NRU :: Browsing by Author "Mutto, Milton"

Browsing by Author "Mutto, Milton"

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Antiretroviral therapy initiation within seven days of enrolment: outcomes and time to undetectable viral load among children at an urban HIV clinic in Uganda
(BMC Infectious Diseases, 2017) Ssebunya, Rogers; Wanyenze, Rhoda K.; Lukolyo, Heather; Mutto, Milton; Kisitu, Grace; Amuge, Pauline; Maganda, Albert; Kekitiinwa, Adeodata
Viral suppression is a critical indicator of HIV treatment success. In the era of test-and-start, little is known about treatment outcomes and time to undetectable viral loads. This study compares treatment outcomes, median times to achieve undetectable viral loads and its predictors under different antiretroviral (ART) treatment initiation schedules (i.e. within seven days of enrolment or later). A retrospective cohort of 367 patients <18 years who enrolled in care between January 2010 and December 2015 with a baseline viral load of >5000 copies/ml were followed up for 60 months. Undetectable viral load measurements were based on both Roche (<20copies/ml) and Abbot (<75copies/ml). Clinical treatment outcomes were compared using chi-squared test. Survival experiences between the two cohorts were assessed through incidence rates and Kaplan Meier curves. A cox model with competing risks was used to assess predictors for time to undetectable viral load. Of the 367 patients, 180 (49.1%) initiated ART within seven days from enrolment, 192 (52.3%) attained undetectable viral load of which 133 (69.3%) were children below six years and 101 (52.6%) were females. Among those who initiated ART within seven days 15 (8.3%) died and 6 (3.3%) were lost to follow-up compared to 27 (14. 4%) and 16 (8.6%) respectively in the later initiators. The median time to undetectable viral load was 24.9 months (95% CI: 19.7, 28.5) among early ART initiators and 38.5 months (95% CI: 31.1, 44.5) among those initiating beyond seven days. There was a significant difference in failure estimates between those initiating within seven and those that deferred (log rank, p = 0.001). Significant predictors for time to undetectable viral load were; starting ART within seven days (SHR = 2.02, 95% CI: 1.24, 3.28), baseline WHO stage I or II (SHR = 1.59, 95% CI: 1.06, 2.28), inconsistent adherence on three consecutive clinic visits (SHR = 0.44, 95% CI: 0.28, 0.67), and baseline weight (SRH = 1.04, 95% CI: 1.01, 1.07).
Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors
(International journal of injury control and safety promotion, 2012) Lawokob, Stephen Emilio Ovugac and Leif Svanstromb; Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif
Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p¼0.0000). Gender differences in time to event were significant (p¼0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p¼0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p¼0.004). Rates varied among schools. Associated factors include sex and school. Rural–urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.
Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: implications for research and policy
(International journal of emergency medicine, 2010) Hsia, Renee Y.; Ozgediz, Doruk; Mutto, Milton; Jayaraman, Sudha; Kyamanywa, Patrick; Kobusingye, Olive C.
Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing countries can help identify risk factors for injury and target interventions for prevention and treatment to decrease disability and mortality. Aim To estimate the epidemiology of the injury seen in patients presenting to the government hospital inKampala, the capital city of Uganda. Methods A secondary analysis of a prospectively collected database collected by the Injury Control Centre-Uganda at the Mulago National Referral Hospital, Kampala, Uganda, 2004-2005. Results From 1 August 2004 to 12 August 2005, a total of 3,750 injury-related visits were recorded; a final sample of 3,481 records were analyzed. The majority of patients (62%) were treated in the casualty department and then discharged; 38% were admitted. Road traffic injuries (RTIs) were the most common causes of injury for all age groups in this sample, except for those under 5 years old, and accounted for 49% of total injuries. RTIs were also the most common cause of mortality in trauma patients. Within traffic injuries, more passengers (44%) and pedestrians (30%) were injured than drivers (27%). Other causes of trauma included blunt/penetrating injuries (25% of injuries) and falls (10%). Less than 5% of all patients arriving to the emergency department for injuries arrived by ambulance. Conclusions Road traffic injuries are by far the largest cause of both morbidity and mortality in Kampala. They are the most common cause of injury for all ages, except those younger than 5, and school-aged children comprise a large proportion of victims from these incidents. The integration of injury control programs with ongoing health initiatives is an urgent priority for health and development.
Estimating the burden of road traffic crashes in Uganda using police and health sector data sources
(Injury prevention, 2021) Muni, Kennedy Maring; Ningwa, Albert; Osuret, Jimmy; Bayiga Zziwa, Esther; Namatovu, Stellah; Biribawa, Claire; Nakafeero, Mary; Mutto, Milton; Guwatudde, David; Kyamanywa, Patrick; Kobusingye, Olive
d In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this crosssectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). Methods A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. Results We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). Conclusions Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
Eﬀectiveness of Peer-supervision on Paediatric Fever Treatment among Registered Private Drug Sellers in East-Central Uganda: An Interrupted Time Series Analysis
(Authorea Preprints, 2020) Bagonza, Arthur; Kitutu, Freddy; Peterson, Stefan; Martensson, Andreas; Mutto, Milton; Awor, Phyllis; Mukanga, David; Wamani, Henry
Rationale, aims and objectives: Appropriate treatment of paediatric fever in rural areas remains a challenge and may be partly due to inadequate supervision of licensed drug sellers. This study assessed the eﬀectiveness of peer-supervision among drug sellers on appropriate treatment of pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than ﬁve years of age in the intervention (Luuka) and comparison (Buyende) districts, in East-Central Uganda. Methods: Data on pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than ﬁve years of age was abstracted from drug shop sick child registers over a 12-month period; six months before and six months after introduction of peer-supervision. Interrupted time series was applied to determine the eﬀectiveness of the peer-supervision intervention on appropriate treatment of pneumonia, uncomplicated malaria and non-bloody diarrhoea among children less than ﬁve years of age attending drug shops in East Central Uganda. Results: The proportion of children treated appropriately for pneumonia symptoms was 10.84% (P<0.05, CI = [1.75, 19.9]) higher, for uncomplicated malaria was 1.46% (P = 0.79, CI = [-10.43, 13.36]) higher, and for non-bloody diarrhoea was 4.00% (p <0.05, CI = [-7.95, -0.13]) lower in the intervention district than the comparison district, respectively. Post-intervention trend results showed an increase of 1.21% (p =0.008, CI = [0.36, 2.05]) in the proportion appropriately treated for pneumonia symptoms, no diﬀerence in appropriate treatment for uncomplicated malaria, and a reduction of 1% (p <0.06, CI = [-1.95, 0.02]) in the proportion of children appropriately treated for nonbloody diarrhoea, respectively. Conclusions: Peer-supervision increased the proportion of children less than ﬁve years of age that received appropriate treatment for pneumonia symptoms but not for uncomplicated malaria and non-bloody diarrhoea. Implementation of community level interventions to improve paediatric fever management should consider including peersupervision among drug sellers.
Healthcare providers’ perceptions on screening for Intimate Partner Violence in healthcare: A qualitative study of four health centres in Uganda
(Open Journal of Preventive Medicine, 2013) Lawoko, Stephen; Seruwagi, Gloria K.; Marunga, Iryne; Mutto, Milton; Ochola, Emmanuel; Oloya, Geoffrey; Piloya, Joyce; Lubega, Muhamadi
The current qualitative study explored the per-ceptions of healthcare providers on screening for Intimate Partner Violence (IPV) in healthcare in Uganda, to develop a conceptual framework for factors likely to hinder/promote IPV screen-ing in the country. Using purposive sampling, the study enlisted 54 healthcare workers (doc-tors and nurses) from four hospitals (i.e. Gulu referral hospital, Iganga referral hospital, Lacor hospital, Anaka hospital) to participate in eight focus group discussions. Data was thematically analysed using Template Analysis. The study found support for an ecological framework suggesting a complex interaction of factors at the individual (e.g. poor skills in detection of IPV by health workers and unwillingness to disclose abuse by patients), organisational (e.g. under-staffing and lack of protocols for IPV screening) and societal (e.g. societal acceptance of abuse of women and poor policy on IPV management) levels as potential barriers to the practice of IPV screening in healthcare Uganda. These findings have important implications on further training of healthcare workers to adequately screen for IPV, re-organisation of the healthcare system so that it is fully-fledged to accommodate IPV scree- ning and improved collaboration between the health sector and other community advocates in IPV management. These initiatives should run concurrently with a concerted community sen-sitization effort aimed at modifying attitudes towards IPV among care providers and recipi-ents a like, as well as preparing the general population to will-fully disclose IPV to health- workers. Study limitations and implications for further research are discussed.
‘I know those people will be approachable and not mistreat us’: a qualitative study of inspectors and private drug sellers’ views on peer supervision in rural Uganda
(Globalization and Health, 2020) Bagonza, Arthur; Peterson, Stefan; Mårtensson, Andreas; Mutto, Milton; Awor , Phllis; Kitutu, Freddy Eric; Linda, Gibson; Wamani, Henry
Peer supervision improves health care delivery by health workers. However, in rural Uganda, self supervision is what is prescribed for licensed private drug sellers by statutory guidelines. Evidence shows that self-supervision encourages inappropriate treatment of children less than ve years of age by private drug sellers. This study constructed a model for an appropriate peer supervisor to augment the self supervision currently practiced by drug sellers at district level in rural Uganda. In this qualitative study, six Key informant interviews were held with inspectors while ten focus group discussions were conducted with one hundred and thirty drug sellers. Data analysis was informed by the Kathy Charmaz constructive approach to grounded theory. Atlas ti.7 software package was used for data management.
Intentional injuries among Ugandan youth: a trauma registry analysis
(Injury Prevention, 2010) Mutto, Milton; Lett, Ronald; Lawoko, Stephen; Nansamba, Catherine; Svanstrom, Leif
To determine intentional injury burden, incident characteristics, and outcomes among Ugandan youth. Methods A cross sectional analysis of trauma registry data from accident and emergency units of five regional referral hospitals was conducted. Data had been prospectively collected from all patients accessing injury care at the five sites between July 2004 and June 2005: youth records were analysed. Results Intentional injuries among youth victims, especially school-age males, are common in all five regions, constituting 7.3% of their injury burden with a male dominance. Intentional youth victimisation mainly occurred at home, on roads, and in public places; incidents were largely due to blunt force, stabs/cuts, and gunshots in general, although variations in causes were evident depending on age. Intentional injuries among the youth victims often manifested as head, neck, and face injuries: 2% were severe and there were 4%case fatalities at 2 weeks. Conclusions and recommendations Intentional injuries among youth victims, especially school-age males, are important contributors of injury burden in all five sites. Homes, roads, and public places are unsafe for Ugandan youth. Although guns were used in all five sites, less lethal mechanisms (blunt force, stabs/cuts, and burns) are the most common with variations between locations. Incidents involving teenage housewives could reflect underlying problem of domestic violence. Community based studies could be highly informative. Youth should be prioritised for prevention of injuries both in and out of school.
Piloting an Educational Response to Violence in Uganda: Prospects for a New Curriculum
(A Journal of Injury and Violence Prevention, 2009) Mutto, Milton; Kahn, Kathleen; Lett, Ronald; Lawoko, Stephen
This pilot study assessed Mato-Oput5 (hereafter the curriculum), a new peace education curriculum, for indications of beneficial efficacy, specifically the capacity to reduce negative attitudes towards conflict and violence, and injury and violence rates. A cluster randomised control design was used. Three of the six purposively selected schools were exposed to the curriculum. Mato-Oput5 is a value-based, formalised curriculum taught by specifically trained teachers. Its learning areas include conflict, conscience, violence, non-violence, impulse control, anger management, kindness, forgiveness, empathy and reconciliation. The results showed the baseline and post-intervention bio-demographic characteristics of the treatment arms to be comparable, thus suggesting baseline group equivalence and randomisation success. The follow-up loss was 9%. The mean pre- and post-intervention intentional incident rates of the intervention and control groups were 270/1000 and 370/1000, and 190/1000 and 350/1000, respectively: these differences were not significant. The intervention had no effect on post-intervention intentional incident rates. There were indications of beneficial efficacy in the curriculum, especially its ability to cause attitude shifts in support of non-violence. Statistically significant behavioural effects were not detected although a downward rate trend was seen in the intervention group.
Piloting the Domestic Violence Healthcare Providers’ Survey for Use in Uganda: Testing Factorial Structure and Reliability
(Psychology, 2012) Lawoko, Stephen; Mutto, Milton; Guwattude, David
A number of instruments to assess healthcare workers readiness to screen for Intimate Partner Violence (IPV) in healthcare are now available to researchers. Before application in new settings however, pilot studies assessing their validity are warranted. Aim: In this pilot study, we assessed the factorial structure and reliability of the Domestic Violence Healthcare Provider Survey Scale (DVHPSS) for future use in Uganda. Method: A convenient sample of healthcare workers at a referral hospital in Arua district, Uganda (n = 90) responded to the DVHPSS. Exploratory factor analysis using principle components and Cronbach’s alphas testing for internal reliability were applied on 86 complete individual responses to items of the DVHPSS. Bivariate correlations were run to assess scale distinctiveness. Re- sults: All but one item of the DVHPSS exhibited significant factor loadings. Most subscales emerging from the factor analysis (i.e. Blame victim, professional role resistance and system support sub-scales) were congruent with the original scales. A split of the original victim/provider safety scale was however evident in the current data, forming two distinct scales i.e. victim and provider safety respectively. Items of the original perceived self-efficacy scale exhibited significant factor loadings but under separate factors, indicating that they may not be measuring a uni-dimensional concept in the Ugandan healthcare context. Conclusions: This data confirms the validity and reliability of the DVHSS for use in Uganda. It is how- ever recommended that items be scored in accordance to the specific sub-scales revealed in this study, to improve the structural validity of any assessment using the DVHPSS in Uganda.
Regulatory Inspection of Registered Private Drug Shops in East-Central Uganda—What it is Versus what it Should Be: A Qualitative Study
(Journal of Pharmaceutical Policy and Practice, 2020) Bagonza, Arthur; Peterson, Stefan; Mårtensson, Andreas; Wamani, Henry; Awor, Phyllis; Mutto, Milton; Musoke, David; Gibson, Linda; Kitutu, Freddy Eric
Regulatory inspection of private drug shops in Uganda is a mandate of the Ministry of Health carried out by the National Drug Authority. This study evaluated how this mandate is being carried out at national, district, and drug shop levels. Specifically, perspectives on how the inspection is done, who does it, and challenges faced were sought from inspectors and drug sellers.Six key informant interviews (KIIs) were held with inspectors at the national and district level, while eight focus group discussions (FGDs) were conducted among nursing assistants, and two FGDs were held with nurses. The study appraised current methods of inspecting drug sellers against national professional guidelines for licensing and renewal of class C drug shops in Uganda. Transcripts were managed using Atlas ti version 7 (ATLAS.ti GmbH, Berlin) data management software where the thematic content analysis was done.Five themes emerged from the study: authoritarian inspection, delegated inspection, licensing, training, and bribes. Under authoritarian inspection, drug sellers decried the high handedness used by inspectors when found with expired or no license at all. For delegated inspection, drug sellers said that sometimes, inspectors send health assistants and sub-county chiefs for inspection visits. This cadre of people is not recognized by law as inspectors. Inspectors trained drug sellers on how to organize their drug shops better and how to use new technologies such as rapid diagnostic tests (RDTs) in diagnosing malaria. Bribes were talked about mostly by nursing assistants who purported that inspectors were not interested in inspection per se but collecting illicit payments from them. Inspectors said that the facilitation they received from the central government were inadequate for a routine inspection.The current method of inspecting drug sellers is harsh and instills fear among drug sellers. There is a need to establish a well-recognized structure of inspection as well as establish channels of dialogue between inspectors and drug sellers if meaningful compliance is to be achieved. The government also needs to enhance both human and financial resources if meaningful inspection of drug sellers is to take place.
Regulatory inspection of registered private drug shops in East-Central Uganda—what it is versus what it should be: a qualitative study
(Journal of Pharmaceutical Policy and Practice, 2020) Bagonza, Arthur; Peterson, Stefan; Mårtensson, Andreas; Wamani, Henry; Awor, Phyllis; Mutto, Milton; Musoke, David; Gibson, Linda; Kitutu, Freddy Eric
Regulatory inspection of private drug shops in Uganda is a mandate of the Ministry of Health carried out by the National Drug Authority. This study evaluated how this mandate is being carried out at national, district, and drug shop levels. Specifically, perspectives on how the inspection is done, who does it, and challenges faced were sought from inspectors and drug sellers. Methods: Six key informant interviews (KIIs) were held with inspectors at the national and district level, while eight focus group discussions (FGDs) were conducted among nursing assistants, and two FGDs were held with nurses. The study appraised current methods of inspecting drug sellers against national professional guidelines for licensing and renewal of class C drug shops in Uganda. Transcripts were managed using Atlas ti version 7 (ATLAS.ti GmbH, Berlin) data management software where the thematic content analysis was done. Results: Five themes emerged from the study: authoritarian inspection, delegated inspection, licensing, training, and bribes. Under authoritarian inspection, drug sellers decried the high handedness used by inspectors when found with expired or no license at all. For delegated inspection, drug sellers said that sometimes, inspectors send health assistants and sub-county chiefs for inspection visits. This cadre of people is not recognized by law as inspectors. Inspectors trained drug sellers on how to organize their drug shops better and how to use new technologies such as rapid diagnostic tests (RDTs) in diagnosing malaria. Bribes were talked about mostly by nursing assistants who purported that inspectors were not interested in inspection per se but collecting illicit payments from them. Inspectors said that the facilitation they received from the central government were inadequate for a routine inspection. Conclusion: The current method of inspecting drug sellers is harsh and instills fear among drug sellers. There is a need to establish a well-recognized structure of inspection as well as establish channels of dialogue between inspectors and drug sellers if meaningful compliance is to be achieved. The government also needs to enhance both human and financial resources if meaningful inspection of drug sellers is to take place.
State of pedestrian road safety in Uganda: a qualitative study of existing interventions
(African Health Sciences, 2021) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny Enock; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods: We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results: Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion: The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda’s pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
State of pedestrian road safety in Uganda: are interventions failing or absent?
(Research Square, 2019) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny E.; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Background In Uganda, pedestrians are the most frequently injured category of road users, accounting for 40% of road traffic fatalities and 25% of serious injuries every year. There is paucity of information on existing pedestrian interventions and challenges that affect their implementation in Uganda. In this paper, we ascertain the state of pedestrian road safety interventions in Uganda and explore the challenges in the process of design, implementation, monitoring and evaluation of existing interventions. Methods We conducted a qualitative study that started with a desk review of existing policy documents, police statistics, media reports, non-governmental organization reports, and published research. We supplemented the review with 14 key informant interviews and 4 focus group discussions. Participants were drawn from various agencies and stakeholders responsible for road safety. In total, we collected and synthesized data on the design, implementation, and evaluation of pedestrian safety interventions from 25 documents. Data were analyzed using qualitative thematic content analysis. Results The National Road Safety Council within the Ministry of Works and Transport is the lead agency tasked with coordinating all road safety efforts, while the Uganda Police is largely engaged in enforcing pedestrian safety. We identified several existing policies and regulations for pedestrian safety like the Non- Motorized Transport policy whose implementation has been inadequate. Implementation is constrained by weak institutional capacity and limited resources. Moreover, road safety stakeholders operated in silos and this hindered efforts to coordinate pedestrian safety activities. Interventions like road designs were implemented with limited reference to any supporting data and therefore did not cater for pedestrian needs. Conclusion There are interventions targeting pedestrian safety in Uganda, but effective implementation is lacking or failing due to constraints related to weak institutional capacity. This necessitates strategies to mobilize resources to strengthen the capacity of the lead agency to effectively coordinate road safety interventions.
Structural validity and reliability of the integrated conflict and violence scale
(International journal of injury control and safety promotion, 2010) Mutto, Milton; Lawoko, Stephen; Ovuga, Omilio; Bangdiwalad, Shrikant
The study validated structure stability, reliability and sub-scale distinctiveness of integrated conflict and violence scale (ICVS) and was cross-sectional; war-affected grade 5 school children participated. ICV internal factorial validity and reliability were evaluated; eigenvalue size and scree plots were used for factor selection. A variable retention factor load threshold of 40.30 was used: Cronbach’s a tests confirmed reliability increments. Pair-wise Pearson correlation tests evaluated sub-scale distinctiveness. Gulu University granted ethical clearance. A total of 280 grade 5 children from 50 primary schools participated: 53% of them were males. Two factors accounted for 100% of variability in attitudes; 18 variables were retained. Expelled variables were: ‘If I catch some one stealing my sugar cane I will fight’ and ‘a bully should be forgiven’. Sub-scale internal consistency reliability coefficients were 0.73 and 0.65, respectively and distinctiveness correlation coefficient was 70.06. The ICVS was validated using standard criteria. Emerging two-factor scale has acceptable psychometric properties especially factorial structure, internal consistency and sub-scale distinctiveness.
Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit
(Journal of injury and violence research, 2011) Mutto, Milton; Lawoko, Stephen; Nansamba, Catherine; Ovuga, Emilio; Svanstrom, Leif
Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. Methods: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years). Results: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. Conclusions: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.

Browsing by Author "Mutto, Milton"

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