School of Bio-Medical Sciences (Bio-Medical) Collection

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    Prevalence and factors associated with self-treatment of symptoms of primary dysmenorrhea among female students of Makerere University
    (Makerere University, 2019) Nakanwagi, Irene
    Background Self-medication is the selection and use of medicines by individuals to treat self-recognised conditions or symptoms. It also encompasses the continued use of medications formerly prescribed by a physician. Aim The aim of the study was to determine the prevalence and factors associated with self-treatment in the management of the symptoms of primary dysmenorrhea among female students of Makerere University. Method This was a cross- section study which was carried out at Makerere university campus. The study participants were undergraduate female students at the university. Data was collected using questionnaires with both closed- and open-ended questions which were administered to the students but before administering them, the participants were required to give consent. The major form of qualitative data analysis was coding both by computer and manually. Results 216 female participants were recruited into the study ranging from 20 to 30 years with an average age of 22 years in first, second, third and fourth years of study. The prevalence of self-treatment of primary dysmenorrhea was found to be 88.9% and Paracetamol was the highly used medicine (37.5%). Majority, 87.5% got medicines from the pharmacy while others got medicines from the clinics and hospitals. The study unveiled the factors leading to self-medication against symptoms of primary dysmenorrhea among Makerere University female students which included having no time to consult healthcare providers (33.3%), knowledge of the medications (83.3%) and being uncomfortable with consulting healthcare providers (16.7%). Conclusion The prevalence of self-medication in the management of primary dysmenorrhea is high among female students of Makerere University. The knowledge of the treatment choice remains the fundamental contributor to self-medication among the students.
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    Cytological evaluation of nipple discharges among symptomatic patients who attended FNAC Clinic of Pathology Core Laboratory Makerere University
    (Makerere University, 2019) Sande, Kenneth
    Background: Nipple discharge (ND), refers to a secreted fluid from the breast and it is the third most common breast disease symptom and complaint following mastaglia and breast lump. Its most often associated with a benign process though can be malignant in some cases that cause it. Cytological examination of nipple discharge smears has been considered for a long time as a routine and useful non-invasive test for studying breast diseases most especially those presenting with no palpable mass. Differentiating between abnormal nipple discharges which result from physiological and benign causes from those secondary to a malignancy macroscopically is a bit difficult and quite challenging but a cytological examination gives useful information in evaluation and differentiation. Aim and objective: To cytologically evaluate nipple discharge among symptomatic patients with a breast abnormality presenting exclusively with nipple discharge. Methodology: This was a retrospective cross-sectional laboratory-based study of all patients presenting with a nipple discharge as a primary symptom with no palpable mass to the FNAC clinic of the pathology laboratory at college of health sciences Makerere university located at Mulago-Kampala over a period of 10years from January 2008-December 2018 (n=73). Patients' medical records and their respective smear slides were retrieved and examined respectively. Parameters evaluated included patient demographics (age and sex), the clinical presentation of the discharge (gross appearance and laterality), and cytological analysis. Results: Seventy-three (73) patients presented with nipple discharge as their primary complaint. all were females aged between 16-76years with a mean age of 40.6years. the majority were aged between 20-39years. Discharges were unilateral in 67cases (91.78%) [right: 32, left: 35] and bilateral in 6cases (8.22%). Grossly appearing; 27(36.99%) were bloody, 10(13.69%) serous, 13(17.81%) milky, 17(23.29%) mucoid, and 6(8.22%) purulent. Benign cases were the most detected 40/73(54.79%), followed by inflammatory 14(19.18%), then 2(2.74%) suspicious and 1(1.37%) malignant case, and 16(21.92%) non-diagnostic cases. Ductal papilloma 20/73(27.39%) was the most detected benign condition among both the bloody and non-bloody discharges. Conclusion: This study aimed to identify the different abnormalities in nipple discharges evaluated by nipple discharge cytology. Based on the analysis, it can be concluded that benign conditions are the commonest cases encountered and the main cause of abnormal nipple discharge compared to malignant conditions. the bloody discharge was more associated with benign diseases, therefore, it should not be of serious concern for malignancy. Nipple discharge cytology is a useful method in the diagnosis of malignant and suspicious cases because of its specificity especially in patients presenting exclusively with discharge and it directs patient management in most benign cases.
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    Parameters for grading the toxic severity of test chemicals : a review article in the advancement of unknown drugs into the clinic
    (Advances in Nanomedicine and Nanotechnology Research, 2019) Belay, Yilkal Tariku
    Grading of toxic severity of a test chemical is a routine procedure in experimental toxicology to support regulatory policy in categorisation and harmful labeling decisions. Harmful labeling decision is usually made on the basis of lethal dose administered to study animal. However, the toxic property of a chemical compound is diverse in which the undesired biological mechanism manifested on treated study animal may not cause death within the period of the experiment. The length of time at which undesired biological effects manifest on study animal depend on the amount of administered dose. The adverse effect of higher dose usually manifests within a shorter period of time than the lower doses. The scientific basis of drug action is the interaction of a drug with its receptor or biological target by which undesired biological changes manifested at the cellular, organs or organismal level depending on the amount of administered test chemical. Drug metabolism is an important biological process to be considered in the study of pharmacological activity of test chemical compounds. It is one of the primary mechanisms by which a chemical compound is inactivated or activated depending on the metabolic enzyme systems involved in biotransformation. Biotransformation of test chemical perhaps leads to the production of reactive metabolites that could be more toxic, mutagenic or carcinogenic than parent chemical compound which could elicit different biological responses such as loss of appetite and suppressed immune response among others. The metabolic and immune systems are highly interrelated in which the proper function of one is highly dependent on the other. Metabolic dysfunction for instance leads to deteriorated immune system which can be evaluated by clinical parameters such as differential blood cell counts (i.e., T-lymphocytes and B-lymphocytes) and immunoglobulin concentration in blood serum. In conclusion, Grading of toxic severity of test chemicals should take into account not only the estimate of hazards on the basis of lethal dose administered into the biological system but also the different biological responses (immunological and physiological) and the length of time at which biological responses manifested in the course of metabolism. Quantitative analysis of undesired biological responses as toxic severity and toxic reaction rate is paramount for grading the toxic severity of test chemical compounds on study subject which allow better identification of real risks to public health safety.
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    Cytological abnormalities in soft tissue tumors seen at Cytology Clinic of Pathology Department Makerere University College of Health Sciences.
    ( 2019) Nabibubbu, Oliver
    Background; Most soft-tissue tumors are benign, outnumbering malignant tumors approximately 150:1 with roughly 20 malignant soft-tissue tumors per 1 million people in the United States (Krumme & Kotwal, 2010). This also corresponds with the research done at Pelagia Library in Europe, where it was found out that benign tumors are more common than malignant counterparts (sarcomas) with a ratio of at least 100: 1(Ivan et al., 2015). Benign soft tissue tumors are encountered more in female than male, while malignant tumors are more among male population than females. Peak age incidence of benign and malignant soft tissue tumors is observed in 30 and 31-40 respectively. Benign soft tissue tumors show predilection for head and neck region whereas malignant show for lower extremities. (Ivan et al., 2015) Aim and Objective: To determine the prevalence of soft tissue tumors and their association with social demographic factors. Methodology: This was retrospective cross-sectional laboratory - based study conducted at Pathology department- Makerere University College of Health Sciences from January 2010 to December 2018. A total of 72 cases of fine-needle aspirations of the soft tissue were retrieved from the archives. Final diagnosis together with the required social demographic factors were recorded and SPSS was used for analysis of the results. Results: Of the 72 patients, 45(62.5%) were females and 27 (37.5%) were males. The majority of the patients were in the age bracket of 20-29, 30-39 and 40-49. Benign cases were most detected (46/72), followed by malignant (26/72). Commonest benign lesions were, fibrolipoma and lipoma while malignant ones were undefined sarcoma and rhabdomyosarcoma. Most sampled anatomical site was the breast followed by the neck, gluteal region and thigh. Close association was found between soft tissue tumors with gender with a P value of 0.05. Conclusion: Among the few patients who presented to the clinic for diagnoses the prevalence of malignancy was relatively higher especially among the male population than females. Both benign and malignant cases were detected among all the age groups. Recommendation: More research needs to be done as I believe this study is a fundamental step in improving research in the field of soft tissue cytology.
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    Prevalence of benign conditions of the thyroid gland as detected by the Pathology Department among patients attending FNAC Clinic Pathology Department Makerere University College of Health Sciences
    (Makerere University, 2019-07) Mbaziira, Tonny
    Background: Benign thyroid disorders are common in Africa. Benign disorders are usually due to environmental toxins such as exposure to radiation, due to genetics, diet, stress, local trauma or injury, inflammation or infection. Surgery is a common type of treatment for benign tumors and it's main aim is to remove the tumor without damaging the surrounding tissues. Other types of treatment of benign tumors may include medication or radiation. Autoimmune thyroid disorders, Hashimoto's thyroiditis and Grave's disease account for the vast majority of thyroid dysfunction seen in most iodine-replete populations. Most thyroid nodules are adenomatous. Some are multiple and that is usually shown on ultrasound, scintigraphy and at surgery. Objective: To determine the prevalence of benign conditions of the thyroid gland as detected by the Pathology Department, College of Health Sciences, Makerere University. Method: The study was a retrospective cross-sectional laboratory study. It included all patients with benign thyroid conditions who attended FNAC clinic at Pathology Department of College of Health Sciences. It was carried out in four months beginning with the month of April, 2019. Results: A total of 291 patients was considered. The study showed that there was a total of 140 with colloidal goiter, 56 with cystic thyroid nodules, 44 with follicular benign thyroid nodules, 27 with thyroiditis and 24 with benign thyroid aspirates. Conclusion: Fine-needle aspiration cytology is widely used in the diagnosis of benign thyroid conditions because it is an excellent, safe and cost effective diagnostic procedure. Recommendation: Common interest should be put in understanding colloidal goiter, its epidemiology, treatment and preventive measures so as to reduce its prevalence among patients. Need for sensitization of the communities about thyroid conditions so as to improve their health seeking behavior.
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    Fine needle aspiration cytology findings of breast lumps in female patients presenting with palpable breast masses at Pathology Department Makerere University College of Health Sciences
    ( 2019-09-12) Kinalwa, Sulaiman
    Background: A palpable breast lump is a common clinical problem that presents to surgeons, gynaecologists and general practitioners. In the past, excisional biopsy was the accepted practice current practices utilize radiological imaging in combination with needle biopsy. Mulago hospital receives referrals mainly from the neighbouring hospitals and occasionally other regional referrals. Unfortunately, majority of the patients present late with attendant poor outcome due to late diagnosis. Objectives: To determine the prevalence of cytological abnormalities of breast masses, correlation between breast abnormalities with age; breast cancer awareness. Method: A cross-sectional prospective review of case notes of all participants that presented with palpable breast masses between January 2019 and May 2019 was carried out. Data studied included demographic characteristics and breast cancer awareness. Results were analysed using SPSS Statistics 16.0. Results: A total of 193 participants were seen, out of which 37 (19.2%) had malignant breast disease and 145 (75.1%) benign breast disease, 10 (10%) suspicious breast disease and 1 (0.5%) atypical breast disease. The minimum age was 11yrs and maximum age was 87yrs. Fibroadenoma 86cases 44.6% was the commonest followed by fibrocystic disease 14cases 7.3% positive for malignancy 13cases 6.7% suspicious 11cases (5.7%). Benign breast lesions were common in the age group of 21-30 years and malignant breast lesion common in the age of 41- 50 years of age. 91 participants were aware of breast lumps/cancer 47.2% and the remaining 102 participants 52.8% were unaware. Conclusion: The prevalence rate of breast cancer in the study was 19.2%, benign breast disease 75.1% suspicious 10% and atypical 0.5. Women aged 55 years and older had an increased risk of breast cancer. Recommendation: There is need to extend Cytology services in remote areas of the country and educate women about breast cancer most importantly breast self examination
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    Assessment of womens’ knowlegde, attitude and beliefs towards cervical cancer screening in Nakaseke Health Center, Central Uganda
    (Makerere University, 2020) Senfuma, Evelyn
    Cervical Cancer is the second commonest cancer affecting the women, where virtually all cases are connected to human papillomavirus genital infection. Women living in urban centers take cervical cancer infection as bad luck and don’t want to know if they have it. Women who do not go for screening claim that once they go for screening people around them will think they are having sex and since they are not active sexually, they do not have to go for any testing and this common among the Hispanic and Asian. In Uganda, cervical cancer is taken as the number one most frequent cancer among women and also as the 2nd most common cancer among women aged 15-44 years. An estimation of approximately 40 women in every100,000 develop Cervical Cancer in Uganda. It has been confirmed by statistics about half of the women with Cervical Cancer die within three years of diagnosis. The most common malignancy among women living in Mbarara is cervical cancer, in West Nile District,it is the second commonest and among women in Kyadondo County,it accounts for over 80% of female cancers, Kampala District, where a well-established population-based cancer registry exists. It has been confirmed by statistics that cancer is deadly for women in Uganda. In sub Saharan Africa, cervical cancer is still one of the major causes of death among women of reproductive age. It must be noted that there is little information on the level of awareness and perceived risk among the women that live in the peri urban slums which most of these are of reproductive age.
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    Characterization of clinical isolates of fungal pathogens in the clinical microbiology laboratory, Department of Medical Microbiology, Makerere University
    (Makerere University, 2020-01) Obira, Yakobo
    Background: This study was carried out with the following objectives; To characterize the clinical isolates of fungal pathogens in the clinical microbiology laboratory, Department of medical microbiology and to determine the species of fungal pathogens in the clinical specimen in the clinical microbiology, Makerere University. Methods: 31 CSF samples and 38 sputum samples which were received in the department of microbiology were subjected to diagnostic fungal microscopic examination using 10% KOH, India ink test, Gram stain, lactophenol cotton blue test and fungal culture on media in Petri dish. This was a cross sectional study, carried out in microbiology BSL Ⅱ laboratory college of health science, Makerere university from October to December. Results; Out of the 31 CSF samples, 1(3.2%) of the sample showered presence of a fungal pathogen that was confirmed as cryptococcus neoformans with the remaining 38(96.8%) of the sample having no organisms. Out of the 38 sputum samples, candida albicans had the highest prevalence with 15.79%, candida tropicalis covered 7.89% of the samples and candida glabrata 5.26% Aspergillus species like fumigatus and flarus both had 5.26%. Conclusion; In this study, there was high prevalence of candida albicans in sputum samples which is the leading fungal pathogen in this sample. And in CSF, there is very low prevalence of fungal infection with cryptococcus neoformans being the only fungal pathogen detected in the 31 CFS samples. Characterization of clinical isolates of fungal pathogens in clinical samples in the clinical microbiology laboratory Makerere university provided the baseline information on the common fungal pathogens to ease future diagnosis and management of fungal infections among patients.
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    Prevalence and factors associated with needlestick and sharps injuries among cleaning staff in Mulago Specialized National Referral Hospital, Uganda
    (Makerere University, 2020-11) Okidi, Geofery
    Background: Needle Stick and Sharps Injuries (NSSIs) are major occupational health hazards among cleaning staff in the healthcare sector yet up to now, there is limited documentation on their occurrence among health facility cleaning staff. Therefore, this study was to determine the prevalence and factors associated with NSSIs among cleaning staff in Mulago Specialised National Referral Hospital, Uganda. Methodology: A facility based cross-sectional study was conducted using structured interviewer administered questionnaires to determine the prevalence of NSSIs from 1st July 2019 to 31st December 2019. The study included 196 cleaning staff working in the hospital. Data was analysed using SPSS version 23. Binary logistic regression was used to identify the predictors and multivariate analysis to identify the factors associated with the NSSIs among the cleaning staff. Results: The prevalence of NSSIs among the cleaning staff was 27.0% in the last six months. About two thirds (62.8%) of the cleaning staff experienced two or more NSSIs in that period. Needles were responsible for about two thirds 62.3% of those injuries. More than half 52.8% of the injuries occurred during arranging equipment. Lack of satisfaction with the work environment [AOR=6.05, 95% CI: (2.46-14.89)], not reporting NSSIs [AOR=7.38, 95% CI: ((3.33-16.34)] were statistically associated with the occurrence of the injuries among the cleaning staff. Conclusion and Recommendations: The study showed a high rate of NSSIs among cleaning staff in Mulago specialised national referral hospital, in Uganda. Lack of satisfaction with the work environment and not reporting NSSIs were associated with occurrence of the injuries. The study suggests that for effective prevention of NSSIs among the cleaning staff, the hospital administrators should formulate a proper surveillance system to monitor NSSIs among the cleaning staff and encourage a proper disposal of sharp materials among HCWs. The supervisors should ensure that cleaning staff are provided with the right physical resources to work with and continue health educating cleaning staff about NSSIs. The cleaning staff should become more vigilant while performing their duties and also make sure that they report all the NSSIs that they experience to the respective authority
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    Design of a mechanical hands-free door opener to eliminate infection through door handles.
    (Makerere University, 2020-11-27) Kirabo, Sheba Winfred ; Lukwago, Phillip ; Migadde, Huzaifah ; Esayu, Samuel ; Nakubulwa, Sharon
    Cross infections are defined as those that a patient acquires during his/her stay in a hospital or any other health facility, which were neither present nor incubating at the time of admission. It is absurd that many patients go to seek medical attention in hospitals and other health centres, only to leave with newer infections. Moreover, some hospital staff such as doctors, nurses, cleaners also develop infections from their working environment as they deliver their services and expertise to clients. Nosocomial pathogens can be spread from their source to a new host directly or indirectly, in the air or by vectors. Direct contact between patients is not common in health-care facilities but an infected health-care worker can get into contact with patients and transmit nosocomial pathogens to them. The increase in transmission of infections within health facilities is a serious problem, increasing both in severity and importance. As a result, bacterial antibiotic resistance also rises making treatment and infection control difficult. Therefore, it is important to find means of limiting or even preventing the transmission of pathogens within medical facilities. Surfaces in patients’ surroundings, including the door knob or handle, are a relevant transmission route for viruses and microorganisms. As door handles represent a transmission route for viruses and micro-organisms, an alternative door opening and closing mechanism, different from the usual one should be developed. One way to intercept this route of transmission is to equip doors with a foot-operated system to negate contact with their handles.
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    Cytological patterns of cervical lymphadenopathy as seen at Makerere Pathology Laboratory of Makerere University
    (Makerere University, 2020-12) Najjuma, Julian
    Introduction: Cervical lymphadenopathy is one of the most common presentations that are seen in patients. The causes of cervical lymphadenopathy are many and they include viral infection, bacterial infection, tuberculosis, malignancies, mestasis, lymphoma to mention but a few. Fine needle aspiration is one of the methods used in the diagnosis of cervical lymphadenopathy. It is simple, safe and less invasive unlike procedures like open biopsy. Methods and materials: The study was conducted on patients who presented with cervical lymphadenopathy in the Makerere Medical School Pathology Department. Results: Patients who were most affected belonged to the age group 21 -30. Tuberculosis was the major cause of cervical lymphadenopathy in patients who presented with it. Conclusion: Fine needle aspiration is an efficient but simple technique that is used in cervical lymphadenopathy diagnosis.
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    Prevalence of Multidrug resistance amongst archived Enterobacteriaceae from patients in Mulago National Referral Hospital maternity ward.
    (Makerere University, 2020-12) Babirye, Sandra Ruth
    Background: Multi drug resistance in enterobacteriaceae is a common cause of hospital and community acquired infections. Enterobacteriaceae are gram negative bacteria like E.coli, Klebsiella Pneumoniae are pathogenic organisms causing many infections like pyelonephritis in pregnant women, neonatal sepsis in babies, blood stream infections which are usually acquired in hospitals. These bacteria can be treated with antibiotics like fluoroquinolones, aminoglycosides, beta lactams, and macrolides. However, bacteria developed resistance to these drugs. For years Carbapenems have been used successfully to treat infections due to resistant Enterobacteriaceae including those producing Extended Spectrum Beta lactamases (ESBLs). Misuse of Carbapenems has led to the emergence of resistance in gram negative bacteria. Objective: The general objective was to determine the prevalence of multidrug resistance (ESBL (CTX-M U) and Carbapenemase (NDM and OXA-48) among archived enterobacteriaceae from patients in Mulago National Referral hospital Maternity ward. Methodology: This was a cross sectional laboratory-based prospective study. The DNA of the archived samples used was extracted using boiling lysis method and the samples selected by random sampling method. Conventional PCR was used during amplification and agarose gel electrophoresis carried out to visualize the bands of the different genes. Results: Out of 44 archived samples, 0% prevalence was detected for NDM and OXA-48 genes with n=0 for E.coli, n=0 for Klebsiella pneumoniae and n=0 for Enterobacter species. However out of the 44 samples, 64% prevalence (P) for CTX-M U was obtained where Klebsiella Pneumoniae with 71%(P=17/24) prevalence was the most predominant for CTX-M U gene followed by Enterobacter species with 64%(P=7/11) prevalence and the E.coli with 44% prevalence for CTX-M U gene(P=4/9). Conclusion: This study showed 64% prevalence of ESBL gene (CTX-M U) a great threat to public health and 0% of Carbapenemase encoding genes (NDM and OXA-48). Implying infection control measures particularly compliance with hand hygiene guidelines, as well as appropriate antibiotic policies in order to prevent the ever-increasing problem of emergence of MDR ESBL and Carbapenemase producing gram negative organisms.
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    Molecular characterization and prevalence of shiga toxigenic E. Coli isolated from children under 5 years in the Molecular Laboratory, Makerere University
    (Makerere University, 2020-12) Obwol, Tonny Walter
    Background: Foodborne infections are a public health concern Worldwide. Shiga toxin–producing Escherichia coli (STEC) is one often most important strain of threat in the food system particularly in children where diarrheal diseases are more rampant. Phenotypic characterization of E. coli was reported to limit proper identification yet rapid spread of resistant STEC serotypes was fast becoming a threat to public health and increased morbidity. It was not known still the prevalence of Shiga toxin-producing Escherichia coli (STEC) and distribution of its genotypes from E. coli isolated from children under five years in the molecular laboratory, Makerere University. Methods: In a descriptive cross-sectional study of molecular characterization and prevalence of shiga toxigenic E. coli isolated from children under five years in the molecular laboratory, Makerere University, the stored E. coli isolates were subcultured onto MacConkey agar and incubated at 370 C for 24 hours to obtain fresh bacterial growth. Pure colonies were then obtained by sub-culturing a single colony of the confirmed isolate on Nutrient agar. DNA was extracted and conventional PCR was used to detect the presence of shiga toxin 1 and 2 virulence genes in the E. coli isolates. Results: A total of 51E. coli isolates from children under five years were used and of these, 4 had STEC, representing a prevalence of 8%. The shiga toxin genotypes had three patterns of distribution including; stx1 (50%), stx2 (25%) and stx1 + stx2 (25%) indicating that some STEC isolates had both stx1 and stx2in combination while others had one of the two. This study did not establish why this kind of trend happened. The findings generally concur with similar studies documented elsewhere. Conclusion: There is a significant prevalence of STEC among E. coli cases. Also, stx1 is more prevalent than stx2 and stx1 + stx2 genotypes. The use of polymerase chain reaction assay should aid quick detection of this virulent pathotype and help curb the severe epidemic of human diseases associated with STEC infections.
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    Management of Hypertension in Pregnancy: Design of a continuous blood pressure monitoring device
    (Makerere University, 2020-12) Mulindwa, Benedict ; Mutungi, Lynnette Kicoonco ; Jjagwe, Martin Bulega ; Ejobi, Joel ; Mubiru, Hussein
    The main objective of the design course is to equip students with appropriate design skills such as teamwork, field surveys, writing skills, brainstorming, designing engineering matrices, and prototyping skills. This report follows team Kainos’s activities to fulfil the design course plans for September 2018 to 20th December 2020. This report is structured in four parts. Part I includes the problem statement and detailed criteria for success, brainstorming session, drafting a design matrix for the solution and eviewing the problemand proposed solution to generate design features. Part II comprises a detailed analysis of the design, virtual prototypingwith engineering drawings and designs, and paper prototyping of the design of Kainos Series1. Part III has the testing and ethics protocols followed to assess the functionality, durability, and reliability of a Kainos Series 1 BP monitoring device. Finally, in part IV, the team performed a re-design of the prototype, did an intellectual property study in Uganda, and designed a business plan and model. Part I Section 1 entails the problem statement from Design I. It explains Hypertensive Disorders in Pregnancy caused by hypertension, related statistics, risk factors, effects, and current management solutions, along with their challenges. Section 2 comprisesthe criteria for success. It briefly describes the key factorsthat guidethe team’s operations to acquire the desired product and evaluate the extent to which the intended goals and objectives are met. Section 3 describes the brainstorming process and design matrix for the solution. It mentions the approach used to generate numerous solution ideas that can be applied to manage hypertension in pregnancy efficiently and select the final idea using a design matrix. Section 4 defines the methodology taken to assess the problem and proposed solution and select design features for Kainos Series 1. Part II Section 5 comprises a detailed analysis of the proposed solution design. It includes a detailed review of some of the device’s features and the basis working principle; photoplethysmography. It also includes an engineering analysis of the solution Section 6 covers virtual prototyping, which involves realizing the proposed design’s virtual model as a representation of the actual design to properly visualise the team’s solution. Section 7 contains the team’s budgeting and prototyping, where the team drew up a budget for necessary fabrication components to make the first physical prototype of the device design.The prototype was then fabricated using acquired components. Part III Section 8 includes an introduction to testing, the team’s fundamental objectives during the testing process, and a general description of the Kainos Series 1 device. Section 9 details the ethics guidelines that were followed by the team throughout the testing process. Section 10 specifies the technical tests, including; repeatability, battery life, drop resistance, and usability tests, and outlines the objectives, pass/fail criteria, test methods, results, analysis, and a conclusion for each test. At the end of the section is a summary of performed tests. The section concludes with deductions from the Kainos Series 1 BP monitoring device’s whole testing process. Section 1 has an appendix showing some relevant information not included in the main report. Part IV Section 11 contains the first redesigning iteration of the hardware, electric components and operating system software of Kainos Series 1. Redesigning is a result of the failed tests during the testing phase. Section 12 describes the intellectual property landscape, and identifies suitable IP for the proposed design in Uganda. It also outlines proposed claims for the IP document. Section 13 gives a detailed view of the business plan of team Kainos for market entry. It states the market segments, distribution channels, and market strategy and the business model canvas. Section 14 outlines some of the challenges that were faced by the team and a conclusion of the report. Section 15 and 16 have the reference bibliography and the appendix respectively.
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    Designing a low cost upper limb prosthesis for people living with upper limb disabilities in low and middle income countries using locally available materials
    (Makerere University, 2020-12) Nabatanzi, Sharon ; Atim, Claire ; Mpuga, Brian ; Muyanja, Jonah
    The human hand is considered to be a very powerful tool for operating in any environment, and a very important means for physical and social interaction. It allows people to accomplish sophisticated movements, like abduction, flexion, extension and this is all thanks to its large number of degree of freedom (21 DoFs for the hand and 6 for the wrist) and the ability of the thumb to carry out the opposition movement (Cordella, Ciancio et al. 2016) but with an increasing number of traumatic injuries most especially in low and middle-income countries like Uganda, most of the victims are losing a section or the whole hand in such incidences. Hence leading to a growing number of people living with upper limb disabilities. Upper limb disability is the partial or full loss of function in the elbow, shoulder and wrist joints that limits physiological, socio environmental and physical wellbeing of the victims (Shiratuddin, Rai et al. 2017). Upper limb disabilities are part and parcel of the outcomes of traumatic injuries either through road accidents, factory accidents or war related traumatic incidences and have resulted to a big percentage of admissions in several hospitals in Uganda. Developed countries have spearheaded the proper handling of these cases unlike developing countries, where these cases are not properly treated and thus individuals suffer repercussions associated with limb loss. The team reviewed current solutions to upper limb disability globally, in Africa and Uganda and reasons as to why their use in developing countries is at a minimal scale. Disabilities brought about by traumatic incidences like road accidents or work-related accidents have majorly led to amputations in most developing countries and very few victims are exposed to designs that can help replace the lost function or part of the body. According to research carried out, one of the biggest challenges that patients living with upper limb disability face in Uganda is a lack of prosthetics that mimic the normal function of the lost limb; hence they are incapable of carrying out their daily tasks. Another challenge is that current prosthetics are quite expensive, this is due to the fact that most hand components are imported. Hence a common Ugandan man or woman will find it hard to purchase the prosthesis since its expensive. As a team we decided to bring into play different current technologies in order to come up with a simple functional hand prosthetic, manufactured in Uganda using readily available local materials and one that is low cost and accessible to a local person in Uganda.
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    Molecular characterization and prevalence of shiga toxigenic e. Coli isolated from children under 5 years in the molecular laboratory, Makerere University
    (Makerere University, 2020-12-14) Mwagale, Sadat
    Background: Foodborne infections are a public health concern Worldwide. Shiga toxin–producing Escherichia coli (STEC) is one often most important strain of threat in the food system particularly in children where diarrheal diseases are more rampant. Phenotypic characterization of E. coli was reported to limit proper identification yet rapid spread of resistant STEC serotypes was fast becoming a threat to public health and increased morbidity. It was not known still the prevalence of Shiga toxin-producing Escherichia coli (STEC) and distribution of its genotypes from E. coli isolated from children under five years in the molecular laboratory, Makerere University. Methods: In a descriptive cross-sectional study of molecular characterization and prevalence of shigatoxigenic E. coli isolated from children under five years in the molecular laboratory, Makerere University, the stored E. coli isolates were subcultured onto MacConkey agar and incubated at 370 C for 24 hours to obtain fresh bacterial growth. Pure colonies were then obtained by sub-culturing a single colony of the confirmed isolate on Nutrient agar. DNA was extracted and conventional PCR was used to detect the presence of shiga toxin 1 and 2 virulence genes in the E. coli isolates. Results: A total of 51 E. coli isolates from children under five years were used and of these, 4 had STEC, representing a prevalence of 8%. The shiga toxin genotypes had three patterns of distribution including; stx1 (50%), stx2 (25%) and stx1 + stx2 (25%) indicating that some STEC isolates had both stx1 and stx2 in combination while others had one of the two. This study did not establish why this kind of trend happened. The findings generally concur with similar studies documented elsewhere. Conclusion: There is a significant prevalence of STEC among E. coli cases. Also, stx1 is more prevalent than stx2 and stx1 + stx2 genotypes. The use of polymerase chain reaction assay should aid quick detection of this virulent pathotype and help curb the severe epidemic of human diseases associated with STEC infections.
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    Cytological patterns of salivary gland lesions on fine needle aspiration as seen in the Pathology Department of Makerere University Medical School
    (Makerere University, 2020-12-14) Ssegawa, Hellen Patricia
    Introduction: Salivary gland lesions are some of the lesions patients present with to the Makerere University Medical School Pathology department. The lesions can be cystic, inflammatory or neoplastic. A histological study in which epithelial tumors of major and minor salivary glands accessioned from 1979 to 1988 were analyzed in respect to age and sex of the patients, anatomical location of the tumor and histological type. During the span of ten years, 268 cases of salivary gland lesions were diagnosed. Of these 113 (42.2%) were males, 148 (55.2%) females and the remaining 7(2.6%) cases the sex was not specified. Fine needle aspiration is one of the methods that are used in the diagnosis of these salivary gland lesions and being a simple and effective method of diagnosis, there needs to be an assessment of the lesions diagnosed by this method. This method is simple, less invasive, and safe unlike open biopsy procedures. Methods and materials: A cross sectional study was conducted on patients who presented with salivary gland lesions in the Makerere medical school pathology department between January and April 2020. Results: The most common salivary gland lesion diagnosed by fine needle aspiration at the Makerere University Medical School Pathology Department Laboratory is Pleomorphic adenoma. Females are most affected by salivary gland lesions at the Makerere University Medical School Pathology Department Laboratory The age group affected most by salivary gland lesions at the Makerere University Medical School Pathology Department Laboratory is 51-60 years Conclusion: Most common salivary gland lesions diagnosed at Makerere University College of Health Sciences Pathology Department are benign and the commonest lesion is a Pleomorphic adenoma. The age group most affected is 51-60 years and the lesions were commonest in females.
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    Prevalence of malaria among pregnant women attending antenantal clinic at Nsinze Health Centre IV, Namutumba District
    (Makerere University, 2021) Gombaniro, Jeremiah
    Introduction Malaria infection during pregnancy has remained a major public health concern in tropical and subtropical countries with notable risk for the pregnant woman and her fetus. According to the estimated yearly report, the number of pregnant women who were at risk of malaria was about 25 million. It has been reported that in sub-Saharan Africa malaria can cause as many as 10,000 cases of malaria-related deaths in pregnancy per year, usually due to severe maternal anemia. More so, each year, malaria in pregnancy is responsible for 20% of stillbirths and 11% of all newborn deaths in sub-Saharan Africa. World Health Organization, (2018) Uganda is among the ten countries in sub-Saharan Africa that contribute to approximately 70% of global malaria cases and deaths. Uganda is a malaria endemic country with active transmission in 99% of the country. Whereas all people in Uganda are at risk of contracting malaria, children under-5 years of age and pregnant women are the most vulnerable group. MOH- Uganda malaria annual report, (July 2017- June 2018) Objectives The main objective of this research was to determine the prevalence of malaria in pregnant women attending antenatal clinic at Nsinze Health Centre IV, Namutumba district. Methodology The study design was cross sectional laboratory and descriptive and the objectives were to determine the prevalence of malaria in pregnant women and to identify the most prevalent species of plasmodium. Approximately 230 women were tested for malaria using both RDT and Microscopy from which the species of malaria parasite were identified and a drug susceptibility test of the plasmodium was carried out to determine the minimum inhibitory concentration of the parasite. The data was analysed by Statistical Package for Social Science (SPSS) and presented as graphs, tables and percentages. Consent was sought from the pregnant women before they participate in the study.
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    Assessing the prevalence of malaria among children under 5 years, attending to treatment in Kamuli general hospital- Kamuli Municipality
    (Makerere University, 2021-01) Beene, Richard
    Malaria is a life threatening disease typically transmitted to humans through female anopheles mosquito carrying the parasite and remains one of the top killers of children below five years despite of the nationwide mosquito net distribution. A study to assess the prevalence of malaria among children under 5 years was carried out in Kamuli General Hospital, A hospital based cross sectional study and laboratory based malaria rapid diagnostic test to determine the prevalence of malaria in children under the age of 5 years were carried out to collect the data, this was done with the use of questionnaires survey that focused on the risk factors that contribute to malaria infection. The sample size of the study was 200 respondents, and the results revealed that 39% (n=78) were positive with malaria and 85% (n=122) of the participants had at least fallen sick due to malaria in 2020. And 65% (n=129) had mosquito nets 45% (n=90) were not sleeping in the net always. While 20% (n=40) were sometimes sleeping in the net. Majority of the participants 78% (n=155) revealed that they had a bush around their house and 60% (n=119) engaged in outdoor activities in the evening thus predisposing them to mosquito bites. However, the study revealed a gap in interventions such as mosquito net distributed and use, presence of stagnant water in the participants’ homesteads coupled with participants’ rampant evening outdoor activities and low knowledge on malaria prevention. The researcher recommends that VHTs should be tasked to educate people on malaria control and prevention as a way of containing the prevalence of malaria in the District, and the Government through Ministry of Health should design customized intervention for Kamuli District and Busoga region at large in order to reduce the high malaria prevalence.