Browsing by Author "Sempa, Joseph"

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    Global Health Leadership Training in Resource-Limited Settings: A Collaborative Approach by Academic Institutions and Local Health Care Programs in Uganda
    (Human Resources for Health, 2015) Nakanjako, Damalie; Namagala, Elizabeth; Semeere, Aggrey; Kigozi, Joanitor; Sempa, Joseph; Ddamulira, John Bosco; Katamba, Achilles; Biraro, Sam; Naikoba, Sarah; Mashalla, Yohana; Farquhar, Carey; Afya Bora Consortium members; Sewankambo, Nelson
    Due to a limited health workforce, many health care providers in Africa must take on health leadership roles with minimal formal training in leadership. Hence, the need to equip health care providers with practical skills required to lead high-impact health care programs. In Uganda, the Afya Bora Global Health Leadership Fellowship is implemented through the Makerere University College of Health Sciences (MakCHS) and her partner institutions. Lessons learned from the program, presented in this paper, may guide development of in-service training opportunities to enhance leadership skills of health workers in resource-limited settings.The Afya Bora Consortium, a consortium of four African and four U.S. academic institutions, offers 1-year global health leadership-training opportunities for nurses and doctors. Applications are received and vetted internationally by members of the consortium institutions in Botswana, Kenya, Tanzania, Uganda, and the USA. Fellows have 3 months of didactic modules and 9 months of mentored field attachment with 80% time dedicated to fellowship activities. Fellows’ projects and experiences, documented during weekly mentor-fellow meetings and monthly mentoring team meetings, were compiled and analyzed manually using pre-determined themes to assess the effect of the program on fellows’ daily leadership opportunities.Between January 2011 and January 2015, 15 Ugandan fellows (nine doctors and six nurses) participated in the program. Each fellow received 8 weeks of didactic modules held at one of the African partner institutions and three online modules to enhance fellows’ foundation in leadership, communication, monitoring and evaluation, health informatics, research methodology, grant writing, implementation science, and responsible conduct of research. In addition, fellows embarked on innovative projects that covered a wide spectrum of global health challenges including critical analysis of policy formulation and review processes, bottlenecks in implementation of national HIV early infant diagnosis and prevention of mother-to-child HIV-transmission programs, and use of routine laboratory data about antibiotic resistance to guide updates of essential drug lists.In-service leadership training was feasible, with ensured protected time for fellows to generate evidence-based solutions to challenges within their work environment. With structured mentorship, collaborative activities at academic institutions and local health care programs equipped health care providers with leadership skills.
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    Knowledge and perceptions of brucellosis in the pastoral communities adjacent to Lake Mburo National Park, Uganda
    (BMC Public Health, 2014) Kansiime, Catherine; Mugisha, Anthony; Makumbi, Fredrick; Mugisha, Samuel; Rwego, Innocent B.; Sempa, Joseph; Kiwanuka, Suzanne N.; Asiimwe, Benon B.; Rutebemberwa, Elizeus
    Brucellosis is one of the most common zoonotic infections globally. Lack of knowledge about brucellosis may affect the health-seeking behavior of patients, thus leading to sustained transmission in these communities. Our study assessed knowledge and perceptions of brucellosis among pastoral communities adjacent to Lake Mburo National Park (LMNP), Kiruhura District, Uganda. Methods: A community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed between June and August 2012. Data collected included communities’ knowledge on causes, symptoms, transmission, treatment, prevention and risk factors of brucellosis. Multivariable logistic regression analysis was performed to explore strength of association between overall knowledge of brucellosis and various individual factors using odds ratios and 95% confidence intervals. Results: Only 70 (19%) knew the symptoms of brucellosis in animals, and three quarters (279, 75.5%) mentioned joint and muscle pain as a common symptom in humans. Almost all participants (370, 99.3%) had ever heard about brucellosis, majority (311, 84.7%) believed it affects all sexes and two thirds (67.7%) of the respondents believed close proximity to wildlife contributes to the presence of the disease. Almost all (352, 95.4%) knew that brucellosis in humans could be treatable using modern drugs. The main routes of infection in humans such as consumption of unpasteurized dairy products were known by 97% (360/371); eating of half-cooked meat by 91.4% and eating contaminated pasture in animals by 97.4%. There was moderate overall knowledge of brucellosis 197 (53.1%). Factors associated with higher overall knowledge were being agro-pastoralists (aOR: 2.08, CI: 1.17-3.71) compared to pure pastoralists while those who reported that the disease was a health problem (aOR: 0.18, CI: 0.06-0.56) compared to those who said it was not were less likely to be knowledgeable. Conclusions: There was moderate overall knowledge of human and animal brucellosis among the participants. Majority of the participants believed that close proximity to wildlife contributes to the presence of the disease in the area. There is a need for collaboration between the public health, veterinary and wildlife sectors to provide health education on brucellosis for better management of the disease in the communities.
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    Trends in Antimicrobial Resistance of Staphylococcus aureus Isolated from Clinical Samples at Mbarara Regional Referral Hospital in Rural Uganda
    (British Microbiology Research Journal, 2014) Bazira, Joel; Boum II, Yap; Sempa, Joseph; Iramiot, Jacobs; Nanjebe, Deborah; Sewankambo, Nelson; Nakanjako, Damalie
    This study aimed at describing the antibiotic susceptibility patterns of S. aureus isolated from clinical samples at Mbarara Regional Referral Hospital from 2003 to 2012. Methods: This was a retrospective study that included clinical specimens cultured at the Microbiology laboratory of Mbarara Regional referral hospital between 2003 and 2012. Cultures and sensitivity data were abstracted from the laboratory registers using a data abstraction form. Among the positive culture reports, the antibiotic sensitivity of the common bacteria isolated were also recorded. Analysis of susceptibility data was limited to Staphylococcus aureus, the commonest organism identified. The data were entered into Epi info and exported to Stata Version 12.1 for analysis. Results: A total of 36,080 cultures were performed over a period of 10 years. Of these 7,744 (21.5%) specimens grew an organism. S. aureus was the most prevalent organism isolated. Fifty nine percent of the S. aureus was isolated from blood samples followed by 22% from pus samples, urine (8%) and HVS (5%). During the study period, resistance of S.aureus to chloramphenicol, amoxycillin, penicillin, tetracycline, and cotrimoxazole ranged from 50-90% while S. aureus resistance to Gentamicin and ceftriaxone ranged from 10-20%. Conclusion: Over the last decade, S. aureus isolates showed up to 90% resistance to commonly prescribed oral antibiotics. We recommend regular review of antibiotic resistance patterns to inform hospitals’ on guidelines on empirical antibiotic prescription, especially in resource-limited settings where susceptibility testing may not be feasible.