Browsing by Author "Onchweri, Albert Nyanchoka"
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- ItemAntibiotic Resistant Escherichia coli Isolates from Barn Swallow Droppings in Ishaka Town, Uganda(Science and Education Publishing, 2016) Okullu, Tonny; Onchweri, Albert Nyanchoka; Miruka, Conrad Ondieki; Eilu, Emmanuel; Abimana, Justus B.; Nyabayo, Maniga JosephatConsiderable concern has been raised over the problem of antibiotic resistance in bacteria from humans and farm animals. However, in spite of this concern, the spread of resistance into wider ecosystems has not received the desired attention. The transfer of antibiotic resistance to wildlife is an important risk for environmental health. Detection of resistance to antibiotics in populations of wild animals usually entails examination of isolates of the common intestinal bacterium Escherichia coli. Bird populations sympatric to areas with human settlements and areas that have high density of livestock are colonised with antibiotic resistant E. coli strains. Data regarding occurrence of antibiotic-resistant bacteria in African domestic and wild mammals is very limited. There is therefore a need to carry out studies in other parts of the African continent to find out if sympatric animals represent a possible reservoir for antibiotic resistant microbes. This study was therefore carried out to analyze faecal samples from barn swallow (Hirundo rustica) droppings in Ishaka Town, Uganda, for the presence of antibiotic resistant E. coli strains. Results of the study showed that, out of the one hundred and sixteen (116) fecal samples of Barn Swallow droppings collected, twenty seven isolates of Escherichia coli were obtained. All the 27 isolates (100%) were resistant to one or more of the tested antibiotics. Out of the 27 isolates, 20 (74.1%) were multi-drug resistant isolates (resistant to three or more classes of antimicrobials). Such birds can act as reservoirs for antibiotic resistant microbes if enough attention is not given to the problem. Further research is recommended to determine the prevalence of antibiotic resistant Escherichia coli from barn swallows residing in other parts of the country and even on the continent and the whole world at large.
- ItemAvailability of Essential Medicines and Supplies during the Dual Pull-Push System of Drugs Acquisition in Kaliro District, Uganda(Pharmaceutical Care & Health Systems, 2015-03) Bruno, Okiror; Onchweri, Albert Nyanchoka; Ondieki, Miruka Conrad; Nyabayo, Maniga JosephatThe Ugandan government has experimented with various supply chain models for delivery of essential drugs and supplies. In 2010, the dual pull-push system was adopted; however drug stock outs are still a common occurrence in health facilities. This study on availability of essential medicines during the dual Pull-Push system in Kaliro District was undertaken, to be used as an indirect or direct indicator of effectiveness of the dual pull-push system of drugs acquisition in the district. The study combined quantitative and qualitative methods; the study mainly based on; document review (stock cards, delivery notes,) and key informant interviews. Results showed that average stock-out duration of essential medicines and supplies was 23.89% (20.47 % for essential medicines and 27.32% for medical supplies). ACT Artemether/lumefantrine 20/120 mg tablets had the highest percentage stock-out followed by Cotrimoxazole 480mg tablets (51.6 and 32.4 %, respectively). Among the short falls of the system were; drug requisitions based on neither morbidity nor consumption methods of quantification, delays during distribution, supplying medicines with short shelf life, rare condition drugs or low usage drugs. In conclusion, the trend of essential medicines and supplies availability during the dual pull-push system seemed to be declining since its initiation in 2010. It is thus recommended that national medical stores involve stakeholders at all stages of medicines and supplies planning, especially the district health officers, who are the final consumers in the supply chain. The government can also adopt a revolving drug fund system, in the form of ‘Special Pharmacies and drug stores’ to enhance availability of essential drugs in public facilities and thus improve the quality of health care.
- ItemFactors Affecting Adherence to Anti-retroviral Therapy at Kampala International University Teaching Hospital, Bushenyi District, Uganda(American Journal of Medical Sciences and Medicine, 2016) Dwoki, Wani Buyu; Miruka, Conrad Ondieki; Maniga, Josephat Nyabayo; Onchweri, Albert NyanchokaComplex regimens present significant challenges to both patients and health-care providers with respect to anti-retroviral therapy (ART) treatment adherence. Improper adherence leads to poor suppression of HIV replication in infected cells. High level of ART treatment adherence leads to better viral suppression outcomes. Proper maintenance of ART treatment adherence over time remains a problematic area especially in resource limited settings, including sub-Saharan African countries. The western region of Uganda has been noted to have a high prevalence of HIV patients. This study was therefore undertaken to determine the factors associated with nonadherence among the HIV patients on ART in a teaching hospital in south-western Uganda. Findings of the study revealed that forgetting treatment was the most cited factor. Feeling better after some medication period, being too ill to take medication, stigma associated with taking ART medication, alcohol consumption and drug stock out were also identified to be associated to non-adherence among the study participants. Most of the patients in this study (150/255, 58.8%) had good adherence, followed by those who had fair rates of adherence (60/255, 23.5%). Forty five patients (17.6%) had the least adherence level. Findings also showed that females were most likely to miss their medication. The age groups of 30-39 and 40-49 were the most likely not to adhere to medications compared to the other age groups while the 0-19 and above 50 years age groups were most likely not to miss their medication. The separated patients were more likely to miss medication compared to others. Patients who had attended only primary education and those who attended tertiary level of education were most likely to be non-adherent to medication. Deliberate measures need to be taken to cater for the non-adherent patients. Interventions aimed at the high-risk nonadherence groups need to be specifically developed.