Browsing by Author "Komuhangi, Alimah"

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Delay in Diagnosis of Tuberculosis Among Patients Attending Kampala Capital City Authority TB Diagnostic and Treatment Units in Uganda.
(International Health Sciences University., 2014-11) Komuhangi, Alimah
Introduction Kampala Capital City Authority (KCCA) TB diagnostic and treatment units are the main publichealth units offering free TB diagnostic services in Kampala City, so identifying factorscontributing to the delay to diagnose TB would be a step forward in reducing TB transmission,morbidity and mortality. Delay in diagnosis of tuberculosis (TB) results in severe disease and higher mortality. It also increases the duration of infectivity in the population (WHO, 2013). Early detection and diagnosis of TB cases is the hallmark of all successful TB control programs. Objective of the study The main objective of the study was to determine the factors contributing to the delay to diagnose TB among patients attending KCCA TB diagnostic and treatment units in the period of July to August 2014. The specific objectives were to determine the socio-demographic, patient and health facility factors contributing to the delay to diagnose TB among patients attending KCCA treatment and diagnostic units in the period of July to August 2014. Methodology A cross sectional study of 281 PTB diagnosed patients was conducted at the 7 public health TB diagnostic and treatment units in Kampala, from July to August 2014. Quantitative methods of data collection using a researcher administered questionnaire and qualitative methods using focus group discussion and key informant guide were utilized. Poisson regression model was used to estimate the incidence risk ratios (IRR) and their 95% confidence interval for the delays comparing them with the independent variables. Results The mean total delay (interval from onset of cough to first contact with the health facility and interval from first contact with health facility to receipt of TB results) was 78 days (S.D =72). 58% of patients often sought care from drug shops or pharmacies before visiting a TB diagnostic and treatment unit (incidence risk ratio [IRR] =1.05; 95% CI: 1.0-1.3). Other factors that contributed to the 'Total delay to diagnose TB' were identified: being unemployed (IRR =1.09; 95% CI: 1.0-1.2), cohabiting (IRR =1.14; 95% CI: 1.0-1.3), never taken alcohol (IRR =0.88; 95% CI: 0.8-1.0), private means of transport (IRR=1.15; 95% CI: 1.0-1.3), and more than three TB clinic visits prior to diagnosis (IRR=1.15; 95% CI: 1.0-1.3). Smoking, HIV status and perceived TB stigma were not associated with total delay in TB diagnosis. Conclusion Delay in diagnosis of PTB is unacceptably high in Kampala. A huge proportion (86.8%) of patient factors contributed to the delay to diagnose TB than the health care related factors (13.2%). Majority 88.3% (248/281) of PTB patients in Kampala take 78 days from onset of cough to TB diagnosis, a factor that increases the rate of TB transmission, morbidity and mortality. Recommendations The Uganda NTLP should pay more attention to certain specific groups such as alcoholics and the unemployed in order to improve their health seeking behavior. TB diagnostic services should be accessible to the general population through community outreaches and contact tracing, so that patients residing more than 5 km from a TB diagnostic unit are diagnosed at home. KCCA TB focal persons should ensure that TB diagnostic supplies are provided to all TB units in order to avoid stock outs and enhance early diagnosis of TB. KCCA TB management team should conduct continuous community sensitization to enable patients understand the importance of early diagnosis. The National Drug Authority should strengthen policies regarding administration of medicines in drug shops/pharmacies without prescription from registered health professionals. Drug shop/pharmacy employees have to be trained in order to have a high index of suspicion for tuberculosis when cardinal symptoms exist. Further areas of research should be conducted in order to enhance early TB diagnosis.
Factors Affecting Management of Biomedical Waste in Mulago National Referral Hospital, Kampala District.
(International Health Sciences University, 2013-09) Komuhangi, Alimah
Introduction Biomedical waste is a by-product of health care service delivery that includes sharps, blood, body parts, chemicals, pharmaceuticals, medical devices and radio-active materials (WHO, 2008).Proper management of biomedical waste is essential in protecting health care workers, waste handlers and the community from infections, toxic effects and injuries. Mulago National Referral Hospital being the leading producers of bio-medical waste little is known about the factors influencing bio-medical waste management. Objective of the study The main objective of the study was to identify the factors affecting management of biomedical waste among health workers in Mulago National Referral Hospital, Kampala district. Method A cross sectional study design that utilized quantitative methods of data collection using a self-administered questionnaire was carried out at Mulago National Referral Hospital. A total of 384 health care workers selected from 6 departments (Paediatrics, ENT, Dental, Orthopaedics, Laboratories and The heart institute) were interviewed. The main outcome of the study was management of bio-medical waste. The study used logistic to estimate the Odds ratios and their 95% confidence interval for safe management of bio-medical waste. Results More than half (55%) of the respondents reported that the hospital’s current status of managing bio-medical waste is safe. Majority (45%) of the health care workers had inadequate knowledge on the management of bio-medical waste. More than three quarters of the health care workers had good attitude towards management of bio-medical waste which represents a very high opportunity to improve management of bio-medical waste in Mulago National Referral Hospital. Factors were found to be significantly associated with safe management of bio-medical waste: cadre, nursing assistants are 0.3 less likely to engage in safe management of bio-medical waste than other cadres; OR =0.3, 95% CI=0.1-0.6 Period of practice (6-10 years); OR =0.4, 95% CI=0.2-0.8 Level of knowledge (Inadequately knowledgeable and Not knowledgeable); OR =0.5, 95% CI =1.1- 3.5 and OR = 0.3, 95% CI= 0.98-0.99 respectively, equipment; OR = 0.3, 95% CI=0.2-0.5 and training; OR =0.5, 95% CI=0.3-0.8). Conclusion The current status of managing bio-medical waste in Mulago national referral is still unsafe as only 55% of health workers reported safe management. This is attributed to the low level of knowledge and lack of equipment in deferent service areas. Recommendation There is need to equip health workers with adequate and up to date information on management of bio-medical waste at all levels of training or cadre by the responsible authorities. There is need to increase on the provision of equipment in all service areas for storage and transportation of bio-medical waste.
Knowledge, perception and practices towards sickle cell disease:
(BMC Public Health, 2018) Tusuubira, Sharifu K; Nakayinga, Ritah; Mwambi, Bashir; Odda, John; Kiconco, Sylvia; Komuhangi, Alimah
Background: Worldwide, the burden of Sickle Cell Disease (SCD) has not been amply addressed. In Africa, Uganda has the 5th highest burden, a situation aggravated by limited and inaccessible formal social support structures to aid patients and families cope better with the psychosocial burden of SCD. In addition, this has been coupled with stigmatization and discrimination of people living with sickle cell disease-causing isolation from family and society. Method: This cross-sectional study, therefore, set out to determine the attitudes, perception and level of awareness towards Sickle Cell disease in Ugandan communities. The study used an interviewer administered questionnaires to collect the data. Results: Out of 110 people sampled; 91.2% of the respondents had ever heard of SCD with the highest proportion 38.7% hearing of SCD from friends and family. Close to half of the respondents 48% knew that SCD is inherited, however a large proportion 44.2% did not know the cause of SCD. However, 68.7% of the respondents said they cannot marry a person with SCD. Conclusion: The study results indicate that more effort needs to be done to promote sickle cell awareness in Uganda communities with an emphasis on the inclusion of sickle cell in health education campaigns.
Low level of tuberculosis preventive therapy incompletion among people living with Human Immunodeficiency Virus in eastern Uganda: A retrospective data review
(Elsevier, 2021-08-28) Lwevola, Paul; Izudi, Jonathan; Kimuli, Derrick; Komuhangi, Alimah; Okoboi, Stephen
ntroduction: In most developing countries, tuberculosis (TB) is the leading cause of mortality among people living with the Human Immunodeficiency Virus (PLHIV). Uganda implements TB preventive therapy (TPT) using Isoniazid but data are limited about TPT incompletion. We, therefore, assessed the magnitude of TPT incom- pletion and the associated factors among PLHIV in a large rural referral health facility in rural eastern Uganda. Methods and materials: We conducted a retrospective data review for PLHIV initiated on TPT between October 2018 and September 2019. The outcome variable was TPT incompletion defined as the failure to finish 6 consecutive months of Isoniazid or failure to finish 9 months of Isoniazid without stopping for more than 2 months at a time. We descriptively summarized numerical data using frequencies and percentages and compared differences in the outcome with independent variables using the Chi-square or fisher’s exact, and the Student’s t- tests. We used a generalized linear model to assess factors independently associated with TPT incompletion, reported using adjusted odds ratio (aOR) and 95% confidence interval (CI). Results: We enrolled 959 participants with a mean age of 41.1 ± 13.8 years, 561 (58.5%) were females, 663 (69.1%) married, 538 (56.1) travelled 5–10 km from their place of residence to the ART clinic, 293 (30.6%) had disclosed HIV status, 362 (37.7%) had been on ART for 5–9 years, and 923 (96.2%) were on first-line ART regimen. We found 26 (2.7%) participants had incomplete TPT. Non-adherence to ART clinic visits (aOR, 2.81; 95% CI, 1.09–7.73), history of switch in ART regimen (aOR, 9.33; 95% CI, 1.19–52.39), patient representation (aOR, 4.70; 95% CI, 1.35–13.99), and one unit increase in ongoing counselling session (aOR, 0.67; 95% CI, 0.46–0.91) were associated with TPT incompletion. Conclusion: We found low rates of TPT incompletion among PLHIV in rural eastern Uganda. Non-adherence to ART clinic visits, patient representation, and history of switch in ART regimen is associated with a higher likelihood of TPT incompletion while ongoing counselling is associated with a reduction in TPT incompletion. The health system should address non-adherence to ART clinic visits and patient representation, through ongoing psychosocial support
Pre-lacteal Feeding Among Infants Within the FirstWeek of Birth in Eastern Uganda:Evidence From aHealth Facility-based Cross-sectional Study
(Research Square, 2021-05-17) Akello, Rachael; Kimuli, Derrick; Okoboi, Stephen; Komuhangi, Alimah; Izudi, Jonathon
Background: Pre-lacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding butis understudied in Uganda. We examined the prevalence and factors associated with pre-lacteal feedingamong postpartum mothers in Kamuli district in rural eastern Uganda.Methods: We conducted a cross-sectional study at four large healthcare facilities and randomly sampledmother-baby pairs attending postnatal care clinics.