NRU :: Browsing by Author "Baingana, Rhona"

Browsing by Author "Baingana, Rhona"

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A Consortium Approach to Competency‑based Undergraduate Medical Education in Uganda: Process, Opportunities and Challenges
(Educ Health, 2014) Kiguli, Sarah; Mubuuke, Roy; Baingana, Rhona; Kijjambu, Stephen; Maling, Samuel; Waako, Paul; Obua, Celestino; Ovuga, Emilio; Kaawa‑Mafigiri, David; Nshaho, Jonathan; Kiguli‑Malwadde, Elsie; Bollinger, Robert; Sewankambo, Nelson
Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non‑communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda’s disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency‑based medical education (CBME).
Developing hospital accreditation standards in Uganda
(The International journal of health planning and management, 2016) Galukande, Moses; Katamba, Achilles; Nakasujja, Noeline; Baingana, Rhona; Bateganya, Moses; Hagopian, Amy; Barnhart, Scott; Luboga, Sam; Tavrow, Paula
Whereas accreditation is widely used as a tool to improve quality of healthcare in the developed world, it is a concept not well adapted in most developing countries for a host of reasons, including insufficient incentives, insufficient training and a shortage of human and material resources. The purpose of this paper is to describe refining use and outcomes of a self-assessment hospital accreditation tool developed for a resource-limited context. Methods We invited 60 stakeholders to review a set of standards (from which a selfassessment tool was developed), and subsequently refined them to include 485 standards in 7 domains. We then invited 60 hospitals to test them. A study team traveled to each of the 40 hospitals that agreed to participate providing training and debrief the self-assessment. The study was completed in 8 weeks
Effect of maternal Helicobacter Pylori infection on gestational weight gain in an urban community of Uganda
(The Pan African Medical Journal, 2017) Wanyama, Ronald; Obai, Gerald; Odongo, Pancras; Kagawa, Michael; Baingana, Rhona
Maternal Helicobacter pylori (H. pylori) infection has been associated with undesirable effects during pregnancy such as; hyperemesis gravidarum, anemia, intrauterine fetal growth restriction and miscarriage. Our aim was to document the effect of H. pylori infection on gestational weight gain (GWG) in a low-income urban setting in Uganda. Methods: This was a prospective cohort study conducted in Kampala between May 2012 and May 2013. The participants were HIV negative, H. pylori positive and H. pylori negative primigravidae and secundigravidae. Recruitment was at gestation age of eighteen or less weeks and follow up assessments were carried out at 26 and 36 weeks gestation age. H. pylori infection was determined using H. pylori stool antigen test. Maternal weight and height were measured, and body mass index (BMI) and rates of GWG were calculated. Results: The participants’ mean±standard deviation (sd) age was 20.9±2.7 years. Primigravidae were 68.8% (n = 132) and 57.3% (n = 110) of the participants were positive for H. pylori infection. Low pre-women pregnancy BMI (< 18.5 kg/m2) was recorded in 14.6% (n = 28). The mean±sd rate of GWG during second and third trimesters was 300.5±79.7 grams/week. The mean±sd weight gained by 36 weeks of gestation was 9.6±2.2 kg while gestation age at delivery was 39.4±1.0 weeks. Factors independently associated with the rates of GWG during the second and third trimesters were parity (P=0.023), H. pylori infection (P = 0.006), pre-pregnancy BMI (P = 0.037), height (P = 0.022) and household income (P = 0.003). Conclusion: H. pylori infection is associated with low rates of GWG among primigravidae and secundigravidae.
High Schistosoma mansoni infection intensity is associated with distinct gut microbiome and low levels of systemic cytokines in children along the Albert-Nile, Northern Uganda
(Research Square, 2024) Mulindwa, Julius; Lujumba, Ibra; Musiime, Caroline; Namulondo, Joyce; Magambo, Phillip Kimuda; Nyangiri, Oscar; Gloria, Cuu; Mwubaha, Caroline; Tukwasibwe, Stephen; Ssemaganda, Aloysious; Ssewanyana, Isaac; Nerima , Barbara; Baingana, Rhona; Harry, Noyes; Annette, MacLeod; Matovu, Enock
Background Schistosomiasis is a chronic neglected disease that affects millions of people in sub Saharan Africa, with a range of impacts on both host immune responses and the gut microbiome. The gut microbiota plays a fundamental in role in the host’s nutrition, metabolism, protection against pathogens, and modulation of host immunity. There is a need to understand the role of the gut microbiome in pathophysiology of Schistosoma mansoni infection and how this influences the host’s immune response. Methodology: A cross sectional study was carried out on 140 faecal samples collected from school children aged 10-15years residing in the schistosomiasis endemic hot spots of the Albert-Nile, Pakwach district, Northern Uganda. The samples were categorised by S. mansoni infection intensity based on the Kato Katz test. Faecal DNA was isolated and microbiome composition was determined by 16S rRNA V3-V4 sequencing. Plasma Th1/Th2 profiling of 13 cytokines was carried out on the Luminex platform and compared with respect to S. mansoni infection intensities. Results The genera Phascolarctobaterium and Prevotella_7 were significantly enriched (padj < 0.05, LDA > 3.0) in the high S. mansoni infection intensity group whereas, Ruminobacter and Alloprevotella were enriched in the Low infection intensity group. We observed significantly lower systemic Th1/Th2 cytokine levels between the high intensity infection and the control samples (padj < 0.05). Linear regression analysis using all cytokines as covariates showed that the genus Alloprevotella, Streptococcus, Gastranaerophilales and Ruminobacter were associated with systemic IL6 response. Conclusion There are alterations in the gut microbiome of S. mansoni infected children with distinct genera that discriminate the high and low infection intensity that could be potentially used as biomarkers. There is an association between the gut microbiome and systemic cytokine response whose mechanism in chronic disease pathophysiology can be further investigated.
A situation analysis of inter‑professional education and practice for ethics and professionalism training at Makerere University College of Health Sciences
(BMC research notes, 2015) Byakika‑Kibwika, Pauline; Kutesa, Annet; Baingana, Rhona; Muhumuza, Christine; Kitutu, Freddy Eric; Mwesigwa, Catherine; Nabirye Chalo, Rose; Sewankambo, Nelson K.
Students at Makerere University College of Health Sciences (MakCHS) are introduced to ethics and professionalism using the inter-professional education (IPE) model. Ethics and professionalism should be running themes throughout succeeding years of study during which students are expected to develop qualities and skills for future inter-professional practice (IPP). We performed a situation analysis of IPE and IPP among students and teaching health professionals at MakCHS to guide development of a relevant training curriculum of ethics and professionalism. Methods: A cross sectional study with quantitative and qualitative methods which included questionnaires, focus group discussions and key informant interviews. Results: We interviewed 236 undergraduate students (148, 63 % male) and 32 teaching health professionals (25, 78 % male). Two hundred fifteen (91 %) students indicated they had joint learning activities with students of other professions and 166 (70 %) stated there was benefit in having an IPE model training curriculum. Most students (140, 59 %) strongly agreed that learning with other students will make them more effective members of the health team. Whereas the respondents reported inter professionalism as being well articulated in their course curricula, more than half said IPE is only implemented in the pre-clinical years of study. They noted that IPE and IPP concepts were not well programmed, health professionals engaged in teaching had poor attitudes towards IPE and IPP, there were limited numbers of skilled health care workers to implement IPP and there was poor communication between students and teaching health professionals. Majority of teaching health professionals noted challenges in implementation of IPE such as poor coordination and large student population and major factors influencing ethics and professionalism in healthcare such as limited government support, low pay for the health care workers, disrespect and lack of appreciation of the health workers by the public. Conclusions: Our findings demonstrate that IPE, IPP, ethics and professionalism are not emphasized in the clinical years of study at MakCHS. We recommend increased sensitization on the concepts of IPE and IPP plus enhanced mentorship for both students and teaching health professionals. Innovative strategies of implementation of IPE and IPP for training in ethics and professionalism must be introduced.
Value Chain Hygiene Practices and Microbial Contamination of Street and Market Vended Ready-to- Eat grasshopper, Ruspolia differens in Uganda: Implications for food safety and public health
(Research Square, 2022) Rutaro, Karlmax; Hawumba, Joseph; Nakimuli, Jane; Mulindwa, Julius; Malinga, Geoffrey M.; Baingana, Rhona
Food safety is a major public health issue, particularly in developing countries. Ready-to-eat street-vended foods contribute to daily dietary life, but with elevated food safety burden. Here, hygiene and food safety practices as well as the microbial contamination in Uganda's edible grasshopper value chain was evaluated. Methods This was a cross-sectional mixed methods study with both qualitative and quantitative approaches. A face-toface administered questionnaire and observational checklists were used to collect data. A total of 29 households (Kampala; 12 and Masaka; 17) participated, and grasshopper samples collected along the value chain. Indicator pathogens were analysed using standard microbiological methods. Results Sociodemographic characteristics reveal that two-thirds of households in Kampala and 53% in Masaka were female headed. In Kampala and Masaka, respectively, 50% and 12% of households had earth or sand floors. All households in Kampala were one or two-roomed dwellings with no separate room as a kitchen, and shared a toilet compared to 43%, 65% and 53%, respectively, in Masaka. 83% households in Kampala and 56% in Masaka obtained drinking water from public taps. Handwashing was inadequate and none of the actors was observed to wash their hands after taking a break or handling waste. Only 8.3% respondents had raised racks for drying utensils. For vendors, wearing protective clothing was not common, with only 28.5% in Kampala and 30.8% in Masaka wearing an apron. Containers for vending grasshoppers were largely uncovered and the utensils (spoon or cup) for measuring the grasshoppers were left mainly uncovered during the observation period. Indicator organisms, E. coli and Salmonella typhimurium, were detected. E. coli was the most common contaminant, but with lower levels in Masaka compared to Kampala. Salmonella typhimurium was mainly a burden in Kampala. Conclusions Our findings demonstrate that there are enormous contributors to poor hygiene and sanitation along the value chain. The existence of pathogenic bacteria such as E. coli in ready-to-eat foods imply that their consumption pose a health risk. There is an urgent need to create awareness among the actors,through regular trainings on food safety and personal hygiene practices in food handling and inspection to prevent foodborne disease
Value chain hygiene practices and microbial contamination of street and market vended ready-to-eat grasshopper, Ruspolia differens in Uganda: Implications for food safety and public health
(Elsevier Ltd, 2024-02) Rutaro, Karlmax; Hawumba, Joseph; Nakimuli, Jane; Mulindwa, Julius; Malinga, Geoffrey M; Baingana, Rhona
Food safety is a major public health issue particularly in developing countries. Ready-to-eat street-vended foods contribute significantly to dietary intake in urban and peri-urban areas, but with elevated public health risk. In this study, hygiene and food safety practices as well as the microbial contamination in Uganda's edible grasshopper value chain were evaluated.''A total of 29 grasshopper-processing households participated, and grasshopper samples collected. Indicator pathogens were analyzed using standard microbiological methods. In Kampala 50% and in Masaka 12% households had earth floors. All households in Kampala were one or two-roomed dwellings with no separate room as a kitchen, and shared a toilet. In contrast, 59% of households in Masaka had three or more rooms, 35% had a separate room for a kitchen and 47% did not share a toilet. 83% households in Kampala and 56% in Masaka obtained drinking water from public taps. Handwashing was inadequate and none of the actors was observed to wash their hands after taking a break or handling waste. For vendors, wearing protective clothing was not common, with only 28.5% in Kampala and 30.8% in Masaka wearing an apron. Containers for vending grasshoppers were largely uncovered and the utensils for measuring the grasshoppers were left mainly uncovered. Indicator organisms, Escherichia coli and Salmonella typhimurium, were detected. E. coli was the most common contaminant, but with lower levels in Masaka compared to Kampala. S. typhimurium was mainly a burden in Kampala. Our findings demonstrate that there are enormous contributors to poor hygiene and sanitation along the edible grasshopper value chain. The existence of pathogenic bacteria such as E. coli in ready-to-eat foods imply that their consumption poses a health risk.
Variation and Abundance of Resistant Starch in Selected Banana Cultivars in Uganda
(Cross Ref, 2024-09) Kajubi, Ali; Baingana, Rhona; Matovu, Moses; Katwaza, Ronald; Kubiriba, Jerome; Namanya, Priver
The physiochemical, structural, and molecular characteristics of starch influence its functional properties, thereby dictating its utilization. The study aimed to profile the properties and quantity of resistant starch (RS) from 15 different banana varieties, extracted using a combination of alkaline and enzyme treatments. Granular structure and molecular organization were analyzed using light microscopy, scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR). The physiochemical and functional properties were also investigated. RS content ranged from 49% to 80% without significant relationship to amylose (AM) (r = −0.1062). SEM revealed significant microarchitectural differences on the granules potentially affecting granule digestibility. FTIR and chemometrics identified differences in the crystalline peaks, yielding varying degrees of the molecular order of the RS polymers that aid in differentiating the RS sources. Despite similar solubility and swelling profiles, the pasting profiles varied across varieties, indicating high paste stability in hydrothermal processing. Clarity ranged from 43% to 93%, attributed to amylose leaching. This study highlights that RS from bananas varies in quantity, structure, and functionality, necessitating individualized approaches for processing and utilization.

Browsing by Author "Baingana, Rhona"

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