Browsing by Author "Taremwa, Ivan Mugisha"

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Adherence to Iron and Folic Acid Supplementation and Its Associated Factors among Pregnant Women Attending Antenatal Care at Bwindi Community Hospital, Western Uganda
(International Journal of Reproductive Medicine, 2021-06-07) Nimwesiga, Christine; Murezi, Mereth; Taremwa, Ivan Mugisha
This study assessed the adherence to iron and folic acid supplementation and the associated factors among pregnant women attending antenatal care at Bwindi Community Hospital, in Western Uganda. Methods. This was a cross- sectional study that used an interviewer-administered questionnaire and reviewed medical records. Binary and multivariable logistic regression analyses were used to identify factors associated with iron and folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to assess for statistical significance. Results. We enrolled 438 pregnant women aged 16 to 41years. Participants’ mean age (±standard deviation (SD)) was 25.9 (±3.17) years. The self- reported adherence to iron and folic acid supplementation (consumed ≥4 tablets a week or 20 tablets in a month daily without missing the prescribed dosage) was 22.37% (N = 98). Among the adherent pregnant women, the reported reasons (and their respective proportionality) for adherence were getting advice and counseling from the healthcare worker about the good effects of iron and folic acid supplementation (N = 34, 34.69%) and knowledge about the health benefits of iron and folic acid supplementation such as preventing anemia (N = 16, 16.33%), among others. On the other hand, the reported reasons (and their respective proportionality) for iron and folic acid nonadherence were forgetfulness (N = 158, 46.47%), taking too many pills (N = 7, 2.06%), not knowing the usefulness of iron and folic acid supplementation (N = 29, 8.53%), fear of the side effects of the medication (N = 119, 35.00%), and not getting the supplement from the hospital (N = 27, 7.94%). Bivariable and multivariable logistic regression analyses indicated that pregnant women who were primigravida (adjusted odds ratio ðAORÞ = 4:5), who have parity of 2 or 3 (AOR = 3:4), who perceived importance of iron and folic acid supplementation to prevent anemia (AOR = 2:9), and who considered it important to take iron and folic acid supplementation (AOR = 2:9) showed a statistically significant association with adherence to iron and folic acid supplementation. Moreover, pregnant women who perceived the risk of not taking iron and folic acid supplementation (AOR = 5:2), those who received sufficient health education regarding the goals of iron and folic acid supplementation as well as the dangers of not taking the supplements (AOR = 4:4) and adequate counseling, and those who obtained an explanation of the effects of iron and folic acid (AOR = 4:8) showed a significant association with adherence to iron and folic acid supplementation. Conclusion. This study found a low adherence of iron and folic acid supplementation and was associated with obstetric and client- and health system-related characteristics. To this end, there is a need for individualized strategies targeting such factors and intensifying health education, guidance, and counseling to optimize adherence to iron and folic acid supplementation.
Adherence to Iron and Folic Acid Supplementation and Its Associated Factors among Pregnant Women Attending Antenatal Care at Bwindi Community Hospital, Western Uganda
(Hindawi, 2021-06-07) Nimwesiga, Christine; Murezi, Mereth; Taremwa, Ivan Mugisha
Aims/Objectives. This study assessed the adherence to iron and folic acid supplementation and the associated factors among pregnant women attending antenatal care at Bwindi Community Hospital, in Western Uganda. Methods. This was a cross- sectional study that used an interviewer-administered questionnaire and reviewed medical records. Binary and multivariable logistic regression analyses were used to identify factors associated with iron and folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to assess for statistical significance. Results. We enrolled 438 pregnant women aged 16 to 41years. Participants’ mean age (±standard deviation (SD)) was 25.9 (±3.17) years. The self- reported adherence to iron and folic acid supplementation (consumed ≥4 tablets a week or 20 tablets in a month daily without missing the prescribed dosage) was 22.37% (N = 98). Among the adherent pregnant women, the reported reasons (and their respective proportionality) for adherence were getting advice and counseling from the healthcare worker about the good effects of iron and folic acid supplementation (N = 34, 34.69%) and knowledge about the health benefits of iron and folic acid supplementation such as preventing anemia (N = 16, 16.33%), among others. On the other hand, the reported reasons (and their respective proportionality) for iron and folic acid nonadherence were forgetfulness (N = 158, 46.47%), taking too many pills (N = 7, 2.06%), not knowing the usefulness of iron and folic acid supplementation (N = 29, 8.53%), fear of the side effects of the medication (N = 119, 35.00%), and not getting the supplement from the hospital (N = 27, 7.94%). Bivariable and multivariable logistic regression analyses indicated that pregnant women who were primigravida (adjusted odds ratio ðAORÞ = 4:5), who have parity of 2 or 3 (AOR = 3:4), who perceived importance of iron and folic acid supplementation to prevent anemia (AOR = 2:9), and who considered it important to take iron and folic acid supplementation (AOR = 2:9) showed a statistically significant association with adherence to iron and folic acid supplementation. Moreover, pregnant women who perceived the risk of not taking iron and folic acid supplementation (AOR = 5:2), those who received sufficient health education regarding the goals of iron and folic acid supplementation as well as the dangers of not taking the supplements (AOR = 4:4) and adequate counseling, and those who obtained an explanation of the effects of iron and folic acid (AOR = 4:8) showed a significant association with adherence to iron and folic acid supplementation. Conclusion. This study found a low adherence of iron and folic acid supplementation and was associated with obstetric and client- and health system-related characteristics. To this end, there is a need for individualized strategies targeting such factors and intensifying health education, guidance, and counseling to optimize adherence to iron and folic acid supplementation
Anti-Mycobacterial Activity of Medicinal Plant Extracts Used in the Treatment of Tuberculosis by Traditional Medicine Practitioners in Uganda
(Scientific Research Publishing, 2023-02-10) Mpeirwe, Moses; Taremwa, Ivan Mugisha; Orikiriza, Patrick; Ogwang, Patrick Engeu; Ssesazi, Duncan; Bazira, Joel
Tuberculosis (TB) remains a public health challenge and one of the leading causes of death worldwide. TB is preventable and curable. However, treatment of tuberculosis has continued to be difficult as a result of rapid increase of multi drug and extensively drug resistant strains of Mycobacterium tuberculosis. Medicinal plants have for centuries been traditionally used in treatment of tuberculosis and similar ailments. They possess antimicrobial properties which render them a new hope as a source of novel bioactive leads in the development of antimycobacterial agents. In this study, 2 plant species commonly used traditionally in Uganda for treatment of tuberculosis,Zanthoxylum leprieurii and Rubia cordifolia were screened for in vitro antimycobacterial activity against Mycobacterium tuberculosis strains; pan sensitive MTB H37Rv, Rifampicin resistant TMC 331 strain and two wild strains (onerifampicin resistant and another one rifampicin susceptible). Antimycobacterial activity of aqueous, ethanolic and methanolic plant extracts was determined using Resazurin Microtiter Assay (REMA). Both plant extracts exhibited significant in vitro antimycobacterial activity against all strains of My-cobacterium tuberculosis. Minimum inhibitory concentrations (MIC) of methanolic crude extracts of both plants ranged from 23.4 μg/mL to 187.5 μg/mL. Comparatively, methanol extracts of both plants possessed superior antimy-cobacterial activity against all Mycobacterium tuberculosis strains. Our findings indicated that both plants exhibited activity against susceptible and resistant strains of Mycobacterium tuberculosis. While antimycobacterial activity of Z. leprieurii confirms results from previous studies, activity of the extracts of R. cordifolia is reported for the first time in East Africa. Further studies aimed at determining the effects of combination of these plant extracts and standard anti-TB drugs should be carried out.
Assessment of Pneumococcal Conjugate Vaccination on Nasopharyngeal Pneumococcal Carriage:
(SCIENCEDOMAIN international (SDI), 2018-03-21) Onyango, Bournventure; Angurini, Kabaka; Taremwa, Ivan Mugisha
Aims: To determine the nasopharyngeal carriage of Streptococcus pnuemoniae among children under-5 years of age who have been vaccinated with Pneumococcal Conjugate Vaccine (PCV-10) and those unvaccinated in Mbale Municipality, Eastern Uganda. Study Design: This was a cross-sectional study. Place and Duration of Study: The study was conducted in Mbale Municipality Health Centres, Eastern Uganda during the period of September 2015 and June 2016.Methodology: We enrolled 280 children (140 vaccinated with PCV 10 and 140 unvaccinated). Demographic data were obtained from the caregivers and vaccination status from the caregiver and the vaccination card. Nasopharyngeal swabs were tested for Streptococcus pneumonia at least four weeks post-immunization. Pneumococcal carriage was defined by a positive culture, with identification of Streptococcus pnuemoniae. Results: The overall prevalence of Streptococcus pnuemoniae carriage was 123 of280 (43.93%; 95% Confidence interval: 39.88-47.69) with the rate among the immunized of 14.29% (95%% CI: 11.33-16.73), compared to the 78.57% (95%CI: 81.34-88.61) among the unvaccinated children. The odds ratio of pneumococcal carriage was 7.4 among the unvaccinated children compared to the PCV immunized children. Conclusion: Vaccination with PCV offers protection to the risk of pneumococcal carriage. This study emphasizes the value of monitoring for the impact of PCV vaccination program in order to reassure health care workers and families.
Assessment of the diagnostic performance of TrueHb ® point-of-care hemometer compared with Sysmex i3 analyzer among patients at International Hospital Kampala, Uganda
(Dove Press, 2019-04-01) Taremwa, Ivan Mugisha; Ndeze, Ivan; Mwambi, Bashir; Atuhairwe, Christine; Achieng, Diana Inda; Natukunda, Bernard
Aim/Objective: To assess the diagnostic performance of TrueHb ® point-of-care (POC) hemometer compared with Sysmex i3 analyzer at International Hospital Kampala, Uganda. Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb ® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17–40.38). The mean difference of the TrueHb ® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095–0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161–2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb ® hemometer was 2.46 mins (95% CI: 2.37–2.55). Conclusion: TrueHb ® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.
The effect of knowledge on uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda
(NCBI, 2018) Atuhairwe, Christine; Amongin, Dinah; Agaba, Elly; Mugarura, Steven; Taremwa, Ivan Mugisha
Background: Breast cancer, the third most frequent cancer of women is preventable through knowledge of breast self-examination. Of the 44% of women diagnosed with breast cancer at the Uganda Cancer Institute, only 22% go for a check-up in less than three months. This study explored the effect of breast cancer knowledge on the uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda. Methods: A household survey of women in Kyadondo County was conducted from June 2014 to August 2015. This involved studying in-depth using a questionnaire the level of breast cancer knowledge of the respondents. Data was analyzed using logistic regression model. Chi-square test was used to establish relationships between knowledge base factors and the uptake of breast cancer prevention modalities. Results: This study has established an empirical relationship between uptake of breast cancer prevention modalities and source of information especially radio (OR 1.94 95% CI: 1.16–3.24), television (OR 1.82 95%CI: 1.14–2.93), awareness of breast cancer (OR 4.03 95%CI: 1.01–15.98), knowledge on how to reduce the risk of breast cancer (OR 1.98 95% CI: 1.20–3.27), what reduces breast cancer acquisition (OR 2.75 95% CI: 1.42–5.35), how to check for signs of breast cancer especially through breast self-examination (OR 3.09 95% CI: 1.62–5.88), and other methods of breast cancer diagnosis in a health care set up. Conclusion: The women’s level of breast cancer awareness as a primary prevention strategy was found wanting, and requires a boost through community health education.
The financing of stand-alone palliative Care Services in Uganda: analysis of the implications for sustainability
(BMC Palliative care, 2019-06-05) Amandua, Jacinto; Kimaro, Melkizedeki Stephen; Mwebesa, Eddie; Taremwa, Ivan Mugisha; Atuhairwe, Christine
Background: Sustainable funding is key for ensuring the quality and coverage of palliative care services. This study examined the sources of funding for stand-alone palliative care services in Uganda as well as their services financial sustainability plans. Methods: Researchers conducted a cross sectional survey of all stand-alone palliative care organizations that have operated for five or more years. Researchers administered a questionnaire survey and interviews on the audited financial statements, services provided and sustainability plans. Results: Nine of the stand-alone palliative care organizations surveyed had operated for five to 25 years. 93% of the funding for palliative care services comes from donations; while 7% is from income generating activities. 94% of the donations are from external sources. The Government of Uganda’s major contribution is in the form of medicines, training and payment of taxes. All the organizations had good financial records. Six of the fifteen Hospices/palliative care providers had sustainability plans included in their operational manuals. The older organizations (those that had been operational for more than 10 years) had better resource mobilization capacity and strategies. Conclusion: The majority of stand-alone palliative care organizations in Uganda are largely donor funded. They have considerable financial sustainability and fund-raising capacity. Government support is in the form of medicines and training. Based on this study findings, the capacity of the stand-alone palliative care services to raise funds should be increased. The Government of Uganda should include palliative care in the national health system and increase funding for these services.
Haematological Parameters of Pregnant Women Attending Antenatal Care at Nakaseke Hospital, Central Uganda
(cient periodique, 2018-12-03) Kyakulaga, Philip; Mwambi, Bashir; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Introduction Establishment of haematological ranges is key to laboratory diagnoses and management of pregnancy-related complications. The parameters to a large extent ought to be population-based, never the less, there are limited studies on the reference ranges of pregnant women for the local population. This study reports on the haematological parameters of pregnant women attending antenatal care at Nakaseke Hospital, central Uganda. Materials and Methods A cross-sectional study involving pregnant women was conducted from the month of May to August 2018. Ethylene diamine tetraacetic acid (EDTA) venous blood samples were collected and a full blood count (FBC) was run. Data for the haematological parameters was presented in tabular form as mean ± SD in reference to 95% reference intervals. Results One hundred and thirty-five adult (18 years, and above) consented pregnant women were enrolled. The red blood cells (RBCs) counts and haemoglobin concentration showed a gradual decrease during the first two trimesters and a slight increase during the third trimester. There was no significant change in MCV. The white blood cells (WBCs) did not show a significant change in the total count from the first to the second trimesters, and there was a significant rise during the third trimester. The granulocytes were affected by the increase in numbers. Platelet count decreased during the first to the third trimesters. Conclusion This study has explored a variance in the haematological parameters. This necessitates incorporation of specific reference ranges for clinical care and management of gestational disorders.
Hematological abnormalities in HIV-antiretroviral therapy naïve clients as seen at an immune suppression syndrome clinic at Mbarara Regional Referral Hospital, southwestern Uganda
(Dove Press, 2018-06-27) Katemba, Crispus; Muzoora, Conrad; Muwanguzi, Enoch; Mwambi, Bashir; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Aim/objective: To assess the common hematological abnormalities among HIV-antiretroviral therapy (ART) naïve clients attending an immune suppression syndrome (ISS) clinic at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Patients and methods: This was a cross-sectional study carried out during the months of March to August 2016 at the ISS clinic of MRRH. We collected approximately 4.0 mL of EDTA anticoagulated blood samples, which were assayed for complete blood count, CD4+ cell count and thin-film examination. Correlation of the hematological abnormalities with CD4+ cell counts was done using correlation coefficient (r) and analysis of variance (F ), and the p-value was set at ≤0.05. Results: A total of 141 clients were enrolled. Of these, 67.38% (95/141) were anemic, 26.24% (40/141) had thrombocytopenia while 26.95% (38/141) had leucopenia. Of the 95 participants with anemia, 89.47% (85/95) presented with normocytic-normochromic anemia, 8.42% (8/95) with microcytic-hypochromic anemia and 2.11% (2/95) with macrocytic-hypochromic anemia. Anemia was not different across the several World Health Organization (WHO) stages of HIV infection disease progression (p>0.05). Statistically significant differences were present among participants with leucopenia (p<0.05). Also, leucopenia was more prevalent (11/38) among participants in WHO stage 4 of HIV infection. CD4+ cell counts correlated with thrombocytopenia (r=0.24, p<0.05) and leucopenia (r=0.15, p<0.05). Conclusion: People living with HIV/AIDS (PLWHIV/AIDS) ought to be routinely monitored and treated for the occurrence of hematological abnormalities. Early initiation of ART can help to prevent some hematological abnormalities.
Human Papillomavirus Vaccination Uptake and Its Predictors Among Female Adolescents in Gulu Municipality, Northern Uganda
(Dovepress, 2022-09-25) Aruho, Caroline; Mugambe, Samuel; Baluku, Joseph Baruch; Taremwa, Ivan Mugisha
Background: Human papillomavirus (HPV) is the putative case of cervical cancer. However, uptake of HPV vaccination is reportedly low in Uganda. This study explored the predictors of HPV vaccination uptake among female adolescents aged 15–18 years in Gulu Municipality, in northern Uganda. Methods: This was an analytical cross-sectional survey that was conducted among adolescents aged 15–18 years in Gulu Municipality. A structured questionnaire was used. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Descriptive statistics and a log binomial model were used to analyze the factors associated with HPV vaccination uptake. Results: Less than a quarter of the female adolescents (22%) aged 15–18 years in Gulu municipality, Gulu district, had been vaccinated with the human papillomavirus vaccine. HPV vaccination uptake was lower by 23% among adolescents who stayed with their mothers only (aPR = 0.769, CI = 0.595–0.995, P = 0.046), and by 14% among adolescents whose parents were unmarried (aPR0.859, CI = 0.776–0.951, P=0.003). Conclusion: This study reports a low HPV vaccination coverage among adolescents in Gulu Municipality, which is associated with parental perceptions and marital status. Efforts to increase uptake should focus on parents of adolescents.
Individual, health facility-related, and psychosocial determinants of retention in chronic HIV care among HIV-positive young people in Mukono Municipality, Uganda
(Research Gate, 2020-06) Kasibante, Phillip; Kyeyune, Jemimah Kiboss; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Introduction: Retention in care is a known determinant of successful treatment outcome and serves as a measure of abating the emergence of resistant strains of human immunodeficiency virus (HIV). We report on the individual, health facility-related, and psychosocial determinants of retention in chronic HIV care among young HIV-infected patients in Mukono Municipality, in Uganda. Material and methods: A cross sectional study included 118 participants, aged 15 to 24 years and health workers, and it was conducted between May and September 2017. Data were obtained using a questionnaire, an abstraction tool, and key informant interviews. Logistic regression analysis was used to establish predictor variables, with a p ≤ 0.05. Results: Slightly half, 53.4% of the HIV patients were retained in care for 24 months. Participants with CD4 cell counts above 500 cells/μl at the initiation of treatment were 3 times more likely to be lost to follow-up (odd, 3 : 1). The availability of peer support services (p = 0.026), no extra support from parents/ friends (p = 0.02), stigma and associated blame on others (p = 0.04) showed statistical correlation to the retention in HIV chronic care. On the other hand, peer support services attendance (p = 0.091) and attitude of health providers (p = 0.762) did not show statistical significance in the retention of care of HIV patients. Conclusions: The study reports a low retention in HIV care among people aged 15 to 24 years, and this was positively associated with individual, health facility-related, and psychosocial factors, which require intensive efforts to abate such barriers.
Laboratory assessment of SD Bioline HIV/ Syphilis Duo Kit among pregnant women attending antenatal clinic Mayuge Health Center III, East central Uganda
(BMC Research Notes, 2019-04-25) Taremwa, Ivan Mugisha; Twelwanike, Alupakusadi; Mwambi, Bashir; Atuhairwe, Christine
Objective: Efforts to dual eradication of mother-to-child transmission of human immune deficiency virus (HIV) and syphilis have improved in the previous decades. This has however been hindered by limited validation studies. A cross-sectional study was conducted among adult pregnant women attending antenatal care clinic at Mayuge Health Center III. Two milliliters of venous blood were collected into Ethylene di-amine tetra acetic acid vacutainers and tested for HIV and syphilis using the SD Bioline HIV/Syphilis Duo assay, and the national HIV and syphilis testing algorithm. Sensitivity and specificity were calculated for the Duo Kit against the gold standards within 95% confidence intervals. Results: Three hundred and eighty-two (382) participants were enrolled. Their mean age was 25.8 years. The prevalence of HIV was 1.8% (95% confidence interval 1.23–2.41); while that of syphilis was 2.1% (95% confidence interval 1.81–2.54), and the dual infection was 0.52% (95% confidence interval 0.37–0.92). The sensitivity and specificity of the SD Bioline HIV/Syphilis Duo assay were all 100.0% (95% confidence interval 99.5 to 100.0 and 98.6 to 100.0, respectively). The performance of the SD Bioline HIV/Syphilis Duo Kit was optimal, reassuring its aptness for use, and favourable qualities to a limited resource setting.
Mind the gap: scaling up the utilization of insecticide treated mosquito nets using a knowledge translation model in Isingiro district, rural south western Uganda
(Open Access Journal, 2020-09-01) Taremwa, Ivan Mugisha; Ashaba, Scholastic; Ayebazibwe, Carlrona; Kemeza, Imelda; Adrama, Harriet Ochokoru; Omoding, Daniel
Background: The phenomenon of Knowledge Translation (KT) is a key intervention towards bridging the ‘know–do’ gap. We conducted a KT initiative in Isingiro district to positively change attitude and improve on the uptake of Insecticide Treated Mosquito Nets (ITNs) as a malaria prevention strategy. Methods: This was a community based interactive initiative that was carried out within the seventeen administrative units of Isingiro district using varied dissemination activities, namely: health talks; drama activities, and the sharing of ITNs success stories. Results: We reached out to 34 dissemination groups, comprising communal gathering, religious crusades, open markets, secondary schools, and district administration. In addition, we spot-visited 46 households to ascertain the physical presence of ITNs, and their appropriate use. The major intervention was improved knowledge base of malaria causation and prevention strategies. The indicators for improved knowledge were hinged on the five-interventions, namely: (a) communal sensitization on malaria to provide, (b) monitoring and support of selected households, (c) emphasis of ITN use as a malaria prevention strategy, (d) promotion of care for ITNs, and (e) promotion of ITN use. In all, the major output was improved knowledge base of malaria causation and prevention strategies by providing accurate information to redress the myths and misconceptions related to malaria and ITNs use. Conclusion: This undertaking describes a consolidated community intervention to promote ITN utilization. It is plausible that this intervention positively enhances and promotes uptake and utilization of ITNs.
Performance of Epidemic Preparedness and ResponseCommittees to Disease Outbreaks in Arua District,West Nile Region
(NCBI, 2019-02-03) Afayo, Robert; Buga, Muzamil; Alege, John Bosco; Akugizibwe, Pardon; Atuhairwe, Christine; Taremwa, Ivan Mugisha
The Epidemic Preparedness and Response Committees (EPPRCs) are at the heart of preventing outbreaks from becoming epidemics by controlling the spread. Evidence-based information regarding factors associated with the performance of EPPRCs in preparedness and response to disease outbreaks is needed in order to improve their performance. A cross-sectional study involving 103 EPPRC members was carried out in Arua district, West Nile region, between the months of July and December 2014. Data were collected using a structured questionnaire, and the chi-square test was used to establish associations. Forty-eight percentage of EPPRC members showed a moderate level of preparedness, and only 39.8% of them had a moderate level of response. The performance drivers of preparedness and response were dependent on presence of a budget (χ2 = 10.281, p=0.002), availability of funds (χ2 = 5.508, p=0.019), adequacy of funds, (χ2 = 11.211, p=0.008), support given by health development partners (χ2 = 19.497, p=0.001), and motivation (χ2 = 20.065, p < 0.001). Further, membership duration (χ2 = 13.776, p=0.001) and respondent cadre (χ2 = 12.538, p=0.005) had a significant association. Based on these findings, there is a big gap in the preparedness and response ability, all of which are dependent on the financial gap to the Committees. To this, funding for preparedness and response is a critical aspect to respond and contain an outbreak.
Perspective for Methicillin-resistant Staphylococcus Aureus colonization, Antibiotic Susceptibility Patterns and Risk factors for Colonization among People Living with HIV at Nyenga Hospital, Buikwe District, in Central Uganda
(open access pub, 2018-07-31) Ssenyonga, Benedict; Mwebaze, Sarah; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background: Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods: We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results: We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug-resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion: These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
Practice, perceived barriers and motivatingfactors to medical-incident reporting:
(BMC Health Services Research, 2020) Naome, Turyahabwe; Mwesigwa, James; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background:Medical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizingunintentional harm among health care providers. We explored medical-incident reporting practices, perceivedbarriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH). Methods:We conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional ReferralHospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. Thechi-square was used to determine factors associated with MIR at MRRH. Results:The results showed that there was no formal incident reporting structure. However the medical-incidencesidentified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error(47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting correctiveaction on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence ofeffective organizational systems like: written guidelines, practices of open door policy, no blame approach, andteam work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIRwere: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear ofbeing punished (p- value 0.669). Conclusion:Medical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident managementteam and conducting routine training MIR among health care workers will increase patient safety.
Prevalence and associated factors of bed bug infestations (Cimex lectularius) in lubaga division, Kampala capital city, Uganda
(open access text, 2019-04-18) Senabulya, George W; Alege, John B; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background: There has been an increasing public health concern as a result of bed bug infestation, with devastating effects on health and quality of life in Uganda. This study provided the first community-based report on the situation of bed bugs in Lubaga division, Kampala Capital City, Uganda. Methods: This was a descriptive cross-sectional study design, in which data was collected using a questionnaire, key informant interview guide and a data abstraction tools. Results: Out of the 356 respondents interviewed, 249(69.9%) had bed bugs in their homes. The study further revealed a significant statistical relationship between the variables of gender, sex, level of education, employment status. The health systems factors that include the availability of professional personnel to control bed bugs, use of effective and recommended chemicals, availability of funds, and resistance of bed bugs to insecticides were all found to have an influence on the risk of bed bugs. Conclusion: The study has established the need to strengthen vector control programs in a city suburb.
Prevalence and factors associated with hyperglycaemia among children under-five years of age at holy innocents childrens’ hospital, mbarara district, south-western Uganda
(open access text, 2018-08-13) Segutunga, George Friday; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Background: Childhood hyperglycaemia is a critical observation because of its links to complications ranging from prolonged hospitalisation to mortality. This study reports the prevalence, clinical patterns and factors associated with hyperglycaemia among children under-five years of age at Holy Innocents Children's’ Hospital (HICH), Mbarara in south-western Uganda. Materials and methods: This was a hospital-based, cross-sectional study conducted during the period between April to July 2017. The study enrolled children under-five years attending outpatients department (OPD) whose caregivers had consented. Random blood glucose levels, height and weight of children were taken; in addition, a structured questionnaire was administered. Results: We enrolled 284 children, of whom, 40.3% (n=114) were aged between 12 to 23 months (mean age: 24.6 months, median age: 9.7 months; IQR: 5.8–46.8 months). There were 124 boys (43.7%). Thirty-nine participants were hyperglycaemic, giving a prevalence of 13.7%, (95% Confidence Interval: 8.4-18.2), with varied clinical patterns. Obese children were six times more likely to be hyperglycaemic (P=0.000). Although those who were overweight did not show statistical significance of hyperglycaemia, they were four times more at risk. Conclusion: Childhood hyperglycemia is highly prevalent in this setting, with the majority of the affected cases being unknown to both health workers and the caregivers. This impedes their medical intervention and also inclines to very poor glycaemic control. This compels the need to regularly monitor glucose levels to subside preventable deaths.
Prevalence and Factors Associated with Intestinal Candidiasis among HIV Infected Clients Attending Anti-retroviral Therapy Clinic at Kisoro District Hospital, Western Uganda
(SCIENCEDOMAIN international (SDI), 2018) Bamanya, Sharon; Mubiru, Martha Nakaye; Mwambi, Bashir; Mucungunzi, Justus; Hersi, Dahir Ali; Atuhairwe, Christine; Taremwa, Ivan Mugisha
Aim: To determine the prevalence and associated factors of intestinal candidiasis among people living with human immune deficiency virus (PLWHIV) attending Kisoro district Hospital in Western Uganda. Study Design: This was a cross-sectional study. Place and Duration of Study: This was conducted in the anti-retroviral therapy (ART) clinic at Kisoro District Hospital (KDH) from May 2016 to June 2017. Methodology: The study analyzed fresh stool and ethylene di-amine tetra acetic acid venous blood specimens from 148 HIV seropositive adult participants. Stool samples were microscopically examined as wet preparation and cultured on Sabouraud dextrose agar for isolation and identification of fungal pathogens. Blood was used to assay their CD 4 +, cell counts. Data were analyzed and presented as proportions. Results: The prevalence of intestinal candidiasis was 62.84%. It was highest among participants with CD 4 + cells below 250/μL, and more among male participants 75% (36/48).
Prevalence of Anemia and Its Associated Socio-Demographic Factors Among Pregnant Women Attending an Antenatal Care Clinic at Kisugu Health Center IV, Makindye Division, Kampala, Uganda
(Dovepress, 2020) Mahamoud, Naimo Khalif; Mwambi, Bashir; Oyet, Caesar; Segujja, Farouk; Webbo, Fred; Okiria, John Charles; Taremwa, Ivan Mugisha
Aims/Objectives: This study sought to determine the prevalence, morphological character- ization and associated socio-demographic factors of anemia among pregnant women attend- ing Kisugu Health Centre IV, Makindye Division, Kampala, in Uganda. Methods: This was a cross-sectional study that employed laboratory analysis of blood samples to determine hemoglobin concentration, and a structured questionnaire to obtain socio-demographic factors associated with anemia during pregnancy. Results: We enrolled 345 pregnant women aged 15 to 43 years. The median, interquartile range, and mean Hb levels were 8.1g/dL, 6.4 ± 2.1g/dL and 7.9g/dL, respectively. There were 89 participants whose Hb levels were indicative of anemia, giving anemia prevalence of 25.8% (95% confidence interval: 21.6–29.8). Of these, 25 (28.1%) had mild anemia, 46 (51.7%) had moderate anemia, while 18 (20.2%) had severe anemia. Thin blood film examination showed normocytic-hypochromic (75.3%), then microcytic-hypochromic (21.6%), and macrocytic- hypochromic red blood cells (3.4%). The socio-demographic factors of gestational age, parity, and mother’s occupation were significantly associated with the risk of anemia (p< 0.05). Conclusion: We report a high prevalence of anemia among pregnant women; with a majority of hypochromic-microcytic anemia. This may necessitate more anemia awareness and it requires institution of nutritional interventions to avert fetal-maternal complications