Browsing by Author "Rachel, Luwaga"

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Exploring parental understanding of child sexual abuse and prevention as a measure for HIV prevention in Rwampara district
(PLOS ONE, 2022-06-30) Aloysious, Kamukama; Rachel, Luwaga; Rodrick, Tugume; Margaret, Kanyemibwa; Betrace, Birungi; Obed, Ndyamuhika; Diana, Ampire; Timothy, Nduhukire; Deborah, Lowell Shindell
Background Worldwide, more than 95 million children are sexually abused each year with children in sub-Saharan Africa experiencing sexual assault at higher rates than those in more devel oped areas. In Uganda, 20% of young people indicated that their sexual debut was non-con sensual. The risk for transmission of HIV to children through Child Sexual Abuse is high because of greater mucosal tissue damage and the often repetitive nature of abuse. This contributes significantly to the burden of HIV in Uganda. Despite these risks, studies have shown gaps in active parental involvement in child sexual abuse prevention despite their being the primary protectors of children. Against this background we sought to explore parental understanding of childhood sexual abuse and prevention as a measure for HIV pre vention in Rwampara District, South Western Uganda. Methods A phenomenological study was carried out in four health centers that serve the communities of Rwampara district. A total of 25 (n = 25) parents or guardians of children aged 9–14 years were purposively selected to participate in the study. The participants were subjected to in depth semi-structured interviews which were recorded, transcribed, and translated for the matic analysis. Results Parents’ understanding of child sexual abuse was limited to penetrative sex between a man and a child. Three of the parents interviewed reported to have had children who had been sexually abused while one of the parents had been abused when she was young. The chil dren reported to have been abused were female and were between 3-14years. We also identified gaps in the sensitization of parents regarding home-based prevention of child sex ual abuse and psychological support for the victims of abuse.
Predictors of in-hospital mortality among under-five children with severe acute malnutrition in South-Western Uganda
(PLOS ONE, 2020) Nduhukire, Timothy; Atwine, Daniel; Rachel, Luwaga; Byonanebye, Joseph E.
Background Severe acute malnutrition (SAM) affects about 13 million under-five children (U5), with an estimated one million dying every year. In this study we aimed at determining the in hospital mortality and its associated factors among U5s admitted with SAM. Methods This was a prospective cohort study of children 6 months to 5 years with SAM admitted at Mbarara Regional Referral Hospital (MRRH) between June and August 2015. Care-takers were interviewed to collect socio-demographic and clinical information. Children under-went physical examination and had blood drawn for HIV, serum glucose, malaria, full blood count, culture and serum electrolytes investigation. Children were managed according to WHO treatment guidelines for SAM. All participants were followed up for a maximum period of 30 days. The proportion of U5 deaths within the first 48 hours and during the entire admission period was calculated. Using Poisson regression analysis, predictors of in-hospital mortality were analyzed with STATA/IC 11.0. Results We enrolled 122 children, median age of 15 months [IQR:11–24], 58.2% males, 90% immu nized, 81% ill for more than 2 weeks before admission, 71% from lower health facilities and majority with unknown HIV status(76%). Overall, 13 (10.7%) children died in hospital. Seven (5.7%) died within the first 48 hours. Intravenous (IV) fluid administration significantly pre dicted in-hospital mortality (adjusted IRR: 7.2, 95%CI: 2.14–24.08, p = 0.001). Conclusion The in-hospital mortality in U5s with SAM was lower than that previously reported in central Uganda. Intravenous fluid administration significantly predicted overall in-hospital mortality. While Administration of intravenous fluids is still the main stay of managing severely malnourished children with shock, more research needs to be conducted in order to review the parameters presently used to assess children for shock with a view of diagnosing and managing shock in these children when it is still early. Adequate guidance on use of IV fluids in management of severely malnourished children should be prioritized during continuous medical education for healthcare workers and in the treatment guidelines.
Providing education and tools increases nurses’ and midwives’ assessment for puerperal sepsis in a regional referral hospital in South Western Uganda
(Elsevier, 2022) Rachel, Luwaga; Esther, Beebwa; Joseph, Ngonzi; Timothy, Nduhukire; Laura, Brennaman
Background: Puerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries. Early identification of sepsis and initiation of sepsis care bundles are crucial the survival of patients. Education about the surviving sepsis campaign guidelines is critical for nurses to understand the indicators for sepsis that inform accurate screening and initiation of life-saving interventions. We sought to establish the effect of an education intervention and implementation of screening tools on maternal sepsis screening in a Regional Referral hospital in South Western Uganda. Methods: A pretest–posttest quasi-experimental study design was employed to determine the change in the level of knowledge regarding sepsis among a purposively selected sample of 16 midwives and 2 intern nurses. Translation of knowledge to practice was determined by pre-intervention retrospective chart review and post intervention evaluation of the maternal sepsis screening. The statistically significant change in knowledge and practice following the educational intervention was determined by Paired t-tests and Chi-square tests using SPSS version 16. Results: There was an improvement in knowledge scores post the educational intervention from a mean score of 5.78 to 7.13. There was a statistically significant difference in the documentation of vital signs observed between the retrospective chart review and the screening done after the education intervention. Conclusion: This study demonstrated that the provision of education and sepsis screening tools created an in cremental improvement in puerperal sepsis screening which is an important step toward reducing maternal mortality.