Browsing by Author "Baguma, Steven"

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    Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital: A Retrospective Study
    (Frontiers in public health, 2022-04-11) Baguma, Steven; Okot, Christopher; Apiyo, Paska; Oloya, Johnson Nyeko; Aloyo, Judith; Kitara, David Lagoro
    The advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021. This was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined. Of the 664 patients treated, 661 (99.5%) were unvaccinated, 632 (95.2%) recovered and 32 (4.8%) died. Mortality was highest in diabetics 11 (34.4%), cardiovascular diseases 12 (37.5%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059–0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726–47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187–6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009–0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007–0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270–0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309–35.957; p = 0.020. The overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide “additional social protection” to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.
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    Pioneering endoscopic retrograde cholangiopancreatography in a Sub Saharan African hospital: A case series
    (International Journal of Surgery Open, 2018) Okello, Michael; Tumusiime, Gerald; Nabimanya, Viola; Baguma, Steven; Ocama, Ponsiano
    Background and study aims: Although endoscopic retrograde cholangiopancreatography (ERCP) was introduced in Europe, Asia and America over four decades ago, East Africa and Africa as a whole has been slow in taking up this very important minimally invasive procedure for the management of various hepatopancreaticobiliary conditions. This has led to reliance on open surgery for even simple benign biliary strictures, stones and malignant causes of biliary and pancreatic duct obstruction that can be treated endoscopically without a need for a morbid open surgical intervention. In Uganda, ERCP was introduced in January 2017 after obtaining training and equipment support from Senior Experten Service (SES), German. We therefore report the first six cases of ERCP performed at our endoscopy unit. Patients and methods: This is a case series report of six patients referred with yellowing of eyes and body itching as the main complaints. They predominantly had raised gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin and direct bilirubin. They also had different imaging investigations demonstrating hepatic ducts dilatation. Results: Four out of the six patients had complete post ERCP symptom resolution. One patient had partial symptom resolution and the other patient recovered after conversion to open surgery. Conclusion: Collaborative skills transfer made ERCP feasible in our institute and this marked the start of this specialised service in Uganda.