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Prevalence, etiology and factors associated with bacteraemia among febrile children with sickle cell anaemia attending Jinja regional referral hospital.
(Kampala International University, 2024-03) Abdifatah Muhuyadin Haji Ali
Children with sickle cell anemia have an increased risk for bacterial infections. Studies done in other parts of Sub Saharan Africa have established the prevalence and etiology of bacteremia among children with sickle cell anemia (SCA), but there are no such studies in Uganda. This study aimed to determine the prevalence, etiology and factors associated with bacteremia among febrile children with SCA attending Jinja Regional Referral Hospital (JRRH). Methods This study employed an observational and analytical cross-sectional design. Febrile children with SCA at JRRH were enrolled. Information regarding their sociodemographic, medical and laboratory characteristics was obtained. Blood culture was done to assess for bacteremia. Binary logistic regression was done to determine the factors associated with bacteremia using Statistical Package for Social Sciences (SPSS) version 26. Results This study enrolled 209 children, majority of whom were males 114(54.5%). Most of the patients were young children under five years of age 116(55.5%). Of the 209 children enrolled, 44 had bacterial growth in their blood, translating into a prevalence of 21.1%. Of the 44 patients that had bacteremia, the commonest isolate was Staphylococcus aureus 25(56.8%), followed by Escherichia coli 8(18.2%), Klebsiella pneumoniae 3(6.8%) and Haemophilus influenzae 3(6.8%). Cloxacillin had good sensitivity against Staphylococcus aureus. All organisms were completely resistant to Gentamicin, Ampicillin, Penicillin and Ofloxacin. In the multivariate analysis, low maternal education level (aOR=1.098, CI=1.007-1.197, P=0.037), and an inflamed tonsil (aOR=1.241, CI=1.112-1.384, P<0.001) were independently associated with bacteremia. Conclusion The prevalence of bacteremia was high. The commonest isolate was Staphylococcus aureus. Blood culture should be considered for all febrile patients with SCA especially those with an inflamed tonsil and whose parents have low education. Other antibiotics should be considered in the management of these children with the exception of ampicillin and gentamicin, which carry high resistance rates.
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Seroprevalence, Immediate Adverseneonatal Outcomes and Factors Associated with Cytomegalovirus Infection Among Women Delivered at Fort Portal Regional Referral Hospital Uganda
(Kampala International University, 2024-09) Naima Bashir Mohamed
Background: Cytomegalovirus (CMV) infection is a prevalent maternal infection during pregnancy, often leading to adverse fetal and neonatal outcomes. Despite its significant impact, CMV infection in postpartum women is rarely studied, particularly in the context of Uganda. This study aims to determine the seroprevalence of CMV, immediate adverse neonatal outcomes, and associated factors among postpartum women delivered at Fort Portal Regional Referral Hospital (FRRH), Uganda. Methods: A prospective cross-sectional study was conducted from January 1 to April 30, 2024. A total of 351 postpartum women were enrolled using consecutive sampling. Data were collected using pre-tested questionnaires and blood samples, which were tested for CMV antibodies (IgG/IgM) using the CMV IGG/IGM COMBO RAPID TEST. Data analysis was performed using STATA Version 14.2, employing both bivariate and multivariate logistic regression analyses to establish the relationships between independent and dependent variables, with a significance level set at p < 0.05. Results: The study found a high CMV seroprevalence of 81.2% (95% CI: 76.7% - 84.97%) among postpartum women, with significant associations between CMV infection and adverse neonatal outcomes, including low birth weight (18.9%) and early neonatal death (17.4%). Multivariate analysis showed higher CMV seropositivity in women aged 25-34 (aOR: 2.9, 95% CI: 1.436 5.828, p = 0.003) and those aged 35 and above (aOR: 4.6, 95% CI: 1.800-11.524, p = 0.001). Rural residence (aOR: 2.2, 95% CI: 1.203-4.152, p = 0.011), lower education levels, and a history of spontaneous abortion (aOR: 3.2, 95% CI: 1.208-8.723, p = 0.020) were also associated with increased seropositivity. Conclusion: This study demonstrates a high prevalence of CMV among postpartum women in Uganda, with significant associations between CMV infection and adverse neonatal outcomes such as jaundice, low birth weight, and early neonatal death. Key risk factors include older maternal age, rural residence, lower education levels, and a history of spontaneous abortion. Enhanced screening and targeted interventions are urgently needed to reduce the impact of CMV on maternal and neonatal health.
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Prevalence, Patterns and Factors associated with Electrocardiogram Abnormalities among patients with Chronic Obstructive Lung Disease attending Fort Portal Regional Referral Hospital, Western Ugnada
(Kampala International University, 2023-12) Ibrahim Ahmed Nur
Background: The respiratory and cardiovascular systems in humans are so closely linked that changes in one may alter in the other. There is strong association between moderate and severe COPD and abnormal ECG with increase morbidity and mortality. This study determined the prevalence, patterns and factors associated with ECG abnormalities in patients with COPD at Fort portal Regional Referral Hospital (FRRH). Method: This was a hospital-based cross-sectional study. Data on socio-demographic, medical history, Spirometry and ECG were performed. Descriptive statistics were presented for all the socio-demographic, medical history, and clinical examination characteristics. Bivariate and multivariate multiple logistic regression was done using State version 17. Factors with p<0.05 were considered statistically significant. Findings: Of the 175 COPD patients enrolled, the prevalence of ECG abnormalities was 54.9% (n = 96) [95%CI: 47.4-62.1 %). Of the 175 patients, the majority had atrial enlargement, 34.3% (n = 60) and mostly RAE, 29.1% (n = 51). At the multivariate stage results revealed that COPD patients who were having low BMI (AOR= 9.1, 95%CI: 3.95-21.10, p <.001), overweight (AOR= 7.1, 95%CI: 2.35-21.36, p <.01) and obese (AOR= 4.9, 95%CI: 1.26-18.74, p <.05) were more likely to be diagnosed with ECG abnormalities compared to those with normal BMI. COPD patients who were diagnosed with moderate COPD (AOR= 3.3, 95%CI: 1.49-7.19, p <.001), and severe COPD (AOR= 7.3, 95%CI: 2.93-18.00, p <.001) were more likely to be diagnosed with ECG abnormality compared to those with mild COPD Conclusions: The prevalence of ECG abnormalities at FRRH was relatively high (55%) and was significantly associated with severity of COPD and BMI. The commonest ECG pattern was especially the right atrial enlargement followed by arrhythmias.
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Prevalence and patterns and factors associated with electrolyte abnormalities among patients with heart failure attending Hoima Regional Referral Hospital
(Kampala International University, 2023-12) Awil Abdulkadir Abdi
Background: Electrolyte abnormalities (EAs) escalate the aggressive clinical course of patients with heart failure (HF), yet there are differing prevalence, patterns, and associated factors among patients with HF in different contextual settings. This study ascertained the prevalence, patterns, and factors associated with electrolyte abnormalities among patients with HF at Hoima Regional Referral Hospital. Methods: This was a hospital-based cross-sectional study using quantitative data from 384 heart failure patients attending Hoima Regional Referral Hospital between 21st February 2023 and 15th May 2023. Data on socio-demographic, lifestyle, medical, and clinical characteristics were collected and presented as descriptive statistics. Bivariate and multiple logistic regression analyses were conducted and variables with p<0.2 or crude OR ≥ 2 or ≤0.5 were entered into a multivariate model. A factor was considered significant at p <0.05. All analyses were done using STATA© 17. Results: Of the 384 patients with HF, the prevalence of electrolyte abnormalities was 89.1% (95%CI: 85.5 – 91.8). Most patients had mixed EAs (53.9%), with the most electrolyte abnormality was hypocalcemia (43.0%). Patients with heart failure with good adherence (AOR = 0.2, 95%CI: 0.1-0.7, p = 0.009) were less likely to have electrolyte abnormalities. The use of diuretics compared to ACEIs/ARBs, and CCBs (AOR = 5.7, 95%CI: 1.3-15.0, p = 0.019) and history of HTN (AOR = 4.0, 95%CI: 1.9 – 8.4, p <0.001) were associated with a higher likelihood of EAs. Conclusions: The prevalence of electrolyte abnormalities in patients with HF at HRRH was high with the majority presenting with mixed pattern of abnormalities. Hypocalcemia was the most common abnormality encountered. Patients with HF with good drug adherence had a relatively lower likelihood of electrolyte abnormalities compared to history of hypertension and receipt of diuretics. Thus, surveillance, as regards good drug adherence, administration of diuretics, and patients with a history of hypertension, are key to minimizing electrolyte abnormalities among patients with heart failure.
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Evaluating construction management practices and procurement standards in the upgrade of health centres in the Bunyoro sub-region. A case study: ministry of health
(Kampala International University, 2023-03) Kasaija John
Successful completion of projects in the construction industry remains a difficult task at all levels. However, the members involved in the construction team are sometimes constrained because the projects are influenced by several factors that differ, which range from internal to external factors. There has been a delay in upgrading health centers II to III in the Bunyoro Sub Region. The research focused on evaluating the construction management practices and procurement standards in the upgrade of health centers II to III in the Bunyoro Sub-region. The objectives of the study were; to examine the level of construction management practices in the upgrade of health centers, to determine the level of procurement standards in the upgrade, to establish the relationship between construction management practices and procurement standards, and to analyze the acquired data and recommend a possible approach of improvement of the construction and procurement practices in the stated region. The study used both Quantitative and Qualitative approaches with descriptive and correlational research designs. Data were collected from 99 respondents using a questionnaire and a checklist sampling is both purposive and snowball. The study found a high level of contract planning and procurement standards with (aggregate mean = 3.17). This suggested that contract planning and procurement standards influenced the upgrade of health center construction projects in the Bunyoro sub-region. The study found a low level of contract implementation and procurement standards (aggregate mean = 1.83). The study found a low level of contract monitoring and procurement standards with (aggregate mean = 2.15). The study found a weak positive relationship between construction management practices and procurement standards in the upgrade of health centers by the Ministry of Health in the Bunyoro sub-region with (r = 0.489, p = 0.0000 ≤ 0.05). The findings suggest that procurement standards will improve when construction management practices (contract planning, implementation, and monitoring). are put in place.