Browsing by Author "Ibingira, Charles"
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Item Automated Validation of Capillary Refill Time Measurements Using Photo-plethysmogram from a Portable Device for Effective Triage in Children(Global Humanitarian Technology Conference, 2011) Karlen, Walter; Pickard, Amelia; Daniels, Jeremy; Kwizera, Arthur; Ibingira, Charles; Dumont, Guy; Ansermino, J. MarkCapillary refill time (CRT) is an important tool for the clinical assessment of trauma and dehydration. Indeed, it has been incorporated into advanced life support guidelines as part of the rapid assessment of critically ill patients. However, digitalized CRT techniques are not readily available and the standard assessment based on the visual inspection of CRT lacks standardization and is prone to a high inter-observer variability. We present an algorithm for the automatic validation of the CRT measurement on the finger using photo-plethysmogram recordings on a small portable device. It is based on a set of deterministic rules for the classification of finger pressure and regular plethysmographic pulses. Validation studies using the classification of 93 pediatric recordings from Canada and Uganda showed that the novel algorithm reliably detects invalid CRT measurements (sensitivity 98.4%). This includes patterns such as insufficient pressure, low perfusion signals, and artifacts. Since our device consists of widely available components already in use, the promising results suggest that the algorithm could be readily integrated in operating rooms and intensive care units around the world. This more robust assessment of CRT would produce a more powerful diagnostic tool for clinical triage in critical care settings.Item A Cross Sectional Study on Knowledge and Attitudes About Organ Donation and Transplantation in an Urban Population in a Low-Income Country(Research Square, 2023) Kituuka, Olivia; Ocan, Moses; Mbiine, Ronald; Ibingira, Charles; Wayengera, Misaki; Tayebwa, MordecaiUganda’s Health Sector Development Plan (2015/16 -2019/2020) noted that most referrals for treatment abroad were for organ transplant services costing government over 5.6 million US dollars. The government of Uganda has invested in building capacity for Organ donation and transplantation services by training human resource and setting up the infrastructure in Kampala where these services can be accessed. However, there is no information on the readiness of communities and the scientific community to embrace (communities) or undertake (science) organ transplantation in the country. We set out to assess Knowledge and Attitudes about organ donation and transplantation among the urban population in Kampala. Methods: We conducted a cross-sectional survey among 395 participants from the urban population of Kampala at Garden City Mall, Wandegeya market and Nakawa market 28th May - 7th June 2021. We asked about knowledge about organ donation and transplantation, collected sociodemographic data and did a sentiment analysis of participants' attitudes towards organ donation and transplantation. Results: The M:F ratio of participants was 1:1, majority (55.9%) of participants were Baganda, two thirds of participants knew about organ donation, 90% of participants did not know of any government policy on organ donation and transplantation. Radio/television was the commonest source of information. The commonest organ donated was the kidney. Overall, there were 94.3% and 93.2% positive sentiments towards organ transplantation and organ donation respectively. The need for stricter laws governing organ donation and transplantation, corruption and fear were the main negative sentiments expressed by participants. Conclusions: Sensitization of the community is required about government policy on organ donation and transplantation, and this should be communicated through radio/television and social media. There was a positive attitude towards organ donation and transplantation.Item Curriculum and training needs of mid-level health workers in Africa: a situational review from Kenya, Nigeria, South Africa and Uganda(BMC health services research, 2018) Couper, Ian; Ray, Sunanda; Blaauw, Duane; Ng’wena, Gideon; Muchiri, Lucy; Oyungu, Eren; Omigbodun, Akinyinka; Morhason-Bello, Imran; Ibingira, Charles; Tumwine, James; Conco, Daphney; Fonn, SharonAfrica’s health systems rely on services provided by mid-level health workers (MLWs). Investment in their training is worthwhile since they are more likely to be retained in underserved areas, require shorter training courses and are less dependent on technology and investigations in their clinical practice than physicians. Their training programs and curricula need up-dating to be relevant to their practice and to reflect advances in health professional education. This study was conducted to review the training and curricula of MLWs in Kenya, Nigeria, South Africa and Uganda, to ascertain areas for improvement.Item Experiences and practices of key research team members in obtaining informed consent for pharmacogenetic research among people living with HIV: a qualitative study(Research Ethics, 2022) Ochieng, Joseph; Kaawa-Mafigiri, David; Munabi, Ian; Nakigudde, Janet; Nabukenya, Sylvia; Nakwagala, Frederick N.; Barugahare, John; Kwagala, Betty; Ibingira, Charles; Twimwijukye, Adelline; Sewankambo, Nelson; Mwaka Sabakaki, ErisaThis study aimed to explore experiences and practices of key research team members in obtaining informed consent for pharmacogenetics research and to identify the approaches used for enhancing understanding during the consenting process. Data collection involved 15 qualitative, in-depth interviews with key researchers who were involved in obtaining informed consent from HIV infected individuals in Uganda for participation in pharmacogenetic clinical trials. The study explored two prominent themes: approaches used to convey information and enhance research participants’ understanding and challenges faced during the consenting process. Several barriers and facilitators for obtaining consent were identified. Innovative and potentially effective consenting strategies were identified in this study that should be studied and independently verified.Item Green synthesis and characterization of iron‑oxide nanoparticles using Moringa oleifera: a potential protocol for use in low and middle income countries(BMC Research Notes, 2022) Kiwumulo, Henry Fenekansi; Muwonge, Haruna; Ibingira, Charles; Lubwama, Michael; Kirabira, John Baptist; Tamale Ssekitoleko, RobertGreen synthesized iron(III) oxide ( Fe3O4) nanoparticles are gaining appeal in targeted drug delivery systems because of their low cost, fast processing and nontoxicity. However, there is no known research work undertaken in the production of green synthesized nano-particles from the Ugandan grown Moringa Oleifera (MO). This study aims at exploring and developing an optimized protocol aimed at producing such nanoparticles from the Ugandan grown Moringa. Results: While reducing ferric chloride solution with Moringa oleifera leaves, Iron oxide nanoparticles ( Fe3O4-NPs) were synthesized through an economical and completely green biosynthetic method. The structural properties of these Fe3O4- NPs were investigated by Ultra Violet–visible (UV–Vis) spectrophotometry, X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX) and scanning electron microscopy (SEM). These nanoparticles exhibited UV–visible absorption peaks at 225 nm (nm) for the sixth dilution and 228 nm for the fifth dilution which indicated that the nanoparticles were photosensitive and the SEM study confirmed the spherical nature of these nanoparticles. The total synthesis time was approximately 5 h after drying the moringa leaves, and the average particle size was approximately 16 nm. Such synthesized nanoparticles can potentially be useful for drug delivery, especially in Low and Middle Income Countries (LMICs).Item A health care professionals training needs assessment for oncology in Uganda(Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, CharlesCancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to downstaging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region. Methods: This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the Open Data Kit platform from which the data was exported to Stata version 15 for analysis using the Wilcoxon signed-rank test and Somers-Delta. Results: There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall, the research and audit domain had the highest ranking for all the health workers (Somers-D = 0.60). The respondent’s level of education had a significant effect on the observed ranking (P value = 0.03). Most of the continuing medical education (CME) topics suggested by the participants were in the clinical task-related category. Conclusion: The “research and audit” domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME programme content, peer support networks and tailored training for the individual health care provider.Item A health care professionals training needs assessment for oncology in Uganda(Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, CharlesCancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to down staging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region.Item Informed consent in clinical practice: patients’ experiences and perspectives following surgery(BMC research notes, 2015) Ochieng, Joseph; Buwembo, William; Munabi, Ian; Ibingira, Charles; Kiryowa, Haruna; Nzarubara, Gabriel; Mwaka, ErisaInformed consent during medical practice is an essential component of comprehensive medical care and is a requirement that should be sought all the time the doctor interacts with the patients, though very challenging when it comes to implementation. Since the magnitude and frequency of surgery related risk are higher in a resource limited setting, informed consent for surgery in such settings should be more comprehensive. This study set out to evaluate patients’ experiences and perspectives of informed consent for surgery. Methods: This was a survey of post-operative patients at three university teaching hospitals in Uganda. The participants were interviewed using guided, semi-structured questionnaires. Patients from different surgical disciplines participated in the study.Item Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting(BMC research notes, 2015) Ochieng, Joseph; Ibingira, Charles; Buwembo, William; Munabi, Ian; Kiryowa, Haruna; Kitara, David; Bukuluki, Paul; Nzarubara, Gabriel; Mwaka, ErisaInformed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting.Item Integration of traditional and complementary medicine into medical school curricula: a survey among medical students in Makerere University, Uganda(BMJ open, 2019) Mwaka, Amos Deogratius; Tusabe, Gersave; Orach Garimoi, Christopher; Vohra, Sunita; Ibingira, CharlesTo describe the disposition and sociodemographic characteristics of medical students associated with inclusion of traditional and complementary medicine in medical school curricula in Uganda. Design A cross-sectional study conducted during May 2017. A pretested questionnaire was used to collect data. Disposition to include principles of traditional and complementary medicine into medical school curricula was determined as proportion and associated factors determined through multivariate logistic regression.Item Iodine deficiency among goiter patients in rural South Sudan(BMC research notes, 2014) Chuot, Chep C.; Galukande, Moses; Ibingira, Charles; Kisa, Nicholas; Fualal, Jane O.It is estimated that 2.2 billion or approximately 30% of the world’s population live in iodine-deficient areas. In a 2005 study households consuming iodized salt in South Sudan increased from 40% to 73%. Despite this achievement, there are still many goiter cases in rural South Sudan and iodine deficiency remains as a major public health problem in this part of sub Saharan Africa. The purpose of this study therefore was to determine the prevalence of iodine deficiency among rural Southern Sudan goiter patients. Methods: A cross-sectional study was carried out in three South Sudan counties, adults with goiter were from three centers following a mobilization campaign that lasted 4 weeks for free medical care. They were clinically evaluated and completed interviewer administered questionnaires to determine their age, gender, diet, family history, drug history, and medical history. Urine samples were then taken for urinary iodine levels. The outcome was iodine deficiency measured as urinary iodine less than 100 μg per/ L. Multiple logistic regression was used to establish the factors associated with iodine deficiency in South Sudan. Ethical approval was obtained. Results: A total of 286 goitre patients were recruited. The mean age was 38 years (SD 9), 262(92%) were females (F: M ratio 11:1), and 257(90%) were rural- peasants, 25% (20/286) had moderate to severe iodine deficiency. 174 (62%) consumed non-iodized salts.Item Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: a New Challenge for Public Health in Low and Middle-Income Countries(Public Health, 2021) Alkhatib, Ahmad; Nnyanzi, Lawrence Achilles; Mujuni, Brian; Amanya, Geofrey; Ibingira, CharlesLow and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub- Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.Item Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries(Int. J. Environ. Res. Public Health, 2021) Alkhatib, Ahmad; Nnyanzi, Lawrence A.; Mujuni, Brian; Amanya, Geofrey; Ibingira, CharlesObjectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub- Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.Item A Randomized Trial of Low-Cost Mesh in Groin Hernia Repair(New England Journal of Medicine, 2016) Löfgren, Jenny; Nordin, Pär; Ibingira, Charles; Matovu, Alphonsus; Galiwango, Edward; Wladis, AndreasThe most effective method for repair of a groin hernia involves the use of a synthetic mesh, but this type of mesh is unaffordable for many patients in low- and middle-income countries. Sterilized mosquito meshes have been used as a lower cost alternative but have not been rigorously studied.Item The reference range of serum magnesium substance concentration among healthy young adults at Makerere University College of Health Sciences 2012(Tanzania Journal of Health Research, 2012) Bimenya, Gabriel S.; Okot, Julius; Othieno, Emmanuel; Kyokunda, Lynnette T.; Ibingira, Charles; Okwi, Andrew L.Magnesium is the second most abundant intracellular cation, with only a small proportion of the body’s content being in the extracellular fluid. It is required for the active transport of other cations such as calcium, sodium and potassium across the membrane by active transport system. It is also needed for many intracellular metabolic pathways. This study was carried to establish the reference intervals for serum magnesium substance concentration among healthy medical students in Uganda.Item Retrospective in silico mutation profiling of SARS-CoV-2 structural proteins circulating in Uganda by July 2021: Towards refinement of COVID-19 disease vaccines, diagnostics, and therapeutics(Plos one, 2022) Odongo, Steven; Okella, Hedmon; Ndekezi, Christian; Okee, Moses; Namayanja, Monica; Mujuni, Brian; Sterckx, Yann G. J.; Kizito, Dennison; Mwiine, Frank Nobert; Lutwama, Julius Julian; Ibingira, CharlesThe SARS-CoV-2 virus, the agent of COVID-19, caused unprecedented loss of lives and economic decline worldwide. Although the introduction of public health measures, vaccines, diagnostics, and therapeutics disrupted the spread of the SARS-CoV-2, the emergence of variants poses substantial threat. This study traced SARS-CoV-2 variants circulating in Uganda by July 2021 to inform the necessity for refinement of the intervention medical products. A comprehensive in silico analysis of the SARS-CoV-2 genomes detected in clinical samples collected from COVID-19 patients in Uganda revealed occurrence of structural protein variants with potential of escaping detection, resisting antibody therapy, or increased infectivity. The genome sequence dataset was retrieved from the GISAID database and the open reading frame encoding the spike, envelope, membrane, or nucleocapsid proteins was translated. The obtained protein sequences were aligned and inspected for existence of variants. The variant positions on each of the four alignment sets were mapped on predicted epitopes as well as the 3D structures. Additionally, sequences within each of the sets were clustered by family. A phylogenetic tree was constructed to assess relationship between the encountered spike protein sequences and Wuhan-Hu-1 wild-type, or the Alpha, Beta, Delta and Gamma variants of concern. Strikingly, the frequency of each of the spike protein point mutations F157L/Del, D614G and P681H/R was over 50%. The furin and the transmembrane serine protease 2 cleavage sites were unaffected by mutation. Whereas the Delta dominated the spike sequences (16.5%, 91/550), Gamma was not detected. The envelope protein was the most conserved with 96.3% (525/545) sequences being wild-type followed by membrane at 68.4% (397/580). Although the nucleocapsid protein sequences varied, the variant residue positions were less concentrated at the RNA binding domains. The dominant nucleocapsid sequence variant was S202N (34.5%, 205/595). These findings offer baseline information required for refining the existing COVID-19 vaccines, diagnostics, and therapeutics.Item The Status of Medical Devices and their Utilization in 9 Tertiary Hospitals and 5 Research Institutions in Uganda(Global Clinical Engineering Journal, 2021) Tamale Ssekitoleko, Robert; Ngabirano Arinda, Beryl; Oshabahebwa, Solomon; Namuli, Lucy Kevin; Mugaga, Julius; Namayega, Catherine; Einyat Opolot, Emmanuel; Baluka, Jackline; Ibingira, Charles; Munabi, Ian Guyton; Lutakome Joloba, MosesAdvancements in technology have led to great strides in research and innovation that have improved healthcare provision around the world. However, the majority of the technology available is underutilized in Sub- Saharan Africa. In addition, the ever-increasing sophistication and cost of medical equipment means that access and proper use is limited in low- and middle-income countries (LMICs). There is, however, a general paucity of well-documented evidence for the utilization of medical equipment in LMICs. Therefore, this study evaluates the current availability and utilization of medical equipment in tertiary hospitals and research facilities in Uganda and provides baseline information to clinical/biomedical engineers, innovators, managers, and policymakers.Item A systematic review of modeling and simulation approaches in designing targeted treatment technologies for Leukemia Cancer in low and middle income countries(Mathematical Biosciences and Engineering, 2021) Fenekansi Kiwumulo, Henry; Muwonge, Haruna; Ibingira, Charles; Kirabira, John Baptist; Tamale Ssekitoleko, RobertVirtual experimentation is a widely used approach for predicting systems behaviour especially in situations where resources for physical experiments are very limited. For example, targeted treatment inside the human body is particularly challenging, and as such, modeling and simulation is utilised to aid planning before a specific treatment is administered. In such approaches, precise treatment, as it is the case in radiotherapy, is used to administer a maximum dose to the infected regions while minimizing the effect on normal tissue. Complicated cancers such as leukemia present even greater challenges due to their presentation in liquid form and not being localised in one area. As such, science has led to the development of targeted drug delivery, where the infected cells can be specifically targeted anywhere in the body.