School of Health Sciences (Health-Sciences)

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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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    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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    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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    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.
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    Assessing adherence of opioid use to established guidelines for pain management in sickle cell disease at sickle cell ward, Mulago Hospital
    (Makerere University, 2024-05) Waako, Francis ; Mazira, Gloria Hope Zole ; Kafuko, Ronald Buyinza
    Sickle cell disease is a hereditary condition resulting from a mutation in the beta globin chain of hemoglobin where valine is substituted for glutamic acid at position 6. Cardinal features of SCD are hemolytic anemia and vaso-occlusion characterized by severe pain with the vaso-occlusive events being the most common cause of hospital admissions, missed school days and morbidity in patients with SCD. Pain management in SCD involves use of opioids among other pharmacological classes of analgesics. Due to potential for abuse, opioid-induced hyperalgesia and development of tolerance, standardized protocols need to be put in place and adhered to in acute care settings to ensure safe and effective use while optimizing patient outcomes. The major objective of this study was to assess adherence of opioid use to established guidelines for management of pain associated with sickle cell disease. A descriptive cross sectional study design was used to extract medical information from 268 patient books sampled consecutively. A checklist questionnaire was used to extract the data which was then filled into Microsoft Excel, analyzed using Jamovi version 2.3.28.0., and presented in tables, figures and graphs. Of the 268 subjects whose information was reviewed, 140(52.2%) were male. Most of the study subjects that presented with acute pain crises 87(32.2%) were in the age range of 0 to 5 years. Adherence of the opioid prescriptions to the Uganda Clinical Guidelines for management of pain in SCD was observed in only 120(44.8%) subjects. The study showed that there was low adherence of opioid use to established guidelines for pain management in SCD patients at the sickle cell ward, Mulago Hospital owing to a number of reasons.
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    Assessing appropriate use and outcomes of emergency contraceptive pills among undergraduate female students of Makerere University: a cross-sectional study
    (Makerere University, 2023-06) Apio, Partricia ; Kyomuhendo, Evalyne ; Muhwezi, Ashraf
    Approximately 68% of females aged 15-25 employ emergency contraceptive pills to mitigate unwanted pregnancy. When taken appropriately emergency contraceptive pills have a 99% chance of preventing unwanted or unplanned pregnancy. Whereas studies have investigated the prevalence of uptake of ECPs among students, the level of appropriate use, associated factors and outcomes of ECPs among this population have not attracted much attention. This study was aimed at assessing the prevalence appropriate use, associated factors, and outcomes of emergency contraceptive pills among undergraduate female students at Makerere university. Objective: The aim of the study was to assess the prevalence of appropriate use, associated factors and outcomes of emergency contraceptive pills among undergraduate female students in Makerere University. A cross sectional study was conducted among undergraduate female students in Makerere university. This was carried out at the different selected colleges CHS, COBAMS, CHUSS and COVAB in Makerere University main campus. A self-administered questionnaire was issued to the students. Data was analysed using SPSS (Stastical Package for Social Science) Out of 385 female students sampled, 57.9% used the ECPs appropriately, 59.5% had experienced side effects from using ECPs and 57% revealed an event of failed efficacy of the ECPs to prevent pregnancy. The most experienced side effect was changes in sexual experience, revealed by 42.3% of the students. There was significant association between religion, year of study, knowledge, source of information, affordability and type of ECPs with appropriate use of ECPs. The prevalence of appropriate use of ECPs among female university students is suboptimal, and outcomes of failed efficacy and adverse effects were highly prevalent. University female students need to be sensitized to enhance appropriate use of ECPs.
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    Assessing availability of oral morphine controls and effects of oral morphine self-medication on quality of life of caregivers and sickle cell patients at Mulago Hospital
    (Makerere University, 2021-12) Wairama, Timothy ; Katende, Deograsias ; Mabi, Mukose Joshua
    Background. Oral morphine diversion is a potential threat to the quality of life of sickle cell patients and their caregivers. It is also pertinent to study the existing internal controls regarding oral morphine use and its home-based use. Objectives. To determine the effect of caregiver self-medication with patient’s oral morphine on the quality of life of sickle cell patients and their caregivers. To determine the availability of necessary written controls for prescribing, dispensing, and administering oral morphine by the Pediatrics Directorate of Mulago National Specialized Hospital. Justification. Findings of this study will be disseminated to the general public through presentations at national and international conferences and peer-reviewed publications of findings will be written and published. This knowledge will comprehensively improve palliative care practice, policy and controls on oral morphine use. Furthermore, lower cases of drug use disorders, patients reduced access to oral morphine and in the long run improve the quality of life of sickle cell patients as well as their caregivers. Methods. Data was collected using -administered questionnaires from the patients, caregivers, and health workers working directly with oral morphine. The data from the questionaires was enterered into EpiData and after exported to SPSS and Microsoft Excel for analysis and later summarized in form of tables, charts, piecharts and graphs. viii Results. For the availability of internal controls study, data was collected from 30 healthcare workers including pharmacists(6.7%), intern pharmacists(10%), medical officers(26.7%), nurses(46.7%), and pharmacy technicians(10%) that were handling oral morphine in the sickle cell clinics. Availability of internal controls was found to be 62.5% in prescribing, 66.67% in dispensing, 23.07% in administration. For the quality of life study, the study enrolled 210 caregivers and 210 patient participants. Self medication does not affect health related quality of life since the P value is greater than 0.05. Therefore self medication is not significant in affecting self related quality of life. Conclusions There is no significant relationship between caregiver self-medication and quality of life caregivers. It was found out that there is very minimal self-medication of oral morphine by the care givers of paediatric sickle cell patients. Additionally, a very minimal association existed between oral morphine exposure and controlled drug use. Recommendations: Home based oral morphine for palliative careshould be highly encouraged to enable palliative care and there should be relaxation of some of the controls of oral morphine and oral morphine should be more available for the patients.
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    Assessing career aspirations and influencing factors: a case study of final year undergraduate Pharmacy Students in Uganda
    (Makerere University, 2022) Nakiwala, Gwita Caroline ; Kagoya, Mariam ; Kigundu, Paul ; Kemigisha, Stella
    The World Health Organization estimates world over shortage of health workers by 2035. Despite the increase in number of undergraduate pharmacy schools and students in Uganda, there is still critical shortage of pharmacists in public hospitals. Public hospitals being the major way through which over half of Uganda’s population access medical care, shortage of pharmacists affects quality healthcare delivery. Understanding the career aspirations of finalist Bachelor of pharmacy students who are prospective pharmacists and the factors influencing their aspirations will greatly influence the availability of pharmacists in the respective sectors. Objectives To determine career aspirations of final year undergraduate Pharmacy students and it’s influencing factors in Uganda. Methods The research employed a quantitative cross-sectional study among 282 finalist students of Bachelor of Pharmacy in all the 3 universities in Uganda, mean age of 26 years, age range 20 - 42 years, males 71.1 %. The study was carried out by distributing online links of the study questionnaires to the different whatsapp class groups of the students. The questionnaire contained three sections of multiple choice and semi-structured questions. Simple frequency was used to determine proportion, bivariate and multi variate analysis done to determine the variables predicting career aspirations of the students. Results Out of 282 anticipated responses, we got 211 responses representing a 75% response rate (211/282). 54/211(25.6%) were interested in doing community pharmacy immediately after qualification well as 52/211(24.7%) were interested in doing clinical pharmacy 5 years post qualification. Work environment, selected by majority 73/211(34.6%) of the participants with very high importance was the most influential factor in choosing career path while geographical location selected by majority 52/211(24.6%) of the participants with very low importance was the least influential factor in choosing a career path by the students. At bivariate, marital status, gender, work experience, Point of entry into Bachelor of Pharmacy and Background profession were associated with career aspirations involving direct patient care. At Multi-variate, only point of entry into Bachelor of Pharmacy was significantly associated with career aspirations involving direct patient care. Conclusions The findings reflect interest of students to practice direct patient care (clinical and community pharmacy), in light to shortage of pharmacists in different pharmacy sectors public hospitals inclusive and work environment was regarded with high importance in choosing a particular career path.
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    Assessing irrational medicine use in community pharmacies: A case study in Kawempe Division, Kampala.
    (Makerere University, 2021-06-10) Kaweesa, Henry ; Zziwa, Habibu ; Muwonge, Raymond
    Irrational medicine use remains a major global health problem which mostly affects developing countries. The World Health Organization (WHO) estimates that more than half of all medicines are inappropriately prescribed, dispensed, or sold. And additionally, around 50% of patients fail to take their medicines correctly (WHO). It is estimated that 60% of medicines in public health facilities and 70% of medicines in private facilities were prescribed and sold inappropriately in developing countries (Mao et al., 2015). In 1985, the WHO convened a meeting of experts on the rational use of drugs, in which the rational use of medicine was defined as a situation where a patient receives medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community (WHO). Irrational use of drugs is most certainly the opposite of rational drug use. Irrational use of medicines includes: use of too many medicines per patient i.e. poly-pharmacy, inappropriate use of antimicrobials; either in inadequate dosage or for non-bacterial infections, over-use of injections when oral formulations would be more appropriate, failure to prescribe in accordance with clinical guidelines, inappropriate self-medication and non-adherence to dosing regimens (WHO). The irrational use of drugs can be caused by economic, cultural and structural factors (Lukali & Michelo, 2015). Economic factors would include the price of the drug, the purchaser's financial means and financial incentives given to prescribers. Structural factors like the health systems, which includes stock levels, availability of inappropriate drugs, expired drugs, and unreliable supply are all involved in the therapeutic process and can contribute to irrational drug use in a number of ways (Quick et al., 1997).
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    Assessing knowledge and perceptions towards the covid-19 vaccine among the community of kalerwe-besina slum
    (Makerere University, 2021-12) Nabirye, Husuna ; Muwanguzi, Mark ; Onenchan, Job
    The corona virus disease-2019 (Covid-19) caused by the novel severe acute respiratory syndrome-corona virus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on the 11th March 2020. Since then, WHO estimated that 10% of the world‘s population had contracted the virus resulting into over 2.9 million deaths as of 22nd April 2021 and complications like pulmonary fibrosis to the survivors. Because of such morbidity and mortality, countries worldwide put up measures to protect their populations against the virus. These measures included putting on masks, partial, total lockdowns and most recently, getting vaccinated. Despite the fact that safe and effective vaccines had been developed and distributed globally, knowledge and perceptions towards the Covid-19 vaccine among slum dwellers is poorly understood and this could affect the uptake of the vaccine among these people thus reducing their herd immunity. Therefore, this study was aimed to assess the knowledge and perceptions towards the Covid-19 vaccine among the community of Kalerwe-Besina slum. Objectives The objective of the study was to assess the knowledge and perceptions towards Covid-19 vaccine among the community of Kalerwe-Besina slum. Methods The research employed a quantitative cross-sectional study among 367 residents in Kalerwe-Besina slum, mean age 35.5, SD 11.39, age range 18-56 years, female 52.6%. the study was carried out by administering semi structured questionnaires containing informed consent along with sections of knowledge, perception and socio-demographics. Simple frequency was used to determine proportion, bivariate and multi variate analysis done to determine the variables predicting knowledge and perceptions towards Covid-19 vaccine. Results 90.5% of the study participants had insufficient knowledge about the Covid-19 vaccine,41.4 % of these were male, 49.1% were female. 49.6% of the participants thought that the vaccine was safe. In Bivariate analysis, marital status, age and education level were significantly associated with knowledge. Over half of the participants thought that everyone should get vaccinated, 14.4% of the participants thought that politicians should get vaccinated. 58.3% were willing to get vaccinated but with reasons of fear of being unable to access services in the future because of not being vaccinated. Conclusion The findings reflect insufficient knowledge and wrong perceptions towards the Covid-19 vaccine among the community of Kalerwe-Besina slum. In order to improve knowledge and perceptions, immediate health education programs need to be initiated.
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    Assessing knowledge, attitudes, and practices about eye health among people of Katanga Slum in Kawempe Division, Kampala District
    (Makerere University, 2023-01-16) Lwibasira, Henry ; Nanfuka, Hilda Emirina ; Agira, Martin
    Background: In Uganda, primary eye care is largely challenged in its organizational structure, availability of human and other resources, and clinical competency. This study seeks to assess the levels of knowledge, attitudes, and practices on eye health amongst people of Katanga slum as no similar study has assessed this previously. Knowledge, attitudes, and practices about eye health are of great importance in assessing health care systems and delivery in a society Main objective: To evaluate the knowledge, attitudes, and practices about eye health among the people of Katanga slum, Kawempe division, Kampala district. Methods: We carried out a cross-sectional survey targeting a sample size of 377 people of Katanga slum aged above 18, we used questionnaires with open and closed ended questions. Afterwards we analyzed our findings from the data collection using IBM SPSS (Statistical Package for The Social Sciences) because of its simplicity, easy to follow command language and well documented user manual. Results: 377 participants took part in the study, 42.2% male and 57.8% female , 138 people within 18-30, 123 within age bracket of 30-40, , and 118 within 40-100 years. The VA amongst the participants was as follows: 317 were (6/6-6/9) , 49 having (6/12-6/18), and 11 with (6/24- 6/40). PH (46 improved and 14 did not) and for the NVA 78.77% had (0.40-0.63), 11.4% with (0.80-1.25) and 9.81%. had (1.50-2.50) 88 of these had previously had an eye exam and 287 had never been examined before. Conclusion: In conclusion, the study showed that the majority had good vision however, the 46 who improved with pinhole and the 14 who failed were referred to the nearest health care facility with eye services (MNRH Eye department). From the research all the 377 participants had access to a clinic/ health care facility however, all the participants had no clue of any school for the blind and visually impaired in the country so this calls for Ministry of Education & Sports to sensitize them of where the schools of children with special needs are.
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    Assessing the adherence by health workers to treatment guidelines for uncomplicated malaria in public health facilities in Tororo District
    (Makerere University, 2022) Maliki, Rajabu Mustapha ; Arinaitwe, Sherif ; Mugele, Elisha M.A.
    Introduction: Malaria remains the most common public health problem in Uganda, which ranks 3rd globally with malaria accounting for 30% to 50% of outpatient visits and 15% to 20% of hospital admissions with average economic loss of over 500USD annually. To achieve effective malaria control, adherence to malaria treatment guidelines has proved to be of critical importance. Experiences from other countries in Africa that revised their case management suggest that in particular, health workers’ adherence to set treatment guidelines may be problematic. The aim of this study was to assess the adherence levels of health workers to the uncomplicated malaria treatment guidelines as well as factors that influence their adherence to these guidelines. Methods: The study was cross sectional study which was carried out in the public health facilities in Tororo district located in the Eastern Uganda which is made up of 28 public Health facilities. The data was collected using health facility checklist, health care worker surveys/ questionnaires and patient exit interview forms. Ethical approval from IRB school of health sciences was obtained and a written informed consent was obtained from participants before enrolling them to the study. Results: All the 384 patients interviewed had had a malaria investigation done as majority of the patients 381 (99.2%) had an RDT done while only 3 (0.8%) were investigated using malaria blood slide (microscopy). A total of 251 (65.4%) respondents had tested positive for malaria of which 251 (100%) were given antimalarial medicines with 236 (94.0%) prescribed with ALU. Out of 22 health facilities evaluated, majority of health facilities did not have wall charts to guide health workers in assessing and treating children under 5years 16 (72.7%), ALU dispensing procedure and dosing schedule 16 (72.7%) and charts on how to do a RDT for Malaria 15 (68.2%). Only 4 (18.6%) facilities reported to have dihydroartemesin/piperaquine and only 3 (13.6%) health facilities had quinine plus artesunate/amodiaquine. Conclusions: The health workers in public health facilities in Tororo district have a good adherence to treatment guidelines for uncomplicated malaria despite insufficient supply of basic equipment for diagnosis and treatment of malaria. The public health facilities in Tororo district should be facilitated with sufficient supply of medical equipment in the management of malaria.
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    Assessing the eating habits and academic performance among Makerere university students
    (Makerere University., 2025) Atwebembire, Lodon
    The discontinuation of government-supported meal programs at Makerere University in 2018 shifted the responsibility of eating management to students, raising concerns about the impact of self-regulated eating habits on academic performance. Despite global evidence linking nutrition to cognitive function, limited research exists on this relationship in Sub-Saharan Africa. This study aimed to assess eating habits, document academic performance, and examine their association among undergraduate students at Makerere University. A cross-sectional study was conducted with 364 undergraduate students residing in university halls. Data were collected via a structured online questionnaire adopted from validated tools. Eating habits were quantified using a 12-item Eating Habits Score (EHS), while academic performance was measured through self-reported Cumulative Grade Point Average (CGPA). Descriptive statistics, Pearson correlations, and regression analyses were performed using SPSS v27. Ethical approval was obtained (MAKSHSREC-2024-775). The study examined the relationship between eating habits and academic performance among 364 university students using both Pearson correlation and binary logistic regression analyses. Pearson correlation results showed statistically significant positive associations between frequency of eating breakfast per week and self-reported CGPA (r = 0.214, p < 0.001), and between eating regular meals and CGPA (r = 0.136, p = 0.009). Logistic regression results showed that students with healthier eating habits had higher odds of better academic performance ([aOR] = 1.14, 95% CI: 0.85–1.52, p = 0.396), and students who ate breakfast more frequently also had increased odds (aOR = 1.14, 95% CI: 0.90–1.44, p = 0.282). Eating regular meals was associated with 47% higher odds of better performance (aOR = 1.47, 95% CI: 0.77–2.82, p = 0.244), though none of these associations were statistically significant in the logistic model. The results indicate that regular meal consumption, having breakfast frequently, and maintaining healthy eating habits are all favourably correlated with academic performance; however, these associations were weak and not statistically significant in the regression model. The significant Pearson correlations, however, point to a possible connection that needs more research. University students' academic performance may increase if healthier eating habits are encouraged, but more thorough, long-term research is required to verify causality.
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    Assessing the economic implications of managing adverse drug reactions from Dolutegravir based therapy that require long-term management in Infectious Diseases Institute Mulago : a cost of illness study
    (Makerere University, 2025) Kigongo, Felix Lubandi ; Ayebazibwe, Christiana ; Ntegeka, Celia Asiimwe
    Introduction: Dolutegravir (DTG)-based antiretroviral therapy (ART) is the World Health Organization’s recommended first-line regimen for people living with HIV (PLWHIV). Despite its clinical advantages, DTG has been associated with adverse drug reactions (ADRs), particularly diabetes mellitus (DM) and hypertension (HTN), which may require long-term management. These ADRs not only affect patient health but also place an economic burden on health systems. However, limited data exists on the cost implications of managing such ADRs in Uganda. Objective: This study aimed to determine the direct healthcare costs associated with managing long-term ADRs linked to DTG-based therapy and assess their budgetary impact on the Infectious Diseases Institute (IDI), Mulago. Methods: A cross-sectional design was employed using quantitative data extracted from the Integrated Clinic Enterprise Application (ICEA) and patient files at IDI. A sample of 144 patients on DTG-based therapy who developed long-term ADRs was selected using simple random sampling. A micro-costing approach estimated the direct medical costs, and a Markov model projected the five-year budget impact. Sensitivity analysis assessed cost variations under different prevalence scenarios. Results: Among the 144 patients reviewed, 60.4% had diabetes mellitus and 39.6% had hypertension. The most frequently used medications were Metformin for DM and Amlodipine for HTN. The annual direct cost of managing these ADRs was USD 4,086.91, with an average of USD 31.73 per diabetic patient and USD 23.26 per hypertensive patient. The five-year projected budget impact was USD 90,669.48, rising to USD 734,345 in worst-case scenario analysis. Conclusion: These study findings suggest a possible metabolic syndrome pattern linked to DTG-based ART. Also, the results of the study show that the costs of management of these ADRs impose a significant financial burden on ART clinics. These therefore call for the need for more stringent clinical monitoring of patients on DTG-based ART, as well as proper allocation of a proportion of clinics’ budgets to account for these costs.