with HIV/AIDS who presented with non-specific symptoms without fever, clinically with hepatomegaly mimicking hepatocellular carcinoma with metastasis. Abdominal ultrasound revealed a mass in the left liver lobe, with diffuse involvement in the right liver lobe. Liver mass histology showed granulomatous pattern with epitheloid cell aggregation. Aspirated blood from fine-needle guided biopsy stained on Ziehl Neelsen for acid fast bacilli turned out positive. Clinical examination did not reveal lymphadenopathy, abdominal ultrasound also ruled out para-aortic lymphadenopathy, and chest x-ray was essentially normal. Evaluation of the patient six months after completing quadruple treatment for tuberculosis showed marked clinical improvement. The objective of this case report is to highlight the importance of considering hepatic tuberculosis as a differential diagnosis in cases of hepatomegaly and initiate appropriate investigations to rule out a possibility of Tuberculosis which is potentially treatable with early diagnosis.

View Article
October 2014
4 Reads

An Unusual Case of Primary Pulmonary Choriocarcinoma with Brain Metastasis in a HIV Positive Patient

International Journal of Health Sciences & Research. 2014 September; 4 (9)

International Journal of Health Sciences and Research

Primary pulmonary choriocarcinoma (PPC) is a rare entity with propensity to rapid metastasis and associated poor outcomes. Pleural effusion has been rarely associated with PPC. We report a case of a 23 year old nulliparous female HIV positive who present with chest pains, dry cough and pleural effusions, with leukocytosis. Poor response to antibiotics prompted further evaluation which revealed PPC with fatal metastasis. Diagnosis of PPC was reached by raised levels of beta HCG, histology and immunohistochemistry. Combination chemotherapy with radiotherapy gave some hope; - however patient demised, mostly likely due to lung metastasis. This case left doctors wondering; - what if, the diagnosis was reached earlier.

View Article
September 2014
4 Reads

Pulmonary artery thrombosis in a patient with right‑sided heart failure

Niger J Clin Pract. 2014;17:534-6.

Nigerian Journal of Clinical Practice

Pulmonary thromboembolism occurring either abruptly or insidious poses a greater challenge in diagnosis. A high index of suspicion is required to proceed with proper investigations in patients with nonspecific cardiac or respiratory presentation to make the diagnosis of pulmonary embolism (PE). Early diagnosis of PE with prompt initiating of anticoagulation therapy has been proven to have a positive impact in mortality reduction associated with recurrent episodes of this condition. We present a case of a 76-year-old man, known to have cardiac failure on regular treatment who presented with predominant features of right-sided heart failure accompanied with dizziness. He was diagnosed to have pulmonary artery thrombosis by computerized tomography. Anticoagulation therapy was initiated with marked clinical improvement.

View Article
July 2014
4 Reads

Asthma prevalence, knowledge, and perceptions among secondary school pupils in rural and urban coastal districts in Tanzania.

BMC Public Health 2014 Apr 23;14:387. Epub 2014 Apr 23.

University of Botswana, Private Bag 0022, Gaborone, Botswana.

View Article
April 2014
66 Reads
2.260 Impact Factor

A Case of Cryptococcal Lymphadenitis in an HIV-Infected Woman

IMAJ 2014; 16: 129–130

Israel Medical Association Journal

Lymphadenopathy is frequent in patients with HIV infection and can be due to non-specific follicular hyperplasia, opportunistic infections or malignancy. Cryptococcus neoformans is an uncommon cause of lymphadenopathy, and in all cases reported so far constitutional symptoms, cutaneous cryptococcal lesions or generalized lymphadenopathy were present. In contrast, in our case, they were all absent. The negative latex agglutination test for detection of cryptococcal capsular polysaccharide antigen is noteworthy in our patient and could possibly be attributed to a low concentration of cryptococcal antigen below the kit detectability limit, a masking effect by unknown non-specific proteins in vivo, a prozone phenomenon due to high concentrations of cryptococcal antigen, or a poorly encapsulated strain with low production of polysaccharide.

View Article
February 2014
4 Reads

Top co-authors

Dereje Habte
Dereje Habte

University of Botswana

3
Amos Massele
Amos Massele

School of Medicine

3
Julius Chacha Mwita
Julius Chacha Mwita

University of Botswana

2
Michael Mwandri
Michael Mwandri

University of Botswana

2
Brian Godman
Brian Godman

Karolinska Institutet

2
Bene D Paramadhas
Bene D Paramadhas

e 5 Nyangabwe Hospital

1