School of Medicine (Sch. of Med.)

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    Adherence to radiation protection measures in paediatric imaging with plain x-ray among radiographers at Mulago National Referral Hospital
    (Makerere University, 2021-12) Akugizibwe, Collins ; Midari, Awuche
    INTRODUCTION; Radiation protection refers to the science and art of protecting people and the environment from the harmful effects of ionizing radiation. Patient radiation protection is described as all activities directed towards minimizing radiation exposure of patients during ionizing radiation exposures. This involves strict adherence to the three cardinal principles of radiation protection that is Distance, Time and Shielding. Children undergoing these examinations require special attention in terms of radiation protection due to the increased sensitivity and damaging effects of ionizing radiation in their body than in adults. AIM. To assess if radiographers at the department adhered to the set paediatric patient radiation protection measures. METHODS AND MATERIALS. A cross-sectional study was conducted amongst radiation workers (radiographers) in radiology department of MNRH. Data was collected using researcher observation checklists and self-administered questionnaires. Collected data was analyzed using Microsoft excel to determine percentages, generate tables, a graph and pie-chart. RESULTS. Majority of the respondents were males (71.4%) and BMR students (53.6%). The mean age was 21 years, oldest being 36 years and the youngest being 22 years. Majority of the respondents (94.6%) understood paediatric radiation protection, the term CPD and were aware that CPD has an impact on their profession and careers (82.1%), although only one participant had attended a CPD in the previous 6 months. The facility had a radiation safety committee and supervision was carried out. For paediatric patients, 53 (56.4%) were females and 41 (43.6%) were males, the mean age was 8 years with the oldest at 16 years and the youngest at 1 year. The commonest radiological examination requested was chest x-ray, x-ray elbow, x-ray femur and abdominal x-ray. CONCLUSION; Knowledge and adherence to radiation protection measures was generally good among BMR, DMR students and qualified radiographers.
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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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    Analysis of x-ray film reject in diagnostic radiology department at China- Uganda Friendship Hospital, Naguru (CUFH)
    (Makerere University, 2021-11) Nabawooya, Hasifah ; Mohammed, Mohammed Said
    Introduction Plain x-ray radiographic examination is an integral part of radiology imaging department even in era where computed and digital radiographs are gaining importance. Still in the developing countries about 60% of the radiology department both government and private hospitals, small or even bigger are always equipped with conventional x-ray machines for providing basic radiographic services at low costs. However, it is not uncommon to encounter poor, suboptimal quality radiographs leading to repetition of the films thus increasing the cost to excheqor, more radiation to patients as well as to personnel, more time consuming as well as delay in diagnosis to the patients. Hence, it is the entail to recognize the factor responsible for diagnostically suboptimal radiograph leading to rejection of the radiographic examinations (Usha at el., 2013) Objective. To determine the causes and rate of x-ray film reject at CUFH and obtain information on how to minimize the reject rate. Methods. Cross-sectional and descriptive approach was used. Rejected films for all x-ray examinations done at CUFH for a period of one month were sorted and collected for data analysis. The research findings were presented in tables and pie charts giving the breakdown of single cause of rejection. Results: Analysis has shown that the overall reject rate is 8.4% in approximately 250 exposed films. The main cause for film rejection was found to be poor film processing (33.3%) and inappropriate exposure (under exposure 23.8%). Individual plain X-ray examinations registered chest X-ray examination (33.3%) being the most repeated examination followed by lumber spine X-ray at 23.8%. Frequently used X-ray film size was found to be (35x35) cm size. Conclusion: Analysis shown the overall reject rate in the X-ray department of CUFH the overall reject rate was 8.4%, which is above the World Health Organization criteria of 5% although, CRCPD’s committee on QA raises reject rates up to 10%. Hence, this justifies continued monitoring of this X-ray department. The main cause being poor film processing was found to be related to the poor manual processing techniques, this can be lowered by introduction of digital film processing as it’s the modern and efficient method widely used in this era.
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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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    Assessing the impact of online learning on practical skills acquisition of Radiography students at Makerere University
    (Makerere University, 2025) Okurut, Steven
    Background: Radiography training at Makerere University used physical mode of learning until the COVID-19 pandemic shifted learning to online. Despite delivering theoretical content effectively, it is associated with reduced clinical attendance and student motivation, especially during biomedical years which may negatively impact on skills acquisition. This study therefore assesses how online learning influences skill acquisition and identify strategies to balance online and practical training. Research objective: To evaluate the influence of online learning on the frequency of students practice and how it affects acquisition of practical skills. Methodology: A mixed-methods study was conducted with 40 randomly selected radiography students from Makerere University. Data was collected through electronic questionnaires (quantitative) and semi-structured interviews (qualitative), analyzed using descriptive statistics and thematic analysis. Ethical clearance was obtained, with confidentiality maintained through anonymization. Results: The study found radiography students spent 3 times more time on online learning than practical training (11-15 vs 0-5 hours weekly), with 65% reporting reduced practical attendance due to online classes. This correlated with low confidence in clinical skills (72.5% agreement), particularly at biomedical years (Year 1 students 12.5x more likely to lack confidence than year 4 students ). Key hindrances were overlapping schedules and demotivation, while proposed solutions were use of timetables (47.4%) and supervisor mentorship (47.4%). Recommendations: Introduce mentorship or supervisor based support for students. Pairing students with experienced clinicians or instructors who can monitor their progress and provide feedback will ensure that students receive guidance and are held accountable for their practical skills development. Give students collaborative tasks to increase motivation and group work among students.
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    Assessing the impact of Teleradiology on diagnostic accuracy and turn around time at Mulago National Referral Hospital
    (Makerere University, 2025) Kabuuka, Bruno
    Teleradiology has revolutionized diagnostic imaging by enabling remote interpretation of radiological images, thereby improving access to specialized care (Kalyanpur et al., 2010; Larson et al., 2014). This study aimed to assess the impact of teleradiology on diagnostic accuracy and turnaround time (TAT) at Mulago National Referral Hospital. A retrospective cohort design was employed, comparing diagnostic accuracy and TAT before and after implementation of teleradiology services. The study utilized a mixed-methods approach, incorporating both quantitative and qualitative data analysis (Creswell & Plano Clark, 2011). Preliminary studies suggest that teleradiology can significantly reduce TAT (Andrabi et al., 2015; Binkhuysen & Bosmans, 2016) and improve diagnostic accuracy (Brady et al., 2012; McTiernan et al., 2018). However, challenges such as image quality, network connectivity, and radiologist fatigue must be addressed (Wysoki et al., 2016; Abujudeh et al., 2017). This study contributed to the growing body of evidence on the effectiveness of teleradiology in resource-limited settings, informing policy decisions and guiding implementation strategies. The findings of this study have implications for improving patient care, reducing healthcare costs, and enhancing the overall efficiency of diagnostic services at Mulago National Referral Hospital This study involved 33 respondents of which 26 (78.79%) were radiography students at Mulago National Referral Hospital while 5 (15.15%) were radiographers at Mulago National referral Hospital. From the study, it was revealed that 48.48% of the respondents had received formal training in teleradiology while the rest had not received any training in teleradiology. Despite the majority of the respondents reported to have used teleradiology frequently, 33%, there were those who had never used it (27%) Most of the respondents 69.7% were not sure of the teleradiology systems that are used at Mulago National referral Hospital while a few respondents reported to be Teleradiology Solutions (TRS) In Conclusion majority of the respondents believed that Teleradiology has improved significantly the diagnostic accuracy (42.42%) while 39.39% said it improved significantly while 12.12% said they were neutral. Almost all respondents believed that teleradiology has improved misdiagnosis hence improved patient care.
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    Assessing the knowledge and attitudes of radiography undergraduate students towards interventional radiological procedures done in Mulago Hospital
    (Makerere University, 2024) Nsubuga, Hamuzah
    Introduction: IR is an emerging and expanding specialty that has a role in many health care disciplines and services, particularly oncology, cardiovascular medicine, trauma, and urology. IR also has many clinical applications and better outcomes, and the procedures performed are minimally invasive and less complicated than routine surgery. Interestingly, it has been reported that new IR procedures are being developed at a rate of 3.5% annually and that an estimated US$108.3 million could be saved each year if just eight surgical procedures were replaced by IR procedures. (Baerlocher MO.2007). However, the harsh reality is that IR is suffering from an increasing shortage in manpower that is impeding the expansion and use of IR procedures, and very small numbers of qualified interventional radiologists are presently serving very large populations. According to the 2016 Clinical Radiology UK Workforce consensus report, growth in the radiology workforce is not keeping up with the demands made on radiology services. The low recruitment rate can be explained by a lack of knowledge and understanding of IR on the part of undergraduate medical students, who are our future doctors (Tang QH, 2020) Therefore, this study aimed at assessing the knowledge and attitudes of Makerere university undergraduate radiography students towards interventional radiological procedures done in Mulago hospital. Methods: This study was based on surveys administered over a one-month period (1st - 31st December 2023). twenty-seven undergraduate radiography students of Makerere University, Uganda were included. The questionnaire was based on a validated questionnaires used previously in European, Saudi and Canadian similar studies. The questionnaire consisted of 23 questions covering perception, knowledge, and interest of interventional radiology Results: The majority of the respondents (52%) felt their knowledge in IR is poor. Only 40% of the respondents either completed or plan to complete an elective rotation in radiology. Thirty-eight percent of respondents were willing to consider a career in IR. The most common reason (43%) for not considering a career in IR was lack of knowledge. Only 33% correctly identified the route of training of interventional radiologist. Conclusion: Awareness of and exposure to IR is poor among medical students, and can only be increased by a direct contribution from IR physicians to the undergraduate curriculum. Lack of a unified radiology curriculum in medical schools across the country should be addressed by the Council of Deans of Uganda Medical Schools.
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    Assessing the knowledge, attitudes and practices of infection prevention and control among radiographers in Mulago Referral Hospital
    (Makerere University, 2025) Mulindwa, Dennis
    Effective infection prevention and control (IPC) practices are vital in healthcare, especially in radiology departments where radiographers ensure patient and staff safety. The purpose of this study was to assess the knowledge, attitudes, and practices (KAP) of radiographers at Mulago Referral Hospital regarding IPC measures, with the aim of identifying areas for improvement in the prevention of healthcare-associated infections (HAIs). This study involved 60 radiographers through a descriptive quantitative cross-sectional study using a self-administered structured questionnaire. The results indicated a high level of awareness of standard infection prevention protocols, with 81.67% of participants familiar with precautions that include personal protective equipment (PPE) and hand hygiene. Furthermore, 88.33% recognized the importance of hand hygiene, and 96.6% reported daily cleaning and disinfecting of equipment, underscoring their commitment to IPC. However, significant barriers to IPC practices were identified, particularly the inadequacy of PPE and resources, making it challenging for radiographers to adhere to IPC standards. This highlights the need for ongoing support and resource provision. To enhance IPC measures at Mulago Referral Hospital, the study recommends continuous education and training for healthcare workers, improved access to PPE, regular audits of IPC practices, and fostering a culture of compliance through feedback and recognition. Implementing these strategies will contribute to a safer healthcare environment, protecting both patients and healthcare workers from healthcare-associated infections (HAIs).
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    Assessing the waiting time for radiotherapy treatment in Uganda : retrospective study at Uganda Cancer Institute
    (Makererere University, 2026) Kigozi, Dickens Collins
    Main objective: This study aimed to investigate the patient waiting time for radiotherapy treatment at the Uganda Cancer Institute. The study focused on understanding the delays and barriers faced by cancer patients in accessing timely radiotherapy treatment, which is crucial to improving patient treatment outcomes. Methodology: The proposed research utilized a retrospective study design to analyze the waiting times experienced by patients seeking radiotherapy at the Uganda Cancer Institute. By examining the historical data and patient records, the study aims to identify bottlenecks in the treatment process and assess whether these delays impact patient care and overall treatment effectiveness. Key components of the research included mapping out the care pathways for patients undergoing radiotherapy, calculating median waiting times from registration to treatment initiation, and identifying any deviations from ideal waiting times. The study also explored reported barriers that contribute to inconsistent patient waiting times in accessing radiotherapy services. Results: A total of 100 patient records were reviewed, with seventy containing complete data for analysis. The mean waiting time from simulation to treatment onset was approximately 16 days, with a median of 26 days and a maximum delay of 7 days. Significant variability was observed, with prostate and cervical cancer patients experiencing the longest delays. Systemic bottlenecks identified included periodic treatment machine breakdowns, specialist shortages, workflow inefficiencies, delays in staging investigations, and financial barriers. A pie chart analysis attributed 25% of delays to specialist shortages, 20% to poor navigation, 18% to external staging investigations, and 12% to financial barriers. These delays were associated with substantial psychological, clinical, and economic consequences, emphasizing the need for a more streamlined workflow, staffing, and infrastructural reforms. Conclusion: By assessing the current waiting times for radiotherapy treatment and identifying issues contributing to a variation in waiting times, the study aimed to contribute towards enhancing the quality of cancer care delivery and optimizing patient treatment outcome.
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    Assessment of awareness and practice of undergraduate medical radiography students towards tele radiology
    (Makerere, 2024-05) Balyagati, Elia Elias
    Introduction: Tele radiology is defined as electronic transmission of radiological images from one geographical location to another for purpose of interpretation or consultation. Tele radiology is the most widely practiced form of telemedicine. Despite its successive development of tele radiology in Africa, still there are several barriers impacting expansion of tele radiology in Africa that include ability (knowledge) of technologists. Hence there is a need to assess knowledge and practices of medical radiography students (technologists) towards tele radiology. Objectives: This study was conducted to assess the awareness and practice of undergraduate medical radiography students towards tele radiology in Makerere University Methodology: A quantitative descriptive cross-sectional design was used involving 41 medical radiography students to assess their awareness and practice towards Tele radiology who were selected using Stratified Random Sampling. Data was collected using a structured questionnaire administered by the researcher and analyzed using Microsoft Office Excel into frequency tables and figures. Results were further interpreted in narratives. Results: Majority 25(60.98%) of the all respondents have received formal education or training in tele radiology hence leading majority of respondents (95.12%) to have ever heard about tele radiology. However 16(39.02%) of all respondents have never received formal education or training in tele radiology with majority 12(75%) from year 2 respondents. Majority 28(68.29%) of the participants have very low knowledge about tele radiology, 9(21.95%) of respondents have moderate knowledge about tele radiology and only 4 (9.76%) of respondents have high knowledge about tele radiology. This clearly shows that tele radiology knowledge is generally still low among the students. Majority 34(82.9%) of the respondents had never used any of tele radiology technologies or platforms with only 7(17.1%) of respondents have used tele radiology technologies or platforms of which 6(85.7%) of respondents rarely used tele radiology. Conclusion: Majority of the respondents had high level of awareness towards tele radiology which indicates its growth in Uganda since majority have received formal education or training in tele radiology while a few have not which indicate the gap in educational opportunity due to limited resources and personnel for training, overall knowledge about tele radiology is still very low of which is a theoretical knowledge which calls for more hands on workshop and training on about tele radiology. Recommendation: Updating the radiology curriculum to include more practices tele radiology, radiology department should Invest and provide regular training sessions and workshops on tele radiology, ministry of health should allocate more funds for the development of tele radiology infrastructure and training programs.
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    Assessment of challenges faced by Makerere University College of Health Sciences radiography students during clinical practice
    (Makerere university, 2024) Namugga, Juliet
    Background: Radiography is the science of using ionizing and non-ionizing radiations to view gross anatomy of the body for diagnostic purposes . However, The education of radiography in Africa has lagged behind the rest of the globe despite nearly starting at around the same time due to a number of reasons. Clinical rotations are of paramount importance in the learning and the acquisition of key competencies such as knowledge, skill and professional attributes required. However, it has been noted that there may be challenges faced by radiography students during clinical rotation, hinted by research done in other countries.Challenges include, shortage of equipment, staff and delays at radiology departments resulting in the failure to provide an adaptive learning environment. This has resulted into neglect of various modalities and high rate of student attrition and the threat of artificial intelligence may replace imaging technologists and radiologists. Aim: The study was aimed at Assessing the Challenges Faced by Radiography Students of MAKCHS during Their Clinical Practice Methodology: cross-sectional study using quantitative techniques involving 37 undergraduate radiography students, sampled with simple random sampling method. It included those who had clinical rotations from any hospital for at least a week. The data from questionnaires was processed and analysed manually with help of calculators, computers and presented in form of tables and graphs. Ethical approval was obtained from the Research and Ethics Committee at Mmulago Nnational Rreferral Hospital and informed consent was sought from the participants. Results: 65% of the participants were male. Of the respondents,10% were aged 18 -21 year, 68% were aged 22-25 years, 16% were aged 26 - 30 and the rest were above 30 years. 95% of the participants were Ugandan and 5% Tanzanian. 38% of the respondents were in their second year of study, 40% were in third year and 22% were in fourth year. Challenges identified included lack of protective gear, rude radiographers, inadequacy of time allocated for practice, lack of timetable to follow among others. Solutions included proper supervision by hospital heads to ensure adequate supply of protective gear, imaging machines and increasing pay of radiographers. Conclusion: The authorities need to institute an internship period for radiography students in Uganda just like other medical courses. This will improve skills of students in the modalities where time allocated during school was inadequate to attain all the skills.
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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.
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    Assessment of knowledge and awareness on MRI safety among patients undergoing MRI examinations at Mulago National Referral Hospital
    (Makerere University, 2025) Nabuduwa, Ketty
    BACKGROUND: Magnetic Resonance Imaging (MRI) is a crucial diagnostic tool, yet patient awareness and knowledge regarding its safety protocols remain limited. This study aimed to assess the knowledge and awareness of MRI safety among patients undergoing MRI examinations at Mulago National Referral Hospital. METHODS: A cross-sectional survey was conducted on 110 participants scheduled for MRI scans. Data was collected using structured questionnaires adopted from (patients’ perceptions and attitudes towards MRI safety in Asir Region, Saudi Arabia) to assess participants' understanding of MRI safety procedures, patient preparation guidelines, awareness of MRI zones, and knowledge of MRI-related risks such as the effects of contrast agents and radiation. RESULTS: The majority of participants (66.4%) were female, and just 4.5% had prior MRI experience. There was low knowledge about MRI safety procedures, with just 16.4% being knowledgeable about safety procedures. Knowledge regarding types of radiation and MRI compatible equipment was poor. However, 79.1% were aware of the need for screening of family members, and 67.3% were aware of MRI scanner noise, though awareness of the risks involved with contrast agents and pregnancy was low. DISCUSSION: These findings illustrate significant deficits in teaching patients regarding MRI safety, such as unfamiliarity with MRI zones, radiation types, and MRI-compatible devices. While some participants understood some basics of safety procedures, such as screening family members, further teaching is required. Further educational efforts are needed to give more comprehensive knowledge of MRI safety. CONCLUSION: This study underscores the importance of enhancing patient education on MRI safety to reduce risks and improve the safety of MRI procedures. A more informed patient population will contribute to a safer healthcare environment and a better understanding of the MRI process.
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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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    Assessment of level of patients' satisfactions towards radiological services and associated factors at Kabale Regional Referral Hospital
    (Makerere University, 2023) Mutamba, Ambrose
    Introduction: Despite relatively high national coverage of imaging services, patients continue to flock for imaging care in Kampala. It is assumed that this is a reflection of their perception of the quality or the actual quality offered in the peripheral and regional hospitals. Objectives: This study was conducted to assess the patients’ satisfaction with the environment, confidentiality and their privacy and their concerns and satisfaction about the waiting period at the department of radiology at Kabale regional hospital. Methods: A quantitative descriptive cross-sectional design was used involving 80 patients who were accessing radiology services at Kabale Regional Referral Hospital selected using convenience sampling. Data was collected using a structured questionnaire administered by the researcher and analyzed using Microsoft Office Excel into frequency tables and figures. Results were further interpreted in narratives. Results: Majority of respondents (66.3%) of patients found the radiology department was organized and majority (41.3%) reported that the layout of the department was good, however, majority (42.5%) were neutral about the comfort of the department; majority (63.7%) reported there were no other people involved during the examinations and giving results; (58.7%) reported taking a very long time scheduling their appointment and majority (51.3%) reported that their x ray/scan were performed with major delays with majority (63.7%) encountering delay during waiting before the examination and generally, majority (61.3%) were dissatisfied with radiology services. Satisfaction was higher in male patients compared to females (41.2% compared to 37.0%), younger age group of 18 to 30 years (64.7%), those who had tertiary level education (73.3%) and those who were civil servants (70.0%). Conclusion: Majority of patients were dissatisfied with radiology services. Satisfaction with radiology services was associated with male gender, younger age group of 18 to 30 years, tertiary level education, history of visits at the radiology department and x-ray services. Recommendations: The administration at Kabele Regional Referral Hospital should ensure comfortability of the radiology department to patients by installing implements such as air conditioners and seats and The Ministry of Health should ensure recruitment of more radiologists at the radiology departments in order to reduce on patient waiting time.
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    Assessment of pretreatment setup variation in cervical cancer patients undergoing conformal radiation therapy
    (Makerere University, 2024) Bukenya, Ashraf
    Introduction: The principal of radiotherapy in the 3D era is to eradicate tumor cells contained in the gross tumor volume (GTV) with a margin of subclinical disease in the clinical target volume (CTV) while sparing surrounding organs at risks (OARs). It is achieved by conforming the treatment portals to the target volume and using appropriate margins to rationalize for uncertainties in organ shape and motion, beam geometry and patient set-up. The patient’s reproducibility and its accuracy are essential for precise radiotherapy delivery. A significant variation/error in the patient’s positioning during conformal cervical cancer radiation therapy delivery leads to a compromise in the ultimate precision of idealized treatment. Objectives: To assess the different sources of variation in pre-treatment setup of cervical cancer patients undergoing conformal radiation therapy (CRT), to determine the solutions to eradicate the sources of variation in pre-treatment set-up of cervical cancer patients undergoing CRT. Methods: This research study was carried out at Uganda cancer institute, selected because it is the only specialized hospital offering radiation therapy in Uganda. A total of 10 cervical cancer patients undergoing CRT treatment courses were included in the study. They were treated in supine position with a knee wedge and ankle rest to a dose of 50 Gy in 25 fractions for five weeks. Anterior-posterior (AP) and lateral onboard images were taken daily, five days a week for five weeks. Setup verification was done using kilo-voltage orthogonal on-board images obtained using an on-board imager (OBI -Varian medical system). Setup variations were estimated using 2D/2D matching (Kv onboard image/DRR) of bony landmarks such as the widest portion of the pelvic brim, anterior border of S1 vertebrae, and the pubic symphysis in the lateral (left to right), vertical (anterior to posterior), and longitudinal (superior to inferior) axes respectively during the course of treatment. The shifts between the origin of the initial treatment and the isocenter of each fraction represents the directional variation setup error (∆) due to baseline deviation between the initial treatment and the fractionated treatment. The setup accuracy at the treatment unit relative to the simulator setup was measured for 10 patients foe at least 5 fractions per patient. Setup corrections were applied, based on an online decision protocol. Results: The random error (day to day variation, σ) in the lateral, longitudinal and vertical directions were 1.41 mm, 1.67 mm, and 0.74 mm respectively. Conclusion: Based on this study, the use of daily DRR allows estimating and making up for pre-treatment setup variation/ random errors according to my configuration. Daily DRR can be a suitable method of accurate patient positioning in treating cervical cancer patients with high precision techniques. This resulted in avoiding geographical miss. Close surveillance through onboard imaging (OBI) is thus recommended for high quality radiation therapy delivery for patients undergoing CRT.
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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 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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    Availability of Radiographic Accessory Equipment at Kiruddu Hospital.
    (Makerere University, 2023-11-16) Wafula, Patrick Bob Ouma
    Introduction:Radiographic accessories are devices that supplement performance of different radiological machines such as x-ray, CT scanner, Fluoroscopy scanner etc. For example Apron Racks, Callipers, Catheter Cabinets, CD/DVD Burners, Compression Devices, Filtration Systems, Lead Letters, Markers, Positioning Blocks, Restraints, Sand Bags, Stools, vaginal speculum, vulsellum forceps etc. In a resource constrained facility, in addition to inadequate cleaning Criteria there was a high risk of hospital associated infection (G. R Chingarade et al 2014) Several Ugandan radiographic units lacked radiation protection accessories and their current radiation protection strategies were found to be ineffective (David Makumbi, Adenola Olatide et al) Objective: To determine the availability of radiographic accessories in the radiology department of kiruddu hospital and the possible effect they have on Quality assurance, radiation protection and infection control in department. Methods: Structured observation methodology with a checklist in addition to quantitative methodology through interviewing imaging technologist in charge. Result: Out of the 25 listed accessory equipment , 36% were available and 64% unavailable. 8% of these equipment were principally for radiation protection for both radiographer and patients and patient attendants. 4% for quality control in the CT scanner. 12% for positioning during examination. And lastly 12% accessory supplies for storage of different accessory equipment in the department. Conclusion: Kiruddu hospital radiology department is not adequately equipped with radiographic accessory equipment. Radiations protection, quality and assurance and infection control are compromised by the various available radiographic accessory equipment
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    Awareness and Attitudes Regarding Breast Cancer and Breast Self-examination Among Female Students at Makerere University.
    (Makerere University, 2022-08-17) Ochieng, Emma Kyaterekela
    Background Although there are huge efforts to increase the level of breast cancer awareness, breast self-examination (BSE) is still poorly practiced across Uganda. This baseline study was aimed at assessing the awareness of female Makerere university students about breast cancer and their practice of BSE. Methodology Using a cross-sectional research design, a self-administered survey was used. A pre-validated, pre-piloted questionnaire was distributed to female Makerere university students. The questionnaire was divided into four domains: socio-demographic characteristics, the respondent’s knowledge of breast cancer and BSE, their attitudes towards risk factors for breast cancer, and their experience of breast cancer screening and BSE. Statistical analysis was performed using descriptive statistics to assess the awareness about breast cancer and practice of BSE among female Makerere university students. Results Of the 370 respondents, 294 were between the age of 21 and 26 years, 129 were in their second year of study, 74.6% were not in any kind of relationship. 100 had no idea of breast cancer being genetically related, 200 knew that childhood radiotherapy to the chest could cause breast cancer, and 153 knew that a painless mass under the armpit could be a sign for breast cancer. 200 and 188 knew that abrupt changes in size and abrupt changes in size of the breast could be a sign of breast cancer respectively. 305 had heard of BSE, 211 had practiced it and 340 would start BSE after the age of 20 years whereas 100 would start mammography after the age of 40 years.