Browsing by Author "Mugenyi, Levi"
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Item Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomised controlled trial in Northern Uganda(British Medical Journal Publishing Group, 2024-02) Nankabirwa, Victoria; Mukunya, David; Ndeezi, Grace; Odongkara, Beatrice; Arach, Agnes A; Achora, Vicentina; Mugenyi, Levi; Sebit, Mohammad Boy; Wandabwa, Julius N; Waako, Paul; Tylleskär, Thorkild; Tumwine, James KAbstract ObjectiveTo assess the effect of an integrated intervention package compared with routine government health services on the frequency of health facility births.SettingThree subcounties of Lira district in Northern Uganda.DesignA cluster randomised controlled trial where a total of 30 clusters were randomised in a ratio of 1:1 to intervention or standard of care.ParticipantsPregnant women at ≥28 weeks of gestation.InterventionsParticipants in the intervention arm received an integrated intervention package of peer support, mobile phone messaging and birthing kits during pregnancy while those in the control arm received routine government health services (‘standard of care’).Primary and secondary outcome measuresThe primary outcome was the proportion of women giving birth at a health facility in the intervention arm compared with the control arm. Secondary outcomes were perinatal and neonatal deaths.ResultsIn 2018–2019, 995 pregnant women were included in 15 intervention clusters and 882 in 15 control clusters. The primary outcome was ascertained for all except one participant who died before childbirth. In the intervention arm, 754/994 participants (76%) gave birth at a health facility compared with 500/882 (57%) in the control arm. Participants in the intervention arm were 35% more likely to give birth at a health facility compared with participants in the control arm, (risk ratio 1.35 (95% CI 1.20 to 1.51)) and (risk difference 0.20 (95% CI 0.13 to 0.27)). Adjusting for baseline differences generated similar results. There was no difference in secondary outcomes (perinatal or neonatal mortality or number of postnatal visits) between arms. Conclusion The intervention was successful in increasing the proportion of facility-based births but did not reduce perinatal or neonatal mortality.Trial registration numberNCT02605369Item Characterization of Asthma and Its Determinants in Ethiopia: Part of the African Severe Asthma Project (ASAP)(Ethiopian Medical Journal, 2021) Bekel, Amsalu; Haile, Tewodros; Mekekasha, Amha; Fuad, Oumer; Muttamba, Winters; Mugenyi, Levi; Katagira, Wincey; Nyale, George; Lugogo, Njira; Worodria, William; Aanyu, Hellen T.; Joloba, Moses; Jong, Corina de; Makumbi, Fred; Molen, Thys van der; Chakaya, Jeremiah; Kirenga, Bruce J; Yimer, GetenetAsthma is a major public health problem globally affecting 339 million people with 300,000 annual death. African Severe Asthma Program was a multi-country prospective cohort study designed to characterize severe asthma in three African countries, Ethiopia, Uganda and Kenya. In this study, we describe the baseline characteristics and disease severity among asthmatics enrolled in the Ethiopia site of African Severe Asthma Program. Asthmatics seen at Tikur Anbessa Specialized Hospital from August 2016 to May 2018 were studied. Asthma was diagnosed based on symptoms and spirometry. Baseline demographic and clinical data were collected using a structured questionnaire. Standardized research tools were used to assess asthma severity, asthma control and asthma quality of life. A total of 419 asthmatic patients were enrolled in the study; the mean age for the group was 52 ± 8 years and 58.2 % were female. The majority of the participants, 365 (87.2%), had a prior diagnosis of asthma with a median (IQR) age at first diagnosis of 29 (IQR: 22 - 36) years. A family history of asthma was present in 149 (35.6%) subjects. Current or previous cigarette smoking was reported in 8.6% of the participants. Overall, 93.8% of the participants reported uncontrolled asthma symptoms (ACQ >1.5). More than half of the patients, had severe persistent asthma and 35% presented with one or more comorbidities. Conclusions: In Ethiopia, asthmatics presenting to a tertiary care hospital were characterized as predominantly female with late onset disease, poor control, and associated comorbidities. Key Words: Asthma, Characteristics, determinants and SevereItem Community Knowledge and Attitudes of Epilepsy in Rural and Urban Mukono District, Uganda; A Cross Sectional Study(Epilepsy & Behavior, 2016) Kaddumukasa, Mark; Kakooza, Angelina; Kayima, James; Kaddumukasa, Martin N.; Ddumba, Edward; Mugenyi, Levi; Furlan, Anthony; Lhatoo, Samden; Sajatovic, Martha; Katabira, EllyThe lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care of patients with epilepsy within the community. The purpose of this study was to determine the knowledge of and attitude towards epilepsy and its treatment by community dwellers in Uganda.A cross sectional population survey was conducted in urban and rural Mukono district, central Uganda. Adult respondents through multistage stratified sampling were interviewed about selected aspects of epilepsy knowledge, attitudes, and perception using a pretested structured questionnaire.Ninety-one percent of the study respondents had heard or read about epilepsy or knew someone who had epilepsy and had seen someone having a seizure. Thirty-seven percent of the respondents did not know the cause of epilepsy, while 29% cited genetic causes. About seventeen percent of the subjects believed that epilepsy is contagious. Only 5.6% (21/377) of the respondents would take a patient with epilepsy to hospital for treatment.Adults in Mukono are very acquainted with epilepsy but have many erroneous beliefs about the condition. Negative attitudes are pervasive within communities in Uganda. The national epilepsy awareness programs need to clarify the purported modes of transmission of epilepsy, available treatment options, and care offered during epileptic seizures during community sensitizations in our settings.