Factors associated with delayed onset of active labor following vaginal misoprostol administration among women at Mbarara Regional Referral Hospital, Uganda

2020 ◽  
Author(s):  
Rogers Kajabwangu ◽  
Francis Bajunirwe ◽  
Henry Lukabwe ◽  
Esther Atukunda ◽  
Dale Mugisha ◽  
...  
Keyword(s):  
Referral Hospital ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Delayed Onset ◽  
Active Labor ◽  
Vaginal Misoprostol

Factors associated with delayed onset of active labor following administration of vaginal Misoprostol among women at Mbarara Regional referral hospital, Uganda: A prospective cohort study

2019 ◽  
Author(s):  
Rogers Kajabwangu ◽  
Francis Bajunirwe ◽  
Henry Lukabwe ◽  
Esther Atukunda ◽  
Baraka Munyanderu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Age ◽  
Labor Induction ◽  
Induction Of Labor ◽  
P Value ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Delayed Onset ◽  
Active Labor ◽  
Vaginal Misoprostol

Abstract Background Vaginal misoprostol has been recommended by the World Health Organization as one of the effective methods for induction of labor. Globally 9.6% of all deliveries follow induction of labor. Although the goal of labor induction is to initiate active labor with subsequent vaginal delivery, some mothers undergoing labor induction delay to get into active labor and some fail completely. The factors associated with delayed onset of active labor following labor induction with vaginal misoprostol have not been sufficiently explored in resource limited settings.Methods We conducted a prospective cohort study over a period of 6 months on the antenatal ward and labor suit of Mbarara Regional Referral Hospital, southwestern Uganda. We enrolled mothers of gestational age at least 28 weeks, with indication for labor induction. They received 50 micrograms of vaginal misoprostol every 6 hours with a maximum of 4 doses and were followed up until onset of active labor. Onset of active labor was considered delayed if it occurred at more than 12 hours after administration of the first dose of vaginal misoprostol. Bivariate and multivariate analysis was done to determine the factors associated with delayed onset of active labor.Results Eighty-eight mothers underwent induction of labor, 22.7% had delayed onset of active labor. After adjusting for potential confounders, low/no parity (Relative Risk or RR 2.67, p-value=0.01), low gestational age (RR 3.1, p-value=0.006) and higher BMI (RR 0.36, p-value=0.005), were associated with delayed onset of active labor following vaginal misoprostol administration.Conclusion Nulliparity, gestational age less than 37weeks are associated with delayed onset of active labor following labor induction with vaginal misoprostol while BMI of 26 and above is protective from delayed onset of labor.

scholarly journals Non-Proteinuric Preeclampsia: Prevalence, Factors Associated and End-Organ Dysfunction at Mbarara Regional Referral Hospital in Southwestern Uganda  

2021 ◽  
Author(s):  
Asiphas Owaraganise ◽  
Wasswa GM Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
Godfrey Twesigomwe ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Complete Blood Count ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Care Providers ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Pregnancy Hypertension ◽  
Factors Associated ◽  
Significant Difference

Abstract Background: Formerly, preeclampsia was only diagnosed if high blood pressure and proteinuria were present in a gravid woman at or past 20 gestation weeks. Although it is possible to have preeclampsia yet never have proteinuria, the literature on how common and factors associated with non-proteinuric preeclampsia as well as whether the frequency of end-organ dysfunction among women with non-proteinuric differs from those with proteinuric pre-eclampsia is scant.Objectives: To determine the prevalence of, factors associated with non-proteinuric preeclampsia, and compare the frequency of end-organ dysfunction between women with non-proteinuric and proteinuric preeclampsia.Methods: Between November 2019 and May 2020, women with pre-eclampsia were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension ≥140/90mmHg and recorded their socio-demographic, medical, and obstetric characteristics. We excluded women with chronic hypertension and pregnancy hypertension. We measured bedside proteinuria on clean-catch urine, complete blood count, and renal function and liver enzyme tests. Pre-eclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1g/dl, and liver transaminases ≥ twice upper normal limit with or without proteinuria. We computed the proportion of total participants with non-proteinuric pre-eclampsia at ≤+2 urine dipstick cut-off, determined the factors associated with non-proteinuric preeclampsia using logistic regression; and used Chi-square test to compare the frequency of end-organ dysfunction between non-proteinuric preeclampsia and proteinuric groups.Results: We enrolled 134 of the screened 136 participants. Their mean age was 26.9 (SD±7.1) years and 51.5% were primigravid. The prevalence of non-proteinuric preeclampsia was 24.6% (95% CI: 17.9-32.7). Primigravidity (aOR 2.70 95%CI:1.09-6.72, p=0.032) was the factor independently associated with non-proteinuric pre-eclampsia. There was a non-significant difference in the frequency of end-organ dysfunction in women with non-proteinuric and proteinuric pre-eclampsia, p=0.309.Conclusion: Non-proteinuric preeclampsia is common, especially among primigravidae. End-organ dysfunction occurs similarly in women with non-proteinuric and proteinuric preeclampsia. Obstetrics care providers should emphasize laboratory testing, beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage non-proteinuric preeclampsia.

scholarly journals Factors Associated With Herbal Medicine Use in Pregnancy Among Postnatal Mothers in Mbarara Regional Referral Hospital in Western Uganda

2021 ◽  
Author(s):  
Laban Muteebwa ◽  
Ali Ssetaala ◽  
Dan Muramuzi ◽  
Annet Nanvubya ◽  
Yunia Mayanja
Keyword(s):  
Herbal Medicine ◽  
Pregnant Women ◽  
Herbal Medicines ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Medicine Use ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Western Uganda ◽  
In Pregnancy

Abstract BackgroundThere is widespread use of herbal medicines among populations in sub-Saharan Africa. However, pregnant women should be conscious about medication taken during pregnancy including herbal medicines because their safety profiles are not known and some of them might affect the mother, fetus and pregnancy outcomes. Knowledge about use and safety of herbs in pregnant women is limited. This study aimed to assess the extent of use and the factors associated with use of herbal medicine in pregnancy.MethodsA cross-sectional study involving 385 women 6 weeks post-partum and below, receiving post-natal services at Mbarara Regional Referral Hospital in Western Uganda was conducted during May to August 2016. Simple random sampling was used to select participants. A structured pretested questionnaire was administered after written informed consent. Data was analyzed using logistic regression (STATA- 14).ResultsOf 385 respondents, 70.4% reported to have used herbal medicine during their most recent pregnancy. Associated factors were perception that herbal medicines are safe (aOR 9.8, 95% CI (4.2-23.0), perception that herbal medicines are important (aOR 12.4, 95% CI (5.2-29.5), staying more than 10KM from the heath facility (aOR 3.1, 95%CI (1.4-6.9), being a first time mother (aOR 2.6, 95%CI (1.1-6.2) and dissatisfaction with ANC services at health facility (aOR 2.6, 95%CI (1.1-6.3)ConclusionHerbal medicine use in pregnancy is common in the study area. Community Sensitization drives about the dangers of herbal medicine use in pregnancy is recommended. Healthcare workers should routinely screen for herbal medicine use during antenatal care visits and labor.

scholarly journals Comorbidities and Factors Associated with Mortality among Children under Five Years Admitted with Severe Acute Malnutrition in the Nutritional Unit of Jinja Regional Referral Hospital, Eastern Uganda

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Desire Banga ◽  
Melvis Baren ◽  
Namale Vivian Ssonko ◽  
Franck Katembo Sikakulya ◽  
Yves Tibamwenda ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Referral Hospital ◽  
Acute Malnutrition ◽  
Health Concern ◽  
Regional Referral Hospital ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated ◽  
Eastern Uganda ◽  
Children Under 5

Background. Mortality among children with severe acute malnutrition remains an immense health concern in the hospitals in developing countries, but its attributes are not completely assessed in various hospital settings. The aim of this study was to determine the proportion of mortality, the comorbidities, and factors associated with in-hospital mortality among children under five years of age admitted with severe acute malnutrition at Jinja Regional Referral Hospital, Eastern Uganda. Methods. This was a hospital-based analytical and descriptive prospective cohort study conducted in the nutritional unit of Jinja Regional Referral Hospital. A total of 338 children and their caretakers who met the criteria were consecutively enrolled into the study. Descriptive statistics were used to each of the independent factors, and comorbidities were subjected to chi-squared test followed by logistic regression analysis to assess its association incidence of mortality among children. All independent variables with p values ≤ 0.05 were entered into a multivariate model for factors and comorbidities independently. Factors and comorbidities with p values ≤ 0.05 were considered as associates of mortality among children. Results. Of the 338 children under 5 years of age enrolled, 49 (14.5%) died, although the majority of children were diagnosed with dehydration, 128 (37.9%); pneumonia, 127(37.6%); and malaria, 87(25.7%). Anemia ( aRR = 2.9 , 95% CI: 1.23-6.62, p = 0.01 ), bacteremia ( aRR = 10.0 , 95% CI: 3.62-29.01, p = 0.01 ), HIV ( aRR = 4.8 , 95% CI: 1.42-16.30, p < 0.01 ), TB ( aRR = 4.3 , 95% CI: 1.28-14.49, p < 0.02 ), and shock ( aRR = 60.9 , 95% CI: 9.05-410.28, p < 0.01 ) were the comorbidities significantly associated with a likelihood of mortality. Conclusions. The mortality among children under 5 years of age admitted with severe acute malnutrition is still high (14.5% versus 5%). The comorbidities are significantly associated with mortality. The clinicians are recommended to follow-up closely patients with severe acute malnutrition and to focus on the critical comorbidities identified.

scholarly journals Factors associated with mortality among the COVID-19 patients treated at Gulu Regional Referral Hospital: A retrospective study

2021 ◽  
Author(s):  
Steven Baguma ◽  
Christopher Okot ◽  
Nelson Alema Onira ◽  
Paska Apiyo ◽  
Denis Acullu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Mortality ◽  
Formal Education ◽  
Significant Risk ◽  
Referral Hospital ◽  
Northern Uganda ◽  
Regional Referral Hospital ◽  
General Body ◽  
Factors Associated ◽  
African Patients

Abstract Background: The advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There is a lack of data on the outcome of hospitalized African patients suffering from COVID-19.This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021.Methods: This was a single-center, retrospective study in patients hospitalized with confirmed COVID-19 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, comorbidities, duration of hospital stay, and treatment were analyzed, and factors associated with increased odds of mortality were determined.Results: Of the 664 patients treated, 661(99.5%) were unvaccinated, 632(95.2%) recovered and 32(4.8%) died. Mortality was highest in diabetics 11(34.4%), cardiovascular diseases 12(37.5%), hypertensive 10(31.3%), females 18(56.3%), > 50-year-olds 19(59.4%), no formal education 14(43.8%), peasant farmers 12(37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32(100.0%), Oxygen saturation (Sp02) <80 4(12.5%), general body aches and pains 31(96.9%), tiredness 30(93.8%) and loss of speech and movements 11(34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR=0.220,95%CI:0.059-0.827;p=0.030; Diabetes mellitus AOR=9.014, 95%CI:1.726-47.067;p=0.010; tiredness AOR=0.059,95%CI:0.009-0.371; p=0.0000; general body aches and pains AOR=0.066,95%CI:0.007-0.605; p=0.020; loss of speech and movement AOR=0.134,95%CI:0.270-0.660;p=0.010 and other comorbidities AOR=6.860, 95%CI:1.309-35.957;p=0.020.Conclusion: The overall hospital mortality was 4.8%. Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide “Enhanced shielding” to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.

scholarly journals Factors Associated With Severe Maternal Outcomes at a Regional Referral Hospital in South-Western Uganda: A Case-Control Study

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Maternal Outcome ◽  
Referral Hospital ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Outcomes ◽  
Regional Referral Hospital ◽  
Live Births ◽  
Factors Associated ◽  
Severe Maternal Outcome ◽  
Mortality Ratio

Background: The Sustainable Development Goal target is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. Maternal morbidity and mortality in sub-Saharan Africa remains high despite global efforts to reduce it. Severe maternal outcome studies offer a panoramic assessment of obstetric care. Objective: The study aimed at determining the factors associated with severe maternal outcomes among women admitted at the obstetrics and gynecology ward of Mbarara Regional Referral Hospital. Methods: In an unmatched case control (1:2) study conducted between February and May 2018, 162 pregnant women admitted on the obstetrics and gynecology ward of Mbarara Regional Referral Hospital, or who had delivered within the past 42 days were recruited. Near miss cases were defined based on the WHO criteria. Near-miss cases and events, maternal deaths and their causes were retrospectively reviewed. Three categories of risk factors (socio-demographic, obstetric and health system) were examined. P-values <0.05 were considered statistically significant. A multivariable logistic regression model was used to identify factors associated with severe maternal outcomes. All analyses were performed using Stata software (Version 12.0, StataCorp, and College Station, TX). Results: In the four-month period there were 2301 live births, there were 45 near miss cases and 9 maternal deaths resulting in a severe maternal outcome ratio of 23.5/1000 live births, maternal near miss ratio of 19.6/1,000 live births, maternal near-miss mortality ratio of 5 and mortality index of 16.7%. Severe obstetric hemorrhage (33%), ruptured uterus (27.8%), sepsis or severe systemic infection (16.7%) and hypertensive disorders in pregnancy (16.7%) were the direct causes of severe maternal outcomes. About seventy-seven percent (77.8%) of the mothers with severe maternal outcomes were referred in from the peripheral health facilities, with a 4-time risk increased risk of a severe maternal outcome (aOR, 4.00; 95 % CI, 1.84-6.66, p-<0.001). Conclusion: Of the severe maternal outcomes, direct causes were the most prevalent and most of which are preventable. Being referred in was significantly associated with severe maternal outcomes. The maternal near miss indicators indicate need for improved quality.

scholarly journals Characteristics of the COVID-19 patients treated at Gulu Regional Referral Hospital, Northern Uganda: A cross-sectional study

2021 ◽  
Author(s):  
Steven Baguma ◽  
Christopher Okot ◽  
Nelson Alema Onira ◽  
Paska Apiyo ◽  
Denis Acullu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Recovery Rate ◽  
Hospital Admissions ◽  
Hiv And Aids ◽  
Referral Hospital ◽  
P Value ◽  
Health Management Information System ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Successful Recovery

Abstract Background Coronavirus Disease 2019 (COVID-19) is a severe respiratory disease that results from infection with a new coronavirus (SARS-CoV-2). One of the most critical issues related to the COVID-19 is the high rate of spread, millions of people have been infected around the world, and hundreds of thousands of people have died till now. However, reports from Africa paint a different picture of the SARS-CoV-2 and its effects on the population. Objectives The objective of this study was to describe the characteristics of the COVID-19 patients treated at the Gulu Regional Referral Hospital and determine factors associated with COVID-19 manifestations, socio-demographic characteristics, and treatment outcomes from March 2020 to October 2021. Methods A retrospective data abstraction of all COVID-19 hospital admissions registered in the Gulu Health Management Information System (HMIS) database and other tools were conducted. The period of study was March 2020 to October 2021. Data that met the inclusion criteria were consecutively abstracted from the Gulu Hospital HMIS database. A local IRB approved the study. SPSS version 25.0 was used for data analysis, and a p-value of 0.05 was considered significant. Results Data suggests there were three waves of COVID-19 in Uganda. Those with comorbidities, e.g., Diabetes mellitus 38(5.7%), hypertension 83(12.5%), cardiovascular diseases 58(8.7%), HIV and AIDS 61(9.2%), and other comorbidities such as liver cirrhosis and hepatitis B 40(6.0%) were more susceptible and presented with severe forms of the disease. Antibiotics 662(99.7%), steroids 73(11.0%), vitamin C 564(84.9%), Ivermectin 7(1.1%), and Vitamin D 24(3.6%) were the most used medicines for the treatment of COVID-19 patients. Most COVID-19 patients were unvaccinated 661(99.5%). However, the recovery rate was 632(95.2%). The commonest complications were pneumonia 60(9.0%), chronic fatigue 49(7.4%), acute respiratory distress syndrome (ARDS) 37(5.6%), depression 20(3.0%), systemic infections 19(2.9%), nightmares 15(2.3%) and septic shock 8(1.2%). The Adjusted Odds Ratios (AOR) on factors associated with recovery were treated with steroids AOR=138.835 at 95% CI:12.258-1572.50; p<0.000 and Vitamin D AOR=0.016 at 95% CI:1.902-520.98; p=0.016. Conclusion This study showed successful management of COVID-19 patients in low-resource settings with a recovery rate of 95.2%. The admission pattern suggests Uganda had three waves of COVID-19, contrary to the official government position of two. Treatment with steroids and Vitamin D is associated with the recovery of COVID-19 patients. There is a need to conduct more extensive studies on the role played by the two drugs in the successful recovery of COVID-19 patients.

scholarly journals Prevalence and Factors Associated with Contraceptive Use among HIV-Infected Women of Reproductive Age Attending Infectious Disease Clinic at Gulu Regional Referral Hospital, Northern Uganda

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Felix Bongomin ◽  
Mercy Chelangat ◽  
Anthony Eriatu ◽  
Bruno Chan Onen ◽  
Priscilla Cheputyo ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Vertical Transmission ◽  
Contraceptive Use ◽  
Referral Hospital ◽  
Northern Uganda ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Infectious Disease Clinic ◽  
Disease Clinic ◽  
Vertical Transmission Of Hiv

Background. Reproductive planning by HIV-infected women is essential, as it helps to prevent transmission of HIV to their unborn babies. Integrating contraceptive services to routine HIV care significantly increases the use of modern contraceptive methods, thus reducing vertical transmission of HIV. Objectives. To determine the prevalence and factors associated with contraceptive use among HIV-infected women attending Infectious Disease Clinic (IDC) at Gulu Regional Referral Hospital (GRRH) in Northern Uganda. Methodology. A hospital-based cross-sectional study was performed. We used simple random sampling to recruit HIV-infected women receiving routine care from IDC, GRRH, into our study. Sample size was estimated using modified Kish-Leslie formula and semistructured questionnaire was used for data collection. Data was entered into EpiData version 3.1 and analysed using Stata v11.0. We used logistic regression model to assess the associations and any factor with p≤0.05 was considered statistically significant. Results. The prevalence of contraceptive use was found to be 36% (95% CI 31 – 40%). Factors which promoted contraceptive use were as follows: being married (aOR=2.68, 95% CI 1.54-4.65, p<0.001) and monthly income of $35 -250 (aOR= 2.38, 95% CI: 1.39- 4.09, p=0.002). Factors that hindered contraceptive use were having no child (nulliparity) (aOR= 0.16; 95% CI: 0.05-0.49; p=0.002) and age range of 31-49 years (aOR= 0.53; 95% CI: 0.33 - 0.84; p=0.007). Conclusion. In this study, just over a third of sexually active HIV-infected women reported use of modern contraceptives. This is a low level of usage and, therefore, clinicians and stakeholders should sensitise HIV-infected women on the importance of contraceptive use in the fight against HIV/AIDS and encourage them to use contraceptives to avoid vertical transmission of HIV through unintended pregnancy.

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