Browsing by Author "Kyamanywa, Patrick"

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    Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: implications for research and policy
    (International journal of emergency medicine, 2010) Hsia, Renee Y.; Ozgediz, Doruk; Mutto, Milton; Jayaraman, Sudha; Kyamanywa, Patrick; Kobusingye, Olive C.
    Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing countries can help identify risk factors for injury and target interventions for prevention and treatment to decrease disability and mortality. Aim To estimate the epidemiology of the injury seen in patients presenting to the government hospital inKampala, the capital city of Uganda. Methods A secondary analysis of a prospectively collected database collected by the Injury Control Centre-Uganda at the Mulago National Referral Hospital, Kampala, Uganda, 2004-2005. Results From 1 August 2004 to 12 August 2005, a total of 3,750 injury-related visits were recorded; a final sample of 3,481 records were analyzed. The majority of patients (62%) were treated in the casualty department and then discharged; 38% were admitted. Road traffic injuries (RTIs) were the most common causes of injury for all age groups in this sample, except for those under 5 years old, and accounted for 49% of total injuries. RTIs were also the most common cause of mortality in trauma patients. Within traffic injuries, more passengers (44%) and pedestrians (30%) were injured than drivers (27%). Other causes of trauma included blunt/penetrating injuries (25% of injuries) and falls (10%). Less than 5% of all patients arriving to the emergency department for injuries arrived by ambulance. Conclusions Road traffic injuries are by far the largest cause of both morbidity and mortality in Kampala. They are the most common cause of injury for all ages, except those younger than 5, and school-aged children comprise a large proportion of victims from these incidents. The integration of injury control programs with ongoing health initiatives is an urgent priority for health and development.
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    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.
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    Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study
    (Research Square, 2022) Mumbere Vahwere, Bienfait; Ssebuufu, Robinson; Namatovu, Alice; Kyamanywa, Patrick; Ntulume, Ibrahim; Mugwano, Isaac; Theophilus, Pius; Katembo Sikakulya, Franck; Okedi, Francis Xaviour; Mulumba, Yusuf; Jorge, Soria; Agaba, Gidio; Nasinyama, George William
    Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) associated with high mortality and morbidity including amputations of lower extremities; and a high economic burden especially in low-income countries like Uganda. The aim of this study was to identify the factors associated with severity of DFU and assess the anatomical distribution of DFU among patients in Uganda. Methodology: This was a multicenter cross-sectional study conducted in 7 selected referral hospitals in Uganda. 117 patients with DM type 1 and 2 and foot ulcers were enrolled for this study from January to March 2021. Using the Wagner classification, patients were categorized as less severe DFU (grade 1 and grade 2) and severe DFU for grade 3 and above. A pre tested questionnaire was used to collect data. Data were analyzed using STATA Version 14 with significance at 95% and p-value of <0.05. Results: Out of 117 patients with DFU, 70 (59.8%) had severe DFU and 47 (40.2%) had less severe DFU. Mean age in years was 57.5 (SD15.2) among all study participants in general. The right foot was affected in (47.9%) of cases and the most frequent ulcer was found on the plantar of the foot (44.4%). Majority of the patients had one ulcer (50.4%) and the most frequent ulcer size was >5 cm (47.9%). Majority (61.5%) of the participants were female. Majority of participants, 90 (76.9%) also had uncontrolled blood sugars and 27(29.1%) had normal glycemia Severity of DFU was 3.4 more prevalent among patients with mild neuropathies (p=0.003), and 2.7 more prevalent for those with moderate neuropathies (p=0.005). Also, severity of DFU was 1.5 more prevalent in patients with an ulcer 5-10 cm of diameter (p=0.047) and 2.5 more prevalent in those with foot ulcer of more than 10 cm of diameter (p=.000). Conclusion:The study showed that most of the DFU patients have severe diabetic foot ulcer and uncontrolled glycemia. Neuropathies and ulcers more than 5cm wide are precipitating factors to severity of DFU and, therefore, early management is important to reduce the burden of the disease.
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    Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey
    (Research Square, 2021) Binezero Mambo, Simon; Sikakulya, Franck K.; Ssebuufu, Robinson; Mulumba, Yusuf; Wasswa, Henry; Thompson, Kelly; Rusatira, Jean Christophe; Bhondoekhan, Fiona; Kamyuka, Louis K.; Olabisi Akib, Surat; Kirimuhuzya, Claude; Nakawesi, Jane; Kyamanywa, Patrick
    The COVID-19 pandemic has disrupted health care access in many countries. The aim of this study was to explore factors that influenced access and utilization of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. Methods This was across-sectional study carried out from April 2020 to May 2020 in Uganda. A questionnaire was administered online to participants aged 18 to 30 years. Subjects were recruited using a snowballing approach. STATA version 14.2 was used for statistical analysis.
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    Malnutrition amongst HIV adult patients in selected hospitals of Bushenyi district in southwestern Uganda
    (Afri Health Sci, 2020) Odwee, Ambrose; Kasozi, Keneth Iceland; Acup, Christine Amongi; Kyamanywa, Patrick; Ssebuufu, Robinson; Obura, Richard; Agaba, Jude B.; Makeri, Danladi; Kirimuhuzya, Claude; Sasirabo, Olivia; Bamaiyi, Pwaveno H.
    Malnutrition is an important clinical outcome amongst HIV patients in developing countries and in Uganda, there is scarcity of information on its prevalence and risk factors amongst HIV adult patients. Methods: A cross-sectional study amongst 253 HIV patients in Bushenyi district assessed their nutritional status using the body mass index (BMI) and mid-upper arm circumference (MUAC), and a questionnaire was used to identify major risk factors. Results: The mean age of the study participants was 38.74 ± 0.80 yrs, while females and males were 52.2% and 47.8% respectively. Prevalence of malnutrition was 10.28% (95% CI: 6.82 – 14.69) in the study. Major socio-economic factors associated with malnutrition were being female, unemployed, dependent and with many family members. Patients with opportunistic infections, low adherence to HAART, and stage of HIV/AIDS had a higher risk of malnutrition Discussion: In rural communities, a majority of malnourished patients are elderly and these were identified as priority groups for HIV outreach campaigns. The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communitie
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    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.
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    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.
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    What are the key leadership competencies required by medical school deans in Uganda? A qualitative cross-sectional study.
    (African Health Sciences, 2021-12) Kyamanywa, Patrick; Redding, Peter
    Background: Effective leadership is vital for organizational growth and sustainability. Globally, medical schools are faced with leadership challenges due to the pace of globalization, technological advances, reduced funding and changed funding cycles, increasing student enrolment, demands of accreditation, academic collaboration, innovations and research. This makes identification and selection for the right leadership competencies a priority. Objectives: To investigate the key leadership competencies required by deans of medical schools in Uganda. Method: A qualitative study using semi-structured interviews with the current deans and purposively selected former deans of medical schools in Uganda was conducted between March and June, 2020. We analysed the data using Grounded theory. Results: Thirteen (13) deans (9 of the 12 current deans and 4 former deans) participated in the study. We established ten (10) key roles of a dean of a medical school categorised as academic leadership, administrative leadership and professional leadership. Eleven (11) key competencies were identified as necessary for effective leadership of medical schools in Uganda, and categorized as personality-related competencies, organizational management competencies and medical/health expertise. Conclusions: A dean of a medical school in Uganda should possess a combination of personality, medical expertise, health professions training and organizational management competencies and have training in leadership, financial and resources management.