Browsing by Author "Ssewante, Nelson"

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    Antimicrobial resistance in bacterial wound, skin, soft tissue and surgical site infections in Central, Eastern, Southern and Western Africa: A systematic review and meta-analysis
    (Public Library of Science, 2024-04-16) Monk, Edward J. M; Jones, Timothy P. W; Bongomin, Felix; Kibone, Winnie; Nsubuga, Yakobo; Ssewante, Nelson; Muleya, Innocent; Nsenga, Lauryn; Rao, V. Bhargavi; van Zandvoort, Kevin
    Abstract Antimicrobial resistance (AMR) is a major global threat and AMR-attributable mortality is particularly high in Central, Eastern, Southern and Western Africa. The burden of clinically infected wounds, skin and soft tissue infections (SSTI) and surgical site infections (SSI) in these regions is substantial. This systematic review reports the extent of AMR from sampling of these infections in Africa, to guide treatment. It also highlights gaps in microbiological diagnostic capacity. PubMed, MEDLINE and Embase were searched for studies reporting the prevalence of Staphylococcus aureus , Eschericheria coli , Klebsiella pneumoniae , Pseudomonas aeruginosa and Acinetobacter baumannii in clinically infected wounds, SSTI and SSI in Central, Eastern, Southern or Western Africa, and studies reporting AMR from such clinical isolates. Estimates for proportions were pooled in meta-analyses, to estimate the isolation prevalence of each bacterial species and the proportion of resistance observed to each antibiotic class. The search (15 th August 2022) identified 601 articles: 59 studies met our inclusion criteria. S . aureus was isolated in 29% (95% confidence interval [CI] 25% to 34%) of samples, E . coli in 14% (CI 11% to 18%), K . pneumoniae in 11% (CI 8% to 13%), P . aeruginosa in 14% (CI 11% to 18%) and A . baumannii in 8% (CI 5% to 12%). AMR was high across all five species. S . aureus was resistant to methicillin (MRSA) in >40% of isolates. E . coli and K . pneumoniae were both resistant to amoxicillin-clavulanic acid in ≥80% of isolates and resistant to aminoglycosides in 51% and 38% of isolates respectively. P . aeruginosa and A . baumannii were both resistant to anti-pseudomonal carbapenems (imipenem or meropenem) in ≥20% of isolates. This systematic review found that a large proportion of the organisms isolated from infected wounds, SSTI and SSI in Africa displayed resistance patterns of World Health Organisation (WHO) priority pathogens for critical or urgent antimicrobial development.
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    Assessment of knowledge, attitude and practice of first aid among taxi operators in a Kampala City Taxi Park, Uganda: A cross-sectional study
    (African journal of emergency medicine, 2022) Ssewante, Nelson; Wekha, Godfrey; Namusoke, Moureen; Sanyu, Bereta; Nkwanga, Ayub; Nalunkuma, Racheal; Olum, Ronald; Katumba Ssentongo, Lawrence; Ahabwe, Rachel; Kalembe, Sharon Esther; Nalwoga Nantagya, Vanessa; Kalanzi, Joseph
    Road traffic accidents are among the leading causes of death in Uganda. Taxi operators are at a high risk of RTA and can potentially be first responders. This study, aimed to assess knowledge, attitude, and practice of first aid among taxi operators in the new taxi park, Kampala Uganda. Methods: A descriptive cross-sectional study was conducted in 2021 among taxi drivers and conductors in the New Taxi Park, Kampala City, Uganda. A semi-structured questionnaire was used to collect quantitative data from taxi operators after informed consent. Chi-square or Fisher’s exact test and logistic regression were performed in STATA 16 to assess the association between first aid knowledge and demographics. P < 0.05 was statistically significant. Results: A total of 345 participants, majority males (n = 338, 98%) aged between 18 and 45 years (76.5%), were recruited. Although 97.7% (n = 337) had heard about first aid, only 19.4% (n = 67) had prior first aid training. Overall mean knowledge score was 40.1% (SD = 14.5%), with 29.9% (n = 103) having good knowledge (≥50%). Participants who had witnessed more than five accidents (aOR = 2.9, 95% CI = 1.7–4.8, p < 0.001), those with first aid kits (aOR = 1.7, 95% CI = 1.0–3.0, p = 0.38) were more likely to have good knowledge while those below post-secondary education level i.e., Primary (AOR = 0.2, 95% CI = 0.1–0.5, p ≤0.001) and secondary (aOR = 0.2, 95% CI = 0.1–0.6, p = 0.001), were less likely to have good knowledge. About 97% and 93% perceived first aid as important and were willing to undergo training, respectively; however, only 69% were willing to give first aid. Only 181(52.5%) had ever attended to accident victims. Conclusion: Majority of taxi operators had poor first aid knowledge. Factors associated with good knowledge included level of education, number of accidents witnessed, having first aid kits. Although their attitudes were favorable, practice was poor. Comprehensive training and refresher courses can help increase first aid knowledge, and improving practice.
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    Basic life support, a necessary inclusion in the medical curriculum: a cross‑sectional survey of knowledge and attitude in Uganda
    (BMC medical education, 2022-03-03) Ssewante, Nelson; Wekha, Godfrey; Musoke, Phillip; Nabukeera, Germinah; Kamuhangire, Lauben; Tagg, Andrew
    Uganda continues to depend on a health system without a well-defined emergency response system. This is in the face of the rising cases of out-of-hospital cardiac arrest contributed largely to the high incidence of road traffic accidents. Non-communicable diseases are also on the rise further increasing the incidence of cardiac arrest. Medical students are key players in the bid to strengthen the health system which warrants an assessment of their knowledge and attitude towards BLS inclusion in their study curriculum. A descriptive cross-sectional study was conducted in 2021 among undergraduate medical students across eight public and private universities in Uganda. An online-based questionnaire was developed using Google forms and distributed via identified WhatsApp groups. Chi-square or Fisher’s exact test and logistic regression were performed in STATA 15 to assess the association between knowledge of BLS and demographics. P < 0.05 was considered statistically significant. Out of the total 354 entries obtained, 351 were analyzed after eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years (n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone formal BLS training. Less than a third of participants (n = 103, 29.3%) had good knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level of academic progress (p = 0.001), and prior BLS training (p = 0.033) were associated with good knowledge. Participants with prior training were more likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1–2.7, p = 0.009). The majority (n = 348, 99.1%) believed that BLS was necessary and would wish (n = 343, 97.7%) to have it included in their curriculum. Undergraduate medical students have poor BLS knowledge but understand its importance. Institutions need to adopt practical teaching methods such as clinical exposures, field experience in collaboration with local implementers, and participating in community health promotion campaigns.
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    Colorectal Cancer in Uganda: A 10-Year, Facility-Based, Retrospective Study
    (Cancer Management and Research, 2021) Wekha, Godfrey; Ssewante, Nelson; Iradukunda, Angelique; Jurua, Micheal; Nalwoga, Shadia; Lanyero, Sharon; Olum, Ronald; Bongomin, Felix
    Colorectal cancer (CRC) is the most common type of gastrointestinal malignancies and the third leading cause of cancer-related deaths for both sexes worldwide. Although the burden of CRC is highest in developed countries, reports are indicating a rise in the incidence of early-onset CRC in developing countries. In this study, we aimed to determine the prevalence of CRC among patients hospitalized with lower gastrointestinal complaints at a tertiary health facility in Uganda. Methods: We conducted a 10-year retrospective chart review of patients admitted to Mulago National Referral Hospital in Kampala, Uganda, between 1st January 2010 and 31st December 2020. We reviewed all charts of patients admitted to the lower gastrointestinal tract (GIT) ward. Charts with grossly missing data, pediatric patients, and those from other non-lower GIT specialties were excluded. Results: Data of 1476 unique eligible patients were analyzed. Of these,138 had a diagnosis of CRC (prevalence: 9.3%, 95% confidence interval (95% CI): 6.5–11.7%). Among patients with CRC, the female:male ratio was 1:1. The most common site for CRC was the rectum (59.8%, n= 79). For the 138 participants with CRC, 44 had staging data with 72.8% (n=32) having advanced disease, that is, stage 3 or 4. Factors independently associated with CRC were age ≥50 years (adjusted odds ratio (aOR): 4.3, 95% CI: 2.6–7.1, p < 0.001), female sex (aOR: 1.8, 95% CI: 1.2 −2.8, p = 0.005), being widowed (aOR: 2.5, 95% CI: 1.3–5.0, p = 0.006), and presence of any risk factor for CRC (aOR: 5.3, 95% CI: 2.9–9.9, p < 0.001). Conclusion: CRC is relatively common among patients hospitalized with lower GIT complaints, particularly among women and those with known risk factors for CRC. Awareness creation and screening programs should be instituted to allow early diagnosis of CRC in our setting.
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    Fear of COVID-19 and the Media Influence on Herbal Medication Use in Uganda: A Cross-Sectional Study
    (Risk Management and Healthcare Policy, 2021) Musoke, Phillip; Nantaayi, Brandy; Kato Ndawula, Rodney; Wannyana, Babrah; Ssewante, Nelson; Wekha, Godfrey; Olum, Ronald; Nakyagaba, Lourita; Nassozi, Dianah Rhoda; Nabukeera, Germinah; Kanyike, Andrew Marvin; Ojilong, Daniel; Madut Akech, Gabriel; Kajjimu, Jonathan; Kiwumulo, Joshua; Agira, Drake; Okot, Jerom; Bongomin, Felix
    The coronavirus disease-2019 (COVID-19) pandemic has created fear in people around the world. This has led to the widespread use of various herbal remedies in its prevention and treatment regardless of the paucity of scientific evidence about their safety and efficacy. This study assessed the fear of COVID-19 and the influence of media on the use of herbal medicine to prevent or treat COVID-19 in Uganda. Methods: In the first 2 weeks of July 2021, a descriptive online cross-sectional study was carried out anonymously in the general population in Uganda. A validated questionnaire was used to collect data on herbal medicine use and the influence of media. Fear of COVID-19 was rated using the Fear of COVID-19 Scale (FCV-19S). Results: We recruited 488 participants, 273 (55.9%) were female, with a median age of 25 (range: 18–73) years. Sixty-seven (57.8%) participants had a confirmed COVID-19 diagnosis. The mean FCV-19S score was 21.7 SD 5.9 with 53.3% reporting high levels of COVID-19 fear. About 57.4% of participants reported using herbal remedies either to prevent or treat COVID-19-like symptoms. Media was the main source of information, with more than 80% of the participants reporting seeing or accessing information about herbal medication use. Women (adjusted odds ratio (aOR): 1.74, 95% CI: 1.2–2.5, p=0.003) and people with a previously confirmed COVID-19 diagnosis (aOR: 3.1, 95% CI: 1.35–7.14, p=0.008) had a statistically significantly higher FCV-19S score. Being unemployed (aOR: 1.0, 95% CI: 1.1–2.3, p=0.008) and a female (aOR: 1.0, 95% CI: 1.1–2.3, p=0.012) were statistically significantly associated with herbal medicine use. Participants who used herbal remedies had a higher median FCV-19S score compared to non-users (23 versus 21, p<0.001). Conclusion: The use of herbal medicines to treat or prevent COVID-19 is a widespread practice among the general population in Uganda amidst the high levels of fear of COVID-19.
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    Research involvement among undergraduate health profession students in a resource‑limited setting: awareness, attitude, motivators and barriers
    (BMC Medical Education, 2022) Kiyimba, Blaise; Atulinda, Linda; Nalunkuma, Racheal; Asasira, Ignatius; Kabunga, Jonathan; Banturaki, Davis; Nabyonga, Anastacia S.; Nakiganda, Rachel; Ndyabawe, Rachael; Nkalubo, Jonathan; Ssewante, Nelson; Bongomin, Felix; Bakeera‑Kitaka, Sabrina
    Involvement of undergraduate health professions students (HPS) in research will facilitate evidencebased clinical practice among future healthcare practitioners. This study aimed to assess research involvement among undergraduate HPS students and associated factors in Uganda. Methods: A cross-sectional study was conducted using an online assessment tool sent through WhatsApp groups and E-mail addresses of HPS in 12 medical schools in Uganda between 20th September and 5th October 2021. Results: We enrolled 398 participants with a mean age of 23.9 ± 3.7 years. Of this, 267 (67.1%) were male. One hundred twenty (30.2%) participants previously participated in a research activity: 90 (58.4%) as research assistants, 39 (25.3%) published as first authors, and 25 (16.2%) as co-authors. Training on the conduct of research was received by 242 (65.8%) participants, and 326 (81.9%) had intentions of conducting research in the future. Factors influencing participation in research activities were, age ≥ 25 years (adjusted odds ratio (aOR): 1.9, 95% confidence interval (95% CI): 1.2–3.2, p = 0.012), being male (aOR: 2.1, 95%CI: 1.2–3.6, p = 0.008), and being in a clinical year i.e., year 3 (aOR: 3.2, 95% CI: 1.1–9.3, p = 0.033), year 4 (aOR: 3.3, 95% CI: 1.1–9.5, p = 0.028) and year 5(aOR: 11.6, 95% CI: 3.2–42.1, p < 0.001). Lack of funds (79.6%), and mentorship (63.3%) were reported as major barriers to research. Conclusions: Despite a high proportion of HPS showing interest in getting involved in research, less than one-third reported previous involvement. Addressing barriers such as funding could potentially improve research involvement and output among undergraduate HPS in resource-limited settings.
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    Treatment of COVID-19 with Herbal Medicines: Perceptions, Attitudes and Practices of Healthcare Professionals Students in Uganda
    (ResearchSquare, 2021) Kiyimba, Blaise; Kanyike, Andrew Marvin; Ssewante, Nelson; Musoke, Phillip; Atulinda, Linda; Namuwaya, Claire; Wamala, Nicholas Kisaakye; Onyait, Teddy; Aringo, Ramona Noeline; Kato, Hussein; Asasira, Ignatius; Bongomin, Felix
    Use of herbal medicine (HM) for the treatment and prevention of the coronavirus disease -2019 (COVID19) has been reported worldwide. In this study, we aimed to assess the perceptions, attitude and practices of healthcare professionals (HP) students in Uganda concerning HM use in the management of COVID-19 illness