Browsing by Author "Nzabandora, Emmanuel"

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    Adverse maternal outcomes and associated factors among mothers of advanced age delivering at a tertiary hospital, southwestern Uganda: a cross-sectional study
    (BioMed Central Ltd, 2024-05) Masembe, Sezalio; Migisha, Richard; Turyasingura, Godwin; Aheisibwe, Hillary; Nzabandora, Emmanuel; Lule, John C.
    Abstract Background Mothers of advanced age, defined as pregnant women aged ≥ 35 years at the time of giving birth, are traditionally known to be associated with increased risks of adverse maternal outcomes. We determined the prevalence of adverse maternal outcomes and associated factors among mothers of advanced age who delivered at Kabale Regional Referral Hospital (KRRH), in Southwestern Uganda. Methods We conducted a cross-sectional study at the Maternity Ward of KRRH from April to September 2023. We consecutively enrolled pregnant women aged ≥ 35 years during their immediate post-delivery period and before discharge. We obtained data on their socio-demographic, obstetric, medical characteristics and their maternal outcomes using interviewer-administered questionnaires. We defined adverse maternal outcome as any complication sustained by the mother that was related to pregnancy, delivery and immediate post-partum events (obstructed labour, antepartum haemorrhage, mode of delivery [cesarean or vacuum extraction], postpartum haemorrhage, hypertensive disorders of pregnancy, preterm or postdate pregnancy, anemia, premature rupture of membranes, multiple pregnancy, and maternal death). A participant was considered to have an adverse outcome if they experienced any one of these complications. We identified factors associated with adverse outcomes using modified Poisson regression. Results Out of 417 participants, most were aged 35–37 years (n = 206; 49.4%), and had parity ≥ 5 (65.5%). The prevalence of adverse maternal outcomes was 37.6% (n = 157, 95%CI: 33.1–42.4%). Common adverse maternal outcomes included caesarian delivery (23%), and obstructed labour (14.4%). Other complications included anemia in pregnancy (4.5%), chorioamnionitis (4.1%), preterm prelabour rupture of membranes (3.9%), and chronic hypertension and preeclampsia (both 2.4%). Factors associated with adverse maternal outcomes were precipitate labour (adjusted prevalence ratio [aPR] = 1.95, 95%CI: 1.44–2.65), prolonged labour, lasting > 12 h (aPR = 2.86, 95%CI: 1.48–3.16), and chronic hypertension (aPR = 2.01, 95%CI: 1.34–3.9). Conclusion Approximately two-fifth of the advanced-aged mothers surveyed had adverse outcomes. Mothers with prolonged labour, precipitate labour and chronic hypertension were more likely to experience adverse outcomes. We recommend implementation of targeted interventions, emphasizing proper management of labor as well as close monitoring of hypertensive mothers, and those with precipitate or prolonged labor, to mitigate risks of adverse outcomes within this study population.
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    Evaluation of the bacterial agents associated with PID among women of reproductive age at Kampala International University Teaching Hospital
    (Biotechnology and Allied Fields, 2022) Baruti, Petrus; Nzabandora, Emmanuel; Agwu, Ezera
    Pelvic inflammatory disease (PID) is major health problem in developed and developing country involving more young women. It is associated with high rate of female reproductive health morbidity; it can complicate with ectopic pregnancy, infertility and chronic pelvic pain. A poor response therapy increases the likelihood of these complications; this could be due to an increase in antimicrobial resistant pathogens. The aim of this research was to determine common bacterial pathogens from endocervical swab of women with PID at Kampala International University Teaching Hospital. This was a cross-sectional study conducted among women who attended gynecology clinic at Kampala International University Teaching Hospital. Consecutive enrolment of 324 participants who consented to participate was done daily until a required sample size was realized from November 2019 to January 2020. Structured questionnaires were used to collect data on associated factors; endocervical swab was taken from patient clinically diagnosed with PID. Culturing for colony characteristics followed by Gram stain was used for provisional identity of pathogenic bacteria. Further identification was done by a set of biochemical tests. Data was analyzed using STATA VERSION 14.2. Not being educated, having two or more sexual partners, previous history of PID and induced abortion, also the previous use of contraceptives specifically the use of IUD ,were all significantly associated with Pelvic inflammatory disease (P value <0.05). The isolated bacteria was Staphylococcus aureus and the least-prevalent pathogen was citrobacter species. In conclusion, Staphylococcus aureus is the commonest organism isolated from the endocervical swab of patients with PID. Keywords: Bacteriology, Pelvic, Inflammatory, Disease and Women
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    Prevalence and Aetiology of Pathological Vaginal Discharge among Third- Trimester’ Women Attending Antenatal Care at Kampala International University Teaching Hospital
    (International Journal of Health Sciences and Research, 2017) Bwaga, Ibrahim; Nzabandora, Emmanuel; Ubarnel, Almenares; Ivan Bonet, Fonseca; Echoru, Isaac; Atuhaire, Collins; Ssebuufu, Robinson
    A vaginal discharge means any secretion originating from the vagina except blood. Pathological vaginal discharge predisposes to preterm labor and prematurity which is a leading cause of infant mortality in the world. Objectives: To determine prevalence and aetiology of pathological vaginal discharge among women in third trimester who attend Antenatal Care (ANC) at Kampala International University Teaching Hospital (KIUTH). Research methods: A cross-sectional study was carried out from February through April, 2017. 394 of the women in third trimester who attended ANC at KIUTH during the study period were recruited, and data was collected using structured interviewer-administered questionnaire and laboratory investigation on the vaginal discharge specimen. The data was analyzed with the use of SPSS software. Results: 45.2% of participants had pathological vaginal discharge. Vaginal Candidiasis largely contributed to pathological vaginal discharge (37.1%) while Trichomoniasis contributed the least (2.2%). Bacterial Vaginosis caused 10.1% of the pathological vaginal discharge while 50.6% was due to bacterial infections (of the total of 178 participants, 34.3% had Staphylococcus Species infection, Streptococcus infection at 1.7%, Klebsiella species at 3.4% and mixed infections at 1.1%). Conclusion: Some pregnant women in third trimester who attend ANC at KIUTH actually harbor pathogenic organisms (Trichomonas spp, Candida spp, Staphylococcus spp, Streptococcus spp, E. coli and Bacterial vaginosis) and these organisms put them at risk of poor perinatal outcomes like premature rupture of membranes, chorioamnionitis, etc. Some pregnant women in third trimester have pathogenic bacterial colonization that requires detection and necessary care given.