Browsing by Author "Mukisa, John"
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Item Acceptability of the Wulira App in Assessing Occupational Hearing Loss among Workers in a Steel and Iron Manufacturing Industry(Plos one, 2022) Atukunda, Immaculate; Semulimi, Andrew Weil; Bwambale, Festo; Mumbere, Joab; Twinamasiko, Nelson; Nakabuye, Mariam; Mukisa, John; Mukunya, David; Batte, CharlesIndustrial workers are at a high risk of acquiring noise induced hearing loss, yet there is minimal hearing loss screening of such groups of people. Pure Tone Audiometry (PTA), the gold standard for hearing loss screening, is expensive, and not readily available at health sites. Mobile audiometry can bridge this gap. However, there is limited knowledge on its acceptability in low-income countries like Uganda. We aimed to assess the acceptability of using the Wulira App, a validated mobile phone app, in assessing hearing loss among industrial workers in Kampala. We carried out a qualitative study in a steel and iron manufacturing industry in Kampala, in April 2021. Four Focus group discussions (FGDs) with 8 participants per FGD, and 12 In-depth Interviews (IDI), were conducted on the industrial workers. The industrial workers were first tested for hearing loss, then enrolled for the FGDs and IDI. A semi-structured interview guide was used. Audio recordings were transcribed verbatim. Themes were derived using thematic content analysis, borrowing from Sekhon’s model of Acceptability of Health Interventions. Industrial workers found the Wulira App user friendly, cheap, time saving, and an effective hearing loss assessment tool. However, barriers such as lack of smart phones, difficulty in navigating the app, and fear of getting bad news hindered the App’s acceptability, as a hearing assessment tool. Hearing loss assessment using Wulira App was acceptable to the industry workers. There is need of informing industrial workers on the essence of carrying out regular hearing loss screening, such that barriers like fear of getting screened are overcome.Item Assessment of the current capacity of intensive care units in Uganda; A descriptive study(Journal of Critical Care, 2020) Atumanya, Patience; Sendagire, Cornelius; Wabule, Agnes; Mukisa, John; Ssemogerere, Lameck; Kwizera, Arthur; Agaba, Peter K.Purpose: To describe the organizational characteristics of functional ICUs in Uganda. Methods: A descriptive survey of 12 ICUs in Uganda; ICU organisation, structure, staffing, and support facilities. A functional ICU was defined as one that admitted critically ill patients and had the ability to provide mechanical ventilation. ICUswere selected based on information of their existence. Direct structured interviewswere carried out with the ICU directors. Results: Of the fourteen ICUs reviewed, 12 were functional, and a majority were located in the central region. There were 55 ICU beds making up a ratio of 1.3 ICU beds per million population. The ICU beds comprised 1.5 % of the total bed capacity of studied hospitals. Most of the ICUs [11] were mixed (paediatric-adults), anaesthesia-led (nine) and five operated in a closed model. There were 171 ICU nurses, of whom 13 had formal training in critical care nursing. Themajority of the ICUs had a nurse to patient ratio ≥ 1.2; nine during the day and seven at night. Conclusions: This study shows limited accessibility to critical care services in Uganda.With a high variability in the ICU operational characteristics, there is a need for standardization of ICU care in the country.Item Assessment of the Impact of COVID-19 Pandemic on The Education and Psychosocial Wellbeing of School-Going Children in Bududa District, Uganda(Research Square, 2021) Batte, Charles; Semulimi, Andrew Weil; Kasoma Mutebi, Ronald; Mukisa, John; Olum, Ronald; Bongomin, FelixThe coronavirus disease – 2019 (COVID-19) pandemic has caused devastating effects across all sectors. The closure of schools negatively affected school going children globally. The present study sought to assess the effect of the ongoing COVID-19 pandemic and measures put in place to curb its spread on the psychosocial wellbeing of school going children in Bududa District, in Uganda. Methods: This was a cross-sectional study in which randomly enrolled school-going children from three conveniently selected sub-counties, Bukalasi, Bushiyi, and Bushika, in Bududa District, Uganda. Pretested standardised semi-structured questionnaires were used to collect data on the impact of COVID-19 pandemic on education and psychosocial status of the participants. Results: A total of 210 participants were studied. Of this, 122 (53.3%) were male, 203 (96.7%) lived in rural settings, and 155 (73.8%) were staying with both parents. The median age of the participants was 12 (interquartile range: 9 -15) years. One hundred ninety one (90.9%) participants were in primary school. Overall, 154 (73.3%) were worried about not going back to school during the lock down, however, 109 (51.9%) were able to return to school after the easing of the lockdown. Eighty-five (40.5%) participants received reading material at home during lockdown with 64 (30.5%) of the participants accessing teachings through radio. Of the 210 participants, 174 (82.9%) felt worried about the future, 172 (81.9%) felt like they were going to die during lockdown, 141 (67.1%) felt lonely at times, and 129 (61.4%) felt sad or low sometimes during the COVID-19 pandemic. A quarter (54) of 210 participants faced abuse of which 42 (77.8%) faced physical abuse from parents. Of 31 participants who sought help, 19 (61.3%) went to their parents with none getting help from non-governmental organisations. Fifty (23.8%) participants were engaged in work; 33 (66%) were paid, 4 (8%) were forced to work, and 22 (44%) faced physical challenges at their jobs. Conclusion: There was a substantial impact of the COVID-19 pandemic on the education and psychosocial wellbeing of school-going children in Bududa District. A comprehensive child psychological support service should be scaled up to provide support to school going children in vulnerable communities.Item Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda(PLoS ONE, 2017) Nangendo, Joanita; Obuku, Ekwaro A.; Kawooya, Ismael; Mukisa, John; Nalutaaya, Annet; Musewa, Angella; Semitala, Fred C.; Karamagi, Charles A.; Kalyango, Joan N.The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% of people living with HIV are unaware of their status. The current HIV testing policy which is strictly blood-based poses several challenges including: a need for high level laboratory skills, stringent waste disposal needs, and painful sample collection. It is envisaged that introduction of a rapid, painless HIV oral fluid test as a potential alternative is likely to increase the number of people testing. The aim of this study was to determine the diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending Kisenyi Health Centre IV in Kampala. Methods and findings We conducted a cross-sectional study among 440 adults recruited consecutively at Kisenyi Health Centre IV from January to March 2016. The diagnostic accuracy of the HIV oral test was assessed by comparing to the national HIV serial testing algorithm. We also assessed for acceptability among patients and health care workers (HCWs) by triangulating responses from a structured questionnaire, three focus group discussions and seven key informant interviews. Acceptability was defined as willingness to take the test at the time of the study and intention for future use of the test if it was availed. The prevalence of HIV infection among study participants was 14.8%. The HIV oral fluid test was highly accurate with sensitivity of 100% (95% CI; 94.5±100.0), specificity of 100% (95% CI; 99.0±100.0), positive predictive value (PPV) of 100% (95% CI; 94.5±100.0) and negative predictive value (NPV) of 100% (95% CI; 99.0±100.0). Acceptability of HIV oral testing was also high at 87.0% (95% CI; 83.6±89.9). Participants preferred HIV oral testing because it was: pain free (91%, n = 399) and did not require blood draw (82%, n = 360). Conclusion The HIV oral fluid test has high diagnostic accuracy and acceptability. HIV oral testing is a suitable addition to the national HIV testing strategies with the potential of increasing access to HIV testing services in Uganda.Item Estimating the Cost and Cost-effectiveness for Obstetric Fistula Repair in Hospitals in Uganda: a Low Income Country(Health Policy and Planning, 2018-09-24) Epiu, Isabella; Alia, Godfrey; Mukisa, John; Mohammed, Lamorde; Andreas, KuznikIn Africa, about 33 000 cases of obstetric fistula occur each year. Women with fistula experience debilitating incontinence of urine and/or faeces and are often socially ostracized. Worldwide, Uganda ranks third among countries with the highest burden of obstetric fistula. Obstetric fistula repair competes for scarce resources with other healthcare interventions in resource-limited settings, even though it is surgically efficacious. There is limited documentation of its cost-effectiveness in the most affected settings. We therefore sought to assess the cost-effectiveness of surgical intervention for obstetric fistula in Uganda so as to provide appropriate data for policy-makers to prioritize fistula repair and reduce women’s suffering in similarly burdened countries. We built a decision-analytic model from the perspective of Uganda’s National Health System to estimate the cost-effectiveness of vesico-vaginal and recto-vaginal fistula surgery vs a competing strategy of no surgery for Ugandan women with fistula. Long-term disability outcomes were assessed based on a lifetime Markov state-transition cohort and effectiveness of surgery. Surgical costs were estimated by micro-costing local Ugandan health resources. Disability weights associated with vesico-vaginal, recto-vaginal fistula and mortality rates among the general population in Uganda were based on published sources. The cost of providing fistula repair surgery in Uganda was estimated at $378 per procedure. For a hypothetical 20-year-old woman, surgery was estimated to decrease the lifetime disability burden from 8.53 DALYs to 1.51 DALYs, yielding a cost per DALY averted of $54. The results were robust to variations in model inputs in one-way and probabilistic sensitivity analyses. Surgery for obstetric fistula appears highly cost-effective in Uganda. In similar low-income countries, governments and non-governmental organizations need to prioritize training and strengthening surgical capacity to increase access to fistula surgical care, which would be an important step towards achieving universal health coverage.Item 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, HermanTraumatic 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.Item Measurement error of mean sac diameter and crown-rump length among pregnant women at Mulago hospital, Uganda(BMC Pregnancy and Childbirth, 2018) Ali, Sam; Kusaba Byanyima, Rosemary; Ononge, Sam; Ictho, Jerry; Nyamwiza, Jean; Loro, Emmanuel Lako Ernesto; Mukisa, John; Musewa, Angella; Nalutaaya, Annet; Ssenyonga, Ronald; Kawooya, Ismael; Temper, Benjamin; Katamba, Achilles; Kalyango, Joan; Karamagi, CharlesUltrasonography is essential in the prenatal diagnosis and care for the pregnant mothers. However, the measurements obtained often contain a small percentage of unavoidable error that may have serious clinical implications if substantial. We therefore evaluated the level of intra and inter-observer error in measuring mean sac diameter (MSD) and crown-rump length (CRL) in women between 6 and 10 weeks’ gestation at Mulago hospital. Methods: This was a cross-sectional study conducted from January to March 2016. We enrolled 56 women with an intrauterine single viable embryo. The women were scanned using a transvaginal (TVS) technique by two observers who were blinded of each other’s measurements. Each observer measured the CRL twice and the MSD once for each woman. Intra-class correlation coefficients (ICCs), 95% limits of agreement (LOA) and technical error of measurement (TEM) were used for analysis. Results: Intra-observer ICCs for CRL measurements were 0.995 and 0.993 while inter-observer ICCs were 0.988 for CRL and 0.955 for MSD measurements. Intra-observer 95% LOA for CRL were ± 2.04 mm and ± 1.66 mm. Inter-observer LOA were ± 2.35 mm for CRL and ± 4.87 mm for MSD. The intra-observer relative TEM for CRL were 4.62% and 3.70% whereas inter-observer relative TEM were 5.88% and 5.93% for CRL and MSD respectively. Conclusions: Intra- and inter-observer error of CRL and MSD measurements among pregnant women at Mulago hospital were acceptable. This implies that at Mulago hospital, the error in pregnancy dating is within acceptable margins of ±3 days in first trimester, and the CRL and MSD cut offs of ≥7 mm and≥ 25 mm respectively are fit for diagnosis of miscarriage on TVS. These findings should be extrapolated to the whole country with caution. Sonographers can achieve acceptable and comparable diagnostic accuracy levels of MSD and CLR measurements with proper training and adherence to practice guidelines.Item Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda(African Health Sciences, 2021) Batte, Charles; Namusobya, Martha S.; Kirabo, Racheal; Mukisa, John; Adakun, Susan; Katamba, AchillesIn Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are. Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDRTB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sensitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant. Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged between 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prevalence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent. Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DRTB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients.Item Prevalence and factors associated with safe male circumcision among Makerere University undergraduate students, Kampala - Uganda(Research Square, 2019) Nyamwiza, Jean; Mukisa, John; Ictho, Jerry; Ssenyonga, Ronald; Nalutaaya, Annet; Kawooya, Ismael; Benjamin, Temper; Nagendo, Joanita; Musewa, Angella; Ali, Sam; Lako Ernesto Loro, Emmanuel; Agaba, Bekiita Bosco; Kiwuwa, Mpungu Steven; Kalyango, Joan N.; Karamagi, CharlesBackground Safe male circumcision (SMC) is currently recognized as a preventive strategy in reducing the risk of HIV; however, the prevalence of circumcised men in Uganda is still quite low at 26%. This study aimed to determine the prevalence and factors associated with SMC and among Makerere University undergraduate students, in Kampala Uganda. Methods We conducted a cross-sectional study among 602 participants selected using multistage probability sampling strategy. Pretested semi-structured questionnaires and focus group discussions were used to collect data. Quantitative data were analyzed with Stata 12.0, the prevalence ratio and p-values were calculated. Possible interactions and confounding variables were assessed with the Poisson regression model while qualitative data was analyzed with content analysis. Results The overall prevalence of safe male circumcision among male undergraduates was 58.3% (95% CI: 54.37 – 62.24). Factors associated with SMC prevalence included: safety of SMC procedure (Prevalence Ratio (PR) = 1.13, 95% Confidence Interval (CI): 1.03 – 1.25) and friendly health workers (PR = 0.78, 95% CI: 0.74 – 0.83). The perceived benefits of SMC included hygiene (86.5%, n = 521), reduced risk of HIV transmission (4.5%, n = 26) and reduced risk of penile cancer (45.7%, n = 275) while, the perceived barrier was pain (10.1%, n = 61). The students perceived that SMC recipient’s first sexual partner post-procedure should not be his girlfriend. Most participants in all the focus group discussions perceived SMC increases sexual pleasure. Conclusion The overall self-reported SMC success rate among participants was high, along with the safety of SMC services and friendly health workers as important factors among male students. There is a need for continuous sensitization campaigns and communication strategies to address beliefs about SMC, some related misconceptions, and barriers so as to increase its prevalence.Item Prevalence and factors contributing to mental health challenges among school-going adolescents: a case of a climate-vulnerable Manafwa Watershed in Uganda(BioMed Central, 2024-10) Batte, Charles; Apio, Pamela Okwir; Semulimi, Andrew Weil; Nuwasiima, Shivan; Kasoma, Ronald Mutebi; Mwesigwa, Martin Menya; Twinamasiko, Nelson; Siddharthan, Trishul; Mukisa, John; Mukunya, David; Abaatyo, Joan; Nalugya, Joyce SserunjogiGlobally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area.BACKGROUNDGlobally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area.This was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges.METHODSThis was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges.A total of 762 adolescents participated, with a median age of 17 years (interquartile range =16-17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% - 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08-1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15-1.24, p value <0.001] were significantly associated with mental health challenges.RESULTSA total of 762 adolescents participated, with a median age of 17 years (interquartile range =16-17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% - 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08-1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15-1.24, p value <0.001] were significantly associated with mental health challenges.The prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.CONCLUSIONThe prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.Item Prevalence of Electrocardiographic Abnormalities Among People Living With HIV/AIDS in Sub-saharan Africa: Protocol for a Systematic Review and Meta analysis(Researchsquare, 2021) Semulimi, Andrew Weil M.; Kyazze, Andrew Peter; Mukisa, John; Batte, Charles; Bongomin, FelixElectrocardiographic (ECG) abnormalities are highly prevalent among people living with HIV/AIDS (PLWHA) contributing to the rising burden of cardiovascular diseases among this population. SubSaharan Africa (SSA) contributes more than two thirds to the global burden of HIV/AIDS. However, an accurate account of the prevalence of ECG abnormalities in SSA is unknown. This study aims to determine the prevalence of ECG abnormalities among PLWHA in Sub-Saharan Africa. A systematic review and meta-analysis will be conducted. Databases including EMBASE, MEDLINE, African Journal Online and The Cochrane Library (Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Methodology Register) will be used to search for studies published between 1st January 2000 and 31st December 2020. Studies reporting any form of ECG abnormalities will be considered. Additionally, articles in both English and French will be reviewed. Articles will be screened and reviewed by two independent reviewers to determine their eligibility and any disagreement will be resolved through discussions with fourth and fifth reviewer. Eligibility of the studies will be assessed and judged based on the pre-set criteria. Retrieved studies will be assessed for validity using the Cochrane risk of bias tool and the modified Newcastle Ottawa Scale by two reviewers. Analysis of proportions will be done using STATA MP Version 16.0. A p<0.05 will be considered statistically significant. In the face of a growing burden of cardiovascular diseases among PLWHA, this study will provide an estimate of ECG abnormalities among PLWHA which will emphasize the importance of ECGs in screening for cardiovascular diseases in this population.Item The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia(Nutrients, 2022) Tsegaye, Adino Tesfahun; Pavlinac, Patricia B.; Turyagyenda, Lynnth; Mbale, Emmie; Mupere, Ezekiel; Mukisa, John; Lwanga, Christopher; Atuhairwe, Michael; Ahmed, Tahmeed; Kazi, Zaubina; Masheti, Mary; Tickell, Kirkby D.Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of wasting is complex, including social, nutritional, and biological causes. We evaluated the contribution of household food insecurity, dietary diversity, and the consumption of specific food groups to the time to recovery from wasting after hospital discharge. Methods: We conducted a secondary analysis of the Childhood Acute Illness Network (CHAIN) cohort, a multicenter prospective study conducted in six low- or lower-middle-income countries. We included children aged 6–23 months with wasting (mid-upper arm circumference [MUAC] ≤ 12.5 cm) or kwashiorkor (bipedal edema) at the time of hospital discharge. The primary outcome was time to nutritional recovery, defined as a MUAC > 12.5 cm without edema. Using Cox proportional hazards models adjusted for age, sex, study site, HIV status, duration of hospitalization, enrollment MUAC, referral to a nutritional program, caregiver education, caregiver depression, the season of enrollment, residence, and household wealth status, we evaluated the role of reported food insecurity, dietary diversity, and specific food groups prior to hospitalization on time to recovery from wasting during the 6 months of posthospital discharge. Findings: Of 1286 included children, most participants (806, 63%) came from food-insecure households, including 170 (13%) with severe food insecurity, and 664 (52%) participants had insufficient dietary diversity. The median time to recovery was 96 days (18/100 child-months (95% CI: 17.0, 19.0)). Moderate (aHR 1.17 [0.96, 1.43]) and severe food insecurity (aHR 1.14 [0.88, 1.48]), and insufficient dietary diversity (aHR 1.07 [0.91, 1.25]) were not significantly associated with time to recovery. Children who had consumed legumes and nuts prior to diagnosis had a quicker recovery than those who did not (adjusted hazard ratio (aHR): 1.21 [1.01,1.44]). Consumption of dairy products (aHR 1.13 [0.96, 1.34], p = 0.14) and meat (aHR 1.11 [0.93, 1.33]), p = 0.23) were not statistically significantly associated with time to recovery. Consumption of fruits and vegetables (aHR 0.78 [0.65,0.94]) and breastfeeding (aHR 0.84 [0.71, 0.99]) before diagnosis were associated with longer time to recovery. Conclusion: Among wasted children discharged from hospital and managed in compliance with wasting guidelines, food insecurity and dietary diversity were not major determinants of recovery.Item Using mobile audiometry (Wulira App) to assess noise induced hearing loss among industrial workers in Kampala, Uganda: A cross-sectional study(Plos one, 2023) Batte, Charles; Atukunda, Immaculate; Semulimi, Andrew Weil; Nakabuye, Mariam; Bwambale, Festo; Mumbere, Joab; Twinamasiko, Nelson; Mukunya, David; Nyarubeli, Israel Paul; Mukisa, JohnOccupational noise is a common cause of hearing loss in low-income countries. Unfortunately, screening for hearing loss is rarely done due to technical and logistical challenges associated with pure tone audiometry. Wulira app is a valid and potentially cost-effective alternative to pure tone audiometry in screening for occupational hearing loss. We aimed to determine the prevalence of occupational hearing loss among workers in a metal industry company in Kampala district.Item “We are never taught anything about the elderly.” Establishing the gap in elderly health care competencies in nursing education in Uganda(BMC nursing, 2022) Nawagi, Faith; Mukisa, John; Najjuma, Josephine N.; Nabirye, Rose C.Nurses contribute the largest portion of Uganda’s health workforce providing care to individuals of all ages and communities. However, despite the growing number of the elderly population in Uganda with improved life expectancy, there is hardly any study that has looked at the elderly health care competencies in the nursing training programs at various levels. This paper provides an overview of the gaps in elderly health care competencies in nursing education in Uganda. Methods: We conducted a descriptive qualitative cross-sectional study that involved document review, Key Informant Interviews (KIIs) with nursing leaders, and Focus Group Discussions ( FGDs) with faculty at all levels of nursing training and nurses in practice. Data was analyzed using latent and manifest content analysis with Open Code software 4.03. Common categories were identified and incorporated into a matrix to create themes. Results: Almost all the curricula and minimum standards for training nurses at certificate, diploma, and degree levels lack a module and nursing competencies on elderly nursing care. This is aggravated by a lack of faculty trained in elderly health care skills, and a lack of specialized wards for nursing elderly care clinical training among others. Conclusions: There is hardly any elderly health care training module and elderly nursing competencies at all levels of nursing training in Uganda.