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A 10 years Trend of Peptic Ulcer Disease and other Gastrointestinal Disorders in Northern Uganda
(East and Central African Journal of Surgery, 2016) Okello, T.R.; Ogwang, D.M; Pecorella, I.
The changing trend of GI disorders has not been expounded in our setting, there is need to examine the extent to which major endoscopically diagnosed upper GI disorders have changed in the last 10 years (2005 to 2015). Methods: This was a retrospective study in which endoscopically diagnosed GI disorders of Jan-Jun 2005 were compared with 2015 (10 years) for the same period Results: In the 10 years (2005 to 2015), the prevalence of peptic ulcer disease (PUD) reduced from 9.6% to 2.9% (P value 0.000), followed by esophageal varices from 10.3% to 4.0%, and duodenitis from 3.2% to 0.7% respectively. Gastritis increased from 18.4% to 48.2% (P value 0.000), followed by cancer esophagus from 3.2% to 5.1%. Conclusion: As the prevalence of PUD decreases in our community, gastritis increases hence patients with upper GI symptoms tend to suffer gastritis thus clinicians should focus on treating gastritis and eradication of Helicobacter pylori.
A 10-year retrospective study of lung cancer in Uganda
(BioMed Central Ltd, 2022-02) Bogere, Naghib; Bongomin, Felix; Katende, Andrew; Omaido, Blair Andrew; Namukwaya, Elizabeth; Mayanja-Kizza, Harriet; Walusansa, Victoria
Abstract Background Lung cancer is a leading cause of cancer-related deaths in Uganda. In this study, we aimed to describe the baseline characteristics and survival of patients with lung cancer at the Uganda Cancer Institute (UCI). Methods We retrospectively reviewed medical records of all patients with a histological diagnosis of lung cancer registered at UCI between January 2008 and August 2018. Data on demographic, clinical, and treatment characteristics, and vital status were abstracted and analyzed. Patients with undocumented vital status on the medical records were contacted through phone calls. We determined survival as time from histological diagnosis to death. The Kaplan-Meier survival analysis was performed to estimate the median survival time and the 5-year overall survival rate. Results Of the 207 patients enrolled, 56.5% (n = 117) were female, median age was 60 years (range: 20–94), 78.7% (n = 163) were never-smokers and 18 (8.7%) were living with HIV. Presumptive anti-tuberculosis treatment was given to 23.2% (n = 48). Majority had non-small cell lung cancer (96.6%, n = 200) with 74.5% (n = 149) adenocarcinoma and 19% (n = 38) squamous cell carcinoma. All had advanced (stage III or IV) disease with 96.1% (n = 199) in stage IV. Chemotherapy (44.9%, n = 93) and biological therapy (34.8%, n = 72) were the commonest treatments used. Overall survival at 6 months, 1-, 2- and 5-years was 41.7, 29.7, 11.8, and 1.7%, respectively. The median survival time of 4.4 months was not statistically significantly different between participants with NSCLC or SCLC (4.5 versus 3.9 months, p = .335). Conclusion In Uganda, adenocarcinoma is the predominant histologic subtype of lung cancer and patients are predominantly females, and non-smokers. Patients present late with advanced disease and poor overall survival. Public awareness should be heightened to facilitate early detection and improve outcomes.
A 10-Year Risk of Cardiovascular Disease among Patients with Severe Mental Illness at Mbarara Regional Referral Hospital, Southwestern Uganda
(BioMed Research International, 2020) Agaba, David Collins; Migisha, Richard; Lugobe, Henry Mark; Katamba, Godfrey; Ashaba, Scholastic
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Patients with severe mental illness (SMI) are at a higher risk for developing CVD and have a higher risk for harboring factors related to CVD. In addition to the effects of antipsychotic medications, unhealthy lifestyle factors, such as poor diet, inadequate physical activity, cigarette smoking, and sedentary behaviors, are known to be risk factors that may contribute to poor cardiovascular health in patients with SMI. Early identification of individuals at elevated risk of CVD is essential so that dietary and lifestyle modifications or pharmacological interventions can be prescribed to alleviate the risk of cardiovascular disease. The objective of the study was to determine the 10-year risk of cardiovascular disease among patients with severe mental illness at Mbarara Regional Referral Hospital, southwestern Uganda. We conducted a cross-sectional study at the outpatient mental health clinic of Mbarara Regional Referral Hospital, between October 2018 and March 2019. We used the Globorisk CVD risk score to estimate the 10-year risk of CVD among patients with SMI, using the online Globorisk calculator. Participants were then assigned to one of three categories depending on their 10-year CVD risk score: <3% (low), 3–10% (intermediate), and >10% (high). We calculated the risk scores of 125 participants aged 40-74 years. Most of the participants were female 75 (60%), had a diagnosis of bipolar disorder 75 (60%), and had mental illness for ≥10 years 57 (46%). Eighty five percent (85%) of the participants had intermediate to high 10-year risk of CVD (64% with intermediate and 21% with high risk). The average risk score was significantly higher in males compared to females, 8.82% versus 6.43%, p = 0:016. We detected a high 10-year risk of CVD in a significant proportion of patients with SMI in southwestern Uganda. We recommend lifestyle modifications and pharmacological interventions to reverse risk or delay progression to CVD in this patient population.
2353.Distance and Time to Clinic Are Associated with Increased Risk of Detectable HIV-1 Viral Load at a Peripheral Health Center in Rural Western Uganda
(US: Oxford University Press., 2022) Hendren, Cate; Ndizeye, Ronnie; Mumbere, Nobert; Rubinstein, Rebecca J.; Baguma, Emma; Muhindo, Rabbison; Goel, Varun; Ntaro, Moses; Siedner, Mark; Mulogo, Edgar
Antiretroviral therapy (ART) improves the health of people living with HIV (PLHIV) and reduces HIV transmission. While availability and efficacy of ART have improved in sub-Saharan Africa (SSA), access remains a challenge. Travel burden, measured as travel time, distance, and cost, has been posited as a potential barrier to ART. For example, a previous study at a large, urban referral center in Uganda showed GPS-measured distance was associated with clinic absenteeism. However, others suggest that PLHIV are willing to travel farther for HIV care because of stigma or for higher quality care. Less is known about the effect of travel burden in rural settings where transportation infrastructure is sparse, and there are few transportation options. Therefore, the objective of this study funded by the IDSA GERM Program was to explore potential associations between distance- and time-to-clinic in a highland area of rural western Uganda with HIV outcomes including viral suppression.
2D-Discrete Fourier Transform: Generalization of the MIA-QSAR strategy in molecular modeling
(Chemometrics and Intelligent Laboratory Systems, 2015) Barigye, Stephen J.; Freitas, Matheus P.
Adequate alignment of chemical structure images with respect to the basic scaffold in a series of chemical compounds constitutes an indispensable requirement for constructing multivariate images (MVIs) and subsequent molecular modeling using the Multivariate Image Analysis applied to Quantitative Structure–Activity Relationship (MIA-QSAR) approach. However, up to the moment, this alignment procedure has been manually performed, based on subjective ocular precision. The 2D-Discrete Fourier Transform (2D-DFT) is introduced as a strategy for creating a common base to construct MVIs for chemical structures using their magnitude spectra. The utility of magnitude spectra in QSAR studies has been evaluated through models for the antimalarial, anticancer and trichomonicidal activity of a series of 2, 5-diaminobenzophenone, 4-phenylpyrrolocarbazole and benzimidazole derivatives, respectively, yielding satisfactory results comparable to superior to those reported in the literature. It is anticipated that this strategy should enable the application of the MIA-QSAR approach to structurally diverse datasets other than a series of congeneric datasets.
3D structure design and simulation for efficient particles capture: The influence of nanofiber diameter and distribution
(Materials Today Communications, 2020) Wu, Jiajun; Akampumuza, Obed; Liu, Penghong; Qin, Xiaohong
Software simulation is a convenient and efficient way to design and check different air filter structures with high efficiency and low pressure drop. In this work, nanofiber filters of different diameters ranging from 100 to 900 nm were designed to check their influence on filtration efficiency, pressure drop and quality factor (QF). Slip-flow effect of air molecules was considered on the surface of single fiber. Then, filters with different diameter distributions were constructed to study the filtration efficiency discrepancy when the filter thickness and porosity were kept equal. With a rotation of the filters composed of nanofibers of 500 nm in diameter in the computational domain, the filtration efficiency and QF increased steadily. The simulation results were partially verified by electrospun cellulose acetate nanofiber filter, and meanwhile provide with new insights into the filter structure design of high filtration efficiency with low pressure drop.
50 Gb/s DMT and 120 Mb/s LTE signal transmission over 5 km of optical fiber using a silicon photonics transceiver
(In Integrated Photonics Research, Silicon and Nanophotonics, 2018) Rahim, Abdul; Abbasi, Amin; Shahin, Mahmoud; Sequeira André, Nuno; Richter, André; Kerrebrouck, Joris Van; Van Gasse, Kasper; Katumba, Andrew; Moeneclaey, Bart; Yin, Xin; Morthier, Geert; Baets, Roel; Roelkens, Gunther
Next-generation passive optical networks will require the use of low-cost, high-performance transceivers to cope with the increasing bandwidth demands for emerging applications such as fixed-mobile convergence for 5G. Silicon photonics is widely acknowledged as a technology that can provide manufacturing of low-cost photonic integrated circuits by using existing CMOS fabrication infrastructure. Intensity modulation/direct detection solutions can reach 100 Gb/s per wavelength, but require high-speed electronics and photonics, which adversely affects the cost. An alternative approach is to use advanced multi-carrier modulation schemes, such as Discrete Multi-Tone (DMT), a real-valued Orthogonal Frequency Division Multiplexing (OFDM) scheme. This technique uses Digital Signal Processing (DSP) to relax electrical and optical bandwidth requirements on the transmitter and receiver side. It promises high spectral efficiency and granularity, higher tolerance to fiber impairments and channel adaptation through flexible multi-level / multi-carrier coding [1]. DMT transmission at 100 Gb/s and even 4x100 Gb/s using modest bandwidth (~ 20 GHz) electronic and optical components has already been demonstrated [2-4]. Despite requiring computationally more expensive DSP compared to single carrier baseband schemes (e.g., OOK, PAM), DMT’s added advantage is that it allows transmission of a mobile data signal within its bandwidth using the same optical transceiver [5]. In this work we demonstrate the combined transmission of a Long Term Evolution (LTE) 4G mobile communication signal (at 3.48 GHz carrier frequency) and a 50 Gb/s DMT signal using a directly modulated InP-on-Silicon Distributed Feedback (DFB) laser. Direct modulation is poised to provide low power consumption and a reduced number of optical components in the transceiver. On the receiver side, a silicon-waveguide-coupled germanium photodiode (GeSi-PD) with a co-designed trans-impedance amplifier (TIA) is used and its performance is compared with a commercial III-V photodiode and TIA.
72 Weeks Post-Partum Follow-Up of Dolutegravir Versus Efavirenz Initiated in Late Pregnancy (DolPHIN-2): An Open-Label, Randomised Controlled Study
(The Lancet HIV, 2022) Malaba, Thokozile R.; Nakatudde, Irene; Kintu, Kenneth; Reynolds, Helen; Mrubata, Megan; Seden, Kay; Twimukye, Adelline; Hodel, Eva Maria; Wang, Duolao; Byamugisha, Josaphat; Bokako, Sharon; Waitt, Catriona
Late initiation of antiretrovirals in pregnancy is associated with increased risk of perinatal transmission and higher infant mortality. We report the final 72-week postpartum results for efficacy and safety of dolutegravir-based compared with efavirenz-based regimens in mothers and infants. DolPHIN-2 was a randomised, open-label trial. Pregnant women in South Africa and Uganda aged at least 18 years, with untreated but confirmed HIV infection and an estimated gestation of at least 28 weeks, initiating antiretroviral therapy in third trimester were eligible for inclusion. Eligible women were randomly assigned (1:1) to receive either dolutegravir-based (50 mg dolutegravir, 300 mg tenofovir disoproxil fumarate, and either 200 mg emtricitabine in South Africa or 300 mg lamivudine in Uganda) or efavirenz-based (fixed dose combination 600 mg tenofovir disoproxil fumarate plus either emtricitabine in South Africa or lamivudine in Uganda) therapy. The primary efficacy outcome was the time to a viral load of less than 50 copies per mL measured at 6, 12, 24, 48, and 72 weeks postpartum with a Cox model adjusting for viral load and CD4 cell count. Safety endpoints were summarised by the number of women and infants with events. This trial is registered with ClinicalTrials.gov, NCT03249181. Between Jan 23 and Aug 15, 2018, 280 women were screened for inclusion, of whom 268 (96%) women were randomly assigned: 133 (50%) to the efavirenz group and 135 (50%) to the dolutegravir group. 250 (93%; 125 [50%] in the efavirenz group and 125 [50%] in the dolutegravir group) women were included in the intention-to-treat analysis of efficacy. Median time to viral load of less than 50 copies per mL was 4·1 weeks (IQR 4·0–5·1) in the dolutegravir group compared with 12·1 weeks (10·7–13·3) in the efavirenz group (adjusted hazard ratio [HR] 1·93 [95% CI 1·5–2·5]). At 72 weeks postpartum, 116 (93%) mothers in the dolutegravir group and 114 (91%) in the efavirenz group had a viral load of less than 50 copies per mL. Of 57 (21%) mothers with a severe adverse event, three (2%) in the dolutegravir group and five (4%) in the efavirenz group were related to the drug (dolutegravir drug-related events were one woman each with suicidal ideation, suicide attempt, herpes zoster meningitis; efavirenz drug-related events were one woman each with suicide attempt and liver cirrhosis, and three people with drug-induced liver injury). Of 136 (56%) infants in whom severe adverse events were recorded, none were related to the study drugs. In addition to the three infant HIV infections detected at birth in the dolutegravir group that have been previously reported, an additional transmission in the efavirenz group occurred during breastfeeding despite optimal maternal viral suppression and serial negative infant tests in the first year of life. Dolutegravir was safe and well tolerated, supporting updated WHO treatment recommendations in pregnant and breastfeeding women. Infant HIV transmissions can occur during breastfeeding despite persistently undetectable maternal viral load highlighting the need for continued infant testing.
A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda
(2024-11) Matte, Michael; Koyama, Natsumi; Giandomenico, Dana; Baguma, Emmanuel; Kibaba, Georget; Ntaro, Moses; Reyes, Raquel; Mulogo, Edgar M; Boyce, Ross M; Ciccone, Emily Jxx
Abstract Background Integrated community case management (iCCM) programs leverage lay village health workers (VHWs) to carry out the initial evaluation of children with common conditions including malaria, pneumonia and diarrhea. Therefore, it is imperative that VHWs are able to identify children who are critically ill and require referral to a health facility. Elevated venous lactate levels have been associated with severe illness and adverse health outcomes, including death. However, lactic acidosis may not be recognized in rural settings because it is not routinely measured outside of hospitals and research studies. Point-of-care lactate tests may help identify patients in need of a higher level of care and improve VHWs’ ability to make timely and appropriate referrals. Methods The study was a cross-sectional evaluation of children aged <5 y presenting to VHWs in rural southwestern Uganda with complaints of fever and cough. Demographics, clinical presentation, evaluation, management and disposition were recorded. VHWs were trained and instructed to perform lactate testing using a point-of-care assay in eligible participants. Results During the study period, 238 children were enrolled and completed an initial assessment. Of the 204 participants included in the analysis, 113 (55.4%) were female, and the median (IQR) age was 23 (9–36) months. Most participants, 139/200 (69.5%), had negative results on the malaria rapid diagnostic test. The median lactate level was 2.1 mmol/L; 12% (24/204) had a lactate ≥3.5 mmol/L and only nine participants (4.4%) had a lactate ≥5 mmol/L. Having a lactate level above either cut-off was not associated with the presence of danger signs at presentation. Conclusions Few children presenting with fever and cough to VHWs in western Uganda had elevated lactate levels. However, most of the children with elevated lactate levels did not otherwise satisfy established iCCM criteria based on physical examination findings for referral to a health facility. Therefore, while elevated lactate was not associated with danger signs in this small study, it is possible that there is under-recognition of severe illness using current iCCM guidelines.
A guide for self-help guides: best practice implementation
(Routledge, 2024-09) Shafran, Roz; Egan, Sarah J; de Valle, Madelaine; Davey, Emily; Carlbring, Per; Creswell, Cathy; Wade, Tracey D.
Guided self-help is an evidence-based intervention used globally. Self-help is a fundamental part of the stepped care model of mental health services that enables the efficient use of limited resources. Despite its importance, there is little information defining the role of the guide and the key competences required. In this context, the guide is defined as the person who facilitates and supports the use self-help materials. This article sets out the role of the guide in guided self-help. It considers practical issues such as the importance of engagement to motivate clients for early change, personalising the intervention, structuring sessions, how best to use routine outcome monitoring and supervision requirements. Key competences are proposed, including generic competences to build the relationship as well as specific competences such as being able to clearly convey the role of the guide to clients. Guides should be prepared for “self-help drift”, a concept akin to therapist drift in more traditional therapies. Knowing how to identify mental health problems, use supervision and manage risk and comorbidity are all key requirements for guides. The paper concludes by calling for increased recognition and value of the role of the guide within mental health services. ProQuest Criminal Justice (Alumni)
Abacavir, zidovudine, or stavudine as paediatric tablets for African HIV-infected children (CHAPAS-3): an open-label, parallel-group, randomised controlled trial
(The Lancet Infectious Diseases, 2016) Mulenga, Veronica; Musiime, Victor.; Kekitiinwa, Adeodata; Cook, Adrian D; Abongomera, George; Kenny, Julia; Chabala, Chisala; Mirembe, Grace; Asiimwe, Alice; Owen-Powell, Ellen; Burger, David; McIlleron, Helen; Klein, Nigel.; Chintu, Chifumbe; Thomason, Margaret J.; Kityo, Cissy.; Walker, Sarah A.; Gibb, Diana M
Background WHO 2013 guidelines recommend universal treatment for HIV-infected children younger than 5 years. No paediatric trials have compared nucleoside reverse-transcriptase inhibitors (NRTIs) in first-line antiretroviral therapy (ART) in Africa, where most HIV-infected children live. We aimed to compare stavudine, zidovudine, or abacavir as dual or triple fi xed-dose-combination paediatric tablets with lamivudine and nevirapine or efavirenz. Methods In this open-label, parallel-group, randomised trial (CHAPAS-3), we enrolled children from one centre in Zambia and three in Uganda who were previously untreated (ART naive) or on stavudine for more than 2 years with viral load less than 50 copies per mL (ART experienced). Computer-generated randomisation tables were incorporated securely within the database. The primary endpoint was grade 2–4 clinical or grade 3/4 laboratory adverse events. Analysis was intention to treat. This trial is registered with the ISRCTN Registry number, 69078957. Findings Between Nov 8, 2010, and Dec 28, 2011, 480 children were randomised: 156 to stavudine, 159 to zidovudine, and 165 to abacavir. After two were excluded due to randomisation error, 156 children were analysed in the stavudine group, 158 in the zidovudine group, and 164 in the abacavir group, and followed for median 2·3 years (5% lost to follow-up). 365 (76%) were ART naive (median age 2·6 years vs 6·2 years in ART experienced). 917 grade 2–4 clinical or grade 3/4 laboratory adverse events (835 clinical [634 grade 2]; 40 laboratory) occurred in 104 (67%) children on stavudine, 103 (65%) on zidovudine, and 105 (64%), on abacavir (p=0·63; zidovudine vs stavudine: hazard ratio [HR] 0·99 [95% CI 0·75–1·29]; abacavir vs stavudine: HR 0·88 [0·67–1·15]). At 48 weeks, 98 (85%), 81 (80%) and 95 (81%) ART-naive children in the stavudine, zidovudine, and abacavir groups, respectively, had viral load less than 400 copies per mL (p=0·58); most ART-experienced children maintained suppression (p=1·00). Interpretation All NRTIs had low toxicity and good clinical, immunological, and virological responses. Clinical and subclinical lipodystrophy was not noted in those younger than 5 years and anaemia was no more frequent with zidovudine than with the other drugs. Absence of hypersensitivity reactions, superior resistance profi le and oncedaily dosing favours abacavir for African children, supporting WHO 2013 guidelines.
Abbreviated HIV counselling and testing and enhanced referral to care in Uganda: a factorial randomised controlled trial
(The Lancet Global Health, 2013) Wanyenze, Rhoda K.; Kamya, Moses R.; Fatch, Robin; Mayanja-Kizza, Harriet; Baveewo, Steven; Szekeres, Gregory; Bangsberg, David; Coates, Thomas; Hahn, Judith A.
HIV counselling and testing and linkage to care are crucial for successful HIV prevention and treatment. Abbreviated counselling could save time; however, its eff ect on HIV risk is uncertain and methods to improve linkage to care have not been studied. We did this factorial randomised controlled study at Mulago Hospital, Uganda. Participants were randomly assigned to abbreviated or traditional HIV counselling and testing; HIV-infected patients were randomly assigned to enhanced linkage to care or standard linkage to care. All study personnel except counsellors and the data offi cer were masked to study group assignment. Participants had structured interviews, given once every 3 months. We compared sexual risk behaviour by counselling strategy with a 6·5% non-inferiority margin. We used Cox proportional hazards analyses to compare HIV outcomes by linkage to care over 1 year and tested for interaction by sex. This trial is registered with ClinicalTrials.gov (NCT00648232). We enrolled 3415 participants; 1707 assigned to abbreviated counselling versus 1708 assigned to traditional. Unprotected sex with an HIV discordant or status unknown partner was similar in each group (232/823 [27·9%] vs 251/890 [28·2%], diff erence –0·3%, one-sided 95% CI 3·2). Loss to follow-up was lower for traditional counselling than for abbreviated counselling (adjusted hazard ratio [HR] 0·61, 95% CI 0·44–0·83). 1003 HIV-positive participants were assigned to enhanced linkage (n=504) or standard linkage to care (n=499). Linkage to care did not have a signifi cant eff ect on mortality or receipt of co-trimoxazole. Time to treatment in men with CD4 cell counts of 250 cells per μL or fewer was lower for enhanced linkage versus standard linkage (adjusted HR 0·60, 95% CI 0·41–0·87) and time to HIV care was decreased among women (0·80, 0·66–0·96).
ABC for people with HIV: responses to sexual behaviour recommendations among people receiving antiretroviral therapy in Jinja, Uganda
(Taylor & Francis, 2011) Allen, Caroline; Mbonye, Martin; Seeley, Janet; Birungi, Josephine; Wolff, Brent; Coutinh, Alex; Jaffar, Shabbar
People living with HIV who are taking antiretroviral therapy (ART) are increasingly involved in ‘positive prevention’ initiatives. These are generally oriented to promoting abstinence, ‘being faithful’ (partner reduction) and condom use (ABC). We conducted a longitudinal qualitative study with people living with HIV using ART, who were provided with adherence education and counselling support by a Ugandan non- governmental organisation, The AIDS Support Organisation (TASO). Forty people were selected sequentially as they started ART, stratified by sex, ART delivery mode (clinic- or home-based) and HIV progression stage (early or advanced) and interviewed at enrolment and at 3, 6, 18 and 30 months. At initiation of ART, participants agreed to follow TASO’s positive-living recommendations. Initially poor health prevented sexual activity. As health improved, participants prioritised resuming economic production and support for their children. With further improvements, sexual desire resurfaced and people in relationships cemented these via sex. The findings highlight the limitations of HIV prevention based on medical care/personal counselling. As ART leads to health improvements, social norms, economic needs and sexual desires increasingly influence sexual behaviour. Positive prevention interventions need to seek to modify normative and economi
Abnormal obstetric shock index and associated factors among immediate postpartum women following vaginal delivery at a tertiary hospital in Southwestern Uganda
(Research Square, 2022) Agaba, David Collins; Lugobe, Henry Mark; Migisha, Richard; Jjuuko, Mark; Saturday, Pascal; Kisombo, Dean; Mlangwa Atupele, Subira; Kirabira, Justus; Tumusiime, Matthew; Katamba, Godfrey; Mugyenyi, Godfrey; Masembe, Sezalio; Kayondo, Musa; Ngonzi, Joseph
Early recognition of haemodynamic instability after birth and prompt interventions are necessary to reduce adverse maternal outcomes due to postpartum haemorrhage. Obstetric shock Index (OSI) has been recommended as a simple, accurate, reliable, and low-cost early diagnostic measure that identifies hemodynamically unstable women. Objectives We determined the prevalence of abnormal obstetric shock index and associated factors among women in the immediate postpartum period following vaginal delivery at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a cross-sectional study at the labour suite and postnatal ward of MRRH from January 2022 to April 2022. We systematically sampled women who had delivered vaginally, and measured their blood pressures and pulse rates at 1 hour postpartum. We excluded mothers with hypertensive disorders of pregnancy. Sociodemographic, medical and obstetric data were obtained through intervieweradministered questionnaires. The prevalence of abnormal OSI was the proportion of participants with an OSI ≥ 0.9 (calculated as the pulse rate divided by the systolic BP). Logistic regression analysis was used to determine associations between abnormal OSI and independent variables. Results We enrolled 427 women with a mean age of 25.66 ± 5.30 years. Of these, 83 (19.44%), 95% CI (15.79– 23.52) had an abnormal obstetric shock index. Being referred [aOR 2.34, 95% CI (1.41–3.89), p = 0.001], having had an episiotomy/perineal laceration [aOR 1.90, 95% CI (1.15–3.13), p = 0.012] and having a visually estimated blood loss > 200 mls [aOR 1.78, 95% CI (1.06–3.01), p = 0.028] were significantly associated with abnormal OSI. Conclusion Approximately one in every five women who delivered vaginally at MRRH during the study period had an abnormal OSI. We recommend that clinicians have a high index of suspicion for haemodynamic instability among women in the immediate postpartum period. Mothers who are referred in from other facilities, those that get episiotomies/perineal lacerations and those with estimated blood loss > 200mls should be prioritized for close monitoring.
"Abortion? That's for Women!" Narratives and Experiences of Commercial Motorbike Riders South-Western Uganda
(African journal of reproductive health, 2005) Nyanzi, Stella; Nyanzi, Barbara; Kalina, Bessie
Although constitutionally illegal, induced abortion is a vital reproductive health option in Uganda. analyses men's narratives about meanings of, and experiences with, abortion. Men play significant tion as instigators, facilitators, collaborators, transporters, advisors, informers, supporters or punishment Many participants were knowledgeable about abortion. Attitudes were ambivalent, with initial reactions and relegation of abortion to women's private domains. Further exploration, however, revealed active and involvement of men. Interpretations of abortion ranged from 'dependable saviour' to 'deceptive Though a private action, abortion is socially scripted and often collectively determined by wider social kinsmen, the community, peers, law and religion. A disjuncture exists between dominant public health and the reality of local men who interact with women and girls as wives, lovers, sex sellers, mothers, sisters. Interventions targeting men about abortion should include safe sex education, provide services and create stronger social support mechanisms. Policy and law should incorporate local knowledge practice
Above-ground biomass and carbon stocks of different land cover types in Mt. Elgon, Eastern Uganda
(International Journal of Research on Land-use Sustainability, 2014) Buyinza, Joel; Balaba Tumwebaze, Susan; Namaalwa, Justine; Byakagaba, Patrick
This research applied selected allometric models to estimate the total above ground biomass (TAGB) and carbon stocks in the different land-use/ land cover (LULC) types in Mt. Elgon National Park, in Eastern Uganda. The LULC types identified for the study were – tropical high forest (THF) - normal, THF- degraded and grasslands. The vegetation in each land cover type was assessed at four levels i.e. the mature trees, poles, saplings and undergrowth. Tree diameter and height of each sampled tree were also measured. In each plot, one sapling was randomly selected, uprooted and sub-samples of the foliage, bole and root components were collected, and their fresh weight was determined in the field. Calculation of the Mean Squared Error (MSE), Prediction Sum of Squares (PRESS) statistic and Predicted R2 values of the selected equations was done to establish the most appropriate equation for biomass and carbon estimation. The TAGB was 652.15t/ha, 55.16t/ha and 41.7t/ha in the THF-Normal, THF-Degraded and Grasslands respectively. The carbon stocks in the THF-normal were 293.65tC ha-1, 25 tC ha-1 in the THF-degraded and 18.76 tC ha-1 in the grasslands. Over 90% of sequestered carbon was lost due to land cover change from THF-Normal to THF-Degraded. This calls for policy makers to urgently come up with interventions to address forest degradation.
Aboveground Species Diversity and Carbon Stocks in Smallholder Coffee Agroforestry in the Highlands of Uganda
(Springer, Cham, 2019) Namaalwa, Justine; Tumwebaze, Balaba Susan; Kigonya, Ritah; Nabanoga, Gorettie
Types of agroforestry systems and their capacity to sequester carbon vary globally, and the extent of carbon sequestered greatly depends on environmental conditions and system management. This study aimed at investigating the species composition and determining the aboveground carbon stocks of coffee agroforests at low (1240–1320 m a.s.l.) and medium (1321–1504 m a.s.l.) elevations of Manafwa District in Uganda. For each elevation, the agroforest structures were described and the aboveground carbon (AGC) stocks estimated using allometric models for all measured shade and coffee trees. Two coffee varieties were cultivated with SL-14 extending up to 40 years, while LWIL-11, a more recently introduced variety, extended up to 7 years only. Therefore, the estimated AGC stocks were significantly greater for the SL-14 (0.250–2.317 tons ha−1) than LWIL-11 (1.044–2.099 tons ha−1) and were significantly higher at the medium versus the low elevation. The analysis for shade trees indicated no significant differences in the species diversity for the elevation sites, but with significant variations in mean DBH and thus AGC stocks. Farms at low elevation were characterized by smaller (2.037 ± 0.131 tCO2e ha−1) and significantly high (2.037 ± 0.131 tCO2e ha−1) mean AGC stocks per unit area for coffee and shade trees, respectively, as compared to the medium elevation farms. While the variation in the coffee trees within the elevation sites could be attributed to the uneven distribution within the age groups, the AGC stocks in the shade trees were attributed to the generally large sizes of the trees that dominated. Irrespective of the differences in elevation attributes, coffee agroforests can potentially provide carbon sinks and thus contribute to climate change mitigation.
Absolute eosinophil count correlates with temperature and CD4 count independently of HIV infection among tuberculosis patients
(Tropical Medicine & International Health, 2020) Baluku, Joseph Baruch; Anguzu, Godwin Tukumbo; Bongomin, Felix; Byonanebye, Dathan Mirembe
To determine clinical correlates of the peripheral absolute eosinophil count (AEC) among bacteriologically confirmed TB patients in Uganda. We evaluated data of bacteriologically confirmed adult TB patients who had a peripheral blood AEC measurement at the National TB Treatment Center in Uganda during a cross-sectional study. We performed linear regression analysis for correlates of log-transformed AEC. We included 235 patients in this analysis with a median (interquartile range, IQR) age of 31 (24–39) years. 60.4% were male, and 33.6% had TB/HIV co-infection. In a multivariable linear regression model that controlled for age, residence type, HIV status, weight loss, anorexia, body mass index, CD8+ T-cell count, haemoglobin level and TB bacillary load, males had a 47.0% higher AEC than females (adjusted coefficient (R2) = 0.385, 95% confidence interval (CI) 0.012–0.759 P = 0.043). Also, a 1 °C raise in temperature resulted in an 11.5% decrease in the AEC (R2 = −0.122 95% CI (−0.233 to −0.011) P = 0.031) while a 1 cell/mm3 increase in the CD4+ T-cell count resulted in a 0.10% increase in the AEC (R2 = 0.001 95% CI (0.000–0.001) P = 0.032). The AEC was higher among males than females, consistent with the normal population distribution of AEC among Ugandans. The AEC was weakly but positively correlated with the CD4 count and negatively correlated with temperature.
Abundance and Diversity of Native Forage Species in Pastoral Karamoja Sub-Region, Uganda
(African study monographs, 2015) Egeru, Anthony; Wasonga, Oliver; MacOpiyo, Laban; Mburu, John; Majaliwa Mwanjalolo, G.J
Low input pastoral production systems rely exclusively on natural forage resources in space and time. Information on the abundance and diversity of such pastures is vital in improving livestock production and managing the biodiversity of grazing landscapes. This study documented grass and browse forage species utilised in pastoral Karamoja, and determined their relative abundance by district, season and grazing land cover. Up to 65 grass and 110 browse species were utilised in Karamoja Sub-region. In-situ assessments revealed that Chloris, Hyparrhennia, Sporobolus, Pennisetum, Aristida, Cynodon, Eragrostis, Setaria, and Panicum grasses had higher relative abundance. Triumfetta annua, Indigofera erecta, Acacia drepanolobium, Grewia holstii, Acacia kirkii, Acacia mellifera, Acacia tortolis, Maerua pseudopetalosa, Acacia oerfota, and Ocimmum canum woody species were the most abundant. From the community assessment, Hyparrhennia, Chloris, Panicum, Bracharia, Eragrostis, and Setaria grasses and Acacia mellifera, Cadaba farinose, Acacia oerfota, Acacia drepanolobium, Caparis tormentosa, Maerua pseudopetalosa and Hisbiscus micrantha woody plants were identified as the most abundant among the grazing land cover. The grass and browse forage species varied by season, location, and land cover type. The study also found detailed local knowledge of grass and browse forage species in the community. This study has shown the existence of high diversity among grass and browse forage species with differentiated relative abundance across space and time. This, and the detailed communal cultural knowledge, form a basis for the improvement of livestock production as well as biodiversity conservation in Karamoja sub-region.
The Abundance of Birds in Uganda’s inhabited Areas and the Importance of Pastoral Areas
(African Journal of Ecology, 2008) Asasira, J.; Pomeroy, D.
The Uganda bird-monitoring programme has so far generated more than 18,600 observations from the 37 sites where land birds are monitored annually. Ten of the sites are in farmed area (agroecosystems), thirteen in semi-natural pastoral ecosystems and fourteen in natural ecosystems (mainly national parks). The farms are almost entirely small-scale and very diverse in their land use systems. Monitoring is by Timed Species Counts from which the frequency of recording of each species at each site can be generated (with over 460 species recorded so far, the overall spread sheet contains many zero values). The species numbers overall were the highest at natural sites (375 species), which also had the highest numbers of birds that often use trees, and those which are specialist grassland or aerial species or Palearctic visitors; but numbers of Red Data species are the highest in semi-natural sites. As one would expect, formerly forested areas and moist savannas support most tree birds, whilst Red Data species were most frequently recorded in areas of impeded drainage – typically, these are periodically flooded. Grassland specialists are more common in dry than in moist savannas. Palearctic migrants are nowhere common. Uganda’s pastoral areas, on which domestic livestock graze and browse on predominant natural vegetation, are rich in birds and deserve a much more detailed study.

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