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

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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 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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    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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    Assessing the prevalence of hypertension and prehypertension and associated risk factors among patients at the Out- Patient Department, Mulago Hospital.
    (Makerere University, 2022-03) Mutebi, Asiraf ; Ssegujja, Jonathan
    Background; Hypertension or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension has been described as the “silent killer” because initially, the disease presents no apparent symptoms, and hence an individual can have hypertension without realizing it. The World Health Organization estimates that approximately 40 percent of people worldwide have raised blood pressure. Factors associated with the development of hypertension can be categorized into modifiable risk factors namely obesity, physical inactivity, high salt diet, smoking and others and non‑modifiable risk factors namely age, race, genetic composition, sex and others. Aim; This study aimed at assessing the prevalence of prehypertension and hypertension and associated risk factors among Out-patient department (OPD) patients at Mulago Hospital. Subjects and Methods: Descriptive cross‑sectional study design was utilized and the study carried out over a period of 2 months (October and November 2021). Purposive sampling was utilized to select a total of 385 respondents for the study.
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    Assessing the prevalence of malaria among children under 5 years, attending to treatment in Kamuli general hospital- Kamuli Municipality
    (Makerere University, 2021-01) Beene, Richard
    Malaria is a life threatening disease typically transmitted to humans through female anopheles mosquito carrying the parasite and remains one of the top killers of children below five years despite of the nationwide mosquito net distribution. A study to assess the prevalence of malaria among children under 5 years was carried out in Kamuli General Hospital, A hospital based cross sectional study and laboratory based malaria rapid diagnostic test to determine the prevalence of malaria in children under the age of 5 years were carried out to collect the data, this was done with the use of questionnaires survey that focused on the risk factors that contribute to malaria infection. The sample size of the study was 200 respondents, and the results revealed that 39% (n=78) were positive with malaria and 85% (n=122) of the participants had at least fallen sick due to malaria in 2020. And 65% (n=129) had mosquito nets 45% (n=90) were not sleeping in the net always. While 20% (n=40) were sometimes sleeping in the net. Majority of the participants 78% (n=155) revealed that they had a bush around their house and 60% (n=119) engaged in outdoor activities in the evening thus predisposing them to mosquito bites. However, the study revealed a gap in interventions such as mosquito net distributed and use, presence of stagnant water in the participants’ homesteads coupled with participants’ rampant evening outdoor activities and low knowledge on malaria prevention. The researcher recommends that VHTs should be tasked to educate people on malaria control and prevention as a way of containing the prevalence of malaria in the District, and the Government through Ministry of Health should design customized intervention for Kamuli District and Busoga region at large in order to reduce the high malaria prevalence.
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    Assessment of bacterial status of washroom door handles and handrails of stairs at the College of Health Sciences, Makerere University
    (Makerere University, 2024) Tumusiime, Jacob ; Osuro, Peter ; Ssentamu, Halidi ; Itega, Onesmus
    Objective: The aim of the study is to assess status and the level of bacterial contamination of washroom door handles and knobs of toilets and bathrooms at college of health sciences (CHS). Background: Bacteria are ubiquitous and constitute part of every ecosystem in the environment where they live either freely or as parasite. Fomite can be described as a non-living object capable of carrying infectious organism and it is considered as one of the major source of spread of community acquired infection. In this study, door handles/knobs were swabbed with sterile swab stick moistened with sterile water. The content was transferred to agar Petri dishes and then incubated for 24 hours at 35˚C – 37C Methods: This was a quantitative. Samples were collected from toilets/washroom door handles and hand rails at the college of health sciences using cotton swabs. The samples were processed and examined for the level of bacterial contamination and presence of gram negative bacteria. Samples were tracked with accompanying requisition forms indicating the points of collections, time of collection and others. Data was cleaned from KoboToolbox and exported to Microsoft excel, validated and then exported to STATA version 14 for analysis; chi-squared test, bivariable and multivariable logistic regression analysis will be performed on the data to relate factors independently associated with microbial burden on washroom door handles and hand rails of Mak-CHS. Conclusions: The study will create awareness to the management of the college and general public so that appropriate hygiene measures can be taken and followed by all students and staffs in the college to avoid community acquired infections.
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    Assessment of dispensing practices on prescription-only medicines in private retail pharmacies in Kawempe division
    (Makerere University, 2024) Opio, Innocent
    Background: The global population is afflicted with several health challenges, numerous infectious diseases and severe painful conditions, and therefore, that calls for urgent medical treatment. In Uganda, Antibiotics, Antihypertensive, Antidiabetics and Narcotics are some of the prescription-only drugs according to the National Drug Authority and Act. The population's control of access to prescription drugs is a huge responsibility, which requires the participation of multiple stakeholders, such as the government, non-governmental organisations, and citizens of Uganda. There is little data regarding dispensing POMs among private retail pharmacies. The study assessed the dispensing practices of POMs in the private retail pharmacies in the Kawempe Division. Materials and methods: A cross-sectional study design in which 204 healthcare workers were involved, questionnaires were used for data collection from the participants who consented in writing to participate. A random sampling technique was used, and data was analysed using SPSS software version 29. Results: The study revealed that a higher percentage of respondents employed at these retail pharmacies were female, had a diploma, many of the respondents were nurses, and those with experience of between 1 to 5 years constituted the majority. Majority of the respondents had good dispensing practices with a mean score range (4.0-5.0,103/204) and a few respondents had a low mean score range (1.0-2.9,45/204). Conclusion: There was a mix of adherence levels to key dispensing practices among pharmacy professionals, ranging from counselling patients on adverse effects and dosage instructions to ensuring the completeness of prescriptions and maintaining patient privacy. While there are areas of strength, such as high rates of instructing patients on dosage and frequency, and checking for the expiry date of medicines, there are also areas that require improvement, like dispensing drugs without a letterhead and counselling patients about adverse effects of drugs.
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    Assessment of non lump changes among women who came with abnormal breast changes for cancer screening at FNAC Clinic at MAKCHS Pathology Department
    (Makerere University, 2021-11) Mugisha, Moses
    Background: Nipple discharge, nipple retraction and inversion the non-lump changes used. These changes could thus be helpful in early diagnosis of breast disease including breast cancer as they could be the only early indication of breast malignancy The breast is a highly sensitive organ especially in the females. Many physiological and pathological processes can lead to visible changes in morphology of the breast. Among these are the non-lump changes that may or may not occur with simultaneously with a lump. Aim and Objective: To assess non-lump changes and their association with age as seen among women who came with abnormal breast changes. Methodology: This was a Retrospective laboratory based study, conducted at MakCHS pathology department core lab located in Mulago (Kampala). A total of 38 slides were reviewed Slide samples are prepared and stained with both DQ and Papanicolaou. The slides were assessed for any cytological abnormalities and result analysis done using SPSS version 16. Results: ND was the commonest non-lump change, affecting women between 17years to 65 years. Twenty eight of the women (73.6%) had ND. 18 (47.3%) of all the patients presented with a clear ND, 6 (15.7%) with bloody ND, 4 (10.6%) with purulent ND and 1 (5.15%) presented with milky ND. 12 (28.6%) of the women presented with NR. Of these, 10 (8.33%) presented with both ND and NR. 8 (80%) of the patients with non-lump changes had a malignant process and 0 (0%) had a benign process and 2 (20%) had infections. Conclusion:Non-lump changes are not usually a sign of breast malignancy especially in younger women. Though not usually a sign of breast malignancy patients with non-lump changes should be closely monitored as these could be the only signs of a premalignant process. Recommendation:Nipple discharge cytology should be embraced as this could be one of the ways to monitor the presentation of malignancy. Triple assessment must also be given careful consideration as some of non-lump changes may not present with a significant palpable lump.
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    Assessment of womens’ knowlegde, attitude and beliefs towards cervical cancer screening in Nakaseke Health Center, Central Uganda
    (Makerere University, 2020) Senfuma, Evelyn
    Cervical Cancer is the second commonest cancer affecting the women, where virtually all cases are connected to human papillomavirus genital infection. Women living in urban centers take cervical cancer infection as bad luck and don’t want to know if they have it. Women who do not go for screening claim that once they go for screening people around them will think they are having sex and since they are not active sexually, they do not have to go for any testing and this common among the Hispanic and Asian. In Uganda, cervical cancer is taken as the number one most frequent cancer among women and also as the 2nd most common cancer among women aged 15-44 years. An estimation of approximately 40 women in every100,000 develop Cervical Cancer in Uganda. It has been confirmed by statistics about half of the women with Cervical Cancer die within three years of diagnosis. The most common malignancy among women living in Mbarara is cervical cancer, in West Nile District,it is the second commonest and among women in Kyadondo County,it accounts for over 80% of female cancers, Kampala District, where a well-established population-based cancer registry exists. It has been confirmed by statistics that cancer is deadly for women in Uganda. In sub Saharan Africa, cervical cancer is still one of the major causes of death among women of reproductive age. It must be noted that there is little information on the level of awareness and perceived risk among the women that live in the peri urban slums which most of these are of reproductive age.
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    Burden of substance abuse, risk factors and associated consequences among the youth in Kisenyi slum area
    (Makerere University, 2024) Musasizi, Aggrey Pius
    Background: Substance abuse among the youth is a global menace currently. According to available statistics, youth abuse substances to seek euphoria mainly which is rooted in several various factors which could be socio-economical, individual factors, and family status among others. Substance abuse is common especially in urban settings globally. Objective: To assess the burden of substance abuse, risk factors, and consequences among the youth in Kisenyi slum Kampala District. Methods: A cross-sectional study was carried out using a modified WHO ASSIST tool on 322 participants. Local leaders of the area were used as guide in the recruitment of study participants. Semi-structured interviews were used in data collection following consent. A single stage cluster sampling technique was used in recruitment of study participants. Data collected was entered in an Excel Spreadsheet and then transferred into STATA version 14 for statistical analysis. Results: A high percentage, 72.4% (n=233) of the study participants reported to the use psychoactive substances. Over a half, 53.1% (n=171) were male. The mean age was 22.7±4.5 years. More than half, 53.7% (n=173) of the study participants reported that khat was the most commonly abused substance. Most of the study participants defined substance abuse as a form of self-medication to cope with emotional or psychological issues such as stress, anxiety, depression, or trauma. Reasons reported for use of these substances include search for euphoria, 58.7% (n=189) and teenagers' curiosity, 38.5% (n=124). Reported consequences were dependence, 54.7% (n=176). Conclusion: Substance abuse is a common practice among the youth in kisenyi slum area with khat and alcohol the most commonly abused. Main driving factors are euphoria, curiosity, unemployment and peer pressure. Main consequences of use of these substances reported include dependence, sleep disorders, depression, gender-based violence and aggression.
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    Carriage of ndm & imp carbapenem resistance genes among e. coli & k. pneumoniae human stool isolates from Mbarara
    (Makerere university, 2022-03) Makumbi, Musa
    Background The purpose of the study is to establish the prevalence of NDM & IMP Carbapenem resistance genes among E. coli and K. pneumonia. The study is to be conducted on the isolates from Mbarara at the College of Health Sciences Makerere University. Carbapenem, a β-lactam that is really potent against Gram- negative bacteria, has been recognized as a last resort for treating of infections caused by multidrug-resistant bacteria. However, the increasing number of carbapenem-resistant Enterobacteriaceae (CRE) is unexpected despite infection control efforts, and it poses a great challenge to clinics worldwide. This study was conducted to determine the prevalence of Carbapenem resistant E.coli and K. pneumoniae from clinical isolates from Mbarara. Objectives 1)To determine the amount of NDM& IMP genes E. coli and k. pneumoniae. 2)To determine the presence of E. coli and k. pneumoniae carrying NDM & IMP genes Methods The study was a descriptive cross-sectional studywith a total of 30 clinical samples previously obtained from stool samples. Following culturing of all the isolates using Lysogenic broth (LB) for 24 hours, the genomic DNA was extracted using CTAB extraction method and the genes amplified by Conventional PCR.The amplicons were analyzed by gel electrophoresis and visualized under UV light.It involved use of both qualitative and quantitave methods to detect the Carbapenemase-resistance genes in E. coli and K. pneumoniae isolates from Mbarara. Results The study found that 5 of 30 isolates were either resistant to NDM or IMP but not both. 3/30 (30%) isolates were resistant to NDM and 2/30 (6.7%) resistant IMP. Therefore, this study recorded a high prevalence of NDM gene than IMP. Conclusion Resistance to carbapenems is on the rise and this is limiting the clinical management of infections caused by Enterobacteriaceae by physicians in Uganda. Therefore, there is a need for antibiotic monitoring programs before the situation exacerbates.
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    Carriage of ndm & imp carbapenem resistance genes among e. Coli & k. Pneumoniae in human stool isolates from Mbarara hospital
    (Makerere University, 2022-03) Asingwire, Sheldon
    Escherichia coli and Klebsiella pneumoniae have become intrinsically resistant to many types of β-lactamase due to the emergence of organisms carrying NDM and IMP genes(Liang et al., 2020). Carbapenems, among the beta-lactams, are the most effective agents for the treatment of severe infection caused by ESBL-positive E. coli and K.pneumoniae, and their unique molecular structure is due to the presence of a carbapenem together with the beta-lactam ring(Sen and Joshi, 2016). Resistance to carbapenems occurs due to the production of carbapenemases, a class of enzymes capable of hydrolyzing carbapenems and other β-lactams; the other mechanisms can be by the poor binding of carbapenems to penicillin-binding proteins present in the bacteria, lack of porins present in the bacterial cell membrane, and overexpression of multidrug efflux pumps by the bacteria(Dong et al., 2019). They are classes of enzymes capable of hydrolyzing carbapenems and other β-lactams, including classes A, B, and D. KPCs are the most frequently encountered enzymes in class A carbapenemases. Class B metallo-β-lactamases (MBLs) are mostly of the VIM, IMP, SPM, GM, SIM, and NDM. Class D β-lactamases, also named OXAs, OXA-48, represent the main enzyme isolated around the world(Roach et al., 2020). Objective The objective of the study was to determine the frequency of NDM and IMP carbapenem resistance genes among E. coli and K. pneumoniae isolates from Mbarara Hospital, Uganda. Methods This was a laboratory-based study conducted between December and February 2022, using isolates of E.coli and K. pneumonia from stool samples from Mbarara hospital, Uganda. Results Out of the 32 samples of emulsified stool only 31 grew on LB media and one did not show any growth and was discarded. Of the total of 31 isolates of, three E. coli isolates (9.4%) were positive for NDM gene well positions; 8 (E. coli38), 10(E. coli41) & 14 (E. coli49) meanwhile IMP was detected among two isolates (6.3%) at positions 11(E. coli42) and 18 (E. coli59).
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    Carriage of NDM & IMP Carbapenem resistance genes among E. coli & K. pneumoniae isolates from Mbarara hospital.
    (Makerere University, 2022-03-20) Musisi, Julius
    Background: The increasing prevalence of carbapenem-resistant Enterobacteriaceae strains is related to high mortality and it is increasing around the world. Among the Enterobacteriaceae family, Klebsiella pneumoniae and Escherichia coli are among the most common agents of community- and hospital-acquired infections and have reportedly high incidence of carbapenem-resistance. Thus, the purposes of this work were to estimate the frequency of NDM and IMP carbapenem-resistant genes in K. pneumoniae and E. coli in isolates from Mbarara. Methods: This was a laboratory-based study conducted between December and February 2022, using of isolates of E. coli and K. pneumonia from stool samples from Mbarara, Uganda. NDM and IMP genes were detected using molecular method (PCR) at Molecular Laboratory, Makerere University. Results: We found that the prevalence Carbapenem-resistant E. coli was 15.6%, with NDM contributing 9.4%) and IMP contributing 6.3%. Conclusion: The prevalence of NDM and IMP is high. This is a great public health concern. We should comply with measures for controlling infection.
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    Carriage of ndm & imp carbapenem resistance genes among e. coli & k. pneumoniae isolates from Mbarara.
    (Makerere University, 2022-01) Jagwe, Paul
    The first reports of carbapenem resistance in Enterobacteriaceae isolates occurred in the early 1990s. Researchers published the first report of an isolate that produced Klebsiella pneumoniae carbapenemase in 2001. Antimicrobial resistance has become one of the greatest threats to public health, with rising resistance to carbapenems being a particular concern due to the lack of effective and safe alternative treatment options. The emerging spread of carbapenemase-producing Enterobacteriaceae strains, in particular, Klebsiella pneumoniae and Escherichia coli, has become a significant threat to hospitalized patients. Carbapenemase genes are frequently located on plasmids that can be exchanged among clonal strains, increasing the antibiotic resistance rate. Colistin and tigecycline have been used as first-line agents for the treatment of infections caused by these pathogens; however, there are uncertainties regarding their efficacy even when used in combination with other agents. More recently, several new agents with activity against certain carbapenem-resistant pathogens have been approved for clinical use or are reaching late-stage clinical development. They include ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, plazomicin, eravacycline, and cefiderocol. In addition, fosfomycin has been redeveloped in a new intravenous formulation. This study aimed to determine the prevalence of NDM and IMP carbapenem resistance genes among E.coli and K.pneumoniae isolates from Mbarara. An investigation of the antibiotic resistance and genetic features of circulating carbapenemase-producing E.coli and K.pneumoniae was carried out. Phenotypic tests and molecular typing were performed on 32 carbapenemase-producing strains of K. pneumoniae and E. coli isolates. Carbapenem-resistance was confirmed by PCR detection of resistance genes. All strains were first cultured and incubated at 37◦C overnight. Genomic DNA was extracted using the CTAB extraction method from the cultured isolates and a conventional PCR was done for the detection of resistant Genes. More than 50% of the strains were found to be multidrug-resistant, and the bla KPC gene was detected in all the isolates except an E. coli strain. According to this study, 5 isolates (16.7%) in total were producers of either NDM or IMP genes. However, none of the isolates were producers of both genes This study highlights the importance of screening patients upon their admission to limit the spread of carbapenem-resistant Enterobacteriaceae in hospitals.
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    Carriage of NDM & IMP Carbapenem resistance genes among Escherichia coli & Klebsiela pneumoniae human isolates from Mbarara
    (Makerere University, 2022-01) Afimani, Sammy
    Introduction Carbapenem, a β-lactam that is really potent against Gram- negative bacteria, has been recognized as a last resort for treating of infections caused by multidrug-resistant bacteria. However, the increasing number of carbapenem-resistant Enterobacteriaceae (CRE) is unexpected despite infection control efforts, and it poses a great challenge to clinics worldwide. This study was conducted to determine the prevalence of Carbapenem resistant Escherichia coli and Klebsiella pneumoniae from clinical isolates from Mbarara. Methodology This was a cross-sectional study with a total of 30 clinical samples previously obtained from stool samples. Following culturing of all the isolates using Lysogenic broth (LB) for 24 hours, the genomic DNA was extracted using CTAB extraction method and the genes amplified by Conventional PCR. The amplicons were analyzed by gel electrophoresis and visualized under UV light. Results The study found that 5 of 30 isolates were either resistant to NDM or IMP but not both. 3/30 (30%) isolates were resistant to NDM and 2/30 (6.7%) resistant IMP. Therefore, this study recorded a high prevalence of NDM gene than IMP. Conclusion Resistance to carbapenems is on the rise and this is limiting the clinical management of infections caused by Enterobacteriaceae by physicians in Uganda. Therefore, there is a need for antibiotic monitoring programs before the situation exacerbates.
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    Carriage of NDM and IPM carbapenem resistance genes among E.coli and K.pneumoniae isolates from Mbarara
    (Makerere University, 2022-03) Kibuuka, Augustine
    Background: The increasing prevalence of carbapenem-resistant Enterobacteriaceae strains is related to high mortality and it is increasing around the world. Among the Enterobacteriaceae family, Klebsiella pneumoniae and Escherichia coli are among the most common agents of community- and hospital-acquired infections and have reportedly high incidence of carbapenem-resistance. Thus, the purpose of this work was to estimate the frequency of New Delhi metallo-lactamase(NDM) and Imepenemase metallo beta lactamase(IMP)carbapenem-resistant genes in K. pneumoniae and E. coli in human stool isolates from Mbarara. Methods: This was a laboratory-based study conducted between December and February 2022, using of isolates of E. coli and K. pneumonia from human stool samples from Mbarara, Uganda. Delhi metallo-lactamase (NDM) and Imepenemase metallo beta lactamase (IMP) genes were obtained following culture of isolates using lysogenic broth(LB) for 24hours, DNA was extracted using CTAB extraction method genes detected using molecular method polymerase chain reaction (PCR) and amplicons were analysed by gel electrophoresis and visualized under uv light at Molecular Laboratory, Makerere University. Results:We found that the prevalence Carbapenem-resistant E. coli was 15.6%, with NDM contributing 9.4%) and IMP contributing 6.3%. Conclusion:The prevalence of NDM and IMP is high. This is a great public health concern. For this agent with limited treatment options. There is urgent need for monitoring programs to prevent emergency and further spread of resistance genes and further studies should be done to determine other genes associated with Carbapenem resistance among other organisms. This will provide sufficient data to enable comparability of results across different organisms and sites.