Browsing by Author "Mugyenyi, Godfrey"

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    Abnormal obstetric shock index and associated factors among immediate postpartum women following vaginal delivery at a tertiary hospital in Southwestern Uganda
    (Research Square, 2022) Agaba, David Collins; Lugobe, Henry Mark; Migisha, Richard; Jjuuko, Mark; Saturday, Pascal; Kisombo, Dean; Mlangwa Atupele, Subira; Kirabira, Justus; Tumusiime, Matthew; Katamba, Godfrey; Mugyenyi, Godfrey; Masembe, Sezalio; Kayondo, Musa; Ngonzi, Joseph
    Early recognition of haemodynamic instability after birth and prompt interventions are necessary to reduce adverse maternal outcomes due to postpartum haemorrhage. Obstetric shock Index (OSI) has been recommended as a simple, accurate, reliable, and low-cost early diagnostic measure that identifies hemodynamically unstable women. Objectives We determined the prevalence of abnormal obstetric shock index and associated factors among women in the immediate postpartum period following vaginal delivery at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a cross-sectional study at the labour suite and postnatal ward of MRRH from January 2022 to April 2022. We systematically sampled women who had delivered vaginally, and measured their blood pressures and pulse rates at 1 hour postpartum. We excluded mothers with hypertensive disorders of pregnancy. Sociodemographic, medical and obstetric data were obtained through intervieweradministered questionnaires. The prevalence of abnormal OSI was the proportion of participants with an OSI ≥ 0.9 (calculated as the pulse rate divided by the systolic BP). Logistic regression analysis was used to determine associations between abnormal OSI and independent variables. Results We enrolled 427 women with a mean age of 25.66 ± 5.30 years. Of these, 83 (19.44%), 95% CI (15.79– 23.52) had an abnormal obstetric shock index. Being referred [aOR 2.34, 95% CI (1.41–3.89), p = 0.001], having had an episiotomy/perineal laceration [aOR 1.90, 95% CI (1.15–3.13), p = 0.012] and having a visually estimated blood loss > 200 mls [aOR 1.78, 95% CI (1.06–3.01), p = 0.028] were significantly associated with abnormal OSI. Conclusion Approximately one in every five women who delivered vaginally at MRRH during the study period had an abnormal OSI. We recommend that clinicians have a high index of suspicion for haemodynamic instability among women in the immediate postpartum period. Mothers who are referred in from other facilities, those that get episiotomies/perineal lacerations and those with estimated blood loss > 200mls should be prioritized for close monitoring.
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    Alcohol Exposure among Pregnant Women in Sub-Saharan Africa: A Systematic Review
    (Canadian Society of Pharmacology and Therapeutics, 2013) Culley, Celia L.; Ramsey, Tasha D.; Mugyenyi, Godfrey; Kiwanuka, Gertrude N.; Ngonzi, Joseph; MacLeod, Stuart; Koren, Gideon; Grunau, Brian E.; Wiens, Matthew O.
    The prevalence of general alcohol use in many countries of sub-Saharan Africa (SSA) is high. However, research examining alcohol use in among pregnant women within this population is limited. A review of the current status of research examining the prevalence of alcohol exposed pregnancies (AEP) is required to inform future research aiming to decrease this occurrence and its subsequent socio-economic complications. Objective The primary objective was to identify all published papers estimating prevalence and risk-factors of alcohol use among pregnant women in SSA. A secondary objective was to determine changes in alcohol use following pregnancy recognition. Methods PubMed/Medline, Embase, IPA, CINAHL were systematically searched using MeSH terms and keywords from inception date to March 2013. Studies from SSA reporting prevalence of alcohol use among pregnant women were included. Results Twelve studies were identified. Studies varied significantly according to design and study population. Prevalence of alcohol use during pregnancy ranged from 2.2%-87%. The most important risk-factors for alcohol use included tobacco use, partner violence, urban living, and having a male partner who drank alcohol. Only three studies examined changes in alcohol use prior to and following pregnancy recognition with absolute reductions of between 9% and 15%. Conclusions Although the burden of alcohol use during pregnancy is likely a significant problem, limited data currently exist for the majority of SSA countries. Furthermore, significant variation likely exists within various populations. Further research is required to explore alcohol use in pregnancy. Strategies to decrease AEP must be developed and implemented in standard pre-natal care.
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    Frequency of HIV status disclosure, associated factors and outcomes among HIV positive pregnant women at Mbarara Regional Referral Hospital, southwestern Uganda
    (The Pan African Medical Journal, 2019) Ngonzi, Joseph; Mugyenyi, Godfrey; Kivunike, Mukasa; Mugisha, Julius; Salongo, Wasswa; Masembe, Sezalio; Mayanja, Ronald; Bajunirwe, Francis
    Positive HIV results disclosure plays a significant role in the successful prevention and care of HIV infected patients. It provides significant social and health benefits to the individual and the community. Non-disclosure is one of the contextual factors driving the HIV epidemic in Uganda. Study objectives: to determine the frequency of HIV disclosure, associated factors and disclosure outcomes among HIV positive pregnant women at Mbarara Hospital, southwestern Uganda.A cross-sectional study using quantitative and qualitative methods among a group of HIV positive pregnant women attending antenatal clinic was done and consecutive sampling conducted.The total participant recruitment was 103, of which 88 (85.4%) had disclosed their serostatus with 57% disclosure to their partners. About 80% had disclosed within less than 2 months of testing HIV positive. Reasons for disclosure included their partners having disclosed to them (27.3%), caring partners (27.3%) and encouragement by health workers (25.0%). Following disclosure, 74%) were comforted and 6.8% were verbally abused. Reasons for non-disclosure were fear of abandonment (33.3%), being beaten (33.3%) and loss of financial and emotional support (13.3%). The factors associated with disclosure were age 26-35 years (OR 3.9, 95% CI 1.03-15.16), primary education (OR 3.53, 95%CI 1.10-11.307) and urban dwelling (OR 4.22, 95% CI 1.27-14.01).Participants disclosed mainly to their partners and were comforted and many of them were encouraged by the health workers. There is need to optimize disclosure merits to enable increased participation in treatment and support programs.
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    Older age and higher parity are associated with nonuse of the partograph at Mbarara Regional Referral Hospital, Uganda
    (International Journal of Gynecology & Obstetrics, 2019) Lugobe, Henry Mark; Kanyesigye, Hamson; Mpiima, Derrick; Ssemujju, Augustine; Masinda, Abraham; Mulisya, Olivier; Twizerimana, Hillary; Bajunirwe, Francis; Mugyenyi, Godfrey
    A retrospective review of medical records from mothers admitted to MRRH's postnatal ward between October 2016 and March 2017. Partograph use and whether it had been completed to standard were analyzed.Of 527 study participants, 409 (77.6%) records contained a partograph, of which only 17 (4.2%) had been completed to standard. Parameters most commonly completed to standard were monitoring of cervical dilatation (n=41, 10%), fetal heart rate (n=21, 5.1%), and uterine contractions (n=18, 4.4%). Age older than 30 years (prevalence ratio 1.73; 95% CI, 1.14–2.64) and parity greater than or equal to five (prevalence ratio 1.88; 95% CI, 1.19–2.98) were associated with nonuse of the partograph. Birth outcome was recorded in 98.8% (n=404) of partographs.Appropriate use of the partograph to monitor mothers in labor was extremely low; most common use was to record birth outcomes. Older mothers and those with higher parity were less likely to have their labor monitored using a partograph and should be targeted for partograph interventions.
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    Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda
    (BMC oral health, 2014) Muwazi, Louis; Mugisha Rwenyonyi, Charles; Nkamba, Moses; Kutesa, Annet; Kagawa, Mike; Mugyenyi, Godfrey; Kwizera, Godfrey; Okullo, Isaac
    Literature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals. Methods: This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes. Results: Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05). Conclusion: Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance.