Bachelors Medicine Laboratory Science

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Assessment Of Anticoagulation Control Among Adult Patients On Warfarin Therapy Attending Uganda Heart Institute.
(Clarke International University., 2022-02) Bamwange, Beatrice
Background: Warfarin is an oral anticoagulant prescribed worldwide with a narrow therapeutic index and wide interindividual variability in dose requirement. Due to its difficult in predicting an accurate dose for an individual, it predisposes patients to risks of thromboembolism or even hemorrhagic events associated with underdoing or overdosing respectively. Thus, Time in Therapeutic Range (TTR) is recommended to monitor warfarin anticoagulation control with TTR >60% considered as well controlled. This study assessed the performance of warfarin and associated patients’ and institutional factors on anticoagulation control among adult at UHI, Mulago Hospital from July to October 2021. Methodology: In this study, 157 patients were enrolled, aged 18 to 80 years on warfarin as an anticoagulant control for not less than six months and had a minimum of three INR results. Consecutive and convenient sampling of all patients was done. Patients’ previous three INR results were retrieved from their respective files plus the INR test done on the review date and these were used to calculate the TTR using the Rosendaal’s method of linear interpolation. Quantitative data was entered into MS excel and later exported to the STATA SE13 for analysis while qualitative data was coded manually to generate themes. A TTR >60% was considered good control. Results: The average TTR among the study participants as 45.97% (95% CI=41.51-50.44) and a median of 43% (IQR=24-67). Only 31.21% had a TTR >60. The association between controlled TTR was assessed with; gender, education, comorbidity, comorbidity medication, missed taking warfarin, vitamin K food substance use, use of non–prescribed substances, indication for warfarin, accessing warfarin, paying for warfarin and knowledge regarding warfarin use. Using chi square test and a p value of 0.05, none of the factors was associated with the poor warfarin anticoagulation control. Participants had their views about the services offered at UHI including; appreciation of the cheaper services and quality time with health workers. There were reports on inadequate doctors and long clinic distance. Conclusion and recommendation: There was inadequate anticoagulation control among adult patients on warfarin therapy attending Uganda Heart Institute, Mulago Hospital with a TTR of 45.97 %.The anticoagulation performance of Warfarin was thought to be intrinsic, not affected by the external factors. Therefore, a need to change individuals who are not responding on warfarin to a superior anticoagulant.
Prevalence OF Cryptosporidium Parvum And Associated Risk Factors Among People Living With HIV Attending ART Clinic AT Wakiso Health Centre IV, Wakiso Town Council
(Clarke International University., 2022-02) Nanziri, Antonie
Introduction: Cryptosporidiosis caused by a coccidian parasite is a common cause of chronic diarrhoea among people living with HIV.It is associated with devastating complications like severe acute malnutrition, severe dehydration, significant weight loss and inflammation of the gall bladder, liver or pancreas. The purpose of the study was to determine the prevalence of cryptosporidium infection and the risk factors associated with cryptosporidiosis among PLWHIV at Wakiso H/CIV. Methods: We enrolled 231 HIV/AIDS patients on ART from July to September 2021. Stool samples were collected from study participants, wet saline preparations made and examined, stool samples concentrated using formal ether concentration, and smears stained using the modified Zeihls-Neilsen technique. Structured questionnaires were used to collect demographic data, patient-related factors and the common signs and symptoms that predisposed the study participants to cryptosporidiosis. Results: Out of 231, 155 (67.09%) were females and 76 (23.67%) males. The age range was 5–67 years and mean age 34.16 years and the CD4 cell count distribution ranged from 100- 800 cells /μl.ART was accessible for 206/231(89.18%). The overall prevalence of cryptosporidiosis was 21.21%. Cryptosporidium infection was found to be associated with animal rearing (p=0.020), duration on ART (p=0.008) with those who had been on ART for .>4 years mostly affected, low CD4 category (P=0.044) and dehydration (p=0.000). There was no significant association between cryptosporidiosis and educational background (P=0.149), marital status (P=0.125), religion (P=0.688), occupation (p=0.125, source of water (p=0.615), ART regimen(p=0.702), ART status(p=0.241), adherence level(p=0.681), diarrhoea(p=0.075), abdominal pain(p=0.596), vomitingp=0.171), nausea(p=0.439) and fever(P=0.940). Conclusion:The prevalence got in this study was high compared to what was observed by other studies done in other parts of Uganda. There is a need for early diagnosis in order to fight the infection, a need to develop more sensitive and specific diagnostic techniques like molecular methods and a need to adopt cryptosporidium screening among the advanced HIV disease priority opportunistic infections Key words: Cryptosporidiosis, HIV, ART, risk factors and prevalence
Prevalence Of Malaria Among Pregnant Women Attending Kitebi Health Centre III, Kampala District.
(Clarke International University., 2021-11) AFaayo, Jeremiah Morrison
ABSTRACT Background: Malaria is a major public health problem affecting between 250 million people globally every year. In endemic areas, approximately 25 million pregnancies are at risk of Plasmodium falciparum infection every year, and 25% of these women have evidence of placental infection at the time of delivery Objective: The main objective of this study was to determine the prevalence of malaria among pregnant women attending Kitebi Health Centre III Kampala district, Uganda. Methods: A descriptive cross-sectional study was carried out among consenting pregnant women attending antenatal from Kitebi health centre III in November 2021. Self- administered questionnaires were used to obtain socio-demographic and knowledge assessment data . Blood was examined for malaria parasites using Malaria RDTs. Data was entered in Excel and analyzed using Stata ver.13 using univariate and bi variate analysis. Results: The overall prevalence of malaria among pregnant women attending Kitebi Health Center was 19.8% (16/81). None of the socio-demographic factors was associated with malaria prevalence except Tribe where malaria prevalence was high among the Basoga 68.75%(11/16) (p<0.001). Majority of the study participants knew use of intermittent preventive treatment (IPT) 87.65% (71 /81) and mosquito net use 75% (61/81) as the most effective ways of malaria prevention among pregnant women. Recommendations: Mothers should be encouraged to start antenatal as early as first trimester and they should be educated about the importance and proper use of mosquito bed- nets and IPT. Conclusion: The prevalence of malaria among pregnant women was high. Majority of the social demographics were not associated with Malaria prevalence. Participants knew that Intermittent preventive treatment (IPT) and mosquito net use as the most effective ways of malaria prevention among pregnant women.
Prevalence OF HIV Among HIV Exposed Infants And Associated Factors, AT Art Clinic Bukomero Health Centre IV Kiboga District.
(Clarke International University., 2021-11) Bazanye, Edward
BACKGROUND The sub-Saharan Africa accounts for 80% of all the new mother to child transmission of HIV globally. There has been a decrease in the number MTCT cases in the past years due to an increase in utilization of PMTCT services however there are still gaps in developing countries Objective To determine the prevalence of HIV among HIV exposed infants and associated factors, at ART clinic Bukomero health Centre IV Kiboga district. Methodology It was a descriptive cross-section study among women living with HIV and their infants attending EID department at Bukomero health centre IV. Data was collected using self- administered questionnaires and Laboratory results were obtained by using results obtained from EID department for infants below 18month and determines HIV 1&2 strips with positives confirmed with start Pak for infants at 18month. Results A total of 102 HIV positive women and their infants attending EID department at Bukomero health Centre IV were enrolled. Out of these, more than half 54 (52.9%) of the children were female whereas the males were 48 (57.1%). Majority 70 (68.6%) of the mothers were staying with their husbands, 31 (30.4%) of the mothers were single mothers and only 1% of the respondents were divorced. a prevalence rate of 2% was obtained among the study population. The study also revealed that majority 98 (96.1%) of the mothers received ARVs during their pregnancy, only 4 (3.9%) did not receive the ARVs during the pregnancy period. Similarly, majority 96 94.1%) of the mothers delivered from a health facility. Only 6 (5.9%) of the respondents did not deliver from a health facility and hospital delivery and imitation on ART were significantly associated with prevalence of HIV. Statistical analysis revealed that level of education was significantly associated with the vertical transmission of HIV among exposed children (P<0.05) in the study population. Conclusion and recommendation Generally, the observed prevalence of vertical transmission of HIV is still high in the study area compared to the WHO goal of elimination of vertical transmission of HIV (< 50case in, the utilization of MCH is high and I recommend initiation of mothers on ART and hospital delivery in order to bridge the
Prevalence And Risk Factors Of Hepatitis B Virus Infection Among Pregnant Women Attending Antenatal Clinic At Lira Regional Referral Hospital.
(Clarke International University., 2021-11) Angom, Doris Brandina
Background: the most common cause of serious liver infection is hepatitis B. Contact with an infected person during childbirth and various horizontal modes of transmission, such as sexual exposure with an infected person or direct contact with an infected person’s blood, are all factors that raise the chance of HBV infection. Objectives: the major aim of the study is to determine the prevalence of HBV infection, associated and other risk factors among pregnant women attending antenatal clinic at Lira regional referral hospital. Methods: A cross sectional study was conducted on pregnant women in lira regional referral hospital between the month of October and November 2021. Study participants were selected using simple random sampling particularly systematic sampling technique and a total of 160 pregnant women were included. Socio-demographic data and exposure to associated and other factors (number of Sexual partners, history of hospital admission and hepatitis B positive family member history. inability to vaccinate against HBV, inadequate health education on HBV and lack of HBV screening services.) were collected through a structured questionnaire. Two milliliters of blood were collected from each study participant. Serum level hepatitis B surface antigen (HbsAg) were detected using HbsAg rapid diagnostic test kit. Data was entered and analyzed using SPSS version 20.To declare the presence of association odds ratio with 95% confidence interval and P value <0.05 were considered statistically significant. Result: A total of 160 pregnant women with the mean age of 25 years were enrolled. The prevalence of HbsAg among the participants was 8.7% with 95% confidence interval (6.52, 10.98). Statistically significant association for HbsAg infection was observed for Hepatitis B positive family history p=0.032, COR- 3.771(1.045-13.615), AOR- 1.962 (0.472-8.159) and hospital admission history p=0.001, COR- 7.259 (1.935-27.226), AOR- 6.436 (1.567- 26.433). Conclusion and recommendations: an intermediate prevalence of HbsAg infection, which was an important public health problem was detected. Therefore implementing strategies for routine mandatory screening and care of pregnant women for hepatitis B would be important. Further, health education modes of transmission and precautions such as immunization of HBV has to be strengthened. Keywords: hepatitis B virus, Risk factors, HbsAg, pregnant women.
Prevalence Of Asymptomatic Bacteriuria Among Pregnant Women At Kisugu Health Center III.
(Clarke International University., 2021-11) Nabawanda, Nodrine S
Background; Asymptomatic bacteriuria is finding of Bacterium in quantitative counts of≥ 10^5 colony forming units/ml in a suitably collected urine sample obtained from a person presenting with no signs and symptoms of a urinary tract infection. It has been linked to adverse maternal complications like pyelonephritis, low birth weight and preterm labor. The purpose of this study was to determine the prevalence of asymptomatic bacteriuria, common causative bacteria and associated risk factors among pregnant women at Kisugu health center III. Methods; this study was a descriptive cross sectional study that enrolled 173 pregnant women presenting without signs and symptoms of urinary tract infections at Kisugu health center III between October and November 2021. Information on socio-demographic factors, obstetric factors and medical history of the pregnant women was acquired through questionnaires. Midstream clean catch urine samples were collected from the pregnant women. Urinalysis, culture and biochemical tests were performed on the samples. SPSS Version 20 was used to analyze the data and the results were presented in tables and pie charts. Logistics regression analysis and chi square tests were done to determine association of factors to asymptomatic bacteriuria. A p value of less than 0.05 was considered statistically significant Results; Twenty nine women out of 173 (16.8%) pregnant women enrolled in this study were positive for asymptomatic bacteriuria. The most isolated bacteria was Escherichia coli at 41.4%. The risk factors that had statistical significant association to asymptomatic bacteriuria were pregnant women that were married, had sexual intercourse more than twice a week and had a history of urinary tract infections. Conclusion; The prevalence of asymptomatic bacteriuria among pregnant women at Kisugu health center III is high. I would recommend that culture and sensitivity is added as part of routine screening in pregnant women for asymptomatic bacteriuria. I would also recommend for another study to be done on antibiotic susceptibility testing.
Prevalence And Risk Factors Associated With Hepatitis B And C Among Patients With Liver Disease At Juba Medical Complex, South Sudan.
(Clarke International University., 2021-11) Moses, Midu Wilson
Background: Hepatitis B and C viruses are a major public health problem worldwide affecting billions of individuals. Limited information exists on this matter in South Sudan. This study was undertaken with the aim of determining the prevalence and risk factors of hepatitis B and C virus infections in patients with liver disease at Juba Medical Complex, South Sudan. Methodology: The study was conducted on 69 clinically diagnosed liver disease patients. Possible associated factors with infections by the viruses were collected from the subjects using questionnaire. Serum was screened for the presence of hepatitis B surface antigen and anti- hepatitis C virus antibodies using Enzyme immunoassay. Results: Hepatitis B surface antigen was detected in 26 (37.9%) and anti-HCV antibody 11 (15.9%) patients clinically diagnosed to have liver diseases. Hepatitis B virus infection was higher in males 16/38 (42.1%) compared to 10/31 (32.2%) in females, while anti-hepatitis C virus antibody was higher in females 6/31 (19.4%) compared to 5/38 (13.2%) in males. Of the study participants, 4 (5.8%) had dual hepatitis B and C virus co-infection. The prevalence increased with age; the highest prevalence of hepatitis B was in the age group of 20 – 29 years 25 (36.2%), and that of hepatitis C virus was in age group of 30 – 39 year. None of the 69 subjects younger than 5 years and none above the age of 80 years had HBsAg or anti-HCV. Various risk factors for acquiring both hepatitis infections were identified; gender, age, injury with sharp object, family history of hepatitis, and surgical history. Conclusion: This study provided much important information concerning hepatitis B and C prevalence and risk factors among patients with liver disease; it showed the intermediate endemicity for HCV infection and pointed to an increasing trend of HBV incidence, which might reclassify South Sudan in high HBV endemicity area, among liver disease patients. This could be attributed to the lack of enough control measures by the government. In this study, HBV and HCV infections were associated with history of injury with sharp object and history of blood transfusion. Therefore, prevention and control measures are needed to reduce the spread of these infections among liver disease patients.
Prevalence Of Hepatitis B Virus Infection And Associated Factors Among Pregnant Women Attending Antenatal Care At Kisugu Health Center III.
(Clarke International University., 2021-11) Nakkungu, Violet
ABSTRACT Background: Infection with Hepatitis B virus (HBV) is life-threatening both to the pregnant woman and the fetus. Consequently, there is growing need to explore the status of the pregnant woman and avert the potential risk of perinatal transmission. Additionally, understanding the associated factors is critical for infection prevention and control. The aim of this study was to determine the prevalence of hepatitis B virus infection and associated factors among pregnant women attending antenatal care (ANC) at Kisugu Health Centre III. Methods: A cross sectional study was carried out among pregnant women attending antenatal care at Kisugu Health Centre III between September and October, 2021. Blood samples were collected in red tops by venipuncture and analyzed for the presence of Hepatitis B surface Antigen (HBsAg) using ASTRACARE HBsAg Rapid Test strips and positive samples were confirmed using Enzyme-linked Immunoarbsorbent assay (ELISA). A researcher administered questionnaire was used to obtain sociodemographic characteristics and the associated factors. Data was analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Results: Four hundred pregnant women were enrolled. Their age ranged from 15 to 40 years with a mean age of 24.93 years. Prevalence of HBsAg was 3.5% (95% CI 1.7 – 5.3). Also, 64.3% were single pregnant women and majority (38.3%) were in the age category of 22-26 years. The variables of age group (OR = 1.838, 95% CI 0.026 – 0.033, p value = 0.019), gravidity (OR = 0.869, 95% CI 0.066 – 0.076, p value = 0.045) and history of dental procedures (OR = 2.914, 95% CI 0.004 – 0.007. p value = 0.004) showed a statically significant association with the risk of HBV infection. Conclusion: There is a low-intermediate prevalence of Hepatitis B virus infection among the study population at Kisugu Health Centre III, and the risk was associated with the history of dental procedure, gravidity and age group. To this, there is an urgent need to avert the likely risk of perinatal transmission.
Bacterial Pathogens Isolated From Drinking Water Sources In Different Homes In Namugongo-Janda Village, Wakiso District .
(Clarke International University., 2021-11) Banana, Afia
ABSTRACT Background: Availability of healthy drinking water sources is a main concern world over. In Uganda, 80% of all infections have been directly linked to poor-quality drinking water due to contaminants arising from unsanitary conditions. This study isolated bacterial pathogens from different homes' drinking water sources in Namugongo-Janda village, Wakiso district, and determined their antimicrobial susceptibility patterns as well as the factors associated with bacterial contamination in drinking water. Methods: A total of 20 drinking water samples were collected using 300 ml sterile glass bottles. Samples were cultured using Muller Hinton and MacConkey agar, identification was done using the biochemical tests and drug sensitivity testing (DST) was done using Muller Hinton Agar. Additionally, a questionnaire was used to assess the associated factors for water contamination. Results: The analysis of the water samples collected from the four sources indicates that only 75% (15) of water samples had observable bacterial counts, whereas the remaining 15% (5) had no growth. The highest total plate count was 1.8 x 105 CFU/ml whereas the lowest total plate count was 480 CFU/ml, both of which were obtained from taps 1 and 2 respectively. All the observed microbial contaminants ranges were above WHO reference standards for drinking water, which are 0 CFU/ml. The biochemical characterization of the possible bacteria in the 15 positive water samples indicated the presence of only Bacillus subtilis, which suggests that 75% of the water sources contain biofilms inside them and so they need to be cleaned regularly. Ciprofloxacin together with Tetracycline, Gentamicin and Erythromycin were the most effective antibiotics from the results. The main factors for contamination of the drinking water sources discovered by this study were absence of a perimeter fence, presence of other potential contaminants, presence of cracks or dirt draining channels, using water source for washing of legs, clothes, containers, animal access to the water source and presence of a toilet nearby. Conclusion and recommendation: The main bacterial contaminant that was isolated from the drinking water samples is Bacillus subtilis, which suggests that 75% of the water sources in Namugongo-Janda village contain biofilms inside them. I highly recommend that there should be regular microbiological assessment of all drinking water sources, and erecting of perimeter fence around all water points in the area in order to prevent animal droppings, debris near water points.
Prevalence Of Echinococcus Granulosus Intestinal Infections Among Dogs Rared In Kijjwa Village, Bukasa Parish, Makindye Division, Kampala District.
(Clarke International University., 2021-11) Asiimwe, Ignatius Paul
ABSTRACT Introduction: Cystic Echinococcosis has been found in humans in Uganda with a prevalence of 1.84% (Emmanuel, 2016). They are one of Echinococcus Granulosus intermediate hosts while the dog is its definitive host thus human dog interaction is a big channel to transmission (Kumar, 2006). There is high dog ownership (Forman et-al., 2013, Daily Monitor, 2019 and Kumar, 2006), thus an active involvement of humans in its life cycle. A very high prevalence (66.3%) of Cystic Echinococcosis was found in karamoja pastoralist population dogs (Francis, 2010). Unfortunately, there are undocumented cases of this disease among urban area dogs (anecdotal data). It is a devastating disease whose control needs a multidisciplinary approach, and thus, understanding Echinococcus Granulosus in dog stool is one way of achieving the One Health strategy in controling zoonotic disease transmission. (The Commonwealth Health Hub, 2019) Objectives: The broad objective was to establish the prevalence of Echinococcus Granulosus infection and the hygienic practices in domestic dogs while the specific objectives were to establish the prevalence of the infection, its common stages in infected dogs, and the hygienic practices of their handlers in Kijjwa-Bukasa from August to October 2021. Method: A descriptive cross-sectional study was done on the domesticated dogs of Kijjwa-Bukasa so as to get a representation of the situation in the whole country. The dogs, kennels, andstool were examined both macroscopically and microscopically for indications and predispositions to echinococcosis and the data collected was analyzed. Results: Of the 176 assessed dogs, 152 (86.36%; 95%CI=80.39 to 91.06) were infected. Of the 152 infected ones, all (152, 100%) had at least eggs in stool among which 108 (71.1%) had proglotids. Of the 176 dogs, 112 (63.64%; 95% CI=56.06 – 70.74) lived in unhygienic conditions. Conclusion: A big number of dogs 86.4% have echinococcosis which has been greatly caused by luck of good hygienic practices on the part of their handlers. Dog handler hygienic practices may not be the only dependent factor of this infection in dogs, but may determine spread of the disease to humans. Recommendations include; Health education about cystic echinococcosis, dog de-worming drives, and training.
Prevalence And Antifungal Susceptibility Patterns Of Vulvovaginal Candidiasis Among Hiv Positive Women Attending Medical Care Clinics At Touch Namuwongo Project (IHK)
(International Health Sciences University, 2018-12) Akona, Jacob
Background: As infection with Acquired Immune-deficiency Virus (HIV) befalls endemic in Uganda; the risk of vulvovaginal candidiasis (VULVOVAGINAL CANDIDIASIS (VVC) ) as one of the most opportunistic infections remains high. Despite this, little is known regarding the prevalence, candida speciation and their antifungal susceptibility profile. This study sought to determine the prevalence of VULVOVAGINAL CANDIDIASIS (VVC) and antifungal susceptibility pattern among HIV-infected women attending Touch Namuwongo Project (TNP) at International Hospital Kampala. Materials and methods: This was a hospital based cross section study involving 150 HIV- positive women attending TNP during the months of May to July, 2017. Data was collected using self-administered questionnaire and laboratory analyses of two high vaginal swabs (HVS) for VULVOVAGINAL CANDIDIASIS (VVC) . Wet preparation, Gram stain, yeast culture, antifungal susceptibility testing using the disk diffusion method, and identification using phenotypic methods like germ tube test and Chrom ID agar were done. CD4 T- lymphocyte for the previous three-months was obtained from hospital records. Data was presented as proportions and the Chi-square test was used where a p-value of <0.05 was considered. Results: The prevalence of VULVOVAGINAL CANDIDIASIS (VVC) was 30.7% (95% Confidence Interval 18.6-39.4). Majority of study participants had C.albicans (n=33, 71.1%). Other Candida species isolated were; C. glabrata (8.7%), C. krusei (17.4%) and C.tropicalis (2.2%). The antifungal susceptibility pattern of Candida species revealed that majority of the strains isolated was either intermediate or resistant to the antifungal agents. Of the 46 participants with Candida species, we found a statistical association with a low immunity shown by CD4 cell counts below 249cells/μL of blood (Odds ratio=4.8, 95% Confidence Interval 3.7-5.1), declining clinical state as designated by WHO stages III and IV (Odds ratio=2.9, 95% Confidence Interval 1.7-3.4) and not being on anti-retroviral therapy (ART) (Odds ratio=4.2, 95% Confidence Interval 3.1-6.2). Conclusion: We report a high prevalence of VULVOVAGINAL CANDIDIASIS (VVC) , with C. albicans as the most specie. Candida antifungal susceptibility testing is recommended to avoid treatment failures. Also resistance to azole drugs such as fluconazole, the most frequent antifungal used in the country could necessitate routine fungal culture and in-vitro drug susceptibility testing.
Prevalence And Risk Factors Of Hepatitis B Virus Among Pregnant Women At International Hospital Kampala
(International Health Sciences University, 2018-12) Fuad, Ahmad Said
Background Hepatitis B infection is viral infection that targets the liver cells, causing liver damage and subsequently disease (WHO, 2015). The disease is transmitted through coming into contact with body fluid(s) of an infected person such as blood, semen, amniotic fluid, vaginal fluid and secretions from mucous membranes. This can occur during sexual intercourse, sharing sharp objects like needles and razors and also vertically from mother to child during childbirth (Gedefaw et al., 2015). Objectives of the study To determine the prevalence and associated risk factors of hepatitis B virus infection among pregnant women at International hospital Kampala. Methodology: A descriptive cross-sectional study was conducted among 145 pregnant women in International Hospital Kampala researcher administered questionnaire and laboratory analysis of blood samples for HBV infection was done. Results. The test results found out that 1% of the respondents tested positive for HBV. All the respondents (100%) had ever heard about a disease called hepatitis B disease. All the respondents knew that hepatitis B a viral disease. Majority (83.4%) of the respondents agreed that contact with infected blood or body fluids is one mode of transmission of HBV. 2.1 % of the respondents agreed that they have ever shared a needle with friends while taking the drugs. Conclusions. The prevalence of HBV was found to be at 1% among pregnant mothers at International Hospital Kampala. Majority of the women had studied up to university and were much aware of HBV. The respondents had good level of knowledge in regard to HBV. Recommendations. The hospital should continue to health educate the pregnant mothers about hepatitis B disease. Vaccination should be done to all the medical staff. Ensuring implementation of infection control measures.
Pre-Analytical Errors Affecting Quality Of Final Results At The Pathology Laboratory College Of Health Sciences, Makerere University Kampala Uganda
(International Health Sciences University, 2018-12) Namwase, Betty
Introduction: These pre-analytical errors have been reported as the major pit hole in Pathology laboratory that affect the quality of reports as well as the management and prognosis of the patient. These errors constitute about 4-5 times of the errors compared to analytical and post-analytical processes. The work flow effectively involves three phases, pre-analytical, analytical and post-analytical in which all phases are interconnected directly or indirectly. The research study was done at the Pathology department, college of health sciences, Makerere University located in upper Mulago. The main objective of the study was to study Pre-analytical errors affecting the quality of the final results produced at Pathology laboratory. The specific objectives were to determine the rate of occurrence, commonest stage presenting with pre-analytical errors and to establish any association between pre- analytical errors and the quality of the final results produced at Pathology laboratory Makerere University College of Health Sciences. Methodology: The study looked at 323 laboratory request forms using a descriptive prospective research design in a period of three (3) months ranging from May to Aug 2018. Data was collected using observation checklist, entered into excess, analyzed and presented using frequency tables and bar charts. Results: The rate of occurrence of pre-analytical errors in the study was 100%. The commonest stage presenting with pre-analytical error was grossing not done by senior 316(97.83%), followed by grossing errors 312(96.59%) and the lowest was clinical summary 27(8.36%). There was no association between pre-analytical and TAT. Conclusion and recommendations: Pre-analytical errors occur frequently in pathology lab, there a strong association between pre-analytical errors especially demographic data, clinical history and grossing. Pathology laboratory should embrace SLIPTA in order to work towards accreditation in any of the accrediting bodies. There is a desperate need of senior pathologist during grossing and there is need to do monitoring and evaluation both in laboratories and clinical.
Prevalence Of Sickle Cell Trait Among Patients Attending Juba Teaching Hospital
(International Health Sciences University, 2018-12) Aputu Dabay, Caroline Mark
Introduction: Sickle cell disease is the most common hereditary disease known to cause death in children under five in Africa. Sickle cell trait is the benign form of the sickle cell disease. Individuals with sickle cell anemia manifest a lot of complications such as pain crisis; while those with trait remain asymptomatic, until exposed to adverse conditions that can trigger hemoglobin polymerization. In South Sudan, there is scarcity of data regarding the occurrence of sickle cell anemia or trait. Therefore this study was conducted with the aim of determining the prevalence of sickle cell trait among patients attending Juba Teaching Hospital. Methodology: This was a cross-sectional study that recruited 384patients attending Juba Teaching Hospital. Solubility screening technique was used. Venous blood samples were picked and analyzed at the hospital laboratory. Interviews were conducted by the principle investigator to assess knowledge, distribution and complications by self-reporting. Approval was obtained from the Research and Ethics Committee at the Ministry of health, South- Sudan. Data was analyzed using SPSS software program. Results: The study reported a prevalence of 9%, seen high in males (11.6%) than females (2.5%) and more prominent among the Bari and Dinka tribes. Knowledge was rated poor among respondents.. Clinical history by self-reporting revealed 14.25% had severe pain, 20% had severe anemia, 55.6% had bloody urine, and 40.4% with urinary tract infection and 71.4% had abdominal pain at high altitude. Conclusion: The study outcome gave a hint on the perception of South Sudanese of sickle cell. This calls for massive awareness to improve understanding of sickle cell and management of those with disease or trait. Screening programs can be established to enable individuals know their sickle cell status.
Assessment Of The Tuberculin Skin Test Positivity Rate Among Students Of International Health Sciences University
(International Health Sciences University, 2018-12) Kabera, Michael
Back ground: TB latency has created a serious hindrance to Global TB control. The Tuberculin skin test (TST) can be used to detect Latent tuberculosis infection (LTBI) and appropriately inform TB control programs. The main objective of this study was to at assess the Tuberculin skin test (TST) positivity rate among all IHSU students. Methods: A cross sectional research study design was used to assess the positivity rate of tuberculin skin among students at International Health Sciences University (IHSU) in August 2018. 0.1ml of Purified protein derivative (PPD) was intradermally introduced on long axis of the fore arm. An induration of ≥5 mm diameter was taken to be positive. Univariate and multivariate method were used to assess the risk factors associated with LTBI. Results: A total of 205 participants were sampled for TST test. The TST positivity rate was years (Z= 2.96, P=0.023) courses of Laboratory (Z= 3.12, P=0.002) and Nursing (Z= 2.21, P=0.027) long time of clinical placement for more than four months (Z= 3.81, P=<0.001) and smoking (Z= 3.97, P=<0.001). Conclusion and recommendations: Tuberculin skin test positivity rate among IHSU students was lower than the studies around Kampala and male students were more affected than girls. The risky factors were associated with a positive LTBI were age, course, duration of placement and smoking. This suggests that health care providers should put on protective equipment like N95 masks, work under Bio safety cabinets and carry out routine screening test for LTBI. Those found positive be advised to do further tests like Zeihl Neelsen, Chest X-ray and culture and sensitivity Keywords: Latent tuberculosis infection, Tuberculin skin test and TB control.
Prevalence Of Intestinal Parasites And Associated Risk Factors Among School Children Attending Bwonda Primary School Mayuge District Eastern Uganda
(International Health Sciences University, 2018-12) Dhatemwa, Rajabu
Background: The risk of intestinal parasite among school going children still remains a high burden in fishing communities, as there is evidently poor sanitation and hygiene. This consequently affects children’s health and general well-being hampering learning. This study sought to determine the prevalence of intestinal parasites and associated factors among children aged 5-15 years attending Bwonda primary school, in Mayuge district. Materials and methods: A cross-sectional study was carried out that enrolled 375 study participants. Researcher-administered questionnaires were used to obtain socio-demographic characteristics and risk factors to the acquisition of intestinal parasites. Stool macroscopy, wet preparations and formol-ether concentration technique were used to identify intestinal parasites from stool specimens. Data obtained was analyzed using SPSS and the reports include descriptive statistics and logistic regression to determine the associated risk factors. Results: The study enrolled 375 pupils, 57.9% (n=217) were females. Their mean age was 8.9years (range 5-15 years). Thirty participants had intestinal parasites, giving a prevalence of 8.0% (95% Confidence Interval: 6.8-10.13). Three species of intestinal parasites were isolated; Schistosoma mansoni (n=17, 56.7%), hook worm ova (n=12, 40.0%), and Gardia lamblia (n=1, 3.3%). Intestinal parasites were uniformly distributed among the gender of the participants. The infection was highest among the age categories of 9-12 years (n=16, 53.3%), followed by the 13-15 years (n=9, 30%) and least among the 5-8 years age category (n=5, 16.7%). Multivariate analysis indicated that lack of knowledge about the signs and symptoms of intestinal parasites, non-use of pit latrines to dispose feacal matter, not washing of hands after using a pit latrine, not being dewormed and walking with bare feet were statistically associated with the risk of acquisition of intestinal parasites (P <0.05). Conclusion and recommendations: There is a high prevalence of intestinal parasites, with the main parasites being S. mansoni, hookworm and Gardia lamblia. Routine screening and treatment and deworming of children in this area need to be emphasized and improvement of sanitation and hygiene as a way to combat the infestation is to be implemented.
Establishment Of Hematological Reference Ranges For Pregnant Women Attending Antenatal Care At Nakaseke Hospital
(International Health Sciences University, 2018-11) Kyakulaga, Philip
Background: Measurement of haematological parameters is key to the diagnosis, treatment and monitoring of many infectious diseases and pregnancy related conditions. However, less effort has been put in establishment of these parameters in developing countries where clinical care strongly relies on laboratory diagnosis. This study reports on the haematological reference ranges among pregnant attending antenatal care in Nakaseke Hospital. Methods: A cross sectional study was conducted during the months of August and November, 2018 among pregnant women attending antenatal care in Nakaseke hospital. Ethylene di-amine tetra acetic acid (EDTA) venous blood were collected and a full blood count (FBC) was run. Data was presented in tabular form as mean ± SD in reference to 95 % reference intervals. Results: Overall, 135 consented pregnant women were enrolled. The red blood cells (RBCs) showed a gradual decrease in haemoglobin and RBCs counts as the pregnancy progressed from 1 st to 2nd and then became constant 3rd trimester as 4.04-5.02, 3.77-4.67 and3.92- 4.7 respectively. The haematocrit value decreases from the1st to the 2nd trimesters and then remains constant in the 3rd trimester as 36.94- 45.3, 34.67-41.35 and 32.47-44.79 respectively. There was no significant change in MCV. For the white blood cells (WBCs), there was no significant change in the total count from the 1 st to the 2nd trimesters, but there is significant rise in the 3 rd trimester as 4.57-8.75 , 4.41-8.85 and 4.8-9.2 respectively. The granulocytes were affected by the increase in numbers. The total platelet count decreased from the 1 st to the 2nd to the 3 rd trimesters as 152.38-267.24, 145.41-224.59 and 128.48-220.94 respectively. Conclusion: This study has explored a variance in the blood cell parameters across the different gestational stages. To this, gestation- and age-based reference values for haematological parameters are key to their clinical care and management.
Knowledge,Attitude and Practices On Hypertension Management Of Essential Hypertensive Patients Attending The Outpatient Clinic Of Mubende Regional Referral Hospital
(CIU, 2018-12) Katongole, Richard
ABSTRACT Introduction: Hypertension is a condition in which the blood vessels have persistently high blood pressure therefore the study was knowledge, attitude and practices on hypertension management of essential hypertensive patients attending the OPD clinic of MRRH. The study accounted for patients who lived in Mubende district for more than six months and aged between 4099years. General objective: The general objective of the study was to assess knowledge, attitude and practices on hypertension management of essential hypertensive patients attended the OPD clinic of MRRH under which the specific objectives of the study were; to assess knowledge on hypertension, determine attitude towards and identify practices on hypertension management among essential hypertensive clients attending OPD clinic of MRRH. Methodology: The study was descriptive crosssectional design and involved 102 respondents who were assessed on their knowledge, attitude and practices towards hypertension management. The study involved both primary and secondary (previous study) sources. The sampling frame was random and respondents were enrolled to complete the questionnaires administered after clear explanations and they consented for their participation in the study. Data was collected and analyzed using, SPSS version 20, Excel word, to aid in explanation and drawing deductions. Results and conclusions: The results revealed that most of the essential hypertensive patients are female, catholic, Baganda, who are married, aged 5569years and maximally studied up to primary level. The study also found that there is limited knowledge on the term HTN, and complications of the disease that may arise due to mismanagement. On addition, it is found that the use of physical exercises as one of the modalities to manage HTN is low. Recommendations: The government of Uganda through MOH and finance should optimize funds on outreach programs, finance communication adverts via; radios, TVs, journals and posters about hypertension and other diseases to boost community awareness about HTN and its proper management. The government through MOH, NDA, UNMS and other organizations should avail adequate drugs and stocks at the health centers and hospitals to step down expenses patients incur or fail to afford on medications so as to make management of their condition effective. Furthermore the government through MOE and sports should implement and sustain UPE, USE programs to aid in eradicating illiteracy and provide physical exercise centers and trainers to the different health centers and hospitals to aid in steppingup the proportions of people involving in the struggle to manage hypertension. Through MOH, MRRH should consider recruiting more hospital and community health workers to increase on the efficiency in health service delivery. Last but not least, the community members of Mubende district should actively participate and support all health service programs in their area to minimize risks to hypertension and other disease as to save generations.
Assessment Of Truehb ® Point-Of-Care Hemometer Among Patients Attending International Hospital Kampala
(International Health Sciences University., 2018-12) Ndeze, Ivan
Background: Accurate determination of hemoglobin (Hb) levels is vital to elucidate the extent of anemia, and thus a guide to clinical and research care in harnessing timely diagnosis. This study assessed the diagnostic performance of TrueHb ® point-of-care hemometer at International Hospital Kampala, Uganda. Methods: We analyzed ethylene-di-amine tetra acetic acid (EDTA) blood samples to estimate Hb levels using parallel testing with TrueHb® hemometer and Sysmex i3 analyzer. Data was analyzed using STATA 12 (College Station, TX, USA) to ascertain diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated. Results: We analyzed 402 EDTA blood samples, the mean difference of the two methods was 2.2219 (SD 1.07915),p-value 0.017 The accuracy of the two assays as measured by the intra- class correlation coefficients (ICC), the average measure was 0.793, which indicated a substantial correlation between the two assays. The average performance TAT for the machine was 2.46 minutes (95% CI= 2.37-2.55) Conclusion: The TrueHb® point-of-care hemometer could be an accurate point of care tool for screening anemia with recalibration done positively by 2.22g/dl. The TAT for the TrueHb® meter is convenient.
Prevalence Of Anaemia And Associated Factors Among Children Under 5 Years Seeking Medical Services At International Hospital Kampala (IHK)
(International Health Sciences University., 2018-12) Abdulhameed, Ahmed
Background Aneamia possesses a significant health burden that is not properly addressed in Uganda with the prevalence ranging from 15% to 75% by region, (Uganda DHS, 2011). Anaemia in children is a grave health problem in 53% of under five year olds with potential on their health and economic wellbeing for instance anaemia if not promptly managed may cause irrevocable cognitive and developmental delays (UBOS & ICF, 2017). Anaemia is known to be results of under nutrition thus, it might be strongly correlated with other child nutritional status. A cross-sectional study was conducted to gather information on the factors associated with anaemia among children under-Five years at IHK from 337 children whose blood samples were drawn for analysis. The main purpose of the study was determine the prevalence and the factors associated with anaemia among children under 5 years seeking medical services at International Hospital Kampala (IHK) Kampala district. Results showed that mild anaemia was 20.9%, moderate anaemia was 11.6% and severe anaemia was 4.3%. demographic characteristics found to be associated were gender of the child (χ 2 =4.113, P=0.043), weight of the child at the time of study (χ 2 =26.088, P=0.000), History or incidence of intestinal worms in children (χ 2 =165.809, P=0.000), HIV status (χ 2 =26.486, P=0.000). Parental factors were found to be education (χ 2 =39.65, P=0.000 mother employment status (χ 2 =31.59, P=0.000), father‟s level of income (χ 2 =25.87, P=0.039), and mother's level of income (χ 2 =41.72, P=0.000). The study concluded that the level of anaemia was generally moderate and sex of child and mothers level of education influenced the anaemic condition. The study recommended that all children should be assessed using a CBC machine in order to offer specific treatment interventions for the children seeking care International Hospital, Kampala.