Journal articles: 'Medical care – Uganda – Evaluation'

1

Van Hout, Marie-Claire, Max Bachmann, Jeffrey V. Lazarus, Elizabeth Henry Shayo, Dominic Bukenya, Camila A. Picchio, Moffat Nyirenda, et al. "Strengthening integration of chronic care in Africa: protocol for the qualitative process evaluation of integrated HIV, diabetes and hypertension care in a cluster randomised controlled trial in Tanzania and Uganda." BMJ Open 10, no. 10 (October 2020): e039237. http://dx.doi.org/10.1136/bmjopen-2020-039237.

Full text

Abstract:

IntroductionIn sub-Saharan Africa, the burden of non-communicable diseases (NCDs), particularly diabetes mellitus (DM) and hypertension, has increased rapidly in recent years, although HIV infection remains a leading cause of death among young-middle-aged adults. Health service coverage for NCDs remains very low in contrast to HIV, despite the increasing prevalence of comorbidity of NCDs with HIV. There is an urgent need to expand healthcare capacity to provide integrated services to address these chronic conditions.Methods and analysisThis protocol describes procedures for a qualitative process evaluation of INTE-AFRICA, a cluster randomised trial comparing integrated health service provision for HIV infection, DM and hypertension, to the current stand-alone vertical care. Interviews, focus group discussions and observations of consultations and other care processes in two clinics (in Tanzania, Uganda) will be used to explore the experiences of stakeholders. These stakeholders will include health service users, policy-makers, healthcare providers, community leaders and members, researchers, non-governmental and international organisations. The exploration will be carried out during the implementation of the project, alongside an understanding of the impact of broader structural and contextual factors.Ethics and disseminationEthical approval was granted by the Liverpool School of Tropical Medicine (UK), the National Institute of Medical Research (Tanzania) and TASO Research Ethics Committee (Uganda) in 2020. The evaluation will provide the opportunity to document the implementation of integration over several timepoints (6, 12 and 18 months) and refine integrated service provision prior to scale up. This synergistic approach to evaluate, understand and respond will support service integration and inform monitoring, policy and practice development efforts to involve and educate communities in Tanzania and Uganda. It will create a model of care and a platform of good practices and lessons learnt for other countries implementing integrated and decentralised community health services.Trial registration numberISRCTN43896688; Pre-results.

APA, Harvard, Vancouver, ISO, and other styles

2

Ovuga, Emilio, Jed Boardman, and Elizabeth G. A. O. Oluka. "Traditional healers and mental illness in Uganda." Psychiatric Bulletin 23, no. 5 (May 1999): 276–79. http://dx.doi.org/10.1192/pb.23.5.276.

Full text

Abstract:

Aims and methodA cross-sectional, interview survey of the beliefs, knowledge, attitudes and practice towards mental illness of 29 traditional healers in the Pallisa district of Uganda was carried out.ResultsMany of the healers had experienced emotional problems that had been treated by other healers. Almost all had a family member who was also a traditional healer. They treated a wide range of conditions and all dealt with mental illness. Most believed that mental disorders were caused by supernatural processes. Many recognised the role of environmental agents. Their diagnosis and management of mental illness was eclectic. The healers were either traditional herbalists or spirit diviners or a mixture of both. Almost all referred patients to the district hospitals and were willing to work with government health services.Clinical implicationsThe results of the survey suggest the presence of fertile ground on which to build cooperation between traditional healers and medical services. Such cooperation may harness primary care resources more effectively. Sequential or simultaneous models of collaboration (or combinations of both) may be considered. Further work on specific treatments, their outcomes and the evaluation of collaborative models is needed.

APA, Harvard, Vancouver, ISO, and other styles

3

van Olmen, Josefien, Pilvikki Absetz, Roy William Mayega, Linda Timm, Peter Delobelle, Helle Mölsted Alvesson, Glorai Naggayi, et al. "Process evaluation of a pragmatic implementation trial to support self-management for the prevention and management of type 2 diabetes in Uganda, South Africa and Sweden in the SMART2D project." BMJ Open Diabetes Research & Care 10, no. 5 (September 2022): e002902. http://dx.doi.org/10.1136/bmjdrc-2022-002902.

Full text

Abstract:

IntroductionType 2 diabetes (T2D) and its complications are increasing rapidly. Support for healthy lifestyle and self-management is paramount, but not adequately implemented in health systems. Process evaluations facilitate understanding why and how interventions work through analyzing the interaction between intervention theory, implementation and context. The Self-Management and Reciprocal Learning for Type 2 Diabetes project implemented and evaluated community-based interventions (peer support program; care companion; and link between facility care and community support) for persons at high risk of or having T2D in a rural community in Uganda, an urban township in South Africa, and socioeconomically disadvantaged urban communities in Sweden.Research design and methodsThis paper reports implementation process outcomes across the three sites, guided by the Medical Research Council framework for complex intervention process evaluations. Data were collected through observations of peer support group meetings using a structured guide, and semistructured interviews with project managers, implementers, and participants.ResultsThe countries aligned implementation in accordance with the feasibility and relevance in the local context. In Uganda and Sweden, the implementation focused on peer support; in South Africa, it focused on the care companion part. The community–facility link received the least attention. Continuous capacity building received a lot of attention, but intervention reach, dose delivered, and fidelity varied substantially. Intervention-related and context-related barriers affected participation.ConclusionsIdentification of the key uncertainties and conditions facilitates focus and efficient use of resources in process evaluations, and context relevant findings. The use of an overarching framework allows to collect cross-contextual evidence and flexibility in evaluation design to adapt to the complex nature of the intervention. When designing interventions, it is crucial to consider aspects of the implementing organization or structure, its absorptive capacity, and to thoroughly assess and discuss implementation feasibility, capacity and organizational context with the implementation team and recipients. These recommendations are important for implementation and scale-up of complex interventions.Trial registration numberISRCTN11913581.

APA, Harvard, Vancouver, ISO, and other styles

4

Nyqvist, Martina Björkman, Andrea Guariso, Jakob Svensson, and David Yanagizawa-Drott. "Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda." American Economic Journal: Applied Economics 11, no. 3 (July 1, 2019): 155–92. http://dx.doi.org/10.1257/app.20170201.

Full text

Abstract:

The delivery of basic health products and services remains abysmal in many parts of the world where child mortality is high. This paper shows the results from a large-scale randomized evaluation of a novel approach to health care delivery. In randomly selected villages, a sales agent was locally recruited and incentivized to conduct home visits, educate households on essential health behaviors, provide medical advice and referrals, and sell preventive and curative health products. Results after 3 years show substantial health impact: under 5-years child mortality was reduced by 27 percent at an estimated average cost of $68 per life-year saved. (JEL I12, I18, J13, O15, O18)

APA, Harvard, Vancouver, ISO, and other styles

5

Kutyabami, Paul, Edson Ireeta Munanura, Rajab Kalidi, Sulah Balikuna, Margaret Ndagire, Bruhan Kaggwa, Winnie Nambatya, et al. "Evaluation of the Clinical Use of Ceftriaxone among In-Patients in Selected Health Facilities in Uganda." Antibiotics 10, no. 7 (June 25, 2021): 779. http://dx.doi.org/10.3390/antibiotics10070779.

Full text

Abstract:

Ceftriaxone has a high propensity for misuse because of its high rate of utilization. In this study, we aimed at assessing the appropriateness of the clinical utilization of ceftriaxone in nine health facilities in Uganda. Using the World Health Organization (WHO) Drug Use Evaluation indicators, we reviewed a systematic sample of 885 patients’ treatment records selected over a three (3)-month period. Our results showed that prescriptions were written mostly by medical officers at 53.3% (470/882). Ceftriaxone was prescribed mainly for surgical prophylaxis at 25.3% (154/609), respiratory tract infections at 17% (104/609), and sepsis at 11% (67/609), as well as for non-recommended indications such as malaria at 7% (43/609) and anemia at 8% (49/609). Ceftriaxone was mostly prescribed once daily (92.3%; 817/885), as a 2 g dose (50.1%; 443/885), and for 5 days (41%; 363/885). The average score of inappropriate use of ceftriaxone in the eight indicators was 32.1%. Only 58.3% (516/885) of the ceftriaxone doses prescribed were administered to completion. Complete blood count and culture and sensitivity testing rates were 38.8% (343/885) and 1.13% (10/885), respectively. Over 85.4% (756/885) of the patients improved and were discharged. Factors associated with appropriate ceftriaxone use were gender, pregnancy status, days of hospitalization, health facility level of care, health facility type, and type of prescriber.

APA, Harvard, Vancouver, ISO, and other styles

6

Macnab, Andrew, Arabat Kasangaki, and Faith Gagnon. "Health Promoting Schools Provide Community-Based Learning Opportunities Conducive to Careers in Rural Practice." International Journal of Family Medicine 2011 (April 7, 2011): 1–5. http://dx.doi.org/10.1155/2011/892518.

Full text

Abstract:

The World Health Organization conceived “health-promoting schools” as a means of providing the information and support systems necessary for the worldwide changes in behavior that are needed to improve health globally and decrease health care costs. We developed and evaluated a model of progressively implementing health-promoting schools with support from university medical school trainees in Canada and Uganda. The model uses oral health as a medium for establishing rapport and success around a topic with little stigma. The evaluation involved questionnaires of the Canadian trainees about practice intentions before and after involvement in the health-promoting schools to determine whether community-based learning in health-promoting schools resulted in more trainees planning to work in rural areas or underserved countries. We found that Canadian medical trainees cited their personal involvement and perceived ability to effect significant and identifiable positive change in both the school children and the community as reasons why they were more willing to practice in rural or under-served areas.

APA, Harvard, Vancouver, ISO, and other styles

7

Moodley, Shreya, Arabat Kasangaki, and Andrew J. Macnab. "Education in Global Health: Experience in Health-Promoting Schools Provides Trainees with Defined Core Competencies." ISRN Education 2012 (March 13, 2012): 1–7. http://dx.doi.org/10.5402/2012/718303.

Full text

Abstract:

Introduction. Medical education has defined essential “universal” core competencies. The value of global health education gained through participation in a health-promoting school project was assessed using Canada’s CanMEDS roles and competencies. Methods. The project involved health care trainees in delivery of “Brighter Smiles,” a global health education program addressing children’s oral health in Canada and Uganda based on the WHO health-promoting (HP) school model. Multidisciplinary teams first visit a Canadian First Nations community for an introduction to HP schooling, team building, and experience working in different cultural environments and then have 4–6 weeks of global health project delivery in rural HP schools in Uganda in partnership with local College of Health Sciences trainees/faculty. Learning opportunities afforded were evaluated by conventional questionnaire and pilot categorization against the 7 CanMEDS roles (divided into 126 core competencies). Results. All collaborator and health Advocate competencies and 16/17 of the communicator roles were addressed. Overall, project experience included 88 (70%) of the 126 competencies. Conclusions. This pilot suggests CanMEDS criteria can be used to effectively evaluate trainee participation in HP school program delivery, allowing the comprehensive educational opportunities to acquire global health knowledge and skills reported by conventional evaluation to be formally categorized against defined educational roles and competencies.

APA, Harvard, Vancouver, ISO, and other styles

8

Tumwebaze, Henry, Elioda Tumwesigye, Jared M. Baeten, Ann E. Kurth, Jennifer Revall, Pamela M. Murnane, Larry W. Chang, and Connie Celum. "Household-Based HIV Counseling and Testing as a Platform for Referral to HIV Care and Medical Male Circumcision in Uganda: A Pilot Evaluation." PLoS ONE 7, no. 12 (December 13, 2012): e51620. http://dx.doi.org/10.1371/journal.pone.0051620.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

Mfinanga, Sayoki Godfrey, Moffat J. Nyirenda, Gerald Mutungi, Janneth Mghamba, Sarah Maongezi, Joshua Musinguzi, Joseph Okebe, et al. "Integrating HIV, diabetes and hypertension services in Africa: study protocol for a cluster randomised trial in Tanzania and Uganda." BMJ Open 11, no. 10 (October 2021): e047979. http://dx.doi.org/10.1136/bmjopen-2020-047979.

Full text

Abstract:

Introduction HIV programmes in sub-Saharan Africa are well funded but programmes for diabetes and hypertension are weak with only a small proportion of patients in regular care. Healthcare provision is organised from stand-alone clinics. In this cluster randomised trial, we are evaluating a concept of integrated care for people with HIV infection, diabetes or hypertension from a single point of care. Methods and analysis 32 primary care health facilities in Dar es Salaam and Kampala regions were randomised to either integrated or standard vertical care. In the integrated care arm, services are organised from a single clinic where patients with either HIV infection, diabetes or hypertension are managed by the same clinical and counselling teams. They use the same pharmacy and laboratory and have the same style of patient records. Standard care involves separate pathways, that is, separate clinics, waiting and counselling areas, a separate pharmacy and separate medical records. The trial has two primary endpoints: retention in care of people with hypertension or diabetes and plasma viral load suppression. Recruitment is expected to take 6 months and follow-up is for 12 months. With 100 participants enrolled in each facility with diabetes or hypertension, the trial will provide 90% power to detect an absolute difference in retention of 15% between the study arms (at the 5% two-sided significance level). If 100 participants with HIV infection are also enrolled in each facility, we will have 90% power to show non-inferiority in virological suppression to a delta=10% margin (ie, that the upper limit of the one-sided 95% CI of the difference between the two arms will not exceed 10%). To allow for lost to follow-up, the trial will enrol over 220 persons per facility. This is the only trial of its kind evaluating the concept of a single integrated clinic for chronic conditions in Africa. Ethics and dissemination The protocol has been approved by ethics committee of The AIDS Support Organisation, National Institute of Medical Research and the Liverpool School of Tropical Medicine. Dissemination of findings will be done through journal publications and meetings involving study participants, healthcare providers and other stakeholders. Trial registration number NCT43896688.

APA, Harvard, Vancouver, ISO, and other styles

10

Chang, Larry W., Stella Alamo, Samuel Guma, Jason Christopher, Tara Suntoke, Richard Omasete, Jennifer P. Montis, Thomas C. Quinn, Margrethe Juncker, and Steven J. Reynolds. "Two-Year Virologic Outcomes of an Alternative AIDS Care Model: Evaluation of a Peer Health Worker and Nurse-Staffed Community-Based Program in Uganda." JAIDS Journal of Acquired Immune Deficiency Syndromes 50, no. 3 (March 2009): 276–82. http://dx.doi.org/10.1097/qai.0b013e3181988375.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Kwizera, Arthur, Mary Nabukenya, Agaba Peter, Lameck Semogerere, Emmanuel Ayebale, Catherine Katabira, Samuel Kizito, Cecilia Nantume, Ian Clarke, and Jane Nakibuuka. "Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit." Critical Care Research and Practice 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/2610873.

Full text

Abstract:

Purpose. In high-income countries, improved survival has been documented among intensive care unit (ICU) patients infected with human immune deficiency virus (HIV). There are no data from low-income country ICUs. We sought to identify clinical characteristics and survival outcomes among HIV patients in a low-income country ICU.Materials and Methods. A retrospective cohort study of HIV infected patients admitted to a university teaching hospital ICU in Uganda. Medical records were reviewed. Primary outcome was survival to hospital discharge. Statistical significance was predetermined in reference toP<0.05.Results. There were 101 HIV patients. Average length of ICU stay was 4 days and ICU mortality was 57%. Mortality in non-HIV patients was 28%. Commonest admission diagnoses were Acute Respiratory Distress Syndrome (ARDS) (58.4%), multiorgan failure (20.8%), and sepsis (20.8%). The mean Acute Physiologic and Chronic Health Evaluation (APACHE II) score was 24. At multivariate analysis, APACHE II (OR 1.24 (95% CI: 1.1–1.4,P=0.01)), mechanical ventilation (OR 1.14 (95% CI: 0.09–0.76,P=0.01)), and ARDS (OR 4.5 (95% CI: 1.07–16.7,P=0.04)) had a statistically significant association with mortality.Conclusion. ICU mortality of HIV patients is higher than in higher income settings and the non-HIV population. ARDS, APACHE II, and need for mechanical ventilation are significantly associated with mortality.

APA, Harvard, Vancouver, ISO, and other styles

12

TUMLINSON, KATHERINE, DAVID HUBACHER, JENNIFER WESSON, and CHRISTINE LASWAY. "MEASURING THE USEFULNESS OF FAMILY PLANNING JOB AIDS FOLLOWING DISTRIBUTION AT TRAINING WORKSHOPS." Journal of Biosocial Science 42, no. 5 (June 9, 2010): 695–98. http://dx.doi.org/10.1017/s0021932010000283.

Full text

Abstract:

SummaryA job aid is a tool, such as a flowchart or checklist, that makes it easier for staff to carry out tasks by providing quick access to needed information. Many public health organizations are engaged in the production of job aids intended to improve adherence to important medical guidelines and protocols, particularly in resource-constrained countries. However, some evidence suggests that actual use of job aids remains low. One strategy for improving utilization is the introduction of job aids in training workshops. This paper summarizes the results of two separate evaluations conducted in Uganda and the Dominican Republic (DR) which measured the usefulness of a series of four family planning checklists 7–24 months after distribution in training workshops. While more than half of the health care providers used the checklists at least once, utilization rates were sub-optimal. However, the vast majority of those providers who utilized the checklists found them to be very useful in their work.

APA, Harvard, Vancouver, ISO, and other styles

13

Corstjens, Paul, Anouk Van Hooij, Elisa Tjon Kon Fat, Shannon Herdigein, Anna Ritah Namuganga, Azaria Diergaardt, Hygon Mutavhatsindi, et al. "OC 8435 MULTI-BIOMARKER TEST STRIP FOR POINT-OF-CARE SCREENING FOR ACTIVE TUBERCULOSIS: A FIVE-COUNTRY MULTI-CENTRE TEST EVALUATION." BMJ Global Health 4, Suppl 3 (April 2019): A6.2—A6. http://dx.doi.org/10.1136/bmjgh-2019-edc.14.

Full text

Abstract:

BackgroundInexpensive rapid screening tests that can be used at the point-of-care (POC) are vital to combat tuberculosis. Particularly, less invasive non-sputum-based biomarker tests for all TB forms can help controlling transmission. Availability of such tests would significantly accelerate and streamline diagnostic approaches, improve cost-efficiency and decrease unnecessary costly GeneXpert referrals.MethodsMulti-biomarker test (MBT) devices measuring levels of selections of up to six serum proteins simultaneously on a single lateral flow (LF) strip were produced. The strip contains individual capture lines for a biomarker selection allowing discrimination of TB-patients from other respiratory diseases (ORD). Only biomarkers successfully evaluated with singleplex strips (single biomarker tests) were applied to the MBT device. Quantitative signals are recorded with a low-cost handheld reader compatible with the applied luminescent up-converting particle (UCP) label. Biomarker selection and algorithms used to distinguish potential-TB and ORD are flexible.ResultsResults obtained with MBT strips containing multiple test lines correlate well with singleplex LF strips. Using LF tests for 5 selected biomarkers a sensitivity of 94% and specificity of 96% could be achieved with a confirmed South African selection of 20 TB and 31 non-TB samples. Patients were designated TB positive when scoring a value above the cut-off threshold for at least 3 out of 5 biomarkers. Serum samples of potential TB patients collected at five medical research institutes (Ethiopia, Namibia, South Africa, The Gambia, Uganda) were tested locally with MBT strips comprised of CRP, SAA, IP-10, Ferritin, ApoA-I and IL-6 and results analysed to obtain an overall pan-Africa applicable signature.ConclusionEvaluated POC applicable UCP-LF devices detecting serum biomarker signatures can help to distinguish active TB from other respiratory diseases and as such can prioritise highest-risk patients for further care. Ongoing prospective studies evaluate the MBT strip with fingerstick blood and do not require a laboratory or trained phlebotomist anymore.

APA, Harvard, Vancouver, ISO, and other styles

14

Anastasaki, Marilena, Maria Trigoni, Anna Pantouvaki, Marianna Trouli, Maria Mavrogianni, Niels Chavannes, Jillian Pooler, et al. "Establishing a pulmonary rehabilitation programme in primary care in Greece: A FRESH AIR implementation study." Chronic Respiratory Disease 16 (January 1, 2019): 147997311988293. http://dx.doi.org/10.1177/1479973119882939.

Full text

Abstract:

Pulmonary rehabilitation (PR) is an evidence-based, low-cost, non-medical treatment approach for patients with chronic respiratory diseases. This study aimed to start and assess the feasibility, acceptability and impact of a PR programme on health and quality of life of respiratory patients, for the first time in primary care in Crete, Greece and, particularly, in a low-resource rural setting. This was an implementation study with before–after outcome evaluation and qualitative interviews with patients and stakeholders. In a rural primary healthcare centre, patients with chronic obstructive pulmonary disease (COPD) and/or asthma were recruited. The implementation strategy included adaptation of a PR programme previously developed in United Kingdom and Uganda and training of clinical staff in programme delivery. The intervention comprised of 6 weeks of exercise and education sessions, supervised by physiotherapists, nurse and general practitioner. Patient outcomes (Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), St. George’s Respiratory Questionnaire (SGRQ), Patient Health Questionnaire-9 (PHQ-9), Incremental Shuttle Walking Test (ISWT)) were analysed descriptively. Qualitative outcomes (feasibility, acceptability) were analysed using thematic content analysis. With minor adaptations to the original programme, 40 patients initiated (24 with COPD and 16 with asthma) and 31 completed PR (19 with COPD and 12 with asthma). Clinically important improvements in all outcomes were documented (mean differences (95% CIs) for CCQ: −0.53 (−0.81, −0.24), CAT: −5.93 (−8.27, −3.60), SGRQ: −23.00 (−29.42, −16.58), PHQ-9: −1.10 (−2.32, 0.12), ISWT: 87.39 (59.37, 115.40)). The direct PR benefits and the necessity of implementing similar initiatives in remote areas were highlighted. This study provided evidence about the multiple impacts of a PR programme, indicating that it could be both feasible and acceptable in low-resource, primary care settings.

APA, Harvard, Vancouver, ISO, and other styles

15

Phipps, Warren T., James Kafeero, Jackson Orem, Rachel Kansiime, Corey Casper, and Rhoda Ashley Morrow. "Using a Novel Peer Mentoring Program to Foster Conversion from Mentee to Mentor Among Clinician/Researchers-in-Training in Uganda." Journal of Global Oncology 2, no. 3_suppl (June 2016): 33s—34s. http://dx.doi.org/10.1200/jgo.2016.004192.

Full text

Abstract:

Abstract 54 Program Purpose: The Uganda Cancer Institute (“UCI”)/Hutchinson Center Cancer Alliance studies infection-related cancers and builds capacity for research and medical care. Weekly research in progress (RIP) meetings for Alliance scientists and staff were started in 2010 and, in 2013, were converted to a structured, facilitated Peer-driven Mentoring and Career Development program (“PMCD”). PMCD includes weekly RIP, monthly consultant lectures or skills workshops (N=16), monthly peer-run journal clubs (N=16), and, recently, quarterly bioethics workshops (N=2). Long-term goals of PMCD include: 1) developing leadership and 2) generating confident, skilled mentors. Evaluation: Confidential surveys (30 questions; 18 scaled 1-5) were conducted at PMCD launch, after one year, and, reported here, after two years (N=58; including 6 Alliance junior investigators, 28 UCI medical/nursing officers, 21 staff, and 3 students). Surveys probed history of PMCD participation and PMCD usefulness. Scaled questions (1=strongly disagree to 5=strongly agree) measured confidence, leadership, and research skills. Outcomes: Eleven (26%) respondents indicated they “often” (vs sometimes, rarely or never) mentored others in the previous year for research-related issues (“R-Mentors”); most (82-91%) had attended PMCD activities for >12 months. Weighted averages of R-Mentors were significantly higher (t-test) than non-mentors (N=32) for career confidence, leadership, and sense of support from PMCD: “I have developed ability to lead research team members.” (4.50 vs 2.97; P<0.001). “PMCD has helped develop my leadership skills (4.70 vs 3.61; P<0.001); or confidence.” (4.27 vs 3.48; P<0.05). “I feel a sense of community in PMCD meetings.” (4.60 vs 3.87; P<0.05) “I know where to turn for help.” (4.36 vs 3.72; P<0.05) “I do not feel alone in facing research challenges.” (4.70 vs 3.52; P<0.001) Conclusion: PMCD is a cost-effective, transferable method to foster development of clinician-scientists who have the leadership, confidence and support to mentor others; a major step toward building capacity for independent research science in Uganda. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Warren T. Phipps No relationship to disclose James Kafeero No relationship to disclose Jackson Orem No relationship to disclose Rachel Kansiime No relationship to disclose Corey Casper Leadership: Temptime Coporation Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, Glaxo Smith Kline Rhoda Ashley Morrow No relationship to disclose

APA, Harvard, Vancouver, ISO, and other styles

16

Buluma, Alfred, Charles Kyasanku, John Kalule, Julius Shopi Mbulankende, Dorothy Kyagaba Sebbowa, and Muhammad Musoke Kiggundu. "Building Bridges into the Future: An Evaluation of Stakeholders’ Perceptions on the Actualisation of the Curriculum in Uganda’s Seed Secondary Schools." East African Journal of Education Studies 5, no. 4 (December 9, 2022): 127–40. http://dx.doi.org/10.37284/eajes.5.4.1001.

Full text

Abstract:

This study evaluates stakeholders’ perceptions of the actualisation of the formal, non-formal, as well as guidance and counselling curriculum in Uganda’s Seed secondary schools. Using a stratified four-stage cluster design, twelve Seed secondary schools, 630 students from senior three and four, and 93 teachers were randomly selected. Using purposive sampling, eight school administrators, four officials from the Directorate of Education Standards (DES), and 48 parents, were selected. Data collection was through administering interviews with school administrators and DES officials, conducting focus group discussions with teachers and parents, and self-administered questionnaires to students. A document review of institutional files and documents was done. Qualitative data was analysed using thematic coding and major themes emerged from the analysis; quantitative data was analysed using SPSS software. Findings on the actualisation of the formal curriculum show low levels of lesson preparations, teacher punctuality, parents’ monitoring of students learning, formative assessments, full-time teaching, equipped science laboratories, and the presence of computer laboratories, digital resources, and ICT teachers. Concerning the implementation of the non-formal curriculum, findings reveal inadequate time, facilities and equipment for co-curricular activities, several stakeholders managing discipline among students including prefects, disciplinary committees, parents, and the disciplinary committee of the board of governors, and poor medical care for students since the posted nurses abscond from duty. Lastly, concerning the implementation of guidance and counselling curriculum, findings indicate that several mechanisms like guidance and counselling programs, the existence of a career’s master/mistress, class visiting days are missing in most of the schools, and the psychosocial needs of students were not met. It is concluded that, to a large extent, a significant gap exists in the implementation of the official curriculum in seed secondary schools of Uganda. The study recommends the recruitment of more teachers on the government payroll in all seed secondary schools in the country. This will make teachers available at the school for consultation with students at all times. Construction and equipping of both science laboratories and computer laboratories in all seed secondary schools. Regular monitoring and close supervision of seed secondary schools by the relevant organs of the Ministry of Education and Sports should be effectively carried out. There is a need for the construction of staff houses at seed schools to maintain teacher presence for the effective implementation of non-formal curricular activities.

APA, Harvard, Vancouver, ISO, and other styles

17

Monroe, Anne K., Christina S. Polyak, Amanda D. Castel, Allahna L. Esber, Morgan E. Byrne, Jonah Maswai, John Owuoth, et al. "Clinical similarities and differences between two large HIV cohorts in the United States and Africa." PLOS ONE 17, no. 4 (April 4, 2022): e0262204. http://dx.doi.org/10.1371/journal.pone.0262204.

Full text

Abstract:

Background Washington, DC, and sub-Saharan Africa are both affected by generalized HIV epidemics. However, care for persons living with HIV (PLWH) and clinical outcomes may differ in these geographically and culturally diverse areas. We compared patient and clinical site characteristics among adult persons living with HIV (PLWH) enrolled in two longitudinal HIV cohort studies—the African Cohort Study (AFRICOS) and the DC Cohort. Methods The DC Cohort is a clinic-based city-wide longitudinal cohort comprised of PLWH attending 15 HIV clinics in Washington, DC. Patients’ socio-demographic characteristics, clinical evaluations, and laboratory data are retrospectively collected from electronic medical records and limited manual chart abstraction. AFRICOS is a prospective observational cohort of PLWH and uninfected volunteers attending 12 select HIV care and treatment facilities in Nigeria, Kenya, Uganda and Tanzania. AFRICOS study participants are a subset of clinic patients who complete protocol-specific visits every 6 months with history and physical examination, questionnaire administration, and blood/sputum collection for ascertainment of HIV outcomes and comorbidities, and neurocognitive and functional assessments. Among participants aged ≥ 18 years, we generated descriptive statistics for demographic and clinical characteristics at enrollment and follow up and compared them using bivariable analyses. Results The study sample included 2,774 AFRICOS and 8,420 DC Cohort participants who enrolled from January 2013 (AFRICOS)/January 2011 (DC Cohort) through March 2018. AFRICOS participants were significantly more likely to be women (58.8% vs 27.1%) and younger (83.3% vs 61.1% aged < 50 years old) and significantly less likely to be MSM (only 0.1% of AFRICOS population reported MSM risk factor) than DC Cohort. Similar rates of current viral suppression (about 75% of both samples), hypertension, hepatitis B coinfection and alcohol use were observed. However, AFRICOS participants had significantly higher rates of CD4<200 and tuberculosis and significantly lower rates of obesity, DM, hepatitis C coinfection and syphilis. Conclusions With similar viral suppression outcomes, but many differences between our cohorts noted, the combined sample provides unique opportunities to assess and compare HIV care and treatment outcomes in the U.S. and sub-Saharan Africa. Comparing these two cohorts may inform care and treatment practices and may pave the way for future pathophysiologic analyses.

APA, Harvard, Vancouver, ISO, and other styles

18

Byonanebye, Dathan Mirembe, Maria S. Nabaggala, Agnes Bwanika Naggirinya, Mohammed Lamorde, Elizabeth Oseku, Rachel King, Noela Owarwo, et al. "An Interactive Voice Response Software to Improve the Quality of Life of People Living With HIV in Uganda: Randomized Controlled Trial." JMIR mHealth and uHealth 9, no. 2 (February 11, 2021): e22229. http://dx.doi.org/10.2196/22229.

Full text

Abstract:

Background Following the successful scale-up of antiretroviral therapy (ART), the focus is now on ensuring good quality of life (QoL) and sustained viral suppression in people living with HIV. The access to mobile technology in the most burdened countries is increasing rapidly, and therefore, mobile health (mHealth) technologies could be leveraged to improve QoL in people living with HIV. However, data on the impact of mHealth tools on the QoL in people living with HIV are limited to the evaluation of SMS text messaging; these are infeasible in high-illiteracy settings. Objective The primary and secondary outcomes were to determine the impact of interactive voice response (IVR) technology on Medical Outcomes Study HIV QoL scores and viral suppression at 12 months, respectively. Methods Within the Call for Life study, ART-experienced and ART-naïve people living with HIV commencing ART were randomized (1:1 ratio) to the control (no IVR support) or intervention arm (daily adherence and pre-appointment reminders, health information tips, and option to report symptoms). The software evaluated was Call for Life Uganda, an IVR technology that is based on the Mobile Technology for Community Health open-source software. Eligibility criteria for participation included access to a phone, fluency in local languages, and provision of consent. The differences in differences (DIDs) were computed, adjusting for baseline HIV RNA and CD4. Results Overall, 600 participants (413 female, 68.8%) were enrolled and followed-up for 12 months. In the intervention arm of 300 participants, 298 (99.3%) opted for IVR and 2 (0.7%) chose SMS text messaging as the mode of receiving reminders and health tips. At 12 months, there was no overall difference in the QoL between the intervention and control arms (DID=0.0; P=.99) or HIV RNA (DID=0.01; P=.94). At 12 months, 124 of the 256 (48.4%) active participants had picked up at least 50% of the calls. In the active intervention participants, high users (received >75% of reminders) had overall higher QoL compared to low users (received <25% of reminders) (92.2 versus 87.8, P=.02). Similarly, high users also had higher QoL scores in the mental health domain (93.1 versus 86.8, P=.008) and better appointment keeping. Similarly, participants with moderate use (51%-75%) had better viral suppression at 12 months (80/94, 85% versus 11/19, 58%, P=.006). Conclusions Overall, there was high uptake and acceptability of the IVR tool. While we found no overall difference in the QoL and viral suppression between study arms, people living with HIV with higher usage of the tool showed greater improvements in QoL, viral suppression, and appointment keeping. With the declining resources available to HIV programs and the increasing number of people living with HIV accessing ART, IVR technology could be used to support patient care. The tool may be helpful in situations where physical consultations are infeasible, including the current COVID epidemic. Trial Registration ClinicalTrials.gov NCT02953080; https://clinicaltrials.gov/ct2/show/NCT02953080

APA, Harvard, Vancouver, ISO, and other styles

19

Baishnab, Elora. "Medical Muzungu – primary care volunteering in Uganda." InnovAiT: Education and inspiration for general practice 7, no. 12 (January 10, 2014): 761–63. http://dx.doi.org/10.1177/1755738013513750.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Kagaha, Alexander, and Lenore Manderson. "Medical technologies and abortion care in Eastern Uganda." Social Science & Medicine 247 (February 2020): 112813. http://dx.doi.org/10.1016/j.socscimed.2020.112813.

Full text

APA, Harvard, Vancouver, ISO, and other styles

21

Roby, Jini L., and Stacey A. Shaw. "Evaluation of a Community-Based Orphan Care Program in Uganda." Families in Society: The Journal of Contemporary Social Services 89, no. 1 (January 2008): 119–28. http://dx.doi.org/10.1606/1044-3894.3716.

Full text

Abstract:

In response to the orphan crisis in sub-Saharan Africa, the international child welfare community has agreed on a model that aims to increase the capacity of families and communities. Yet, little is known thus far about the service content and efficacy of programs based on the model. This project examined a community-based program in Uganda that provides support and assistance to families raising orphaned and other vulnerable children. Findings suggest that the households' need in certain categories, such as housing and food security, decreased significantly after services were received. Children's senses of belonging and permanency appeared promising. The program's strengths are discussed with recommended changes, as well as implications for policy, practice, and further research.

APA, Harvard, Vancouver, ISO, and other styles

22

Irumba, Lisa Christine, and Octivia Evelyn. "Community day care at hospice Africa Uganda." BMJ Supportive & Palliative Care 2, Suppl 1 (March 2012): A82.2—A82. http://dx.doi.org/10.1136/bmjspcare-2012-000196.240.

Full text

APA, Harvard, Vancouver, ISO, and other styles

23

Bidandi, Fred, John J. Williams, and Jeremy Waiswa. "An Evaluation of Predatory Governance in Uganda and Indonesia." Journal of Sociological Research 13, no. 1 (January 21, 2022): 25. http://dx.doi.org/10.5296/jsr.v13i1.19645.

Full text

Abstract:

The first part of this article theorises predatory governance in general and acmes some exceptions to the process. Subsequently, it reviews the characteristics of predatory governance literature in Africa and East Asia with emphasis on Uganda and Indonesia. The study shows how leaders utilise state resources and institutions for their self-interest and exclude the masses or tax payers who sustain such regimes. We show that, the extent to which regimes, influence policies on the general population politically or otherwise, creates inequality, poverty, unemployment, and bad governance. We, therefore, theorise that predatory governance is hinged on the idea that the state usually has limited capacity to protect citizen rights, the political and socio-economic spaces are usually controlled by the elites either through coercion, corruption or the use of violence. The impact of predatory governance and the developmental state as an approach for economic development has been discussed and we observe practical realities of vote-buying to win elections being a common practice in Uganda and Indonesia. In this understanding, both case scenarios portray an image of predatory behaviour. The study utilised secondary data to evaluate what predatory governance, its characteristics and impact. Findings show that predatory governance affects economic outcomes of a country, produces corruption, violence, nepotism, poverty, unemployment and shrinking democratic space and deficiencies to name but few.

APA, Harvard, Vancouver, ISO, and other styles

24

Hearn, Jason, Sahr Wali, Patience Birungi, Joseph A. Cafazzo, Isaac Ssinabulya, Ann R. Akiteng, Heather J. Ross, Emily Seto, and Jeremy I. Schwartz. "A digital self-care intervention for Ugandan patients with heart failure and their clinicians: User-centred design and usability study." DIGITAL HEALTH 8 (January 2022): 205520762211290. http://dx.doi.org/10.1177/20552076221129064.

Full text

Abstract:

Background The prevalence of heart failure (HF) is increasing in Uganda. Ugandan patients with HF report receiving limited information about their illness and associated self-care behaviours. Interventions targeted at improving HF self-care have been shown to improve patient quality of life and reduce hospitalizations in high-income countries. However, such interventions remain underutilized in resource-limited settings like Uganda. This study aimed to develop a digital health intervention that enables improved self-care amongst HF patients in Uganda. Methods We implemented a user-centred design (UCD) process to develop a self-care intervention entitled Medly Uganda. The ideation phase comprised a scoping review and preliminary data collection amongst HF patients and clinicians in Uganda. An iterative design process was then used to advance an initial prototype into a functional digital health intervention. The evaluation phase involved usability testing of the intervention amongst Ugandan patients with HF and their clinicians. Results Medly Uganda is a digital health intervention that allows patients to report daily HF symptoms, receive tailored treatment advice and connect with a clinician when showing signs of decompensation. The system harnesses Unstructured Supplementary Service Data (USSD) technology that is already widely used in Uganda for mobile phone-based financial transactions. Usability testing showed Medly Uganda to be both acceptable and feasible amongst clinicians, patients and caregivers. Conclusions Medly Uganda is a functional digital health intervention with demonstrated acceptability and feasibility in enabling Ugandan HF patients to better care for themselves. We are hopeful that the system will improve self-care efficacy amongst HF patients in Uganda.

APA, Harvard, Vancouver, ISO, and other styles

25

Galiwango, Ronald M., Lawrence Lubyayi, Richard Musoke, Sarah Kalibbala, Martin Buwembo, Jjingo Kasule, David Serwadda, Ronald H. Gray, Steven J. Reynolds, and Larry W. Chang. "Field Evaluation of PIMA Point-of-Care CD4 Testing in Rakai, Uganda." PLoS ONE 9, no. 3 (March 10, 2014): e88928. http://dx.doi.org/10.1371/journal.pone.0088928.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Osur, Joachim, Traci L. Baird, Brooke A. Levandowski, Emily Jackson, and Daniel Murokora. "Implementation of misoprostol for postabortion care in Kenya and Uganda: a qualitative evaluation." Global Health Action 6, no. 1 (April 24, 2013): 19649. http://dx.doi.org/10.3402/gha.v6i0.19649.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Parkes-Ratanshi, Rosalind, Ruth Kikonyogo, Yu-Hsiang Hsieh, Edith Nakku-Joloba, Yukari C. Manabe, Charlotte A. Gaydos, and Anne Rompalo. "Point-of-care diagnostics: needs of African health care workers and their role combating global antimicrobial resistance." International Journal of STD & AIDS 30, no. 4 (January 9, 2019): 404–10. http://dx.doi.org/10.1177/0956462418807112.

Full text

Abstract:

Point-of-care tests (POCTs) offer the opportunity for increased diagnostic capacity in resource-limited settings, where there is lack of electricity, technical capacity, reagents, and infrastructure. Understanding how POCTs are currently used and determining what health care workers (HCWs) need is key to development of appropriate tests. In 2016, we undertook an email survey of 7584 HCWs who had received training at the Infectious Diseases Institute, Uganda, in a wide variety of courses. HCWs were contacted up to three times and asked to complete the survey using Qualtrics software. Of 555 participants answering the survey (7.3% response rate), 62% completed. Ninety-one percent were from Uganda and 50.3% were male. The most commonly-used POCTs were pregnancy tests (74%), urine dipstick (71%), syphilis rapid test (66%), and Gram stain (41%). The majority (74%) practiced syndromic diagnosis for sexually transmitted infections/HIV. Lack of availability of POCTs, increased patient wait time, and lack of training were the leading barriers for POCT use. Increasing POCT availability and training could improve uptake of POCTs for sexually transmitted infections in Africa and decrease syndromic management. This could reduce overtreatment and slow the emergence of antibiotic resistance. This is the first published email survey of HCWs in Uganda; mechanisms to increase the response rate should be evaluated.

APA, Harvard, Vancouver, ISO, and other styles

28

Olum, Ronald, Jonathan Kajjimu, Andrew Marvin Kanyike, Gaudencia Chekwech, Godfrey Wekha, Dianah Rhoda Nassozi, Juliet Kemigisa, et al. "Perspective of Medical Students on the COVID-19 Pandemic: Survey of Nine Medical Schools in Uganda." JMIR Public Health and Surveillance 6, no. 2 (June 19, 2020): e19847. http://dx.doi.org/10.2196/19847.

Full text

Abstract:

Background The coronavirus disease (COVID-19) pandemic is a global public health concern affecting over 5 million people and posing a great burden on health care systems worldwide. Objective The aim of this study is to determine the knowledge, attitude, and practices of medical students in Uganda on the COVID-19 pandemic. Methods We conducted an online, descriptive cross-sectional study in mid-April 2020, using WhatsApp Messenger. Medical students in 9 of the 10 medical schools in Uganda were approached through convenience sampling. Bloom’s cut-off of 80% was used to determine good knowledge (≥12 out of 15), positive attitude (≥20 out of 25), and good practice (≥12 out of 15). Results The data of 741 first- to fifth-year medical students, consisting of 468 (63%) males with a mean age of 24 (SD 4) years, were analyzed. The majority (n=626, 84%) were pursuing Bachelor of Medicine and Bachelor of Surgery degrees. Overall, 671 (91%) had good knowledge, 550 (74%) had a positive attitude, and 426 (57%) had good practices. Knowledge was associated with the 4th year of study (adjusted odds ratio [aOR] 4.1, 95% CI 1.6-10.3; P<.001). Attitude was associated with the female sex (aOR 0.7, 95% CI 0.5-1; P=.04) and TV or radio shows (aOR 1.1, 95% CI 0.6-2.1; P=.01). Practices were associated with the ≥24 years age category (aOR 1.5, 95% CI 1.1-2.1; P=.02) and online courses (aOR 1.8, 95% CI 1.1-3.2; P=.03). In total, 592 (80%) medical students were willing to participate in frontline care if called upon. Conclusions Medical students in Uganda have sufficient knowledge of COVID-19 and will be a large reservoir for health care response when the need arises.

APA, Harvard, Vancouver, ISO, and other styles

29

Mills, Edward J., Anna Funk, Steve Kanters, Esther Kawuma, Curtis Cooper, Barbara Mukasa, Mary Odit, et al. "Long-Term Health Care Interruptions Among HIV-Positive Patients in Uganda." JAIDS Journal of Acquired Immune Deficiency Syndromes 63, no. 1 (May 2013): e23-e27. http://dx.doi.org/10.1097/qai.0b013e31828a3fb8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

Organ, PJ. "Quality assessment and medical care evaluation." Journal of the American Podiatric Medical Association 78, no. 6 (June 1, 1988): 320–27. http://dx.doi.org/10.7547/87507315-78-6-320.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Ojok, Miriam F., Esezah K. Kakudidi, Maud M. Kamatenesi, Wilfred Mabusela, and Joanita Adams. "Immunological evaluation of Commicarpus plumbagineus Standl. (Nyctaginaceae) use in reproductive health care in Uganda." African Journal of Ecology 45, s3 (December 2007): 116–19. http://dx.doi.org/10.1111/j.1365-2028.2007.00867.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Luyirika, E., and F. Kiyange. "A Regional Palliative Care Entity Working With a Host Government to Facilitate Exchange Visits From Across Africa to Improve Access to Controlled Medicines for Cancer Patients." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 164s. http://dx.doi.org/10.1200/jgo.18.17300.

Full text

Abstract:

Background and context: The African Palliative Care Association (APCA) is a pan-African palliative care organization hosted in Uganda but supporting initiatives to integrate palliative care into national health systems across Africa. Uganda hosts one of the oldest cancer units in Africa and also reconstitutes its own oral liquid morphine to reduce barriers and cost of access to pain control for patients. Aim: The aim of this effort is to expose government officials and other NGOs from other African countries to best practices in oral morphine manufacture, distribution and access to controlled medicines for pain control in cancer and other conditions with a view to benchmark and establish similar or better systems. Strategy/Tactics: APCA working with its funders in consultation with the Ugandan Ministry of Health and Hospice Africa Uganda, facilitates other African ministries of health delegations to conduct study visits in Uganda to benchmark the oral morphine reconstitution, the supply chain mechanisms for its distribution to patients in both public and private hospitals and at home. Program/Policy process: APCA identifies countries with morphine access challenges and makes arrangements for key personnel in those countries in ministries of health, medicines control authority, central medicines stores and national palliative care associations where they exist to spend a study period in Uganda. While in Uganda, the delegations visit the oral morphine manufacturing facility, Hospice Africa Uganda, the Ministry of Health, national medical stores, National Drug Authority, joint medical stores and some of the palliative care providers and training facilities. Once the period with the various stakeholders in the country is completed, the visiting teams draw up plans for implementation and identify required technical assistance from APCA. The costing and sources of funding are identified including contribution from the government in need and then activities are implemented. Outcomes: As a result of this South-to-South approach, Uganda has hosted delegations from 14 African countries. At one instance, it involved the Minister Of Health from Swaziland heading a delegation to Uganda while others sent other high level delegates to the peer learning and bench marking. All these countries have taken steps to establish access to oral liquid morphine as well as policy and capacity building activities for their staff. Some of the countries like Malawi and Swaziland are already having morphine reconstitution and national palliative care policies while others such as Rwanda and Botswana are in the process of changing to the same system. Cancer and palliative care related activities are also being implemented in some of countries. Some countries have graduated to host others like Uganda does. What was learned: The South-to-South learning and bench marking visits are very practical in Africa and have triggered palliative care initiatives at national level.

APA, Harvard, Vancouver, ISO, and other styles

33

Davis, J. Lucian, Patricia Turimumahoro, Amanda J. Meyer, Irene Ayakaka, Emma Ochom, Joseph Ggita, David Mark, et al. "Home-based tuberculosis contact investigation in Uganda: a household randomised trial." ERJ Open Research 5, no. 3 (July 2019): 00112–2019. http://dx.doi.org/10.1183/23120541.00112-2019.

Full text

Abstract:

IntroductionThe World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.MethodsWe performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.ResultsThere were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14% versus 15%; difference −1%, 95% CI −9% to 7%, p=0.81) and yields of confirmed TB (1.5% versus 1.1%, p=0.62) and new HIV (2.0% versus 1.8%, p=0.90) diagnoses were similar.ConclusionsHome-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components.

APA, Harvard, Vancouver, ISO, and other styles

34

Ssetaba, Leoson Junior, Joy Mirembe, Jotham Omega, Jerom Okot, Sarah Kiguli, Frederick Nelson Nakwagala, and Felix Bongomin. "Coronavirus disease–2019 morbidity and mortality among health care workers in Uganda." Therapeutic Advances in Infectious Disease 9 (January 2022): 204993612211364. http://dx.doi.org/10.1177/20499361221136415.

Full text

Abstract:

Background: Health care workers (HCWs) are at increased risk of acquiring coronavirus disease 2019 (COVID-19). This study aimed to determine and compare the morbidity and mortality rates due to COVID-19 among the HCWs and the general population (non-HCWs). Methods: We conducted a retrospective chart review. We accessed electronic database of participants admitted at Mulago National Referral Hospital COVID-19 Treatment Unit (CTU) between March 2020 and September 2021. Participants with missing occupations were excluded. Results: Of 594 eligible participants, 6.4% ( n = 38) were HCWs. Compared with non-HCWs, HCWs were much younger (48 versus 55 years, p = 0.020). The proportion of participants with severe disease (73.7% versus 77.6%, p = 0.442), who had not received COVID-19 vaccine (91.2% versus 94.7%, p = 0.423), mortality rate (44.7% versus 54.8%, p = 0.243) and the median length of hospitalization (6 versus 7 days, p = 0.913) were similar among HCWs and non-HCWs, respectively. A higher proportion of HCWs required oxygen therapy (24.3% versus 9.7%, p < 0.01). At admission, the presence of cough ( p = 0.723), breathlessness ( p = 0.722), fever ( p = 0.19), sore throat ( p = 0.133), comorbidities ( p = 0.403) and headache ( p = 0.162) were similar across groups. Rhinorrhoea was more common among HCWs (34.4% versus 16.6%, p = 0.017). Among HCWs, nurses had the highest morbidity (52.6%) and mortality (58.8%). Conclusion: The morbidity and mortality among HCWs in Uganda were substantial, with a low COVID-19 vaccination rate and a higher requirement for oxygen therapy despite a younger age.

APA, Harvard, Vancouver, ISO, and other styles

35

Bloom, Bernard S., and A. Mark Fendrick. "Timing and Timeliness in Medical Care Evaluation." PharmacoEconomics 9, no. 3 (March 1996): 183–87. http://dx.doi.org/10.2165/00019053-199609030-00001.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Baumgartner, Joy Noel, Jennifer Headley, Julius Kirya, Josh Guenther, James Kaggwa, Min Kyung Kim, Luke Aldridge, Stefanie Weiland, and Joseph Egger. "Impact evaluation of a maternal and neonatal health training intervention in private Ugandan facilities." Health Policy and Planning 36, no. 7 (June 29, 2021): 1103–15. http://dx.doi.org/10.1093/heapol/czab072.

Full text

Abstract:

Abstract Global and country-specific targets for reductions in maternal and neonatal mortality in low-resource settings will not be achieved without improvements in the quality of care for optimal facility-based obstetric and newborn care. This global call includes the private sector, which is increasingly serving low-resource pregnant women. The primary aim of this study was to estimate the impact of a clinical and management-training programme delivered by a non-governmental organization [LifeNet International] that partners with clinics on adherence to global standards of clinical quality during labour and delivery in rural Uganda. The secondary aim included describing the effect of the LifeNet training on pre-discharge neonatal and maternal mortality. The LifeNet programme delivered maternal and neonatal clinical trainings over a 10-month period in 2017–18. Direct clinical observations of obstetric deliveries were conducted at baseline (n = 263 pre-intervention) and endline (n = 321 post-intervention) for six faith-based, not-for-profit primary healthcare facilities in the greater Masaka area of Uganda. Direct observation comprised the entire delivery process, from initial client assessment to discharge, and included emergency management (e.g. postpartum haemorrhage and neonatal resuscitation). Data were supplemented by daily facility-based assessments of infrastructure during the study periods. Results showed positive and clinically meaningful increases in observed handwashing, observed delayed cord clamping, partograph use documentation and observed 1- and/or 5-minute APGAR assessments (rapid scoring system for assessing clinical status of newborn), in particular, between baseline and endline. High-quality intrapartum facility-based care is critical for reducing maternal and early neonatal mortality, and this evaluation of the LifeNet intervention indicates that their clinical training programme improved the practice of quality maternal and neonatal healthcare at all six primary care clinics in Uganda, at least over a relatively short-term period. However, for several of these quality indicators, the adherence rates, although improved, were still far from 100% and could benefit from further improvement via refresher trainings and/or a closer examination of the barriers to adherence.

APA, Harvard, Vancouver, ISO, and other styles

37

Cherniak, William, Eben Stern, Carol Picart, Sarah Sinasac, Carolyn Iwasa, Michael Silverman, and Geoffrey Anguyo. "Grassroots Partnership to See and Treat Cervical Cancer in Rural Uganda." Journal of Global Oncology 3, no. 2_suppl (April 2017): 14s. http://dx.doi.org/10.1200/jgo.2017.009639.

Full text

Abstract:

Abstract 9 Background: In Uganda, cervical cancer is the leading cause of cancer death, affecting 45 in every 100,000 women annually and killing 25 in every 100,000 annually. To effect change, two Canadian registered charities partnered with a Ugandan nongovernmental organization, a university, and the Ministry of Health to develop a novel screening, treatment, and educational training program. The two major goals of our program were to develop a training program for health care providers in southwestern Uganda for visual inspection of the cervix with acetic acid (VIA) and a cryotherapy see and treat model; and to implement the first cervical cancer screening program of its kind in the Kabale region of southwestern Uganda. Methods: Our program was developed in partnership with Mbarara University of Science and Technology, a grass-roots Ugandan community development organization (Kigezi Healthcare Foundation [KIHEFO]), a Canadian charity that is focused on providing medical and dental care and educational training and infrastructure development (Bridge to Health Medical and Dental), and a Canadian charity that is focused on treatment for advanced cervical cancer (Road to Care). Results: Requisite supplies were obtained by Bridge to Health Medical and Dental and left behind with KIHEFO. A partnership was formed between academia, government, and civil society across Canada and Uganda. Over 5 days, 15 Ugandan health care workers were trained in VIA and cryotherapy, and 96 patients were screened for cervical cancer. Six patients were successfully treated for precancerous lesions. One biopsy was sent for pathology review and analysis. Conclusion: Since the pilot program, KIHEFO has conducted two additional cervical cancer screening programs using VIA and the see and treat approach. A new cervical cancer screening and treatment campaign, along with a quality control and educational training refresher, for the original 15 health care providers is planned for February 2017. Funding: Bridge to Health Medical and Dental and Kigezi Healthcare Foundation in partnership with the Ugandan Ministry of Health. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

APA, Harvard, Vancouver, ISO, and other styles

38

Kebebew, Electron, Jane Fualal, Willieford Moses, Margaret Nalugo, Doruk Ozgediz, and Jessica Gosnell. "Characterizing Thyroid Disease and Identifying Barriers to Care and Treatment in Uganda." World Journal of Endocrine Surgery 4, no. 2 (2012): 47–53. http://dx.doi.org/10.5005/jp-journals-10002-1094.

Full text

Abstract:

ABSTRACT Thyroid disease in Uganda continues to be endemic, despite national salt iodinization. This study describes the local characteristics of thyroid disease and identifies potential barriers to surgical access. A prospective database was established for all patients with suspected thyroid disease who presented to the Endocrine Surgery Clinic at Mulago National Referral Hospital in Kampala, Uganda in 2008. A cross-sectional study collected and analyzed for presentation, diagnostics and the surgical plan. A total of 89 patients were included, with an average age of 40 years, and 88% were women. The most common presentation was compressive symptoms (39%, n = 35), signs and symptoms of hyperthyroidism (30%, n = 27) and cosmetic concerns (16%, n = 14). Ultrasound, which is subsidized by the hospital, was performed in 85% of patients (n = 76). Thyroid function tests (TFTs), which are less subsidized, were done in 67% (n = 60). Of these, 27% (n = 16) were hyperthyroid and 7% (n = 4) were hypothyroid. Fine needle aspiration was done in 30% (n = 27) and were suspicious for malignancy in 27% of patients (n = 7). The most common diagnosis was multinodular goiter (n = 55) and tracheal compression or deviation and/or retrosternal extension was seen on imaging in 22 of 75 patients (29%). Thyroid disease in Uganda is more advanced, involves a different population than in Western countries and includes high rates of symptomatic multinodular goiter and cancer. Resource constraints limit the care of these clinically challenging conditions. Further evaluation of these potential barriers to surgical care needs to be conducted. How to cite this article Fualal J, Moses W, Jayaraman S, Nalugo M, Ozgediz D, Duh QY, Gosnell J, Kebebew E. Characterizing Thyroid Disease and Identifying Barriers to Care and Treatment in Uganda. World J Endoc Surg 2012;4(2):47-53.

APA, Harvard, Vancouver, ISO, and other styles

39

K Lubega, Samuel, Timothy Makubuya, Haruna Muwonge, and Mike Lambert. "A descriptive prospective study of sports medicine practices for athletes in Uganda." African Health Sciences 21, no. 2 (August 2, 2021): 826–34. http://dx.doi.org/10.4314/ahs.v21i2.43.

Full text

Abstract:

Background: Many international sporting organizations have recommended practices to reduce the risk of injury. These practices include screening for injury, having appropriate emergency medical care, and protocols for managing injury before return-to-play. The extent of the uptake of these practices in a developing country such as Uganda, is unknown. Methodology: Using a descriptive case study approach, this investigation focused on a sample of injured athletes (n = 75) in Uganda from four main sports associations (football, athletics, basketball and rugby). The data were collected through observations and interviews after the injury. Using a best medical practice framework the phases of emergency, intermediate, rehabilitative, and return-to-sports participation were described. Result: Nine conditions/types of injury were included. The results revealed a lack of specific pre-season screening or re- turn-to-play readiness for all the injured athletes. Further, there was a lack of application of best practice principles for most of the injury types. For athletes who received medical care, the results show inconsistencies and inadequacies from the acute stage of the injury to return-to-sports participation. Conclusion: This study identified barriers such as up-to-date knowledge among the sports resource providers; the gaps for appropriate and adequate specific facilities for managing injured athletes, and policies to mandate care of injured athletes. These barriers detract from applying best medical practices. Keywords: Injuries; medical; Uganda; emergency; intermediate; rehabilitation; return-to-sports.

APA, Harvard, Vancouver, ISO, and other styles

40

Kakembo, Nasser, David F. Grabski, Tamara N. Fitzgerald, Arlene Muzira, Maija Cheung, Phyllis Kisa, John Sekabira, and Doruk Ozgediz. "Burden of Surgical Infections in a Tertiary-Care Pediatric Surgery Service in Uganda." Surgical Infections 21, no. 2 (March 1, 2020): 130–35. http://dx.doi.org/10.1089/sur.2019.045.

Full text

APA, Harvard, Vancouver, ISO, and other styles

41

Samuels, Thomas H. A., Priya B. Shete, Chris Ojok, Talemwa Nalugwa, Katherine Farr, Stavia Turyahabwe, Achilles Katamba, Adithya Cattamanchi, and David A. J. Moore. "Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda." PLOS ONE 16, no. 7 (July 16, 2021): e0253927. http://dx.doi.org/10.1371/journal.pone.0253927.

Full text

Abstract:

Introduction Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation. Materials and methods We conducted a cross-sectional study of 70 patients with a negative TB evaluation at four community health centres in rural and peri-urban Uganda. Patients were traced 9 months post-evaluation using contact information from TB registers. We collected information on healthcare visits and implemented locally-validated costing questionnaires to assess the financial impact of their symptoms post-evaluation. Results Of 70 participants, 57 (81%) were traced and 53 completed the survey. 31/53 (58%) surveyed participants returned to healthcare facilities post-evaluation, making a median of 2 visits each (interquartile range [IQR] 1–3). 11.3% (95%CI 4.3–23.0%) of surveyed patients and 16.1% (95%CI 5.5–33.7%) of those returning to healthcare facilities incurred catastrophic costs (i.e., spent >20% annual household income). Indirect costs related to lost work represented 80% (IQR 32–100%) of total participant costs. Conclusions Patients with TB symptoms who experience financial catastrophe after negative TB evaluation may represent a larger absolute number of patients than those suffering from costs due to TB. They may not be captured by existing definitions of non-TB catastrophic health expenditure.

APA, Harvard, Vancouver, ISO, and other styles

42

Okuku, Fred, Elizabeth M. Krantz, James Kafeero, Moses R. Kamya, Jackson Orem, Corey Casper, and Warren Phipps. "Evaluation of a Predictive Staging Model for HIV-Associated Kaposi Sarcoma in Uganda." JAIDS Journal of Acquired Immune Deficiency Syndromes 74, no. 5 (April 2017): 548–54. http://dx.doi.org/10.1097/qai.0000000000001286.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

Muddu, Martin, Andrew K. Tusubira, Srish K. Sharma, Ann R. Akiteng, Isaac Ssinabulya, and Jeremy I. Schwartz. "Integrated Hypertension and HIV Care Cascades in an HIV Treatment Program in Eastern Uganda." JAIDS Journal of Acquired Immune Deficiency Syndromes 81, no. 5 (August 2019): 552–61. http://dx.doi.org/10.1097/qai.0000000000002067.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Campbell, Stephen M., Umesh Chauhan, and Helen Lester. "Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation." British Journal of General Practice 60, no. 576 (July 1, 2010): e295-e304. http://dx.doi.org/10.3399/bjgp10x514800.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

COLES, C. R., and JANET GALE GRANT. "Curriculum evaluation in medical and health-care education." Medical Education 19, no. 5 (September 1985): 405–22. http://dx.doi.org/10.1111/j.1365-2923.1985.tb01345.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Pego-Fernandes, Paulo Manuel, Ricardo Mingarini Terra, Leticia Leone Lauricella, and Benoit Jacques Bibas. "Quality evaluation of medical care in clinical practice." Sao Paulo Medical Journal 131, no. 3 (2013): 143–44. http://dx.doi.org/10.1590/1516-3180.2013.1313694.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Park, Hyun-Jeong, Jung Hoon Lee, Jun Young Lee, and Baik Kee Cho. "Clinical evaluation of medical skin care in korea." Journal of the American Academy of Dermatology 50, no. 3 (March 2004): P35. http://dx.doi.org/10.1016/j.jaad.2003.10.145.

Full text

APA, Harvard, Vancouver, ISO, and other styles

48

Were, Martin C., Changyu Shen, Mwebesa Bwana, Nneka Emenyonu, Nicholas Musinguzi, Frank Nkuyahaga, Annet Kembabazi, and William M. Tierney. "Creation and evaluation of EMR-based paper clinical summaries to support HIV-care in Uganda, Africa." International Journal of Medical Informatics 79, no. 2 (February 2010): 90–96. http://dx.doi.org/10.1016/j.ijmedinf.2009.11.006.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Lyadova, M. V., and E. S. Tuchik. "Medical expert evaluation of medical care for patients with musculoskeletal injuries." Sudebno-meditsinskaya ekspertiza 65, no. 4 (2022): 9. http://dx.doi.org/10.17116/sudmed2022650419.

Full text

APA, Harvard, Vancouver, ISO, and other styles

50

Ellis, Cathryn, Laura Schummers, and Jean-Francois Rostoker. "Reducing Maternal Mortality in Uganda: Applying the “Three Delays” Framework." International Journal of Childbirth 1, no. 4 (2011): 218–26. http://dx.doi.org/10.1891/2156-5287.1.4.218.

Full text

Abstract:

PURPOSE: This article examines maternal mortality in Uganda through the “Three Delays” framework. This framework asserts that maternal mortality in developing countries results from three delays to accessing appropriate health care: (a) the delay in making a timely decision to seek medical assistance, (b) the delay in reaching a health facility, and (c) the delay in provision of adequate care at a health facility.STUDY DESIGN: This study provides a review and synthesis of literature published about maternal mortality, the “Three Delays” concept, Uganda, and sub-Saharan Africa between 1995 and 2010.MAJOR FINDINGS: The “Three Delays” framework has relevance in the Ugandan context. This framework allows for an integrated and critical analysis of the interactions between cultural factors that contribute to the first delay and inadequate emergency obstetrical care related to the third delay.MAJOR CONCLUSION: In order to reduce maternal mortality in Uganda, governments and institutions must become responsive to the cultural and health needs of women and their families. Initiatives that increase educational and financial status of women, antenatal care, and rates of institutional care may reduce maternal mortality in the long term. Improvements to emergency obstetrical services are likely to have the most significant impact in the short term.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Medical care – Uganda – Evaluation'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles