College of Health Sciences (CHS)

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    Academic performance of undergraduate students before and after the introduction of online learning in Makerere University
    (Makerere University, 2026-01) Umar, Saidi
    Introduction. The abrupt shift to online learning during the COVID-19 pandemic posed significant challenges to higher education, particularly in resource-limited setting. Makerere university implemented online learning as an alternative to traditional instruction. This study aimed to assess the impact of this transition on the academic performance of undergraduate students in the College of Health Sciences. Methodology. A retrospective comparative study was conducted using data from 124 students across two cohorts: 2015/16(physical class) and 2020/21(online class). Academic performance was measured using cumulative grade point averages (CGPAs) obtained from the academic registrar’s office. An independent samples t-test was used to assess differences in performance before and after the adoption of online learning. Additionally, multiple regression analyses were employed to identify factors associated with performance in the two classes. Results. The findings revealed no statistically significant difference in academic performance between the two classes (p = .267). In both learning periods, sponsorship (p = 0.001 and p = 0.030 in the physical class and online class respectively) emerged as a significant predictor of academic performance. Students who were government-sponsored tended to perform better than their privately-sponsored counterparts. Conclusion. The transition to online learning did not significantly affect the overall academic performance of undergraduate students. However, the mode of sponsorship played a critical role in both learning periods, suggesting that socioeconomic factors may influence academic success in both learning environments. Addressing these disparities is essential to ensure equity in education.
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    Acceptability of prescription and use of long acting injectable PrEP among health workers and key populations at the MARPI and KCCA clinics providing HIV prevention services
    (Makerere University, 2021-06) Lukubuya, Derrick Joanthan ; Baguma, Micheal ; Kaguta, Andrew
    Background:HIV is still a major public health concern, with are over 32.2–38.8 million HIV-positive cases globally and 71% of these live in Sub-Saharan with Uganda having a prevalence of 6.2% among adults. Pre Exposure Prophylaxis (PrEP) as prevention to HIV infections was approved by Food and Drugs Authority (FDA), and Long-acting Injectable PrEP (LAI-PrEP), was developed to overcome some of the barriers with oral PrEP. Oral PrEP has been introduced to high-risk populations to prevent HIV infections. But its acceptance has been limited due to stigma, unproven fears around the increased spread of antiretroviral resistance, pill burden, high cost, forgetting refill dates, high frequency, and physiological challenges associated with the daily dose. Therefore, this study aims at determining the acceptability of injectable PrEP use among key populations attending MARPI clinic and other HIV clinics in Kampala and the acceptability of LAI-PrEP administration among health workers. Methods: A cross-sectional study was conducted. Overall, 344 participants were enrolled in the study from four different categories (health workers, those that are currently on oral PrEP, oral PreP dropouts and naïve key propulsions). Results: Majority of oral PrEP dropouts were females constituting 62.4%. The median age was 28 (IQR 19-45) years. 57.89% of them were female sex workers. The majority of those currently on oral PreP were either female sex workers (33.33%), truck drivers (23.52%), or people who inject drugs (23.52%). The majority of the respondent naïve about PrEP were females (64.0%). The median age was 29 (IQR 20-38) years. The majority of the people in all key populations had ever heard about PrEP and heard about PrEP from a health worker. Majority of the oral PrEP drop outs were willing to use long acting injectable PrEP (77.19%) followed by naïve and those currently on oral PrEP at 63.73%. There was a statistically significant association between willingness to use LAI-PrEP among those that are currently on Oral PrEP and key population (FSW, MSM, PWID, Truck drivers) (P value 0.011)). 93.07% of health workers that had ever been asked by a patient about PrEP were found to accept administration LAI-PrEP, (P value <0.001). Health workers who were comfortable with giving injections were also more likely to accept the administration of LAI-PrEP (P-value <0.001). Conclusions: The key population is quite knowledgeable about PrEP, and there is a potentially high demand for LAI-PrEP among female sex workers, men who have sex with men, people who inject drugs, and truck drivers, among other high-risk groups.
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    Acceptance of antimicrobial stewardship programs in community pharmacies in kampala city.
    (makerere, 2019-05-23) Sekasi, Moses
    Background: Increasing Antimicrobial resistance (AMR) hastens a post-antibiotic era and so underscores the need for rational and judicious use of antibiotics. World Health organization (WHO) points out antimicrobial stewardship as one of the strategies to slow the development of resistance. Antimicrobial stewardship has been adopted in hospitals but to a small extent in community pharmacies. To implement Antimicrobial stewardship in community pharmacies requires people with the right knowledge, attitudes, right practices and willingness to take up Antimicrobial stewardship programs. Objective: To assess the acceptance of Antimicrobial Stewardship Programs (AMS) by health workers in community pharmacies in Kampala city. Materials and methods: A descriptive cross-sectional study was conducted among health workers in community pharmacies in Kampala, Uganda between April, 2019 and May 2019. Pre-tested, self-administered questionnaires were used for data collection. A simple random-sampling method was used to select community pharmacies to be included in the study. Independent-sample Mann–Whitney U tests, independent sample Kruskal–Wallis tests, and logistic regression analysis were performed with SPSS version 25.0 Results: Of the 275 health workers in community pharmacies, 203 responded to the survey (response rate 73.8%). The participants had good understanding of the drivers of antimicrobial resistance. They showed positive perceptions, but poor practices regarding AMS. All of the participants were of the view that AMS program could be beneficial for health care professionals for improvement of patient care, and 78% (n=159) of participants gave their opinion about incorporation of AMS programs in community pharmacies. Collaboration was never/rarely undertaken by health workers in community pharmacies with other health care professionals over the use of antibiotics (n=158, 77.8%), and a significant proportion of participants (n=178, 87.8%) never/rarely participated in AMS-awareness campaigns. Logistic regression analysis revealed that male sex (OR 0.204, 95% CI 0.104−0.4; P<0.001), age 20–29 years (OR 0.172, 95% CI 0.05−0.595; P=0.005), and <1 year of experience (OR 0.197, 95% CI 0.083−0.468; P<0.001) were the factors associated with poor practices regarding AMS. Conclusion: The present study concludes that health workers in community pharmacies have a good understanding of the drivers of antimicrobial résistance. Health workers in community pharmacies have positive perceptions regarding AMS programs in community pharmacies. In addition, the practices of health workers in community pharmacies regarding AMS were poor. Finally, health workers in community pharmacies were willing to integrate antimicrobial stewardship programs into their practice. We recommend incorporation of AMS programs in community settings, involving health workers in community pharmacies. Further studies should be carried out by researchers on a larger scale in order to evaluate the knowledge and perceptions of health workers in community pharmacies regarding AMR and AMS programs across Uganda.
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    Access and utilization of cervical cancer screening services among women attending Naguru hospital in Uganda.
    (Makerere University, 2021-12-17) Musira, Chacha Mwita
    Background: Globally Cervical cancer is ranked the fourth most common cancer in women, ranking after breast cancer (2.1 million cases), colorectal cancer (0.8 million) and lung cancer (0.7 million) 1st, 2nd, and 3rd respectively. Even though there is a proof that early detection of cervical cancer through screening is key way of fighting cervical cancer, the screening rate in African countries including Uganda is still low due to a number of factors. This study was done to investigate the access and utilization of cervical cancer screening services among women attending Naguru Hospital in Uganda. Aim: To assess the access and utilization of cervical cancer screening services among women attending at OPD of Naguru hospital in Uganda. Methods: The descriptive cross sectional survey was conducted among women of 25- 49 years attending OPD clinics of Naguru hospital in Uganda. Conveniently sampling was used to select 251 women for the study. Interview administered questionnaire was used to collect data. Data analysis: Collected data was coded, entered and cleaned in Microsoft excel 2016 spread sheet and exported to STATA (version 14.2) software package for analysis. Descriptive analysis was done and result reported inform of frequency and proportions. Bivariate analysis was done using chi-test and logistic regression and P-values reported at 0.05 level of significance. Results: About 1 in 5 women (22.311%) had ever screened for cervical cancer. Our multivariate logistic regression model indicated cervical cancer screening was significantly associated with having more than three children [AOR=10.55 (95% CI: 2.269-41.331, p<0.05]) and being employed [AOR=0.030 (95% CI: 0.001-0.708 p<0.05]). Conclusion: Generally, the utilization of cervical cancer screening services is low. Occupation and number of children significantly influence cervical cancer screening among women at OPD of Naguru Hospital. Recommendations: Efforts to increase access and utilization of cervical cancer screening services must address disparities parity and occupation.
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    Adherence to diet recommendations and associated factors among type 2 diabetic patients at Mulago National Referral Hospital
    (Makerere University, 2025) Ejang, Patricia
    Type 2 Diabetes Mellitus (T2DM) is increasingly prevalent in Uganda, especially in urban centers like Kampala. Despite routine dietary counseling at tertiary hospitals such as Mulago National Referral Hospital, adherence to dietary recommendations remains low, contributing to poor glycemic control and complications. Since diet is central to diabetes management, it is vital to understand adherence levels and influencing factors to improve outcomes. To assess adherence levels to dietary recommendations among T2DM patients at Mulago Hospital and identify associated factors. A cross-sectional study was conducted with 379 adult T2DM patients attending outpatient care at Mulago. Data were collected using interviewer-administered tools, including the Perceived Dietary Adherence Questionnaire (PDAQ). Adherence was categorized as low (<30), moderate (30–45), and high (46–63). Descriptive statistics summarized participant data, and Chi- square tests assessed associations with adherence (significance at p<0.05). Among participants, 72% had low dietary adherence, 27% moderate, and only 1% high. Significant associations (p<0.05) were observed between adherence and variables such as age, sex, marital status, education, residence, employment, and chronic illness. Better adherence was more common in older adults (≥60 years: 40.7%), females (38.1%), widowed (45.5%), tertiary- educated, rural dwellers (40.9%), unemployed/retired, and those without chronic illness. Logistic regression did not show statistically significant odds (CIs included 1.0), but trends supported chi- square findings. Notably, females had 46% higher odds of adherence (OR=1.46, 95%CI: 0.83–2.58), and those without chronic illness had 2.3 times the odds (OR=2.27, 95%CI: 0.57–9.02). Barriers to adherence included poor nutritional knowledge and low self-control. Dietary adherence among T2DM patients at Mulago is generally low and influenced by demographic, comorbid, and behavioral factors. Strengthening nutrition education, improving access to diabetes-friendly foods, and incorporating behavioral support into care are crucial strategies to enhance adherence.
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    Adherence to guidelines of managing peptic ulcer disease at Mulago Hospital
    (Makerere University, 2021-12) Mugula, Mervyn ; Ssejjemba, Jimmy ; Kuteesa, John
    Background. Peptic ulcer disease (PUD) is defined as the mucosal break of the upper gastrointestinal tract due to acid peptic digestion which results in ulcer formation that extends beyond the muscularis mucosae into the submucosa. Globally over 250,000 people die from Peptic Ulcer Disease (PUD) each year, 70% of which are due to perforated disease. This study aims to identify the diagnostic tests for PUD and to assess the treatment of PUD at Mulago hospital in line with the Uganda Clinical Guidelines (UCG), 2016. Methodology. A descriptive retrospective study design involving a 1-year chart review of patients diagnosed with PUD and managed for PUD at Mulago hospital in the year 2020 to 2021 was done. The sample size of the study was 80 files which were selected by simple random sampling technique. However, only 65 files met our inclusion criteria and were thus reviewed and the data collected was entered into excel spreadsheets and STATA version 14.0 for analysis. Results. Out of the 65 files selected, 5 (7.7%) were for patients aged between below 20 years, 38 (58.5%) for 21-40 years, 14(21.5%) for 41-60 years and 8(12.3%) for patients above 61 years. Female were 43(66%) and males were 22(34%). The most marked presenting complaints were epigastric pain that worsens with eating 30(46%), epigastric pain that reduces with eating 23 (35%) and nausea and vomiting at 14(26%). The commonest risk factor identified was irregular meals 17 (26%), use of NSAIDs 6(9%) and stress 3 (5%). Endoscopy 61(94%) and stool antigen test 43(66%) were the commonest diagnostic tests for the diagnosis of PUD. Among the medication prescribed, esomeprazole 24(36.9%), followed by Triple therapy 20(30.85%) was most prescribed. Conclusions. The most commonly ordered investigation was endoscopy followed by the stool antigen test. The most prescribed medication was esomeprazole and then triple therapy, with percentage adherence of 38.46%. . There is therefore need to conduct further research in lower health facilities since results of this study are not generalised.
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    Adherence to hydroxyurea use among patients with sickle cell disease attending the sickle cell clinic at Mulago National Referral Hospital
    (Makerere University, 2023) Nambi, Phiona
    In Uganda, about 20,000 babies are born per year with sickle cell disease with a life expectancy of less than 20 years. Hydroxyurea was proven safe and effective by FDA to reduce frequency of complications due to SCD and preferred for treatment of SCD. This study aimed to determine level of adherence to hydroxyurea and associated factors among patients with sickle cell disease. A cross-sectional study was conducted with 221 caretakers recruited using consecutive sampling. Adherence was measured using the Morisky Medication Adherence-8 items and the visual analogue scales. Semi-structured questionnaires were used to assess the factors. Descriptive statistics was used to analyse data. The level of good adherence to hydroxyurea was low(8.60%). Key factors that influence adherence were marital status (OR=0.158, 95% CI=0.035-0.712, P=0.016), education level (OR=0.075, 95% CI=0.009-0.612, P=0.016), occupation (OR=3.916, 95% CI=1.091-14.052, P=0.036), access barriers (OR=4.014, 95% CI=1.269-12.702, P=0.018), and experiencing challenge with hydroxyurea (OR=0.322, 95% CI=0.124-0.840, P=0.021). Adherence to hydroxyurea was low. The most important factors that influence adherence to hydroxyurea were; marital status, education level, occupation, access barriers, and experiencing challenge with hydroxyurea. Findings suggest further research be made on interventions to remind patients and their caretakers to take Hydroxyurea as prescribed and also further research is needed on the subsidised prices
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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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    Adulteration of locally manufactured herbal medicinal preparations for diabetes mellitus with metformin and glibenclamide on the Ugandan market
    (Makerere University, 2023) Bukhupe, Nathaniel Wafula ; Yiga, Edward ; Mayanja, Eric
    Background: Adulteration of herbal antidiabetic products has been reported all over the globe. Studies conducted in Hong Kong showed that Glibenclamide and Metformin were commonly use adulterants detected in the products on market. Severe adverse events have also been reported following use of adulterated herbal products. Purpose: To detect and quantify metformin and glibenclamide in locally manufactured antidiabetic herbal preparations sold in Kampala, Uganda Methods: A cross-sectional study was conducted to document the locally produced herbal antidiabetic products. Products were obtained from the 5 divisions of Kampala going to herbal drug shops, pharmacies and local markets in the different sub-counties. Key parameters documented include included label quality, directions to use, indication claims and NDA notification status. The documented products were then prepared and screened using the TLC technique to rapidly detect presence of metformin and glibenclamide. The detection was based on the retention factors of the peaks obtained from the samples in comparison to the peaks of the Metformin and Glibenclamide standards. The positive products were analyzed using the HPLC technique to quantify the metformin and glibenclamide present. Calibration curves were generated from the peak area versus concentration data of the serial dilutions of the prepared standards curves. Results: Eighteen locally made herbal antidiabetic products sold in Kampala were examined and documented. They were mostly powders which are meant to be taken as a tablespoonful of powder in warm water twice daily. Two of the eighteen had good labels having all the basic requirements as stipulated by the NDA guidelines. Only one of the products was NDA notified. Three of the eighteen products were found to be adulterated with synthetic antihyperglycemics; metformin and glibenclamide. The adulterated products contained approximately 0.11 mg of glibenclamide, 6.14 mg and 20.7 mg of metformin for every 1 gram of the product Conclusion: Three of the eighteen documented products were adulterated with metformin and glibenclamide. There is need for more product registration and notification with the NDA to ensure better monitoring and regulation of product quality and safe use of these locally made herbal antidiabetic products.
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    Alcohol and substance abuse among the youth in Kamwokya slum in central division, Kampala district.
    (Makerere University, 2023-12-08) Kansiimeruhanga, Fortunate ; Kirande, Bildad Felix
    Background: Alcohol and substance abuse has continued to be a serious health problem among the youth in Kamwokya slum, Central Division, Kampala district and it has been affecting the community for a long time. However, the burden of drug abuse and the risk factors predisposing them to vice are not fully known. A cross-sectional was conducted to assess the burden of alcohol and substance abuse and the associated risk factors among the youth in the Kamwokya slum in the Central division of Kampala district. Methods: A cross sectional study was conducted amongst the youth of Kamwokya slum, Central Division, Kampala district. This study was approved by the Makerere University School of Biomedical Sciences Research and Ethics Committee with reference number SBS- 2023-355. Study participants were recruited consecutively until the sample size was reached. A modified WHO ASSIST tool was used to collect data on alcohol and substance abuse among the youth in the Kamwokya slum area in Kampala District. Data was double-entered into EpiData , validated and exported to STATA version 14 for analysis. Chi-square test, bivariate and multivariate logistic regression were performed to relate the findings to alcohol and other substance abuse. Results: A total of 145 study participants were interviewed. Majority of respondents interviewed were males (62%, n=90). Most of the respondents were aged between 18 – 24 years (51%, n=75). Study findings showed that most of the respondents were students (30%, n=44), followed by business persons (25%, n=36). The majority of the respondents stayed in rentals (63%, n=91), and (27%, n=40) of the respondents stayed in their ' 'parent's houses. Findings showed that (58%, n=84) had ever used alcohol and other substances of abuse in the past one month. Most of the respondents were taking alcoholic beverages (35%, n=51), followed by those cannabis (27%, n=40) and followed by those taking tobacco (22%, n=32). There was a significant association between occupation and drug/alcohol use (p < 0.001). Findings showed a significant association between age and drug/alcohol use (p = 0.019). Findings showed that there was a significant association between residence and drug/alcohol use (p = 0.020). The majority of the respondents (58.6%, n=85) agreed with eradicating alcohol and other substances and Opinions were more evenly distributed across the categories. However, there was no significant association between this opinion and drug/alcohol use (p > 0.05). Respondents who disagreed that alcohol and other substances of abuse are okay if consumed responsibly were less likely to abuse drugs and alcohol consumption compared to those who were neutral (OR=0.073; 95%CI: 0.014 to 0.372; P = 0.002) and (OR=0.226; 95%CI: 0.058 to 0.888; P = 0.033) Conclusion: More than half (58%) of the youth in this study had ever used substance abuse. Most of the respondents were taking alcoholic beverages (35%), followed by those cannabis (27%,) and followed by those taking tobacco (22%).
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    Analysis of patient flow in the Accident and Emergency Department at Mulago National Referral Hospital, Kampala
    (Makerere University, 2022-10) Tukahirwa, Beteth
    Background: The patient flow processes refer to the sequence of events in clinical care that patients experience from the point of entry until they are discharged from the hospital premises. Processes involved in patient handling and flow at hospital emergency departments lead to delays in patient care and management, overcrowding, increased medical errors, reduced patient satisfaction, and it increases mortality and morbidity. Improving patient flow is key in process management in health care facilities. It is therefore worthwhile to establish the patient flow process and the factors affecting the patient flow process at the A & Et. Objective: To assess the patient flow at Accident and Emergency Department at Mulago National Referral Hospital. This was categorized into actual patient flow and factoring affecting patient flow. Methods: A qualitative cross-sectional research approach was adopted and utilized key informant and in-depth interviews respectively on a total of 13 respondents that were purposively selected. Results: The findings indicate that patients accessed A&E Department from triage area as an entry point, records unit, yellow area, red area, theatre, laboratory unit. In some instances, there was forth back movement of patients to these areas and units and this practical interaction was drawn diagrammatically. Secondly, the following factors affected how patients flow at A&E Department; facility based or infrastructural, health worker based, patient based and environmental factors. Conclusions and recommendations: The flow of patients at A&E Department was not sequentially organized. Several factors affected the patient flow process including the high patient volumes, under staffing, and insufficient equipment. Interventions should therefore be developed to improve the patient flow process at the A&E.
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    Analysis of typhoid serodiagnostic data and patient socio-demographic and clinical characteristics at Uganda Martyrs' Hospital, Lubaga
    (Makerere University, 2023) Aguma, Nicholus ; Moparti, Sri Venkata Satya Sai Eswar ; Noumechi, Tietche Rochel ; Wejjo, Yonasan
    INTRODUCTION Typhoid fever remains a major public health concern. According to World Health Organization (WHO), there were an estimated 10.9 million cases of typhoid fever worldwide in 2019 with 110,000 deaths. Typhoid fever (also known as enteric fever) is a systemic infection transmitted through ingestion of food and water contaminated with human feces and caused by the Gram-negative bacteria Salmonella enterica serotypes Typhi or Paratyphi A, B and C (Background document: the diagnosis, treatment and prevention of typhoid fever. Geneva, Switzerland: 2003, Andrews JR, Ryan ET, 2015). It is characterized by numerous nonspecific symptoms, including high fever, headache, malaise, joint pain, abdominal pain, and gastrointestinal symptoms such as nausea, vomiting, constipation, and diarrhea. In Uganda, there was an outbreak of typhoid fever in the Kasese District from 2008 till 2011 causing a high rate of intestinal perforation (MS Walters et al 2009). According to Health Management Information System (HMIS), in Kampala over the period of two years from January 2021 to December 2022, the number of typhoid cases reported was 86,622, however, they might not represent the actual positivity rate of typhoid in Kampala because it is likely that most of them were diagnosed solely based on clinical characteristics or a few serological diagnoses. It is therefore not certain whether the figures in the HMIS reflect the true picture of typhoid in Kampala. Estimating the prevalence of positive S.Typhi serology over the same period and the associated demographic and clinical characteristics in a busy health care center shall contribute to clarifying the burden of typhoid in Kampala. METHODOLOGY The research employed a descriptive cross-sectional study design, utilizing laboratory records and conducting statistical analysis to identify significant trends and patterns. The data for this study was collected using tools capturing relevant socio demographic characteristics and typhoid serology test results from the records at Lubaga Hospital Laboratory. The results of the analysis were presented in the form of tables and charts. Results: Findings revealed only 13 cases (0.36%) positives at Lubaga Hospital for typhoid compared to 86,622 positives throughout Kampala according to the HMIS data extract. Conclusion: The prevalence of typhoid-positive tests among suspected cases at Lubaga Hospital was 0.36% which is very low relative to the number of reported cases in HMIS for Kampala district. It is likely that many of the cases reported in the HMIS were not accurately diagnosed.At Lubaga hospital, typhoid diagosis is majorly relient on commercial rapid tests whose performances are not well documented.
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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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    Antibiotic activity of garlic, ginger and tamarind crude extracts on methicillin resistant staphylococcus aureus
    (Makerere University, 2022-08) Bongo, Emmanuel ; Bwambale, Pinon ; Atuhairwe, Vivian ; Pitua, Ivaan
    Introduction: Due to the increased resistance to antibiotics by bacteria like MRSA, antibiotics which were once used to treat these become less effective. As a result, medicinal plants could be a reliable alternative for therapy. Garlic, Ginger and Tamarind have traditional dietary and medicinal applications as antimicrobial agents. A biologically active compound derived from these plants may increase the effectiveness of clearing infections therefore, the present study aims to determine the antibacterial effect of ethanol extracts of garlic, ginger and tamarind against isolates of Methicillin Resistant Staphylococcus aureus (MRSA). Methodology: Most recent clinical specimen stored at the laboratory’s biorepository were retrieved, reinoculated in Blood Agar and grown under favorable conditions. Susceptibility of bacteria to the antibiotics and plant extracts was determined by disc diffusion method on Mueller-Hinton Agar by measuring the diameter of the Zone of Inhibition (ZOI) Results: Findings revealed that all plant extracts exhibited significant inhibitory effect on the growth and proliferation of most of the MRSA isolates. The maximum antibacterial effect was exhibited by Garlic n=24 (ZOI = 16.25±2.72 mm, p =0.02) followed by Tamarind n=15 (ZOI = 8.21±1.33 mm, p = 0.00) and Ginger n=11 (ZOI = 7.46±1.02 mm, p = 0.01). As Cefoxitin (FOX) was used to determine resistance, the means and interquartile ranges in comparison to plant extracts were FOX (mean=14.33, IQR=2.25); Garlic (mean=16.25, IQR=3.25); Tamarind (mean=8.21, QR=2); Ginger (mean=7.46, IQR=1). Conclusions: There is significant antibacterial activity when plant extracts of garlic, ginger or tamarind are used against MRSA bacteria.
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    Antibiotic activity of turmeric, castor oil, honey and apple cider vinegar extracts on MRSA on isolates from medical microbiology laboratory, Makerere University.
    ( 2023-12-15) Nakyeyune, Grace Zziwa ; Amuge, Mary ; Babigumira, Davis ; Abala, Pey Samuel ; Masaba, Adam
    Background Herbal medicine is used by approximately 80% of the world’s population according to WHO. In Uganda, herbal remedies play a significant role in the health care system being the oldest yet continuously utilized medical treatment across different cultures. Furthermore, plant extracts used as food colorants, additives, and preservatives such as turmeric, honey, castor oil, and apple cider vinegar have also been reported to treat infections like skin diseases and coughs. This study aimed to assess the in vitro antibiotic activity of turmeric, castor oil, honey, and apple cider vinegar on MRSA. Objectives To determine the Antibiotic activity of turmeric, castor oil, honey, and Apple cider vinegar extracts on MRSA on isolates from the medical microbiology laboratory, Makerere University Methodology This was an analytical study where 20 isolates were retrieved, and cultured. Gram staining and various biochemical test like catalase test, coagulase test, DNase test, mannitol salt agar test and cefoxitin susceptibility testing were carried out to ascertain MRSA. 17 of the 20 isolates were viable MRSA stains and were subjected to antibiotic susceptibility testing with turmeric, apple cider vinegar, honey, and castor oil. Results Results were recorded following CLSI guidelines. Apple cider vinegar had the highest antibacterial effect, n=17 (ZOI = 31±2.52 mm) followed by honey n=17 (ZOI =18±4.29 mm) then castor oil n=7 (ZOI=15±6.26 mm) where n is the number of isolates that showed susceptibility and ZOI being the zone of inhibition. Turmeric did not show any antibiotic effect. Conclusion Therefore, the findings of this study can be used as a baseline for future research and development of novel antibiotics for the treatment of MRSA infections. This will reduce on high costs of healthcare and prolonged hospital stay in the long run resulting from drug resistance.
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    Antibiotic resistance patterns of Klebsiella Pneumoniae isolates obtained from microbiology laboratory Makerere University Uganda
    (Makerere University, 2023-05) Luyima, Jamali ; Kambwe, Christopher ; Kilabo, Nagitta Isabella ; Oribokiriho, Bright
    Antimicrobial resistance has become a major public health concern worldwide, with increasing morbidity and mortality rates associated with resistant infections. Klebsiella pneumoniae is a common cause of nosocomial infections, and resistance to multiple antibiotics has been reported, posing a significant challenge to clinicians. The aim of this retrospective study was to determine the antibiotic resistance patterns of Klebsiella pneumoniae isolates obtained from the microbiology laboratory at Makerere University in Uganda from January 2020 to December 2022. A retrospective review of laboratory records was conducted to identify all clinical samples that tested positive for Klebsiella pneumoniae from 2020 to 2022. Patient and sample information, as well as antibiotic susceptibility test results, were collected from the records. The susceptibility of K. pneumoniae isolates to a range of antibiotics from different classes, including carbapenems, beta-lactams, aminoglycosides, imipenems, quinolones, folate inhibitors, and nitrofurantoin, was analyzed. The data were analyzed using descriptive statistics to determine the prevalence and patterns of antibiotic resistance. In this study, a total of 195 Klebsiella pneumoniae isolates were analyzed. The majority of the isolates (60%) were collected from male patients. The most frequently encountered sample type was urine (15%), followed by pus swabs (50%), pus aspirates (25%), and blood (10%). The results revealed high levels of resistance among the isolates. Carbapenem resistance was observed in 30% of the isolates, indicating a significant concern for the emergence of multidrug-resistant strains. Beta-lactam antibiotics, including amoxicillin/clavulanic acid, ampicillin, cefotaxime, cefoxitin, and ceftriaxone, exhibited high resistance rates of 80-90%. However, imipenem and meropenem demonstrated relatively lower resistance rates, ranging from 20-25%. Aminoglycosides, such as amikacin and gentamicin, showed resistance in 40-50% of the isolates, further highlighting the growing issue of resistance among this class of antibiotics. Quinolones, specifically ciprofloxacin, exhibited a high resistance rate of 70%. Folate inhibitors, represented by trimethoprim sulfamethoxazole, displayed resistance in 50% of the isolates. Notably, nitrofurantoin had the lowest resistance rate at 10%. The findings of this study highlight the alarming prevalence of antibiotic resistance among Klebsiella pneumoniae isolates. High resistance rates were observed for beta-lactams, aminoglycosides, quinolones, and trimethoprim-sulfamethoxazole, posing significant challenges for treatment options. The emergence of carbapenem resistance is particularly concerning. Effective antimicrobial stewardship programs and infection control measures are crucial to combat this growing threat. Continued surveillance, research, and development of new treatment strategies are essential to address the issue of antibiotic resistance in Klebsiella pneumoniae effectively.
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    Antimicrobial resistance profiles of Klebsiella Pneumoniae at Clinical Microbiology Laboratory of Makerere College of Health Sciences
    (Makerere University, 2024) Okwerede, John ; Kaija, Pius ; Nakawungu, Phildauce
    Background: Klebsiella pneumoniae is a frequent nosocomial pathogen. It has also emerged as an agent of severe community-acquired infections, including pyogenic liver abscess, pneumonia, and meningitis. The beta-lactam antibiotics, in combination with aminoglycosides, are among the most widely prescribed antibiotics and are important components in empirical therapy. However, reports of multidrug resistant K. pneumoniae is a major public health concern The aim of this study was to determine the antimicrobial resistance (AMR) profile of K. pneumoniae isolates recovered from the Clinical Microbiology Laboratory of Makerere University, College Health Sciences in the period of January to December 2023. Objectives: The objectives of this study were to determine antimicrobial resistance profile, the phenotypes of antimicrobial resistance and to demonstrate antimicrobial resistant gene transferability of Klebsiella pneumoniae isolates at the Clinical Microbiology Laboratory. Methods: A laboratory-based cross-sectional study was conducted from April 2024 to June 2024 at Clinical Microbiology at the College of health sciences; Makerere University located on Mulago Hill, Kampala. The archived isolates of K. pneumoniae were re-identified by cultural and biochemical methods and antibiotic sensitivity test (AST) performed according to Kirby Bauer disk diffusion methods on Mueller-Hinton agar. Extended spectrum beta-lactamase (ESBL) production in Klebsiella pneumoniae was tested by double-disc synergy test and antibiotic resistant gene transferability demonstration done by carrying out a conjugation experiment and the trans conjugant subjected to AST tests using similar antibiotics as those used for the donor to determine co-resistance. Results: The re-identification tests of the archived isolates confirmed 22 isolates to be K. pneumoniae out of the 23 received. The isolates showed resistances to the antibiotics as follows; Ampicillin (100%), Cefuroxime (100%), Ceftriaxone (100%), Cotrimoxazole (95.5%), Ceftazidime (95.5%), Cefotaxime (90.9%) and Gentamycin (72.7%). Moderate resistance was seen in Nitrofurantoin (59.1%) and Amoxiclav (54.1%). The least resistance was seen in Imipenem (4.5%). The conjugation experiment demonstrated a successful transfer of resistance against ceftriaxone from 05KP isolate to J53 strain of E. coli. The 05T demonstrated co-resistance against lower class beta-lactams like Ampicillin, Cefuroxime, Ceftazidime and Cefotaxime. Conclusion: These findings suggest a high resistance of K. pneumoniae to commonly used antibiotics and therefore there is a need to opt for AST guided management of patients and to continually do surveillance on AMR. The study further confirms evidence of transfer of resistance from one organism to another. There is therefore need for improvement of IPC practices in healthcare settings.
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    Antimicrobial susceptibility profiles of gram negative rods isolated from ICU patients' samples in Mulago Hospital
    (Makerere University, 2021-02) Namulyanga, Sandra
    Monitoring the prevalence and susceptibility profiles of these GNB is key in empirical therapy as it will guide physicians on which specific antibiotics to administer to these patients with minimal or no drug resistance cases hence quick and successful management of these infections. The purpose of this study therefore was to collect data on the prevalence and susceptibility profiles of GNB and the data generated would guide physicians in providing successful empirical therapy and antibacterial stewardship for ICU patients hence decrease their morbidity, patient stay in hospitals and mortality rate
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    Assesment of knowledge, attitudes and practices on adverse drug reaction reporting in retail community pharmacies in kampala
    (Makerere University, 2019-05-22) Narika, Racheal Lodor ; Namaganda, Veronica
    ABSTRACT Background; Adverse Drug Reactions (ADRs) are scantly reported with poor contribution by healthcare professionals worldwide and in particular in developing countries. The aim of this study was to assess the knowledge, attitudes and practices of adverse drug reactions (ADRs) reporting in retail community pharmacies in Kampala. Methods; a cross sectional study was done in retail community pharmacies in Kampala. A self-administered questionnaire was adapted from similar studies that have been done and modified to our setting. Data was collected by the principal investigators and research assistants from dispensers in retail community pharmacies in Kampala. Completed questionnaires were collected and data were analyzed. Data were expressed in numbers as well as percentages. Results; 203 healthcare professionals responded including 13 pharmacists, 34 pharmacy technicians, 24 allied health professionals, 126 nurses. 95% knew what the term adverse drug reaction means, 93% were aware that ADRs should be reported. 68% of the respondents knew that Uganda has ADR reporting forms, and that Uganda has a national Pharmacovigilance Centre. Overall 97% of the respondents had good knowledge. All the respondents had good attitudes; all of them agreed that ADR reporting is important and necessary, and 71% thought that it should be voluntary. All participants were willing to take up a training on ADR reporting. In practices; 45% of the respondents had ever suspected an ADR however only 9% of these had ever reported to the NDA with a frequency of less than 10 times. Only 24% of the respondents were aware of the availability of ADR reporting forms at the facility. 56% of the facilities encouraged reporting especially through training (94%) and only 25% of the community pharmacies have SOPs for reporting ADRs. Conclusions; The study showed that the health care professionals had a good knowledge and attitude towards ADR reporting. However this was not reflected in the practices as most didn’t report ADRs despite suspecting their occurrence.