NRU :: Browsing by Author "Kobusingye, Olive"

Browsing by Author "Kobusingye, Olive"

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Building capacity for injury research: A case study from Uganda
(Abstracts, 2016) Hyder, Adnan A.; Kobusingye, Olive; Bachani, Abdulgafoor M.; Paichadze, Nino; Bishai, David; Wegener, Stephen; Mbona Tumwesigye, Nazarius; Guwatudde, David; Atuyambe, Lynn; Stevens, Kent A.
Despite the high burden of injuries, they have largely been overlooked in global health research. One of the reasons for this is that in many developing countries there is limited supply of trained human resources for addressing injury research. Uganda is one such country where two critical gaps in addressing the lifelong consequences of trauma, injuries and disability are the lack of trained human resources and the lack of data. Objectives Through innovative model of sustainable development, the Johns Hopkins University-Makerere University Chronic Consequences of Trauma, Injuries and Disability in Uganda (JHU-MU Chronic TRIAD) program aims to strengthen research capacity on the long-term health and economic consequences of trauma, injuries and disability across the lifespan in Uganda.
Child pedestrian crossing behaviour and associated risk factors in school zones: a video-based observational study in Kampala, Uganda
(BMJ Publishing Group Ltd, 2024-05) Osuret, Jimmy; Van Niekerk, Ashley; Kobusingye, Olive; Atuyambe, Lynn; Nankabirwa, Victoria
Abstract BackgroundPedestrian crashes, often occurring while road crossing and associated with crossing behaviour, make up 34.8% of road casualties in Uganda. This study determined crossing behaviour and associated factors among child pedestrians around primary schools in Kampala, Uganda.MethodsWe conducted a cross-sectional study in 2022 among 2100 primary school children. Data on their crossing behaviour were collected using video recordings from cameras staged at the crossing points of 21 schools. We estimated prevalence ratios (PR) with their corresponding 95% CIs using a modified Poisson regression model for the association between unsafe behaviour and the predictors.ResultsThe prevalence for each of 5 unsafe child pedestrian behaviour was 206 (25.8%) for crossing outside the crosswalk, 415 (19.8%) for failing to wait at the kerb, 238 (11.3%) for failing to look for vehicles, 361 (17.2%) for running and 235 (13%) for crossing between vehicles. There was a higher likelihood of crossing outside the crosswalk when an obstacle was present (adjusted PR (aPR) 1.8; 95% CI 1.40 to 2.27) and when children crossed alone (aPR 1.5; 95% CI 1.13 to 2.06). Children who crossed without a traffic warden (aPR 2; 95% CI 1.40 to 2.37) had a significantly higher prevalence of failing to wait at a kerb.ConclusionThese findings reveal the interaction between child pedestrians, vehicles and the environment at crossings. Some factors associated with unsafe child pedestrian behaviour were the presence of an obstacle, crossing alone and the absence of a traffic warden. These findings can help researchers and practitioners understand child pedestrian crossing behaviour, highlighting the need to prioritise targeted safety measures.
Estimating the burden of road traffic crashes in Uganda using police and health sector data sources
(Injury prevention, 2021) Muni, Kennedy Maring; Ningwa, Albert; Osuret, Jimmy; Bayiga Zziwa, Esther; Namatovu, Stellah; Biribawa, Claire; Nakafeero, Mary; Mutto, Milton; Guwatudde, David; Kyamanywa, Patrick; Kobusingye, Olive
d In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this crosssectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). Methods A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. Results We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). Conclusions Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
Intra-abdominal hypertension in severe burns: prevalence, incidence and mortality in a sub-Saharan African hospital
(International journal of burns and trauma, 2017) Mbiine, Ronald; Alenyo, Rose; Kobusingye, Olive; Kuteesa, Job; Nakanwagi, Cephas; Monka Lekuya, Hervé; Kituuka, Olivia; Galukande, Moses
Severe burns have been shown to be a risk factor for developing intra-abdominal hypertension (IAH). Fluid resuscitation practices used in burns management further predispose patients to intra-abdominal hypertension. The mortality associated with IAH in severe burns is estimated to be more than 74.5% once organ dysfunction occurs. Despite 95% of all burns occurring in Low and Middle income countries (LMIC), there is paucity of published data on this topic in sub-Saharan Africa. Objectives: To determine the prevalence, incidence, organ dysfunction and mortality of intra-abdominal hypertension among severe burns patients. Methods: A prospective cohort study was conducted over a 6 months period in the Burns Unit of Mulago National Referral Hospital. Patients of all age groups with burns ≥25% and 20% in adults and children respectively were recruited and followed up for 7 days or until death occurred. Patients with burns older than 48 hours were excluded. The outcome variables were intra-abdominal pressure, organ dysfunction and seven day mortality. Results: Of all the 335 burns patients admitted, 64 patients met the inclusion criteria. The overall prevalence of IAH was 57.8% while the prevalence in the children and adults was 54.5% and 61.3% respectively. The incidence of IAH was 13.1 cases/100 person days with the incidence in adults being twice that of the children. The one week mortality of patients with IAH was 82.6% with the risk of dying being 3.34 (p=0.0035) and seven day survival being less than 50%. Conclusion: One in two patients with severe burns exceeding 20% or 25% in children or adults respectively developed IAH. Adults had a higher prevalence and incidence of IAH. Mortality associated with IAH exceeded 80%.
Patterns Of Traumatic Brain Injury And Six-Month Neuropsychological Outcomes In Uganda
(BMC neurology, 2019) Bangirana, Paul; Giordani, Bruno; Kobusingye, Olive; Murungyi, Letisia; Mock, Charles; John, Chandy C.; Idro, Richard
Traumatic brain injuries in Uganda are on the increase, however little is known about the neuropsychological outcomes in survivors. This study characterized patients with traumatic brain injury (TBI) and the associated six-month neuropsychological outcomes in a Ugandan tertiary hospital.Patients admitted at Mulago Hospital with head injury from November 2015 to April 2016 were prospectively enrolled during admission and followed up at six months after discharge to assess cognition, posttraumatic stress symptoms (PTSS), depression symptoms and physical disability. The outcomes were compared to a non-head-injury group recruited from among the caretakers, siblings and neighbours of the patients with age and sex entered as covariates.One hundred and seventy-one patients and 145 non-head injury participants were enrolled. The age range for the whole sample was 1 to 69 years with the non-head injury group being older (mean age (SD) 33.34 (13.35) vs 29.34 (14.13) years of age, p = 0.01). Overall, motorcycle crashes (36/171, 38.6%) and being hit by an object (58/171, 33.9%) were the leading causes of TBI. Head injury from falls occurred more frequently in children < 18 years (13.8% vs 2.8%, p = 0.03). In adults 18 years and older, patients had higher rates of neurocognitive impairment (28.4% vs 6.6%, p < 0.0001), PTSS (43.9% vs 7.9%, p < 0.0001), depression symptoms (55.4% vs 10%, p < 0.0001) and physical disability (7.2% vs 0%, p = 0.002). Lower Glasgow Coma Score (GCS) on admission was associated with neurocognitive impairment (11.6 vs 13.1, p = 0.04) and physical disability (10 vs 12.9, p = 0.01) six months later.This first such study in the East-African region shows that depth of coma on admission in TBI is associated with neurocognitive impairment and physical disability.
Road safety compliance among motorcyclists in Kawempe Division, Kampala, Uganda: a crosssectional study
(International Journal of Injury Control and Safety Promotion, 2019) Ndagire, Margaret; Kiwanuka, Suzanne; Paichadze, Nino; Kobusingye, Olive
Motorcyclists are vulnerable road users in Uganda and 21.7% (3912/18,016) experienced crashes in 2012. This study determined the prevalence of and factors associated with compliance to selected road safety measures (helmet use, retro-reflective jackets use, riding permit and carrying one passenger) among commercial motorcyclists in Kawempe, from April to June 2014 using interviewer administered questionnaires. Total compliance was 0.9% and 24.4% to at least 3/4 measures. Compliance by measure was; 7.6% retroreflective jackets, 28.8% riding permits, 69.4% helmet use and 86.1% carrying one passenger. The associated factors were; knowing that (training before one starts to ride prevents crashes, Adjusted-odds-ratio (AOR) ¼ 2.38 (1.36–4.19), maintaining the motorcycle in good condition prevents crashes, AOR ¼ 0.34 (0.15–0.77) and padding reduces impact of road traffic injury, AOR ¼ 0.37 (0.15–0.89)). Prevalence to compliance is very low. Road safety messages should highlight the importance of all road safety measures to improve compliance.
State of pedestrian road safety in Uganda: a qualitative study of existing interventions
(African Health Sciences, 2021) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny Enock; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods: We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results: Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion: The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda’s pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
State of pedestrian road safety in Uganda: are interventions failing or absent?
(Research Square, 2019) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny E.; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Background In Uganda, pedestrians are the most frequently injured category of road users, accounting for 40% of road traffic fatalities and 25% of serious injuries every year. There is paucity of information on existing pedestrian interventions and challenges that affect their implementation in Uganda. In this paper, we ascertain the state of pedestrian road safety interventions in Uganda and explore the challenges in the process of design, implementation, monitoring and evaluation of existing interventions. Methods We conducted a qualitative study that started with a desk review of existing policy documents, police statistics, media reports, non-governmental organization reports, and published research. We supplemented the review with 14 key informant interviews and 4 focus group discussions. Participants were drawn from various agencies and stakeholders responsible for road safety. In total, we collected and synthesized data on the design, implementation, and evaluation of pedestrian safety interventions from 25 documents. Data were analyzed using qualitative thematic content analysis. Results The National Road Safety Council within the Ministry of Works and Transport is the lead agency tasked with coordinating all road safety efforts, while the Uganda Police is largely engaged in enforcing pedestrian safety. We identified several existing policies and regulations for pedestrian safety like the Non- Motorized Transport policy whose implementation has been inadequate. Implementation is constrained by weak institutional capacity and limited resources. Moreover, road safety stakeholders operated in silos and this hindered efforts to coordinate pedestrian safety activities. Interventions like road designs were implemented with limited reference to any supporting data and therefore did not cater for pedestrian needs. Conclusion There are interventions targeting pedestrian safety in Uganda, but effective implementation is lacking or failing due to constraints related to weak institutional capacity. This necessitates strategies to mobilize resources to strengthen the capacity of the lead agency to effectively coordinate road safety interventions.
Where are pedestrians injured and killed on Kampala city's road network?
(Frontiers Media, 2022-08) Zziwa, Esther Bayiga; Kobusingye, Olive; Guwatudde, David
Abstract Road traffic crashes are a threat to walkers in cities in the global south. It is important for us to know where these crashes frequently occur as well as gain an in-depth understanding of the traffic generators around these sites. Kampala city has experienced many changes over time, and as a result, the crash sites could have changed over time. Pedestrian crashes in cities cluster in specific places than others on a road network known as black spots. It is important to know and update the current black spots as well as reassess the circumstances surrounding these crash sites. This study utilized 5-year traffic crash data (2015–2019) to map and categorize pedestrian black spots in Kampala city, Uganda, by road location type, as well as the nature of activity happening around. A total of 1,095 unique crash locations emerged from the data. Based on the criteria of locations with at least 10 serious or fatal crashes in 5 years, 46 locations were identified as black spots. The bulk (48%) of serious and fatal pedestrian black spots were junctions, especially those with traffic lights, while 74% of these black spots were around places with commercial land use. Whereas implementation of appropriate interventions at black spots is a general well-proven method for reducing the number and severity of crashes at these sites on the road network, the measures taken to treat accident black spots vary from place to place dependent on the unique local circumstances and risk factors. The draft black spot list serves as a basis for further investigation and analysis of the local risk factors surrounding serious and fatal pedestrian crashes in low-income settings as a key step in generating appropriate interventions.

Browsing by Author "Kobusingye, Olive"

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