Bachelor of Medicine and Surgery (BMS)

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    Prevalence and factors associated with preterm birth at Kiryandongo general hospital
    (Kampala International University. School of Health Sciences Western Campus, 2018-04) Kijja, Joyce
    Background: The World Health Organization (WHO) estimates the prevalence of preterm birth to be between 5% and 18% across 184 countries. Of the estimated 3 million neonatal deaths occurring globally each year, about 1 million are directly related to prematurity. Uganda has one of the highest preterm birth rates in the world estimated at 13.6 per 1000 live births and little was known about prevalence of preterm birth in Kiryandongo hospital. In order to realize a reduction in pre-term births, interventions that target the risk factors are paramount. Hence, this study was to explore the prevalence and risk factors of preterm birth in Kiryandongo general hospital. All mothers who had live births at Kiryandongo Hospital and their newborns were included in the study. Mothers were interviewed using a standard pretested questionnaire to identify factors associated with preterm birth. Data was analyzed using excel analysis package version 2016 and a pvalue < 0.05 was considered significant .A total of 154 mother-baby pairs were enrolled into the study. The mean maternal age was 26±5 years while most mothers (83%) were married and had attained primary level of education or below (85%). The prevalence of preterm birth in this study was found to be 18.3% (95% CI of 14.1- 22.5). Parity ≥ 4, previous preterm birth, multiple gestation, pregnancy induced hypertension (PIH), antepartum hemorrhage (APH), prolonged preterm prelabor rupture of membranes (PPROM) and urinary tract infection (UTI) in pregnancy were all significantly associated with preterm birth (p=<0.05). On logistic regression, only PIH, APH and prolonged PPROM remained significant. Marital status, maternal level of education, smoking, alcohol use in pregnancy, maternal occupation, ANC attendance, HIV status, anaemia and interpregnancy interval were not associated with preterm birth. APH and parity ≥ 4 were more associated with early than late preterm (OR=4.7 versus 1.7 and OR=6.2 versus 3.9 respectively) while those who had multiple gestation had an almost 7 fold risk of delivering late preterms (OR=6.7). Conclusion: The prevalence of preterm birth in Kiryandongo hospital was 18.3%. Parity ≥ 4, previous preterm birth, twin pregnancy, PIH, APH, preterm PROM and UTI were associated with preterm birth. PIH, APH and prolonged PPROM were independent determinants of preterm birth. APH and parity were predictors of early preterm birth while multiple gestation and UTI were strongly associated with late preterm delivery. At-risk mothers should receive intensified antenatal care to lessen preterm birth.
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    Prevalence, awareness and challenges associated with condom use among enrolled nursing students at Kampala International University
    (Kampala International University. School of Health Sciences Western Campus, 2018-10) Luswata, Herbert
    Background Sexually transmitted diseases (STDs) are highly prevalent in developing countries. They greatly increase the risk of Human Immunodeficiency Virus (HIV) transmission therefore, constituting a major public health problem. Over one billion people are affected by HIV/AIDS worldwide with a higher prevalence among the adolescents and the young adults. Most countries around the world have put in efforts to combat AIDS. One of the most common tools employed is the use of condoms. Correct condom-use in sexual relations has proven effective against STDs. Despite decades of condom-use awareness, gaps still remain in the way the public receives and makes use of the information. Condom use among the young adults in Uganda is declining and the government is unable to meet the demand that exists. These instabilities about condom use have tempted the researcher to investigate the prevalence, awareness and challenges of condom use among enrolled nursing students at KIU-WC. This study therefore, sought to determine prevalence, awareness and challenges associated with the practice of condom use among enrolled nursing students of Kampala International University. A prospective university-based cross-sectional descriptive study of enrolled Nursing students aged between 18-25 years at KIU-WC from November to December 2017. Information about demographic data, the practice of condom use, access to condoms and challenges associated with condom use was collected and analyzed using Epi-data analysis software.Results from the study revealed that 62.7% of students were aged between 18-21 years. There was a high level of awareness about condom use among enrolled nursing students (88.2%) and that they understood the importance of using condoms (89.1%). Despite the knowledge of condom use, majority of the students were reluctant to use the condoms. The proportion of students that embraced using condoms upon their first sexual encounter was below average (42.6%). The commonest challenges of condom-use were; negative HIV status of partners with limited fear for other STIs, association of condom-use with commercial sex and the high cost of condoms among others. Students at KIU-WC have adequate knowledge about condom-use. However, they are reluctant to use them appropriately. There are several challenges associated with condom-use. There is need for implementation of specified; focused; continuous health education on condom use practices and to increase the availability of free condoms to students.
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    Assessment of knowledge, attitudes and practice of induced abortion among secondary and univeristy students in Fortportal municipality, Kabarole District
    (Kampala International University. School of Health Sciences Western Campus, 2017-11) Namutebi, Sharifah
    Abortion is a contentious issue with religious, moral, cultural and political dimensions. The doctrines of religious denominations in Uganda frown at abortion making it hard for adolescents and young adults who have had it in the past to want to talk about it. Those who want to do it go to places where no one will recognize them, and want it done as quickly as possible to avoid stigmatization and mockery. The complications of induced abortions have been documented in many studies around the world but knowledge and attitudes about induced abortions among young people have been addressed in very few previous studies. This study assessed the knowledge, attitudes and practices of induced abortion among secondary and university students in Fortportal municipality, Kabarole district. A cross section descriptive study design was adopted. A multistage sampling method was used to select 150 respondents from purposively selected five institutions (three secondary schools and two universities) with each contributing randomly selected 30 respondents. Data was collected with a self administered questionnaires and analyzed by SPSS version 20. The questionnaire was divided into four sections: socio-demographic characteristics, knowledge about induced abortion, attitudes towards induced abortion and the practice of induced abortions. Responses to knowledge and attitude statements were scored and graded as good, moderate and poor for knowledge, then positive and negative for attitude. The response rate was 95.3%, the majority (87%) of the respondents had moderate (33%) to good (54%) knowledge. 81.8% of respondents had negative attitude and 18.2% had a positive attitude towards induced abortion. 6% of the respondents had done an induced abortion while 46% knew a friend/relative that had an induced abortion. Despite the good knowledge and negative attitude, induced abortion is still practiced and because of its illegal status in this country, it is done in hiding and often in dangerous places where complications are more likely to happen.
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    Factors that influence male partner involvement in emergency obstetric care in Fortportal regional referral hospital
    (Kampala International University. School of Health Sciences Western Campus, 2018-04) Norah, Ngami Mutuku
    Male partner involvement has been recognized as a key factor in improving maternal health and reducing maternal mortality in settings where men play key role in decision making in the household. Male partner involvement is one of the strategies that can be used to accelerate the decline in maternal mortality and improve maternal health. The objective of this study was to determine the level of male partner involvement in emergency obstetric care and/or came from home in labour and identify factors that influenced their involvement. A cross-sectional survey using interviewer-administered structured questionnaire was conducted among 150 women aged 18 years. Male involvement was measured using a composite measure of 5 key points. Pearson Chi-Square was used to test association between the various factors and the level of male involvement and logistic regression analysis was carried out to determine the influence of these factors on the level of male involvement. The mean age of participants was 32.9 years (SD=8.2). Overall, 26.4% had high level of involvement, 55.2% had moderate level of involvement and 18.4% had low level of involvement. The period with the highest proportion of high male involvement was during labour and delivery. Younger age (18-25years vs. 26-35years: OR=0.28, 95%CI: 0.12, 0.66) and the couple living with other family members negatively impacted on the level of male involvement. On the other hand, higher level of education (Tertiary: OR=40.57, 95%CI- 3.16, 520.32; Senior Secondary: OR=7.73, 95% CI- 1.61, 37.15) and the couple living together (OR= 13.12, 95%CI 6.86, 25.08) had a positive influence on the level of male involvement. Healthcare institution barriers to male partner involvement included poor staff attitudes, restrictions on male access to labour and delivery rooms and unwelcoming health facility environment. Male involvement in emergency obstetric care and/or came from home in labour was not optimal. Improving male-friendliness of health facilities in terms of infrastructure, organization of services and staff attitudes and education of the community especially men to sensitize them against the negative attitudes towards male participation in maternity care can improve male involvement. The Hospital management Team in collaboration with the community leaders should organize educational campaigns within the communities to educate community members especially the men, on the importance and benefits of male involvement in maternal health care. Such campaigns can also address negative socio cultural norms and attitudes.The hospital should restructure the maternal health clinics to make them more male friendly. Adequate space and privacy must be provided.Given the sociocultural diversity in the country, more research must be encouraged in this important area to enable the design of culturally appropriate and sensitive male friendly services throughout the country.
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    Prevalence and contributing factors of high risk pregnancies among women attending antenatal clinic at Mubende regional referral hospital Mubende district, Uganda
    (Kampala International University. School of Health Sciences Western Campus, 2018-03) Sabina, Bright
    In 2013, complications of pregnancy resulted globally in 293,000 deaths, down from 377,000 deaths in 1990. The most common causes of maternal mortality are maternal bleeding, maternal sepsis and other infections, hypertensive diseases of pregnancy, obstructed labor, and pregnancy with abortive outcome, which includes miscarriage, ectopic pregnancy, and elective abortion (GBD 2013) .Across sectional study design was used to determine the prevalence of high risk pregnancies among mothers who attend ANC in Mubende Regional Hospital. A systematic random sampling to obtain a sample of 384 respondents, and structured questionnaire to collect data were used. Data was coded, entered, and prevalence of high risk pregnancies was analyzed with SPSS, reporting frequency counts and percentages and then treated to descriptive statistics.The prevalence of high risk pregnancy was 72.7%. Among the contributing factors for high risk BMI more than 25 124(32.3) was the most common followed by too soon pregnancies 107(27.9) and the least was systolic blood pressure more than 140 5(1.3). A big number of mothers who attended ANC in, 277(72.1) had high risk pregnancies.The prevalence of high risk factors among pregnant mothers is very high.We recommend organization of out reaches to sensitize the community on dangers of high risk pregnancies to the mother and the child; and health education about the causes and prevention of the effects of high risk pregnancies.