Browsing by Author "Lule, Herman"

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    Determinants of contraceptive utilisation amongst teenage mothers: a case-control study in kyangwali refugee settlement (Uganda)
    (International Journal of Current Advanced Research, 2015) Lule, Herman; Echoru, Isaac; Nnabagulanyi, Mary; Mulumba, Richard
    The determinants of contraceptive utilisation amongst teenage mothers in refugee settings are poorly understood. To establish and compare determinants of contraceptive utilisation amongst refugee and host teenage mothers in Kyangwali Refugee Settlement, we conducted a case-control study to interview 132 cases and 264 controls made up of mothers aged 13-19 years during April 2014, using survey questionnaires and a focussed group discussion. Quantitative data was analysed using SPSS 16.0.Chi-square testing and Odds ratios at 95% confidence interval, and p<0.05 as significant were conducted to determine factors that significantly influenced contraceptive utilisation. Of the 396 teenage mothers, 64.6% (256) were refugees whereas 35.4% (140) were host nationals. Spousal support [X2=6.489, p=0.039; OR=2.250 (1.994-2.571) 95% CI], husband’ level of education [X2=16.189, p=0.000; OR=2.043(1.442-2.896) 95% CI] and a low birth order [X2=7.749, p=0.005; OR=1.227 (1.072-1.405) 95% CI] were significant determinants of contraceptive use. The major barriers contraception were fear of side effects 35.4% (140), refusal by the husband 30.3% (120) and lack of community based access 23.0% (91). There was no significant statistical difference in current use of contraceptives between refugee teenage mothers and host nationals [X2=0.138, p=0.710; OR=1.087(0.701-1.686) 95% CI].There is need to restructure delivery of contraceptive services in a way that enhances maximum uptake amongst teenage mothers in refugee settings, through integrated outreaches, girl-child education and male targeted messages in order to curtail the consequences of contraceptive underutilisation in this population.
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    Hyperglycemia in severe traumatic brain injury patients and its association with thirty-day mortality: a prospective observational cohort study in Uganda
    (PeerJ, 2021) Matovu, Paul; Kirya, Musa; Galukande, Moses; Kiryabwire, Joel; Mukisa, John; Ocen, William; Wilson, Michael Lowery; Abio, Anne; Lule, Herman
    Traumatic brain injury (TBI) is a growing public health concern that can be complicated with an acute stress response. This response may be assessed by monitoring blood glucose levels but this is not routine in remote settings. There is a paucity of data on the prevalence of hyperglycemia and variables associated with mortality after severe TBI in Uganda. Objective: We aimed to determine the prevalence of hyperglycemia in patients with severe TBI and variables associated with 30-day mortality at Mulago National Referral Hospital in Uganda. Methods: We consecutively enrolled a cohort 99 patients patients with severe TBI. Serum glucose levels were measured at admission and after 24 h. Other study variables included: mechanism of injury, CT findings, location and size of hematoma, and socio-demographics. The main outcome was mortality after 30 days of management and this was compared in patients with hyperglycemia more than 11.1 mmol/L to those without. Results: Most patients (92.9%) were male aged 18–30 years (47%). Road Traffic Collisions were the most common cause of severe TBI (64.7%) followed by assault (17.1%) and falls (8.1%). Nearly one in six patients were admitted with hyperglycemia more than 11.1 mmol/L. The mortality rate in severe TBI patients with hyperglycemia was 68.8% (OR 1.47; 95% CI [0.236–9.153]; P = 0.063) against 43.7% in those without hyperglycemia. The presence of hypothermia (OR 10.17; 95% CI [1.574–65.669]; P = 0.015) and convulsions (OR 5.64; 95% CI [1.541–19.554]; P = 0.009) were significant predictors of mortality. Conclusion: Hypothermia and convulsions at admission were major predictors of mortality in severe TBI. Early hyperglycemia following severe TBI appears to occur with a tendency towards high mortality. These findings justify routine glucose monitoring and could form the basis for establishing a blood sugar control protocol for such patients in remote settings.