School of Biosecurity, Biotechnolgy and Laboratory Sciences (SBLS) Collection

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https://dissertations.mak.ac.ug/handle/20.500.12281/6445

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    Antimicrobial susceptibility and risk factors associated with bacterial post-operative surgical site infections in obstetrics and gynaecology patients at Naggalama Hospital, Uganda
    (Makerere University, 2024) Acen, Beatrice Gloria.
    Background: Surgical site infection (SSI) is one of the nosocomial infections that threatens health systems. The aim of this research was to determine antimicrobial susceptibility, biosafety considerations and risk factors associated with bacterial post-operative SSI in obstetrics and gynaecology patients. Despite the efforts put in place to minimize incidence of surgical site infections through sterilization of equipment, disinfection of theater surfaces, aseptic surgical techniques, antimicrobial prophylaxis; post-operative surgical site infections still and is continuing to cause burden in health care units evidenced by increased cases of mortality, costs of treatment and length of hospital stays. These may be due to several risk factors associated with post-operative surgical site infection and on the other hand, the existence of additional measures such as the availability of personal protective equipment and training among healthcare staff are factors that can contribute for reducing risk factors of contamination and spread of pathogens. Some of isolated bacteria are resistant to antibiotics including multi-drug resistant (MDR) strains which can be a burden globally. Methodology: A cross-sectional study was conducted at Naggalama hospital over a four-month period. The study involved mothers that were admitted and underwent obstetric and/or gynecological operation at Naggalama hospital. Results: One hundred twenty-four (124) women were enrolled in the study, majority in age group of 17-25 years. 98.4% of patients underwent obstetrics procedures with only 1.6% gynecological procedures. 96.8% were caesarean section and 96.1% of patients had emergency procedures. Mean estimated blood loss during operation was 335.7±130.2 ml. Prevalence of SSI was 20.97% and risk factors associated with surgical site infection were; level of education, P value = 0.017 (AOR 0.064, 95%CI 0.007-0.61), availability of medicines from the hospital pharmacy, P value = 0.017 (AOR 9.851, 95% CI 1.5-64.69). Referral patients, P value = 0.011 (AOR 0.115, 95% CI 0.022-0.61). Increase in the amount of blood loss during operation, p value = 0.011 (AOR 1.009, 95% CI 1.002-1.016). Increase in the number of baths per day, p value = 0.024 (AOR 0.152, 95% CI 0.029-0.783). The commonest isolated bacteria were S. aureus (33.3%) followed by K. pneumonia (20%) and E. coli (16.7%). Resistance to, Oxacillin and Tetracycline among Enterobacteriaceae. E. coli showed 80% resistance Ceftazidime-clavulanic as most K. Pneumoniae were susceptible (80%). Except Ciprofloxacin for E. coli, K. pneumoniae and E. coli were susceptible to Imipenem, Ciprofloxacin, Chloramphenicol and Gentamycin. S. aureus showed susceptibility to Imipenem, Vancomycin, Ceftazidime-Clavulanic acid, Tetracycline and Chloramphenicol. Most bacteria were multi drug resistant. Ampicillin was completely ineffective against all bacteria isolated. Antibacterial options for SSI are; Gentamycin, Ciprofloxacin, imipenem, chloramphenicol, Ceftazidime-clavulanic acid, Vancomycin, Chloramphenicol and Tetracycline. In addition, the biosafety considerations are required to protect the healthcare workers and the patients from exposure to infectious agents. Biosafety procedures such as putting on personal protective equipment, disinfection of surgical materials, ensuring aseptic surgical procedure were observed by medical practitioners and use to standard operating procedures. In some wards, patients with septic cases were isolated in the “septic room” to separate them from those without sepsis but in other wards it wasn’t observed. Recommendations: Due to high burden of SSI, it greatly threatens maternal child health, this calls for improvement of appropriate infection prevention and control measures and need for regular training on biosafety procedures. More studies are required to explore the level of bacterial contamination of theater and ward fomites as well as level of bacterial contamination of air in the operating theaters. At laboratory level, the government and hospital administration should enforce and regularly monitor the storage and/or disposal of bio materials such as bacterial cultures since some contains potentially drug resistant bacterial strain that can pose serious biological threat to the environment and the population. Further studies are also required to explore into the biosafety and biosecurity status in clinical settings. Patients should be offered appropriate advice on how to maintain personal hygiene and they should be made aware of the relevance of adhering to recommended medications with emphasis on timeliness of antibiotic therapy post-operation and completion of dose.
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    Prevalence of dyslipidemia and its associated risk factors among HIV patients on antiretroviral therapy attending Mbarara Municipal Council Health Centre IV
    (Makerere University, 2022) Itinot, Patricia Belinda
    The development of antiretroviral drugs and subsequent access to combined antiretroviral therapy contributes to the decline in morbidity and mortality rates associated with AIDS, resulting in an increased life expectancy and improved quality of life for people living with HIV. However, a cluster of metabolic derangements such as dyslipidemia is increasing, especially for those on ART. The aim of the study was to determine the prevalence of dyslipidemia and its associated risk factors among HIV patients taking ART attending Mbarara Municipal Council Health Center IV.
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    Prevalence of gestational diabetes mellitus and associated risk factors in women attending Stopes Hospital and Maternity, Lugogo, Kampala
    (Makerere University, 2023) Kasanvu, Anthony
    Diabetes mellitus (DM) is a chronic disease in which the required amount of insulin is not produced by the body or insulin is not properly used by the body, resulting in excessively high blood sugar (glucose) levels which is a common condition among pregnant women. A total of participants; N=194 pregnant women were enrolled into the study and 17(8.8%) had GDM. The mean age of study participants was 28.90 (SD 4.55) years; range 19 to 44 years. The results confirmed age 30 to 32 years, 36 to 38 years and 39 to 41, literate, multiparty with more than 5 live children, and second trimester pregnancy as independent risk factors for GDM prevalence. The age group 30 to 32 years and 36 to 38years showed a positive correlation with abnormal results for gestational diabetes mellitus at at 2.8% OR 0.25 [95%CI -1.80-2.31] Pvalue0.001*.15.4% OR 2.01[95% CI 0.42-3.61] P value0.025*, and 50.0% OR 11.67 [95%CI 9.64-13.70] P value0.001*relatively.
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    Ascaris lumbricoides occurrence and risk factors among children (0-15 years) attending Bugembe HCIV, Jinja City
    (Makerere University, 2025) Kayiira, Joel
    This study aimed to assess the prevalence of Ascaris lumbricoides infection and identify the social, demographic, and environmental factors associated with the infection among children aged 0–15 years attending Bugembe Health Centre IV in Jinja City, Uganda. The findings revealed that 38% of the children tested positive for Ascaris lumbricoides, indicating a relatively high burden of infection in the area. This level of prevalence is comparable to similar studies done in Tanzania and Rwanda but higher than those found in other regions of Uganda. The results also showed that children under five years of age were more likely to be infected compared to older children. Male children had a higher infection rate than females, and children whose caregivers were male or had no formal education were significantly more affected. Environmental and behavioral factors such as not having access to a toilet, failure to wash hands with soap before meals, and after using the toilet were also strongly linked to the presence of infection. These findings suggest that both biological vulnerability and poor household sanitation contribute to the spread of Ascaris lumbricoides among children. The results support earlier research from other low-resource settings, which also identified lack of education, overcrowding, and poor hygiene as key risk factors. The study concludes that in order to reduce the prevalence of Ascaris lumbricoides infection in this population, it is essential to improve access to clean water, sanitation facilities, and promote hygiene education. Regular deworming programs should also be strengthened, particularly targeting younger children and households with lower levels of education and poor sanitation. Without addressing these underlying issues, children in this community will remain at high risk of infection, which may affect their growth, development, and overall well-being.
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    Prevalence of hypertension and its risk factors among Type II Diabete Mellitus patients attending Mayuge District Health Centre IV, Mayuge District
    (Makerere University, 2026) Ntale, Ivan Budhugo
    Hypertension is one of the most prevalent non-communicable diseases and a leading cause of premature mortality worldwide. Its co-existence with diabetes mellitus significantly increases the risk of cardiovascular events and death. This study aimed to determine the prevalence of hypertension and associated factors among individuals with type II diabetes mellitus among patients attending Mayuge Health Centre IV in Mayuge District Eastern Uganda. A cross-sectional study was conducted from February to June 2025 involving 315 individuals aged 18 years and above with type II diabetes mellitus, who were receiving care at Mayuge District Health Centre IV in Mayuge District. Participants were selected using a systematic random sampling method. Data were collected using the WHO STEPS survey tool for non-communicable diseases and analyzed using version 27 of SPSS. A multiple logistic regression model was employed to estimate odds ratios (OR) and 95% confidence intervals (CIs) for factors associated with hypertension, adjusting for demographic, behavioral, and clinical characteristics. Among the 315 respondents, the mean age was 58.62 ± 10.8 years, and 58.4% were female. The prevalence of hypertension was 55.2%, and it was independently associated with older age—specifically, individuals aged 60–69 years (OR = 2.75, 95% CI: 1.14–6.64, p = 0.02) and those aged 70 years or older (OR = 5.61, 95% CI: 1.65–19.04). Additional significant associations included a history of cigarette smoking (OR = 3.98, 95% CI: 1.25–12.72) and a history of ischemic heart disease (OR = 16.86, 95% CI: 2.03– 140.3). The finding that over half of individuals with diabetes had co-existing hypertension highlights the need for routine and regular blood pressure monitoring in diabetic clinics. Particular attention should be directed toward older adults (≥60 years), smokers, and those with a history of ischemic heart disease to facilitate early prevention and effective management of complications related to both diabetes and hypertension.