School of Medicine (Sch. of Med.)

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  • Item
    Assessment of the in vitro antibacterial activity of a combination of Methanolic extracts of Magnifera indica leaves and Citrus Aurantium leaves against Escherichia coli.
    (Makerere University, 2018-07-03) Kisumba, Timothy ; Walukagga, Jamiru
    Introduction: Escherichia coli is a common causative pathogen in human bacterial infections like UTIs, neonatal meningitis, sepsis and diarrhea. The various strains exhibit multiple-antibiotic resistance thus a need to find alternative sources of new anti-infective agents. Mango and bitter orange plant leaves were assessed for potential activity to establish their potential use as new sources of anti-infective agents. Objectives: To evaluate the in vitro antibacterial activity of a combination of methanolic extracts of Magnifera indica and Citrus aurantium leaves against Escherichia coli. Methodology: Citrus aurantium and Magnifera indica, the plants of interest were freshly collected from mutundwe Kanaala zone, washed, dried, ground and extracted with 96% methanol. Dilutions of 20mg/ml, 10mg/ml, 5mg/ml and 2.5mg/ml for each of the extracts were tested for antibacterial activity against Escherichia coli, to determine individual MICs. In combination, the plant extract proportions were varied at percentage ratios of 75:25, 50:50, 25:75 of Citrus aurantium: Magnifera indica respectively, and the MIC of the most active combination Magnifera indica 75: 25 Citrus aurantium was determined. Gentamicin (40mg/ml) was the positive control and 10% DMSO the negative control. One-way ANOVA analysis was run using graph pad prism ver 7. 03. Results: Individual methanolic extracts of Citrus aurantium did not exhibit antibacterial activity, while the Magnifera indica extracts exhibited activity with an MIC of 0.678mg/ml against Escherichia coli. The combination was less active than the individual Magnifera indica extract. The combination exhibited additive effect with FICI = 0.55. Conclusion: The individual Magnifera indica extract exhibited greater activity than the combination, thus a need for further evaluation of the combinations to ascertain ideal concentrations for antibacterial activity
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    PREVALENCE AND FACTORS ASSOCIATED WITH UNDERNUTRITION AMONG CHILDREN UNDER FIVE YEAR ATTENDING MUKONGOLA HOSPITAL, SOUTH-KIVU, DR CONGO
    ( 2019)
    Background: Malnutrition and poor nutrition constitute the number-one driver of the global burden of disease.at the early stages of life. In 1996, the regional civil war in the DRC created an enormous loss of life and socio-economic destruction. Kabare where Mukongola Hospital is implanted has arable land and the territory is near the town of Bukavu but there is proliferation of undernutrition since the beginning of war in 1996. Objectives: To determine the prevalence and factors associated with undernutrition among children under five years attending Mukongola General Referral Hospital. Methods: A facility based, cross-sectional study was conducted on 383 children children under five years in December 2018 and January 2019. Anthropometric measurements of height and weight of 383 study children were taken to identify the. Both anthropometric and non-anthropometric data were entered and analysed using WHO Anthro Software and Stata13. Both bivariate and multivariate analysis (logistic regression model) was used to identify the determinants of child undernutrition. Results: Result of the study revealed that the overall prevalence of undernutrition in the community was high with 61.6% of the children with 9.9% being wasted, 51.9% for stunting and 28% for underweight. Regression analysis shows that the significant determinants of undernutrition were weight of birth, knowledge on prevention and cause of malnutrition, history of breastfeeding, level of education, the characteristic of feeding, marital status, place of delivery, history of child illness, attendance on ANC and the HIV status of the mother. Conclusions: The prevalence of child undernutrition among the under five children was high, indicating that the nutrition situation in study area is critical. Thus, undernutrition is a major public health problem. Further studies should also be encouraged to look for improved interventions.
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    X-Ray Film Reject Analysis at the X-Ray Department Mulago Hospital.
    (Makerere university, 2019-04-02) Joseph, Lukanga
    Introduction: It is not surprising to encounter patients who undergo repeat x-ray examinations after their initial x-rays are rejected for poor image quality thereby subjecting them to excess radiation exposure and avoidable extra cost. This creates a situation which necessitates the need to explore causes of reject and repeat of x-ray examinations. The employment of reject analysis as part of overall Quality Assurance (QA) programs in clinical radiography and radiology services in the evaluation of image quality is a well-established practice. The role of reject analysis in providing relevant information that would help achieve sound reduction in radiation exposure and cost as well as develop acceptable image quality was explored in this study. The use of reject analysis as part of quality assurance programs in clinical radiology is vital.Purpose: To determine the film reject rate at the X-ray department Mulago hospital and obtain information for further recommendation on improving film quality, reduce utility costs and the unnecessary radiation exposure to both patients and radiology personnel. Method: A Cross section descriptive study approach was employed. Plain x-ray films examinations were encountered in the period of study. The Reject rate was measured using structured format checklists on which relevant data for reject were recorded. The Checklists were used to capture the number of rejected radiographs, sizes of films used, examinations done and reasons for reject. The exposure factors were captured. The results were then collected and entered into a database for analysis.
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    Assessment of level of patient satisfaction with Radiological services at Mulago National Referral Hospital.
    (Makerere University, 2019-05) Nuwagaba, Andrew
    Background: Patient satisfaction is an important commonly used indicator for measuring the quality in healthcare. It affects clinical outcomes, patient retention, and medical malpractice claims. Patient satisfaction surveys may provide the only means for patients to express concerns about services received Purpose: To investigate patients’ satisfaction with diagnostic radiology services in Mulago National Referral Hospital. Methods: A cross-sectional and descriptive survey employing a quantitative method of gathering data was used. Purposive sampling was used to choose survey participants from the patients who had undergone diagnostic radiological services at Mulago National Referral Hospital. The survey was conducted with a self-administered questionnaire to measure patients’ satisfaction with various aspects and overall satisfaction with diagnostic radiology services. Results:The overall patient satisfaction level towards radiological services was 75%. Lowest satisfaction levels were reported towards the following items; receiving sufficient information on how to prepare for the examination 29.3%, length of time waiting in reception area 21.3%, confidentiality, and privacy during examinations 34.7%. On the other hand, 98% of participants were satisfied with the results provided. Patients of a younger age and those with lower education level were more satisfied with radiological service at Mulago National Referral Hospital than the older age patients, and those with a higher educational level. Conclusion: The majority of participants were satisfied with the radiological services. Young age and lower education level were the factors associated with patient satisfaction.
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    Knowledge and practices of radiation protection among radiographers in mulago national referral hospital
    (Makerere University, 2020-04-16) Anyanzo, Godfrey Omeson ; Balyesiima, Jonan
    Introduction. Medical radiation workers are potentially at a risk of unwanted ionizing radiation exposures. The use of radiation protection equipments, distance, and barriers to reduce the risk of exposure to ionizing radiation in a health care facility, research center, or industrial site where radiation-emitting devices are operated is very important. Radiation exposure poses hazards for health-care providers as well as patients in health-care facilities (HCFs). Objective This study assesses the knowledge and practices of radiation protection among radiographers in Mulago National Referral Hospital. Methodology: This was a quantitative cross-sectional descriptive study that involved radiographers working in Mulago National Referral Hospital. Semi-structured self-administered questionnaire written in English having both open and close ended questions were used. Findings: Generally, a larger proportion of the radiographers have sufficient knowledge on radiation protection and take in consideration radiation safety cautions when using to use ionizing radiations in medical practices, however, there is need for routine training of the radiographers in Mulago National Referral Hospital to enable them update their knowledge on radiation protection as per the current IAEA legislation. Conclusion: Basing on the results obtained from the study in which the knowledge and the practices of radiation protection of the radiographers were assessed, larger percentage of the radiographers are informed about how, why and when to use ionizing radiations in medical practices though to a lesser extent few members still need continuous professional development through training to update their knowledge on radiation protection.
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    Methods, challenges and staffing requirements for medical record management in the radiology department of Mulago National Referral Hospital (Uganda).
    (Makerere University, 2020-05) Tomusange, William ; Anjjo, Sophie Winnie
    Medical records are a vital asset in ensuring that hospitals are run effectively and efficiently. They support clinical decision-making, provide evidence of policies and support the hospitals in cases of litigation. This paper reveals the numerous methods, challenges and assessment of the staffing requirements of the management of medical record management in the radiology department of Mulago national referral hospital. The study emphasised the concept, types and significance of medical records, in view of the methods, challenges and assessment of the staffing requirements for the management of medical records affecting the radiology department. Aim The study aimed at evaluating the challenges and staffing requirements for medical records management in the radiology department of Mulago national referral hospital (Uganda). Methods: A cross-sectional study was carried out in the radiology department of Mulago national referral hospital. The study participants were qualified radiographers of Mulago national referral hospital. The sample size was 50 radiographers. Data was collected using self-administered questionnaires. The findings were documented and data was analyzed manually and using Statistical package for the social science, and Microsoft excel. The study documented the challenges and the staff requirements of medical records management in the radiology department and the possible solutions to the challenges were recommended/ addressed. This will therefore help in improving the records management practices and hence effective and efficient radiological service.
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    Radiography students' satisfaction with clinical training at Makerere University
    (Makerere University, 2020-09) Okello, Innocent
    The acquisition of quality clinical experience within a supportive and pedagogically adjusted clinical learning environment is a significant concern for educational institutions. The quality of clinical learning usually reflects the quality of the curriculum structure. The assessment of the clinical settings as learning environment is a significant concern within the contemporary radiography education. The radiography students’ satisfaction is considered as an important factor of such assessment, contributing to any potential reforms in order to optimize the learning activities and achievements within clinical settings. The purpose of the study was to examine the satisfaction levels of radiography students with clinical training at Makerere University. A cross-sectional survey design was used; the study was conducted at Makerere University on third and fourth radiography students. A sample size of 42 students was used. All data was collected using a questionnaire and descriptive statistics was used to analyze it. Data collected was represented in form of pie charts, bar graphs and tables. After data analysis, the study identified the following challenges faced by the students and these included lack of allocation of the students to ward or theatre rooms (63.2%), and Dental imaging rooms (64.9%). The allocated time to each of the imaging modality rooms such as MRI, CT, mammography, dental and ward/theatre had (100%) each and this was grossly inadequate. Absence or inadequate number(s) of qualified radiographers, lack of Knowledge update (Seminars/presentations), and distance from accommodation to the hospital had a distribution of (27%), 2(51.4%) and (56.8%) respectively. The research revealed, that less than half (13.5%) of the students were of the opinion that clinical posting was very educating regardless of the challenges faced. These challenges include, inadequate allocation of students to different wards (ward radiography), inadequate time allotted to some of the imaging modality rooms, absence or inadequate qualified radiographers, lack of Knowledge update (Seminars/presentations), and distanced to accommodation.
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    A study on the level of Makerere University Radiography students’ participation in clinical practice
    (Makerere University, 2020-11) Waswa, Ronald ; Mwebesa, Lonard
    Introduction: Medical radiography being a practical course, one can’t rely only on theory got from class but has to attend clinicals as often as possible in order to improve on his or her practical skills, gain confidence while at work and learn how to relate with his or her medical professionals (radiographers) or else will always put the health of their clients at risk. Thus, the need to study their participation by developing a number of questions and objectives to guide the study. Aim: The overall task of this study was to find out the level of student radiographers’ participation in clinical practice. Methodology: A descriptive cross-sectional study was carried out which included a total of forty-eight (48) respondents; 26 were second years, 11 were third years, and 11 were fourth year radiography students. Data was collected using self-administered questionnaires to student radiographers in their respective classrooms. Data was then analyzed manually using a scientific calculator. Results: The study findings revealed that; 1. The majority of the student radiographers attended clinical practice as per the duty rosters designed by their class representatives, (62.5%). 2. An overwhelming majority of student radiographers’ were always supervised during clinical practice, (91.7%). 3. More than a half of the student radiographers were motivated to improve on their practical skills through attending clinical practice as often as possible, (79.2%). 4. Most of the student radiographers were encouraged to effectively participate in clinical practice by the techniques of assessment, (84.6%). Conclusion: Since most of the student radiographers followed their duty rosters, were supervised, motivated, and assessed using suitable techniques during clinicals, therefore, their level of participation in clinical practice was moderately high. The following recommendations were drawn for the radiology department, school of medicine, Makerere university; 1. All student radiographer should be further sensitized on the importance of a duty roster as a means of encouraging them to follow it. This should be done as early as year one. 2. Practical assessment should at least be done at the end of each placement period using suitable techniques to further encourage students to actively participate in clinical practice. 3. Students should be further sensitized on the importance of rotating around in all the radiology units including nuclear medicine. 4. Since this study did not focus on the comparable views of supervisors towards radiography students’ participation in clinical practice, further research is recommended.
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    The prevalence and factors associated with abortion among pregnant mothers attending ultrasound department at Lira Regional Referral Hospital: A cross-sectional study
    (Makerere University, 2020-11) Nanngonzi, Federess ; Nsamba, Swamadu
    Background; Abortion is one of the prevalent negative reproductive outcomes among women around the world, which is a great challenge that affects maternal health promotion. In the recent years no documentary evidence has been indicative of an increase in the prevalence of induced abortion in developing countries. Study objective; This study was aimed at determining the prevalence of abortion and associated factors among women attending ultrasound at Lira regional referral hospital. Methodology; This was a cross-sectional descriptive study conducted among 150 women. Purposive sampling technique was used to recruit study participants and data was obtained using questionnaires. Findings; The prevalence of abortion was 27% which is high in comparison to the global and regional WHO estimates. Maternal infections, age, socioeconomic status, education level, uterine abnormalities and use of pharmacological and chemical agents were the established individual factors contributing to this prevalence. Additionally, lack of sexuality counseling/health education and lack of access to contraceptives, were seen as health service-related contributing factors. Conclusion; The high abortion rate among mothers highlights the need to improve sexuality health education and family planning in Uganda.
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    Clinicians’ perspectives on radiology reports at Mulago Hospital.
    (Makerere University, 2020-11) Namwase, Eunice ; Muhangi, Micah
    Introduction: The radiology report is the primary written communication between the radiologist interpreting the study and the physician who requested the examination. A radiology report serves as a medico-legal document and it also guides patient management. Therefore, it needs to be as accurate as possible. Referring clinicians are the primary consumers of radiology reports, therefore it is necessary to get feedback from them on radiology reports. The purpose of this study was to find out the perspectives of referring clinicians towards radiology reports submitted from the radiology department at Mulago Hospital. Methods: Permission was sought from the research and ethics committee of radiology department of Makerere University and Mulago National Referral Ethics Committee. The study is a descriptive cross-sectional study employing quantitative and qualitative techniques. Purposive sampling method was used to select clinicians who refer patients for radiology examinations. Clinicians perspectives on delivery time, terminologies, diagnosis & recommendations of the radiology reports was done using questionnaires and observations. STATA 16 and SPSS 16.0 software were used in analyzing the quantitative data. Qualitative data was analyzed narratively. Results: Seventy questionnaires were distributed and a response rate of 70％(49) achieved with department of pediatrics 15(30％) having highest response rate and accidents and emergency having the least 4％(2). Using blooms cutoff perceptions were graded as negative, moderate and positive. The demographics did not affect the perception of the clinicians towards the radiology report as bi-variate analysis of sex, age and department (p=0.49) showed no associations. There were more clinicians with negative perspective(27％, 13) as compared those with a positive perceptive(24％, 12) about the delivery time of radiology reports. Majority of the clinicians had a positive perspective(76％, 37) towards the terminologies used in radiology reports with few(6％, 3) expressing a negative perspective towards the terminologies noting that they are sometimes unnecessarily complicated. Close to three quarters of the respondents(67％, 33) had a moderate perception while a meagre(11%, 5) had negative perception that the radiology reports answer clinical questions asked. Most of the referring clinicians (76％, 36) expressed a positive perspective while few(9％, 4) had a negative perception towards the recommendations written in the radiology report. None of the clinicians who participated had views that they do not totally understand the terminologies used or that the recommendations are not necessary to be included, neither that reports do not answer clinical questions asked. Conclusion; Clinicians in Mulago hospital have a moderate-positive perceptive towards the radiology reports from the radiology department with respect to time, terminologies, diagnosis and recommendations.
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    Assessing the antifungal effect of a combination of fluconazole and tithon a diversifolia leaf extract against candida albicans
    (Makerere University, 2020-11-02) Oonyu, Richard ; Nyiiro, Grant ; Nadiope, Wilber
    Background: Candida albicans remains the most common cause of candidiasis of the 30 species that have the ability to infect humans. It affects the oral and vaginal mucosa as well disseminated blood stream and deep tissue infections mainly in the immunocompromised. It’s managed with azoles, polyene among others but majorly azoles are used because they are relatively cheap, less toxic and effective, however there are reports of development of resistance to these. combination therapy is one of the ways to manage these infections. The azoles are currently combined with amphotericin which is toxic even at therapeutic dose. Tithonia diversifolia leaf extract has activity against Candida albicans. This study therefore aimed at stems for a need for another safe, effective drug that can be combined with azoles to reduce development of resistance. Objectives: To assess the antifungal activity of a combination of ethanolic extract of Tithonia diversifolia and fluconazole against candida albicans. Method: The extraction was done by maceration in alcohol 70%, and then evaporation using a rotary evaporator to obtain the extract, the extract and fluconazole was tested for antifungal activity using well diffusion method, the MICs were determined by plotting a graph of square of radius of inhibition against log concentration and the nature of activity of combination was elucidated by use of FICI equation. The significance of combination using Graphpad prism 8.0.2 Results: The antifungal activities in terms of MICs of Fluconazole, fluconazole in combination, extract and extract in combination were (0.973, 1.169, 3.774 and 4.073) mg/ml respectively. The combination showed antagonistic activity as illustrated by the FIC index of 2.28. There was no significance difference between the effect of combination and fluconazole (p=0.586, ordinary one-way ANOVA), and combination and extract (p=0.231, ordinary one-way ANOVA). Conclusion and recommendation: Fluconazole showed better activity than extract against candida albicans, however the combination did not show synergistic activity, but rather antagonistic activity and it’s therefore not recommended for use against Candida albicans., but rather the extract alone 1
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    Evaluation of quality of generic brands of enrofloxacin available on the Ugandan market
    (Makerere, 2020-11-11) Maseruka, Richard ; Juba, Mark ; Akello, lydia
    ABSTRACT This study intended to evaluate the quality of enrofloxacin brands available on the Ugandan market for veterinary use. Enrofloxacin is a fluoroquinolone antibiotic with a broad-spectrum activity commonly used for the treatment of various bacterial infections in animals and poultry. Two batches of eight different brands of generic enrofloxacin were purchased from Veterinary pharmacies in Kampala and Mbarara city. Standard physical and chemical tests for quality surveillance were performed on the brands according to the methods outlined in the US Pharmacopoeia 2013. High Performance Liquid Chromatography using a UV-VIS detector was used for quantitative determination of enrofloxacin in the various brands. All brands assessed were clear solutions showing a statistically significant difference between the obtained pH value and the expected pH value of 7 as per USP specification at a P≤ 0.05. The product label on both the primary and secondary pack of the brands had clearly stated the proprietary name, product strength, manufacture and expiry dates, batch number, specific storage conditions, name of manufacturer and country of origin of the drug. However, some key compendial information was lacking on the label with only 37.5% (3/8) indicating the generic name, 87.5% (7/8) indicating the route of administration while 25% (2/8) indicated the composition on the label. HPLC analysis revealed that the mean drug concentration in all the brands were within compendial specifications. The clarity of all the brands was also within compendial limits.
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    Knowledge, attitudes and practices of pregnant women towards obstetric ultrasound at Mulago Hospital
    (Makerere University, 2020-11-20) Kasozi, Derrick ; Maniragena, Janvier
    Introduction: Prenatal sonography is very important for quality patient management and effective service delivery in diagnostic radiology during the antenatal period (ANP). Obstetric ultrasonography in antenatal care (ANC) is now globally recognized as one of the ways through which maternal mortality can be reduced. However, the majority of pregnant women attend antenatal ultrasound late and at times, some do not attend at all. This increases pregnancy and delivery associated risks including mortality. Pregnant women’s awareness, knowledge, perceptions, and attitudes are thought to influence their response towards antenatal ultrasound scan. Therefore, this study was aimed at exploring the knowledge, attitudes, and practices of pregnant women towards prenatal sonography at Mulago hospital, Kampala, Uganda. Methodology: This was a descriptive cross-sectional study that involved 300 pregnant women who attended obstetric sonography at Mulago hospital, Kampala, Uganda and consented to participate. Consecutive sampling technique was used to recruit participants into the study. The data was collected using interviewer-administered questionnaires and was analyzed quantitatively into descriptive statistical tables, percentages and graphs using SPSS version 20. Results: A total of 300 questionnaires were distributed to the pregnant women and the response rate was 100%. Most participants were within 20-29 years age group. Most participants knew the use of ultrasound scan in antenatal care. However, the majority also reported a misconception that ultrasound has harmful effects. Generally, participants showed a positive attitude towards obstetric ultrasound scan but they had poor practices. Long waiting time and lack of privacy were reported by most participants as leading factors that contributed to the poor practices. Conclusion: This study shows that the knowledge and attitude of pregnant women towards obstetric ultrasound in Mulago hospital were good. However, their practices were poor. The concerns that need to be addressed include patient’s privacy, waiting time and the misconception regarding the safety of ultrasound that it can cause cancer.
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    Determination of rejection rate and factors associated with rejection of conventional plain X-ray films at the Department of Radiology, Mulago National Referral Hospital
    (Makerere University, 2020-11-28) Nabafu, Flavia ; Ibanda, Derrick
    Background: Reject plain X-ray film analysis can be used as a quality indicator and is an important tool in localizing areas where optimization is required. Reduction in the number of rejects is important because it reduces the effects of radiation exposure and increases efficiency in health care service delivery. Purpose: To find out the rejection rate of films and to identify factors that contributed to the rejection of films at the department of Radiology, Mulago National Referral Hospital. Material and methods: A cross-sectional study was carried out and descriptive data were collected from March to June 2020 using a structured format on which relevant data from rejected films were recorded. The results were then collected and entered into Microsoft Excel for univariate analysis from July to August 2020 and descriptive statistics generated were presented in frequency distribution tables, graphs, and pie-charts. Results: The overall reject rate was 18.9%. Chest films contributed 9.5% of the total rejection rate. 57.9% of the errors leading to film rejection were performed by radiographers with less than one year of practicing experience and the highest cause of rejection was over exposure (34.4%). Conclusions and recommendations: The findings from this study showed that the overall rejection rate was higher than the recommended 5% by WHO and up to 10% by CRPD. We therefore recommend that quality assurance and quality control programs should be put in place for optimization of service delivery.
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    Prevalence and disposal practices of unused medicines among households in Kavumba Ward, Wakiso District, Uganda.
    (Makerere University, 2020-11-30) Paul, Kakande ; Brian Samuel, Musoke ; Stephen, Waziko
    ABSTRACT Background: Most medicines found unused among households are those that are required for common ailments such as pain, fever, cough and epigastric distress. While this practice may not be entirely irrational, safe disposal of unused medicines is important as malpractice may lead to harmful consequences such as undesirable effects, prescription drug abuse, overstocking, self-medication, accidental overdose, and even death. This study explored the prevalence and disposal methods of unused medicines among households in Kavumba Ward. Objective: To determine the prevalence and disposal practices of unused medicines among households in Kavumba Ward, Wakiso District. Methods: This was a cross sectional study conducted among randomly selected households in Kavumba Ward, Wakiso District in November, 2020 using interviewer administered structured questionnaires. Data was entered into Microsoft Excel (2013) and exported to Python 3.7.2 software for analysis. Frequencies and proportions of unused medicines found in surveyed households were calculated. Factors associated with the prevalence of unused medicines among households in Kavumba Ward were explored using chi-square tests. Descriptive statistics of the disposal methods of unused medicines were provided using frequencies and graphs. Results: A total of 369 households in Kavumba Ward, Wakiso District was surveyed. 62.9% (232) of the respondents were female wile 37.1% (137) were males. Unused medicines were present among 45.5% of the surveyed households. Analgesics (27.9%) and antibiotics (17.9%) were the most common unused medicines. The factors that influenced the presence of unused medicines among households were gender (p=0.039), anticipated future use (p=0.07) and recent common illnesses (p<0.001). Throwing into the household garbage (40.1%) was the most used method of disposal. Conclusion and recommendations: Almost half of the population (45.5%) in Kavumba Ward were in possession of unused medicines. There is a lack of guidance on how patients should safely dispose of their unused medicines and thus need for increased awareness of the potentially detrimental effects on the environment, human and animal health arising from improperly disposed of medications among the population.
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    Adherence to the multi-dose Hepatitis B vaccination schedule and factors associated: A case study of Makerere University students
    (Makerere, 2020-11-30) Walakira, Joshua Felix ; Mutaka, Martin ; Murungi, Johnbrebeuf
    Background:Adherence to hepatitis B vaccination is a major public health concern. Makerere University students are in a setting that has a high population density, high sexual activity all which influence high spread of hepatitis B yet there was no data on adherence to hepatitis B vaccination among them. This study therefore sought to find data that was lacking on level of adherence to hepatitis B vaccination among Makerere University students and factors associated with adherence which would prove resourceful in developing solutions and a framework into which the university and other stakeholders can come in to bolster the vaccination program. Methods: The research was a mixed method cross sectional study done at Makerere University, Norvik Hospital and Makerere University Health Services. The quantitative and qualitative data was obtained by reviewing hospital records and conducting in-depth interviews respectively. Level of adherence to the second and third dose was analyzed as a proportion of those who received the first dose whiledeductive thematic analysis was used to obtain the factors associated with adherence to the vaccination program. Results: The level of adherence among the Makerere University students was 96.4%and 69.1% for the second and third dose respectively. Thefactors associated with the HBV vaccination werefound to be categorized into personal factors like lack of proper knowledge on the importance of vaccination completion, poor attitude, institutional factors like non-existence of an HBV vaccination policy and health care system factors like patient follow up and cost subsidies. Conclusions: Adherence to HBV vaccination among Makerere University students was lower than the WHO target of 90% coverage of hepatitis B virus vaccine (third dose) by 2020 though higher than seen in other similar studies.
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    Development of a herbal cream containing ethanolic leaf extract of cassia alata for management of tinea corporis
    (Makerere University, 2020-11-30) Abimanya, Willbrod ; Ssemakula, Andrew Benon ; Kitandwe, Stuart
    ABSTRACT Background: Tinea corporis is a superficial dermatophyte infection that is highly prevalent (20–25%)and can be problematic if poorly managed. Its management today with oral and topical antifungal agents is associated with increasing resistance and this calls for more intervention. The efficacy of some of these hasbeen proven but little pharmaceutical development has been done.Cassia alata has shown considerable efficacy and has been chosen for the formulation of GO-TINEA for management of Tinea Corporis. General objective: To develop a herbal cream from Cassia alata for management of Tinea Corporis. Specific objectives: To formulate a herbal cream containing the ethanolic extract of Cassia alata for management of Tinea corporis and to determine the acute of the prepared herbal cream. METHODS:This was an experimental study to formulate a herbal antifungal cream containing ethanolic extract of Cassia alata against cutaneous Tinea corporis.The ethanolic extract was screened for presence flavonoids, alkaloids, tannins and Saponins. The antifungal assay of the extract was demonstrated using Trichophyton rubrum cultured on PDA using Ketoconazole as the positive control. The MIC was determined and used during formulation of GO-TINEA. GO-TINEA was also tested for acute dermotoxicity by applying a large amount of cream and the site inspected for any cutaneous changes within 24 hours. RESULTS: A soft extract was obtained from Cassia alata leaves by maceration with 96% ethanol. The extract had antifungal activity against Trichophyton rubrum with an MIC of 9.137mg/ml. GO-TINEA was formulated with strengths of 1%, 2% and 5%.The 1% GO-TINEA had the lowest dermal irritation score and therefore the safest for topical use. CONCLUSION:A herbal cream, GO-TINEA from the ethanolic leaf extract of Cassia alata has activity against Trichophyton rubrum and can be considered an alternative to conventional creams like ketoconazole cream. It is also safe for topical use. 1 CHAPTER ONE INTRODUCTION 1.1 BACKGROUND TO THE STUDY The prevalence of superficial mycotic infection worldwide is 20–25% of which dermatophytes are the most common agents (Sahoo and Mahajan 2016). Dermatophytosis is therefore currently a disease of global importance and a public health burden. It is caused by dermatophytes, which attack and grow on dead animal keratin. Tinea corporis is the second most clinical type, after Tinea capitis (Nweze and Eke 2017). Dermatophytes are a group of filamentous fungi referred to as the ringworm fungi. They are keratinolytic and invade keratinized tissues causing mostly superficial infections involving the skin, hair and nails. They are amongst the most common causes of skin disease in the world, and the real prevalence is probably underestimated (Hayette and Sacheli 2015). The most common and most widely distributed etiological agent is Trichophyton rubrum, which causes different types of infection in different parts of the world (Oke, Onayemi et al. 2014). The other pathogenic fungi commonly known to cause Tinea corporis include Trichophyton mentagrophytes. Currently, the treatment of these dermatophytoses is by oral or topical antifungal agents. Examples of these antimycotics include itraconazole, fluconazole, griseofulvin, terbinafine etc.(Gupta and Foley 2015). However, due to the increasing development of drug resistance in human pathogens as well as the appearance of undesirable effect of certain antimicrobial agents, there is a need to search for new agents. The use
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    Pre-clinical validation and formulation of capsules of abelmoschus esculentus seed extract for weight loss.
    (Makerere, 2020-11-30) Namuli, Veronica ; Niwandinda, Phionah ; Bitamazire, Ava Airizibwe
    ABSTRACT Back ground; Abelmoschus esculentus (Okra) is a vegetable that is consumed worldwide and has been studied and found to be rich in phytochemicals like flavonoids, polyphenols etc. Various studies about the plant have proved its medicinal importance in conditions like diabetes mellitus, hyper-lipidemia and obesity among others. Over 315million people are affected by obesity and it’s putting them at a risk of developing chronic conditions like cardiovascular diseases. The current medications e.g. orlistat are associated with high cost and intolerable adverse effects like faecal incontinence. The use of locally available natural agents to curb obesity would be of tremendous benefit Objective: To pre-clinically validate weight loss activity of Abelmoschus esculentus seed extract and formulate capsules of seed extract to aid in weight loss Method: An experimental study design was used in the study. Dry Abelmoschus esculentus seeds were ground and extracted using 70% ethanol. Weight loss activity of the extract was tested in hamster albino rats by first inducing overweight with cheese and then orally administering different doses of the extract for 24 days. Weights were taken every 3 days to assess weight loss. Acute toxicity and histopathological studies done to assess the safety of the extract. From the extract, capsules were formulated and their physical properties, dissolution, uniformity of weight and stability profile were determined using appropriate methods from the British Pharmacopoeia (2009). Results: The extract induced significant weight loss (P value less than 0.05) which was greater than that caused by the positive control orlistat. The acute toxicity and histopathological studies showed no serious effects on the organs (kidneys, liver and heart). The formulated capsules passed the quality control and stability tests. Conclusion: Abelmoschus esculentus seed extract causes weight reduction, is safe for use and can easily be formulated into capsules of acceptable quality to aid in weight loss
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    Assessment of Salmonella contamination in locally prepared oral liquid anti-cough preparations sold in pharmacies in Kampala
    (Makerere University, 2020-12) Mulekwa, Helon ; Adoki, Pius ; Kakonde, Dieme ; Nicas, Issa Nelson
    Background The manufacturing of oral liquid herbal products needs strict quality control measures in order to ensure that products are safe, have high quality, are efficacious before they are authorized to be released on the market for human consumption. However much, oral pharmaceutical preparations do not necessarily need to be sterile, herbal medicines intended for internal use should not be contaminated by Salmonella even in trace amount at any stage. Despite the benefits, herbal products have been found to be contaminated with contaminants such as microbial agents like Salmonella. Objective This study aimed at assessing the Salmonella contamination of locally prepared oral liquid herbal anti-cough preparations sold in pharmacies in Kampala. Methodology This was an experimental study. Herbal oral liquid preparations locally prepared and sold in Kampala were included. A total of six types of herbal products were purchased and the samples assessed for Salmonella spp contamination by culture techniques and biochemical methods. The results were analysed using EXCEL spreadsheet. Results There was no sample contaminated with Salmonella. However, there were some other bacterial contaminants in 8 of the 18 samples tested. Conclusion If manufacturers of oral liquid herbal anti-cough preparations follow the cGMP and these products are kept in a clean environment such as in pharmacies, these preparations can remain free of Salmonella contamination. The samples that showed some bacterial growth can be a source of microbial inoculation into the body.
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    Assessment of inpatient parenteral antibiotic use in Kiruddu National Referral Hospital
    (Makerere University, 2020-12-01) Lubega, Ashiraf ; Toko, Rashid
    Background. Parenteral antibiotic use is a complex system that involves the prescribers, dispensers, nurses and the patients. This is influenced mainly by factors such as prescribing criteria and experience, essential medicines list compliance, parenteral antibiotics availability and actual administered parenteral antibiotics after dispensing. Objective. To assess the inpatient parenteral antibiotic use in KIRUDDU NATIONAL REFERRAL HOSPITAL. Methods. Retrospective cross sectional study was used to collect data with a sample size of 210, necessary research data was obtained from prescribers in the general wards, dispensers in the ward pharmacy, nurses in the wards and patient treatment sheets or files. A pretested semi-structured questionnaire was used to collect information from prescribers, dispenser, and nurses after seeking their verbal consent plus patient treatment sheets. Simple random sampling technique was used to select the participants in the study. Data was entered double checked and edit using online google forms and analyzed using python software version 3.7.2. Results. Parenteral antibiotic therapy was initiated after obtaining positive laboratory results of patients. Prescription by generic name was 93.1%, compliance to essential medicines list was 100%. The two most commonly prescribed parenteral antibiotic was ceftriaxone 58.8% and metronidazole 23.0%. Availability of parenteral antibiotics at the ward pharmacy was 83.3% and the administration of parenteral antibiotics to patients was 67.3% and missed doses accounted for 33.7%. Conclusion. According to the study results, prescription by generic name, availability of parenteral antibiotics at ward pharmacies and their administration were all slightly below the required standards set by WHO. Missed doses which stimulate and accelerate antibiotic resistance should be prevent and antibiotic stewardship programmes are highly encouraged. The administrators of the hospital should ensure at all times the availability of parenteral antibiotics to prevent missed doses and antibiotic complications.