Browsing by Author "Kitutu, Freddy"

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    Cross sectional study of drug substitution in community pharmacies in the Ugandan capital city
    (BMC Health Services Research, 2014) Nabbale, Asha; Odoi-Adome, Richard; Kitutu, Freddy
    The escalating cost of pharmaceuticals is a global challenge and major hindrance to access to medicines in developing countries. Half of the Ugandan population lacks reliable access to essential medicines and out of pocket expenditure by patients is as high as 80% [1]. Generic medicines provide an opportunity for savings on medicine expenditure due to their cheaper price [2,3]. Generic substitution has been recommended by World Health Organisation and is widely practised in Africa as long as the prescriber does not forbid nor the patient decline [4]. Therefore, this study was conducted to determine the nature and prevalence of drug substitution in community pharmacies in Kampala, the capital city of Uganda. Dispensers’ perceptions were also explored.
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    Cure Rate and Associated Factors for Children with Severe Acute Malnutrition Under the Out patient Therapeutic Care Programme in the Health Centres of Kabale District in Southwestern Uganda. A Cross Sectional Study.
    (Research Square, 2021) Ssekajja, Vincent; Wamani, Henry; Kitutu, Freddy; Atukwase, Abel
     Severe Acute Malnutrition (SAM) is one of the leading causes of morbidity and mortality among children under the age of ve.  Globally, SAM affects 19 million children with sub-Saharan Africa being the most affected. In Uganda, Global acute malnutrition (GAM) affects 4% and SAM 1% children. Kabale district in South Western Uganda, located in Kigezi sub-region, has been reported to have a GAM prevalence of 3.8 % and SAM of 2.9% among children below ve years. To ensure timely detection and management of SAM, the government of Uganda in collaboration with development partners introduced Out Patient Therapeutic Care (OTC) program in all health centre level III and IV in Kabale district.  However, there is limited information about the Cure rate of children and associated factors under the OTC program in Kabale district. This study was therefore designed to assess the Cure rate and factors affecting it.  
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    Effectiveness of Peer-supervision on Paediatric Fever Treatment among Registered Private Drug Sellers in East-Central Uganda: An Interrupted Time Series Analysis
    (Authorea Preprints, 2020) Bagonza, Arthur; Kitutu, Freddy; Peterson, Stefan; Martensson, Andreas; Mutto, Milton; Awor, Phyllis; Mukanga, David; Wamani, Henry
    Rationale, aims and objectives: Appropriate treatment of paediatric fever in rural areas remains a challenge and may be partly due to inadequate supervision of licensed drug sellers. This study assessed the effectiveness of peer-supervision among drug sellers on appropriate treatment of pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age in the intervention (Luuka) and comparison (Buyende) districts, in East-Central Uganda. Methods: Data on pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age was abstracted from drug shop sick child registers over a 12-month period; six months before and six months after introduction of peer-supervision. Interrupted time series was applied to determine the effectiveness of the peer-supervision intervention on appropriate treatment of pneumonia, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age attending drug shops in East Central Uganda. Results: The proportion of children treated appropriately for pneumonia symptoms was 10.84% (P<0.05, CI = [1.75, 19.9]) higher, for uncomplicated malaria was 1.46% (P = 0.79, CI = [-10.43, 13.36]) higher, and for non-bloody diarrhoea was 4.00% (p <0.05, CI = [-7.95, -0.13]) lower in the intervention district than the comparison district, respectively. Post-intervention trend results showed an increase of 1.21% (p =0.008, CI = [0.36, 2.05]) in the proportion appropriately treated for pneumonia symptoms, no difference in appropriate treatment for uncomplicated malaria, and a reduction of 1% (p <0.06, CI = [-1.95, 0.02]) in the proportion of children appropriately treated for nonbloody diarrhoea, respectively. Conclusions: Peer-supervision increased the proportion of children less than five years of age that received appropriate treatment for pneumonia symptoms but not for uncomplicated malaria and non-bloody diarrhoea. Implementation of community level interventions to improve paediatric fever management should consider including peersupervision among drug sellers.
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    Inclusion of private sector in district health systems; case study of private drug shops implementing modified Integrated Community Case Management (iCCM) strategy in Rural Uganda
    (BMC Health Services Research, 2014) Kitutu, Freddy; Mayora, Chrispus; Awor, Phyllis; Birger, Forsberg; Peterson, Stefan; Wamani, Henry
    Uganda Ministry of Health passed the Public Private Partnership for Health (PPPH) policy to strengthen the health system by leveraging strategic advantages of private healthcare providers [1]. The National Malaria program has gone further to develop a malaria case management strategy through a multi-stakeholder consultative process [2]. Makerere University School of Public Health (MakSPH) partnered with Mbarara district to implement the iCCM strategy in private licensed drug shops in rural areas. The partnership aimed to increase access to quality medicines and point of care diagnostics for child febrile illnesses, minimize excess use of antimalarials and antibiotics, share information of cases diagnosed and treated at the drug shops and promote child survival.
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    Is there a distinction between malaria treatment and intermittent preventive treatment? Insights from a cross-sectional study of anti-malarial drug use among Ugandan pregnant women
    (Malaria journal, 2015) Odongo, Charles O.; Bisaso, Kuteesa R.; Kitutu, Freddy; Obua, Celestino; Byamugisha, Josaphat
    In Uganda, treatment of clinical malaria and intermittent preventive treatment with sulphadoxinepyrimethamine (SP) are common during pregnancy. As a result, both formal and informal reports from antenatal sources suggest possible misuse of SP for malaria treatment among pregnant women. The objective of this study was to investigate anti-malarial drug use patterns among women who had recently suffered malaria illness before and during pregnancy. Methods: A cross-sectional study in which a structured questionnaire (interviewer-administered) was used to collect data from pregnant women attending an urban antenatal clinic. Details of medicines used to treat malaria episodes suffered before and during pregnancy were captured. A first order Markov probability model was used to estimate probabilities of transitioning between treatment choices made before and during pregnancy. Logistic regression was used to explore whether demographic and obstetric characteristics were associated with transition patterns. Results: Seven hundred women were interviewed among whom 428 had suffered malaria in both instances. Three hundred thirty of these could recall the medicines used in both instances. Women who used ACT/QNN (correct choice) before pregnancy had higher probabilities of transitioning to SP than staying on ACT/QNN during pregnancy (0.463 versus 0.451). Access of medicines from private outlets (clinics and pharmacies) were more than nine times predictive of receiving correct medicines (p=0.035 and p=0.039 respectively). Access of medicines from clinics was 5.9 times protective against receiving SP for malaria treatment (p=0.033). Among those who used SP before pregnancy, there was a 0.75 probability of staying on it during pregnancy. None of the factors explored could explain this observation. Conclusion: Use of SP for malaria treatment is common during pregnancy. This may be contributing to adverse pregnancy outcomes. Antenatal care providers should endeavour to emphasize the distinction between treatment and prevention of malaria during pregnancy.