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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 Nerve Cell Cultures and Complex Physiological Relevance
(Drug Discovery Today, 2018) Cheng, Xin; Ndyabawe, Kenneth; Asthana, Amish; Kisaalita, William S.
The field of tissue engineering has not yet provided knowledge on which a consensus for the complex physiological relevance (CPR) of neuronal cultures could be established. The CPR of 3D neuronal cultures can have a profound impact on the drug discovery process through the validation of in vitro models for the study of neuropsychiatric and degenerative diseases, as well as screening for neurotoxicity during drug development. Herein, we assemble evidence in support of the potential of [Ca 2+] i oscillation frequency as a CPR outcome that can demonstrate the in vivo-like behavior of 3D cultures and differentiate them from 2D monolayers. We demonstrate that [Ca 2+] i oscillation frequencies in 2D cultures are significantly higher than those found in 3D cultures, and provide a possible molecular explanation.
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.
8-Year Follow-up of a Maternal Education Trial in a Low-Resource Setting
(Pediatrics, 2024-04) Kakwangire, Paul; Muhoozi, K. M. Grace; Ngari, Moses; Matovu, Nicholas; Westerberg, Cecilie Ane; Iversen, Ole Per; Atukunda, Prudence
OBJECTIVES: Nutrition and stimulation interventions promote early childhood development, but little is known about their long-term benefits in low- and middle-income countries. We conducted a follow-up study of a cluster-randomized maternal education trial performed in children aged 6 to 8 months to assess the sustainability of developmental benefits after 8 years. METHODS: The education intervention lasted 6 months and consisted of nutrition, hygiene, sanitation, and child stimulation aspects. We assessed child processing and cognitive abilities using the Kaufman Assessment Battery for Children Second Edition (KABC-II) and attention and inhibitory control using the Test of Variables of Attention after 8 years. The original trial included 511 mother-child pairs (intervention, n 5 263; control, n 5 248), whereas in the current study, 361 (71%; intervention, n 5 185; control, n 5 176) pairs were available for analyses. RESULTS: The intervention group scored higher than the controls (all P < .001) on all 5 KABC-II subscales and on the KABC-II global score (mean difference: 14; 95% confidence interval, 12–16; P < .001). For all 5 Test of Variables of Attention variables, the intervention group scored higher than the controls on both the visual and auditory tasks (all P < .05). Because the intervention was delivered as a package, a limitation is that we cannot pinpoint the individual contribution of each component (nutrition, hygiene, and stimulation) to the developmental benefits. CONCLUSIONS: The intervention group consistently scored markedly higher on both neuropsychological tests. Thus, even 8 years after the original maternal education intervention, the developmental benefits that we observed at child age of 1, 2, and 3 years, were sustained.
A “religious revolution”? Print media, sexuality, and religious discourse in Uganda
(Informa UK Limited, 2014-12-15) Bompani, Barbara; Brown, S. Terreni
Recently, Uganda has made international headlines for the controversial Anti-homosexuality Bill and for a set of tight measures that have limited the freedom of sexual minorities. This article argues that Uganda's growth of Pentecostal-charismatic churches (PCCs) is playing a major role in influencing and defining the Ugandan public sphere, including (but not limited to) the ways in which sex and sexuality are conceptualized by and within Uganda's print media. This article suggests that the socially conservative nature of PCCs is highly influential in shaping the way print media write about sex and sexuality. This is because Pentecostal-charismatic (PC) constituencies constitute a considerable numerical market that print media cannot ignore. Second, PCs actively work toward influencing and shaping public policies, politics, and public spaces, like newspapers, that discuss and address public morality and decency in the country. As this article will show, within a highly “Pentecostalized” public sphere, alternative public discourses on sexuality are not allowed.
A 'hidden problem': Nature, prevalence and factors associated with sexual dysfunction in persons living with HIV/AIDS in Uganda
(Public Library of Science, 2024-03-07) Mutamba, Brian Byamah; Rukundo, Godfrey Zari; Sembajjwe, Wilber; Nakasujja, Noeline; Birabwa-Oketcho, Harriet; Mpango, Richard Stephen; Kinyanda, Eugene
We conducted a clinic-based cross-sectional survey among 710 people living with HIV/AIDS in stable 'sexual' relationships in central and southwestern Uganda. Although sexual function is rarely discussed due to the private nature of sexual life. Yet, sexual problems may predispose to negative health and social outcomes including marital conflict. Among individuals living with HIV/AIDS, sexual function and dysfunction have hardly been studied especially in sub-Saharan Africa. In this study, we aimed to determine the nature, prevalence and factors associated with sexual dysfunction (SD) among people living with HIV/AIDS (PLWHA) in Uganda. We conducted a clinic based cross sectional survey among 710 PLWHA in stable 'sexual' relationships in central region and southwestern Uganda. We collected data on socio-demographic characteristics (age, highest educational attainment, religion, food security, employment, income level, marital status and socio-economic status); psychiatric problems (major depressive disorder, suicidality and HIV-related neurocognitive impairment); psychosocial factors (maladaptive coping styles, negative life events, social support, resilience, HIV stigma); and clinical factors (CD4 counts, body weight, height, HIV clinical stage, treatment adherence). Sexual dysfunction (SD) was more prevalent in women (38.7%) than men (17.6%) and majority (89.3% of men and 66.3% of women) did not seek help for the SD. Among men, being of a religion other than Christianity was significantly associated with SD (OR = 5.30, 95%CI 1.60-17.51, p = 0.006). Among women, older age (> 45 years) (OR = 2.96, 95%CI 1.82-4.79, p<0.01), being widowed (OR = 1.80, 95%CI 1.03-3.12, p = 0.051) or being separated from the spouse (OR = 1.69, 95% CI 1.09-2.59, p = 0.051) were significantly associated with SD. Sexual dysfunction has considerable prevalence among PLWHA in Uganda. It is associated with socio-demographic, psychiatric and clinical illness factors. To further improve the quality of life of PLWHA, they should be screened for sexual dysfunction as part of routine assessment.
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.
A Bayesian Approach to Regional and Local-Area Prediction From Crop Variety Trials
(Journal of Agricultural, Biological, and Environmental Statistics, 2002) Theobald, Chris M.; Talbot, Mike; Nabugoomu, Fabian
The inclusion of covariates in models for analyzing variety£ environmentaldata sets allows the estimation of variety yields for speci c locations within a region as well as for the region as a whole. Here we explore a Bayesian approach to the estimation of such effects and to the choice of variety using a possibly incomplete variety £ location£ year data set that includes location£ year covariates.This approachallows expert knowledge of the crop and uncertainty about local circumstances to be incorporated in the analysis. It is implemented usingMarkov chain Monte Carlo simulation.An example is used to illustrate the approach and investigate its robustness.
A behavioural model for integrated phase-change photonics devices
(European Phase Change and Ovonics Symposium, 2017) Carrillo, Santiago G-C; Gemo, Emanuele; Youngblood, Nathan; Li, Xuan; Katumba, Andrew; Bienstman, Peter; Pernice, Wolfram; Bhaskaran, Harish; Wright, C. David
The use of phase-change materials in integrated photonics applications has enabled the development of new types of all-optical devices, including multilevel photonic memories, arithmetic and logic processors and synaptic and neuron mimics. In order to design, optimise and understand the performance of large-scale systems, fast and accurate material and device models are needed. Here we present a behavioural model for phase-change photonic devices that can simulate the write, erase and readout operations in time spans compatible with system level performance evaluation.
A bibliometric Analysis of Cancer Research in South Africa: study protocol
(BMJ open, 2015) Moodley, Jennifer; Singh, Vedantha; Kagina, Benjamin M.; Abdullahi, Leila; Hussey, Gregory D.
Cancer is an important and growing public health burden in South Africa (SA). Over the past few decades, there has been considerable scientific activity in cancer in SA. However, there has been limited analysis of cancer scientific publications. In this paper, we present a protocol for bibliometric analysis of cancer research conducted in SA. A comprehensive search of the journal databases PubMed, SCOPUS, Web of Science and EBSCO will be conducted to identify and retrieve data from primary peer-reviewed cancer research articles using a set of consensus search words. Articles that involve cancer research conducted in SA or using biological or clinical data from South African participants and published between 2004 and 2014 will be included in the study. Two independent researchers will screen the articles for eligibility. Bibliometric indicators and study characteristics will be extracted, entered into a database and analysed. The cancer disease site will be recorded and research will be classified using the Common Scientific Outline system. Data obtained will be analysed to determine SA's publication productivity index in cancer research. Annual trends in bibliometric indicators and the type of cancer research will be determined. The degree of collaboration in research conducted in SA will be analysed using co-authorship matrix software. A publication to disease type ratio will be used to assess scientific production relative to disease burden.
A broadcast scheme for vehicle-to-pedestrian safety message dissemination
(International Journal of Distributed Sensor Networks, 2017) Eyobu, Odongo Steven; Joo, Jhihoon; Seog Han, Dong
Ensuring cooperative awareness by periodic message beaconing in vehicular environments is necessary to address pedes- trian safety. However, high periodic basic safety message broadcasting in dense vehicular environments makes accessing the communication channel very competitive. Furthermore, high-frequency periodic broadcasting causes fast device energy dissipation which is a key issue for small computing devices used in wireless sensor and mobile communications. Therefore, in order to achieve reliable message dissemination for vehicle-to-pedestrian safety, energy loss minimization mechanisms for pedestrian mobile devices should be developed. This article proposes controlling the number of broad- casts by eliminating periodic safety message broadcasts from pedestrian nodes; these nodes only receive broadcasts from vehicles and then conditionally communicate with the vehicles when safety alerts are raised. When the pedestrian nodes do not receive messages from any vehicle for a specified period, pedestrian nodes broadcast a high-priority message advertising their position. Furthermore, for the pedestrian, adaptive message emission rates and transmission duration are proposed based on defined vehicle-to-pedestrian separation distances. This approach reduces the pedestrian device energy consumption and end-to-end delay and improves the packet delivery ratio compared to the vehicular broadcast approach for safety messages defined in the IEEE 802.11 standard.
A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons
(Global Health Action, 2017) Ajeani, Judith; Mangwi Ayiasi, Richard; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Namazzi, Gertrude; Muhumuza Kananura, Rornald; Namusoke Kiwanuka, Suzanne; Beyeza-Kashesya, Jolly
There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. Objectives: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model. Methods: The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors. Results: Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better. Conclusions: The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved capacity among local mentors to provide mentorship among local district staff.
A case control study of the factors associated with occurrence of aerodigestive foreign bodies in children in a regional referral hospital in South Western Uganda
(BMC Ear Nose Throat Disord, 2016) Nakku, Doreen; Byaruhanga, Richard; Bajunirwe, Francis; Kyamwanga, Imelda T.
Aerodigestive foreign bodies (ADFB) in children are a common emergency in ENT clinics globally. The aim of this study was to determine the prevalence and common types of ADFB’s presenting to a referral hospital in South Western Uganda, and to review clinical presentation and factors that influence their occurrence among children under 12 years of age.
A case for urban liveability from below: exploring the politics of water and land access for greater liveability in Kampala, Uganda
(Research Sqaure, 2019) Nastar, Maryam; Isoke, Jennifer; Kulabako, Robinah; Silvestri, Giorgia
Improving urban liveability and prosperity is commonly set as a priority in urban development plans and policy around the world. Several annual reports produced by international consulting firms, media, and global agencies rank the liveability of cities based on a set of indicators, to represent the quality of life in these cities. The higher is the ranking, the more liveable is the city. In this paper, we argue that such quantitative approaches to framing and addressing urban liveability challenges leave little room to reflect on people's experiences of this liveability, which cannot be expressed through numbers. To illustrate our argument, we draw on empirical evidence of urban liveability challenges in access to water and land in Kampala, the capital city of Uganda, ranked recently as the most liveable East African city by various global agencies and media outlets. By showing that increasing the number of water connections does not guarantee improved access to water and sanitation in the long run, first, we demonstrate how urban liveability challenges are tightly linked with land-title issues in the city. Second, we highlight the political game-playing between the central government, the opposition, the traditional leadership, and the slum dwellers in governance processes of service delivery. Finally, by arguing that urban liveability can be enhanced by broadening political participation in city development planning, we discuss some of the strategies that can be used by communities to make collective claims towards improving their quality of life and the environment.th cities related poor air quality to specific health outcomes such as asthma or lung cancer.
A Case of Cryptococcal Lymphadenitis in an HIV-Infected Child
(AIDS research and human retroviruses, 2011) Natukunda, Eva; Musiime, Victor; Ssali, Francis; Kizito, Hilda; Kityo, Cissy; Mugyenyi, Peter
An 8-year-old HIV-positive antiretroviral therapy-naive child developed severe headache and generalized lymphadenopathy. The serum cryptococcal antigen (CRAG) test was positive, the histology on the lymph node biopsy revealed budding yeast cells, and Cryptococcus neoformans was isolated on culture of his cerebrospinal fluid. He was treated with intravenous amphotericin B followed by oral fluconazole with a good response. Therefore cryptococcal lymphadenitis should be considered in the differential diagnosis of children presenting with lymphadenopathy and a positive serum CRAG.

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