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Factors Associated with Uptake of Cervical Cancer Screening Among Reproductive AgedWomen attending the Gynecology Outpatient Clinic at Kampala International UniversityTeaching Hospital
(Kampala International University, 2021-10) John Chidanga
Background. Cervical cancer remains one of leading causes of maternal morbidity and mortality. It contributes to about 7.9% of all women related cancers and is the ranked 4th among all women cancers. In the fight against cervical cancer, its prodromal and asymptomatic stage has been found to be detectable and curable. Several screening modalities like Visual Inspection with acetic acid and Lugol’s Iodine, Human Papilloma Virus DNA, Pap smear have largely been instrumental to the reduction of cervical cancer prevalence. However, the uptake to these lifesaving methods remains inexplicably low and several barriers exist towards this. These hindering factors include lack of knowledge about causes of cervical cancer, lack of knowledge on when to screen and when to start screening, personal factors like fear of pain, fear of a positive diagnosis and fear of embarrassment. The result is 80% of women who present to Uganda Cancer Institute, do so in late stage of disease and it poses a detrimental challenge to the patients, their families and the health infrastructure.
Objective.To determine the factors associated with uptake of cervical cancer screening in women of reproductive age attending Gynecological OPD clinic at Kampala International University Teaching Hospital.
Methodology.This was a hospital-based descriptive and analytical cross-sectional study conducted at the antenatal clinic and maternity ward of KIU-TH between August and October 2021. A sample of 309 women were recruited, open-ended questionnaires were administered and pap-smear tests were carried out for those who took up screening. Slides were analysed and results of patterns of cytological findings were documented. The datat was then analysed using logistic regression.
Results. The uptake to cervical cancer screening was found to be 18.8% (95% CI, 14.8%-23.5%). In multivariable analysis, being from a rural residence, HIV positive and have 2 or more sexual partners was found to be statistically significant. Further analysis on pap smear results revealed 37.93% being normal pap smears not having any intra epithelial lesion or malignancy, 29.31% had inflammatory findings, 27.59% were LSIL, 3.45% were ASCUS, and 1.72%HSIL.
Conclusion.The uptake of cervical cancer screening falls within the global range despite it being low. The patterns on pap smear dictate the majority being normal followed by inflammatory changes then low grade changes then other findings. Being of a rural residence, HIV positive and having two or more sexual partners confers a higher chance of screening for cervical cancer.
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Electrocardiogram Pattern and Factors Associated with Abnormal Findings among Heart Failure Patients at Kampala International University Teaching Hospital, Ishaka, Uganda
(Kampala International University, 2021-08) Yves Tibamwenda Bafwa
Background: The prevalence of cardiovascular diseases is increasing rapidly in Sub-Saharan Africa. A multicenter prospective cohort study of 1,006 patients with acute heart failure in a Sub-Saharan Africa survey showed that 814 patients had ECGs readings among which 97.7% had abnormalities. There is paucity of data on ECG abnormalities among heart failure patients in many developing countries, Uganda inclusive.
Methods: A descriptive cross sectional survey was conducted in six months at KIU-TH between January and March then completed between October and December 2020. The study recruited 122 heart failure patients. Questionnaires were administered to respondents to obtain factors associated with ECG abnormalities among heart failure patients. A 12-lead ECG machine was used to obtain ECG findings. Data were analyzed using univariate, bivariate and multivariate logistic regression analyses to determine the ECG pattern and factors associated with abnormal ECG findings among heart failure patients.
Results: The mean age of study respondents was 63.4 ± 21 years and 57.4% of the respondents were females. The prevalence of ECG abnormalities among heart failure patients was 82.8 % (95% CI: 74.91-88.56). The main ECG abnormalities were left ventricular hypertrophy (24.6%), left bundle branch block (8.2%) and right bundle branch block (7.4%). The factors associated with ECG abnormalities were heart failure duration more than one year (aOR = 6.4, 95% CI: 1.14 – 35.53, p= 0.035), hypertension (aOR = 6.7, 95% CI: 1.45 – 31.24, p= 0.015) and being in NYHA functional class III and IV (aOR = 7.2, 95 % CI: 1.88 – 27.74, p=0.004).
Conclusion: The prevalence of abnormal ECG among heart failure patients was very high. Respondents with heart failure duration of more than one year, hypertensive and those staged in NYHA functional classes III and IV had a higher risk of having abnormal ECG. Regular refresher training on use of ECG in the management of heart failure should be organized for clinicians. Routine health education on heart failure prevention measures, should be encouraged at triage centres of all health facilities by the Ministry of Health in Uganda.
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Microfinance Services and Women Involvement in Business in Kasese District: A Case of Women Entrepreneurs in Hima Town Council
(Kampala International University, 2021-03) Thabugha Hannington
This study assessed how Microfinance Services affect Women Involvement in Business in Kasese District: A Case of Women Entrepreneurs in Hima Town Council and it was guided by three objectives namely; To find out the relationship between loans and women involvement in business in hima town council; To examine the relationship between savings and women involvement in business in hima town council and To assess the relationship between trainings and women involvement in business in hima town council. The study adopted descriptive cross-sectional research and correlational designs on a sample of 236 respondents. Data were collected using a questionnaire and an interview guide. Quantitative data were analysed using frequencies, percentages means, correlation and regression. Qualitative data were analysed using thematic analysis. Descriptive results revealed that loans from micro finance institutions play a big role, followed by savings and trainings by financial institutions. Inferential analysis results indicated that loans have a high positive significant relationship with women involvement in business, savings have moderate relationship with women involvement in business and training a weak positive relationship with women involvement in business. Therefore, it was concluded that loans and savings contribute much to women involvement in business as compared to training Thus, the study recommended that Government should support Micro finance institutions’ activities so as to improve women involvement in business since sometimes Micro finance institutions’ lack enough resources. Should encourage every woman to get involved in any venture that is able to earn her some income every weak or every month and financial institutions especially micro finance institutions should carry out regular training programs of women and other client on microfinance services to provide them with the required skills to manage economic resources for developing their families and the country in general. Should regulate the conditions of offering loans to their clients especially women so as to enable them to get involved in businesses and be able to be self-reliant
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Prevalence and Factors Associated with Overweight and Obesity among Adolescents in Selected Secondary Schools in Bushenyi-Ishaka Municipality, Western Uganda
(Kampala International University, 2021-07) Simon Odoch
Background:Childhood obesity has become a worldwide epidemic.Developing countries, particularly Uganda, are not immune.Several non-communicable diseases such as diabetes among others are now being found among overweight and obese adolescents.There is lack of regional and context specific data on the prevalence of overweight and obesity as well as its associated comorbidities.Overweight and obesity among adolescents in selected secondary schools in Bushenyi-Ishaka municipality were investigated, as well as factors that may contribute to these conditions.It also determined the proportion of overweight and obese adolescents with hyperglycemia.
Methodology: A school-based cross-sectional, descriptive and analytical study was conducted.Multistage sampling technique was used to reach the study participants. Interviewer administered questionnaires were used to obtain data on thesociodemographic, socioeconomic, psychosocial, drug and substance abuse, physical activity and sedentary lifestyle, medical and dietary factors.Food Frequency Questionnaire, International Physical Activity Questionnaire and HEADSS assessment tool were adapted to assess dietary, physical activity and sedentary lifestyle,and psychosocial factors, respectively. Weight was measured using Seca digital weighing scale to the nearest 0.1kg and height was measured using stadiometer to the nearest 0.1cm. Body mass index was calculated by dividing weight by height insquared meter. International Obesity Task Force BMI cut-off references for a given age and gender were used to define normal weight, overweight and obesity.A glucometer of model On-Call Plus, with glucose strips was used to measure fasting blood glucose. Fasting blood glucose ≥ 5.6 mmol/L was considered hyperglycemia. Data were entered using Microsoft Excel 2019, and analyzed using SPSS version 27.0. The prevalence of overweight and obesity were determined as a proportion. Binary logistic regression was used to determine factors associated with overweight and obesity taking a p-value < 0.05 at 95% confidence intervalto be statistically significant. Hyperglycemia among overweight and obese adolescents was determined as a proportion.
Results:Of the 752 study participants, 563 (74.9%) were from private schools and 189 (25.1%) from public schools. The mean age and body mass index of the respondents’ were16.47 ± 1.34 years and21.7 ± 2.8 Kg/m2,respectively. Prevalenceof overweight and obesity was 15% with overweight and obesity only being 14.1% and 0.9%, respectively. Out of 113 overweight and obese adolescents, 11 (9.7%) had hyperglycemia. Female gender (aOR = 10.17, 95%CI: 4.52-22.91, p < 0.001), urban residence(aOR 1.70, CI 1.12-2.53, p = 0.013),family history of obesity and overweight (aOR = 2.86, 95%CI: 1.62-5.05, p < 0.001),less than moderate to vigorous physical activity(aOR 2.82, 95% CI: 1.46-5.47, p = 0.002), and, unhealthy diet, (aOR = 2.91 95%CI: 1.53-5.53, p = 0.001) were independently associated with overweight and obesity. In addition, adolescents who received pocket money from their parents/guardians were more likely to be overweight or obese (aOR = 3.77, 95% CI: 1.47-9.66, p = 0.006).
Conclusion:The prevalence of overweight and obesity in adolescents attending schools in Bushenyi-Ishaka municipality was consistent with urban findings in East Africa but much higher than finding in rural setting with almost one in six adolescents being affected. Female sex, urban residency, family history of obesity and overweight, less thanmoderate to vigorous physical activity, receiving pocket money and unhealthy diet were significantly associated with overweight and obesity. One in 10 overweight and obese adolescents had hyperglycemia. Adolescents at high risk of obesity should be targeted for healthy lifestyle programs in secondary schools.
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Design, synthesis and evaluation of the activity of 4-aminoquinoline derivatives as potential cruzain and rhodesin inhibitors
(Kampala International University, 2023-10) Rahamah Idrees
In this research work a series of aminoquinolines, potential inhibitors of cruzain was designed, studied in silico by molecular modeling docking methods, synthesized and evaluated in vitro assays. Chagas disease is a neglected disease called America Trypanosomiasis caused by Trypanosoma cruzi and about 8 million people are estimated to be infected worldwide. Trypanosoma cruzi is 70 percent related to Trypanosoma brucei responsible for Human Africa Trypanosomiasis, is a major health problem worldwide. Current drugs used in treatment of both diseases shows high toxicity and low efficacy at chronic stage of the disease. Cruzain (or cruzipain) and TbrCATL is a cathepsin L-like cysteine protease considered the dominant protease of the protozoan Trypanosoma cruzi and Trypanosoma brucei, respectively. These proteases are believed to be involved in the acquisition of nutrients, degradation of host proteins and evasion of the immune system, representing a promising target for developing trypanocidal drugs. A series of potential inhibitors of cruzain was planned based on 7-chloro-4-aminoquinolines 2 and 3 (IC50 = 13.2 μM and 25μM) respectively. The molecular modeling docking results of the studies suggest that designed compounds are possible to be potent. The synthesized series contains a 7-chloro-4-aminoquinolines motif and different side chain lengths were explored. QFF (3) inhibited more than 85% of the activity of both cruzain and TbrCATL, with IC50 value of 23 and 29 μM, respectively. The results of the enzymatic assays without pre-incubation suggest that the compounds are not time dependent inhibitors. However, additional assay is required to exclude the possibility of QFF acting as a promiscuous inhibitor through aggregation. The overall results showed that aminoquinolines is a promising class in further investigation of cruzain and rhodesain inhibition.