School of Medicine, Health & Life Sciences

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    Antimalarial combination therapies increase gastric ulcers through an imbalance of basic antioxidative-oxidative enzymes in male Wistar rats
    (BMC, 2020-05-09) Muhamudu Kalange, Miriam Nansunga , Keneth Iceland Kasozi , Josephine Kasolo , Jackline Namulema , Jovile Kasande Atusiimirwe , Emmanuel Tiyo Ayikobua, Fred Ssempijja, Edson Ireeta Munanura, Kevin Matama, Ibrahim Semuyaba , Gerald Zirintunda and Alfred Omachonu Okpanachi
    Antimalarials are globally used against plasmodium infections, however, information on the safety of new antimalarial combination therapies on the gastric mucosa is scarce. This study investigated the effects of Artesunate-Amodiaquine and Artemether-Lumefantrine on ulcer induction. Malondialdehyde (MDA), reduced glutathione (GSH), and major histological changes in male Wistar rats following ulcer induction using Indomethacin were investigated. Gastric ulcers were in four groups; Group I was administered Artesunate, group II received ArtesunateAmodiaquine, group III received Artemether-Lumefantrine, and Group IV was a positive control (normal saline). Group V was the negative control consisting of healthy rats. Antimalarial combination therapies were associated with a higher gastric ulcer index than a single antimalarial agent, Artesunate. In addition, levels of MDA were significantly higher in the combination of therapies while GSH levels were lower compared to Artesunate and the negative control. Microscopically, antimalarial combination therapies were associated with severe inflammation and tissue damage than Artesunate in the gastric mucosa showing that antimalarial combination therapies exert their toxic effects through oxidative stress mechanisms, and this leads to cellular damage. The findings in this study demonstrate a need to revisit information on the pharmacodynamics of major circulating antimalarial agents in developing countries. Keywords: Antimalarials, Pharmacodynamics of antimalarial agents, Malaria in developing countries, Gastric ulcers
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    Prevalence of Trypanosoma congolense and Trypanosoma vivax in Lira District, Uganda
    (Hindawi, 2021-06-15) Aziz Katabazi, Adamu Almustapha Aliero , Sarah Gift Witto, Martin Odoki , and Simon Peter Musinguzi
    Animal African trypanosomiasis (AAT) is one of the most significant vector-borne diseases of domestic animals in the Tsetse belt of Africa including East Africa. AAT is caused by Trypanosoma species which are transmitted cyclically by the tsetse fly belonging to the Glossina spp. Animal African trypanosomiasis (AAT) affects a wide range of hosts, namely, goats, sheep, donkeys, and cattle. The disease is characterized by the presence of parasites in the blood and alternating fever. Anaemia usually develops in infected animals, accompanied by weight loss, body loss, miscarriage, abortion, decreased productivity, and sometimes mortality [3]. Animal African trypanosomiasis causes more than 3 million animals to die each year with 50 million animals at risk of infection [4]. Therefore, AAT is the main hindrance to food security, as it makes vast areas of semiarid savannah land in Africa unsuitable for breeding domestic animals that are a source of dairy and meat production. Also, AAT remains a setback in most livestock-dependent economies in Sub-Saharan Africa, causing economic losses of agricultural productivity of about 20% [6], and because most livestock rearing is commonly practiced by rural communities, AAT impedes rural development [7]. In livestock, AAT is caused by Trypanosoma congolense, Trypanosoma vivax, Trypanosoma evansi, Trypanosoma simiae, and Trypanosoma brucei brucei [8]. Trypanosoma species infection in cattle is primarily spread through bites of infected tsetse flies found in over 37 African countries in Sub-Saharan Africa including Uganda [9]. Other biting flies such as Stomoxys have also been implicated in the spread of AAT although they lack epidemiological significance [10]. Several host factors, including the physiological status of the host and nutritional and environmental factors, have an important effect on pathogenicity and determine the severity of the disease [11]. Illness in animals affected with T. congolense, T. vivax, or T. b. brucei is characterized by fluctuating parasitaemia with periods of paroxysms and intermission. This leads to anaemia; the roughness of the hair coat, abortion, reduced milk yield, intermittent pyrexia, depression, and gradual loss of condition lead to extreme emaciation and death of the animal. Diagnosis is an important factor in the controlling of infection. Several diagnostic techniques for trypanosomiasis exist; however, only a few tests have been objectively analyzed and standardized. Trypanosomiasis has traditionally been diagnosed using microscopy to directly observe the Trypanosoma parasites in blood either through a wet film system for detecting mobile trypanosomes or as thick and thin dried smears. Recently, with the explosion of new techniques, because of the rapid developments in molecular biology, new approaches and technologies can be used for diagnosis. The use of molecular methods such as polymerase chain reaction (PCR) has helped to diagnose and classify Trypanosoma species. There are several methods for detecting trypanosomiasis in animals, including parasitological, immunological, and molecular methods. This study used traditional microscopy and molecular techniques to quantify the prevalence and identify the circulating species. Materials and Methods Study Area. This study took place in Lira District, Uganda (Figure 1), which is located in the following coordinates: 2°14′50.0″N 32°54′00.0″E (latitude: 02.2472; longitude: 32.9000) in Northern Uganda [17]. Lira District is the main economic hub in northern Uganda, and livestock keeping is one of the main economic activities. Furthermore, Lira District is one of the districts that benefitted from the restocking program funded by the African Development Bank (ADB). In 2008, the national livestock census reported the cattle population to be 15,933. This put Lira District among the cattle-rearing districts which rendered it an AAT hotspot. The cattle were sampled from the Acungkena, Barropok, and Acanakwo A sub counties. 2.2. Sample Size Determination. This study used a survey formula previously reported by Kish [18]: n = z2pð1 −pÞ/d2, where z is the Z score for 95%confidenceinterval = 1:96, p is the prevalence, and d is the acceptable error (5%). We used the prevalence of bovine African trypanosomes 15.3% in Tororo District, southeastern Uganda [1]. 2.3. Study Design. This was a cross-sectional study aimed at establishing the prevalence of Animal African trypanosomes in Lira District using two selected diagnostic methods. A simple random sampling technique was used to identify the study sites. Two hundred and fifty-four (254) animals were selected and assigned unique numbers for identification according to the village and farm that they came from. This study was carried out from March 2020 to April 2020. 2.4. Sample Collection. From each selected animal, the blood was collected from the jugular vein into vacutainer tubes containing EDTA stored at 4°C in a cooler box, and transported to the district laboratory for microscopy analysis and sample processing for molecular analysis. For molecular analysis, the blood from the vacutainer tubes was applied onto Whatman FTA cards left to dry, and then stored in sealed plastic bags at room temperature. To have a higher chance of detecting parasites, blood sample collection was done in the morning. 2.5. Microscopy. For microscopy, 50μl of whole blood was used to make thin and thick blood films. The blood films were allowed to air dry and then fixed in concentrated methyl alcohol for about 1-2 minutes followed by staining with 10% Giemsa for 25-35 minutes. The blood films were then washed with distilled water to remove the excess stain, and the slides were left to air dry before viewing under an oil immersion lens.
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    Risk Factors for Plasmodium falciparum Recurrence in Artemether Lumefantrine Treated Population from Bushenyi District, Uganda
    (Journal of Advances in Medicine and Medical Research, 2022) Josephat Nyabayo Maniga, Mfitundinda Wilberforce, Katabazi Aziz, Kaweesa Simon Peter, Odoki Martin, Onchoke Vera Bella, Jacqueline Njeri Muchiri, Ochweri Albert, Saheed Adekunle Akinola, Ismail Abiola Adebayo and Odda John
    ABSTRACT Background: Malaria remains a major public health problem. In 2019, it was reported that Uganda accounts for 5% of the total global cases of malaria-related deaths, following Nigeria and the Democratic Republic of Congo. Various risk factors may be responsible for poor treatment outcomes. Thus, the main aim of this study was to evaluate the risk factors for Plasmodium falciparum recurrence in an Artemether-lumefantrine-treated population from Bushenyi district, Uganda. Methods: A descriptive cross-sectional study was conducted in four selected health centers of Bushenyi district, Uganda, using questionnaires, direct observations, and laboratory-based studies. Data analysis was performed using the Statistical Package for Social Sciences (SPSS version 23 windows) for descriptive statistics. Logistic regression analysis was conducted to evaluate the association between Plasmodium falciparum recurrence and associated risk factors. Results: Statistically independent predictor risk factors for Plasmodium falciparum recurrence at p<0.05 were: Previous diagnosis used before the current artemether-lumefantrine (AL) treatment (OR=11.864; 95% CI: 1.477-95.280; p=0.020), Sleeping with animals (OR=0.193; 95% CI: 0.075-0.894; p=0.032), Age (OR=1.435; 95% CI: 0.082-0.975; p=0.040), Travelling outside the study area (OR=2.324; 95% CI: 0.050-0.699; p=0.012), Weight (OR=1.543; 95% CI: 0.085-0.987; p=0.002), and Gametocytes on day 0 (OR=0.284; 95% CI: 0.062-0.735; p=0.032). Conclusions: Monitoring the transmission potentiality after Artemisinin combined therapies (ACTs) treatment is vital in the fight against malaria infection. Keywords: Risk factors; Plasmodium falciparum; recurrence; Uganda.
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    EXPLORING HEALTHCARE WORKERS' PRACTICES IN PREVENTING NOSOCOMIAL INFECTIONS AT KASANGATI HEALTH CENTER, UGANDA
    (King Ceasor University, 2022-08-01) FLAVIA NAAMALA
    This study examines healthcare workers' practices in preventing nosocomial infections at Kasangati Health Center IV, Uganda, focusing on knowledge, attitudes, and practices related to infection prevention. A cross-sectional descriptive design was employed, and data were collected from a sample of 70 healthcare workers using structured interviews. Descriptive statistics, chi-square tests, logistic regression, and correlation analysis were utilized for data analysis. The findings reveal a significant gap between healthcare workers' knowledge, attitudes, and practices regarding nosocomial infection prevention. While 65.7% of healthcare workers demonstrated adequate knowledge and positive attitudes towards infection control measures, only 48.6% exhibited consistent adherence to recommended practices. Organizational support, resource availability, individual perceptions, and clear policy guidelines emerged as key factors influencing healthcare workers' practices. Correlation analysis demonstrated significant positive correlations between healthcare workers' knowledge, attitudes, and practices regarding nosocomial infection prevention (Knowledge-Practices: r = 0.70, p < 0.001; Attitudes-Practices: r = 0.55, p = 0.03). Logistic regression analysis revealed that healthcare workers perceiving supportive organizational cultures were 1.85 times more likely to exhibit positive infection control practices (AOR: 1.85, 95% CI: 1.12-3.07). Similarly, those with positive perceptions and beliefs regarding infection control were 2.15 times more likely to adhere to recommended practices (AOR: 2.15, 95% CI: 1.31-3.52). These findings underscore the importance of addressing the identified gaps in knowledge, attitudes, and practices to enhance infection prevention and control measures at Kasangati Health Center IV. Recommendations include government support, healthcare facility management prioritization, continuous education and training, community engagement, and research and monitoring efforts. Implementing these recommendations can strengthen infection prevention and control practices, ultimately improving patient safety and healthcare outcomes at Kasangati Health Center IV and similar healthcare facilities in Uganda.
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    EXPLORING HEALTHCARE WORKERS' PRACTICES IN PREVENTING NOSOCOMIAL INFECTIONS AT KASANGATI HEALTH CENTER, UGANDA
    (2022-08-01) NAAMALA, FLAVIA
    This study examines healthcare workers' practices in preventing nosocomial infections at Kasangati Health Center IV, Uganda, focusing on knowledge, attitudes, and practices related to infection prevention. A cross-sectional descriptive design was employed, and data were collected from a sample of 70 healthcare workers using structured interviews. Descriptive statistics, chi-square tests, logistic regression, and correlation analysis were utilized for data analysis. The findings reveal a significant gap between healthcare workers' knowledge, attitudes, and practices regarding nosocomial infection prevention. While 65.7% of healthcare workers demonstrated adequate knowledge and positive attitudes towards infection control measures, only 48.6% exhibited consistent adherence to recommended practices. Organizational support, resource availability, individual perceptions, and clear policy guidelines emerged as key factors influencing healthcare workers' practices. Correlation analysis demonstrated significant positive correlations between healthcare workers' knowledge, attitudes, and practices regarding nosocomial infection prevention (Knowledge-Practices: r = 0.70, p < 0.001; Attitudes-Practices: r = 0.55, p = 0.03). Logistic regression analysis revealed that healthcare workers perceiving supportive organizational cultures were 1.85 times more likely to exhibit positive infection control practices (AOR: 1.85, 95% CI: 1.12-3.07). Similarly, those with positive perceptions and beliefs regarding infection control were 2.15 times more likely to adhere to recommended practices (AOR: 2.15, 95% CI: 1.31-3.52). These findings underscore the importance of addressing the identified gaps in knowledge, attitudes, and practices to enhance infection prevention and control measures at Kasangati Health Center IV. Recommendations include government support, healthcare facility management prioritization, continuous education and training, community engagement, and research and monitoring efforts. Implementing these recommendations can strengthen infection prevention and control practices, ultimately improving patient safety and healthcare outcomes at Kasangati Health Center IV and similar healthcare facilities in Uganda.
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    Analysis Of Issues Associated With Legalizing Induced Abortion Among Women Of Reproductive Age In Uganda: A Situational Analysis Among Doctors, Lawyers And University Medical Students.
    (IKSAD Publishing House, 2022-12-22) Suleiman Faisal Sophia; Kalukusu Amos Ronald
    Analysis Of Issues Associated With Legalizing Induced Abortion Among Women Of Reproductive Age In Uganda: A Situational Analysis Among Doctors, Lawyers And University Medical Students. Authors: **Faisal Sophia Suleiman1, Amos Ronald Kalukusu2 ** Corresponding Author: Email [email protected] 2. [email protected] 1 & 2 King Ceasor University, College of Medicine, Health & Life Sciences Abstract This study investigated issues associated with legalizing induced abortion among women of reproductive age in Uganda. Due to the restrictive abortion laws in Uganda, women opt for clandestine abortions which are usually unsafe leading to several complications including death. The target population for the study was 200 among whom it selected 131 respondents who included 36 doctors, 80 medical students, and 15 lawyers. The doctors were selected purposively, the medical students were selected using a random sampling technique while a snowball sampling technique was used to arrive at the 15 lawyers for the study. The specific objectives of the study were: (a) to determine the level of awareness of doctors, medical students, and lawyers on the current laws and policies on induced abortion among women of reproductive age in Uganda. (b) to investigate the insight of doctors, medical students, and lawyers on the advantages of legalizing induced abortion among women of reproductive age in Uganda and (c) to evaluate the insight of doctors, medical students, and lawyers on the barriers to legalizing induced abortion among women of reproductive age in Uganda. Data was collected using a structured questionnaire and then entered and analyzed using SPSS version 20, and the results were represented in both tabular and graphical forms. The study found that there was a significant gap in the knowledge of the laws and policies on abortion in Uganda among doctors, medical students, and lawyers (Sig=0.000, P-value < 0.05). Legalizing induced abortion was viewed to have the advantage of reducing maternal mortality by 59% of the variance while it was further viewed to reduce abortion complications by 15% of the variance. The most significant barrier to legalizing induced abortion in Uganda comes from religious organizations that contribute 49% of the variance. Additionally, few policymakers can articulate publicly in favor of the liberal abortion laws as this contributed 22% of the variance. In terms of implementation of the abortion laws in Uganda, 41% of the variance is a result of the laws being too complicated, accompanied by a failure to inform the public, the health workers, and government officials on the interpretation of the abortion laws (24.1% of the variance). The insights of the doctors and medical students towards legalizing induced abortion in Uganda predicted an 80.5% variance in terms of their willingness to perform an induced abortion, while it predicted a 65.9% variance towards launching a constitutional challenge by the lawyers. It was concluded that there is a significant gap in the knowledge of doctors, medical students, and lawyers on the current laws and policies on induced abortion and the study recommended that Uganda’s abortion laws and policies should be clarified to improve the level of awareness among the citizenry. Keywords: Induced Abortion, legalizing Induced Abortion, Abortion Laws & Policies, Maternal Mortality.
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    Analysis Of Issues Associated With Legalizing Induced Abortion Among Women Of Reproductive Age In Uganda: A Situational Analysis Among Doctors, Lawyers And University Medical Students.
    (IKSAD Publishing House, 2022-12-22) Faisal Sophia Suleiman; Amos Ronald Kalukusu
    Abstract This study investigated issues associated with legalizing induced abortion among women of reproductive age in Uganda. Due to the restrictive abortion laws in Uganda, women opt for clandestine abortions which are usually unsafe leading to several complications including death. The target population for the study was 200 among whom it selected 131 respondents who included 36 doctors, 80 medical students, and 15 lawyers. The doctors were selected purposively, the medical students were selected using a random sampling technique while a snowball sampling technique was used to arrive at the 15 lawyers for the study. The specific objectives of the study were: (a) to determine the level of awareness of doctors, medical students, and lawyers on the current laws and policies on induced abortion among women of reproductive age in Uganda. (b) to investigate the insight of doctors, medical students, and lawyers on the advantages of legalizing induced abortion among women of reproductive age in Uganda and (c) to evaluate the insight of doctors, medical students, and lawyers on the barriers to legalizing induced abortion among women of reproductive age in Uganda. Data was collected using a structured questionnaire and then entered and analyzed using SPSS version 20, and the results were represented in both tabular and graphical forms. The study found that there was a significant gap in the knowledge of the laws and policies on abortion in Uganda among doctors, medical students, and lawyers (Sig=0.000, P-value < 0.05). Legalizing induced abortion was viewed to have the advantage of reducing maternal mortality by 59% of the variance while it was further viewed to reduce abortion complications by 15% of the variance. The most significant barrier to legalizing induced abortion in Uganda comes from religious organizations that contribute 49% of the variance. Additionally, few policymakers can articulate publicly in favor of the liberal abortion laws as this contributed 22% of the variance. In terms of implementation of the abortion laws in Uganda, 41% of the variance is a result of the laws being too complicated, accompanied by a failure to inform the public, the health workers, and government officials on the interpretation of the abortion laws (24.1% of the variance). The insights of the doctors and medical students towards legalizing induced abortion in Uganda predicted an 80.5% of variance in terms of their willingness to perform an induced abortion, while it predicted a 65.9% variance towards launching a constitutional challenge by the lawyers. It was concluded that there is a significant gap in the knowledge of doctors, medical students, and lawyers on the current laws and policies on induced abortion and the study recommended that Uganda’s abortion laws and policies should be clarified to improve on the level of awareness among the citizenry. Keywords: Induced Abortion, legalizing Induced Abortion, Abortion Laws & Policies, Maternal Mortality.
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    Fundamentals of medicine handbook
    (2023-02-28)
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    To Investigate the Correlation Between the Socioeconomic Status and Cardiometabolic Associated Risk Indicator Among Middle Aged Adults in Selected Sub-Counties in Kisumu County in Nyanza Region in Kenya
    (Asian Journal of Natural Sciences (AJNS), 2023-05-09) Barasa M Ambrose, Cherop Doreen, G.R Neel, Mercyline Natasha Aluoch, Aziz Katabazi5, Eilu Emmanuel.
    According to World Health Organization (WHO) 2022 projections, cardio metabolic related risk indicators are already a worldwide epidemic, with an estimated 57.8% of individuals worldwide anticipated to be exposed to the risk indicators by 2030. Other indicators include diabetes, hypertension, dyslipidemia, cardiovascular disease, and many malignancies. Obesity, defined as an excessive accumulation of body fat, gives rise to considerable cardiac metabolic-related risk indicators. Consequently, obesity is usually referred to as the primary cardiometabolic risk factor and a critical public health concern that demands immediate treatment to avoid cardiometabolic illnesses. Advances in health care, as well as lifestyle and behavioral changes brought about by globalization, have increased the incidence of cardiometabolic risk markers. These markers, such as lower quality of life, greater healthcare expenses, and a higher risk of mortality, are linked to socioeconomic levels. Cardiometabolic multimorbidity (CM), defined as the presence of two or more cardiometabolic illnesses in the same person, is on the rise in middle-aged people. Recent research has discovered that combining cardiac metabolic disorders multiplicatively increases the risk of mortality, with each new ailment doubling the risk of mortality. Many Sub-Saharan African nations, including Kenya, are now undergoing nutrition transitions characterized by changes in dietary patterns and physical activity that predispose them to lifestyle metabolic illnesses.
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    Zinc oxide nanoparticles accelerate the healing of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in rabbits
    (Asian Pacific Journal of Tropical Biomedicine, 2023-05-09) Muhammad Asif1, Ayesha Safdar Chaudhry, Ambreen Ashar, Hamad Bin Rashid, Muhammad Hassan Saleem, Hassaan Bin Aslam, Abdul Aziz
    The study was about Zinc oxide nanoparticles accelerate the healing of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in rabbits. The main objective was to synthesize zinc oxide nanoparticles (ZnONPs) and evaluate their antibacterial and wound healing effects against wounds infected with methicillin-resistant Staphylococcus aureus (MRSA). The methods used were as follows: ZnONPs were prepared using the sol-gel method and characterized by X-ray diffraction (XRD) analysis and scanning electron microscopy (SEM). Eighteen rabbits were divided into three groups: the ZnONPs group, the gentamicin group, and the control group. Each rabbit was inflicted with a 3 cm^2 wound contaminated with MRSA inoculum. Treatment commenced on the fourth day post-surgery. Wound healing, microbiological analysis, and histopathological analysis were performed to assess the efficacy of ZnONPs ointment. The results are: XRD analysis confirmed the hexagonal wurtzite structure of the ZnONPs with an average crystallite size of 29.23 nm. SEM revealed discoid-shaped ZnONPs with a rough surface and an average size of 48.36 nm. Energy-dispersive X-ray analysis confirmed the purity of ZnONPs. Moreover, the particle size ranged from 100-700 nm with a high agglomeration trend. Treatment with ZnONPs promoted the healing of MRSA-infected wounds. Additionally, ZnONPs exhibited a good antibacterial effect, as evidenced by a dose-dependent increase in the zone of inhibition. Conclusions: ZnONPs accelerate the healing of MRSA-infected wounds, suggesting their potential for the treatment of MRSA infection.
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    The Correlation between the Overweight and Obesity as Predisposing Risk Indicators to Cardiometabolic Disorders among Adults in Kisumu County Nyanza Region of Kenya
    (Salient Visionary Publications [(Annal of Clin Med & Med Res (AOCMMR) ], 2023-08-27) Barasa M Ambrose, Cherop Doreen, Neel GR, Mercyline Natasha Aluoch, Aziz Katabazi, Moazzam Mohiuddin Lodhi, Khurram Ansar
    Lifestyle is broadly defined as the way or manner by which a person or a group of people lives. However, lifestyle can be influenced by a complex set of factors that are intertwined and can affect the quality of living and health. The socioeconomic position (SEP) stands out among these factors because it has a direct impact on the quality of nutrition and the living environment, including access to adequate physical activity facilities and education. Consequently, a comprehensive view must be adopted whenever addressing this topic but a majority of studies tend to focus on this area in a fragmented manner. Aim: To find out correlation between the overweight and obesity as predisposing risk indicators to cardiometabolic disorders among adults in Kisumu County Nyanza region of Kenya. Methodology: This was a cross-sectional quantitative study among the Western Kenya population, where the participants were randomly selected from type II diabetic adult patients 18 years and above attending diabetes clinic in selected district hospitals in Western Kenya. A Pretested Questionnaire was used to collect the data. Blood pressure, anthropometric measurements, height, weight, and waist circumference were taken. Results: The sample size was 202. Most of the participants (48%) were aged 36-50 years, 129(64%) were females, most (55.4%) of the participants were Obese and 26.7% had a healthy weight. The females who had a waist-to-hip Ratio of over 0.8 were classified as centrally obese (55%) while 49% of the males had a waist-tohip Ratio of 0.9, which was also classified as central obese. Most of the participants were hypertensive (60%) while 9% had hypertensive emergencies. Conclusions: The participants had mostly two indicators of cardiometabolic disorders present and obesity among the study population in this study, our results point to the need for measures to prevent and treat obesity in this and other high-risk groups. Keywords: Overweight, Obesity, Cardiometabolic Risk Markers, Correlation
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    Investigating The Factors Contributing To The Persistence Of Hospital-Acquired Infections At Mulago National Referral Hospital, Uganda.
    (Un-published Dissertation, 2024-02-08) Kugonza Grace; Amos Ronald Kalukusu
    Abstract The study investigated the factors contributing to the persistence of hospital-acquired infections in hospitals while considering Mulago National Referral Hospital as the case study. The main objective was to comprehensively investigate and understand the factors contributing to the persistence of hospital-acquired infections at Mulago National Referral Hospital, Uganda. Three specific objectives guided the research and these were (a) to assess the prevalence and epidemiology of Hospital Acquired Infections at Mulago National Referral Hospital; (b) to determine the association between the demographic characteristics of patients and their likelihood of acquiring hospital-acquired infections; (c) to identify contributing factors to Hospital Acquired Infections at Mulago National Referral Hospital. The research adopted a descriptive design incorporating both quantitative and qualitative approaches. A comprehensive survey was conducted, involving 219 participants, to examine the interplay between demographic factors, patient perceptions, and healthcare practices concerning HAIs and data was collected using self-administered questionnaires, interviews, and focus group discussions. The key findings of the study indicate that there were statistically significant associations between demographic factors and the length of hospital stays, where individuals who stayed in the hospital for 3 days to 1 week exhibited a significantly higher chi-square (X2) value of 2.609, indicating a more substantial association with the study objectives. The adjusted odds ratio (AOR) of 3.598 and the p-value of 0.003 suggest that this group's length of stay is statistically significant regarding the factors contributing to hospital-acquired infections. Longer hospitalization within this range appears to have a notable impact. On the other hand, individuals who stayed in the hospital for 1 to 2 weeks exhibited a chi-square (X2) value of 5.976, indicating a strong association with the study's objectives. The adjusted odds ratio (AOR) of 4.509 and the p-value of 0.008 emphasize the significance of this group's length of stay. Prolonged hospitalization within this range is statistically significant for the persistence of hospital-acquired infections. Older patients (aged 50 and above), those with lower education levels, specific marital statuses, and gender-related factors experienced longer hospital stays, leading to an increased risk of HAIs. These findings underscore the importance of tailored infection prevention strategies for specific patient profiles. Concerning healthcare practices and patient perceptions, participants generally held positive perceptions of healthcare practices related to infection control, including antimicrobial prescribing patterns, hand hygiene, infection control protocols, and efforts to identify vulnerabilities. These positive perceptions were crucial in fostering patient trust and engagement in infection prevention efforts. The study’s implications and recommendations suggest that Mulago National Referral Hospital and healthcare facilities worldwide should include tailoring infection prevention strategies to specific patient profiles, continuous monitoring and education, patient engagement, interdisciplinary collaboration, and resource allocation. It was concluded that this research should be viewed as a potential source of information to support the ongoing efforts to enhance infection control practices at Mulago National Referral Hospital and provide valuable insights for healthcare facilities worldwide in their fight against hospital-acquired infections. By addressing the complex interplay between demographic factors, healthcare practices, and patient perceptions, we can move closer to a healthcare system where HAIs are minimized, patient outcomes are improved, and patient trust in healthcare providers is strengthened.
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    Exploring The Role Of Nurse-Led Health Promotion Programs In Preventing Chronic Diseases In Underserved Communities Of Komamboga, Kawempe Division, Kampala Uganda
    (Un-published Dissertation, 2024-02-29) Fatima Dianah; Amos Ronald Kalukusu
    ABSTRACT This study investigates the role of nurse-led health promotion initiatives in preventing chronic diseases within underserved communities, focusing on Komamboga, Kawempe Division, Kampala, Uganda. A mixed-methods approach was employed to assess perceptions, experiences, and satisfaction levels among community members and healthcare providers. Demographic data from 85 participants revealed a diverse population, with 55% female and 45% male respondents. Analysis indicated a high prevalence of chronic diseases, with 29.4% reporting diabetes, 47.1% hypertension, and 23.5% obesity. Regression analysis showed significant associations between participation in nurse-led programs and improved health outcomes, with adjusted odds ratios (AOR) ranging from 1.5 to 2.3 (p < 0.05). Correlation analysis demonstrated a positive relationship between community engagement and program satisfaction (r = 0.65, p < 0.001). Moreover, chi-square values indicated significant associations between program effectiveness and participant demographics (χ² = 18.6, df = 3, p < 0.001). Findings underscore the importance of nurse-led initiatives in promoting community health and reducing chronic disease burdens. Recommendations include continued investment in such programs and integration of participant feedback to enhance effectiveness and sustainability. This study contributes valuable insights to the field of public health, highlighting the pivotal role of nurses in addressing health disparities and improving overall well-being in underserved populations.
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    Medicine hndndbook
    (2024-03-28)
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    Knowledge, attitudes and practices of presure ulcer prevention in critically ill patients among nurses at Mulago National Referral Hospital, Uganda.
    (King Ceasor University, Institutional Repository, 2024-05-06) Kirabo Violet Vicky
    This dissertation report is from a study aimed at establishing the knowledge, attitude, and practices on pressure ulcer prevention in critically ill patients among Nurses at Mulago National Referral Hospital. The researcher used a descriptive cross-sectional study design to obtain quantitative and qualitative data from the respondents. The study population was constituted by nurses attending to critically ill patients and the sample size was 50. Specific objectives: of the study: To determine the knowledge, attitude, and practices on pressure ulcer prevention in critically ill patients among Nurses at Mulago National Referral Hospital, the study setting. Key study findings: Indicated that in demographics almost three quarters were female, almost half 48% had working experience of 6-10 years and more than half 58% were diploma holders and only 30% had undergone specialized training in managing PUP in critically ill patients at Mulago National Referral Hospital. Knowledge: Most respondents 80.6% had inadequate knowledge towards managing PUP in critically ill patients. There was a serious gap as regards both specialized and refresher training. Attitudes: More than 30% of the respondents had poor attitudes towards managing PUP in critically ill patients. Which was attributed to limited mentoring. Practices: More than 30% of the respondents exhibited poor practices towards managing PUP in critically ill patients. Which was attributed to limited knowledge and support supervision, as well as poor attitudes towards the practice. Conclusions: Study findings therefore indicated that the absence of regular support supervision and mentoring by senior nurses, as well as the lack of specialized and refresher training were more likely to compromise the knowledge, attitudes, and practices of young inexperienced nurses towards the management of critical ill patients against the condition of pressure ulcers which will in turn compromise the quality of health service delivery among the patients. Recommendations: Regular support supervision and mentoring by senior nurses, as well as providing specialized and refresher training were more likely to significantly improve the knowledge, attitudes, and practices of young inexperienced nurses towards the management of critically ill patients against the condition of pressure ulcers which will in turn improve the quality of health service delivery among the patients.
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    Implications of Sero-Status disclosure among sexual partners in Uganda: A situational analysis among clients reporting for counselling & testing at Mulago National Referral Hospital.
    (King Ceasor University, Institutional Repository, 2024-05-06) Naluwooza Esther and Amos Ronald Kalukusu
    Voluntary HIV disclosure among sexual partners has both advantages and disadvantages. The advantages include helping people with HIV to ask for and receive social support, have safer sex, and assistance to access HIV treatment among sexual partners while disadvantages are such as being blamed, discriminated against, depressed, divorced, and verbally abused after a voluntary disclosure. This study assessed the implication of serostatus disclosure among sexual partners at the HIV counseling and testing center at Mulago National Referral Hospital in Uganda. This was a cross-sectional and descriptive study, involving 157 adult PLWHA, selected using a non-probability convenience sampling method and questionnaires to collect data, which was analyzed using Statistical Package for Social Scientists (SPSS). Data was presented in frequency tables, pie charts, and graphs with explanatory remarks. The study revealed that 98(62.4%) of the respondents disclosed their HIV-positive serostatus to their sexual partners. Sixty respondents (61.2), 50(51%), 26(26.5), and 18(18.3%) of those who disclosed their HIV status with sexual partners reported having depression, being blamed/beaten, divorced, and being stigmatized respectively. On the other hand, 19(19.3%), 11(11.2%), and 8(8.1%) received social support from their partners, their partners were tested after their disclosure and discussed safer sex with their sexual partner after disclosure respectively. The findings suggest that PLWHA have varying experiences, ranging from depression, being blamed/beaten, desertion or separation, and stigma to support, safer sex, and partner testing, with the majority suffering negative experiences. Therefore, there is a need to develop programs for counseling PLWHA on the management of negative experiences, living positively, self-disclosure, and prevention of re-infection with HIV. Key Words: Sero-Status; Disclosure; HIV
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    Healthcare professionals’ knowledge of and compliance with the ASCO/ ESMO/GLIM guidelines for the diagnosis and management of cancer cachexia (CC): the ASSIST-CC baseline findings in Uganda
    (ecancermedicalscience Journal, 2024-06-07) Innocent Atuhe, Alfred Jatho, Babra Nalwadda, Judith Asasira, Martha Nantayi, Joseph Semujju, Naome Namwira, Kulusum Namayanja, Ashley Atwine, Semei Buwambaza Sekitene, and Jackson Orem
    Background: More than 50% of people with advanced cancer suffer from cancer-related cachexia (CC) – a major contributor to morbidity and mortality. Despite the lack of local guidelines on CC diagnosis and management in Uganda, the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO) and the Global Leadership Initiative on Malnutrition (GLIM) developed guidelines on CC screening and management. However, the level of knowledge on CC and compliance with the available guidelines among Ugandan oncology health professionals is unknown. This study aimed to assess the level of awareness and knowledge of CC diagnosis and management and com pliance with the ASCO/ESMO/GLIM guidelines on CC among healthcare professionals (HCPs) involved in the care of cancer patients. Methods: In this phase one, a self-administered structured questionnaire developed using the ASCO/ESMO and GLIM guidelines on diagnosis and management of CC was used to assess the level of awareness, and knowledge of 200 health professionals from three hospital settings on CC, and compliance with the ASCO/ESMO/GLIM guidelines on CC related core communication, barriers to communication, clinician training in com munication, discussing goals of care, treatment options and meeting the needs of the underserved populations. The data were entered into Research Electronic Data Capture software analyzed using STATA version 18.0 software. Results: The overall objectively correct knowledge score of CC diagnosis criteria was 67.5% (n = 135), yet there was a much lower level of awareness about ASCO/ESMO/ GLIM guidelines on CC at 30% (n = 60) and only 21% (n = 42) of the HCPs have ever assessed Quality of life of CC patients. The compliance with ASCO/ESMO/GLIM guidelines on nutritional interventions for patients with CC varied across the variables markedly, ranging from 25.1% (n = 50) to 81% (n = 162) for the specific ASCO/ESMO/GLIM guidelines’ recommendations. Whereas compliance with the guidelines on discussing goals of care, prognosis, treatment options and end-of-life care scored the highest in most variables, most HCPs exhibited low compliance with the discussion about patientsend-of-life preferences early in the course of incurable illness (49.8%, n = 99). There were statistically significant differences between the mean scores of only two variables among the three hospitals in compliance with ASCO/ESMO/GLIM guidelines on the provision of additional calories by feeding tubes (p = 0.038), and the available evidence to recommend medication to improve CC outcomes (p = 0.0286). On discuss ing goals of care, prognosis, treatment options and end-of-life care there was a statistically significant difference between the mean scores of only one variable; clinician’s simplicity of providing information to patients (p = 0.0132) among the HCPs in the three hospital settings. Conclusion: This study indicated that the overall objectively correct knowledge of CC diagnosis criteria was inadequate, with a much lower level of awareness about the ASCO/ESMO/GLIM guidelines on CC and a handful of the HCPs have ever assessed the quality of life of CC patients. Quality improvement interventions on CC diagnosis and management should prioritize improving the level of knowledge on CC, diagnostic criteria and patient-clinician communication, including discussion about patients’ end-of-life care using standardized tools such as ASCO/ESMO or GLIM guidelines on CC using a multidisciplinary team approach. Keywords: cancer cachexia, cancer cachexia diagnosis, cancer cachexia management
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    Knowledge Of Diabetic Foot Disease, Foot Self- Care Practices And The Beliefs Of Diabetic Patients Attending Atutur Hospital In Kumi District Uganda
    (King Ceasor University Institutional Repository., 2024-07-18) Acen Gertrude & Amos Ronald Kalukusu
    This study investigated the knowledge, self-care practices, beliefs, and perceptions of diabetic patients regarding diabetic foot disease, focusing on Atutur Hospital in Uganda. The objectives included evaluating patients' knowledge levels, examining foot self-care practices, and exploring patients' beliefs and perceptions towards diabetes and diabetic foot disease. A quantitative research approach was employed, with data collected from 300 diabetic patients using structured questionnaires and analyzed using SPSS version 26. Key findings revealed significant gaps in patients' knowledge regarding diabetic foot disease, with only 40% demonstrating adequate awareness of risk factors, symptoms, and preventive measures. Concerning self-care practices, 66.7% of patients reported appropriate footwear selection, while only 40% engaged in regular foot inspections. Chi-square analyses indicated significant associations between certain self-care practices and demographic variables (χ² = 12.67, p = 0.001 for footwear selection). Adjusted Odds Ratios (AORs) were calculated, with appropriate footwear selection associated with a 3.25 times higher likelihood of adherence to self-care practices. Patients' beliefs and perceptions towards diabetes and diabetic foot disease varied, influenced by cultural, social, and psychological factors. Positive attitudes towards medical treatment were observed in some patients, while others faced barriers such as financial constraints and stigma. The study underscores the importance of addressing patients' beliefs and perceptions in diabetes management to improve treatment adherence and health outcomes. In conclusion, targeted educational interventions are necessary to enhance patients' knowledge and promote preventive behaviors. Healthcare providers should prioritize patient-centered approaches and culturally sensitive care to address the diverse needs of diabetic patients. Recommendations include the development of comprehensive diabetes management strategies and the implementation of multidisciplinary interventions to mitigate the burden of diabetic foot disease. Keywords: Diabetic foot disease; Self-care practices; Patient perceptions
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    Assessment Of Health Staff Response To Physical Trauma Patients In Uganda A Case Of Mulago National Referral Hospital
    (Unpublished Dissertation., 2024-07-18) Rebecca Friday & Dr. Herbert Tumusiime
    Physical trauma is a leading cause of disability and mortality worldwide, and data characterizing the response of health staff towards physical trauma patients in Uganda is limited. This study aims to characterize the responses of health workers toward physical trauma patients presenting to Mulago National Referral Hospital (MNRH) to identify opportunities for quality improvement and policy development. The study used a cross-sectional survey design and 96 questionnaires were administered to both health staff and patients to collect data and SPSS was used to analyze the data. The response rate was 92.7% and 7.3% was the non-response rate. From November 2023 to March 2024, data was prospectively captured on injured patients and health workers using a properly designed questionnaire and also conducted some interviews. Information was analyzed in line with the three objectives which were; i) To find out the impact of physical trauma on the socio-demographic characteristics of patients and health staff at Mulago National Referral Hospital; ii) To find out the responses of health staff towards physical trauma patients at Mulago National Referral Hospital in Uganda. iii) To find out the consequences faced by patients due to physical trauma at Mulago National Referral Hospital at the Trauma ward. Descriptive and bivariate statistical analyses were conducted. A total of 89 respondents were chosen of which 63 injured patients were treated during the study period by 23 health workers. The study established that the majority of the respondents were male (59.6%), the occupations most affected by physical trauma injuries were students (33.7%), and people within the age group of 30-40 years at 29.2%. The health workers gave first aid to patients on arrival at the hospital and recommended a professional in case of a serious injury. It was also found that the medical equipment used in the treatment and care of the victims was not enough. 88.4% of the health workers offer counseling services to patients who obtain any type of disability and also 76.9% do not follow up on the patients after discharging them. Falls (44.4%) and road traffic injuries (RTIs, 31.7%) were the leading causes of injury. Over three-quarters (71.4%) of all patients had a temporary disability. The lower body extremities were the most recorded body injuries at 55.6% followed by upper body extremities (30.2%) and the head/neck and face at 14.3%. It took about 30 minutes to one hour for most patients to arrive at the hospital where ambulances were used to transport severely injured victims and motorcycles (68.3%)were the most used to arrive to the hospital. In Uganda, there is a significant need for injury prevention efforts to protect vulnerable populations such as children and women from physical trauma on roads/streets and in the home. Specialized professionals like Orthopedics and neurosurgeons are important targets for the strengthening of health systems. The comprehensive data provided by the researcher will continue to inform such efforts and provide a way to monitor their progress moving forward. Key Words: Physical trauma, Health worker responses, Injury prevention