Browsing by Author "Nekaka, Rebecca"
Now showing 1 - 17 of 17
Results Per Page
Sort Options
Item Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda(PloS one, 2020) Nteziyaremye, Julius; Iramiot, Stanley Jacob; Nekaka, Rebecca; Musaba, Milton W.; Wandabwa, Julius; Kisegerwa, Enoch; Kiondo, PaulAsymptomatic bacteriuria in pregnancy (ASBP) is associated with adverse pregnancy outcomes such as pyelonephritis, preterm or low birth weight delivery if untreated. The aim of this study was to determine the prevalence of asymptomatic bacteriuria, the isolated bacterial agents, and their antibiotic sensitivity patterns in pregnant women attending antenatal care at Mbale Hospital. Methods This was a cross sectional study in which 587 pregnant women with no symptoms and signs of urinary tract infection were recruited from January to March 2019. Mid-stream clean catch urine samples were collected from the women using sterile containers. The urine samples were cultured using standard laboratory methods. The bacterial colonies were identified and antibiotic sensitivity was done using disc diffusion method. Chi squared tests and logistic regression were done to identify factors associated with asymptomatic bacteriuria. A p value < 0.05 was considered statistically significant. Results Out of the 587 pregnant women, 22 (3.75%) tested positive for asymptomatic bacteriuria. Women aged 20–24 years were less likely to have ASBP when compared to women aged less than 20 years (AOR = 0.14, 95%CI 0.02–0.95, P = 0.004). The most common isolates in descending order were E. coli (n = 13, 46.4%) and S.aureus (n = 9, 32.1%). Among the gram negative isolates, the highest sensitivity was to gentamycin (82.4%) and imipenem (82.4%). The gram positive isolates were sensitive to gentamycin (90.9%) followed by imipenem (81.8%). All the isolates were resistant to sulphamethoxazole with trimethoprim (100%). Multidrug resistance was 82.4% among gram negative isolates and 72.4% among the gram positive isolates. Conclusion There was high resistance to the most commonly used antibiotics. There is need to do urine culture and sensitivity from women with ASBP so as to reduce the associated complications.Item Asymptomatic Bacteriuria and Candida Colonization among Pregnant Women in a District Hospital in Eastern Uganda(Journal of Advances in Medicine and Medical Research, 2019) Bakandonda, Fredrick; Muwanguzi, Shadrack; Nakate, Prossy; Opolot, Ismail; Imongit, Sam; Nnakanwagi, Mariam Mirembe; Nteziyaremye, Julius; Nekaka, Rebecca; Iramiot, Jacob StanleyUrinary tract infection (UTI) is the most common reason for which antimicrobials are prescribed in pregnancy Worldwide. This study aimed to determine the prevalence of asymptomatic bacteriuria, Candida colonization and antimicrobial susceptibility patterns among pregnant women attending antenatal in a District Hospital in Eastern Uganda. Materials and Methods: A descriptive cross sectional study was conducted in which pregnant mothers who had come for routine antenatal care were counseled and their consents obtained before taking off urine samples for laboratory diagnosis. For those samples found to have pus cells, culture and sensitivity test was done to identify the organisms and determine susceptibility to particular antibiotics and antifungal agents. Results: Gram negative isolates were more sensitive to meropenem (100%), and ciprofloxacin (93.8%) but less sensitive to trimethoprim/sulphurmethoxazole (20%), Ceftazidime (7%), and Cefepime (6%). Gram positive isolates were more sensitive to vancomycin (100%), meropenem (87%) and linezolid (88.1%) but less sensitive to Cefotaxime (31%) and Trimethoprim / sulphurmethoxazole (14%). All bacteria isolated in this study were multi-drug resistant (MDR). All Candida isolates were susceptible to Econazole and Nystatin whereas all isolates were resistant to Griseofulvin. Conclusion: The prevalence of asymptomatic bacteriuria among pregnant women in Butaleja district is high with many of the bacteria isolated exhibiting resistance to the commonly used antibiotics. Antifungal resistance was common in this study.Item 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 StanleyPostpartum 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.Item Baseline Assessment of Risk Factors of Presumptive Tuberculosis among under Five Children Living with an Index Client under Treatment in Mbale District, Eastern Uganda(Microbiology research journal international, 2020) Tumusiime, Rosemary; Mukasa, Charles; Kisakya-Maria, Agatha K.; Neumbe, Irene Mildred; Odyeny, Jerome; Maube, Bernard; Gavamukulya, Yahaya; Nekaka, RebeccaChildren in contact with adults having pulmonary Tuberculosis (TB) are vulnerable to TB infection and hence contact tracing and screening is important for early detection of infection. However, there are few contacts traced and the prevalence and risk factors for transmission are not well studied. The objective of this study was to determine the prevalence of infection and risk factors associated with TB transmission among under five children in household contact with adult pulmonary TB patients. Materials and Methods: A cross sectional study was carried out in three health facilities with a high TB burden in Mbale District, Eastern Uganda involving all under five household contacts of adults with pulmonary tuberculosis recorded in the TB register from October 2018 to March 2019 and still on treatment. Structured questionnaires were administered to the index clients to obtain their demographic and clinical data about TB, HIV as well as information on the children. Children were screened using the intensive case finding forms to identify presumptive cases. Results: The total number of index TB Clients line listed were 70. Number of clients traced was 38, 21 (%) of whom had children under five years and a total of 33 children were identified. The number of presumptive cases was 9/33 (27.27%). 77.8% of the presumptive cases were living in poorly ventilated houses. Conclusion: The study identified children with presumptive TB and various risk factors for TB transmission. Intensive contact tracing can therefore help reduce TB transmission within the communities. It is recommended to undertake studies aiming at improving contact tracing and strategies to eliminate the risk factors to TB transmission.Item Bottlenecks and opportunities towards achieving the targeted 95-95-95 HIV services in a rural district in Eastern Uganda [version 1; peer review: awaiting peer review](F1000Research, 2022) Namenkere, Monkya Samuel; Stella, Ayaa Mary; Linda, Sukuku; Kharono, Juliet; Mugabi, Charles; Chelangat; Chelangat, Benina; Abwola Olwedo, Mary; Nabasumba, Carol; Oboth, Paul; Osele, Julius; Nekaka, Rebecca; Iramiot, Jacob StanleyBackground: Uganda has made progress in reducing its HIV prevalence from 7.3% in 2011 to 6% in 2017, however, more needs to be done to meet the World Health Organization (WHO) target of 95% of the population knowing their HIV status, 95% enrolled on treatment and 95% achieving viral suppression. This study aimed to assess the bottlenecks and opportunities towards achieving the 95 95 95 targeted HIV services in the Bukedea district. Methods: A mixed-methods cross-sectional study was conducted in the Bukedea district covering males and females aged 18-65 years who had consented to participate in the study. We used a purposive sampling procedure to select our study participants. Qualitative data was collected through focus group discussions, key informant interviews, and document reviews for quantitative data. Quantitative data were analyzed using STATA v 14 whereas qualitative data were analyzed using the thematic analysis approach. Results: The challenges were grouped as patient-related, medicationrelated, and facility-related. The patient-related challenges were stigma, fear of taking the medication, poor nutrition, long distances, alcoholism, busy working schedules, and domestic violence. The medication-related challenges were side effects and pill burden. The facility-related challenges were inadequate pretest counseling and stock-outs. The use of anti-retroviral drugs (ART) was common in piggery and poultry and the sources of these drugs were reported to be the people on ART and the health workers. The opportunities included home-based counseling, organizing more outreaches, counseling and health education, targeted testing, and strengthening the Village Health Teams (VHT) networks. Conclusions: The study revealed that the major challenges towards achieving the targeted 95-95-95 HIV services were stigma, inadequate pre-test counseling, fear of disclosure, and poor adherence due to alcoholism, sharing of drugs with animals and partners. The use of anti-retroviral drugs in animal husbandry was common in the Bukedea District.Item Choice, Attitudes, and Perceptions of Undergraduate Nursing Students towards the Nursing Profession(Research Square, 2022) Neumbe, Irene Mildred; Ssenyonga, Lydia; Soita, David Jonah; Iramiot, Jacob Stanley; Nekaka, RebeccaNursing students are the upcoming contributors to the nursing workforce and their attitudes towards the profession depict the quality of care they will offer to patients upon qualification. This study aimed to determine the reasons for choice, attitudes, and perceptions of undergraduate nursing students towards their profession. Methods: This cross-sectional study involved 165 nursing students from year one to year four registered in the two public universities in Uganda. The Attitude Scale for Nursing Profession was used to collect quantitative data. Focus Group Discussions were held to collect qualitative data about the reasons for choice and perceptions towards the nursing profession. Results: Students chose the nursing program because of its availability, poor academic performance in high school, desire to pursue a medical-related course, failure to get admitted for Medicine and Surgery, low cut-off points for the Nursing course, and interest in nursing. The majority of the students (81.8%) had positive attitudes towards the nursing profession. There was a statistically significant difference between the mean attitude scores of nursing students according to the year of study, entry scheme into the University, and source of funding for the program. Perceptions about the nursing profession were based on their personal experiences, experiences of colleagues, and observation of how nurses are treated at work. Conclusion: Although nursing students had positive attitudes towards the nursing profession, the majority of their perceptions about the profession were negative. Nursing training institutions should ensure that students receive pre-nurse counseling and introductory courses about the profession to enhance the acquisition of an accurate perception of the nursing profession.Item 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 StanleyFear 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.Item Factors Associated with Teenage Pregnancy and its Effects in Kibuku Town Council, Kibuku District, Eastern Uganda: A Cross Sectional Study(Primary Health Care: Open Access, 2018) Manzi, Fred; Ogwang, Joshua; Akankwatsa, Allen; Wokali, Oliver Caroline; Obba, Francis; Bumba, Ahmed; Nekaka, Rebecca; Gavamukulya, YahayaThe prevalence of teenage pregnancy in Kibuku District was reported to be 35.8% in 2016, higher than the average rate for rural areas in Uganda estimated at 27%. This study aimed at determining the factors associated with teenage pregnancy and its effects in Kibuku Town Council, Kibuku District. The research used a cross sectional study that employed both quantitative and qualitative methods. Researcher administered questionnaires were given to 180 teenagers in three randomly selected secondary schools in Kibuku Town Council while oral interviews were conducted to 40 pregnant teenagers and teenage mothers attending antenatal clinic at Kibuku Health Centre IV. Microsoft excel and SPSS were used to analyze the data and it was represented in form of frequency tables and figures. There was a big knowledge gap about reproductive health as 75% of school going teenagers believed the minimum age of conception was above 14 years. Bad peer groups, enticement with gifts and poverty were the most common causes of teenage pregnancy while school dropout at 48%, broken marriages and miscarriages at 9% were recorded as its major effects. In conclusion, teenage pregnancy remains a major problem in Kibuku Town Council, Kibuku District and needs urgent interventions which include encouraging parents and schools to adopt a culture of discussing sexual and reproductive health, advocating for abstinence and where necessary, contraception be made open and accepted without stigma.Item Impact of Differentiated Service Delivery Models on Retention and Viral Load Suppression among Art Clients in Communities in Eastern Uganda(Research Square, 2022) Jemba, Brian; Waiswa, Sinani; Balinaine, Joseph; Lomuria, Rosaria; Nabutanyi, Gift Gloria; Ongala, Emmanuel; Opus, Benjamin; Iramiot, Jacob Stanley; Oboth, Paul; Anwola Olwedo, Mary; Nekaka, RebeccaAlthough Uganda rolled out Differentiated Service Delivery models in 2017 to improve retention and achieve viral load suppression, these have remained low relative to UNAIDs targets of 95-95-95 by 2030. We determined the impact of facility and community DSD Models on viral load suppression and retention among ART clients in Katakwi district in North Eastern Uganda. Methods; A retrospective cohort study of all ART clients in the different approaches of DSD models who were active by 2017, were followed up to 2020. The primary outcomes were retention and viral load suppression of ART clients in different approaches. Eight health facilities providing ART services were purposively sampled and 771 ART clients were sampled out by simple random sampling out of 4742 total population on ART in Katakwi district. We analysed retention, viral load suppression, and their determinants by logistic regression method using STATA. Results; A total of 771 participants were sampled of whom 42.7% were male and 57.3% were females, with the mean age being 40 years. While retention rates at 95% CI of participants were 99.35% at 12 months, 94.03 at 24 months, 89.88% at 36months, and 84.57% at 48months. The viral load suppression rates were57.3% at 12 months, 70.3% at 24 months, 70.3% at 36 months, and 69% at 48 months. Retention was higher in the community-based DSD model as compared with the facility-based model. Viral load suppression was higher in the community-based DSD models in which CDDP had the highest achievement (92%) followed by CCLAD (79%) compared to the facility-based DSD models in which FBIM performance (34.3%) was far below the set standard of 95%, followed by FBG (65%) with FTDR having relatively better performance (80.9%).Being 40–59 years, receiving care from the general hospital, being married, having good current adherence, being on the first line of the current regimen, and being a female as other predictors of viral load suppression whereas being 40–59 years of age, having good current adherence, being on the current first-line regimen, and having no comorbidities were predictors of good retention. Conclusions; Both facility and community-based DSD models have led to improved retention and viral load suppression however community-based models have shown to be more effective than facility-based models through mitigation of barriers to effective HIV/AIDS care of patients on ART. Viral load suppression remained low below the UNAIDs target of 95% by 2030 albeit it improved over time.Item Infectious Waste Management in the Face of COVID- 19 in a Rural Health Facility in Eastern Uganda(Asian Journal of Medicine and Health, 2021) Okia, David; Iramiot, Jacob Stanley; Kagoya Kawala, Enid; Nekaka, Rebecca; Karungi, Veronica; Musoki, Drake; Oteko, Alfred; Nakisuyi, Janet; Aisu, EmmanuelThis study aimed to assess Infectious Waste Management in face of COVID-19, among Health care workers in Rural Health Facilities in Amuria district, Eastern Uganda. Little evidence exists of the challenges that occur while implementing Infectious waste management in the face of COVID-19 in resource-limited settings in Eastern Uganda. Our findings will close this apparent research gap and inform current district and national policies in Infectious Waste Management. Materials and Methods: We conducted cross-sectional survey in five health facilities in Amuria district, using modified CDC Infection Control Assessment Tool for health facility, and a validated structured questionnaire to assess the knowledge of health care workers present on Infectious waste management in the face of COVID-19. Observation and in-depth interviews were also conducted in addition to assess the practice and attitude of staff towards infectious waste management. Results: The five (100%) of the Health Facilities assessed in Amuria district lacked written infection prevention policies and procedures that are current, and are based on evidence-based guidelines. The facilities also had no competency-based training program that provides job-specific training on infection prevention policies and procedures to health care personnel. In terms of knowledge, Waste handlers had poor knowledge in infection control only 8.3% of the medical waste handlers could identify biohazard symbols and knew how infectious waste is segregated into the different categories at the point of generation. All (100%) of the health care workers were knowledgeable about the COVID-19 standard operating procedures. Conclusion: The doctors, nurses, clinical officers, and laboratory personnel had good knowledge of infectious waste Management and were up to date with COVID-19 standard operating procedures. The Medical Waste handlers had poor knowledge of Infectious Waste Management and COVID-19 standard operating procedures. Medical Waste handlers also had a poor attitude, towards the use of personal protective gear while on duty. All the Medical Waste handlers were willing to be trained in Infectious Waste Management. The facilities assessed had no enabling environment for infection control (no policies and in-service training in infection control for staff).We recommend Medical Waste Handlers to be trained in infection control and prevention before and after they are employed.Item Knowledge and Perception of Caregivers about Risk Factors and Manifestations of Pneumonia among Under Five Children in Butaleja District, Eastern Uganda(Microbiology Research Journal International, 2018) Aguti, Beatrice; Kalema, Godfrey; Lutwama, Dinah Maria; Mawejje, Martin Loy; Mupeyi, Emmanuel; Okanya, David; Nekaka, RebeccaDespite the widespread national intervention strategies to curb its occurrence, Pneumonia remains one of the leading causes of morbidity in Butaleja district. This was a crosssectional study carried out at Busolwe Hospital and aimed at establishing the knowledge and perception of caregivers about risk factors and manifestations of childhood pneumonia and it's high prevalence among the under-five children (U5C) in the district. Methods: Structured researcher administered questionnaires were given to 302 caregivers of U5C visiting the hospital who were enrolled on a continuous random basis from April to May 2018. Microsoft Excel was used to retrieve and analyze the data which was then represented in form of frequencies and proportions. Results: The study found that the majority of caregivers had inadequate knowledge about the condition, despite 69.5% of their U5C having suffered from pneumonia in the previous year. Additionally, some of the contributing factors to the high prevalence of pneumonia included poor ventilation in the houses, the presence of swamps contributing to coldness, failure to complete the immunisation dose and overcrowding in the households leading to household air pollution. Conclusion: Pneumonia remains a big health challenge in Butaleja District as evidenced by the knowledge gap among caregivers as well other contributing factors which lead to its increased prevalence. In order reduce the burden, a comprehensive community sensitisation program needs to be rolled out to address most of the factors. It would also be important to look into the possible misdiagnosis of the condition and rule out antibiotic resistance to come up with an effective management strategy for curbing the high prevalence of pneumonia among the U5C in Butaleja District. Finally, the establishment of a National Health Insurance Scheme is strongly recommendedItem Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda(PloS one, 2020) Nekaka, Rebecca; Nteziyaremye, Julius; Oboth, Paul; Iramiot, Jacob Stanley; Wandabwa, JuliusUganda ranks third in the number of deaths attributable to malaria and has some of the highest recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated with detrimental effects for the mother and unborn baby and these effects seem to have long term effects and consequences on the life of the baby. Despite the preventive measures put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy is still high. We determined the use of malaria preventive strategies during pregnancy and the presence of plasmodium infection, anemia, and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. Methods A cross-sectional study was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, antenatal care, and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for Plasmodium infection by both microscopy of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2 mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia was determined by the use of an automated hemoglobin analyzer. Data were analyzed using descriptive and analytical statistics. Results Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively. PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at least three doses of IPTp-SP and 57.9% reported sleeping under an Insecticide Treated Net the night before the survey. The women who reported sleeping under a mosquito net the previous night (OR 0.67, 95% CI: 0.24–1.86) and those who reported taking fansidar as a directly observed therapy (OR 0.31, 95% CI: 0.04–2.39) appeared to have few chances of getting plasmodium infection though the findings were not statistically significant. Conclusion The effective use of malaria preventive strategies (IPT-SP and Insecticide Treated Nets) was generally low. Most of the women took less than three doses of SP and there was no strict adherence to the recommended directly observed therapy. The prevalence of Plasmodium infection during pregnancy was low though maternal anaemia and low birth weight were relatively high.Item Pneumococcal carriage and antibiotic susceptibility patterns in mother-baby pairs in a rural community in Eastern Uganda: a cross-sectional study(F1000Research, 2020) Madut Akech, Gabriel; Naloli, Mercy; Sebwami, Paul; Kazibwe, Patrick; Atwikiriize, Maureen; Onyait, Julius; Oboth, Paul; Nteziyaremye, Julius; Nekaka, Rebecca; Iramiot, Jacob StanleyPneumonia poses a significant threat to the lives of children below five years old worldwide, contributing to a high number of hospitalizations and death. Morbidity and morbidity are especially common in children under five and the elderly, although any age group can be affected. This study aimed to estimate pneumococcal carriage and determine antibiotic susceptibility patterns of the pneumococci isolated from mother-baby pairs in Ngora district after the rollout of the pneumococcal vaccine. We hypothesized that high carriage of Streptococcus pneumoniae in mothers leads to carriage in their babies and hence a greater chance of contracting pneumonia. Methods: Consecutive sampling was used to select 152 mother-baby pairs from community visits and those seeking care at the health facility. We collected nasal swabs from both baby and mother for culture and sensitivity testing using the Kirby-Bauer’s agar disc diffusion method. Results: This study found that there was a low prevalence of pneumococcal carriage in the mother-baby pair in Ngora district. We also observed high rates of microbial resistance to penicillin, which is the first-line drug for the management of pneumonia in Uganda. Conclusions: The relationship between pneumococcal carriage and immunization status suggests that the pneumococcal vaccine is protective against pneumococcal carriage. Resistance of S. pneumoniae to commonly used antibiotics was high.Item Sero-Prevalence and Factors Associated with Helicobacter pylori Infection in a Rural Population in Eastern Uganda: A Community Cross-sectional Study(Primary Health Care: Open Access, 2021) Nekaka, Rebecca; Oboth, Paul; Nteziyaremye, Julius; Gavamukulya, Yahaya; Ssenyonga, Lydia V. N.; Iramiot, Jacob StanleyGlobally, 50% or more of the world’s population is infected with Helicobacter pylori making it the most widely spread bacteria across the world. The low developed countries are more overburdened by Helicobacter pylori infection than the developed countries. H. pylori infection is associated with duodenal ulcer, chronic atrophic gastritis (CAG), lymphomas, and adenocarcinoma. This study reports the prevalence of H. pylori and its associated factors in Eastern Uganda. Materials and methods: A cross-sectional study involving 275 participants was carried out in eastern Uganda. H. pylori serology was done and face to face interviewer-administered questionnaire were used for data collection. Data were entered in Microsoft Excel and imported to Stata version 14 for analysis and a P value of <0.05 was considered statistically significant. Results: The seroprevalence of H. pylori was 27.3% (75/275) with 28.4% (50/176) of the females being positive compared to 25.3% (25/99) of the males. Consumption of animal products (meat, milk, and eggs) was the only statistically significant factor associated with H. pylori seropositivity (P <0.001, 95% CI =1.934-4.209, AOR=2.85). Conclusion: The H. pylori seroprevalence is high in eastern Uganda. Consumption of animal products was a positive predictor of infectivity.Item Sharp/Needlestick Injuries Among Clinical Students at A Tertiary Hospital in Eastern Uganda.(medRxiv, 2023) Ndyamuhakyi, Elisa; Ssenyonga, Lydia; Iramiot, Jacob Stanley; Nuwasiima, Doreck; Nekaka, RebeccaClinical students, like health workers, are at risk of sharp/needle stick injuries and potential percutaneous exposure to blood and body fluids. They acquire infections like Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) through injuries. This study determined the prevalence and factors associated with sharp injuries among clinical students at Mbale Regional Referral Hospital. Methods: Across sectional study was carried out at Mbale Regional Referral Hospital, a teaching hospital located along Pallisa road, Mbale City, Eastern Uganda. Ethical approval was obtained, Printed and soft copy questionnaires eliciting demographics, injury occurrence and associated factors were randomly and conveniently distributed respectively to 322 clinical students. Data was entered in Microsoft excel, cleaned and exported to STATA version 14 for analysis. Results: One hundred sixty (55.2%) clinical students had sustained a sharp injury in their clinical practice with a self-reported prevalence of 46.6% in the last year. The majority of the students 93(68.9%), sustained multiple sharp injuries. The common cause and site of injury were solid needles 72(45%) and finger (83.1%). Most students, 197(67.9%) reported ward procedures not being supervised and 124(42%) students worked on 15 and above patients daily. Final year clinical students were more likely to sustain sharp injuries than semi-finalists (P=0.000, OR 3.195% CI 1.7-5.5). Students who worked on ≥15 patients were more likely to sustain a sharp injury than those who attended to < 15 patients daily (P=0.000, OR 6.3 95% CI 3.7-10.8%). Students’ knowledge about sharp/infection control was limited. Conclusion: This study showed a high prevalence of needle stick injuries among clinical students. The associated factors were; the year of study, having not learned about infection control, the number of patients attended to daily. Students should attend to a manageable number of patients, carry out procedures not rushing while supervised. It is important to create awareness and train students on infection control before and during their deployment in clinical areas as their health and the future of the health sector depend on them.Item Socio-demographic Determinants of Vaccine Coverage for Pneumococcus and Rotavirus among under Five Children in Busolwe Town Council, Butaleja District, Eastern Uganda: A Cross Sectional Study(International journal of tropical disease & health, 2019) Wafana Nabwana, Brenda; Namayanja, Sylvia Sidney; Kemigisha, Collette; Kisakye, Erina; Kuddiza Kusetula, Amos; Wakabi, Silvester; Wambi, Ivan; Musiime, Innocent; Nekaka, Rebecca; Gavamukulya, YahayaThere is a high burden of vaccine-preventable diseases in the children under five years of age, particularly pneumonia diarrhea and which is greatly affected by low immunization coverage despite the existing efforts and policies. This study was carried out in Butaleja district and was aimed at establishing the socio-demographic determinants of vaccine coverage for pneumococcus and rotavirus among under five children (U5C) in the district. Study Design: This was a mixed methods cross-sectional study.Place and Duration of Study: Busolwe Town Council, Butaleja District, Eastern Uganda. Methodology: Structured researcher administered questionnaires were administered to 434 caregivers of U5C in different parts of Butaleja district. In-depth interviews with key informants and focused group discussions with Village Health Teams and community members were conducted. Review of Health Management Information Systems records was done. STATA 15 was used to analyze the data. Results: The study found that there is a declining trend in completion of the doses of Pneumococcal vaccine (PCV) and Rotavirus vaccine. For example, in quarter 1 of 2019, out of the 312 children who started immunization, only 2 completed Rota virus immunization and only 117 completed PCV vaccinations a trend that has been observed since 2016. The factors that showed a significant association with the the fact that they gave their child at least one dose of the vaccine were having been sensitized on the current immunisation schedule(P-value = <0.001), misunderstanding that vaccine is harmful for child (P-value = 0.007), willingness to take children to vaccination (P-value = <0.001), and social factors such as family (P-value = <0.030). Gender also played a key determinant role where the children’s fathers lacked knowledge on significance of immunization and thus discouraged the mothers from taking the children for immunization. Inadequate funding was also highlighted from the Focus Group Discussions. Conclusion: Vaccine coverage for pneumococcus and rotavirus is still low in Butaleja district mainly due to the attitudes and perceptions of caregivers as well as the knowledge gap. There is need for extensive sensitization of all community members to enable them understand the significance of immunization. It would further be important to increase the funding of the immunization programme to intensify and ensure effectual outreaches as well as the establishment and enforcement of a policy for immunization compliance.Item Towards universal health coverage: Data for determinants of immunization coverage of Pneumococcal and Rota virus vaccines among under five children in Busolwe Town Council, Butaleja District, Eastern Uganda(Data in brief, 2019) Wafana Nabwana, Brenda; Namayanja, Sylvia Sidney; Kemigisha, Collette; Kisakye, Erina; Kuddiza Kusetula, Amos; Wakabi, Silvester; Wambi, Ivan; Musiime, Innocent; Nekaka, Rebecca; Gavamukulya, YahayaThe data described stipulates the factors influencing the immunization coverage of Pneumococcal and Rota Virus Vaccines among under five children (U5C) in Butaleja district in Eastern Uganda. The data was obtained in three major sections of demographic characteristics, knowledge, and attitude and perceptions of care takers of U5C on immunization. Both qualitative and quantitative types of data obtained from Primary and Secondary data sources are presented. The Primary sources included administration of questionnaires to the caretakers of U5C in communities surrounding different health centers in Butaleja district. The secondary source of datawas majorly the Health Management Information Systems (HMIS) records of Busolwe District Hospital. The data includes raw data from individual participants in form of Google forms portable document format, the consolidated raw data from all the participants in Microsoft excel format, as well as raw data from secondary HMIS record on immunization coverage in form of Microsoft excel format. The data provides a general outlook on the state of Butaleja district in terms immunization coverage of Pneumococcal and Rota Virus Vaccines.The data can be useful in taking action to decrease the burden of vaccine preventable diseases in Butaleja and elsewhere in similar settings.