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

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

10.21203/rs.3.rs-1191937/v1 ◽

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.

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

10.21203/rs.3.rs-242190/v1 ◽

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.

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

10.21203/rs.3.rs-141153/v1 ◽

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.

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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

International Journal of Pediatrics ◽

10.1155/2020/7809412 ◽

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.

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Implementation of a Collaborative HIV Testing Model Between an Emergency Department and Infectious Disease Clinic

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000000153 ◽

2014 ◽

Vol 66 (3) ◽

pp. e67-e70 ◽

Cited By ~ 1

Author(s):

Brooke E. Hoots ◽

Pamela W. Klein ◽

Ian B.K. Martin ◽

Peter A. Leone ◽

E. Byrd Quinlivan ◽

...

Keyword(s):

Infectious Disease ◽

Emergency Department ◽

Hiv Testing ◽

Testing Model ◽

Infectious Disease Clinic ◽

Disease Clinic

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Rare Causes of Pleural Effusion in Children: Differential Diagnosis in a Pediatric Infectious Disease Clinic

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.20219922 ◽

2021 ◽

Vol 15 (1) ◽

pp. 26-32

Author(s):

Ayşe Kaman ◽

Türkan Aydın Teke ◽

Fatma Nur Öz ◽

Sevgi Yaşar Durmuş ◽

Rumeysa Yalçınkaya ◽

...

Keyword(s):

Infectious Disease ◽

Differential Diagnosis ◽

Pleural Effusion ◽

Pediatric Infectious Disease ◽

Infectious Disease Clinic ◽

Disease Clinic

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Clostridium difficile-associated diarrhea in the Clinical Center of Vojvodina, Serbia, in the period 2008 to 2012

Archives of Biological Sciences ◽

10.2298/abs1401057s ◽

2014 ◽

Vol 66 (1) ◽

pp. 57-64

Author(s):

Sandra Stefan-Mikic ◽

Vedrana Petric ◽

S. Sevic ◽

Ivana Hrnjakovic-Cvjetkovic ◽

Vesna Milosevic ◽

...

Keyword(s):

Infectious Disease ◽

Clostridium Difficile ◽

Hospital Costs ◽

Control Measures ◽

Infectious Disease Clinic ◽

Disease Clinic ◽

Clinical Center ◽

Number Of Patients ◽

Costs Of Treatment ◽

Clostridium Difficile Associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been recognized as the leading cause of diarrhea worldwide. In the last five years, it has become the leading cause of diarrhea in the Clinical Center of Vojvodina (CCV) as well. The aim of this study was to determine the epidemiology and total cost of treatment for all patients with Clostridium difficile-associated diarrhea hospitalized at the Infectious Disease Clinic of the CCV; to analyze the costs of treatment with regard to therapeutic approach; to compare the costs of treatment in each year of the investigated period related to the number of patients, and to analyze the outcome of treatment. The study was retrospective, and the data were collected from the medical records of 472 patients with Clostridium difficile diarrhea treated from 2008 to 2012 and analyzed. Of the total 472 patients with CDAD, 54.23% were female and the average age was 65.84. A statistically significant majority of them had been previously treated in other hospitals and a minority in ambulatory settings (395 inpatients vs. 77 outpatients, p=0.000, p<0.05). Of the 395 previously hospitalized patients, most were from the Clinic of Urology of the CCV (58, 14.68%). When comparing therapeutic options, oral vancomycin was significantly more frequently used than other protocols. The average mortality rate during the study period was 6.51%. In this period, total hospital costs related to Clostridium difficile diarrhea in the Infectious Disease Clinic were $636,679.92. Implementation of infection-control measures and a restricted use of antibiotics would result in a great reduction in material costs.

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