School of Medicine (Sch. of Med.) Collection
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ItemSexual reproductive health experiences, and service needs of adolescent girls and young women with sickle cell disease at Mulago Hospital(Makerere University, 2026)Sickle cell disease (SCD) affects multiple aspects of Adolescent girls and Young Women’s (AGYW) lives, yet their sexual and reproductive health (SRH) is often overlooked.Significant physical, and psychological outcomes are associated with neglected sexual reproductive health.There is limited data on the SRH of AGYW with chronic diseases including sickle cell disease in Uganda. Objective: To explore the sexual and reproductive health experiences and assess the reproductive health service needs of adolescent girls and young women with SCD attending Mulago Hospital. Methods: A parallel convergent mixed-methods study design was used. Quantitative data were collected from 368 AGYW with SCD using a survey questionnaire adapted from the World Health Organization’s illustrative questionnaire for interview surveys with young people. Qualitative data were collected using in-depth interviews (IDI) with 26 AGYW and Key informant interviews (KIIs) with six health care providers. Quantitative data were analyzed using STATA version 17 and summarized using frequencies and percentages. Qualitative data were analyzed using content thematic approach. Results: Among the 368 participants, N=278 (76.6%) were aware of the growth and developmental changes which occur at puberty. N=218 (59%) attained thelarche above 15 years, N=299 (82.1%) perceived their thelarche delayed when compared to their peers without sickle cell disease, N=204 (55%) perceived themselves shorter and n=253 (68%) perceived themselves smaller in weight and hip size. For menstrual experiences; 29 (7.8%) participants had never had menarche, late menarche was reported by N=235 (75.5%) and painful crises during menstruation N=156 (46.7%).Overall, 121 (33.06%) reported sexual activity; N= 63 (17.4%) reported sexual abuse experiences, N=296 (80.4%) had never been screened for HIV and only N=97 (26.7%) had received HPV vaccination. Pregnancy experiences were reported by 47 (38.8%) among those who were sexually active, during pregnancy; N=30 (63.8%) had anemia, N=26 (55.3%) painful crises, preterm births N=22 (46.8%), Still births N=10 (21.2%), spontaneous abortions N=24 (51.1%).Key positive SRH experiences included; support from family members and friends, the joy of motherhood, supportive institutions( school and health). Negative experiences were predominant and they included; poor body image, anxiety due to delayed puberty, shortened life expectancy influenced sexual behaviours, societal stigma, and intimate partner violence while menstrual experiences were characterized by painful crises. Pregnancy experiences were marked by poor outcomes, pregnancy complications, unintended pregnancies, limited psychosocial support and infertility. Nearly all respondents expressed a desire for adolescent responsive SRH services to be integrated within routine sickle cell care. Services such as comprehensive SRH information (99.4%), STI screening and testing (99.46%). Conclusions and Recommendations: The shared sexual and reproductive health experiences of AGYW living with SCD were predominantly negative, with significant gaps in care accounting for the high proportion of unmet SRH service needs. Health systems should integrate adolescent-appropriate SRH services into routine sickle cell care, improve menstrual health management and strengthen psychosocial support systems.
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ItemAssessment of knowledge and awareness on MRI safety among patients undergoing MRI examinations at Mulago National Referral Hospital(Makerere University, 2025)BACKGROUND: Magnetic Resonance Imaging (MRI) is a crucial diagnostic tool, yet patient awareness and knowledge regarding its safety protocols remain limited. This study aimed to assess the knowledge and awareness of MRI safety among patients undergoing MRI examinations at Mulago National Referral Hospital. METHODS: A cross-sectional survey was conducted on 110 participants scheduled for MRI scans. Data was collected using structured questionnaires adopted from (patients’ perceptions and attitudes towards MRI safety in Asir Region, Saudi Arabia) to assess participants' understanding of MRI safety procedures, patient preparation guidelines, awareness of MRI zones, and knowledge of MRI-related risks such as the effects of contrast agents and radiation. RESULTS: The majority of participants (66.4%) were female, and just 4.5% had prior MRI experience. There was low knowledge about MRI safety procedures, with just 16.4% being knowledgeable about safety procedures. Knowledge regarding types of radiation and MRI compatible equipment was poor. However, 79.1% were aware of the need for screening of family members, and 67.3% were aware of MRI scanner noise, though awareness of the risks involved with contrast agents and pregnancy was low. DISCUSSION: These findings illustrate significant deficits in teaching patients regarding MRI safety, such as unfamiliarity with MRI zones, radiation types, and MRI-compatible devices. While some participants understood some basics of safety procedures, such as screening family members, further teaching is required. Further educational efforts are needed to give more comprehensive knowledge of MRI safety. CONCLUSION: This study underscores the importance of enhancing patient education on MRI safety to reduce risks and improve the safety of MRI procedures. A more informed patient population will contribute to a safer healthcare environment and a better understanding of the MRI process.
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ItemKnowledge and attitudes of fourth year medical students at Makerere University towards MRI and its role in breast cancer screening(Makerere University, 2025)INTRODUCTION: Breast cancer is a growing health risk in Uganda, with rising incidence and limited screening. MRI is a sensitive modality reserved for high risk individuals, but its use is not well established in the country. This study is meant to assess the knowledge and attitudes of medical students regarding MRI and its role in breast cancer screening. RESEARCH AIM:To evaluate whether there is a need for more facilitation and education regarding MRI and its role in Breast Cancer screening among medical students. METHODS: This was a cross sectional quantitative study among the year 4 medical students in the 2024/2025 academic year. Data was collected using a questionnaire consisting of 52 questions divided into five sections. A combination of stratified, snowball sampling was used. The estimated study sample size is 148 as by Raosoft sample size calculator with a confidence interval of 95%. The participants were recruited by physically or online. Descriptive and inferential statistics were applied to analyze the data. Microsoft Excel was applied in analysis of data. RESULTS AND CONCLUSION: The study demonstrates that the students have limited knowledge on MRI breast screening guidelines. However, they have fairly good knowledge on breast cancer risk factors. Good knowledge was also noted about MRI as a modality. There was appositive attitude towards the screening. There is therefore a knowledge gap that needs to be covered. This may be done through seminars, workshops, lectures and whatever possible way. Given the increasing breast cancer (BC) cases in Uganda, it would reflect also an increase in potentially high risk BC patients who are best evaluated with MRI. This would foster earlier detection of disease.
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ItemKnowledge, attitudes and perception of medical radiography students in Makerere University towards the implementation of artificial intelligence (ai) in medical radiology imaging.(Makerere University, 2025-05)Background As the science of artificial intelligence (AI) continues to grow, there is an increasing adoption across medical practices worldwide. The increasing use of AI in medical imaging has created worldwide interest about its effects on radiological practice and education. The workforce implications of AI in radiography remain unclear especially for low-resource settings such as Uganda. The future practitioners who will work with AI need to be understood because they represent the student population of radiography. The situation demands research into how radiography students view AI. Objective To explore the knowledge, attitudes, and perceptions of medical radiography students in Uganda regarding the implementation of AI in medical radiology imaging. Methods A qualitative study was conducted among medical radiography students at Makerere University in two focus group discussions to explore their views on AI in medical radiology imaging. Open-ended questions were used as a guide in both FGDs and the recorded audios were transcribed and analyzed using thematic analysis to identify similar patterns in the students’ responses. Results Most students showed large learning gaps and limited exposure to AI technologies. However, they recognized AI’s potential for improvements in image quality, diagnostic speed, and workflow efficiency. Respondents cited ethical considerations such as data protection, algorithmic bias and trust and feared replacement by AI though some felt that human expertise would remain essential. Even an overreliance on AI could potentially affect patient–provider relationships. Limited infrastructure, high costs, and insufficient local expertise or training resources to support AI systems were the cited barriers to AI implementation. All participants strongly expressed the need to integrate AI topics into the radiography curriculum to prepare them for an AI-augmented workplace and their future career advancements. Conclusion While AI can improve radiological services, there are concerns about ethics, jobs, and patient interaction highlight the human factors that cannot be overlooked. Equipping students with AI-related competencies and ensuring adequate resources will empower future radiographers to confidently and safely work alongside AI.
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ItemCommunication difficulties in adults with stroke at the Neurology Ward at Mulago National Referral Hospital(Makerere University, 2025)Stroke is a focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide (Murphy & David, 2020). Globally, stroke is a leading cause of long-term disability worldwide, with communication difficulties being one of the most common and debilitating sequelae. Approximately one-third of stroke survivors experience aphasia, a language disorder that affects the ability to speak, understand, read, and write (Stefan T. Engelter, et al., 2019). Between 2000 and 2010, the relative rate of stroke deaths dropped by 35.8% in the United States. However, each year stroke affects nearly 800,000 individuals, with many survivors experiencing persistent difficulty with daily tasks as a direct consequence. More than two thirds of stroke survivors receive rehabilitation services after hospitalization (Carolee J. Winstein, et al., 2016). Communication difficulties, including aphasia and dysarthria, are among the most common and debilitating consequences of stroke, affecting up to 40% of stroke survivors (Berthier, 2005). Aphasia, a language disorder that impairs the ability to speak, understand, read, and write, occurs in approximately 21-38% of stroke cases, while dysarthria, a motor speech disorder, affects 20-30% of stroke survivors (Brady, et al., 2016). In Africa, the continent has one of the highest stroke mortality rates globally, with stroke accounting for 5.5% of all deaths in sub-Saharan Africa (SSA) (Kengne & Anderson, 2016). Communication difficulties in stroke survivors are often overlooked in African healthcare systems, where the focus is primarily on acute stroke management and physical rehabilitation (Urimubenshi, et al., 2018). Studies in sub-Saharan Africa highlight the significant impact of stroke-related communication impairments on patients' ability to reintegrate into their communities and resume their social roles (Kengne & Anderson, 2016). Africa faces a growing burden of stroke due to rapid urbanization, lifestyle changes, and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity (Owolabi, et al., 2015). In East Africa, communication difficulties in stroke survivors are often compounded by cultural and linguistic diversity, which can complicate diagnosis and treatment. (Mushi, Burton, & Mtuya, 2011). In Tanzania, for example, a study found that stroke survivors with aphasia faced significant social isolation and stigma, further exacerbating their condition (Miller, et al., 2014). Similarly, in Kenya, the lack of specialized speech and language therapists has been identified as a major barrier to effective stroke rehabilitation (Peter, 2021). In Uganda, stroke is estimated to be the sixth highest ranking cause of death. The consequences of stroke on the persons' daily lives clearly reach beyond the person with stroke, affecting the whole family and their proximate social networks (Linda, et al., 2023). Communication-related difficulties may manifest as cognitive, language and/or speech impairments. Language impairments, such as aphasia, occur in an estimated 30% of persons affected with stroke (Martino, et al., 2013). This condition affects people’s ability to understand and/or use language for communicative purposes. Speech impairments, which can manifest as poor speech intelligibility, often include dysarthria, occurring in approximately 42% of stroke cases (Martino, et al., 2013)