Browsing by Author "Mubuuke, Aloysius G."

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    Adult Computed Tomography examinations in Uganda: Towards determining the National Diagnostic Reference Levels
    (BMC Medical Imaging, 2022) Erem, Geofrey; Ameda, Faith; Otike, Caroline; Olwit, William; Mubuuke, Aloysius G.; Schandorf, Cyril; Kisolo, Akisophel; Kawooya, Michael G.
    Diagnostic Reference Levels (DRLs), typically set at the 75th percentile of the dose distribution from surveys conducted across a broad user base using a specified dose-measurement protocol, are recommended for radiological examinations. There is a need to develop and implement DRLs as a standardisation and optimisation tool for the radiological protection of patients at Computed Tomography (CT) facilities. This was a retrospective cross-sectional study conducted in seven (7) different CT scan facilities in which participants were recruited by systematic random sampling. The study variables were dose length product (DLP) and volume-weighted CTDI (CTDIvol) for the radiation doses for head, chest, abdomen and lumbar spine CT examinations. The DRLs for CTDIvol and DLP were obtained by calculating the 3rd quartiles of the radiation doses per study site by anatomical region. The national diagnostic reference levels were determined by computation of DRLs using the 75th centile of the median values. A total of 574 patients were examined with an average age of 47.1 years. For CTDIvol estimates; there was a strong positive significant relationship between the CTDIvol and examination mAs (rs = 0.9017, p-value < 0.001), and reference mAs (rs = 0.0.7708, p-value < 0.001). For DLP estimates; there was a moderate positive significant relationships between DLP and total mAs (rs = 0.6812, p-value < 0.001), reference mAs (rs = 0.5493, p-value < 0.001). The DRLs were as follows; for head CT scan – the average median CTDIvol was 56.02 mGy and the DLP was 1260.3 mGy.cm; for Chest CT, the CTDI volume was 7.82 mGy and the DLP was 377.0 mGy.cm; for the abdomen CT, the CTDI volume 12.54 mGy and DLP 1418.3 mGy.cm and for the lumbar spine 19.48 mGy and the DLP was 843 mGy.cm, respectively. This study confirmed the need to optimize the CT scan parameters in order to lower the national DRLs. This can be achieved by extensive training of all the CT scan radiographers on optimizing the CT scan acquisition parameters. Continuous dose audits are also advised with new equipment or after every three years to ensure that values out of range are either justified or further investigated.
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    Carotid Doppler findings among patients admitted with stroke in two tertiary care facilities in Uganda
    (Research Square, 2023-04) Walubembe, Jonathan; Ssinabulya, Isaac; Mubuuke, Aloysius G.; Kagwa, Mark Mohan; Babirye, Deborah; Okot, Jerom; Bongomin, Felix; Nakku, Miriam; Okello Ongom, Diana; Ameda, Faith
    Carotid Atherosclerotic Disease (CAD) Doppler ndings including carotid artery stenosis, thickened intima media thickness, and high-risk atherosclerotic plaques are associated with increased risk of stroke and symptomatic cerebrovascular disease. However, few studies have explored these Doppler characteristics among stroke patients in Africa. This study, therefore, investigates these carotid artery Doppler characteristics among stroke patients in Uganda. Methods A hospital-based cross-sectional study of 95 stroke patients attending two national referral hospitals in Uganda between March and July 2022. Following the caption of their sociodemographic and clinical characteristics, they underwent Doppler sonography of the extracranial carotid arteries using a standard carotid Doppler protocol. Multivariate logistic regression was used to determine factors associated with abnormal carotid Doppler parameters (i.e., carotid intima-media thickness, carotid stenosis). Results The mean age of the study participants was 61 ± 13 years with 60% (57/95) of the participants being male. Most participants had an ischemic stroke (67%), hypertension (76.4%), and used alcohol (58.9%). The prevalence of signi cant carotid stenosis in participants with ischemic stroke was 12.5% (8/64) (i.e., 7.8% had severe carotid stenosis and 4.7% had moderate stenosis). The prevalence of high carotid intima media thickness (CIMT) and atherosclerotic plaques were 31.6% (30/95) and 26.3% (25/95), respectively. Most atherosclerotic plaques were echogenic. Age above 60 years (adjusted odds ratio [aOR] = 5.2, 95% Con dence Interval [CI]:1.97-14; p < 0.010), high low-density lipoprotein cholesterol (aOR = 4.2, 95% CI: 1.29–8.79; p = 0.013) increased the likelihood of having abnormal CIMT. Conclusion The burden of carotid atherosclerotic disease is increasing among stroke patients in Uganda. Large-scale epidemiological studies are needed to further pro le the disease in high risk populations.
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    A health care professionals training needs assessment for oncology in Uganda
    (Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, Charles
    Cancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to downstaging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region. Methods: This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the Open Data Kit platform from which the data was exported to Stata version 15 for analysis using the Wilcoxon signed-rank test and Somers-Delta. Results: There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall, the research and audit domain had the highest ranking for all the health workers (Somers-D = 0.60). The respondent’s level of education had a significant effect on the observed ranking (P value = 0.03). Most of the continuing medical education (CME) topics suggested by the participants were in the clinical task-related category. Conclusion: The “research and audit” domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME programme content, peer support networks and tailored training for the individual health care provider.
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    A health care professionals training needs assessment for oncology in Uganda
    (Human Resources for Health, 2020) Byamugisha, Josaphat; Munabi, Ian G.; Mubuuke, Aloysius G.; Mwaka, Amos D.; Kagawa, Mike; Okullo, Isaac; Niyonzima, Nixon; Lusiba, Pastan; Ainembabazi, Peruth; Kankunda, Caroline; Muhumuza, Dennis D.; Orem, Jackson; Atwine, Diana; Ibingira, Charles
    Cancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to down staging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region.