Cost-Effectiveness of Exploratory Laparotomy in a Regional Referral Hospital in Eastern Uganda

2020 ◽  
Vol 245 ◽  
pp. 587-592 ◽  
Author(s):  
Nikhil Bellamkonda ◽  
Girish Motwani ◽  
Andrew Hyginus Wange ◽  
Christopher De Boer ◽  
Fred Kirya ◽  
...  
2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Desire Banga ◽  
Melvis Baren ◽  
Namale Vivian Ssonko ◽  
Franck Katembo Sikakulya ◽  
Yves Tibamwenda ◽  
...  

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.


Author(s):  
Esther Nambala ◽  
Jayne Byakika-Tusiime ◽  
Yahaya Gavamukulya

Aim: To determine nutritional knowledge and practices among patients with Non-Communicable Diseases (NCD) attending Mbale Regional Referral hospital, in Eastern Uganda. Study Design: A mixed methods cross sectional study design was used. Place and Duration of Study: Mbale Regional Referral Hospital among patients attending the NCD clinic from May to July 2017. Methodology: Two hundred sixty clients were recruited for the study. Quantitative data was collected through structured administered questionnaires. Quantitative data was analyzed at univariate, bivariate and multivariate levels. Chi square test and logistic regression were used to determine the association between nutrition knowledge and utilization. Qualitative data was coded first and summarized according to the themes. Results: The mean age of the respondents was 55 years (SD= 14) and hospital was the main source of nutrition information (n=156, 60%). Most respondents (n=156, 60%) had a high level of nutrition knowledge, however only 48.8% (n=127) were utilizing the knowledge. Those who had attained secondary level of education were 2.308 more likely to utilize the nutrition knowledge than those who had never studied P value of .028, 95CI (1.093-4.874). Those with tertiary education were even 9.261 times more likely to utilize the knowledge P value <.001 95CI (2.721-31.522). Those with adequate knowledge were about 1.6 times most likely to utilize the nutrition knowledge compared to those with inadequate knowledge level, however, with the adjusted odd ratio of 1.573 at 95% CI (0.923- 2.868) the results were not statistically significant (P value .098). Conclusion: NCD patients had adequate knowledge, with a few of them utilizing the knowledge. High education level was associated with better nutrition practices.


PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180929 ◽  
Author(s):  
David M. Goodman ◽  
Rohit Ramaswamy ◽  
Marc Jeuland ◽  
Emmanuel K. Srofenyoh ◽  
Cyril M. Engmann ◽  
...  

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240528
Author(s):  
Armand Zimmerman ◽  
Samara Fox ◽  
Randi Griffin ◽  
Taylor Nelp ◽  
Erika Bárbara Abreu Fonseca Thomaz ◽  
...  

2021 ◽  
Author(s):  
Asiphas Owaraganise ◽  
Wasswa GM Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
Godfrey Twesigomwe ◽  
...  

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.


2021 ◽  
Author(s):  
Laban Muteebwa ◽  
Ali Ssetaala ◽  
Dan Muramuzi ◽  
Annet Nanvubya ◽  
Yunia Mayanja

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.


Author(s):  
Samson Mvandal ◽  
Godfrida Marandu

Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods: A cross-sectional study was conducted among outpatient client at Sekou-Tour&eacute; regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of &le; 0.05 was considered to be statistically significant. Results: A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion: A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.


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