Midwives' practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda

2020 ◽  
Vol 14 (1) ◽  
pp. 1-12
Author(s):  
Ziidah Namwaya ◽  
Imelda Namagembe ◽  
Dan Kaye ◽  
Gorrette Nalwadda ◽  
Grace Edwards ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Current Practice ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Mulago Hospital ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Mulago National Referral Hospital ◽  
Perception Of Care ◽  
National Referral Hospital

Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Conclusions Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.

Prevalence and antibiotic susceptibility of urinary tract infections in febrile children below ten years attending mulago hospital, Uganda

2019 ◽  
Author(s):  
Ronald Ssemambo ◽  
Isaac Odongo ◽  
Joseph Kungu
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Referral Hospital ◽  
Urine Samples ◽  
Mulago Hospital ◽  
Cross Sectional ◽  
Mulago National Referral Hospital ◽  
Tract Infections ◽  
National Referral Hospital

Abstract Background: Urinary tract infections (UTIs) are one of the most common infections in the pediatrics population. This study was performed to determine the prevalence of urinary tract infections amongst febrile children below 10 years attending Mulago National Referral Hospital, and the susceptibility patterns of the isolated uropathogens to common antibiotics. Methods: A cross-sectional study of febrile pediatric patients below 10 years from various ward of Mulago National Referral Hospital was conducted between January and May 2019. Biodata and midstream urine samples were collected from 160 children .The urine samples were cultured onto Blood Agar and Cystine Lactose Electrolyte Deficient (CLED) simultaneously. Growth was considered significant when a pure isolate had ≥ 10 5 CFU/mL. Susceptibility to 8 antibiotics was set using the modified Kirby-Bauer disc diffusion technique. Results: Out of the 160 urine samples analyzed, 29(18.1%) had significant bacterial growth. The frequency of UTIs was significantly higher in girls 20(69.0%) than boys 9(31.0%). Escherichia coli was the most predominant microorganism (41.4%), followed by Klebsiella pneumoniae (20.7%) and Staphylococcus aureus at (13.8%). Overall susceptibility tests exhibited a very high Antibiotic resistance of uropathogens to ampicillin (96.6%), cotrimoxazole (82.8%) and nalidixic-acid. Nitrofurantoin and imipenem showed the lowest resistances of 34.5% and 31.0% respectively. A total of 24(82.8%) isolates were multidrug resistant. Conclusion: Bacteriuria is a highly prevalent condition amongst febrile children attending Mulago hospital, with Enterobacteriaceae being the most predominant uropathogens. Uropathogens were highly sensitive to nitrofurantoin and imipenem but with significant resistance to ampicillin and cotrimoxazole. This information can be useful in decision making during management of UTIs among children.

scholarly journals Prevalence and predictors of ocular complications among children with nephrotic syndrome in a resource-limited setting

2020 ◽  
Author(s):  
Faith Nakubulwa ◽  
Rebecca Claire Lusobya ◽  
Anthony Batte ◽  
Bashir Ssuna ◽  
Damalie Nakanjako ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
High Dose ◽  
Renal Unit ◽  
Ocular Complications ◽  
Cross Sectional ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children with nephrotic syndrome receiving care at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three (3) months at pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71%(95%CI 61.1–79.6) and 56%(95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) P = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

scholarly journals Prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment in a resource-limited setting

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Faith Nakubulwa ◽  
Rebecca Claire Lusobya ◽  
Anthony Batte ◽  
Bashir Ssuna ◽  
Damalie Nakanjako ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
High Dose ◽  
Renal Unit ◽  
Ocular Complications ◽  
Cross Sectional ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three [3] months at the pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71% (95%CI 61.1–79.6) and 56% (95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) p = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

scholarly journals Factors associated with delayed uptake of cataract surgery among adult patients at Mulago National Referral Hospital, Uganda

2021 ◽  
Vol 21 (3) ◽  
pp. 1259-1265
Author(s):  
Francis O Sebabi ◽  
Walter O Okello ◽  
Faith Nakubulwa ◽  
Rogers Sempindu ◽  
Catherine Driciru ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Adult Patients ◽  
Sub Saharan Africa ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Background: Cataract is the leading cause of blindness globally. Many patients with cataract in developing countries delay to come for cataract surgery. Objectives: This study aimed to determine the factors associated with delayed uptake of cataract surgery among adult pa- tients seen at Mulago National Referral Hospital eye clinic in Uganda. Methods: Employing a hospital based cross-sectional study, adult patients with cataract and having moderate visual impair- ment or blindness were recruited. Patient-related factors for delayed surgery were assessed using a predetermined question- naire. Data was analyzed using stata version 14.2. Logistic regressions were used to determine the factors associated with delayed uptake of cataract surgery among these patients. Results: Eighty two participants with operable cataract were evaluated. Females were 44 (54%) and the mean age of partic- ipants was 67 years. Fifty three (65%) had delayed uptake of cataract surgery. The factors associated with delayed uptake of cataract surgery among patients with cataract were financial constraint, felt no need for surgery and good unilateral vision. Conclusions: Financial constraints, no felt need for cataract surgery and having good unilateral vision are the factors asso- ciated with delayed uptake of cataract surgery among cataract patients. We recommend cataract surgical outreach to remote areas and health education. Keywords: Risk factors; operable cataract; cataract; surgery; Uganda; sub-Saharan Africa.

scholarly journals Prevalence of Leptospirosis Among Patients Attending Renal and General Outpatient Clinics in Mulago Hospital, Kampala, Uganda

2021 ◽  
Author(s):  
Rogers Wambi ◽  
William Worodria ◽  
James Muleme ◽  
Siya Aggrey ◽  
Lawrence Mugisha
Keyword(s):  
Cross Sectional Study ◽  
Outpatient Clinics ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Samples ◽  
Mulago National Referral Hospital ◽  
Causative Agents ◽  
Leptospira Serovars ◽  
National Referral Hospital

Abstract In this study we sought to establish the prevalence and associated factors of Leptospirosis among renal patients and general outpatients attending Mulago National Referral Hospital, Uganda. This cross-sectional study recruited and collected blood samples from a total of 254 patients attending Mulago hospital from July to October 2018. Additionally, the semi-structured questionnaires were administered to enrolled patients to collect data on socio-demographics and occupational practices that may be risks of getting infected with Leptospirosis. The blood samples were analyzed using the standard Microscopic Agglutination Test (MAT) with a panel of 14 Leptospira-serovars belonging to 10 serogroups. We identified 12 seropositivity of Hebdomadis, Hebdomadis (L.borgapetersenii serovar Nona), Icterohaemorrhagiae (L.interrogans Serovar Icterohaemorrhagiae, Canicola (L. interrogans serovarCanicola), Djasiman (L. interrogansserovarDjasiman), Pomona (L. interrogans serovar Pomona) and Ballum (L. borgpetersenii serovar Kenya). The overall prevalence of leptospirosis in examined samples was 4.7% (CI = 2.6-8.3, P<0.05) among patients attending Renal and General Outpatient clinics in Mulago hospital. The participants who reported with fever were 15.4 times more likely to be diagnosed with leptospirosis. The study reveals that leptospirosis may be among the causative agents among renal patients and should be included among the differential diagnostic list to consider for further testing and diagnosis.

scholarly journals High rates of gastroesophageal cancers in patients with dyspepsia undergoing upper gastrointestinal endoscopy in Uganda

2021 ◽  
Vol 09 (07) ◽  
pp. E997-E1000
Author(s):  
Ronald Mbiine ◽  
Cephas Nakanwagi ◽  
Olivia Kituuka
Keyword(s):  
Positive Association ◽  
Referral Hospital ◽  
Outcome Variable ◽  
Mulago Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Female Ratio ◽  
Mulago National Referral Hospital ◽  
Male To Female ◽  
Upper Gastrointestinal ◽  
National Referral Hospital

Abstract Background and study aims Dyspepsia is the most common presenting symptom in the gastrointestinal clinic of Mulago National Referral hospital. The etiology is essentially not fully described in our patient population. This study was therefore conducted to establish the causes of dyspepsia based on endoscopic diagnosis among patients with dyspepsia seeking care at the National Referral hospital of Uganda. Patients and methods This retrospective study conducted in the endoscopy unit of Mulago hospital reviewed 356 patient endoscopy reports spanning January 2018 to July 2020 with a focus on those with a referral indication of dyspepsia. Age and sex were the independent variables of interest while the endoscopy findings as reported by the endoscopist were the outcome variable of interest. Results Of the 356 endoscopy reports reviewed, 159 met the inclusion criterion of dyspepsia as the indication. Participant mean age was 47.7 years (± 16.53) with the majority (25.79 %) in the fifth decade while the male to female ratio was 1. The majority of patients had organic dyspepsia (90.57 %) while the commonest finding was gastritis 69 (43.4 %). Gastroesophageal cancers represented (18) 11.32 % of all findings. There was a positive association between age > 50 years with gastroesophageal cancers (7.639) as well as age < 50 years and functional dyspepsia (2.794); however, all these were not statistically significant (P = 0.006 and (P = 0.095, respectively). Conclusions Organic/structural dyspepsia comprises over 90 % of investigated dyspepsia with 11 % comprising cancer among patients seeking endoscopy at the National Referral Hospital of Uganda.

scholarly journals Pterygium and associated factors among adults: a hospital-based prospective study

2020 ◽  
Vol 6 (1) ◽  
pp. 32-37
Author(s):  
Chhimi Wangmo ◽  
Nor Tshering Lepcha
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Adult Patients ◽  
Age Group ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
High Prevalence ◽  
Grade 3 ◽  
National Referral Hospital

Introduction: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium wasmost common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusion: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium

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