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Acute and Sub-Acute Toxicity of Ethanolic Leaf Extracts of Rumex abyssinica Jacq. (Polygonaceae) and Mentha spicata L. (Lamiaceae)
(Pharmacology & Pharmacy, 2014-03-05) Maud, Kamatenesi Mugisha; James, Gakunga Ndukui; Agnes, Namutembi; Paul, Waako; Ann-Karl, Borg Karlson; Patrick, Vudriko
Rumex abyssinica Jacq. (Polygonaceae) is locally used in management of allergies and female reproductive healthcare; whereas Mentha spicata L. (Lamiaceae) is used to treat gastrointestinal and respiratory distress, dandruff, halitosis and malaria in Uganda. Owing to the paucity of data on their safety profiles, this study evaluated the acute and sub-acute toxicities of 70% ethanolic leaf extracts of both plants in mice and Wistar albino rats. The oral acute toxicity of both plants was evaluated in Swiss mice of 7 - 8 weeks old (16 - 22 g) body weight and LD50 determined. Sub-acute toxicity was evaluated in Wistar albino rats (6 per group) at dose rates of 500, 1000 and 1500 mg/kg for 28 days. The LD50 of R. abyssinica and M. spicata in mice was 7727 mg/kg and 13,606 mg/kg body weight, respectively. General signs of toxicity due to large doses of both plants extract included hyperurination, abdominal muscle twitches and convulsions. In the sub-acute toxicity test, rats treated with both extracts did not exhibit any clinical signs of toxicity; no mortality and changes in body weight were observed. R. abyssinica did not cause significant changes in haematological indices, except a significant increase in HCT (p < 0.05). However, a dose dependant significant decrease in HCT (p < 0.05) and a significant increase (p < 0.05) in the levels of WBC, LMY and MCHC were observed in rats treated with M. spicata extract. Biochemical test showed that both extracts caused a significant dose dependent increase (p < 0.05) in levels of ALT and ALP. Marked increase in the levels of AST was also observed in rats treated with M. spicata extract. Of the two extracts, only rats treated with R. abyssinica revealed congestion, hemorrhages and cellular infiltration in vital organs. In conclusion, the LD50 values of both plant extracts were above 5000 mg/kg suggesting that they are experimentally safe, thus justifying their use in traditional medicine. However, prolonged exposure to higher doses may cause observable alterations in histopathological, biochemical, and haematological parameters, particularly with R. abyssinica.
Assessing the Knowledge, Attitude and Practices among Health Workers on Rotavirus Diarrhoea Prevention in Rukiga District
(European Journal of Health Sciences, 2023) Davis, Ahabwe; Francis, Kazibwe
Purpose: Rotavirus has been identified as the most common pathogen associated with severe diarrhoea. Rotavirus infection is the leading cause of diarrhea in children under five and it is highly contagious. It poses an exception to typical diarrheal disease management rules. While improved access to clean water and better sanitation and hygiene practices are vital to preventing most diarrheal diseases, they have done little to disrupt infection. The virus may cause severe, dehydrating diarrhea in young children and, in untreated cases, lead to death. The aim of this study is to determine the knowledge, attitude and practices regarding Rotavirus Prevention and its vaccination among medical workers in Rukiga district Methodology: A total of 263 health workers were selected through random sampling. A structured and validated questionnaire was used. Questions about knowledge, attitude and practices were collected and verified on scale. Descriptive statistics were presented; multivariable regression analysis was done to determine the correlation of knowledge, attitude level, and practices with socio demographic variables such as age, sex and education. The p value≤0.05 considered was statistically significant. Findings: 118(47.14%) had adequate knowledge, 164(66.138%) positive attitude and 102(41.1%) appropriate practices on the Rotavirus diarrhoea prevention. Knowledge, attitude level and practices were increased significantly with increasing age, sex and education. After controlling for variables in the multivariable regression model, age, sex and education were the significant factors in determining the scores on knowledge, attitude and practices. About the knowledge. Age (β=4.15, p<0.001), sex (β=3.012, p=0.001) and education level (β=14.04, p<0.038), then attitude, age (β=4.32, p<0.001), sex (β=0.015, p=0.003) and education level (β=0.021, p<0.001) while for practices, age (β=0.021, p<0.001). Similarly, sex (β=0.022, p<0.001), education level (β=0.136, p=0.006). Generally, there was inadequate knowledge, positive attitude and inappropriate practices amongst the respondents on Rotavirus diarrhoea prevention in Rukiga District. Recommendations: Rukiga District needs to train, mentor and coach the health workers on prevention of Rotavirus including vaccination in order to have increased knowledge level, positive attitude and appropriate actions
Assessment of Knowledge, Attitude, and Perception of Human Papillomavirus Vaccination among Parents of Young Girls (Aged 8 – 12) In Mbarara City; a Cross-Sectional Study
(Student’s Journal of Health Research Africa, 2023) Twikirize, Bright; Kalibwani, Rebecca; Amanyire, Jordan
Introduction: To reduce the cervical cancer burden, many governments have emphasized the Human papillomavirus (HPV) vaccine as an important prevention strategy. Despite its effectiveness in preventing human papillomavirus (HPV) infection and free HPV immunization programs, vaccine acceptance is not guaranteed as some cultures are still against it due to various reasons. This study was conducted to assess the knowledge, attitude, and perception of human papillomavirus vaccination (HPV) among parents of young girls (aged 8 – 12) in Mbarara City. Methodology: The study was cross-sectional employing both qualitative and quantitative approaches for data collection and analysis. Information was collected from a sample of 288 respondents and 12 key informants using questionnaires and interviews. Data was analyzed using Microsoft Excel and STATA Version 18.0 Results: The study discovered that the level of Knowledge on HPV vaccination among parents of young girls was relatively low (41.3%) despite most respondents revealing to have heard about HPV and its associated infections like cervical cancer and genital warts. The study also found out that a large portion of community members (62.1%) still had negative attitudes towards the vaccine which has negatively affected their perceptions. Negative attitudes and perceptions equally played a big role towards vaccination leading to low vaccine acceptability in the area. The study further discovered a wide knowledge gap about HPV infection and HPV vaccine uptake (42%) and this has to be addressed. Conclusion: In conclusion, the study confirmed that knowledge about human papillomavirus vaccination (HPV) was low and attitude and perception of human papillomavirus vaccination (HPV) was poor among parents of young girls (aged 8 – 12). Recommendations: Tailored community-based interventions and sensitization programs are a viable means to achieve this for multiple reasons. There is a need for specific training for healthcare workers who are the first contact point for patients.
An Assessment of the Factors Affecting Utilization of Focused Antenatal Care at Mbaare Health Centre III, Isingiro District
(Bishop Stuart University, 2021-09) Akankwasa, Johnson
Background: Focused Antenatal care is an effective health intervention for averting maternal morbidity and mortality. Although there has been progressed improvement in antenatal care and access in Uganda, the use of FANC services remains low. The study was on the assessment of the factors affecting utilization of focused antenatal care at Mbaare Health Centre III Isingiro District. The specific objectives were to; determine socio-demographic, cultural behavioral, and health facility-based factors affecting the utilization of focused antenatal care services. Methods: The study was cross-sectional and employed both qualitative and quantitative approaches for data capture and analysis. Information was captured from 359 women attending ANC using questionnaires and interviews. Data were analyzed using STATA version 13 to generate both descriptive and inferential statistics. Results: the study found out main socio-demographic factors associated with the utilization of FANC services included level of education [AOR = 2.624; (95% CI: 1.056 – 6.516); p = 0.038], marital status [AOR = 0.47; (95% CI: 0.275 – 0.804); p = 0.006], and employment [AOR = 1.58; (95% CI: 1.014 – 2.46); p = 0.043] The study also identified tribe [AOR = 1.71; (95% CI: 1.11 – 2.641); p = 0.016] as the main cultural obstacle to FANC service utilization at the Health Centre. The study further identified poor behavior of the health workers [AOR = 0.51; 95% CI: 0.302 – 0.851; p = 0.01], long waiting time at the facility [AOR = 2.013; 95% CI: 1.12 – 3.62; p = 0.019] and un-flexible clinical hours [AOR = 2.72; 95% CI: 1.52 – 4.851; p = .001] as the main health facility based factors that affect utilization of focused antenatal care services. Conclusion: as a result of the significant results, the study concludes that there are different socio-demographic, cultural behavioral, and health facility-based factors associated with the utilization rate of FANC services at Mbaare Health Centre III Isingiro District. Therefore, the study recommends Ministry of Health increases regular community sensitization campaigns to ensure greater awareness of the importance of ANC services among the vulnerable groups. It also recommends behavior change strategies through behavior change campaigns at the community level to provide a platform for both the health care workers to learn about the perceptions of women to get to know them better and also to use that opportunity to educate women on the benefits of FANC services.
An Assessment of the Socio-Demographic Factors Affecting Utilization of Focused Antenatal Care at Mbaare Health Centre III Isingiro District, Uganda
(Bishop Stuart University, 2020) Akankwasa, J; Atukunda, G; Waswa, B.L
Background: Focused Antenatal care is an effective health intervention for averting maternal morbidity and mortality. Although there has been progressed improvement in antenatal care and access in Uganda, the use of FANC services remains low. The study was on the assessment of the factors affecting utilization of focused antenatal care at Mbaare Health Centre III Isingiro District. The specific objectives were to; determine socio-demographic, cultural behavioral, and health facility-based factors affecting the utilization of focused antenatal care services. Methods: The study was cross-sectional and employed both qualitative and quantitative approaches for data capture and analysis. Information was captured from 359 women attending ANC using questionnaires and interviews. Data were analyzed using STATA version 13 to generate both descriptive and inferential statistics. Results: the study found out main socio-demographic factors associated with the utilization of FANC services included level of education [AOR = 2.624; (95% CI: 1.056 – 6.516); p = 0.038], marital status [AOR = 0.47; (95% CI: 0.275 – 0.804); p = 0.006], and employment [AOR = 1.58; (95% CI: 1.014 – 2.46); p = 0.043] The study also identified tribe [AOR = 1.71; (95% CI: 1.11 – 2.641); p = 0.016] as the main cultural obstacle to FANC service utilization at the Health Centre. The study further identified poor behavior of the health workers [AOR = 0.51; 95% CI: 0.302 – 0.851; p = 0.01], long waiting time at the facility [AOR = 2.013; 95% CI: 1.12 – 3.62; p = 0.019] and un-flexible clinical hours [AOR = 2.72; 95% CI: 1.52 – 4.851; p = .001] as the main health facility based factors that affect utilization of focused antenatal care services. Conclusion: as a result of the significant results, the study concludes that there are different socio-demographic, cultural behavioral, and health facility-based factors associated with the utilization rate of FANC services at Mbaare Health Centre III Isingiro District. Therefore, the study recommends Ministry of Health increases regular community sensitization campaigns to ensure greater awareness of the importance of ANC services among the vulnerable groups. It also recommends behavior change strategies through behavior change campaigns at the community level to provide a platform for both the health care workers to learn about the perceptions of women to get to know them better and also to use that opportunity to educate women on the benefits of FANC services
Caregiving burden and mental health problems among family caregivers of people with dementia in rural Uganda
(Cambridge University Press, 2020) Herbert E., Ainamani; Paul E., Alele; Godfrey Z., Rukundo; Samuel, Maling; Edith K., Wakida; Celestino, Obua; Alexander C., Tsai
Background. Alzheimer’s disease and related dementias are associated with increasing health burden in low- and middle-income countries. Less well-recognized is the potential health bur den experienced by other affected individuals, such as family caregivers. In this study, we sought to profile the burden of care and its association with symptoms of depression and anx iety among informal caregivers of people living with dementia in rural southwestern Uganda. Method. We conducted a cross-sectional study of 232 family caregivers of people with demen tia. The key measured variables of interest were caregiving burden (Zarit Burden Index) and symptoms of depression and anxiety (Depression Anxiety Stress Scales). We fitted multivari able regression models specifying depression and anxiety symptoms as the primary outcomes of interest and caregiving burden as the primary explanatory variable of interest. Results. Family caregivers of people with dementia experience significant caregiving burden, with each item on the Zarit Burden Index endorsed by more than 70% of study participants. Nearly half [108 (47%)] of caregivers had Zarit Burden Interview scores >60, suggestive of severe caregiving burden. In multivariable regression models, we estimated a statistically significant positive association between caregiving burden and symptoms of both depression [b = 0.42; 95% confidence interval (CI) 0.34–0.49] and anxiety (b = 0.37; 95% CI 0.30–0.45). Conclusion. Family caregivers of people with dementia in rural Uganda experience a high caregiving burden, which is associated with symptoms of depression and anxiety. Interventions aimed at reducing caregiving burden may have important collateral mental health benefits
Chemical composition and Toxicological evaluation of the aqueous leaf extracts of Plectranthus amboinicus Lour. Spreng
(International Journal of Pharmaceutical Science Invention, 2014-02) Savina, Asiimwe; Anna-Karin, Borg- Karlsson; Muhammad, Azeem; Kamatenesi, Maud Mugisha; Agnes, Namutebi; Ndukui, James Gakunga
Ethnopharmacological relevance: Plectranthus amboinicus is used in traditional medicine to treat several diseases and ailments including opportunistic infections associated with HIV/AIDS. However, there is little insight as to the possible toxic effects of this herbal formulation on major organ systems of the body. This study was designed to assess the acute and sub acute toxic effects of the aqueous leaf extract of P. amboinicus on the histology of tissues, biochemical (liver and kidney functions) as well as hematological indices in albino swiss mice and wistar rats respectively. Materials and methods: In this study, phytochemical screening of the aqueous extracts of P. amboinicus was carried out using standard qualitative and quantitative (SPME and GCMS) analytical methods. The extracts were tested for acute toxicity in mice and for sub acute toxicity in Wistar rats according to the OECD guidelines No 425. In acute toxicity test, the dose of 5000 mg/kg was used as the limit dose test. The sub acute toxicity test was evaluated through biochemical, hematological, histopathological and body weight of rats using daily doses of 2500 mg/kg, 1250 mg/kg and 625 mg/kg of the aqueous extract for 28 days. Any signs of toxicity were recorded. Histopathological examination was done on the liver, kidneys, lungs and intestines. Body weight changes were measured weekly for 28 days of daily single dose of extract administration. Results: Phytochemical screening of the aqueous extracts revealed the presence of tannins, saponins, flavonoids, steroid glycosides and polyuronides. GCMS analysis revealed the presence of 11 chemical compounds constituting 97.6% of the total extract composition. The principle constituents include linalool (50.3 %), nerol acetate (11.6%), geranyl acetate (11.7 %) and carvacrol (14.3%). In acute toxicity, the extracts did not cause any mortality or evidence of adverse effects following oral administration of the highest dose of 10,000 mg/kg of crude extract in both mice. In sub acute study, normal body weight gains were observed during the study period compared to the control group. The kidney function parameters (Urea, creatinine, uric acid) were significantly increased following administration of extract. Histopathological examination of extract treated groups showed necrosis of hepatic cells with generalized congestion in the renal cortex, pneumonitis and sloughing of intestinal villi. Conclusion: The aqueous extract is rich in phytochemical compounds that are of therapeutic value. No mortalities were observed during acute and sub acute toxicity study period. These finding indicate that the extract caused treatment- related toxicological abnormalities which increased with dosage. The aqueous extract of P. amboinicus is safe to use as indicated by the high LD50 value, but should be used with caution at high doses.
Chemotherapy for Schistosomiasis in Ugandan Fishermen
(American Society for Microbiology, 2004-04-02) Kazibwe, Francis.et.al
Chemotherapy for blood-dwelling schistosomes kills the worms and exposes parasite antigen to the circu lation. In many people from areas of endemicity, this treatment increases parasite-specific immunoglobulin E (IgE) and other Th2 responses in the months following therapy, responses that have been associated with subsequent resistance to reinfection. Here we investigate much earlier changes in immune reactions after praziquantel therapy in Schistosoma mansoni-infected fishermen working in an area of high transmission in Uganda. The subjects gave blood before treatment and at 1 and 21 days posttreatment. Blood cultures were incubated with schistosome soluble worm antigen (SWA) or soluble egg antigen (SEA). Interleukin-4 (IL-4), IL-5, IL-10, IL-13, gamma interferon, and transforming growth factor levels were measured in the cultures and in plasma. A marked transient increase in plasma IL-5 levels was observed in 75% of the subjects (n 48) by 1 day posttreatment. This response was dependent on pretreatment intensity of infection and was accom panied by a transient decrease in eosinophil numbers. One day posttreatment, blood cultures from the 16 subjects with the greatest increase in plasma IL-5 level (>100 pg/ml) displayed reduced IL-5, IL-13, and IL-10 responses to SWA, and in contrast to the rest of the cohort, these high-IL-5 subjects displayed reduced levels of SWA-specific IgE in plasma 21 days posttreatment. Twenty months after treatment, the intensity of reinfection was positively correlated with the increase in plasma IL-5 level seen 1 day posttreatment. These studies describe the heterogeneity in early immune reactions to treatment, identifying subgroups who have different patterns of reaction and who may have different capacities to mount the responses that have been associated with resistance to reinfection.
Child Maltreatment Increases the Risk of Self-esteem Impairment
(East African Journal of Health and Science, 2023) Eunice, Ndyareeba; Herbert E., Ainamani; Grace, Ankunda; Agnes, Amanya
Child maltreatment exposes children to developmental risks pertaining to internalizing problems both in early and later life. However, research on this phenomenon in low- and middle-income countries is scanty. Our study aimed at examining the association between different forms of child maltreatment and self-esteem among children and adolescents in Uganda. The present investigation involved conducting interviews with a cohort of 232 school going children and adolescents. The Maltreatment and Abuse Chronology Exposure Pediatric-Version (MACE) questionnaire was employed to evaluate the various forms of maltreatment that the participants may have encountered. Furthermore, the Rosenberg Self-esteem Scale (RSE) was utilized to gauge their self-esteem. To explore the association between diverse maltreatment categories and self-esteem levels, descriptive statistics were employed, and linear regression analysis was conducted using SPSS. Our results showed that the majority 162 (70%) of the children had low self-esteem and high levels of childhood maltreatment (M = 28.7, SD = 2.16). The study found a statistically significant inverse relationship between child maltreatment and self-esteem (b -0.012, p=-.0.0025). It was also found that the regression model was statistically significant and therefore the data fits the model (F = 5.82, E = .017). The regression equation indicated that for every unit increase in child maltreatment, self-esteem decreases by 1.3%. It was concluded that maltreatment has a negative detrimental impact on the self-esteem of children and adolescents. The study contributes to the existing knowledge base and its implications for intervention, support, and prevention efforts in the context of child maltreatment.
Community Perceptions on the use of Traditional Medicine among People experiencing Sexual Dysfunctions in Greater Mbarara, western Uganda.
(Kyokusiima Naome Kapere, 2022) Kyokusiima Naome Kapere; Maud Kamatenesi Mugish; Otwine Anne Tweheyo; Waisindye Noah
In Uganda, studies have indicated that up to 52% of the sexually active population aged 18 to 70yrs experience different sexual dysfunctions and it is predicted that the prevalence of dysfunctions will increase dramatically by 2050. The study was carried out to find out community perceptions about the use of traditional medicine among people experiencing sexual dysfunctions in Greater Mbarara, western Uganda. The study aimed to examine the common sexual dysfunctions which exist among people, identifying the common beliefs associated with the use of herbal medicine remedy for treatment of sexual dysfunction, carry out an Ethno botanical documentation of commonly used herbal medicines in the treatment of sexual dysfunctions and determine the relationship between the use of traditional medicine remedy and treatment of sexual dysfunctions among people. Using a cross-sectional survey design, Data was captured from a sample of 103 respondents through questionnaire approach and interviews. The respondents were selected using purposive criteria and simple random technique. Data was analyzed using SPSS to generate descriptive statistics for quantitative data and inferences from qualitative data. Different sexual dysfunctions existed and were common to both men and women in the society. Common among men were; pain during penetration, erectile disorder, short erections, lack of sexual arousal and premature ejaculation unlike women who experienced; lack of sexual arousal, lack of orgasm, atrophic vaginitis, short orgasms and dyspareunia. It was established that most people shy away from the use of herbal remedies for treatment of sexual dysfunctions because of the commonly held beliefs associated with the use of herbal medicine. The commonly used herbs by men were; Acacia abysinica Scheele, Dichrostachy scinerea L, Coffea Sp, Citropsis articulata, Mondia whiteii Skeels, Impetiens sp, Rumex abyssinicus, Allium cepa L. , Albizia coriaria welw and main mode of administration was oral using water, food, tea and porridge. Minor modes of administration included nasal inhalation of fumes. The use of traditional herbs is significantly associated with the treatment of sex dysfunctions for both men and women however, there’s need for collaboration between health professionals and traditional medicine practitioners to further identify and scientifically test on the efficacy of the identified plants.
A CROSS-SECTIONAL STUDY ON PREVALENCE AND FACTORS ASSOCIATED WITH BODY FLUIDS EXPOSURE AMONG NURSING STUDENTS OF BISHOP STUART UNIVERSITY.
(SJ Nursing and Midwifery Africa, 2024) Tusimiirwe, Happiness; Natwijuka, Andrew
Background: Purpose: The purpose of this study was to determine the prevalence and factors associated with body fluid exposure among nursing students. Method: A cross-sectional study design that employed a quantitative method of data collection was used. This design took a short time and no intervention was done after data collection. A total of 107 participants were selected by simple random sampling technique and data obtained was analyzed by SPSS version 20. Results: One hundred eight nursing students consented to participate in the study and all completed questionnaires making it 100% response. The majority of the respondents (90.7%) had ever been exposed to body fluids with 55.1% having been exposed to blood .49.0% of the respondents were exposed to body fluids over 3 times during their clinical practicum. The overall findings from the study revealed a significant relationship between the level of education, availability and use of PPEs, annual IPC training, availability of PPEs, and number of patients with exposure body among nursing students. Conclusion: The study highlighted a large percentage (90.7%) of the nursing students to have been exposed to body fluids with most of them having been exposed to blood and had more than 3 exposures to body fluids during their clinical practice. Recommendation: Institutional administrators should also ensure that students are provided with support supervision and continuous medical education to empower them on proper waste disposal and infectious disease control/management.
Culture, tradition and healthcare
(International Journal of Anthropology and Ethnology, 2024) Alex Ayebazibwe Kakama; Ambrose Atuheire; Danson Kahyana
In southwestern Uganda, a custom of health and social support has been man- aged through collective organizations known as engozi for centuries. Subscribers advanced help for those who were not able to provide for themselves and their house- holds. Participants pooled financial and food resources, offered emotional assis- tance, and aided in transporting patients to hospitals. The institution of “free gov- ernment health amenities” caused the decline of the engozi custom. However, with an insufficient annual health sector budget allocation, the state health services can- not satisfactorily meet the needs. The Kisiizi neighborhood, while depending on the engozi practice, arrived at a CHI system in 1996 as a self-help innovation to elimi- nate financial obstacles and enhance access to quality health amenities. Numerous studies on CHI have examined the structure, registration and memberships, health- related advantages, and monetary-related benefits, but little has been documented on how cultural beliefs and customs have affected its application. This study aimed to identify the role of culture and customs in tackling healthcare disparities via a CHI strategy. This study adopted a case study methodology and qualitative methods. The study utilizes Woolcock’s social capital theory and Cultural competence theory as the analytical framework. It identifies Brotherhood, Solidarity, Belonging, Coop- eration, Volunteering, Reciprocity, and Respect for Authority and Leaders as key values upheld by the engozi tradition, strengthening social capital and laying a solid foundation for successful CHI. This study also identified that societal values and tra- ditions have significantly impacted the implementation of the Kisiizi CHI scheme, as evidenced by the influence on CHI leadership and governance, collecting pre- mium fees from subscribers, mobilization and registration of participants, and infor- mation dissemination. Lastly, the study identified that CHI has positively affected healthcare challenges within the community, evidenced by increased utilization of healthcare services, improved access to antenatal care, health promotion and disease prevention initiatives, and improved quality of services due to user feedback.
Culture, tradition and healthcare
(2024) Alex Ayebazibwe Kakama; Ambrose Atuheire; Danson Kahyana
In southwestern Uganda, a custom of health and social support has been man- aged through collective organizations known as engozi for centuries. Subscribers advanced help for those who were not able to provide for themselves and their house- holds. Participants pooled financial and food resources, offered emotional assis- tance, and aided in transporting patients to hospitals. The institution of “free gov- ernment health amenities” caused the decline of the engozi custom. However, with an insufficient annual health sector budget allocation, the state health services can- not satisfactorily meet the needs. The Kisiizi neighborhood, while depending on the engozi practice, arrived at a CHI system in 1996 as a self-help innovation to elimi- nate financial obstacles and enhance access to quality health amenities. Numerous studies on CHI have examined the structure, registration and memberships, health- related advantages, and monetary-related benefits, but little has been documented on how cultural beliefs and customs have affected its application. This study aimed to identify the role of culture and customs in tackling healthcare disparities via a CHI strategy. This study adopted a case study methodology and qualitative methods. The study utilizes Woolcock’s social capital theory and Cultural competence theory as the analytical framework. It identifies Brotherhood, Solidarity, Belonging, Coop- eration, Volunteering, Reciprocity, and Respect for Authority and Leaders as key values upheld by the engozi tradition, strengthening social capital and laying a solid oundation for successful CHI. This study also identified that societal values and tra- ditions have significantly impacted the implementation of the Kisiizi CHI scheme, as evidenced by the influence on CHI leadership and governance, collecting pre- mium fees from subscribers, mobilization and registration of participants, and infor- mation dissemination. Lastly, the study identified that CHI has positively affected healthcare challenges within the community, evidenced by increased utilization of healthcare services, improved access to antenatal care, health promotion and disease prevention initiatives, and improved quality of services due to user feedback.
Dating Stress, Depression and Anxiety Symptoms
(International Journal of Public Health and Safety, 2020) Talbert, Muhwez; Maud, Kamatenesi-Mugisha; Herbert, E Ainamani
Introduction: Worldwide, dating related stress and its impact on mental health among students has turned out to be of public health concern. However, research on this phenomenon in low- and middle-income countries (LAMIC) remains lacking. This study described the occurrence of dating-related stress and its association with psychological state aspects of depression and anxiety among students in a Ugandan University. Methods: In this cross-sectional study using convenient sampling, 255 students from Bishop Stuart University were interviewed on their exposure to dating stress using psychological victimization scale (PVS), depression using Patient Health Questionnaire (PHQ-9) and anxiety using Generalized Anxiety Disorder (GAD-7). Data were analyzed using Stata version 12.1 and correlations and associations were determined using multivariate logistic regression analysis. Results: The prevalence rate of dating-related stress was at 88%. Specifically, students who had ever experienced dating related stress were more than five times likely to suffer from depression compared to those who have never experienced dating related stress (OR=5.9; 95% CI=1.9, 13.3, P ≤ 0.001). Students who had ever experienced dating related stress were more than four times likely to suffer anxiety than those who have never experienced dating related stress (OR= 4.2; 95% CI=1.6, 11.1; P=0.004). Conclusion: There is high dating related stress which subsequently impacts the psychological wellbeing of students in Universities. We recommend that dating related stress be given due attention and corrective action from institution officials and counselors to provide appropriate positive coping mechanisms like psycho-education and stress prevention programs.
Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda
(Scientific Research Publishing, 2023) Mutambi Amanyire, Jordan; Aheisibwe, Irene; Mohan Kaggwa, Mark; Rukundo, Godfrey Zari
Background: Due to the increase in longevity and use of antiretroviral treat ment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we deter mined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, south west Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively se lected HIV/AIDS care centers in Mbarara city, southwest Uganda were re cruited. Data on depression and suicidal ideation were collected using a Pa tient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Ap proximately 8.3% and 12.1% had depression and suicidal ideation, respec tively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for financial independence among older persons living with HIV/AIDS to reduce the burden of depression, and suicidal behaviours among this vulnerable population.
Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda
(Scientific Research Publishing, 2023) Mutambi Amanyire, Jordan; Aheisibwe, Irene; Kaggwa, Mark Mohan
Background: Due to the increase in longevity and use of antiretroviral treat ment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we deter mined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, south west Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively se lected HIV/AIDS care centers in Mbarara city, southwest Uganda were re cruited. Data on depression and suicidal ideation were collected using a Pa tient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Ap proximately 8.3% and 12.1% had depression and suicidal ideation, respec tively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for financial independence among older persons living with HIV/AIDS to reduce the burden of depression, and suicidal behaviours among this vulnerable popu lation.
Determinants for Effective Nutritional Counselling on Prognosis of Moderate Acute Malnutrition in Paediatric HIV/AIDS Positive Patients Conducted at Hoima Regional Referral Hospital, Uganda
(East African Journal of Health and Science, 2023) Abigaba, Emily; Aheisibwe, Irene
This study evaluated the determinants of effective nutritional counselling on the prognosis of moderate acute malnutrition in Paediatric HIV/AIDS patients at Hoima Regional Referral Hospital. This study used pre- and post study design, which measured the occurrence of an outcome of interest using specific values in a group of participants before and after the intervention; it was conducted among 157 paediatric HIV/AIDS patients at Hoima RRH, western Uganda. Data were obtained from all the participants using a questionnaire, and focus group discussion was analysed using Stata 17. The findings reveal that of the 157 paediatric HIV/AIDS patients studied, 67.5% improved after nutritional counselling. Paediatric HIV/AIDS patients aged ≥ 60 months (p = 0.009), caretakers whose occupations other than peasantry (p = 0.021), and attendance to ≥ 3 nutritional counselling sessions (p = 0.004) were associated with a higher likelihood of improvement after nutritional counselling with a significant increase in Body Mass Index of (p = 0.007). Thus, the majority of Paediatric HIV/AIDS patients indicated a significant improvement in prognosis after nutritional counselling and being aged ≥ 60 months, having an attendance of ≥ 3 sessions and having a caretaker’s occupation other than peasantry determined the effectiveness of nutritional counselling. The study concludes that there is a need to routinely refer Paediatric HIV/AIDS patients with moderate acute malnutrition for nutritional counselling
Determinants for Effective Nutritional Counselling on Prognosis of Moderate Acute Malnutrition in Paediatric HIV/AIDS Positive Patients Conducted at Hoima Regional Referral Hospital, Uganda
(East African Journal of Health and Science, 2023) Abigaba, Emily; Aheisibwe, Irene
This study evaluated the determinants of effective nutritional counselling on the prognosis of moderate acute malnutrition in Paediatric HIV/AIDS patients at Hoima Regional Referral Hospital. This study used pre- and post study design, which measured the occurrence of an outcome of interest using specific values in a group of participants before and after the intervention; it was conducted among 157 paediatric HIV/AIDS patients at Hoima RRH, western Uganda. Data were obtained from all the participants using a questionnaire, and focus group discussion was analysed using Stata 17. The findings reveal that of the 157 paediatric HIV/AIDS patients studied, 67.5% improved after nutritional counselling. Paediatric HIV/AIDS patients aged ≥ 60 months (p = 0.009), caretakers whose occupations other than peasantry (p = 0.021), and attendance to ≥ 3 nutritional counselling sessions (p = 0.004) were associated with a higher likelihood of improvement after nutritional counselling with a significant increase in Body Mass Index of (p = 0.007). Thus, the majority of Paediatric HIV/AIDS patients indicated a significant improvement in prognosis after nutritional counselling and being aged ≥ 60 months, having an attendance of ≥ 3 sessions and having a caretaker’s occupation other than peasantry determined the effectiveness of nutritional counselling. The study concludes that there is a need to routinely refer Paediatric HIV/AIDS patients with moderate acute malnutrition for nutritional counselling
Diagnosis and treatment of advanced breast cancer
(BMJ, 2009-02) Kazibwe, Francis; N, Murray; J, Winstanley; A, Bennett
The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic
(African Health Sciences, 2019) Francis, Kazibwe et.al
Background: Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices. Objectives: We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among pa tients with UGIB in rural SSA where schistosomiasis is endemic. Methods: We studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accu racy. Results: We studied 107 participants with UGIB and 21% had active bleeding. One hundred and three (96%) had liver disease and 86(80%) varices. Factors associated with varices (p-value <0.05) were ≥ 4 lifetime episodes of UGIB, prior blood trans fusion, splenomegaly, liver fibrosis, thrombocytopenia, platelet count spleen diameter ratio <909, and a dilated portal vein. Two models showed an overall diagnostic accuracy of > 90% in detection of varices with a number needed to misdiagnose of 13(number of patients who needed to be tested in order for one to be misdiagnosed by the test). Conclusion: Where access to endoscopy is limited, routine clinical findings could improve the diagnosis of patients with UGIB in Africa.

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