Browsing by Author "Ictho, Jerry"

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    The burden of drug resistant tuberculosis in a predominantly nomadic population in Uganda: a mixed methods study
    (BMC Infectious Diseases, 2021) Nakafeero Simbwa, Brenda; Katamba, Achilles; Katana, Elizabeth B.; Laker, Eva A. O.; Nabatanzi, Sandra; Sendaula, Emmanuel; Opio, Denis; Ictho, Jerry; Lochoro, Peter; Karamagi, Charles A.; Kalyango, Joan N.; Worodria, William
    Emergence of drug resistant tuberculosis (DR-TB) has aggravated the tuberculosis (TB) public health burden worldwide and especially in low income settings. We present findings from a predominantly nomadic population in Karamoja, Uganda with a high-TB burden (3500 new cases annually) and sought to determine the prevalence, patterns, factors associated with DR-TB. Methods: We used mixed methods of data collection. We enrolled 6890 participants who were treated for tuberculosis in a programmatic setting between January 2015 and April 2018. A cross sectional study and a matched case control study with conditional logistic regression and robust standard errors respectively were used to the determine prevalence and factors associated with DR-TB. The qualitative methods included focus group discussions, in-depth interviews and key informant interviews. Results: The overall prevalence of DR-TB was 41/6890 (0.6%) with 4/64,197 (0.1%) among the new and 37/2693 (1.4%) among the previously treated TB patients respectively. The drug resistance patterns observed in the region were mainly rifampicin mono resistant (68.3%) and Multi Drug-Resistant Tuberculosis (31.7%). Factors independently associated with DR-TB were previous TB treatment, adjusted odds ratio (aOR) 13.070 (95%CI 1.552–110.135) and drug stock-outs aOR 0.027 (95%CI 0.002–0.364). The nomadic lifestyle, substance use, congested homesteads and poor health worker attitudes were a great challenge to effective treatment of TB. Conclusion: Despite having the highest national TB incidence, Karamoja still has a low DR-TB prevalence. Previous TB treatment and drug stock outs were associated with DR-TB. Regular supply of anti TB medications and health education may help to stem the burden of TB disease in this nomadic population.
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    Measurement error of mean sac diameter and crown-rump length among pregnant women at Mulago hospital, Uganda
    (BMC Pregnancy and Childbirth, 2018) Ali, Sam; Kusaba Byanyima, Rosemary; Ononge, Sam; Ictho, Jerry; Nyamwiza, Jean; Loro, Emmanuel Lako Ernesto; Mukisa, John; Musewa, Angella; Nalutaaya, Annet; Ssenyonga, Ronald; Kawooya, Ismael; Temper, Benjamin; Katamba, Achilles; Kalyango, Joan; Karamagi, Charles
    Ultrasonography is essential in the prenatal diagnosis and care for the pregnant mothers. However, the measurements obtained often contain a small percentage of unavoidable error that may have serious clinical implications if substantial. We therefore evaluated the level of intra and inter-observer error in measuring mean sac diameter (MSD) and crown-rump length (CRL) in women between 6 and 10 weeks’ gestation at Mulago hospital. Methods: This was a cross-sectional study conducted from January to March 2016. We enrolled 56 women with an intrauterine single viable embryo. The women were scanned using a transvaginal (TVS) technique by two observers who were blinded of each other’s measurements. Each observer measured the CRL twice and the MSD once for each woman. Intra-class correlation coefficients (ICCs), 95% limits of agreement (LOA) and technical error of measurement (TEM) were used for analysis. Results: Intra-observer ICCs for CRL measurements were 0.995 and 0.993 while inter-observer ICCs were 0.988 for CRL and 0.955 for MSD measurements. Intra-observer 95% LOA for CRL were ± 2.04 mm and ± 1.66 mm. Inter-observer LOA were ± 2.35 mm for CRL and ± 4.87 mm for MSD. The intra-observer relative TEM for CRL were 4.62% and 3.70% whereas inter-observer relative TEM were 5.88% and 5.93% for CRL and MSD respectively. Conclusions: Intra- and inter-observer error of CRL and MSD measurements among pregnant women at Mulago hospital were acceptable. This implies that at Mulago hospital, the error in pregnancy dating is within acceptable margins of ±3 days in first trimester, and the CRL and MSD cut offs of ≥7 mm and≥ 25 mm respectively are fit for diagnosis of miscarriage on TVS. These findings should be extrapolated to the whole country with caution. Sonographers can achieve acceptable and comparable diagnostic accuracy levels of MSD and CLR measurements with proper training and adherence to practice guidelines.
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    Prevalence and factors associated with safe male circumcision among Makerere University undergraduate students, Kampala - Uganda
    (Research Square, 2019) Nyamwiza, Jean; Mukisa, John; Ictho, Jerry; Ssenyonga, Ronald; Nalutaaya, Annet; Kawooya, Ismael; Benjamin, Temper; Nagendo, Joanita; Musewa, Angella; Ali, Sam; Lako Ernesto Loro, Emmanuel; Agaba, Bekiita Bosco; Kiwuwa, Mpungu Steven; Kalyango, Joan N.; Karamagi, Charles
    Background Safe male circumcision (SMC) is currently recognized as a preventive strategy in reducing the risk of HIV; however, the prevalence of circumcised men in Uganda is still quite low at 26%. This study aimed to determine the prevalence and factors associated with SMC and among Makerere University undergraduate students, in Kampala Uganda. Methods We conducted a cross-sectional study among 602 participants selected using multistage probability sampling strategy. Pretested semi-structured questionnaires and focus group discussions were used to collect data. Quantitative data were analyzed with Stata 12.0, the prevalence ratio and p-values were calculated. Possible interactions and confounding variables were assessed with the Poisson regression model while qualitative data was analyzed with content analysis. Results The overall prevalence of safe male circumcision among male undergraduates was 58.3% (95% CI: 54.37 – 62.24). Factors associated with SMC prevalence included: safety of SMC procedure (Prevalence Ratio (PR) = 1.13, 95% Confidence Interval (CI): 1.03 – 1.25) and friendly health workers (PR = 0.78, 95% CI: 0.74 – 0.83). The perceived benefits of SMC included hygiene (86.5%, n = 521), reduced risk of HIV transmission (4.5%, n = 26) and reduced risk of penile cancer (45.7%, n = 275) while, the perceived barrier was pain (10.1%, n = 61). The students perceived that SMC recipient’s first sexual partner post-procedure should not be his girlfriend. Most participants in all the focus group discussions perceived SMC increases sexual pleasure. Conclusion The overall self-reported SMC success rate among participants was high, along with the safety of SMC services and friendly health workers as important factors among male students. There is a need for continuous sensitization campaigns and communication strategies to address beliefs about SMC, some related misconceptions, and barriers so as to increase its prevalence.