Browsing by Author "Nakawuki, Ashley Winfred"

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    Bacterial colonization, species diversity and antimicrobial susceptibility patterns of indwelling urinary catheters from postpartum mothers attending a Tertiary Hospital in Eastern Uganda
    (PLoS ONE, 2022) Nakawuki, Ashley Winfred; Nekaka, Rebecca; Ssenyonga, Lydia V. N.; Masifa, George; Nuwasiima, Dorreck; Nteziyaremye, Julius; Iramiot, Jacob Stanley
    Postpartum urinary Catheter-Related Infections (CRIs) are a significant cause of maternal sepsis. Several studies done have reported the presence of mixed populations of bacteria with a significant increase in Extended-Spectrum Beta-Lactamase (ESBL) Enterobacteriaceae spps, Methicillin-Resistant Staphylococcus aureus (MRSA), Multi-Drug Resistant (MDR) bacteria in urine and blood cultures of catheterized patients despite the use of prophylactic antibiotics. This study aimed at determining the bacterial species diversity and susceptibility patterns of indwelling urinary catheters from postpartum mothers attending Mbale Regional Referral Hospital (MRRH). Methods A cross-sectional study employing quantitative and qualitative was carried out in MRRH among postpartum mothers with urinary catheters and their care-takers. The purposive non-random sampling strategy was used to collect data using an interviewer-administered questionnaire for the quantitative data collection and in-depth interviews for qualitative data collection. All the data collection tools used were developed, pretested and validated. At the point of de-catheterization, Catheter tips from enrolled participants were cut about 2-3cm below the balloon aseptically into test-tube containing peptone water, sonication technique employed, and incubation done 24hours then cultured to ensure phenotypic identification. An antibiotic sensitivity test was performed using the disc diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Quantitative data collected was entered in Microsoft Excel and then exported to STATA14 for statistical analysis. Thematic analysis was used to analyse and organise qualitative data by an inductive coding method using Nvivo 12 software. Results In this study, 208 postpartum mothers participated, the majority of whom were caesarean section mothers of age range 20–24 years and 17 care-takers with a median age of 32 years. The prevalence of catheter tips bacterial colonisation was 98% despite 88.5% of the participants being on broad-spectrum antibiotics. The average duration of catheterisation was 2 days. All bacteria isolates were potential uro-pathogens with a mean occurrence of 2 bacteria species in each urinary catheter tip. The rates of MDR to commonly used antibiotics were high. The urinary catheter size of greater than F14 and duration of catheterization greater than 2 days were significantly associated with the number of bacterial species isolated from each sample. The maintenance care and knowledge of care-urinary catheter care among the care-takers was found sub-optimal. Conclusion There was a high prevalence of catheter colonisation with bacterial spps diversity averaging 2 spps per sample despite use of broad spectrum antibiotics. The MDR rates were high, which calls for routine culture and sensitivity. Health workers practicing obstetric medicine need to pay attention to catheter sizes during catheterisation and its duration. Health education should be part of antenatal and postnatal care education.
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    COVID-19 Vaccination Uptake and Self-Reported Side Effects among Healthcare Workers in Mbale City Eastern Uganda
    (medRxiv, 2022) Madut Akech, Gabriel; Kanyike, Andrew Marvin; Galabuzi Nassozi, Ashah; Aguti, Beatrice; Nakawuki, Ashley Winfred; Kimbugwe, Denis; Kiggundu, Josen; Maiteki, Robert; Mukyala, Dorothy; Bongomin, Felix; Obakiro, Samuel Baker; Nekaka, Rebecca; Iramiot, Jacob Stanley
    Fear of anticipated side effects has hindered the COVID-19 vaccination program globally. We report the uptake and the self-reported side effects (SEs) of the COVID-19 vaccine among Healthcare workers (HCWs) in Mbale City Eastern Uganda. Methods: A cross-sectional survey of HCWs at seven different level health facilities was conducted from 6th September to 7th October 2021 using a structured self-administered questionnaire. Results: COVID-19 vaccine had been received by 119 (69%) participants of which 79 (66%) received the two recommended doses of the AstraZeneca vaccine. Getting vaccinated was associated with working in a lower health facility (aOR= 14.1, 95% CI: 4.9 – 39.6, P=0.000), perceived minor risk of contracting COVID-19 (aOR= 12.3, 95% CI: 1.0 – 44.6, p=0.047), and agreeing that COVID-19 vaccine is protective (aOR= 16.7, 95% CI: 5.6 – 50.4, p=0.000). 97 (82%) of participants experienced side effects to at least one dose of which most were mild on both the first (n=362, 51%) and second dose (n=135, 69%). The most frequently reported side effects on the first and second dose were fever (79% and 20%), injection site pain (71% and 25%), and Fatigue (69% and 20%) respectively. Conclusions: The majority of the HCWs in Mbale City had received at least one dose of the COVID-19 vaccine and experienced a side effect. The side effects were mostly mild on either dose thus the vaccines are generally safe.